Medicine (Western Health) - Research Publications

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    The Role of the Nuclear Envelope Protein MAN1 in Mesenchymal Stem Cell Differentiation
    Bermeo, S ; Al-Saedi, A ; Kassem, M ; Vidal, C ; Duque, G (WILEY, 2017-12)
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    SERUM PARATHYROID HORMONE BUT NOT VITAMIN D IS ASSOCIATED WITH IMPAIRED GAIT IN COMMUNITY-DWELLING OLDER ADULTS
    Montero-Odasso, M ; Sakurai, R ; Muir-Hunter, S ; Islam, A ; Doherty, T ; Duque, G ; Crilly, R (WILEY-BLACKWELL, 2016-12)
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    EFFECT OF DENOSUMAB ON FALLS, MUSCLE STRENGTH, AND FUNCTION IN COMMUNITY-DWELLING OLDER ADULTS
    Phu, S ; Hassan, EB ; Vogrin, S ; Kirk, B ; Duque, G (WILEY, 2019-12)
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    The Cost of Osteoporosis, Osteopenia, and Associated Fractures in Australia in 2017
    Tatangelo, G ; Watts, J ; Lim, K ; Connaughton, C ; Abimanyi-Ochom, J ; Borgstrom, F ; Nicholson, GC ; Shore-Lorenti, C ; Stuart, AL ; Iuliano-Burns, S ; Seeman, E ; Prince, R ; March, L ; Cross, M ; Winzenberg, T ; Laslett, LL ; Duque, G ; Ebeling, PR ; Sanders, KM (WILEY, 2019-04)
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    Fragile X syndrome and connective tissue dysregulation
    Ramirez-Cheyne, JA ; Duque, GA ; Ayala-Zapata, S ; Saldarriaga-Gil, W ; Hagerman, P ; Hagerman, R ; Payan-Gomez, C (WILEY, 2019-02)
    Fragile X syndrome (FXS) is the most common cause of inherited intellectual disabilities and autism spectrum disorders, and it is an X-linked disorder in which there is a deficiency of the fragile X mental retardation 1 protein. This protein is crucial in regulating translation of mRNAs related to dendritic maturation and cognitive development. The phenotype of FXS is characterized by neurobehavioral alterations, social deficits, communication difficulties, and findings which suggest an alteration of connective tissue, especially in the ligaments and muscles, cardiovascular system and genitourinary system. Connective tissue connects and supports all other tissues of the body and is composed of cells and extracellular matrix (ECM). Several proteins have been involved in the connective tissue abnormalities associated with the FXS, such as matrix metalloproteinase 9, which plays an important role in the homeostasis of the ECM, being a potential therapeutic target for certain tetracycline antibiotics that have shown beneficial effects in FXS. Here, we review connective tissue problems described in FXS.
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    Osteoporosis in Older Persons: Old and New Players
    Zanker, J ; Duque, G (WILEY, 2019-04)
    Osteoporosis is the most common bone disease in humans. Older persons are at higher risk of osteoporotic fractures that also result in poor quality of life, disability, loss of independence, institutionalization, and higher mortality. Osteoporosis shares a distinct pathophysiologic relationship with sarcopenia, an age-related disease comprising declines in muscle mass, strength, or function. The combination of these two diseases is known as osteosarcopenia. Understanding the pathophysiology of osteosarcopenia, in addition to its diagnostic and therapeutic approaches, is key in providing older adults with the best falls and fractures prevention strategies. This review provides updated information on new discoveries on the combined pathophysiology of osteoporosis and sarcopenia that have led to the development of novel therapeutic approaches. New recommendations for the use of risk calculators and densitometry are also presented in this review as well as evidence on current and upcoming pharmacologic treatments to prevent falls and fractures in older persons. J Am Geriatr Soc 67:831-840, 2019.
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    Does obesity reduce risk for osteoporosis and fractures in older adults?
    Scott, D ; Duque, G ; Ebeling, PR (WILEY, 2018-01)
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    Association between structural changes in brain with muscle function in sarcopenic older women: the women's healthy ageing project (WHAP)
    Hassan, EB ; Szoeke, C ; Vogrin, S ; Phu, S ; Venkatraman, V ; Desmond, P ; Steward, C ; Duque, G (JMNI, 2019-06)
    OBJECTIVES: The involvement of changes in brain structure in the pathophysiology of muscle loss (sarcopenia) with aging remains unclear. In this study, we investigated the associations between brain structure and muscle strength in a group of older women. We hypothesized that structural changes in brain could correlate with functional changes observed in sarcopenic older women. METHODS: In 150 women (median age of 70 years) of the Women's Healthy Ageing Project (WHAP) Study, brain grey (total and cortex) volumes were calculated using magnetic resonance imaging (MRI) analyses. Grip strength and timed up and go (TUG) were measured. The brain volumes were compared between sarcopenic vs. non-sarcopenic subjects and women with previous falls vs. those without. RESULTS: Based on handgrip strength and TUG results respectively, 27% and 15% of women were classified as sarcopenic; and only 5% were sarcopenic based on both criteria. At least one fall was experienced by 15% of participants. There was no difference in brain volumetric data between those with vs. without sarcopenia (p>0.24) or between women with falls (as a symptom of weakness or imbalance) vs. those without history of falls (p>0.25). CONCLUSIONS: Brain structure was not associated with functional changes or falls in this population of older women.
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    In eHealth in India today, the nature of work, the challenges and the finances: an interview-based study
    Jaroslawski, S ; Saberwal, G (BMC, 2014-01-06)
    BACKGROUND: Care pathways are generally paper-based and can cause communication failures between multidisciplinary teams, potentially compromising the safety of the patient. Computerized care pathways may facilitate better communication between clinical teams. This study aimed to investigate whether an electronic care pathway (e-pathway) reduces delays in surgery and hospital length of stay compared to a traditional paper-based care pathway (control) in hip fracture patients. METHODS: A single-centre evaluation with a retrospective control group was conducted in the Orthogeriatric Ward, Nepean Hospital, New South Wales, Australia. We enrolled patients aged > 65 years that were hospitalized for a hip fracture in 2008 (control group) and 2012 (e-pathway group). The e-pathway provided the essential steps in the care of patients with hip fracture, including examinations and treatment to be carried out. Main outcome measures were delay in surgery and hospital length of stay; secondary outcomes were in-hospital mortality and discharge location. RESULTS: A total of 181 patients were enrolled in the study (129 control; 54 e-pathway group). There was a significant reduction in delay to surgery in the e-pathway group compared to control group in unadjusted (OR = 0.19; CI 0.09-0.39; p < 0.001) and adjusted (OR = 0.22; CI 0.10-0.49; p < 0.001) models. There were no significant differences between groups for length of stay (median 11 vs 12 days; p = 0.567), in-hospital mortality (1 vs 7 participants; p = 0.206) or discharge location (p = 0.206). CONCLUSIONS: This pilot study suggests that, compared to a paper-based care pathway, implementation of an e-pathway for hip fracture patients results in a reduction in total number of delays to surgery, but not hospital length of stay. Further evaluation is warranted using a larger cohort investigating both clinical and patient-reported outcome measures.
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    Dynapenia and Sarcopenia as a Risk Factor for Disability in a Falls and Fractures Clinic in Older Persons.
    Benjumea, A-M ; Curcio, C-L ; Duque, G ; Gómez, F (Scientific Foundation SPIROSKI, 2018-02-15)
    BACKGROUND: The role of sarcopenia and dynapenia in disability in older persons from falls and bone health clinics remain unknown. AIM: This study aims to compare the association of sarcopenia and dynapenia with physical and instrumental disability in a population of older persons attending a falls and fractures clinic. METHODS: This is a cross-sectional study in Manizales, Andes Mountains, Colombia. A cohort of 534 subjects (mean age = 74, 75% female) Sarcopenia was measured according to the European Working Group on Sarcopenia in Older People (EWGSOP) including an index of skeletal mass, muscle strength, and gait speed. Dynapenia was defined as a handgrip force ≤ 30 kg for men and ≤ 20 kg for women. RESULTS: Dynapenia and sarcopenia were present in 84.6% and 71.2% respectively. Both were more prevalent in older subjects and women than men. While sarcopenia was associated with body mass index and hypertension, dynapenia was associated with hypothyroidism and visual impairment. After controlling for all covariates, sarcopenia was associated with low IADL and mobility disability. CONCLUSIONS: Sarcopenia was associated with mobility, ADL and IADL disability. Dynapenia was not associated with disability in this high - risk population. Systematic assessment of sarcopenia should be implemented in falls and fractures clinics to identify sarcopenia and develop interventions to prevent functional decline among elderly individuals.