Odanacatib for the treatment of postmenopausal osteoporosis: results of the LOFT multicentre, randomised, double-blind, placebo-controlled trial and LOFT Extension study
Publication date: Available online 31 October 2019Source: The Lancet Diabetes &EndocrinologyAuthor(s): Michael R McClung, Michelle L O'Donoghue, Socrates E Papapoulos, Henry Bone, Bente Langdahl, Kenneth G Saag, Ian R Reid, Douglas P Kiel, Ilaria Cavallari, Marc P Bonaca, Stephen D Wiviott, Tobias de Villiers, Xu Ling, Kurt Lippuner, Toshitaka Nakamura, Jean-Yves Reginster, Jose Adolfo Rodriguez-Portales, Christian Roux, José Zanchetta, Cristiano A F ZerbiniSummaryBackgroundOdanacatib, a cathepsin K inhibitor, reduces bone resorption while maintaining bone formation. Previous work has shown that odanacatib increases bone mineral density in postmenopausal women with low bone mass. We aimed to investigate the efficacy and safety of odanacatib to reduce fracture risk in postmenopausal women with osteoporosis.MethodsThe Long-term Odanacatib Fracture Trial (LOFT) was a multicentre, randomised, double-blind, placebo-controlled, event-driven study at 388 outpatient clinics in 40 countries. Eligible participants were women aged at least 65 years who were postmenopausal for 5 years or more, with a femoral neck or total hip bone mineral density T-score between −2·5 and −4·0 if no previous radiographic vertebral fracture, or between −1·5 and −4·0 with a previous vertebral fracture. Women with a previous hip fracture, more than one vertebral fracture, or a T-score of less than −4·0 at the total hip or femoral nec...
We present a rare case of hemichorea associated with a hemorrhagic stroke in the contralateral striatum.
Antipsychotic medications are a vital part of controlling psychosis in schizophrenic patients. However, when those patients live in nursing facilities, we are obligated by CMS to undertake gradual dose reductions of antipsychotic medication if possible. Sometimes, these efforts are successful and sometimes they fail. Antipsychotic medications have many side effects, including sedation, diabetes, hyperlipidemia, weight gain, motor rigidity, impaired gait, and falls. Monitoring of blood glucose, lipids, and extrapyramidal symptoms is mandatory.
Management of diabetes in post-acute settings needs special considerations. Hypoglycemia in the skilled nursing and rehabilitation facilities can lead to readmissions and complications including falls. Current EHR care-sets may not make a distinction between hospital and post-acute settings regarding diabetes management. The current diabetes management care-set in the EHR of our large healthcare system includes checking the blood sugar QID/AC/HS (before breakfast, lunch and dinner, and bedtime).
The geriatric population is at high risk of severe low blood glucose (LBG) events due to diminished homeostatic mechanisms, especially on hypoglycemic medications. Moderate to severe LBG events in these patients can contribute to behavior changes such as agitation, change in level of consciousness, disruption of sleep, instability and increased risk of myocardial infarction, stroke and falls. Rapid recognition and appropriate treatment and prevention of LBG and recurrences can reduce risk for hospitalization in the geriatric population.
Authors: Lee YM, Park SH, Lee DH Abstract OBJECTIVE: The aim of this paper is to propose a new hypothesis for the role of lipophilic chemical mixtures stored in adipose tissue in the development of dementia. Specifically, we present how the dynamics of these chemicals can explain the unexpected findings from the Action for Health in Diabetes (Look AHEAD) study, which failed to show long-term benefits of intentional weight loss on cognition, despite substantial improvements in many known risk factors for dementia. Moreover, we discuss how the role of obesity in the risk of dementia can change depending on the dynami...
New brain imaging evidence of people who experience an ischemic stroke reveals differences between men and women.Medscape Medical News
Authors: Medeiros MC, Rocha N, Bandeira E, Dantas I, Chaves C, Oliveira M, Bandeira F Abstract Sclerostin (Scl) is an osteoblast-inhibiting glycoprotein that is secreted mainly by osteocytes and is regulated by hormonal changes and skeletal loading. Decreased physical function and high serum Scl concentrations have been reported in chronic renal failure patients but little is known to date about the differences between diabetic and non-diabetic patients on hemodialysis who are susceptible to both sarcopenia and bone fragility. Objective.To determine the prevalence of sarcopenia and its association with serum Scl co...
Publication date: Available online 25 February 2020Source: The Lancet Diabetes &EndocrinologyAuthor(s): Ida Pernicova, Stephen Kelly, Sharon Ajodha, Anju Sahdev, Jonathan P Bestwick, Plamena Gabrovska, Olufunso Akanle, Ramzi Ajjan, Blerina Kola, Marietta Stadler, William Fraser, Mirjam Christ-Crain, Ashley B Grossman, Costantino Pitzalis, Márta Korbonits
Publication date: Available online 25 February 2020Source: The Lancet Diabetes &EndocrinologyAuthor(s): Martin Reincke