Friday Facts, July 30, 2010, Vol. 65

Bureau of Nutrition and Health Promotion part of the Iowa Department of Public Health produces of weekly newsletter about the Iowa WIC Program for the State of Iowa citizen.

Retinal pigment epithelium protein of 65 kDA gene-linked retinal degeneration is not modulated by chicken acidic leucine-rich epidermal growth factor-like domain containing brain protein/Neuroglycan C/ chondroitin sulfate proteoglycan 5.

PURPOSE: To analyze in vivo the function of chicken acidic leucine-rich epidermal growth factor-like domain containing brain protein/Neuroglycan C (gene symbol: Cspg5) during retinal degeneration in the Rpe65⁻/⁻ mouse model of Leber congenital amaurosis. METHODS: We resorted to mice with targeted deletions in the Cspg5 and retinal pigment epithelium protein of 65 kDa (Rpe65) genes (Cspg5⁻/⁻/Rpe65⁻/⁻). Cone degeneration was assessed with cone-specific peanut agglutinin staining. Transcriptional expression of rhodopsin (Rho), S-opsin (Opn1sw), M-opsin (Opn1mw), rod transducin α subunit (Gnat1), and cone transducin α subunit (Gnat2) genes was assessed with quantitative PCR from 2 weeks to 12 months. The retinal pigment epithelium (RPE) was analyzed at P14 with immunodetection of the retinol-binding protein membrane receptor Stra6. RESULTS: No differences in the progression of retinal degeneration were observed between the Rpe65⁻/⁻ and Cspg5⁻/⁻/Rpe65⁻/⁻ mice. No retinal phenotype was detected in the late postnatal and adult Cspg5⁻/⁻ mice, when compared to the wild-type mice. CONCLUSIONS: Despite the previously reported upregulation of Cspg5 during retinal degeneration in Rpe65⁻/⁻ mice, no protective effect or any involvement of Cspg5 in disease progression was identified.

Evolution du contrôle des facteurs de risque cardiovasculaire chez les patients coronariens de 65 ans

Cette étude rétrospective a eu pour but de comparer la prise en charge des patients coronariens de 65 ans et plus, au sortir d'un séjour à la Clinique de réhabilitation cardiaque de Genolier, et ce conformément aux recommandations publiées successivement par les sociétés européennes et américaines de cardiologie entre 1994 et 1999. La comparaison entre les deux périodes d'observation (1994-1995 et 1999-2000) chez les 342 patients étudiés, a montré une amélioration de la prise en charge des facteurs de risque cardiovasculaire. L'augmentation de la prescription de statines en est l'exemple le plus démonstratif. Cependant, les données recueillies indiquent qu'il existe une sous-utilisation des médicaments cardioprotecteurs chez ces patients à haut risque et qui bénéficieraient, par conséquent, le plus d'une prise en charge optimale des facteurs de risque cardiovasculaire. L'élaboration d'un protocole commun de prise en charge de la maladie coronarienne à disposition du réseau des centres spécialisés devrait permettre d'améliorer la qualité des soins par une comparaison de leur pratique respective.

Airway stenting with the LT-Mold? for severe glotto-subglottic stenosis or intractable aspiration: experience in 65 cases.

The purpose of this study was to assess the safety and efficacy of stenting in upper airway reconstructions for benign laryngotracheal stenosis (LTS) with a newly designed prosthesis, the LT-Mold?. The LT-Mold and its proper use during open surgery and endoscopy are described, and the experience gathered from a prospectively collected database on 65 patients treated for complex LTS or severe aspiration is reported. This series is compared to the results of other stenting methods. All patients were available for evaluation. In all but one case, the prosthesis was removed at the end of the study. The new prosthesis did not induce any stent-related trauma to the supraglottis, glottis and subglottis. Before adding a distal round-shaped silicone cap to the LT-Mold, granulation tissue was usually seen at the stent-mucosal interface at the tracheostoma level. In 14 cases, there has been a spontaneous extrusion of the prosthesis through the mouth; this problem was solved by fixing the prosthesis through the reinforced portion of the prosthesis at the cap level and by adding one fixation stitch in the supraglottis. We have to document the loss of the silicone cap in three cases. This problem was resolved by designing a new prototype with an integrated cap, glued with a slow hardening silicone glue. Fifty-four (83 %) of 65 patients were decannulated after a mean duration of stenting of 3 months (range 1-12 months). The mean follow-up after decannulation was 23 months (range 1 month to 10 years). The experience gathered with the LT-Mold shows that long-term stenting for complex LTS is safely achieved when the prosthesis is used with its distal integrated silicone cap. The softness and smoothness of the prosthesis with a round-shaped configuration of both extremities help avoid ulceration and granulation tissue formation in the reconstructed airway. Adequate fixation is mandatory to avoid extrusion.

Programa para la disminución del incumplimiento terapéutico en las personas mayores de 65 años

Actualmente, en nuestra sociedad, el incumplimiento terapéutico es un problema de salud a nivel nacional y que va en aumento. La Organización Mundial de la Salud (OMS) considera la falta de adherencia a los tratamientos crónicos y sus consecuencias negativas clínicas y económicas un tema prioritario en salud; se considera al paciente anciano polimedicado como la principal diana de actuación. En el año 2012 se pasó una encuesta a población estadounidense mayor de 65 años, y un 57% de los encuestados admitieron que se olvidan de tomar alguno de sus medicamentos. También se debe señalar que dentro de este grupo se encuentran pacientes con déficits neurológicos, algunos de los cuales a veces no están diagnosticados y son los únicos responsables de su medicación. En algunos casos puede suceder que esta persona sea además la responsable de la medicación del familiar más cercano.

The Annals of Iowa, Spring/Summer 2006, Vol. 65, nos. 2-3

A quarterly journal of Iowa authors and their works produced by State Historical Society of Iowa. Special Commemorative Issue: Mormon Handcraft Trek

The Annals of Iowa, Winter 2006, Vol. 65, no. 1

A quarterly journal of Iowa authors and their works produced by State Historical Society of Iowa.

The Annals of Iowa, Fall 2006, Vol. 65, no. 4

A quarterly journal of Iowa authors and their works produced by State Historical Society of Iowa.

Alcohol use and frailty in community-dwelling older persons aged 65 to 70 years.

Background: Alcohol use has beneficial as well as adverse consequences on health, but few studies examined its role in the development of age-related frailty. Objectives: To describe the cross-sectional and longitudinal association between alcohol intake and frailty in older persons. Design: The Lausanne cohort 65+ population-based study, launched in 2004. Setting: Community. Participants: One thousand five hundred sixty-four persons aged 65-70 years. Measurements: Annual data collection included demographics, health and functional status, extended by a physical examination every 3 years. Alcohol use (AUDIT-C), and Fried's frailty criteria were measured at baseline and 3-year follow-up. Participants were categorized into robust (0 frailty criterion) and vulnerable (1+ criteria). Results: Few participants (13.0%) reported no alcohol consumption over the past year, 57.8% were light-to-moderate drinkers, while 29.3% drank above recommended thresholds (18.7% "at risk" and 10.5% "heavy" drinkers). At baseline, vulnerability was most frequent in non-drinkers (43.0%), least frequent in light-to-moderate drinkers (26.2%), and amounted to 31.9% in "heavy" drinkers showing a reverse J-curve pattern. In multivariate analysis, compared to light-to-moderate drinkers, non-drinkers had twice higher odds of prevalent (adjOR: 2.24; 95%CI:1.39-3.59; p=.001), as well as 3-year incident vulnerability (adjOR: 2.00; 95%CI:1.02-3.91; p=.043). No significant association was observed among "at risk" and "heavy" drinkers. Conclusion: Non-drinkers had two-times higher odds of prevalent and 3-year incident vulnerability, even after adjusting for their baseline poorer health status. Although residual confounding is still possible, these results likely reflect a healthy survival effect among drinkers while those who experienced health- or alcohol-related problems stopped drinking earlier.

Les courts-séjours médico-sociaux dans le canton de Vaud : expériences des usagers de 65 ans et plus

La prestation court-séjour est proposée dans le canton de Vaud depuis 1984. Elle s'inscrit dans la volonté des services publics de permettre aux personnes, âgées notamment, de vivre à domicile le plus longtemps possible. Il s'agit d'accueillir temporairement en établissement médico-social (EMS) ou en division C d'un hôpital, les personnes momentanément affaiblies à la suite d'une hospitalisation ou d'un problème de santé, mais aussi des personnes durablement atteintes dans leur santé, en particulier pour donner quelques jours ou semaines de répit à leur entourage. En 2013, afin de faire un bilan de cette prestation et démarrer une phase de réflexion quant aux améliorations qui pourraient lui être apportées, le Service des assurances sociales et de l'hébergement (SASH) a mandaté l'Institut universitaire de médecine sociale et préventive (IUMSP) pour la réalisation d'une enquête sur l'expérience des usagers des courts-séjours dans le canton de Vaud.