PHYSICIAN HEALTH CARE NEWS
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Trilostane, the latest therapy for Cushing's disease in canines, is available at Compounding Specialists of Wyoming. We have strengths ranging from 60mg to 240mg depending on the weight of your canine.
Daily dose:
60mg (Dogs 5 - 20kg)
120mg (Dogs 20 - 40kg)
120-240mg (Dogs > 40kg) |
Attention: Family Physicians www.mdlinx.com
Testosterone replacement therapy for older men
Stephen E Borst, Thomas Mulligan
Geriatrics Research, Education, and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
Abstract: Despite intensive research on testosterone therapy for older men, important questions remain unanswered. The evidence clearly indicates that many older men display a partial androgen deficiency. In older men, low circulating testosterone is correlated with low muscle strength, with high adiposity, with insulin resistance and with poor cognitive performance. Testosterone replacement in older men has produced benefits, but not consistently so. The inconsistency may arise from differences in the dose and duration of testosterone treatment, as well as selection of the target population. Generally, studies reporting anabolic responses to testosterone have employed higher doses of testosterone for longer treatment periods and have targeted older men whose baseline circulating bioavailable testosterone levels were low. Most studies of testosterone replacement have reported anabolic that are modest compared to what can be achieved with resistance exercise training. However, several strategies currently under evaluation have the potential to produce greater anabolic effects and to do so in a safe manner. At this time, testosterone therapy can not be recommended for the general population of older men. Older men who are hypogonadal are at greater risk for the catabolic effects associated with a number of acute and chronic medical conditions. Future research is likely to reveal benefits of testosterone therapy for some of these special populations. Testosterone therapy produces a number of adverse effects, including worsening of sleep apnea, gynecomastia, polycythemia and elevation of PSA. Efficacy and adverse effects should be assessed frequently throughout the course of therapy.
Pain Gels
At Compounding Specialists of Wyoming we compound many pain formulations. Some of the items we custom compound are ketoprofen, lidocaine, ketamine, capsaicin gapapentum, amitriptyline, cyclobenzaprine, carbamazepine, etc. We can combine anti-inflammatory, anesthetic, or anti-spasmotic items into one cream, or gel for topical application of pain relief. We are able to ship anywhere in Wyoming, and we are available for consultation at anytime during regular business hours.
Abstract
Objective To evaluate plasma lipid levels in elderly women in the general population as a function of use of lipid-lowering agents (LLA) and hormone therapy (HT).
Methods A total of 4271 women aged over 65 years were recruited from three French cities. Analyses were performed after stratification by LLA treatment and HT and adjusting for a large range of sociodemographic and clinical factors.
Results Fifteen percent of women currently used HT (78% transdermal estradiol), and 30% were taking LLA. In this population, 4.6% of women were taking both HT and LLA (fibrate for 2.4% and statin for 2.2%). In non-LLA-treated women, current HT was associated with lower total cholesterol, low density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) compared to never users. Women treated with LLA also had lower total cholesterol, LDL-C, and non-HDL-C compared to non-LLA users, whereas triglyceride levels were the highest in statin users and lowest in fibrate users. Fibrate use was associated with a more favorable lipid pattern than statin treatment independently of HT use. In women without coronary heart disease or diabetes, HT, statin or fibrate use were associated with lower LDL-C level risk based on National Cholesterol Education Program guidelines (adjusted odds ratio (OR) = 0.67 (95% confidence interval (CI) = 0.53-0.85), 0.38 (95% CI = 0.29-0.47), and 0.32 (95% CI = 0.25-0.42), respectively) with a possible interaction between fibrate and HT (0.18 (95% CI = 0.10-0.30)).
Conclusions Estradiol-based HT may lower atherogenic lipoproteins in postmenopausal women. In primary prevention of coronary heart disease, combining HT and a fibrate may provide additional benefits compared to fibrate use alone.
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Attention: Dentists www.mdlinx.com
RESEARCH REPORT
Biological |
Inhibition of Experimental Periodontitis by a Topical Boron-based Antimicrobial
Q. Luan1,3, T. Desta1, L. Chehab1, V.J. Sanders2, J. Plattner2, and D.T. Graves*,1
1 Department of Periodontology and Oral Biology, Boston University School of Dental Medicine, Boston, MA 02118, USA;
2 Anacor Pharmaceuticals, Inc., Palo Alto, CA 94303, USA;
3 Department of Periodontology, Peking University School of Stomatology, Beijing, China 100081
AN0128 is a boron-containing compound with antibacterial and anti-inflammatory properties. To test its potential effectiveness in treating periodontal disease, we induced experimental periodontitis in the rat by placing ligatures and assessed the impact of AN0128 and positive and negative controls by micro-CT and histologic measurements. The formation of an inflammatory infiltrate was measured in hematoxylin-and-eosin-stained sections. Daily application of AN0128 (1%) compared with controls reduced bone loss by 38 to 44% (P < 0.05), while vehicle alone had no effect (P > 0.05). The reduction in bone loss with AN0128 was similar to that achieved with a NSAID, ketorolac, and Total toothpaste containing triclosan. AN0128 also reduced the level of gingival inflammation 42% compared with the ligature only (P < 0.05), whereas vehicle alone had no effect (P > 0.05). The results indicate that AN0128 significantly reduces the formation of an inflammatory infiltrate and reduces bone loss, measured histologically and by micro-CT. |
Attention: Women's Health Nurse Practitioners www.mdlinx.com
Benefits of hormone replacement therapy in postmenopausal women
- Richard Canderelli, MSN (Clinical Specialist) Memorial Regional Hospital, Hollywood, Florida
- Lisa A. Leccesse, MS, ARNP (Family Nurse Practitioner) Memorial Regional Hospital, Hollywood, Florida, &
- Nancy L. Miller, MSN, RNC, CCM, LNC (Assistant Clinical Professor) College of Nursing and Health Sciences, Florida International University, Miami, Florida
- Column Editor: Janice Unruh Davidson, PhD, RN, CNAA, APRN, BC, FAANP
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1 Memorial Regional Hospital, Hollywood, Florida
2 College of Nursing and Health Sciences, Florida International University, Miami, Florida
Purpose: To provide an overview of current research regarding hormone replacement therapy (HRT) and to assist healthcare providers to better educate patients about potential benefits of this therapy.
Data sources: A systematic review of healthcare literature was conducted with 602 articles selected from CINAHL, Medscape, Pubmed, and Medline databases. Keywords directing the search included hormone replacement therapy, benefits of hormone replacement therapy and trends, hormone replacement therapy and osteoporosis, hormone replacement, and menopause symptoms.
Conclusions: According to the literature, HRT can assist women with postmenopausal symptoms. In addition, research shows that HRT can help some postmenopausal women with selected comorbid conditions such as osteoporosis, type II diabetes, certain cardiovascular pathologies, and colorectal cancer. The decision as to who should use any form of HRT needs to be based on the individual woman’s needs, quality of life, and potential risks versus benefits.
Implications for practice: HRT has been a benefit to many women in the treatment of postmenopausal symptoms. Recent studies have shown that HRT, whether it is combined estrogen and progesterone therapy, or estrogen-only therapy, can help postmenopausal women with osteoporosis and some selected comorbid conditions. Recent research indicates that some women are dying from comorbid conditions rather than breast cancer. Although the research regarding HRT in some areas may be limited, further research adds to existing knowledge and offers new ideas and possibilities in the treatment of postmenopausal symptoms and selected comorbid conditions. Certainly HRT can improve quality of life and possibly longevity for selected women. Ongoing research is needed to further validate such benefits, as well as to further explore the risks and benefits of long-term HRT. Increased knowledge about HRT will help healthcare providers better educate patients about the potential benefits of HRT, while providing documentation about who should take selected types of HRT or whether alternative treatment is preferred.
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