Restoration of energy homeostasis by SIRT6 extends healthy lifespan

Aging leads to a gradual decline in physical activity and disrupted energy homeostasis. The NAD+-dependent SIRT6 deacylase regulates aging and metabolism through mechanisms that largely remain unknown. Here, we show that SIRT6 overexpression leads to a reduction in frailty and lifespan extension in both male and female B6 mice. A combination of physiological assays, in vivo multi-omics analyses and 13C lactate tracing identified an age-dependent decline in glucose homeostasis and hepatic glucose output in wild type mice. In contrast, aged SIRT6-transgenic mice preserve hepatic glucose output and glucose homeostasis through an improvement in the utilization of two major gluconeogenic precursors, lactate and glycerol. To mediate these changes, mechanistically, SIRT6 increases hepatic gluconeogenic gene expression, de novo NAD+ synthesis, and systemically enhances glycerol release from adipose tissue. These findings show that SIRT6 optimizes energy homeostasis in old age to delay frailty and preserve healthy aging

Demographics of extra-articular calcaneal fractures: Including a review of the literature on treatment and outcome

Introduction: Extra-articular calcaneal fractures represent 25-40% of all calcaneal fractures and an even higher percentage of up to 60% is seen in children. A disproportionately small part of the literature on calcaneal fractures involves the extra-articular type. The aim of this study was to investigate the incidence of extra-articular calcaneal fractures in a Level 1 trauma centre, define the distribution of the various types of fractures and compare patient demographics between extra- and intra-articular calcaneal fractures. In addition the literature was reviewed for the most common types of extra-articular calcaneal fractures with regard to incidence, treatment and clinical outcome. Methods: The radiological records between 2003 and 2005 were reviewed for intra- and extra-articular calcaneal fractures. Patient gender-distribution and age were compared. A literature search was conducted for the treatment of extra-articular calcaneal fractures. Results: In this 3-year study period a total of 49 patients with 50 extra-articular calcaneal fractures and 91 patients with 101 intra-articular fractures were identified. The median age for the first group was 32.7 years, and for the second group 40.3 years; P = 0.04. Male predominance was significantly less pronounced for extra-articular (63%) compared with intra-articular fractures (79%; P = 0.04). Conclusion: One-third of all calcaneal fractures are extra-articular. Significant differences exist between the intra- and extra-articular groups, in terms of lower age and male-female ratio. The literature study shows inconsistencies in treatment options, but most extra-articular fractures are well manageable conservatively

Dénutrition protéino-énergétique du sujet âgé (dépistage, surveillance, mise en place d'un protocole de renutrition dans une structure EHPAD)

PARIS7-Xavier Bichat (751182101) / SudocSudocFranceF

Embolie pulmonaire (apport du scaner multibarrette)

PARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF

The anterior tarsal tunnel syndrome: a case Report

peer reviewedLe syndrome tarsien antérieur constitue une neuropathie canalaire rare, impliquant le nerf fibulaire profond, au niveau de son passage sous le rétinaculum inférieur des extenseurs. Régulièrement méconnu, il engendre errance diagnostique et retard de traitement. Nous rapportons le cas d’un patient de 77 ans se plaignant de symptômes d’un syndrome tarsien antérieur, avec douleurs neuropathiques du cou de pied, sans déficit sensitivo-moteur. L’étude électroneuromyographique objective l’atteinte motrice du nerf fibulaire profond. L’IRM de la cheville a mis en évidence une excroissance osseuse millimétrique du pôle supérieur du naviculaire, effectivement irritative pour le nerf fibulaire profond. L’infiltration de l’excroissance du naviculaire a entraîné une réduction partielle et temporaire de la symptomatologie douloureuse. Une intervention chirurgicale de décompression nerveuse a ensuite été envisagée.The anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the inferior extensor retinaculum of the ankle. It is unrecognized and may lead to misdiagnosis and delayed treatment. We report the case of a 77 years old patient complaining of anterior tarsal tunnel syndrome’s symptoms with neuropathic pain located at the dorsal part of the foot without any sensorimotor loss. The electroneuromyography was in favour of the motor impairment of the deep peroneal nerve. MRI exploration of the ankle showed a millimetric bony overgrowth of the upper pole of the navicular irritative to the deep peroneal nerve. Infiltration at overgrowth of the navicular provided a partial and temporary decrease in pain symptoms. Surgical nerve decompression was then considered

Anterior cruciate ligament surgery in the rabbit

BACKGROUND: Various methods regarding allograft knee replacements have been described. The animal models, which are generally used for this purpose include sheep, dogs, goats, and pigs, and accrue significant costs for study protocols. The authors herein describe an efficient and cost-effective model to study either native or tissue-engineered allografts for anterior cruciate ligament (ACL) replacement in a New Zealand rabbit model with the potential for transgenic and cell migration studies. METHODS: ACL reconstructions were performed in rabbits under general anesthesia. For fresh allograft implantations, two animals were operated in parallel. Each right extensor digitorum longus tendon was harvested and prepared for implantation. After excision of the ACL, tibial and femoral bone tunnels were created to implant each graft in the native ACL position. RESULTS: During a 2-year period, the authors have successfully undertaken this surgery in 61 rabbits and have not noticed any major complications attributed to this surgical technique. In addition, the authors have observed fast recovery in the animals postoperatively. CONCLUSION: The authors recommend this surgical procedure as an excellent model for the study of knee surgery