Effect of Fenofibrate Medication on Renal Function / 가정의학회지

BACKGROUND: Fibrates are widely used to treat hypertriglyceridemia, a risk factor for arteriosclerosis, but these compounds have been associated with renal dysfunction. This study aimed to investigate the effects of fibrates on renal function in relatively healthy adult subjects with no cardiovascular diseases. METHODS: This retrospective study included 558 outpatients who were prescribed 160 mg fenofibrate (fenofibrate group) or 10 mg atorvastatin (control group) between August 2007 and October 2015. The groups were randomly matched using propensity scores at a 1:1 ratio. Serum creatinine levels and estimated glomerular filtration rates before and after treatment were compared between the two groups. RESULTS: Patients in the fenofibrate group showed greater changes in serum creatinine levels than those in the control group (9.73%±9.83% versus −0.89%±7.37%, P<0.001). Furthermore, 55.1% of patients in the fenofibrate group, but only 6.1% of those in the control group, exhibited a serum creatinine level increase ≥0.1 mg/dL (P<0.001). The fenofibrate group showed significantly greater declines in the estimated glomerular filtration rate than the control group (−10.1%±9.48% versus 1.42%±9.42%, P<0.001). Moreover, 34.7% of the fenofibrate group, but only 4.1% of the control group, exhibited an estimated glomerular filtration rate decrease ≥10 mL/min·1.73 m² (P<0.001). CONCLUSION: Fenofibrate treatment resulted in increased serum creatinine levels and reduced estimated glomerular filtration rates in a primary care setting. Therefore, regular renal function monitoring should be considered essential during fibrate administration.

Effects of Sleep on Balance Control and Reaction Time to Visual Stimuli / 수면정신생리

OBJECTIVES: To find evidence that sleep is necessary for normal brain function, thus indicating that declines in both sleep quality and quantity are related to worse performance of many daily tasks and deteriorated physical functions. The present study investigates the relationships of balance control and reaction time with sleep quality. METHODS: 58 healthy (male 20, female 38) volunteers with informed consent participated in this study. The Self-reported Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality and relevant factors, and the subjects were divided into groups A (PSQI < 5) and B (PSQI ≥ 5) based on this index. Static balance control and reaction time to visual stimuli were conducted to assess their relationship with sleep quality. RESULTS: Group B exhibited excessive daytime sleepiness significantly more often compared to group A. Static balance control did not markedly change relative to sleep quality, but reaction time and error to visual stimuli were significantly increased in group B compared to group A. CONCLUSION: These findings indicate that a decline in sleep quality can result in delayed reactions, as well as decreased accuracy of these reactions. They also suggest that low sleep quality may be associated with changes in physical functions, including balance control through reduced selective attention.

Differential expression of caveolins and myosin heavy chains in response to forced exercise in rats / 한국실험동물학회지

Exercise training can improve strength and lead to adaptations in the skeletal muscle and nervous systems. Skeletal muscles can develop into two types: fast and slow, depending on the expression pattern of myosin heavy chain (MHC) isoforms. Previous studies reported that exercise altered the distribution of muscle fiber types. It is not currently known what changes in the expression of caveolins and types of muscle fiber occur in response to the intensity of exercise. This study determined the changes in expression of caveolins and MHC type after forced exercise in muscular and non-muscular tissues in rats. A control (Con) group to which forced exercise was not applied and an exercise (Ex) group to which forced exercise was applied. Forced exercise, using a treadmill, was introduced at a speed of 25 m/min for 30 min, 3 times/day (07:00, 15:00, 23:00). Homogenized tissues were applied to extract of total RNA for further gene analysis. The expression of caveolin-3 and MHC2a in the gastrocnemius muscle of female rats significantly increased in the Ex group compared with the Con group (P<0.05). Furthermore, in the gastrocnemius muscle of male rats, the expression of MHC2x was significantly different between the two groups (P<0.05). There was an increased expression in caveolin-3 and a slightly decreased expression in TGFbeta-1 in muscular tissues implicating caveolin-3 influences the expression of MHC isoforms and TGFbeta-1 expression. Eventually, it implicates that caveolin-3 has positive regulatory function in muscle atrophy induced by neural dysfunction with spinal cord injury or stroke.

Factors Related to Bone Mineral Density in Menopausal Women Younger than 65 Years

BACKGROUND: Bone mineral density (BMD) screening guidelines for women younger than 65 years are inconsistent. We investigated BMD-related factors in postmenopausal women younger than 65 years to help clinicians identify which women in this age group should undergo this investigation. METHODS: The study subjects included 108 postmenopausal women, younger than 65 years, who visited one university hospital from January to June 2007 and had a BMD by DEXA. Information on socio-demographic characteristics, menarche, menopause, smoking, alcohol use, past history of fracture and diet were gathered using a self-reported questionnaire. Height and weight were measured. The association between each risk factor and BMD was assessed using Pearson's correlation and ANOVA test. Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis. RESULTS: In our subjects, age was negatively and body weight was positively correlated with BMD of lumbar spine and femur. The reproductive years was positively correlated with BMD of lumbar spine and past history of fragility fracture was negatively associated with BMD of femur. Moderate alcohol users had higher BMDs of lumbar spine and femur. CONCLUSIONS: In postmenopausal women younger than 65 years, age and body weight are major determinants of BMD of lumbar spine and femur, negatively and positively, respectively. Our data suggest women younger than 65 years with low lean body mass, past history of fracture, and premature menopause could be good candidates for BMD.

Factors Related to Bone Mineral Density in Menopausal Women Younger than 65 Years

BACKGROUND: Bone mineral density (BMD) screening guidelines for women younger than 65 years are inconsistent. We investigated BMD-related factors in postmenopausal women younger than 65 years to help clinicians identify which women in this age group should undergo this investigation. METHODS: The study subjects included 108 postmenopausal women, younger than 65 years, who visited one university hospital from January to June 2007 and had a BMD by DEXA. Information on socio-demographic characteristics, menarche, menopause, smoking, alcohol use, past history of fracture and diet were gathered using a self-reported questionnaire. Height and weight were measured. The association between each risk factor and BMD was assessed using Pearson's correlation and ANOVA test. Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis. RESULTS: In our subjects, age was negatively and body weight was positively correlated with BMD of lumbar spine and femur. The reproductive years was positively correlated with BMD of lumbar spine and past history of fragility fracture was negatively associated with BMD of femur. Moderate alcohol users had higher BMDs of lumbar spine and femur. CONCLUSIONS: In postmenopausal women younger than 65 years, age and body weight are major determinants of BMD of lumbar spine and femur, negatively and positively, respectively. Our data suggest women younger than 65 years with low lean body mass, past history of fracture, and premature menopause could be good candidates for BMD.

Successful general anesthesia for cervical spine fusion in a patient with spondyloepiphyseal dysplasia congenita: A case report

Spondyloepiphyseal dysplasia congenita (SEDC) is a kind of skeletal dysplasia, inheritable condition. The clinical features of SEDC are dwarfism, myopia with or without retinal detachment, coxa vara, thoracic dysplasia with respiratory failure and laryngotracheal stenosis. A point of particular concern to anesthetists is odontoid hypoplasia which, combined with ligamentous laxity, leads to atlantoaxial instability. We report successful general anesthesia for cervical spine fusion of a patient with SEDC.

A case involing anesthesia for middle cerebral artery-distal internal carotid artery bypass surgery for a ruptured cerebral aneurysm in a patient with a descending aortic dissection and who had previously undergone a bentall operation: A case report

We experienced a case of middle cerebral artery-distal internal carotid artery bypass surgery for treating a ruptured cerebral aneurysm in a 50-year-old female who also had a descending aortic dissection and a past history of receiving a Bentall operation for an ascending aortic dissection 7 years previously. The patient successfully underwent surgery and we report on this experience along with a brief review of the relevant literature.