Clinical calcium
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Excessive actions of fibroblast growth factor 23(FGF23)result in several kinds of hypophosphatemic rickets and osteomalacia. A combination of oral active vitamin D3 and phosphate is the current standard therapy for FGF23-related hypophosphatemia. However, these medications can lead to long-term complications, such as secondary hyperparathyroidism and renal impairment. ⋯ The efficacy of anti-FGF23 antibody was confirmed in a Hyp mouse, a murine model of XLHR. A recent phase 1 double-blind, placebo-controlled study and the subsequent open-label phase 1/2 study in adults with XLHR showed the safety and the efficacy of human anti-FGF23 antibody, KRN23. KRN23 has a potential for effectively treating patients with XLHR and other types of FGF23-related hypophosphatemia as well.
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Review
[Hip Fracture--Epidemiology, Management and Liaison Service. Osteoporosis liaison service in Japan].
Osteoporosis liaison service (OLS) is a coordinator-based service provided by Japan Osteoporosis Society. Fracture Liaison Services, commonly known as FLS, are coordinator-based, secondary fracture prevention services implemented by health care systems for the treatment of osteoporotic patients. ⋯ Japan Osteoporosis Society gives coordinators the certificate as a specialist for OLS since 2015. OLS in Japan should facilitate better performance of the treatment of osteoporosis and should contribute the reduction of clinical fractures.
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Sarcopenic dysphagia is difficulty swallowing due to sarcopenia of generalized skeletal muscles and swallowing muscles. Presbyphagia refers to age-related changes in the swallowing mechanism in the elderly associated with a frailty in swallowing. Presbyphagia is different from dysphagia. ⋯ Treatment of age-related sarcopenia should include resistance training and dietary supplements of amino acids. Therapy for activity-related sarcopenia includes reduced bed rest time and early mobilization and physical activity. Treatment for disease-related sarcopenia requires therapies for advanced organ failure, inflammatory disease, or malignancy, while therapy for nutrition-related sarcopenia involves appropriate nutrition management to increase muscle mass.
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Glucocorticoids (GCs) were widely used for the treatment of various disorders. And Osteoporosis is one of the major complications of glucocorticoid therapy. ⋯ The skeletal effects of glucocorticoids include both direct and indirect actions on bone that result in an early, transient increase in bone resorption accompanied by a decrease in bone formation, which is maintained for the duration of glucocorticoid therapy. Bisphosphonates are the front-line choice for prevention of fracture in glucocorticoid-treated patients and are recommended renewal GIOP guideline from Japan.
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A non-enzymatic reaction between reducing sugars and amino groups of proteins, lipids and nucleic acids contributes to the aging of macromolecules. Over a course of days to weeks, early glycation products undergo further reactions such as rearrangements and dehydration to become irreversibly cross-linked, fluorescent protein derivatives termed advanced glycation end products (AGE). The formation and accumulation of AGE have been known to progress at a normal physiological aging and at an accelerated rate under diabetes. ⋯ Further, food- or smoking-derived AGE have also been shown to promote the aging-associated organ damage in humans. These observations suggest that inhibition of the AGE-RAGE-induced oxidative stress generation might be a novel therapeutic target for slowing down the aging process and achieving a successful life. In this paper, we discuss the role of AGE-RAGE-oxidative stress and its therapeutic interventions in osteo-vascular disorders.