Presse Med
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GAIT IS A VOLUNTARY, AUTOMATIC AND REFLEX RHYTHMIC ACTIVITY: It is generated by a central pattern generator identified from animal models. This spinal gait generator (SGG) is controlled by various parts of the central nervous system: the descending tracts and locomotor regions of the brainstem, the cerebellum, the basal ganglia, the motor and parietal cortex and the hippocampus. Kinesthetic inputs which project to the SGG and the cerebellum, play an important role in the production of postural reflex responses; vestibular and visual inputs mainly control balance.
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A COMMON DISORDER: Sleep is one of the most often altered functions in elderly people. Obviously, insomnia is one of the main complain, inducing benzodiazepine (BSD) abuse, but we must keep in mind that sleep apnoea syndrome (SAS) and restless legs syndrome (RLS) are also frequent in this group of age. After exclusion of the various age-related conditions that could induce sleep disorders, we must focalise on primary and secondary sleep disorders. ⋯ It is important to note that SAS and RLS prevalence are correlated with age. Also crucial is the complex association between sleep, depression and dementia. These interactions are addressed from a diagnostic and a therapeutic point of view.
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TWO MAIN FEATURE: Indication for surgery in patients with pituitary tumors depends first on the anatomical situation: the enclosed or invasive nature of the tumor. Total resection of an enclosed tumor, even if it is a huge one, can be expected to be successful. ⋯ At present, only secreting pituitary adenomas are accessible to medical therapy. Other pituitary tumors, and non-functioning pituitary adenomas are not suitable for valid medical treatment and may warrant a surgical strategy.
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A MAJOR PUBLIC HEALTH ISSUE: Osteoporosis in the elderly limits independence and quality of life. Preventive and curative treatment should be adapted to the patient's age.