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https://www.readbyqxmd.com/read/27909987/orexin-ox2-receptor-antagonists-as-sleep-aids
#1
Laura H Jacobson, Sui Chen, Sanjida Mir, Daniel Hoyer
The discovery of the orexin system represents the single major progress in the sleep field of the last three to four decades. The two orexin peptides and their two receptors play a major role in arousal and sleep/wake cycles. Defects in the orexin system lead to narcolepsy with cataplexy in humans and dogs and can be experimentally reproduced in rodents. At least six orexin receptor antagonists have reached Phase II or Phase III clinical trials in insomnia, five of which are dual orexin receptor antagonists (DORAs) that target both OX1 and OX2 receptors (OX2Rs)...
December 2, 2016: Current Topics in Behavioral Neurosciences
https://www.readbyqxmd.com/read/27908492/fragility-fractures-of-the-ankle-in-the-elderly-open-reduction-and-internal-fixation-versus-tibio-talo-calcaneal-nailing-short-term-results-of-a-prospective-randomized-controlled-study
#2
D Georgiannos, V Lampridis, I Bisbinas
INTRODUCTION: The management of ankle fractures in the elderly remains unpredictable, secondary to their various co-morbidities. Although tibiotalocalcaneal (TTC) nailing has been an effective option for ankle arthrodesis due to ankle arthritis or Charcot arthropathy there are few reports regarding the use of TTC nail for the treatment of ankle fractures. PURPOSE: Aim of this study was to compare the results of ORIF versus TTC nailing for the treatment of unstable ankle fractures in the elderly...
November 17, 2016: Injury
https://www.readbyqxmd.com/read/27908253/assessment-of-bone-quality-in-osteoporosis-treatment-with-bone-anabolic-agents-really-something-new
#3
Fabio Massimo Ulivieri, Renata Caudarella, Marzia Camisasca, Daniela Maria Cabrini, Ilaria Merli, Carmelo Messina, Luca Petruccio Piodi
Osteoporosis is a chronic pathologic condition, particularly of the elderly, in which a reduction of bone mineral density (BMD) weakens bone, leading to the so-called fragility fractures, most often of spine and femur. The gold standard exam for the quantitative measurement of BMD is the dual X-ray photon absorptiometry (DXA), a radiological method. However, a relevant number of fragility fractures occurs in the range of normal BMD values, meaning that also qualitative aspects of bone play a role, namely bone architecture and bone geometry...
December 1, 2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#4
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27900934/gender-relations-and-women-s-reproductive-health-in-south-sudan
#5
Sumit Kane, Matilda Rial, Anthony Matere, Marjolein Dieleman, Jacqueline E W Broerse, Maryse Kok
BACKGROUND: In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births. DESIGN: A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender...
2016: Global Health Action
https://www.readbyqxmd.com/read/27896467/audit-of-geriatric-hip-fracture-care-a%C3%A2-slovenian-trauma-center-analysis
#6
Dejan Krušič, Drago Brilej, Colin Currie, Radko Komadina
BACKGROUND: The aim was to describe an audit of hip fracture patient care and outcomes in a Slovenian healthcare setting prior to the implementation of the Geriatric Fracture Center (GFC) model of care. METHODS: The Fragility Fracture Network (FFN) hip fracture audit database was used to collect data on hip fracture care in elderly patients. Epidemiological data were submitted as well as fracture type, prefracture residence and mobility prior to the fracture. The timeline of events and acute care data were also collected...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895472/safety-and-effectiveness-of-daily-teriparatide-for-osteoporosis-in-patients-with-severe-stages-of-chronic-kidney-disease-post-hoc-analysis-of-a-postmarketing-observational-study
#7
Atsushi Nishikawa, Fumito Yoshiki, Masanori Taketsuna, Kenta Kajimoto, Hiroyuki Enomoto
Teriparatide (recombinant 1-34 N-terminal sequence of human parathyroid hormone) for the treatment of osteoporosis should be prescribed with caution in patients with severe stages of chronic kidney disease (CKD). However, in clinical settings, physicians and surgeons who treat such patients have few available options. We sought to further explore the safety and effectiveness of teriparatide for the treatment of osteoporosis in Japanese patients with severe stages of CKD. This was a post hoc analysis of a postmarketing surveillance study that included patients with osteoporosis at high risk of fracture and stage 4 or 5 CKD...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27867811/dramatic-mitigation-of-bone-pain-after-phosphorus-replacement-therapy-in-a-subject-with-fgf23-related-hypophosphatemic-osteomalacia
#8
Fuminori Tatsumi, Megumi Horiya, Akihito Tanabe, Momoyo Nishioka, Yoshiro Fushimi, Junpei Sanada, Yurie Hirata, Shintaro Irie, Tomoe Kinoshita, Shinji Kamei, Masashi Shimoda, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
INTRODUCTION: Fibroblast growth factor 23 (FGF23) is secreted from bone and suppresses the absorption of phosphorus in renal proximal tubule and in intestinal tract. Therefore, the increase of serum FGF23 levels leads to hypophosphatemic situations. Tumor-induced osteomalacia is often induced by various tumors, but it is often difficult to identify the localization of tumor, because most of the FGF23-producing tumors are small and could be observed in any part of the body. CASE DESCRIPTION: Here we report a case of elderly female subject with FGF23-related hypophosphatemic osteomalacia who repeatedly experienced severe bone pain and fragility fracture in various parts of the body...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#9
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27856519/transcriptional-landscape-analysis-identifies-differently-expressed-genes-involved-in-follicle-stimulating-hormone-induced-postmenopausal-osteoporosis
#10
Katre Maasalu, Ott Laius, Lidiia Zhytnik, Sulev Kõks, Ele Prans, Ene Reimann, Aare Märtson
Osteoporosis is a disorder associated with bone tissue reorganization, bone mass, and mineral density. Osteoporosis can severely affect postmenopausal women, causing bone fragility and osteoporotic fractures. The aim of the current study was to compare blood mRNA profiles of postmenopausal women with and without osteoporosis, with the aim of finding different gene expressions and thus targets for future osteoporosis biomarker studies. Our study consisted of transcriptome analysis of whole blood serum from 12 elderly female osteoporotic patients and 12 non-osteoporotic elderly female controls...
November 17, 2016: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/27830521/surgical-treatment-of-secondary-hyperparathyroidism-in-elderly-patients-an-institutional-experience
#11
Andrea Polistena, Alessandro Sanguinetti, Roberta Lucchini, Segio Galasse, Stefano Avenia, Massimo Monacelli, Louis Banka Johnson, Bengt Jeppsson, Nicola Avenia
BACKGROUND: Secondary hyperparathyroidism in elderly fragile patients presents clinical difficulties due to severity of symptoms and related comorbidity. The optimal surgical approach for this group of patients is still debated. AIM: The aim of the study was to define the optimal technique of parathyroidectomy in elderly patients with secondary hyperparathyroidism. METHODS: Retrospective analysis in a series of 253 patients including 35 elderly individuals at a single institution was carried out...
November 9, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27828571/factors-associated-with-negative-self-rated-health-among-non-institutionalized-elderly-in-montes-claros-brazil
#12
Sarah Magalhães Medeiros, Lorena Santos Rocha Silva, Jair Almeida Carneiro, Gizele Carmen Fagundes Ramos, Ana Teresa Fernandes Barbosa, Antônio Prates Caldeira
This study aimed to obtain an understanding of the self-rated health among community-dwelling elderly people in the north of Minas Gerais, identifying factors associated with negative self-rated health. We conducted a population-based cross-sectional study with two-stage random sampling. Data collection was carried out in the home of elderly people by trained staff who used questionnaires that had already been validated. To identify the variables associated with negative self-rated health, bivariate analyses were performed, followed by Poisson regression analysis...
November 2016: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/27823868/effects-of-glimepiride-versus-saxagliptin-on-%C3%AE-cell-function-and-hypoglycemia-a-post-hoc-analysis-in-older-patients-with-type-2-diabetes-inadequately-controlled-with-metformin
#13
Shira Perl, William Cook, Cheryl Wei, Peter Ohman, Boaz Hirshberg
PURPOSE: The management of hyperglycemia is challenging in older patients with type 2 diabetes owing to excess fragility and risk for adverse outcomes should hypoglycemia episodes occur. We evaluated baseline β-cell function as a potential risk factor for the development of hypoglycemia when saxagliptin or glimepiride was added in patients aged ≥65 years whose type 2 diabetes was poorly controlled on stable metformin monotherapy. METHODS: A post hoc analysis of data from the GENERATION (Efficacy and Tolerability of Saxagliptin Compared with Glimepiride in Elderly Patients with Type 2 Diabetes: A Randomized, Controlled Study) trial, which enrolled 720 patients aged ≥65 years, was conducted...
November 4, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27808666/multimodal-therapy-is-feasible-in-elderly-anal-cancer-patients
#14
Jon Espen Dale, Sigrun Sebjørnsen, Sabine Leh, Cornelia Rösler, Stein Aaserud, Bjørn Møller, Øystein Fluge, Christian Erichsen, Saied Nadipour, Hartwig Kørner, Frank Pfeffer, Olav Dahl
BACKGROUND: Many patients are diagnosed with an anal cancer in high ages. We here present the outcome after oncological therapy for patients above 80 years compared with younger patients. MATERIALS AND METHODS: A series of 213 consecutive patients was diagnosed and treated at a single institution from 1984 to 2009. The patients received similar radiation doses but with different techniques, thus progressively sparing more normal tissues. The majority of patients also had simultaneous [5-fluorouracil (5FU) and mitomycin C] or induction chemotherapy (cisplatin and 5FU)...
November 3, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27790378/vitamin-d-calcium-homeostasis-and-aging
#15
REVIEW
Vaishali Veldurthy, Ran Wei, Leyla Oz, Puneet Dhawan, Yong Heui Jeon, Sylvia Christakos
Osteoporosis is characterized by low bone mass and microarchitecture deterioration of bone tissue, leading to enhanced bone fragility and consequent increase in fracture risk. Evidence is accumulating for an important role of calcium deficiency as the process of aging is associated with disturbed calcium balance. Vitamin D is the principal factor that maintains calcium homeostasis. Increasing evidence indicates that the reason for disturbed calcium balance with age is inadequate vitamin D levels in the elderly...
2016: Bone Research
https://www.readbyqxmd.com/read/27745919/fluorescence-assisted-sentinel-snd-and-pelvic-node-dissections-by-single-port-transvaginal-laparoscopic-surgery-for-the-management-of-an-endometrial-carcinoma-ec-in-an-elderly-obese-patient
#16
Eric Leblanc, Fabrice Narducci, Lucie Bresson, Delphine Hudry
OBJECTIVE: To explore the feasibility of an oncologically acceptable management for an intermediate-risk endometrial cancer (EC) in an elderly, using the combination of transvaginal single-port laparoscopy and sentinel node policy. METHODS: For this 85-years old patient, BMI 32kg/m(2), with IB grade 2 endometrioid EC, a single vaginal approach was attempted [1] to perform a total hysterectomy, bilateral salpinago-oophorectomy and pelvic node assessment guided by SND [2]...
December 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27699081/fear-of-falling-correlates-with-subtle-neuromuscular-balance-and-strength-deficits-of-fragility-fracture-patients
#17
Corinne E Wee, Tyler D Ames, Khoi M Le, Tiffany Wang, Laura S Phieffer, Carmen E Quatman
Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures...
October 2016: Aging and Disease
https://www.readbyqxmd.com/read/27696099/utilization-of-osteoporosis-medication-after-a-fragility-fracture-among-elderly-medicare-beneficiaries
#18
Akeem A Yusuf, Thomas J Matlon, Andreas Grauer, Richard Barron, David Chandler, Yi Peng
: Osteoporosis medications are recommended for elderly patients after a fragility fracture. However, we found substantial under-treatment in the post-fracture year, especially among patients who had not previously received such medications. Improved treatment of elderly patients experiencing fragility fractures is needed. INTRODUCTION: Osteoporosis medications are recommended for elderly patients after a fragility fracture, but under-treatment is common. We determined osteoporosis medication use after fragility fractures and examined associated factors...
December 2016: Archives of Osteoporosis
https://www.readbyqxmd.com/read/27681935/postmenopausal-osteoporosis
#19
Richard Eastell, Terence W O'Neill, Lorenz C Hofbauer, Bente Langdahl, Ian R Reid, Deborah T Gold, Steven R Cummings
Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population...
2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27676796/an-alternative-treatment-for-contractures-of-the-elderly-institutionalized-persons-microinvasive-percutaneous-needle-tenotomy-of-the-finger-flexors
#20
Alexis Schnitzler, Aurelie Diebold, Bernard Parratte, Laurent Tliba, Francois Genêt, Philippe Denormandie
OBJECTIVE: Almost 10% of older adults in nursing homes have a fixed flexion deformity of the fingers (claw hand). Such contractures have important functional consequences, often leading to hygiene difficulties. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not always effective and surgery is often not possible in such fragile patients. Microinvasive tenotomy with a large needle could be a useful alternative because it can be carried out in an ambulatory setting under local anaesthesia...
September 2016: Annals of Physical and Rehabilitation Medicine
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