The mobility gap between older men and women: the embodiment of gender.

OBJECTIVES: To present the study design and baseline results of the longitudinal International Mobility in Aging Study (IMIAS) on gender differences in physical performance and mobility disability prevalence in five diverse societies. METHODS: Data are from surveys on random samples of people aged 65-74 years at Canadian (Kingston, Ontario; Saint-Hyacinthe, Quebec), Mediterranean (Tirana, Albania) and Latin American sites (Natal, Brazil; Manizales, Colombia) (N=1995). Mobility disability was defined as reporting difficulty in walking 400m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. The short physical performance battery (SPPB) was used to assess physical performance. Poisson regression models were fitted to estimate prevalence ratios. RESULTS: Age-adjusted prevalence of low SPPB, mobility disability and ADL disability were higher in women than in men in all sites except for Kingston. After adjustment for education and income, gender differences in SPPB and ADL disability attenuated or disappeared in Saint-Hyacinthe and Manizales but remained large in Tirana and Natal and mobility disability remained more frequent in women than in men at all sites except Kingston. After further adjustment by chronic conditions and depressive symptoms, gender differences in mobility remained large at all sites except Kingston but only in Tirana did women have significantly poorer physical performance than men. DISCUSSION: Results provide evidence for gender as a risk factor to explain poorer physical function in women and suggest that moving toward gender equality could attenuate the gender gap in physical function in old age.

Ovulation requires the activation on proestrus of M1 muscarinic receptors in the left ovary.

We analyzed the effects of chemically blocking type 1 muscarinic receptors (M1R) on either the left or right ovary on ovulation rate, number of ova shed and steroid hormones levels. M1R were unilaterally blocked in ovary with the M1R selective antagonist pirenzepine (PZP). PZP was delivered into the bursa ovarica of the left or right ovary of adult rats at 13:00 h on proestrus day. PZP treatment in the left but not in the right ovary blocked ovulation. PZP did not modify the number of ova shed, nor progesterone or 17ß-estradiol serum levels. The surge of luteinizing hormone levels was diminished while that of follicle-stimulating hormone did not change in animals treated with PZP in the left ovary. Interestingly, treatment with either synthetic luteinizing hormone-releasing hormone or human chorionic gonadotropin 1 h after PZP administration in the left ovary restored ovulation in both ovaries. The presence of M1R protein in the theca cells of the ovarian follicles as well as in cells of the corpus luteum was detected on proestrus day. These results suggest that M1R activation in the left ovary is required for pre-ovulatory gonadotropin-releasing hormone (GnRH) secretion and ovulation. Furthermore, these results also suggest that M1R in the left ovary might be regulating ovulation asymmetrically through a stimulatory neural signal relayed to the hypothalamus via the vagus nerve to induce the GnRH secretion which then triggers ovulation.

Evaluación del tratamiento de fracturas cerradas de la diáfisis de la tibia con clavos intramedulares fresados y no fresados / Evaluation of the treatment of open and closed fractures of the tibial shaft

Objetivos: Comparar el resultado clínico y radiológico de las fracturas cerradas de la tibia a dos esquemas de manejo quirúrgico: clavos intramedulares fresados y clavos intramedulares no fresados. Métodos: Pacientes que ingresaron al servicio de urgencias entre el 1 de enero de 1998 y el 31 de diciembre de 1999 fueron aleatorizados a dos tratamientos, clavos intramedulares fresados y clavos intramedulares no fresados. Los pacientes fueron seguidos durante dos oportunidades en el primer mes después de la cirugía y al menos en nueve oportunidades cada mes. El seguimiento consistió en la evaluación clínica del dolor, movilidad articular de la rodilla y tobillo y del grado de apoyo del miembro inferior, además del seguimiento radiológico mensual en la búsqueda de la aparición de callo óseo, remodelación y consolidación total de la fractura. Análisis de sobrevida de Kaplan Meyer, fueron realizados para comparar la respuesta en cada uno de los grupos. Resultados: Un total de 104 pacientes fueron seguidos. Solo tres pérdidas se presentaron durante el seguimiento. Los dos grupos de pacientes fueron similares en las características al ingreso. Los resultados clínicos muestran que los pacientes que recibieron los clavos fresados apoyaron el miembro inferior más temprano, promedio 130 días, que los que recibieron los no fresados, promedio 141 días (p=0,02). No se encontraron diferencias en la incidencia de dolor y en el tiempo hasta la recuperación total de la movilidad articular de la rodilla y el tobillo. La proporción de pacientes que consolidan la fractura fue significativamente mayor para el grupo que recibió el clavo fresado después del 5 mes. La aparición de callo óseo se presentó mas temprano en el grupo fresado, pero las diferencias no fueron significativas después del segundo mes de seguimiento. Las complicaciones tardías se presentaron con mas frecuencia en el grupo no fresado pero las diferencias no fueron significativas