Regional variability in changes in the incidence of hip fracture in the Spanish population (2000-2012).

UNLABELLED: The objective is to analyse the evolution of the incidence of hip fracture in the female population of Spain from 2000 to 2012 and to establish the possible changes which may have been seen over this period of time, including the trends in the different regions of the country. INTRODUCTION: Fragility-related hip fractures are considered to be the fractures of greatest significance to public health due to their high degree of morbidity and mortality. The change in their incidence, both in absolute values and when adjusted for age, is the subject of debate. The objective of this article is to describe the changes in the rates of hip fracture in Spain by autonomous community between the years 2000 and 2012. METHODS: Using the data from the Spanish Minimum Basic Data Set, in which are all the recorded cases of women with a principal diagnosis of hip fracture, the incidence rates by age group and by autonomous community were obtained. Poisson distribution or negative binomial regressions were carried out to estimate the average annual change over the time period analysed. RESULTS: There have been statistically significant changes in the trends of rates of incidence for all age groups of women over 65 years of age. The annual reduction was 2.2% for women of 65-74 years of age and less for those between 75 and 84. The rates of incidence for those over 85 increased annually by 0.58%. CONCLUSIONS: Hip fractures continue to increase in absolute numbers, although if the rates are adjusted for age, a downward trend is seen in certain age groups. These findings have various origins, although in the absence of great changes in population structure, we believe that drug treatments for osteoporosis may play a role. There is variability in the change in incidence of hip fractures in different parts of the country. Further studies are required to be able to identify the causes.

Dysautonomia Differentially Influences the Effect of Affective Pain Perception on Quality of Life in Parkinson's Disease Patients.

Background. Our aim was to evaluate the real effect of dysautonomic symptoms on the influence of affective pain perception on quality of life in PD patients. Methods. An observational cross-sectional study was carried out using 105 Parkinson's disease (PD) patients of the Movement Disorders Unit, Hospital de Cruces (Bilbao, Spain) [men 59 (56.2%), women 46 (43.85%)]. Statistical analysis was made in order to evaluate the possible association of pain with life quality. Results. Quality of life measured by PDQ-39 (Parkinson's Disease Questionnaire for quality of life) was statistically associated with affective dimension of pain (PRIA, affective pain rating index). However, the influence of this dimension on PDQ-39 was different in the specific case of PD patients that experimented a high score (>12) in SCOPA-AUT (Scale for Outcomes in PD-Autonomic scale). Conclusions. These results confirm the effect of affective perception of pain in life quality of PD patients, indicating the critical role of autonomic symptoms in the modulation of the influence of pain on quality of life and showing the possible utility of dysautonomia as clinical prognostic indicator of quality of life in PD patients affected by pain.

Effects of fluoxetine administration on mu-opoid receptor immunostaining in the rat forebrain.

Fluoxetine is a selective serotonin reuptake inhibitor. Analysis of mu-opioid receptor immunostaining after chronic fluoxetine administration in rats revealed an increase in the density of cells expressing mu-opioid receptors in the caudatus-putamen, the dentate gyrus, the lateral septum and the frontal, parietal and piriform cortices. These data suggest that mu-opioid receptor expression in the rat forebrain is altered by in vivo chronic fluoxetine treatment.

Lithium alters mu-opioid receptor expression in the rat brain.

Lithium can potentiate the effects of antidepressant drugs and alters morphine analgesia and phosphoinositide turnover. Analysis of mu-opioid receptor immunostaining after chronic lithium administration in rats revealed an increase in the density of cells expressing mu-opioid receptors in the caudatus-putamen, the dentate gyrus, the lateral septum and the frontal, parietal and piriform cortices. These data suggest that mu-opioid receptor expression in the rat forebrain is altered by in vivo chronic lithium treatment. This could be a compensatory mechanism, induced in part by the effects of lithium on mu-opioid receptor transduction mechanism.

[Comparison of the effects of the administration of fluoxetine and sertraline on the immune markers of the mu opioid receptor in the rat brain]. / Comparación de los efectos de la administración de fluoxetina y sertralina sobre el inmunomarcaje del receptor opioide mu en el cerebro de la rata.

INTRODUCTION: Chronic fluoxetine or imipramine administration in rats can generate a similar increase in the number of neural cells immunostained for mu opioid receptors in several prosencephalic regions. OBJECTIVE: The aim of the present work was to describe the effects of chronic sertraline administration on mu opioid receptor immunostaining in several rat brain prosencephalic regions, in order to compare with previously described fluoxetine effects. MATERIALS AND METHODS: Experimental animals were chronically administered with sertraline (i.p.). An immunocytochemical method, with the aid of a computerized image analysis system, was used in order to measure the number of neural cells immunostained for mu opioid receptors in several prosencephalic regions. RESULTS: Although chronic sertraline administration in rats generates a significant increase in the number of neural cells immunostained for mu opioid receptors in the caudatus-putamen, dentate gyrus, lateral septum and the frontal, parietal and piriform cortices, slight regional differences, with respect to fluoxetine action, were found. Thus, a more marked action on parietal cortex and lateral septum, and a lesser action on the frontal cortex, were found. CONCLUSION: Regional differences in sertraline effects, with respect to fluoxetine, could be related to a lesser incidence of psychomotor impairment.

In vitro activity of fluconazole on Candida albicans.

Fluconazole is a triazole antifungal compound suitable for the treatment of fungal infections, including those caused by Candida albicans. Fluconazole, as all azole antifungals, is a potent inhibitor of ergosterol biosynthesis. The aims of this study are to evaluate the susceptibility of C. albicans strains isolated from clinical specimens against fluconazole, and to assess the decrease in ergosterol produced on these strains when they are incubated in vitro with this antifungal compound. Sixty six yeast strains were isolated and identified from vaginal specimens of 710 women of a tocogynecology surgery (9.3%), C. albicans being the most frequent species (n = 52, ca. 79%). An agar dilution technique was used to determine the minimal inhibitory concentration (MIC) of fluconazole for the C. albicans strains. The MICs rank was between 1 and 20 micrograms/ml (mean = 6.6 micrograms/ml). Ergosterol content from ten C. albicans strains (MIC for fluconazole = 5 micrograms/ml) was assessed using the method proposed by Breivik and Owades, with three concentrations of fluconazole (2.5, 5 and 20 micrograms/ml) and four contact times (1, 6, 12 and 24 h), in comparison to no treated strains (control). The mean content of ergosterol was lower in the treated strains than in the control ones, and became statistically significant after 12 h of incubation.

Sibutramine decreases body weight gain and increases energy expenditure in obese Zucker rats without changes in NPY and orexins.

The aim of the present work was to describe the effects of sibutramine on body weight and adiposity and to establish the potential involvement of neuropeptide Y (NPY) and orexins in the anorectic action of this drug. Male obese Zucker rats were daily administered with sibutramine (10 mg/kg, intraperitoneal) for two weeks. Carcass composition was assessed using the official methods of the Association of Official Analytical Chemists. Total body oxygen consumption was measured daily for 60 min before sibutramine or saline injection and for 30 min (from 60 to 90 min) after drug or saline injection. Hypothalamic arcuate and paraventricular nuclei, and the lateral hypothalamic area were immunostained for NPY, orexin A and orexin B. Commercial kits were used for serum determinations. Reductions in body weight and adipose tissue weights were observed after sibutramine treatment in obese Zucker rats. No changes in NPY immunostaining in the arcuate and paraventricular nuclei were found. Orexin A and orexin B immunostaining was not modified in the lateral hypothalamic area in treated rats. The reduction in body weight and adiposity induced by sibutramine was achieved by both a reduction in food intake and an increase in energy expenditure. NPY and orexins do not seem to be involved in the anorectic effect of sibutramine.

Nefazodone alters NPY immunostaining in rat arcuate-paraventricular projection without changes in food intake and body weight.

Nefazodone is an antidepressant drug that inhibits serotonin and noradrenaline reuptake. The aim of the present work was to study the effects of nefazodone on food intake, body weight, adiposity and hypothalamic NPY immunostaining in rats. For this purpose, male Sprague-Dawley rats (3-month-old) were administered with nefazodone (20 mg/kg; i.p) daily for two weeks. The control group was given 0.9% NaCl solution. Hypothalamic arcuate, paraventricular, periventricular, supraoptic and suprachiasmatic nuclei and the lateral hypothalamic area were immunostained for NPY. Chronic nefazodone administration in rats did not modify food intake, body weight and adipose depot size (subcutaneous, perirenal and epididymal white adipose tissues, and interscapular brown adipose tissue). However, a significant decrease in paraventricular NPY immunostaining was found in the nefazodone group compared with the control group. No changes in other hypothalamic regions such as arcuate, periventricular, supraoptic and suprachiasmatic nuclei, and lateral and medial preoptic areas were observed. Because nefazodone is an alpha1-adrenoceptor antagonist, it can be proposed that the expected decrease in food intake after nefazodone administration, due to its effects on NPY arcuate-paraventricular projection, could be masked by the opposite orexigenic effect of alpha1-adrenoceptor blockade.