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Objective. To assess the transcultural equivalency of the Spanish version of the Fibromyalgia Rapid Screening Tool (FiRST) and its discriminatory ability in different Latin American samples. Design. Validation study. Setting. Departments of Rheumatology in general hospitals and private centers; fibromyalgia unit in a university hospital. Subjects. 350 chronic pain patients from Spain, Argentina, Mexico, Peru, and Ecuador. Methods. The cultural relevance of the Spanish version of the FiRST was evaluated. The ability of the FiRST as a screening tool for fibromyalgia was assessed by logistic regression analysis. To determine the degree to which potential confounders, such as differences in demographics, pain, affective distress, catastrophizing, and disability, might affect the discriminatory ability, the tool was reassessed by hierarchical multivariate logistic regression. Results. Slightly different versions of the FiRST were recommended for use in each Latin American subsample. The FiRST showed acceptable criterion validity and was able to discriminate between fibromyalgia and non-fibromyalgia patients even after controlling for the effect of potential confounders. However, low specificities were observed in samples from Spain and Mexico. Conclusions. The Spanish version of the FiRST may be used as a screening tool for fibromyalgia in several Latin American subsamples, even in those patients with high scores on potential confounders. In Spain and Mexico, the low specificity of the FiRST suggests, however, that it would be best used to support a suspected diagnosis of fibromyalgia, rather than to exclude the diagnosis. [ABSTRACT FROM AUTHOR]

Vascular Calcification (VC), low bone mass and fragility fractures are frequently observed in ageing subjects. Although this clinical observation could be the mere coincidence of frequent age-dependent disorders, clinical and experimental data suggest that VC and bone loss could share pathophysiological mechanisms. Indeed, VC is an active process of calcium and phosphate precipitation that involves the transition of the vascular smooth muscle cells (VSMCs) into osteoblast-like cells. Among the molecules involved in this process, parathyroid hormone (PTH) plays a key role acting through several mechanisms which includes the regulation of the RANK/RANKL/OPG system and the Wnt/ß-catenin pathway, the main pathways for bone resorption and bone formation, respectively. Furthermore, some microRNAs have been implicated as common regulators of bone metabolism, VC, left ventricle hypertrophy and myocardial fibrosis. Elucidating the common mechanisms between ageing; VC and bone loss could help to better understand the potential effects of osteoporosis drugs on the CV system. [ABSTRACT FROM AUTHOR]

The epidemiology and the clinical characteristics of three entities that lead to dysmobility, falls and fractures (osteoporosis, sarcopenia, and frailty) are reviewed. Osteoporosis is a worldwide health problem causing bone fragility and fractures. Sarcopenia is an ageassociated decline of skeletal muscle mass and function. Frailty results from the accumulation of age-related deficits in different physiological systems and is a clinical state that leads to greater SARCOPENIA, OSTEOPOROSIS AND FRAILTY. A TRIAD COMES OF AGE ARIEL SÁNCHEZ,1 MARITZA VIDAL,2 LUIS FERNANDO VIDAL NEIRA,2, 3, 4 OSVALDO D. MESSINA5 1) Director, Center of Endocrinology, Rosario, Argentina; 2) Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru; 3) Hospital María Auxiliadora, Lima, Peru; 4) International Osteoporosis Foundation (IOF), Nyon, Switzerland; 5) Chief, Rheumatology Service, Hospital Argerich; Director, Rheumatologic and Osteological Investigations Ltd., Buenos Aires, Argentina. risks of adverse health outcomes, such as falls, fractures, hospitalizations, loss of independence, and death. The three entities have a common denominator (aging), but they can be secondary to other diseases. There are patients presenting with all three pathologies, which should be properly identified by the treating physicians. [ABSTRACT FROM AUTHOR]

Osteoporosis is an evolving disease which affects over 200 million people worldwide. Our recommendations are guidelines for its diagnosis, prevention and treatment, but they do not constitute standards for clinical decisions in individual cases. The physician must adapt them to individual special situations, incorporating personal factors that transcend the limits of these guidelines and are dependent on the knowledge and art of the practice of Medicine. These guidelines should be reviewed and updated periodically as new, better and more effective diagnostic and therapeutic tools become available.