Hasil untuk "Other systems of medicine"

Deepika Kumari, Manoj Kumar, Ashish Datt Upadhyay et al.

Background: Hormonal imbalance, mitochondrial dysfunctions, and oxidative stress (OS) have been implicated in the pathogenesis of polycystic ovarian syndrome (PCOS) and its associated clinical features. A sedentary lifestyle, exposure to air pollutants, prenatal exposure to endocrine-disrupting chemicals, processed and nutritionally depleted food, rich in trans fats, salts, and sugars, and high BMI specifically in visceral adiposity induce OS. OS damages the mitochondrial DNA, lipids, and proteins that impair mitochondrial function. Sequentially, dysfunctional mitochondria produce more reactive oxygen species that aggravate the OS. Mitochondria is pivotal for ovarian cell functioning for instance steroidogenesis, ovarian follicle development, and energy metabolism. Dysfunctional mitochondria can alter the ovarian follicle functioning leading to ovulatory dysfunction and infertility in PCOS. Aims and Objectives: This study is designed to investigate the effect of 12-week yoga practice on endocrine parameters, OS, and mitochondrial health, comparing outcomes in yoga and non-yoga groups. Material and Methods: A total of 75 participants, 32 PCOS females who completed yoga intervention in the yoga group and 29 in the nonyoga group. Hormonal levels were assessed through an immunoassay, while mitochondrial health markers, such as mtDNA copy number (mtDNA CN), reactive oxygen species, and lipid peroxidation were measured through quantitative polymerase chain reaction (qPCR), chemiluminescence, and ELISA respectively. Gene expression related to mitochondrial integrity, respiratory chain, and inflammation was analyzed via reverse transcription qPCR. Additionally, depression severity was also assessed using beck depression inventory II. Result: The Yoga group showed a significant increase in mtDNA-CN and upregulation of transcripts responsible for maintaining mitochondrial integrity and the mitochondrial respiratory chain. In addition, the post-yoga group shows a reduction in, lipid peroxidation, inflammatory, OS markers, and an improvement in telomere length. Conclusion: Yoga positively affects hormonal balance, mitochondrial health, OS, and inflammation in women with PCOS. It also alleviates depression symptoms, highlighting yoga as an effective adjunct therapy for managing PCOS. Regular yoga practice could prevent, delay, and help in managing PCOS symptoms.

Zhihan Chen, Kaifang Yao, Xinrui Wang et al.

Abstract At present, a number of studies have shown that acupuncture at Zusanli (ST 36) can relieve pain, but the changes of local microenvironment in the acupoint area after acupuncture have not been elucidated. As a temperature and pain receptor, TRPV1 plays an important role in pain perception and inflammation regulation. In this study, RT-PCR technique was used to screen the types of mechanically sensitive ion channels in the local response to acupuncture in the acupoint area, and western bolt technique was used to verify in gene knockout and antagonist injection mice. Immunofluorescence double labeling technique was used to further determine the key cell types of TRPV1-mediated acupuncture analgesia. Finally, through the combined analysis of proteomics and phosphorylated proteomics, the local signaling pathways of acupoints that can be activated by acupuncture were analyzed. This study systematically explored the analgesic effect of acupuncture on inflammatory pain in mice and its mechanism. The study found that acupuncture can significantly improve the thermal pain threshold and mechanical pain threshold in mice, showing a significant analgesic effect. Further analysis revealed that this analgesic effect was closely related to the up-regulation of local TRPV1 expression at ST36, and its deletion or functional inhibition would significantly weaken the analgesic effect of acupuncture. In addition, we also found that acupuncture in the deep muscle layer can more effectively promote the expression and activity of TRPV1 than in the superficial fascia layer, and muscle cells are the key cell types of TRPV1-mediated acupuncture analgesia. Finally, through the combined analysis of multi-omics, it was clear that acupuncture could activate the local signal pathway TRPV1/CaMKII/AMPK/PGC1α to exert analgesic effect. In conclusion, this study not only confirmed the analgesic effect of acupuncture on inflammatory pain in mice, but also revealed the core role of TRPV1 in the mechanism of acupuncture analgesia, especially the important contribution of TRPV1 expression and activity in the muscle layer of ST36 acupoint to the analgesic effect of acupuncture, which provided a new scientific basis and potential therapeutic target for acupuncture treatment of inflammatory pain. Graphical abstract

Lamiaa K. Al-Amery, Zainab J. Al-Mousawi, Ali Ali

This study was conducted to investigate the effect of kinetin and coconut milk on the formation of micro tubers in potato plants and their content of medically active compounds in vitro. The experiment was carried out in the Plant Biology Laboratory of the Medicinal and Aromatic Plants Research Unit, College of Agricultural Engineering Sciences, University of Baghdad, Iraq. during the period from March 1, 2024, to December 15, 2024. Potato tuber explants were surface-sterilized with 6% sodium hypochlorite solution to eliminate contaminants before culture.The resulting shoots were then transferred to MS medium supplemented with 0.5 mg L⁻¹ BA to promote shoot multiplication and growth.The obtained shoots were segmented into nodal cuttings and cultured in MS medium containing four kinetin levels (0, 2.5, 5, 7 mg L⁻¹) in combination with four concentrations of coconut milk (0, 50, 75, 100 ml L⁻¹) to induce microtuber formation and enhance the production of certain medically active compounds. The results demonstrated the superiority of the interaction treatment between kinetin and coconut milk (K₂C₂) in improving the studied traits, as it recorded the highest values for microtuber number, diameter, fresh weight, and dry matter content. Furthermore, this treatment contributed to an increase in the percentage of protein and starch, Moreoverthe stimulation of the production of two medically active compounds, lutein, and Xanthine.

Vahid Barati, Anna Hruzíková, Eliška Procházková et al.

Heterocyclic drugs display diverse pharmacological activities and metabolic stability. However, their poor solubility and pharmacokinetic properties often compromise bioavailability and clinical outcomes. Nevertheless, the prodrug approach provides a viable strategy to overcome unwanted attributes of drug candidates. In this proof-of-concept study, we report the synthesis and biological evaluation of glycol methylene-bridged phosphate (GMBP) prodrugs developed for heterocyclic drug delivery. Through methylene bridging, the heterocyclic nitrogen was directly attached to the phosphate, whereas the glycol moiety enabled drug release via cyclization, as confirmed by 31P NMR spectroscopy. Additional prodrugs of carboxylic acids, phenols, and thiols confirmed the broad application scope of our GMPB approach. Heterocyclic GMBP prodrugs were stable in aqueous buffers and activated by phospholipase CAL-B in vitro. Select prodrugs, including zidovudine prodrug 33, were even more potent (3 nM on HIV-1) than the parent compound. These findings demonstrate that our GMBP approach is not only feasible but also highly versatile.

Valesca Cristina de Oliveira Monteiro, Fernanda Farias de Castro, Vanusa do Nascimento et al.

Este estudo teve como objetivo identificar as estratégias de enfrentamento da COVID-19 de idosos rurais e ribeirinhos, por meio de uma revisão integrativa da literatura. A pesquisa foi realizada nas bases de dados Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF), Medical Literature Analysis and Retrievel System Online (MEDLINE), PubMed e WHO COVID-19. O material foi organizado no gerenciador de arquivos Mendeley, seguindo as etapas de leitura, amostragem, categorização, avaliação de estudos incluídos, análise/interpretação dos resultados e síntese dos estudos, realizados em pares. Foram identificados 832 artigos, dos quais, seis foram selecionados e agrupados em três categorias: 1 - Compreensão e percepção dos idosos sobre o enfrentamento de COVID-19; 2 - O impacto da pandemia da COVID-19; 3 - Estratégias de enfrentamento da pandemia no cuidado com a saúde. Os artigos analisados mostraram a necessidade de os idosos construírem relacionamentos participativos e sustentáveis baseados na comunidade; de apoiar e sustentar projetos de pesquisa inovadores; de aplicar abordagens relevantes para ambientes rurais; de reconhecer e identificar a diversidade entre as populações rurais e desenvolver ações de enfrentamento macroestruturais, comunitárias e individuais. O enfrentamento da pandemia trouxe aos idosos aprendizados relacionados à lavagem das mãos, uso de máscara e oportunizou o crescimento da espiritualidade, da fé, da resiliência, da esperança, da readaptação e da recriação. Novas pesquisas tornam-se necessárias para dar visibilidade às estratégias de enfrentamento à pandemia de COVID-19 e qualificar o cuidado no Sistema Único de Saúde (SUS).

Michele da Rosa Ferreira, Cecilia Biasibetti Soster, Dinara Dornfeld et al.

O Projeto Pedagógico do Curso Técnico em Enfermagem de uma instituição pública de ensino no sul do Brasil passou por revisão durante o período de 2019 a 2021. O processo de revisão ocorreu de forma colaborativa entre as docentes do curso, que refletiram coletivamente sobre o trabalho docente e a intencionalidade desta formação. Desde a concepção deste curso, buscou-se superar os modelos tradicionais de ensino tecnicista e procedimental, à formação humanista e reflexiva com vistas a atender às necessidades dos cidadãos por um atendimento qualificado, na perspectiva da integralidade da atenção, do trabalho em equipe e dos princípios do SUS. Com o objetivo de tornar o projeto pedagógico acessível à comunidade escolar, em especial aos discentes, optou-se pelo desenvolvimento de um e-book composto por 48 páginas ilustradas. Este produto bibliográfico foi registrado e catalogado  na Biblioteca Nacional e está disponível para acesso livre no site institucional. O e-book possibilitou que os discentes do curso conhecessem e compreendessem o processo que estrutura a formação à qual estão vinculados, contribuindo para o comprometimento com o seu processo de aprendizado, pois as propostas e expectativas foram claramente compreendidas. Este produto integra uma pesquisa em desenvolvimento, submetida e aprovada pelo Comitê de Ética em Pesquisa sob o CAE: 49430621.4.0000.5530. Palavras-chave: Educação Técnica em Enfermagem. Métodos Pedagógicos. Educação Profissionalizante.

Chuanyin Dai

Nidal Jaradat, Mohammed Hawash, Gada Dass

Abstract Background Rumex rothschildianus is the sole member of a unique section of the genus Rumex, in the family Polygonaceae. This species is a very rare small dioecious annual, endemic to Palestine that is traditionally used as food and for the treatment of various diseases. Therefore, the current investigation aimed to screen the chemical constituents, antioxidants, anti-α-amylase, anti-α-glucosidase, antilipase, and cytotoxic effects of four solvents fractions of R. rothschildianus leaves. Methods Dried powder of R. rothschildianus leaves was extracted in four solvents with different polarities. Several qualitative and quantitative phytochemical tests were performed to determine the components of the extracts. The colorimetric analysis was used for the quantitative determination of phenols, flavonoids, and tannins. In-vitro assays were performed to evaluate the extracts for antioxidant, anti-α-amylase, anti-α-glucosidase, and antilipase inhibitory activities, as well as cytotoxicity by MTS assay against cervical carcinoma cells line (HeLa) and breast cancer cell line (MCF7). Results The acetone fraction of R. rothschildianus leaves showed the most significant antioxidant activity, due to having the highest content of flavonoids and phenolics, with an IC50 value of 6.3 ± 0.4 μg/ml, compared to 3.1 ± 0.9 μg/ml for Trolox, and regarding lipase inhibition activity the acetone fraction showed the most potent activity with an IC50 value of 26.3 ± 0.6 μg/ml, in comparison with orlistat positive control IC50 12.3 μg/ml. The same extract was the most potent inhibitor of α-amylase and α-glucosidase, with IC50 values of 19.1 ± 0.7 μg/ml and 54.9 ± 0.3 μg/ml, respectively, compared to 28.8, 37.1 ± 0.3 μg/ml of acarbose, respectively. The hexane fraction showed 99.9% inhibition of HeLa cells and 97.4% inhibition for MCF7 cells. Conclusion The acetone fraction of R. rothschildianus leaves might provide a source of bioactive compounds for the treatment of oxidative stress. Similarly, the hexane fraction indicates the promising antitumor potential of R. rothschildianus. Clearly, these initial indications need further purification of potentially active compounds, and ultimately, in-vivo studies to determine their effectiveness.

Francisco-Javier Hinojo-Lucena, Inmaculada Aznar-Díaz, María-Pilar Cáceres-Reche et al.

Introduction: The collaboration between professionals from different countries has become a claim in the globalised world where we live. In this scenario, collaborative social networks play a fundamental role in bringing people from different territories together in the same virtual space that it favours the exchange of information. Objective: To analyse the use and integration of social networks to favour international collaboration between medical students from the University of Granada (Spain) and the University of Sheffield (UK). Methodology: A quantitative methodology has been used using a questionnaire developed ad hoc to quantify the degree of student satisfaction after participation in the collaborative social network. The sample was composed of 110 students of the degree in medicine, 74 from the University of Granada and 36 from the University of Sheffield. Results: We find high percentages according to the improvement of learning from collaboration, as well as the relevance for the exchange of information and collaborative work between countries. Conclusion: This type of experience highlights the need to collaborate from digital networks with health professionals from other countries to improve student learning and know different methods and systems of action that improve daily medical practice. Resumen: Introducción: La colaboración entre profesionales de diferentes países se ha convertido en un reclamo en el mundo globalizado donde vivimos. En este escenario, las redes sociales colaborativas juegan un papel fundamental al reunir a personas de diferentes territorios en el mismo espacio virtual para favorecer el intercambio de información. Objetivo: Analizar el uso y la integración de las redes sociales para favorecer la colaboración internacional entre estudiantes de medicina de la Universidad de Granada (España) y la Universidad de Sheffield (Reino Unido). Metodología: Se ha utilizado una metodología cuantitativa empleando un cuestionario ad hoc para cuantificar el grado de satisfacción del estudiante después de participar en la red social colaborativa. La muestra estuvo compuesta por 110 estudiantes del grado de medicina, 74 de la Universidad de Granada y 36 de la Universidad de Sheffield. Resultados: Encontramos altos porcentajes de acuerdo con la mejora del aprendizaje a partir de la colaboración, así como la relevancia para el intercambio de información y el trabajo colaborativo entre países. Conclusiones: Este tipo de experiencia resalta la necesidad de colaborar desde redes digitales con profesionales de la salud de otros países para mejorar el aprendizaje de los estudiantes y conocer diferentes métodos y sistemas de actuación que mejoran la práctica médica diaria. Keywords: Social networks, Collaborative learning, Students, Medicine degree, Palabras clave: Redes sociales, Aprendizaje colaborativo, Estudiantes, Grado en medicina

María del Carmen Suárez-Cotelo, María Jesús Movilla-Fernández, Paula Pita-García et al.

ABSTRACT Objective: Determine the level of knowledge about maternal breastfeeding and analyze to what extent this influences the intention to breastfeed after the introduction of infant feeding at the 6th and 16th weeks and at 6 months postpartum. Method: Prospective descriptive study conducted with pregnant women in Galicia (Spain). By means of a self-filling questionnaire, data were collected on the intention of the woman to feed the newborn and their knowledge about breastfeeding. Pregnant women were also contacted at the 6th and 16th weeks and at 6 months postpartum to know the type of feeding they gave their child. Results: 297 pregnant women participated in the study, of which 90.4% wanted to exclusively breastfeed their baby, however, only 28.2% continued up to 6 months. The level of knowledge about breastfeeding was regular and it was observed that it influences both the intention and the type of feeding of the newborn, thus it is an element to be considered when developing educational strategies aimed at increasing breastfeeding rates. Conclusion: The level of pregnant women’s knowledge about breastfeeding is regular and influences the choice of how to feed their babies and the duration of exclusive breastfeeding. Strategies should be implemented to increase knowledge and improve breastfeeding rates.

Piyawan Kumnerdkhonkaen, Somprasong Saenglee, Md. Ali Asgar et al.

Abstract Background Houttuynia cordata Thunb. and Phyllanthus emblica Linn. are native plants with medicinal and nutritive significance in Asia. The present study was aimed at evaluating antiproliferative effects on human cancer cell lines and identifying the phenolic acid composition of water and ethanolic extracts of the powdered formula of H. cordata fermented broth and P. emblica fruit. Methods Anticancer activity of the extracts was evaluated against HeLa, HT29, HCT116, MCF7 and Jurkat cells using an MTT assay and flow cytometric analysis of apoptosis induction and cell cycle arrest. Reverse phase HPLC was exploited for identification and quantification of some phenolic acids. Results MTT assay showed that both water and ethanolic extracts significantly decreased the viability of cancer cells in a dose- and time-dependent fashion. Based on the IC50 values, ethanolic extract (IC50 values = 0.12–0.65 mg/mL) was more cytotoxic than water extract (IC50 values = 0.22–0.85 mg/mL) and Jurkat cells were the most sensitive to both extracts (IC50 values = 0.12–0.69 mg/mL). The underlying mechanism for antiproliferative activity was apoptosis induction, especially in HT29, HCT116, MCF7 and Jurkat cells. HT29 cells were the most sensitive to extract-induced apoptosis. Ethanolic extract was more effective at inducing apoptosis than water extract. Moreover, cell cycle arrest was found to be another mechanism behind growth inhibition in Jurkat and HCT116 cells. However, these extracts were relatively less toxic to non-cancer Vero cells. HPLC analysis demonstrated that the powder mix extracts contained seven identified phenolic acids namely gallic, p-hydroxybenzoic, vanillic, syringic, p-coumaric, ferulic and sinapinic acids, where p-coumaric acid was detected in the highest concentration followed by ferulic acid. Conclusion Overall, the results of this study suggest the powdered formula of H. cordata fermented broth and P. emblica fruit as an alternative medicine for cancer prevention and treatment.

Jalal Hassanshahi, Maryam Maleki, Mehdi Nematbakhsh

Background: Unilateral ureteral obstruction (UUO) alters the expression of renin-angiotensin system (RAS) components and angiotensin II (Ang II) as the main arm of RAS is affected by UUO. Objectives: In this study the role of Ang II subtypes 1 and 2 receptors (AT1R and AT2R) antagonists (losartan and PD123319) was examined in renal hemodynamic responses to graded Ang II infusion in sham, 3-day UUO and removal UUO (RUUO) models in rats. Materials and Methods: Seventy-one male Wistar rats randomly divided into three different sets of animal models; sham-operated, UUO and RUUO that each set contains three groups treated with vehicle, losartan, and PD123319. Renal vascular responses to Ang II infusion were measured at controlled renal perfusion pressure (RPP). Results: The graded Ang II infusion decreased renal blood flow (RBF), increased renal vascular resistance (RVR) and mean arterial pressure (MAP) in vehicle or PD123319 treated groups significantly (P<0.005), but no significant difference was found between these treated groups. However, RBF, RVR and MAP responses to graded Ang II infusion in losartan-treated rats were attenuated significantly when compared with vehicle or PD123319 treated groups (P<0.05). In addition, the RBF, RVR and MAP responses to Ang II were not similar in sham, UUO and RUUO rats treated with losartan. Conclusions: Vascular responses to Ang II in UUO and RUUO rat model treated with losartan is not as the normal pattern.

Tanaporn Hengpratom, Gordon M. Lowe, Kanjana Thumanu et al.

Abstract Background Oroxylum indicum (L.) Kurz (O. indicum) is found in Thailand. It has been used for the treatment of obesity. This study aimed to investigate the effects of an O. indicum extract (OIE) on the adipogenic and biomolecular change in 3T3-L1 adipocytes. Methods Initial studies examined the chemical components of OIE. The cell line 3T3-L1 was used to establish potential toxic effects of OIE during the differentiation of pre-adipocytes to adipocytes. The inhibitory effect of OIE on lipid accumulation in 3T3-L1 cells was investigated. Moreover, the impact of OIE on pancreatic lipase activity was determined. In further experiments, Fourier Transform Infrared (FTIR) was used to monitor and discriminate biomolecular changes caused by the potential anti-adipogenic effect of OIE on 3T3-L1 cells. Results Chemical screening methods indicated that OIE was composed of flavonoids, alkaloids, steroids, glycosides, and tannins. The percentage viability of 3T3-L1 cells was not significantly decreased after exposure to either 200 or 150 μg/mL of OIE for 2 and 10 days, respectively compared to control cells. The OIE exhibited a dose-dependent reduction of lipid accumulation compared to the control (p < 0.05). The extract also demonstrated a dose-dependent inhibitory effect upon lipase activity compared to the control. The inhibitory effect of the OIE on lipid accumulation in 3T3-L1 cells was also confirmed using FTIR microspectroscopy. The signal intensity and the integrated areas relating to lipids, lipid esters, nucleic acids, glycogen and carbohydrates of the OIE-treated 3T3-L1 adipocytes were significantly lower than the non-treated 3T3-L1 adipocytes (p < 0.05). Principal component analysis (PCA) indicated four distinct clusters for the FTIR spectra of 3T3-L1 adipocytes based on biomolecular changes (lipids, proteins, nucleic acids, and carbohydrates). This observation was confirmed using Unsupervised hierarchical cluster analysis (UHCA). Conclusions These novel findings provide evidence that the OIE derived from the fruit pods of the plant is capable of inhibiting lipid and carbohydrate accumulation in adipocytes and also has the potential to inhibit an enzyme associated with fat absorption. The initial observations indicate that OIE may have important properties which in the future may be exploited for the management of the overweight or obese.

Camila Porto Nascimento, Karla Cavalcante Silva de Morais, Vanessa Cruz Miranda et al.

Introdução: A Síndrome de Burnout é um distúrbio psiquiátrico de caráter depressivo, precedido de esgotamento físico e mental, com íntima associação à atividade profissional. As Unidades de Terapia Intensiva encontram-se dentro do contexto de risco à saúde ocupacional, por se tratarem de ambientes fechados, possuírem rotinas de trabalho exigentes e desgastantes, que envolvem rotineiramente questões éticas e tomada de decisões difíceis, além do permanente convívio com o sofrimento e morte. Esses fatores abrem portas para patologias ligadas ao estresse, passando a haver uma preocupação com a qualidade de vida dos profissionais que atuam nessas unidades. Objetivo: Avaliar a presença de aspectos relacionados a Síndrome de Burnout em fisioterapeutas intensivistas de Vitória da Conquista-BA e correlacionar com sua qualidade de vida. Metodologia: Trata-se de um estudo descritivo, exploratório, analítico, com delineamento transversal e abordagem quantitativa, teve como amostra 25 profissionais, composta por Fisioterapeutas atuantes nas Unidades de Terapia Intensiva adulto de Vitória da Conquista- BA. Foi utilizado dois questionários autoaplicáveis para avaliar a presença de aspectos relacionados à Síndrome de Burnout e a Qualidade de Vida. Resultados: Observou-se a prevalência de Burnout em apenas um profissional dos que participaram do estudo (4%) e outros quatro apresentaram alto risco de desenvolvê-la (16%). Observou-se também que a maioria dos fisioterapeutas estão com a qualidade de vida boa na maior parte dos domínios do WOQOL-bref. Ao correlacionar os aspectos da Síndrome de Burnout com a Qualidade de Vida pôde-se observar uma correlação negativa estatisticamente significativa a 1% entre a Qualidade de Vida no domínio físico e a despersonalização (r=-0,53). Notou-se também ao nível de 10%, correlações positivas entre o domínio físico e realização profissional (r=0,39), e que há correlação negativa entre o domínio psicológico e despersonalização (r=-0,34), para este mesmo nível de significância. Conclusão: Embora os fisioterapeutas que trabalham em Unidades de Terapia Intensiva estejam expostos a fatores de risco, não foi observado elevados níveis de Burnout. Destaca-se também, que uma parcela de profissionais apresentou alto risco de desenvolvê-la, constituindo-se como alerta, já que, se não forem implementadas medidas preventivas, estes profissionais poderão vir a desenvolver a síndrome.

Blanch J, Nogués X, Moro MJ et al.

Objetivos: Alcanzar un consenso sobre los circuitos de atención médica de la paciente con osteoporosis postmenopáusica (OPM), incluyendo los circuitos de derivación y manejo (herramientas de evaluación y pruebas médicas), identificando perfiles de acuerdo con la opinión de expertos en metabolismo óseo pertenecientes al Sistema de Salud Español. Material y métodos: Se empleó la técnica Delphi con dos rondas de consulta sucesivas. Participaron 38 expertos en el manejo de OPM pertenecientes a 14 sociedades científicas. La revisión de la literatura y la opinión del comité científico nutrieron el cuestionario. Los expertos expresaron su “deseo” (1=rechazo total; 9=deseo más fuerte) y “pronóstico” (1=no ocurrirá en absoluto; 9=ocurrirá con máxima probabilidad) acerca de las cuestiones planteadas. Se alcanzó consenso cuando el 75% o más de los participantes puntuaron 1-3 (desacuerdo) o 7-9 (acuerdo). Adicionalmente, los expertos se dividieron en 3 grupos de discusión para complementar la información según los perfiles de pacientes previamente hallados en el método Delphi. Resultados: Se alcanzó consenso en el 75% de las preguntas. Los expertos establecieron tres perfiles de pacientes con OPM: sin fractura, con fractura vertebral y con fractura no vertebral, así como los recursos diagnósticos y terapéuticos que conviene emplear en estas pacientes. La paciente sin fractura debería ser manejada por Atención Primaria o Reumatología y se utilizarán escalas para valorar el riesgo de fractura en fases tempranas de la enfermedad. La paciente con fractura vertebral crónica debería referirse a Reumatología y Rehabilitación, y se derivará a Reumatología; mientras que la paciente con fractura vertebral aguda debería ser tratada por Cirugía Ortopédica, y así es como posiblemente ocurrirá. El diagnóstico de la paciente con fractura vertebral estará basado principalmente en la radiografía. Para la evaluación de la progresión se deberían utilizar cuestionarios sobre la capacidad funcional y escalas del dolor. Sin embargo, no se utilizarán en la práctica habitual debido a la falta de tiempo. La paciente con fractura no vertebral debería ser y será referida a Cirugía Ortopédica, recomendando realizar 3-4 radiografías anuales para asegurar la consolidación de la fractura. Conclusiones: Los resultados del método Delphi muestran los circuitos de derivación de la paciente con OPM, que se concentran en Atención Primaria y Reumatología, cuando no existe fractura, y Cirugía Ortopédica, en caso de fractura.