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Effects of Astaxanthin on Oxidative Stress in Overweight and Obese Adults Phytotherapy Research, 04/15/11

Choi HD et al. ? This study revealed that supplemental astaxanthin (ASX) for 3 weeks improved oxidative stress biomarkers by suppressing lipid peroxidation and stimulating the activity of the antioxidant defense system. Methods A prospective, randomized, double–blind study was performed to investigate the effect of astaxanthin (ASX), which is known to be a potent antioxidant, on oxidative stress in overweight and obese adults in Korea. Twenty–three adults with BMI > 25.0 kg/m2 enrolled in this study and were randomly assigned to two dose groups: ASX 5 mg and 20 mg once daily for 3 weeks. Malondialdehyde (MDA), isoprostane (ISP), superoxide dismutase (SOD) and total antioxidant capacity (TAC), as oxidative stress biomarkers, were measured at baseline and 1, 2 and 3 weeks after ASX administration. Results Compared with baseline, the MDA (by 34.6% and 35.2%) and ISP (by 64.9% and 64.7%) levels were significantly lowered, whereas SOD (by 193% and 194%) and TAC (by 121% and 125%) levels were significantly increased in two dose groups after the 3 week intervention. Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Parental overweight/obesity, social factors, and child overweight/obesity at 7 years of age Pediatrics International, 04/07/11 Cardiovascular risk factors attributable to obesity and overweight in Switzerland Nutrition, Metabolism & Cardiovascular Diseases, 04/14/11 Stress in obesity: Cause or consequence

 

 

Dementia in Parkinsons Disease Current Treatment Options in Neurology, 04/14/11

Kurtz AL et al. ? Parkinsonian motor signs that are accompanied by clinically significant cognitive impairment should be treated with carbidopa/levodopa only, as dopamine agonists and other antiparkinsonian medications generally carry a higher risk of provoking or exacerbating psychotic symptoms. Minimizing sedating medications during the day and promoting nocturnal sleep may help the daytime sleepiness; melatonin, clonazepam, gabapentin, and possibly memantine may be useful in treating REM sleep behavior disorder. Orthostatic hypotension can be managed with various nonpharmacologic interventions, and if needed, fludrocortisone and pyridostigmine. Midodrine should be used cautiously, if at all. Dementia in Parkinson?s disease encompasses a spectrum relating to motor, psychiatric, and cognitive symptoms that are classified as either Dementia with Lewy Bodies (DLB) (initial cognitive symptoms) or Parkinson?s Disease Dementia (PDD) (initial motor signs preceding cognitive symptoms by at least a year). Anticholinergic and antipsychotic drugs have a high risk of adverse cognitive and/or motor effects, so their use should be minimized or avoided. Neuroleptic sensitivity is a severe psychomotor adverse reaction that is particularly associated with potent dopamine-blocking agents such as haloperidol. It occurs in up to 50% of individuals with PDD or DLB. Mild psychotic symptoms should first be addressed by reducing anticholinergic and/or dopaminergic agents, if possible. Patients with psychotic symptoms that threaten the safety of the patient or caregiver may benefit from treatment with quetiapine or, in refractory cases, clozapine. Cholinesterase inhibitors as a drug class have been shown to have beneficial effects on cognition in DLB and PDD, and may help to alleviate some psychiatric symptoms, such as apathy, anxiety, hallucinations, and delusions. Memantine may help to moderate cognitive symptoms in DLB and PDD, although current data suggest a more variable response, particularly in PDD. Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Almitrine-Raubasine combination for dementia Cochrane Reviews, 04/06/11 Ventricular dilatation and brain atrophy in patients with Parkinsons disease with incipient dementia Movement Disorders, 03/29/11 How to evaluate quality of care from the perspective of people with dementia: An overview of the literature Dementia, 03/14/11

Your Article Summary Rhythm- and Rate-Controlling Effects of Dronedarone in Patients With Atrial Fibrillation (from the ATHENA Trial) The American Journal of Cardiology, 03/29/11

Richard L. Page et al. - Dronedarone demonstrated both rhythm- and rate-controlling properties in ATHENA and reduced the risk for first cardiovascular hospitalization or death from any cause. The effects are likely to contribute to the reduction of important clinical outcomes observed in this trial. Methods This was a Placebo-Controlled, Double-Blind, Parallel Arm Trial. Patients were randomized to dronedarone 400 mg twice daily (n = 2,301) or placebo (n = 2,327). Electrocardiographic tracings were classified for atrial fibrillation (AF) or atrial flutter (AFL) or sinus rhythm. Patients with AF or AFL on every postbaseline electrocardiogram were classified as having permanent AF or AFL. All electrical cardioversions were documented. The use of rate-controlling medications was equally distributed in the 2 treatment groups. Results The median time to first AF or AFL recurrence of patients in sinus rhythm at baseline was 498 days in placebo patients and 737 days in dronedarone patients (hazard ratio 0.749, 95% confidence interval 0.681 to 0.824, p <0.001). In the dronedarone group, 339 patients (15%) had >=1 electrical cardioversion, compared to 481 (21%) in the placebo group (hazard ratio 0.684, 95% confidence interval 0.596 to 0.786, p <0.001). The likelihood of permanent AF or AFL was lower with dronedarone (178 patients [7.6%]) compared to placebo (295 patients [12.8%]) (p <0.001). At the time of first AF or AFL recurrence, the mean heart rates were 85.3 and 95.5 beats/min in the dronedarone and placebo groups, respectively (p <0.001). Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Dronedarone for atrial fibrillation: How does it compare with amiodarone Cleveland Clinic Journal of Medicine, 03/03/11 Irbesartan in Patients with Atrial Fibrillation New England Journal of Medicine, 03/17/11 Irregular Heart Beat Plus Stroke May Increase Dementia Risk MedLinePlus, 03/09/11

Your Article Summary Calcium Citrate and Vitamin D in the Treatment of Osteoporosis Clinical Drug Investigation, 04/07/11

Quesada Gomez JM et al. ? Calcium citrate formulations taken between meals may help to prevent abdominal distension and flatulence, as well as minimize the risk of renal calculus formation, thus helping to optimize patient compliance. Therefore, calcium citrate combined with vitamin D is the combination of choice for the prevention or treatment of osteoporosis. The combination of calcium with vitamin D (vitamin D3 [colecalciferol]) forms the basis of preventive and therapeutic regimens for osteoporosis. A number of studies have suggested that the combination of calcium and vitamin D is effective when administered at respective dosages of at least 1200 mg and 800 IU per day, although efficacy is, as expected, affected by patient compliance. Treatment with this combination appears to be effective in reducing the incidence of non-vertebral and hip fractures. Also, in all drug studies (of antiresorptive and anabolic agents and strontium ranelate) that demonstrated a reduction in risk of osteoporotic fractures, patients also took calcium and vitamin D supplements. An important finding in this regard is that vitamin D levels have been demonstrated to be inadequate in more than half of women treated for osteoporosis in the US and Europe. The capacity of the small intestine to absorb calcium salts depends on the solubility and ionization of the salts. These properties vary for different salts, with fasting calcium citrate absorption being greater than that of calcium lactogluconate and calcium carbonate. Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Use of bisphosphonate and risk of atrial fibrillation in older women with osteoporosis Osteoporosis International, 03/30/11 Prevalence of osteoporosis and vertebral fractures in postmenopausal women with type 2 diabetes mellitus and their relationship with duration of the disease and chronic complications Journal of Diabetes and its Complications, 04/05/11 Role of zoledronic acid in the prevention and treatment of osteoporosis Clinical Interventions in Aging, 04/01/11

Your Article Summary Treatment satisfaction and persistence among postmenopausal women on osteoporosis medications: 12-month results from POSSIBLE US Osteoporosis International, 04/15/11

Barrett-Connor E et al. ? Lower treatment satisfaction was associated with a 22% (1/0.82) to 67% (1/0.60) increased risk of discontinuation/switching osteoporosis medication during 1 year of follow-up. Methods Data from 2,405 participants in Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBLE US?) Study evaluated Cox proportional hazards regression used to estimate HR for association between treatment satisfaction at study entry and self-reported discontinuation/switching of pharmacologic PMO medications over 1-year follow-up period Logistic regression used to evaluate relationships between treatment satisfaction, lifestyle behaviors, and compliance with bisphosphonate dosing instructions Results Median TSQM scores highest (indicating greatest satisfaction) for SE domain [n=1,182; median=87.5 (Q1=75.0, Q3=100.0)] and lowest for global satisfaction [n=2,340; median=64.0 (Q1=55.7, Q3=77.7)] Median scores decreased for SE and global satisfaction domains as patient-reported SE severity increased Women with higher satisfaction less likely to discontinue/switch medications than women with lower scores (adjusted HRs for convenience 0.73, 95% CI=0.63?0.85; effectiveness 0.82, 95% CI=0.70?0.97; and global satisfaction 0.73, 95% CI=0.63?0.85) Lower treatment satisfaction particularly influential among women reported moderate/severe SE (HR=0.60, 95% CI=0.37?0.97) Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Bisphosphonates for postmenopausal osteoporosis Bone , 03/18/11 Validation of the adherence evaluation of osteoporosis treatment (ADEOS) questionnaire for osteoporotic post-menopausal women Osteoporosis International, 04/12/11 Lasofoxifene: Selective estrogen receptor modulator for the prevention and treatment of postmenopausal osteoporosis Annals of Pharmacotherapy, 04/07/11

Your Article Summary Denosumab and bisphosphonates: Rivals or potential partners? A hybrid molecule hypothesis Medical Hypotheses, 04/12/11

Anastasilakis AD et al. – The authors hypothesize that bisphosphonates could serve as a vehicle for the delivery of denosumab selectively to the skeleton. Thus, the effect on the immune system could be minimized, along with a potential increase in the antiresorptive efficacy, as a result of the combined action of denosumab and the bisphosphonate on the earlier and later stages of osteoclast life, respectively. Bisphosphonates are well established as the treatment of choice for disorders of excessive bone resorption, including osteoporosis. They bind bone mineral with high affinity and through internalization by the resorbing osteoclasts, affect their function and survival. Receptor activator of nuclear factor–kB ligand (RANKL) is a cytokine essential for osteoclast differentiation, activation, and survival. Denosumab, a human monoclonal antibody that neutralizes RANKL, constitutes a promising antiresorptive agent for osteoporosis treatment. However, its presumable interaction with the immune system could adversely affect immune response resulting in increased risk of infections. Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Use of bisphosphonate and risk of atrial fibrillation in older women with osteoporosis Osteoporosis International, 03/30/11 Calcium Citrate and Vitamin D in the Treatment of Osteoporosis Clinical Drug Investigation, 04/08/11 Prevalence of osteoporosis and vertebral fractures in postmenopausal women with type 2 diabetes mellitus and their relationship with duration of the disease and chronic complications Journal of Diabetes and its Complications, 04/05/11

Your Article Summary Undertreatment of osteoporosis in persons with dementia? A population-based study Osteoporosis International, 04/18/11

Haasum Y et al. ? The results indicate an undertreatment of osteoporosis in persons with dementia, although osteoporotic fractures are common among these patients. Methods The authors analyzed data from the baseline examination (2001?2004) of The Swedish National Study on Aging and Care– Kungsholmen (SNAC–K), Stockholm, Sweden. Participants were aged ≥66 years (n=2610). The authors analysed the use of bisphosphonates, raloxifene, and calcium/vitamin D combinations in relation to clinically based dementia diagnosis. Information about osteoporotic fractures during the previous 4 years was obtained from the Swedish National Patient Register. They used logistic regression to analyze the association between dementia status and use of osteoporosis drugs. Results Osteoporosis drugs (mainly calcium/vitamin D combinations) were used by 5% of the persons with dementia and 12% of the persons without dementia. Furthermore, 25% of the persons with dementia and 7% of the persons without dementia had had at least one osteoporotic fracture during the past 4 years. After controlling for age, sex, osteoporotic fractures, and type of housing (own home or institution), persons with dementia were less likely to use osteoporosis drugs than persons without dementia (OR=0.34; 95% CI, 0.19?0.59). Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Use of bisphosphonate and risk of atrial fibrillation in older women with osteoporosis Osteoporosis International, 03/30/11 Treatment satisfaction and persistence among postmenopausal women on osteoporosis medications: 12-month results from POSSIBLE US Osteoporosis International, 04/15/11 Calcium Citrate and Vitamin D in the Treatment of Osteoporosis Clinical Drug Investigation, 04/08/11

Your Article Summary Aliskiren vs. Angiotensin Receptor Blockers in Hypertension: Meta-Analysis of Randomized Controlled Trials American Journal of Hypertension, 04/21/11

Gao D et al. - Aliskiren is as effective as angiotensin receptor blockers (ARBs) (losartan, valsartan, and irbesartan) in controlling blood pressure (BP) and does not differ from ARBs in risk of adverse events. Methods Reports of randomized controlled trials (RCTs) comparing aliskiren and ARBs in patients with hypertension were selected by a search of the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. The main outcome measures were reduction in diastolic BP (DBP) and systolic BP (SBP) and rates of therapeutic response and BP control. The authors also compared the tolerability of aliskiren and ARBs. Revman v5.0 was used to obtain the pooled estimates. Results The authors analyzed data from 10 reports of trials involving 3,732 participants. DBP and SBP reduction did not differ between aliskiren and ARBs (weighted mean difference (WMD), -0.18; 95% confidence interval (CI), -1.07 to 0.71, and WMD, 0.15; 95% CI, -1.38 to 1.69, respectively). Aliskiren and ARB treatment did not differ in rates of BP control or therapeutic response. Moreover, aliskiren and ARB treatment led to a similar number of adverse events, severe adverse events, and withdrawal due to adverse events. Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties.

Other articles in Internal Medicine >> Click here to see the complete list Age-dependent gender differences in hypertension management Journal of Hypertension, 04/08/11 Bevacizumab-related arterial hypertension as a predictive marker in metastatic colorectal cancer patients Cancer Chemotherapy and Pharmacology, 04/11/11 Endothelial dysfunction, platelet activation, thrombogenesis and fibrinolysis in patients with hypertensive crisis Journal of Hypertension, 04/11/11