155 research outputs found
Proportion of Osteoporotic Women Remaining at Risk for Fracture Despite Adherence to Oral Bisphosphonates
Background
Adherence to oral bisphosphonates is often low, but even adherent patients may remain at elevated fracture risk. The goal of this study was to estimate the proportion of bisphosphonate-adherent women remaining at high risk of fracture.
Methods
A retrospective cohort of women aged 50 years and older, adherent to oral bisphosphonates for at least two years was identified, and data were extracted from a multi-system health information exchange. Adherence was defined as having a dispensed medication possession ratio ≥ 0.8. The primary outcome was clinical occurrence of: low trauma fracture (months 7–36), persistent T-score ≤ − 2.5 (months 13–36), decrease in bone mineral density (BMD) at any skeletal site ≥ 5%, or the composite of any one of these outcomes.
Results
Of 7435 adherent women, 3110 had either pre- or post-adherent DXA data. In the full cohort, 7% had an incident osteoporotic fracture. In 601 women having both pre- and post-adherent DXA to evaluate BMD change, 6% had fractures, 22% had a post-treatment T-score ≤ − 2.5, and 16% had BMD decrease by ≥ 5%. The composite outcomes occurred in 35%. Incident fracture was predicted by age, previous fracture, and a variety of co-morbidities, but not by race, glucocorticoid treatment or type of bisphosphonate.
Conclusion
Despite bisphosphonate adherence, 7% had incident osteoporotic fractures and 35% had either fracture, decreases in BMD, or persistent osteoporotic BMD, representing a substantial proportion of treated patients in clinical practices remaining at risk for future fractures. Further studies are required to determine the best achievable goals for osteoporosis therapy, and which patients would benefit from alternate therapies
ECG Response of Koalas to Tourists Proximity: A Preliminary Study
Koalas operate on a tight energy budget and, thus, may not always display behavioral avoidance reaction when placed in a stressful condition. We investigated the physiological response of captive koalas Phascolarctos cinereus in a conservation centre to the presence of tourists walking through their habitat. We compared, using animal-attached data-recorders, the electrocardiogram activity of female koalas in contact with tourists and in a human-free area. One of the koalas in the tourist zone presented elevated heart rate values and variability throughout the recording period. The remaining female in the exhibit area showed a higher field resting heart rates during the daytime than that in the isolated area. In the evening, heart rate profiles changed drastically and both the koalas in the exhibit and in the tourist-free zones displayed similar field resting heart rates, which were lower than those during the day. In parallel, the autonomic nervous systems of these two individuals evolved from sympathetic-dominant during the day to parasympathetic-dominant in the evening. Our results report ECG of free-living koalas for the first time. Although they are preliminary due to the difficulty of having sufficient samples of animals of the same sex and age, our results stress out the importance of studies investigating the physiological reaction of animals to tourists
Parasite Zoonoses and Wildlife: Emerging Issues
The role of wildlife as important sources, reservoirs and amplifiers of emerging human and domestic livestock pathogens, in addition to well recognized zoonoses of public health significance, has gained considerable attention in recent years. However, there has been little attention given to the transmission and impacts of pathogens of human origin, particularly protozoan, helminth and arthropod parasites, on wildlife. Substantial advances in molecular technologies are greatly improving our ability to follow parasite flow among host species and populations and revealing valuable insights about the interactions between cycles of transmission. Here we present several case studies of parasite emergence, or risk of emergence, in wildlife, as a result of contact with humans or anthropogenic activities. For some of these parasites, there is growing evidence of the serious consequences of infection on wildlife survival, whereas for others, there is a paucity of information about their impact
Environmental and Climatic Determinants of Molecular Diversity and Genetic Population Structure in a Coenagrionid Damselfly
Identifying environmental factors that structure intraspecific genetic diversity
is of interest for both habitat preservation and biodiversity conservation.
Recent advances in statistical and geographical genetics make it possible to
investigate how environmental factors affect geographic organisation and
population structure of molecular genetic diversity within species. Here we
present a study on a common and wide ranging insect, the blue tailed damselfly
Ischnuraelegans, which has been the target of many
ecological and evolutionary studies. We addressed the following questions: (i)
Is the population structure affected by longitudinal or latitudinal gradients?;
(ii) Do geographic boundaries limit gene flow?; (iii) Does geographic distance
affect connectivity and is there a signature of past bottlenecks?; (iv) Is there
evidence of a recent range expansion and (vi) what is the effect of geography
and climatic factors on population structure? We found low to moderate genetic
sub-structuring between populations (mean
FST = 0.06,
Dest = 0.12), and an effect of longitude, but
not latitude, on genetic diversity. No significant effects of geographic
boundaries (e.g. water bodies) were found. FST-and
Dest-values increased with geographic distance; however, there was no
evidence for recent bottlenecks. Finally, we did not detect any molecular
signatures of range expansions or an effect of geographic suitability, although
local precipitation had a strong effect on genetic differentiation. The
population structure of this small insect has probably been shaped by ecological
factors that are correlated with longitudinal gradients, geographic distances,
and local precipitation. The relatively weak global population structure and
high degree of genetic variation within populations suggest that I.
elegans has high dispersal ability, which is consistent with this
species being an effective and early coloniser of new habitats
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