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1.
J Anim Ecol ; 92(9): 1771-1785, 2023 09.
Article de Anglais | MEDLINE | ID: mdl-37340858

RÉSUMÉ

The thermal sensitivity of early life stages can play a fundamental role in constraining species distributions. For egg-laying ectotherms, cool temperatures often extend development time and exacerbate developmental energy cost. Despite these costs, egg laying is still observed at high latitudes and altitudes. How embryos overcome the developmental constraints posed by cool climates is crucial knowledge for explaining the persistence of oviparous species in such environments and for understanding thermal adaptation more broadly. Here, we studied maternal investment and embryo energy use and allocation in wall lizards spanning altitudinal regions, as potential mechanisms that enable successful development to hatching in cool climates. Specifically, we compared population-level differences in (1) investment from mothers (egg mass, embryo retention and thyroid yolk hormone concentration), (2) embryo energy expenditure during development, and (3) embryo energy allocation from yolk towards tissue. We found evidence that energy expenditure was greater under cool compared with warm incubation temperatures. Females from relatively cool regions did not compensate for this energetic cost of development by producing larger eggs or increasing thyroid hormone concentration in yolk. Instead, embryos from the high-altitude region used less energy to complete development, that is, they developed faster without a concomitant increase in metabolic rate, compared with those from the low-altitude region. Embryos from high altitudes also allocated relatively more energy towards tissue production, hatching with lower residual yolk: tissue ratios than low-altitude region embryos. These results are consistent with local adaptation to cool climate and suggest that this is underpinned by mechanisms that regulate embryonic utilisation of yolk reserves and its allocation towards tissue, rather than shifts in maternal investment of yolk content or composition.


Sujet(s)
Climat , Basse température , Femelle , Animaux , Température , Acclimatation , Embryon non mammalien/métabolisme
2.
Proc Biol Sci ; 288(1951): 20210271, 2021 05 26.
Article de Anglais | MEDLINE | ID: mdl-34034513

RÉSUMÉ

Emerging patterns suggest telomere dynamics and life history are fundamentally linked in endotherms through life-history traits that mediate the processes underlying telomere attrition. Unlike endotherms, ectotherms maintain the ability to lengthen somatic telomeres throughout life and the link between life-history strategies and ectotherm telomere dynamics is unknown. In a well-characterized model system (Niveoscincus ocellatus), we used long-term longitudinal data to study telomere dynamics across climatically divergent populations. We found longer telomeres in individuals from the cool highlands than those from the warm lowlands at birth and as adults. The key determinant of adult telomere length across populations was telomere length at birth, with population-specific effects of age and growth on adult telomere length. The reproductive effort had no proximate effect on telomere length in either population. Maternal factors influenced telomere length at birth in the warm lowlands but not the cool highlands. Our results demonstrate that life-history traits can have pervasive and context-dependent effects on telomere dynamics in ectotherms both within and between populations. We argue that these telomere dynamics may reflect the populations' different life histories, with the slow-growing cool highland population investing more into telomere lengthening compared to the earlier-maturing warm lowland population.


Sujet(s)
Lézards , Télomère , Adulte , Animaux , Humains , Nouveau-né , Lézards/génétique , Reproduction , Télomère/génétique , Homéostasie des télomères , Raccourcissement des télomères
3.
Osteoporos Int ; 31(8): 1603-1605, 2020 Aug.
Article de Anglais | MEDLINE | ID: mdl-32533195

RÉSUMÉ

The original version of this article, published on 21 March 2019, unfortunately contains some typos in Figs. 2, 3, 4, and Supplemental Fig. 1. The corrected figures are given below.

4.
Osteoporos Int ; 31(5): 1017-1018, 2020 May.
Article de Anglais | MEDLINE | ID: mdl-32232508

RÉSUMÉ

The original version of this article, published on 21 March 2019, unfortunately contained a mistake.

5.
Osteoporos Int ; 31(7): 1299-1304, 2020 Jul.
Article de Anglais | MEDLINE | ID: mdl-32062687

RÉSUMÉ

This study expands on previous findings that hip fracture rates may no longer be declining. We found that age- and sex-adjusted fracture rates in the US plateaued or increased through mid-2017 in a population of commercially insured and Medicare Advantage health plan enrollees, in contrast to a decline from 2007 to 2013. INTRODUCTION: The purpose of this study was to evaluate fracture trends in US commercial and Medicare Advantage health plan members aged ≥ 50 years between 2007 and 2017. METHODS: Retrospective analysis of the Optum Research Database from January 1, 2007, to May 31, 2017. RESULTS: Of 1,841,263 patients identified with an index fracture, 930,690 were case-qualifying and included in this analysis. The overall age- and sex-adjusted fracture rate decreased from 14.67/1000 person-years (py) in 2007 to 11.79/1000 py in 2013, followed by a plateau for the next 3 years and then an increase to 12.50/1000 py in mid-2017. In females aged ≥ 65 years, fracture rates declined from 27.49/1000 py in 2007 to 22.08/1000 py in 2013, then increased to 24.92/1000 py in mid-2017. Likewise, fracture rates in males aged ≥ 65 years declined from 2007 (12.00/1000 py) to 2013 (10.72/1000 py), then increased to 12.04/1000 py in mid-2017. The age- and sex-adjusted fracture rates for most fracture sites declined from 2007 to 2013 by 3.7% per year (P = 0.310). CONCLUSIONS: Following a consistent decline in fracture rate from 2007 to 2013, trends from 2014 to 2017 indicate fracture rates are no longer declining and, for some fracture types, rates are rising.


Sujet(s)
Fractures de la hanche , Fractures ostéoporotiques , Adolescent , Sujet âgé , Femelle , Fractures de la hanche/épidémiologie , Humains , Incidence , Mâle , Programmes de gestion intégrée des soins de santé , Medicare (USA) , Fractures ostéoporotiques/épidémiologie , Études rétrospectives , États-Unis/épidémiologie
7.
Infect Prev Pract ; 2(4): 100100, 2020 Dec.
Article de Anglais | MEDLINE | ID: mdl-34368728

RÉSUMÉ

BACKGROUND: Carbapenems are a family of end line antibiotics with increasing levels of resistance that are a cause for concern. AIM: To ascertain whether the CPE screening programme employed in an acute tertiary hospital is fit for purpose. METHOD: We outlined the current working algorithm employed using a universal screening programme over a 26-month screening period. Rectal swabs are cultured on arrival. Those with suspicious growth are further investigated using NG-Carba 5 lateral flow tests and Vitek 2.0 sensitivity cards. These practices were compared with NHS guidelines. FINDINGS & CONCLUSIONS: In all, 53 true positives were detected from 45 patients since the screening was implemented in early 2018 (46 OXA-48, 6 KPC, 1 NDM). As the rate of screening increased, the number of positive screens decreased over time. There were a lot of similarities between the HSE guidelines and the published NHS CPE toolkit. It was evident that there is no standard practice being employed across all hospitals. Comparing the MUH to national guidelines it appears to be quicker and more effective with universal screening in place at reducing the potential contacts and identifying carriers. Cost analysis indicates that the need to confirm all positive strains in a reference lab is costly, unnecessary and time consuming. There are adequate confirmatory tests available in-house for routine positive screens. It was concluded that infection prevention and control are key to identifying and controlling possible outbreaks in a hospital setting.

8.
Oecologia ; 191(4): 767-776, 2019 Dec.
Article de Anglais | MEDLINE | ID: mdl-31620874

RÉSUMÉ

Telomere dynamics vary fundamentally between endothermic populations and species as a result of differences in life history, yet we know little about these patterns in ectotherms. In ectotherms, the relationships between climate, metabolism and life history suggest that telomere attrition should be higher at relatively high environmental temperatures compared to relatively low environmental temperatures, but these effects may vary between populations due to local adaptation. To address this hypothesis, we sampled reactive oxygen species (ROS) and telomere length of lizards from warm lowland and cool highland populations of a climatically widespread lizard species that we exposed to hot or cold basking treatments. The hot treatment increased relative telomere length compared to the cold treatment independent of climatic origin or ROS levels. Lizards from the cool highland region had lower ROS levels than those from the warm lowland region. Within the highland lizards, ROS increased more in the cold basking treatment than the hot basking treatment. These results are in the opposite direction to those predicted, suggesting that the relationships between temperature, metabolism, ROS and telomere dynamics are not straightforward. Future work incorporating detailed understanding of the thermal reaction norms of these and other linked traits is needed to fully understand these processes.


Sujet(s)
Lézards , Télomère , Animaux , Climat froid , Basse température , Température
9.
Biol Lett ; 15(7): 20190151, 2019 07 26.
Article de Anglais | MEDLINE | ID: mdl-31288685

RÉSUMÉ

Large-scale tissue regeneration has potential consequences for telomere length through increases in cell division and changes in metabolism which increase the potential for oxidative stress damage to telomeres. The effects of regeneration on telomere dynamics have been studied in fish and marine invertebrates, but the literature is scarce for terrestrial species. We experimentally induced tail autotomy in a lizard ( Niveoscincus ocellatus) and assessed relative telomere length (RTL) in blood samples before and after partial tail regeneration while concurrently measuring reactive oxygen species (ROS) levels. The change in ROS levels was a significant explanatory variable for the change in RTL over the 60-day experiment. At the average value of ROS change, the mean RTL increased significantly in the control group (intact tails), but there was no such evidence in the regenerating group. By contrast, ROS levels decreased significantly in the regenerating group, but there was no such evidence in the control group. Combined, these results suggest that tail regeneration following autotomy involves a response to oxidative stress and this potentially comes at a cost to telomere repair. This change in telomere maintenance demonstrates a potential long-term cost of tail regeneration beyond the regrowth of tissue itself.


Sujet(s)
Lézards , Télomère , Animaux , Stress oxydatif , Espèces réactives de l'oxygène , Régénération , Queue
10.
Osteoporos Int ; 30(7): 1465-1473, 2019 Jul.
Article de Anglais | MEDLINE | ID: mdl-30953114

RÉSUMÉ

This network meta-analysis assessed the efficacy of abaloparatide versus other treatment options to reduce the risk of fractures in women with postmenopausal osteoporosis. The analysis indicates that abaloparatide reduces the risk of fractures in women with postmenopausal osteoporosis versus placebo and compared with other treatment options. INTRODUCTION: This network meta-analysis (NMA) assessed the relative efficacy of abaloparatide versus other treatments to reduce the risk of fractures in women with postmenopausal osteoporosis (PMO). METHODS: PubMed®, Embase®, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials published before December 20, 2017, that included women with PMO who were eligible to receive interventions for primary or secondary fracture prevention. The NMA was conducted by fracture site (vertebral [VF], nonvertebral [NVF], and wrist), with the relative risk (RR) of fracture versus placebo the main clinical endpoint. The NMA used fixed-effects and random-effects approaches. RESULTS: A total of 4978 articles were screened, of which 22 were included in the analysis. Compared with other treatments, abaloparatide demonstrated the greatest treatment effect relative to placebo in the VF network (RR = 0.13; 95% credible interval [CrI] 0.04-0.34), the NVF network (RR = 0.50; 95% CrI 0.28-0.85), and the wrist fracture network (RR = 0.39; CrI 0.15-0.90). Treatment ranking showed that abaloparatide had the highest estimated probability of preventing fractures in each of the networks (79% for VF, 70% for NVF, and 53% for wrist fracture) compared with other treatments. Individual networks demonstrated a good level of agreement with direct trial evidence and direct pair-wise comparisons. CONCLUSIONS: This NMA indicates that abaloparatide reduces the RR of VF, NVF, and wrist fracture in women with PMO with or without prior fracture versus placebo, compared with other treatment options. Limitations include that adverse events and drug costs were not considered, and that generalizability is limited to the trial populations and endpoints included in the NMA.


Sujet(s)
Agents de maintien de la densité osseuse/usage thérapeutique , Ostéoporose post-ménopausique/traitement médicamenteux , Fractures ostéoporotiques/prévention et contrôle , Protéine apparentée à l'hormone parathyroïdienne/usage thérapeutique , Fractures du rachis/prévention et contrôle , Femelle , Fractures de la hanche/prévention et contrôle , Humains , Méta-analyse en réseau , Essais contrôlés randomisés comme sujet/méthodes , Comportement de réduction des risques , Traumatismes du poignet/prévention et contrôle
11.
Osteoporos Int ; 30(6): 1187-1194, 2019 Jun.
Article de Anglais | MEDLINE | ID: mdl-30899994

RÉSUMÉ

PURPOSE: Wrist fractures are common, contribute significantly to morbidity in women with postmenopausal osteoporosis, and occur predominantly at the ultradistal radius, a site rich in trabecular bone. This exploratory analysis of the phase 3 ACTIVE study evaluated effects of abaloparatide versus placebo and teriparatide on forearm bone mineral density (BMD) and risk of wrist fracture. METHODS: Forearm BMD was measured by dual energy X-ray absorptiometry in a subset of 982 women from ACTIVE, evenly distributed across the three treatment groups. Wrist fractures were ascertained in the total cohort (N = 2463). RESULTS: After 18 months, ultradistal radius BMD changes from baseline were 2.25 percentage points greater for abaloparatide compared with placebo (95% confidence interval (CI) 1.38, 3.12, p < 0.001) and 1.54 percentage points greater for abaloparatide compared with teriparatide (95% CI 0.64, 2.45, p < 0.001). At 18 months, 1/3 radius BMD losses (versus baseline) were similar for abaloparatide compared with placebo (-0.42; 95% CI -1.03, 0.20; p = 0.19) but losses with teriparatide exceeded those of placebo (-1.66%; 95% CI -2.27, -1.06; p < 0.001). The decline with abaloparatide was less than that seen with teriparatide (group difference 1.22%; 95% CI 0.57, 1.87; p < 0.001). The radius BMD findings, at both ultradistal and 1/3 sites, are consistent with the numerically lower incidence of wrist fractures observed in women treated with abaloparatide compared with teriparatide (HR = 0.43; 95% CI 0.18, 1.03; p = 0.052) and placebo (HR = 0.49, 95% CI 0.20, 1.19, p = 0.11). CONCLUSIONS: Compared with teriparatide, abaloparatide increased BMD at the ultradistal radius (primarily trabecular bone) and decreased BMD to a lesser extent at the 1/3 radius (primarily cortical bone), likely contributing to the numerically lower wrist fracture incidence observed with abaloparatide.


Sujet(s)
Agents de maintien de la densité osseuse/usage thérapeutique , Densité osseuse/effets des médicaments et des substances chimiques , Ostéoporose post-ménopausique/traitement médicamenteux , Fractures ostéoporotiques/prévention et contrôle , Protéine apparentée à l'hormone parathyroïdienne/usage thérapeutique , Traumatismes du poignet/prévention et contrôle , Absorptiométrie photonique , Sujet âgé , Sujet âgé de 80 ans ou plus , Méthode en double aveugle , Femelle , Humains , Estimation de Kaplan-Meier , Adulte d'âge moyen , Ostéoporose post-ménopausique/complications , Ostéoporose post-ménopausique/physiopathologie , Fractures ostéoporotiques/étiologie , Fractures ostéoporotiques/physiopathologie , Radius/physiopathologie , Fractures du radius/étiologie , Fractures du radius/physiopathologie , Fractures du radius/prévention et contrôle , Traumatismes du poignet/étiologie , Traumatismes du poignet/physiopathologie
12.
Arch Osteoporos ; 14(1): 15, 2019 02 05.
Article de Anglais | MEDLINE | ID: mdl-30719589

RÉSUMÉ

We evaluated the efficacy of abaloparatide in women who were at increased risk for fracture, based on CHMP recommended risk thresholds, at the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE) study baseline. Among patients at high risk based on FRAX probabilities, 18 months of abaloparatide significantly decreased risk for all fracture endpoints compared with placebo. PURPOSE: Abaloparatide, a novel anabolic agent for the treatment of postmenopausal osteoporosis, significantly reduced the risk of vertebral and nonvertebral fractures in the ACTIVE study compared with placebo. In this post hoc analysis, we evaluated abaloparatide's efficacy in a subset of women in the study at an increased risk of fracture at baseline, based on the Committee for Medicinal Products for Human Use (CHMP) recommended risk thresholds for inclusion in clinical trials. METHODS: Women with a baseline 10-year risk of major osteoporotic fracture ≥ 10% or hip fracture ≥ 5%, assessed using the FRAX® tool (including femoral neck bone mineral density), were included in the analysis. The proportion with one or more events of new morphometric vertebral fractures was calculated. Event rates for nonvertebral, major osteoporotic, and all clinical fractures were estimated using Kaplan-Meier analysis. RESULTS: Following 18 months of treatment, abaloparatide significantly reduced incident vertebral fractures compared with placebo (relative risk reduction = 91%; 0.5% versus 5.6%; p < 0.001). Abaloparatide treatment was also associated with significantly fewer nonvertebral, major osteoporotic, and clinical fractures compared with placebo: 2.7% versus 5.8%, p = 0.036; 1.3% versus 6.0%, p < 0.001; and 3.5% versus 8.2%, p = 0.006, respectively. The effect of abaloparatide on major osteoporotic fractures (78% reduction) was significantly greater than that seen with teriparatide (23% reduction, p = 0.007). CONCLUSION: In a subset of postmenopausal women at increased risk of fracture as judged by CHMP guidance, abaloparatide significantly decreased the risk of all fracture endpoints compared with placebo.


Sujet(s)
Agents de maintien de la densité osseuse/usage thérapeutique , Densité osseuse/effets des médicaments et des substances chimiques , Ostéoporose post-ménopausique/traitement médicamenteux , Fractures ostéoporotiques/prévention et contrôle , Protéine apparentée à l'hormone parathyroïdienne/usage thérapeutique , Sujet âgé , Femelle , Fractures de la hanche/épidémiologie , Fractures de la hanche/étiologie , Fractures de la hanche/prévention et contrôle , Humains , Adulte d'âge moyen , Ostéoporose post-ménopausique/complications , Fractures ostéoporotiques/épidémiologie , Fractures ostéoporotiques/étiologie , Post-ménopause , Facteurs de risque , Fractures du rachis/épidémiologie , Fractures du rachis/étiologie , Fractures du rachis/prévention et contrôle , Résultat thérapeutique
13.
Osteoporos Int ; 30(3): 667-673, 2019 Mar.
Article de Anglais | MEDLINE | ID: mdl-30635696

RÉSUMÉ

Early PINP changes correlate with 18-month lumbar spine BMD changes and the correlation was greater with abaloparatide versus teriparatide. The uncoupling index was similar between the two agents. INTRODUCTION: We evaluated the relationship between early PINP changes and subsequent changes in spine BMD following abaloparatide and teriparatide treatments. We also explored the use of an "uncoupling index" (UI), the balance between bone formation and bone resorption, which we hypothesised would be similar in response to these treatment groups. METHODS: Blood samples were taken for measurement of bone turnover markers (BTMs) s-PINP and s-CTX at baseline, 1, 3, 6, 12, and 18 months from 189 abaloparatide patients and 227 teriparatide patients randomly selected from all participants who completed the study. BMD was measured by DXA at baseline, 6, 12, and 18 months. Correlations were calculated between log ratio of BTMs from baseline to 3 months and percent change from baseline in BMD at 18 months. A UI was calculated using log transformation and subtraction of the standard deviate for s-CTX from the standard deviate for s-PINP for each patient. RESULTS: Early BTM changes were associated with subsequent BMD changes for both treatments. Pearson correlations for the log ratio of PINP over baseline at 3 months and BMD percent change from baseline at 18 months were larger (P < 0.0001) with abaloparatide (r = 0.561) than teriparatide (r = 0.198). The mean UI at 1 month was greater for abaloparatide versus teriparatide (1.743 and 1.493, respectively; P = 0.03) but was similar at 3 months or later time points. CONCLUSIONS: Early s-PINP changes correlate with percentage change in lumbar spine BMD 18 months after treatment with both abaloparatide and teriparatide, though the correlation with abaloparatide was greater. The UI was similar between abaloparatide and teriparatide suggesting that the balance between formation and resorption markers was similar.


Sujet(s)
Agents de maintien de la densité osseuse/pharmacologie , Remodelage osseux/effets des médicaments et des substances chimiques , Ostéoporose post-ménopausique/physiopathologie , Protéine apparentée à l'hormone parathyroïdienne/pharmacologie , Tériparatide/pharmacologie , Sujet âgé , Marqueurs biologiques/sang , Densité osseuse/effets des médicaments et des substances chimiques , Densité osseuse/physiologie , Agents de maintien de la densité osseuse/usage thérapeutique , Remodelage osseux/physiologie , Collagène de type I/sang , Méthode en double aveugle , Femelle , Humains , Vertèbres lombales/physiopathologie , Adulte d'âge moyen , Ostéoporose post-ménopausique/sang , Ostéoporose post-ménopausique/traitement médicamenteux , Protéine apparentée à l'hormone parathyroïdienne/usage thérapeutique , Fragments peptidiques/sang , Peptides/sang , Procollagène/sang , Tériparatide/usage thérapeutique
14.
Bone ; 120: 137-140, 2019 03.
Article de Anglais | MEDLINE | ID: mdl-30359763

RÉSUMÉ

BACKGROUND: Abaloparatide is a 34-amino acid peptide that selectively binds to the RG conformation of the parathyroid hormone receptor type 1. It was developed for the treatment of women with postmenopausal osteoporosis at high risk of fracture. In ACTIVE, an 18-month phase 3 study (NCT01343004), abaloparatide increased bone mineral density (BMD), decreased the risk of vertebral and nonvertebral fractures compared with placebo, and decreased the risk of major osteoporotic fractures compared with placebo and teriparatide. Here, we report a prospective, exploratory BMD responder analysis from ACTIVE. METHODS: Proportions of patients experiencing BMD gains from baseline of >0%, >3%, and >6% at the total hip, femoral neck, and lumbar spine at 6, 12, and 18 months of treatment were compared among the placebo, abaloparatide, and teriparatide groups in ACTIVE. Responders were defined prospectively as patients experiencing BMD gains at all 3 anatomic sites. RESULTS: At months 6, 12, and 18, there were significantly more >3% BMD responders in the abaloparatide group compared with placebo and teriparatide: month 6, 19.1% vs 0.9% for placebo and 6.5% for teriparatide; month 12, 33.2% vs 1.5% and 19.8%; month 18, 44.5% vs 1.9% and 32.0% (P < 0.001 for all comparisons of abaloparatide to placebo and to teriparatide). Findings were similar for the >0% and >6% responder thresholds. CONCLUSIONS: In postmenopausal women with osteoporosis, a significantly greater proportion of patients treated with abaloparatide experienced increases in BMD than did those treated with placebo or teriparatide.


Sujet(s)
Densité osseuse/effets des médicaments et des substances chimiques , Protéine apparentée à l'hormone parathyroïdienne/pharmacologie , Tériparatide/pharmacologie , Sujet âgé , Os et tissu osseux/effets des médicaments et des substances chimiques , Femelle , Humains , Placebo
15.
Osteoporos Int ; 29(8): 1747-1757, 2018 Aug.
Article de Anglais | MEDLINE | ID: mdl-29947869

RÉSUMÉ

The present study, drawn from a sample of the Icelandic population, quantified high immediate risk and utility loss of subsequent fracture after a sentinel fracture (at the hip, spine, distal forearm and humerus) that attenuated with time. INTRODUCTION: The risk of a subsequent osteoporotic fracture is particularly acute immediately after an index fracture and wanes progressively with time. The aim of this study was to quantify the risk and utility consequences of subsequent fracture after a sentinel fracture (at the hip, spine, distal forearm and humerus) with an emphasis on the time course of recurrent fracture. METHODS: The Reykjavik Study fracture registration, drawn from a sample of the Icelandic population (n = 18,872), recorded all fractures of the participants from their entry into the study until December 31, 2012. Medical records for the participants were manually examined and verified. First sentinel fractures were identified. Subsequent fractures, deaths, 10-year probability of fracture and cumulative disutility using multipliers derived from the International Costs and Utilities Related to Osteoporotic fractures Study (ICUROS) were examined as a function of time after fracture, age and sex. RESULTS: Over 10 years, subsequent fractures were sustained in 28% of 1498 individuals with a sentinel hip fracture. For other sentinel fractures, the proportion ranged from 35 to 38%. After each sentinel fracture, the risk of subsequent fracture was highest in the immediate post fracture interval and decreased markedly with time. Thus, amongst individuals who sustained a recurrent fracture, 31-45% did so within 1 year of the sentinel fracture. Hazard ratios for fracture recurrence (population relative risks) were accordingly highest immediately after the sentinel fracture (2.6-5.3, depending on the site of fracture) and fell progressively over 10 years (1.5-2.2). Population relative risks also decreased progressively with age. The utility loss during the first 10 years after a sentinel fracture varied by age (less with age) and sex (greater in women). In women at the age of 70 years, the mean utility loss due to fractures in the whole cohort was 0.081 whereas this was 12-fold greater in women with a sentinel hip fracture, and was increased 15-fold for spine fracture, 4-fold for forearm fracture and 8-fold for humeral fracture. CONCLUSION: High fracture risks and utility loss immediately after fracture suggest that treatment given as soon as possible after fracture would avoid a higher number of new fractures compared with treatment given later. This provides the rationale for very early intervention immediately after a sentinel fracture.


Sujet(s)
Fractures ostéoporotiques/épidémiologie , Adulte , Répartition par âge , Facteurs âges , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Traumatismes de l'avant-bras/épidémiologie , Fractures de la hanche/épidémiologie , Humains , Fractures de l'humérus/épidémiologie , Islande/épidémiologie , Mâle , Adulte d'âge moyen , Récidive , Enregistrements , Appréciation des risques/méthodes , Répartition par sexe , Fractures du rachis/épidémiologie , Facteurs temps
16.
J Anim Physiol Anim Nutr (Berl) ; 102(3): 670-678, 2018 Jun.
Article de Anglais | MEDLINE | ID: mdl-29427381

RÉSUMÉ

The effects on rumen kinetics after feed and water had been deprived for 72 hr were studied using four fistulated Bos indicus steers. The animals were assigned in a 2 × 4 crossover design with two treatments: feed and water ad libitum (control) and no feed and water for 72 hr (deprived) with four steers per treatment over two time periods. Feed and water deprivation caused decreases in the numbers of cellulolytic bacteria (1.4 vs. 0.4 cfu × 106 /ml; p = .001), live (23.7 vs. 0.8 × 109 /ml; p = .001), dead (12.7 vs. 0.5 × 109 /ml; p = .001) and total bacterial counts (36.4 vs. 1.4 × 109 /ml; p = .001) at day 0, compared with the control treatment. However, the deprived group had greater numbers of cellulolytic bacteria (2.7 vs. 50.1 cfu × 106 /ml; p = .001), live (18.3 vs. 42.2 × 109 /ml; p = .001), dead (6. 5 vs. 19.1 × 109 /ml; p = .001) and total bacterial counts (24.8 vs. 61.3 × 109 /ml; p = .001) from rumen fluid on day 4, compared with the control treatment. The numbers of protozoa in rumen fluid from the deprived group were less than (551.2 vs. 2.4 × 103 /ml; p = .001) the control group on day 0. However, the deprived treatment had fewer protozoa in rumen fluid than the control treatment on day 4 (p = .001) and day 9 (p = .001). Volatile fatty acids and in vitro gas production as functional measurements of rumen fluid followed the same trend as the bacterial and protozoa populations. These results indicate that feed and water deprivation would have a negative but transient effect on the rumen kinetics of Bos indicus steers.


Sujet(s)
Bovins/physiologie , Privation alimentaire , Motilité gastrointestinale/physiologie , Rumen/physiologie , Privation hydrique , Animaux , Études croisées , Mâle
17.
Osteoporos Int ; 29(2): 323-328, 2018 02.
Article de Anglais | MEDLINE | ID: mdl-29167971

RÉSUMÉ

In a phase 2 trial of 222 postmenopausal women with osteoporosis aged 55 to 85 years randomized to one of three different doses of abaloparatide-SC, subcutaneous teriparatide, or placebo for 24 weeks, abaloparatide-SC resulted in improvements in skeletal microarchitecture as measured by the trabecular bone score. INTRODUCTION: Subcutaneous abaloparatide (abaloparatide-SC) increases total hip and lumbar spine bone mineral density and reduces vertebral and non-vertebral fractures. In this study, we analyzed the extent to which abaloparatide-SC improves skeletal microarchitecture, assessed indirectly by trabecular bone score (TBS). METHODS: This is a post hoc analysis of a phase 2 trial of 222 postmenopausal women with osteoporosis aged 55 to 85 years randomized to abaloparatide-SC (20, 40, or 80 µg), subcutaneous teriparatide (20 µg), or placebo for 24 weeks. TBS was measured from lumbar spine dual X-ray absorptiometry (DXA) images in 138 women for whom the DXA device was TBS software compatible. Assessments were made at baseline, 12 and 24 weeks. Between-group differences were assessed by generalized estimating equations adjusted for relevant baseline characteristics, and a pre-determined least significant change analysis was performed. RESULTS: After 24 weeks, TBS increased significantly by 2.27, 3.14, and 4.21% versus baseline in participants on 20, 40, and 80 µg abaloparatide-SC daily, respectively, and by 2.21% in those on teriparatide (p < 0.05 for each). The TBS in the placebo group declined by 1.08%. The TBS increase in each treatment group was significantly higher than placebo at 24 weeks (p < 0.0001 for each) after adjustment for age, BMI, and baseline TBS. A dose-response was observed at 24 weeks across the three doses of abaloparatide-SC and placebo (p = 0.02). The increase in TBS in the abaloparatide-SC 80 µg group was significantly greater than TPTD (p < 0.03). CONCLUSIONS: These results are consistent with an effect of abaloparatide-SC to improve lumbar spine skeletal microarchitecture, as assessed by TBS.


Sujet(s)
Agents de maintien de la densité osseuse/administration et posologie , Densité osseuse/effets des médicaments et des substances chimiques , Ostéoporose post-ménopausique/traitement médicamenteux , Protéine apparentée à l'hormone parathyroïdienne/administration et posologie , Absorptiométrie photonique , Sujet âgé , Sujet âgé de 80 ans ou plus , Agents de maintien de la densité osseuse/pharmacologie , Agents de maintien de la densité osseuse/usage thérapeutique , Os spongieux/effets des médicaments et des substances chimiques , Os spongieux/physiopathologie , Relation dose-effet des médicaments , Méthode en double aveugle , Femelle , Humains , Injections sous-cutanées , Vertèbres lombales/physiopathologie , Adulte d'âge moyen , Ostéoporose post-ménopausique/physiopathologie , Fractures ostéoporotiques/prévention et contrôle , Protéine apparentée à l'hormone parathyroïdienne/pharmacologie , Protéine apparentée à l'hormone parathyroïdienne/usage thérapeutique , Tériparatide/usage thérapeutique
18.
BMJ Open ; 6(12): e012004, 2016 12 07.
Article de Anglais | MEDLINE | ID: mdl-27927656

RÉSUMÉ

OBJECTIVES: To (1) assess the hydration knowledge, attitudes and practices (KAP) of doctors; (2) develop an evidence-based training package; and (3) evaluate the impact of the training package. DESIGN: Educational intervention with impact evaluation. SETTING: Cambridgeshire, UK. PARTICIPANTS: General practitioners (GPs (primary care physicians)). INTERVENTIONS: Hydration and healthcare training. MAIN OUTCOME MEASURES: Hydration KAP score before and immediately after the training session. RESULTS: Knowledge gaps of doctors identified before the teaching were the definition of dehydration, European Food Safety Authority water intake recommendations, water content of the human body and proportion of water from food and drink. A face-to-face teaching package was developed on findings from the KAP survey and literature search. 54 questionnaires were completed before and immediately after two training sessions with GPs. Following the training, total hydration KAP scores increased significantly (p<0.001; median (25th, 75th centiles); 32 (29, 34)). Attendees rated the session as excellent or good (90%) and reported the training was likely to influence their professional practice (100%). CONCLUSIONS: The training package will continue to be developed and adapted, with increased focus on follow-up strategies as well as integration into medical curricula and standards of practice. However, further research is required in the area of hydration care to allow policymakers to incorporate hydration awareness and care with greater precision in local and national policies.


Sujet(s)
Compétence clinique/normes , Déshydratation/thérapie , Traitement par apport liquidien/méthodes , Médecins généralistes/enseignement et éducation , Déshydratation/diagnostic , Formation médicale continue comme sujet , Femelle , Connaissances, attitudes et pratiques en santé , Humains , Formation en interne , Mâle , Projets pilotes , Évaluation de programme , Facteurs de risque , Royaume-Uni
19.
Anim Reprod Sci ; 171: 87-97, 2016 Aug.
Article de Anglais | MEDLINE | ID: mdl-27346587

RÉSUMÉ

This study aimed to evaluate the reproductive response of anoestrous goats that were either hormonally treated and/or supplemented with maize for 9days to determine which treatment combination was the most effective in enhancing follicular development and ovulation rate, and whether these responses were associated with increases in metabolic hormones. The experiment was carried out using 28 does, using a 2×2 factorial design with seven does in each group to test the effect of synchronisation of oestrus, supplementation with maize and their interactions. Synchronisation of oestrous cycles (P<0.001) but not supplementation with maize or the interaction between the two (P>0.05) increased the number of codominant follicles, the diameter of the largest follicle on Day 9 and growth rate of follicles during the period of supplementation. Compared with non-supplemented animals, supplementation with maize increased the total number of follicles observed between Days 7 and 9 (P=0.039). In addition, nutritional supplementation with maize in combination with synchronisation of oestrus increased the ovulation rate by 43% (P=0.074). Interactions between time and supplementation with maize showed that plasma concentrations of insulin, leptin and IGF-1 were greater in does supplemented with maize compared with non-supplemented does (P<0.001). The findings show that hormonal synchronisation had the most influence on modifying follicular development and ovulation in anoestrous goats. Supplementation with maize increased the concentrations of insulin, leptin and IGF-1, which could potentially modify the sensitivity of follicles to gonadotrophins and reduce rates of atresia.


Sujet(s)
Aliment pour animaux , Régime alimentaire/médecine vétérinaire , Synchronisation de l'oestrus/effets des médicaments et des substances chimiques , Capra/physiologie , Follicule ovarique/effets des médicaments et des substances chimiques , Zea mays , Phénomènes physiologiques nutritionnels chez l'animal , Animaux , Femelle , Progestérone/administration et posologie , Progestérone/pharmacologie
20.
J Anim Sci ; 94(1): 424-9, 2016 Jan.
Article de Anglais | MEDLINE | ID: mdl-26812348

RÉSUMÉ

The objectives of the present study were to evaluate the basal concentrations of heat shock proteins (HSP) between and cattle and to determine if HSP basal concentrations change as an animal matures. A total of 40 cattle were used in a 2 × 2 factorial design to evaluate the effects of genotype and age (heifers and mature cows) on basal concentrations of heat shock protein 27 (HSP27), α B-crystallin (Cryab), and heat shock protein 70 (HSP70). Each experimental group of 10 animals was sampled on a separate day over a period of 4 wk during July 2014. A muscle sample was collected from the longissimus thoracis (LT) and concentrations of HSP were quantified using ELISA. There were no significant differences in HSP concentration for the interaction between age and genotype or for age alone. cattle had greater ( < 0.05) basal concentrations of HSP27, Cryab, and HSP70 in the LT than cattle. The results of this study show that basal in vivo HSP concentrations differ between and cattle. However, further studies are needed to investigate the relationship between HSP concentrations and meat tenderness with respect to genotypes to see if HSP concentrations account for at least some variability in tenderness differences.


Sujet(s)
Bovins/métabolisme , Protéines du choc thermique HSP27/métabolisme , Protéines du choc thermique HSP70/métabolisme , Chaîne B de la cristalline alpha/métabolisme , Vieillissement , Animaux , Bovins/génétique , Test ELISA/médecine vétérinaire , Femelle , Régulation de l'expression des gènes/physiologie , Protéines du choc thermique HSP27/génétique , Protéines du choc thermique HSP70/génétique , Muscles squelettiques/physiologie , Chaîne B de la cristalline alpha/génétique
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