Psykoosilääkkeiden käyttö iäkkäillä : järjestelmällinen katsaus

VertaisarvioituLÄHTÖKOHDAT Psykoosilääkkeitä määrätään psykoosien lisäksi muistisairaiden käytöshäiriöihin. Tarkastelemme tässä järjestelmällisessä katsauksessa, mitä suomalaisten ikäihmisten psykoosilääkkeiden käytöstä tiedetään. MENETELMÄT Medline-tietokannasta valikoitui 27 artikkelia vuosilta 2000–2015. Selvitimme lääkkeiden käytön laajuutta ja riskejä sekä interventioita käytön järkeistämiseksi. TULOKSET Kotona asuvista iäkkäistä 3–14 % käytti psykoosilääkkeitä, muistisairaista 22–32 %. Laitoshoidossa käyttäjien osuus oli noin 40 % eikä muistisairaudella ollut vaikutusta. Lääkkeen aloittaneista noin 40 %:sta tuli pitkäaikaiskäyttäjiä. Perinteisistä psykoosilääkkeistä on siirrytty atyyppisiin. Käytöllä oli yhteys lisääntyneeseen kuolemanriskiin, mutta tulokset olivat ristiriitaisia. Lääkityksen arviointi kerran vuodessa ei kotona asuvilla vaikuttanut käyttöön. Laitoshoidossa hoitajien koulutus vähensi käyttöä. PÄÄTELMÄT Psykoosilääkkeitä määrätään iäkkäille yleisesti ja pitkinä jaksoina muuhun kuin varsinaisiin indikaatioihin.Peer reviewe

Theory and practice in Finnish teacher education : a rhetorical analysis of changing values from the 1960s to the present day

Our aim in this article is to examine the relationship between theory and practice in Finnish teacher education from the 1960s to the present. We identify four different periods to represent this relationship based on our analysis of national committee and evaluation reports. Theory and practice gradually converged, culminating in a research-based agenda that reflects the current situation. This relationship between theory and practice also reflects the ideal teacher of different times and what a teacher's working orientation should be. We use rhetorical analysis and the concept of a 'philosophical pair' introduced by Perelman and Olbrechts-Tyteca to interpret this development.Peer reviewe

Use of CNS medications and cognitive decline in the aged: a longitudinal population-based study

<p>Abstract</p> <p>Background</p> <p>Previous studies have found associations between the use of central nervous system medication and the risk of cognitive decline in the aged. Our aim was to assess whether the use of a single central nervous system (CNS) medication and, on the other hand, the combined use of multiple CNS medications over time are related to the risk of cognitive decline in an older (≥ 65 yrs) population that is cognitively intact at baseline.</p> <p>Methods</p> <p>We conducted a longitudinal population-based study of cognitively intact older adults. The participants were 65 years old or older and had Mini-Mental State Examination (MMSE) sum scores of 24 points or higher. The study included a 7.6-year follow-up. The use of benzodiazepines and related drugs (BZDs), antipsychotics (APs), antidepressants (ADs), opioids (Ops), anticholinergics (AChs) and antiepileptics (AEs) was determined at baseline and after a 7.6-years of the follow-up period. Cognitive functioning was used as an outcome variable measured with MMSE at baseline and at the mean follow-up of 7.6 years. Control variables were adjusted with analyses of covariance.</p> <p>Results</p> <p>After adjusting for control variables, the use of Ops and the concomitant use of Ops and BZDs as well as the use of Ops and any CNS medication were associated with cognitive decline. The use of AChs was associated with decline in cognitive functioning only in men.</p> <p>Conclusions</p> <p>Of all the CNS medications analyzed in this study, the use of Ops may have the greatest effect on cognitive functioning in the ageing population. Due to small sample sizes these findings cannot be generalized to the unselected ageing population. More studies are needed concerning the long-term use of CNS medications, especially their concomitant use, and their potential cognitive effects.</p

The Terminal Oxidase Cytochrome bd Promotes Sulfide-resistant Bacterial Respiration and Growth

Hydrogen sulfide (H2S) impairs mitochondrial respiration by potently inhibiting the heme-copper cytochrome c oxidase. Since many prokaryotes, including Escherichia (E.) coli, generate H2S and encounter high H2S levels particularly in the human gut, herein we tested whether bacteria can sustain sulfide-resistant O2-dependent respiration. E. coli has three respiratory oxidases, the cyanide-sensitive heme-copper bo3 enzyme and two bd oxidases much less sensitive to cyanide. Working on the isolated enzymes, we found that, whereas the bo3 oxidase is inhibited by sulfide with half-maximal inhibitory concentration IC50=1.1±0.1μM, under identical experimental conditions both bd oxidases are insensitive to sulfide up to 58μM. In E. coli respiratory mutants, both O2-consumption and aerobic growth proved to be severely impaired by sulfide when respiration was sustained by the bo3 oxidase alone, but unaffected by ≤200μM sulfide when either bd enzyme acted as the only terminal oxidase. Accordingly, wild-type E. coli showed sulfide-insensitive respiration and growth under conditions favouring the expression of bd oxidases. In all tested conditions, cyanide mimicked the functional effect of sulfide on bacterial respiration. We conclude that bd oxidases promote sulfide-resistant O2- consumption and growth in E. coli and possibly other bacteria. The impact of this discovery is discussed

Psychotropic drugs and the risk of fractures in old age: a prospective population-based study

<p>Abstract</p> <p>Background</p> <p>There is evidence that the use of any psychotropic and the concomitant use of two or more benzodiazepines are related to an increased risk of fractures in old age. However, also controversial results exist. The aim was to describe associations between the use of a psychotropic drug, or the concomitant use of two or more of these drugs and the risk of fractures in a population aged 65 years or over.</p> <p>Methods</p> <p>This study was a part of a prospective longitudinal population-based study carried out in the municipality of Lieto, South-Western Finland. The objective was to describe gender-specific associations between the use of one psychotropic drug [benzodiazepine (BZD), antipsychotic (AP) or antidepressant (AD)] or the concomitant use of two or more psychotropic drugs and the risk of fractures in a population 65 years or over. Subjects were participants in the first wave of the Lieto study in 1990-1991, and they were followed up until the end of 1996. Information about fractures confirmed with radiology reports in 1,177 subjects (482 men and 695 women) during the follow-up was collected from medical records. Two follow-up periods (three and six years) were used, and previously found risk factors of fractures were adjusted as confounding factors separately for men and women. The Poisson regression model was used in the analyses.</p> <p>Results</p> <p>The concomitant use of two or more BZDs and the concomitant use of two or more APs were related to an increased risk of fractures during both follow-up periods after adjusting for confounding factors in men. No similar associations were found in women.</p> <p>Conclusions</p> <p>The concomitant use of several BZDs and that of several APs are associated with an increase in the risk of fractures in older men. Our findings show only risk relations. We cannot draw the conclusion that these drug combinations are causes of fractures.</p

Exciton localization and structural disorder of GaAs1−xBix/GaAs quantum wells grown by molecular beam epitaxy on (311)B GaAs substrates

In this work, we have investigated the structural and optical properties of GaAs(1−x)Bix/GaAs single quantum wells (QWs) grown by molecular beam epitaxy on GaAs (311)B substrates using x-ray diffraction, atomic force microscopy, Fourier-transform Raman (FT-Raman) and photoluminescence spectroscopy techniques. The FT-Raman results revealed a decrease of the relative intensity ratio of transverse and longitudinal optical modes with the increase of Bi concentration, which indicates a reduction of the structural disorder with increasing Bi incorporation. In addition, the PL results show an enhancement of the optical efficiency of the structures as the Bi concentration is increased due to important effects of exciton localization related to Bi defects, nonradiative centers and alloy disorder. These results provide evidence that Bi is incorporated effectively into the QW region. Finally, the temperature dependence of the PL spectra has evidenced two distinct types of defects related to the Bi incorporation, namely Bi clusters and pairs, and alloy disorder and potential fluctuation

Phosphorylation of bamboo mosaic virus satellite RNA (satBaMV)-encoded protein P20 downregulates the formation of satBaMV-P20 ribonucleoprotein complex

Bamboo mosaic virus (BaMV) satellite RNA (satBaMV) depends on BaMV for its replication and encapsidation. SatBaMV-encoded P20 protein is an RNA-binding protein that facilitates satBaMV systemic movement in co-infected plants. Here, we examined phosphorylation of P20 and its regulatory functions. Recombinant P20 (rP20) was phosphorylated by host cellular kinase(s) in vitro, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and mutational analyses revealed Ser-11 as the phosphorylation site. The phosphor-mimic rP20 protein interactions with satBaMV-translated mutant P20 were affected. In overlay assay, the Asp mutation at S11 (S11D) completely abolished the self-interaction of rP20 and significantly inhibited the interaction with both the WT and S11A rP20. In chemical cross-linking assays, S11D failed to oligomerize. Electrophoretic mobility shift assay and subsequent Hill transformation analysis revealed a low affinity of the phospho-mimicking rP20 for satBaMV RNA. Substantial modulation of satBaMV RNA conformation upon interaction with nonphospho-mimic rP20 in circular dichroism analysis indicated formation of stable satBaMV ribonucleoprotein complexes. The dissimilar satBaMV translation regulation of the nonphospho- and phospho-mimic rP20 suggests that phosphorylation of P20 in the ribonucleoprotein complex converts the translation-incompetent satBaMV RNA to messenger RNA. The phospho-deficient or phospho-mimicking P20 mutant of satBaMV delayed the systemic spread of satBaMV in co-infected Nicotiana benthamiana with BaMV. Thus, satBaMV likely regulates the formation of satBaMV RNP complex during co-infection in planta

Short-term associations between particle oxidative potential and daily mortality and hospital admissions in London.

BACKGROUND: Particulate matter (PM) from traffic and other sources has been associated with adverse health effects. One unifying theory is that PM, whatever its source, acts on the human body via its capacity to cause damaging oxidation reactions related to its content of pro-oxidants components. Few epidemiological studies have investigated particle oxidative potential (OP) and health. We conducted a time series analysis to assess associations between daily particle OP measures and numbers of deaths and hospital admissions for cardiovascular and respiratory diseases. METHODS: During 2011 and 2012 particles with an aerodynamic diameter less than 2.5 and 10μm (PM2.5 and PM10 respectively) were collected daily on Partisol filters located at an urban background monitoring station in Central London. Particulate OP was assessed based on the capacity of the particles to oxidize ascorbate (OP(AA)) and glutathione (OP(GSH)) from a simple chemical model reflecting the antioxidant composition of human respiratory tract lining fluid. Particulate OP, expressed as % loss of antioxidant per μg of PM, was then multiplied by the daily concentrations of PM to derive the daily OP of PM mass concentrations (% loss per m(3)). Daily numbers of deaths and age- and cause-specific hospital admissions in London were obtained from national registries. Poisson regression accounting for seasonality and meteorology was used to estimate the percentage change in risk of death or admission associated with an interquartile increment in particle OP. RESULTS: We found little evidence for adverse associations between OP(AA) and OP(GSH) and mortality. Associations with cardiovascular admissions were generally positive in younger adults and negative in older adults with confidence intervals including 0%. For respiratory admissions there was a trend, from positive to negative associations, with increasing age although confidence intervals generally included 0%. CONCLUSIONS: Our study, the first to analyse daily particle OP measures and mortality and admissions in a large population over two years, found little evidence to support the hypothesis that short-term exposure to particle OP is associated with adverse health effects. Further studies with improved exposure assessment and longer time series are required to confirm or reject the role of particle OP in triggering exacerbations of disease

Exciton localization and structural disorder of GaAs1−xBix/GaAs quantum wells grown by molecular beam epitaxy on (311)B GaAs substrates

In this work, we have investigated the structural and optical properties of GaAs(1−x)Bix/GaAs single quantum wells (QWs) grown by molecular beam epitaxy on GaAs (311)B substrates using x-ray diffraction, atomic force microscopy, Fourier-transform Raman (FT-Raman) and photoluminescence spectroscopy techniques. The FT-Raman results revealed a decrease of the relative intensity ratio of transverse and longitudinal optical modes with the increase of Bi concentration, which indicates a reduction of the structural disorder with increasing Bi incorporation. In addition, the PL results show an enhancement of the optical efficiency of the structures as the Bi concentration is increased due to important effects of exciton localization related to Bi defects, nonradiative centers and alloy disorder. These results provide evidence that Bi is incorporated effectively into the QW region. Finally, the temperature dependence of the PL spectra has evidenced two distinct types of defects related to the Bi incorporation, namely Bi clusters and pairs, and alloy disorder and potential fluctuation