An inadequate serum vitamin D status is commonly seen in elderly people as the result of various risk factors interacting in this population. Apart from the well-known effects on bone metabolism, this condition is also associated with muscle weakness, predominantly of the proximal muscle groups. Muscle weakness below a certain threshold affects functional ability and mobility, which puts an elderly person at increased risk of falling and fractures. Therefore, we wanted to determine the rationale behind vitamin D supplementation in elderly people to preserve and possibly improve muscle strength and subsequently functional ability. From experimental studies it was found that vitamin D metabolites directly influence muscle cell maturation and functioning through a vitamin D receptor. Vitamin D supplementation in vitamin D-deficient, elderly people improved muscle strength, walking distance, and functional ability and resulted in a reduction in falls and non-vertebral fractures. In healthy elderly people, muscle strength declined with age and was not prevented by vitamin D supplementation. In contrast,severe comorbidity might affect muscle strength in such a way that restoration of a good vitamin D status has a limited effect on functional ability. Additional research is needed to further clarify to what extent vitamin D supplementation can preserve muscle strength and prevent falls and fractures in elderly people.

Daily 400 IU vitamin D + 500 mg calcium supplementation is not enough to significantly improve strength or mobility in vitamin D-insufficient female geriatric patients.

Progression of neurulation in the chick embryo has not been well documented. To provide a detailed description, chick embryos were stained in ovo after the least manipulation possible to avoid distortion of the neural plate and folds. This allowed a morphological and morphometric description of the process of neurulation in relatively undisturbed chick embryos. Neurulation comprises several specific phases with distinct closure patterns and closure rates. The first closure event occurs, de novo, in the future mesencephalon at the 4–6 somite stage (sst 4–6). Soon afterwards, at sst 6–7, de novo closure is seen at the rhombocervical level in the form of multisite contacts of the neural folds. These contacts occur in register with the somites, suggesting that the somites may play a role in forcing elevation and apposition of the neural folds. The mesencephalic and rhombocervical closure events define an intervening rhombencephalic neuropore, which is present for a brief period before it closes. The remaining pear‐shaped posterior neuropore (PNP) narrows and displaces caudally, but its length remains constant in embryos with seven to ten somites, indicating that the caudal extension of the rhombocervical closure point and elongation of the caudal neural plate are keeping pace with each other. From sst 10 onward, the tapered cranial portion of the PNP closes fast in a zipper‐like manner, and, subsequently, the wide caudal portion of the PNP closes rapidly as a result of the parallel alignment of its folds, with numerous button‐like temporary contact points. A role for convergent extension in this closure event is suggested. The final remnant of the PNP closes at sst 18. Thus, as in mammals, chick neurulation involves multisite closure and probably results from several different development mechanisms at varying levels of the body axis. © 1996 Wiley‐Liss, Inc.

Both obstructive sleep apnoea (OSA) and chronic insomnia disorder are highly prevalent in the general population. Whilst both disorders may occur together by mere coincidence, it appears that they share clinical features and that they may aggravate each other as a result of reciprocally adverse pathogenetic mechanisms. Comorbidity between chronic insomnia disorder and OSA is a clinically relevant condition that may confront practitioners with serious diagnostic and therapeutic challenges. Current data, while still scarce, advocate an integrated and multidisciplinary approach that seems superior over the isolated treatment of each sleep disorder alone.

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Knee extension strength remains a strong determinant of mobility and fall occurrence in women referred to a geriatric outpatient clinic. Performing light to moderate household work remains independently associated with functional mobility.