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1.
Osteoarthritis Cartilage ; 30(10): 1328-1336, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35870736

RESUMEN

OBJECTIVE: Native biglycan (BGN), which can undergo proteolytic cleavage in pathological conditions, is well known to be involved in bone formation and mineralization. This study aimed to delineate the specific cleavage fragment, a neo-epitope for BGN (BGN262), in synovial fluid (SF) from young racehorses in training, osteoarthritic (OA) joints with subchondral bone sclerosis (SCBS), and chip fracture joints. DESIGN: A custom-made inhibition ELISA was developed to quantify BGN262 in SF. Cohort 1: A longitudinal study comprising 10 racehorses undergoing long-term training. Cohort 2: A cross-sectional study comprising joints from horses (N = 69) with different stages of OA and radiographically classified SCBS. Cohort 3: A cross-sectional study comprising horses (N = 9) with chip fractures. Receiver operating characteristic (ROC) curve analysis was performed (healthy joints vs chip joints) to evaluate BGN262 robustness. RESULTS: Cohort 1: SF BGN262 levels from racehorses showed a statistical increase during the first 6 months of the training period. Cohort 2: BGN262 levels were significantly higher in the SF from severe SCBS joints. Cohort 3: SF BGN262 levels in chip fracture joints showed a significant increase compared to normal joints. The ROC analysis showed an AUC of 0.957 (95% C.I 0.868-1.046), indicating good separation between the groups. CONCLUSIONS: The data presented show that BGN262 levels increase in SF in correlation with the initiation of training, severity of SCBS, and presence of chip fractures. This suggests that BGN262 is a potential predictor and a novel biomarker for early changes in subchondral bone (SCB), aiming to prevent catastrophic injuries in racehorses.


Asunto(s)
Enfermedades de los Caballos , Animales , Biglicano , Biomarcadores , Estudios Transversales , Epítopos , Caballos , Humanos , Estudios Longitudinales
2.
Mol Pharm ; 14(4): 1307-1314, 2017 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-28195732

RESUMEN

The overall objective of OrBiTo, a project within Innovative Medicines Initiative (IMI), is to streamline and optimize the development of orally administered drug products through the creation and efficient application of biopharmaceutics tools. This toolkit will include both experimental and computational models developed on improved understanding of the highly dynamic gastrointestinal (GI) physiology relevant to the GI absorption of drug products in both fasted and fed states. A part of the annual OrBiTo meeting in 2015 was dedicated to the presentation of the most recent progress in the development of the regulatory use of PBPK in silico modeling, in vivo predictive dissolution (IPD) tests, and their application to biowaivers. There are still several areas for improvement of in vitro dissolution testing by means of generating results relevant for the intraluminal conditions in the GI tract. The major opportunity is probably in combining IPD testing and physiologically based in silico models where the in vitro data provide input to the absorption predictions. The OrBiTo project and other current research projects include definition of test media representative for the more distal parts of the GI tract, models capturing supersaturation and precipitation phenomena, and influence of motility waves on shear and other forces of hydrodynamic origin, addressing the interindividual variability in composition and characteristics of GI fluids, food effects, definition of biorelevant buffer systems, and intestinal water volumes. In conclusion, there is currently a mismatch between the extensive industrial usage of modern in vivo predictive tools and very limited inclusion of such data in regulatory files. However, there is a great interest among all stakeholders to introduce recent progresses in prediction of in vivo GI drug absorption into regulatory context.


Asunto(s)
Tracto Gastrointestinal/metabolismo , Preparaciones Farmacéuticas/química , Preparaciones Farmacéuticas/metabolismo , Administración Oral , Biofarmacia/métodos , Absorción Gastrointestinal/fisiología , Humanos , Modelos Biológicos , Solubilidad
3.
Osteoarthritis Cartilage ; 22(4): 566-77, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24561281

RESUMEN

OBJECTIVE: Growth differentiation factor 5 (GDF5) is important for joint formation and associated with osteoarthritis (OA). Its role for the homeostasis of cartilage extracellular matrix (ECM) is, however, unknown. The canonical Wnt signaling pathway is also implemented in OA and activation of the pathway has detrimental effects on the cartilage ECM. The objective of this study was to investigate the effect of GDF5 stimulation on the Wnt signaling pathway and on the expression of known modulators of cartilage ECM. DESIGN: Human chondrocytes were cultured in the pellet mass system and stimulated with increasing concentrations of GDF5. Expression of matrix modulating enzymes and canonical Wnt inhibitors dickkopf 1 (DKK1) and frizzled related protein (FRZB) were measured with quantitative PCR (qPCR). Protein levels of matrix metalloprotease 13 (MMP13), DKK1 and ß-catenin were measured with enzyme-linked immunosorbent assay (ELISA). Canonical Wnt signaling was stimulated with Wnt3a and small molecule CHIR-99021 and DKK1 was blocked with small molecule WAY-262611. RESULTS: In this study, we show that GDF5 stimulation of human chondrocytes inhibits expression of the cartilage ECM degrading enzymes MMP13 and ADAMTS4 and stimulates the expression of cartilage anabolic genes ACAN and SOX9. We further show that the stimulation inhibits the canonical Wnt signaling pathway through expression of the canonical Wnt inhibitors DKK1 and FRZB. Finally we show that inhibition of MMP13 expression through GDF5 stimulation is mediated by DKK1. CONCLUSION: Herein, we provide evidence of a previously unknown link between GDF5 signaling and canonical Wnt signaling that may contribute to the understanding of the molecular mechanisms of OA.


Asunto(s)
Cartílago Articular/metabolismo , Condrocitos/metabolismo , Factor 5 de Diferenciación de Crecimiento/farmacología , Metaloproteinasa 13 de la Matriz/metabolismo , Osteoartritis/metabolismo , Vía de Señalización Wnt/fisiología , Proteínas ADAM/metabolismo , Proteína ADAMTS5 , Adulto , Agrecanos/metabolismo , Colágeno Tipo XII/metabolismo , Ensayo de Inmunoadsorción Enzimática , Glicoproteínas/metabolismo , Humanos , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Péptidos y Proteínas de Señalización Intracelular , Reacción en Cadena de la Polimerasa , Factor de Transcripción SOX9/metabolismo , Inhibidores Tisulares de Metaloproteinasas/metabolismo , beta Catenina/metabolismo
4.
Analyst ; 139(21): 5350-3, 2014 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-25199816

RESUMEN

The interaction of human-derived chondrocytes and thin hyaluronan layers was studied using the quartz crystal microbalance with dissipation (QCM-D) technique combined with light microscopy. This approach allowed unique real-time monitoring of the interface between the cells and the sensor surface. Our results suggest that the hyaluronan layer is rapidly degraded by chondrocytes.


Asunto(s)
Acústica , Condrocitos/citología , Ácido Hialurónico/química , Materiales Biocompatibles , Cuarzo
5.
Cells Tissues Organs ; 198(3): 237-48, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24217112

RESUMEN

BACKGROUND: Moderate exercise regimens have shown minor positive effects on matrix turnover in articular cartilage (AC), while effects at cellular level, e.g. proliferation, are scarcely described. AIM: The aim of this study was to investigate the effects of moderate exercise on cell proliferation and recruitment of cells possibly active in regeneration in different regions of cartilage in the rat knee joint. METHODS: Eighteen rats were orally given 5-bromo-2-deoxyuridine (BrdU) for 14 days for in vivo DNA labeling. Nine rats underwent treadmill training for 50 min/day, 5 days/week (exercise group), and 9 rats served as controls (no exercise). Animals were sacrificed after 14, 56 and 105 days, and knee joints were harvested. BrdU+ cells were visualized immunohistochemically (IHC) and counted in AC, posterior stem cell niche (PN), potential migration route (PMR; area between PN and the AC border), potential migration area (PMA; region between PN and AC including PN) and epiphyseal cartilage plate (EP) of the tibia and femur. RESULTS: Compared to controls, in the exercise group BrdU+ cells/mm(2) were increased on days 14 (p = 0.022) and 105 (p = 0.045) in AC of the tibia and on day 105 (p = 0.014) in AC of the femur. BrdU+ cell numbers were increased in the PMR region of the tibia on days 14 (p = 0.023) and 105 (p = 0.0018) and in the PMR region of the femur on day 105 (p = 0.0099) as well as in the PMA region of the tibia (p = 0.0008) and femur (p = 0.0080) on day 105. No significant differences in BrdU+ cells/mm(2) were seen in PN or EP between the groups at any time point. Regarding collagen 2A1 expression and proteoglycan accumulation, no significant differences between groups were detected. CONCLUSIONS: The results indicate increased cell activity in AC in response to physical exercise and may help to understand the complexity of AC regeneration in the normal mammal knee joint.


Asunto(s)
Cartílago Articular/fisiología , Articulación de la Rodilla/fisiología , Condicionamiento Físico Animal/fisiología , Animales , Cartílago Articular/citología , Cartílago Articular/metabolismo , Ciclo Celular/fisiología , Procesos de Crecimiento Celular/fisiología , Movimiento Celular/fisiología , Femenino , Articulación de la Rodilla/citología , Articulación de la Rodilla/metabolismo , Modelos Animales , Ratas , Ratas Sprague-Dawley , Nicho de Células Madre
7.
Osteoarthr Cartil Open ; 5(3): 100381, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37416846

RESUMEN

Objective: This study aimed to test a novel treatment combination (TC) (equivalent to sildenafil, mepivacaine, and glucose) with disease-modifying properties compared to Celestone® bifas® (CB) in a randomized triple-blinded phase III clinical study in horses with mild osteoarthritis (OA). Joint biomarkers (reflecting the articular cartilage and subchondral bone remodelling) and clinical lameness were used as readouts to evaluate the treatment efficacy. Methods: Twenty horses with OA-associated lameness in the carpal joint were included in the study and received either TC (n = 10) or CB (n = 10) drug intra-articularly-twice in the middle carpal joint with an interval of 2 weeks (visit 1 & 2). Clinical lameness was assessed both objectively (Lameness locator) and subjectively (visually). Synovial fluid and serum were sampled for quantification of the extracellular matrix (ECM) neo-epitope joint biomarkers represented by biglycan (BGN262) and cartilage oligomeric matrix protein (COMP156). Another two weeks later clinical lameness was recorded, and serum was collected for biomarkers analysis. The overall health status was compared pre and post-intervention by interviewing the trainer. Results: Post-intervention, SF BGN262 levels significantly declined in TC (P = 0.002) and COMP156 levels significantly increased in CB (P = 0.002). The flexion test scores improved in the TC compared to CB (P =0.033) and also had an improved trotting gait quality (P =0.044). No adverse events were reported. Conclusion: This is the first clinical study presenting companion diagnostics assisting in identifying OA phenotype and evaluating the efficacy and safety of a novel disease-modifying osteoarthritic drug.

8.
Phys Rev Lett ; 108(3): 033004, 2012 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-22400737

RESUMEN

We report on the first experimental observation of a new threshold behavior observed in the 5(2)G partial channel in photodetachment of K(-). It arises from the repulsive polarization interaction between the detached electron and the residual K(5(2)G) atom, which has a large negative dipole polarizability. In order to account for the observation in the K(5(2)G) channel, we have developed a semiclassical model that predicts an exponential energy dependence for the cross section. The measurements were made with collinear laser-ion beams and a resonance ionization detection scheme.

11.
Vet J ; 267: 105579, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33375964

RESUMEN

Nerve growth factor (NGF) is a neurotrophin with many functions. In humans, it is involved in inflammation, nerve growth, apoptosis and pain signalling. Increased concentrations of NGF in synovial fluid has been shown in humans and dogs with osteoarthritis. Despite osteoarthritis being a common problem in horses, no studies have previously been published on NGF in the equine joint. The aim of this study was to quantify NGF in equine synovial fluid from healthy joints, acutely inflamed septic joints and joints with structural changes associated with osteoarthritis. A secondary aim was to identify the localisation of NGF and its two receptors, TrkA and p75NTR, in healthy and osteoarthritic articular cartilage. NGF concentrations in synovial fluid from osteoarthritic joints (n = 27), septic joints (n = 9) and healthy joints (n = 16) were determined by ELISA. In addition, articular cartilage from osteoarthritic and healthy joints was examined for NGF, TrkA and p75NTR using immunohistochemistry staining. NGF was present in equine synovial fluid and articular cartilage. Compared to synovial fluid from healthy joints, NGF concentration was higher in synovial fluid from joints with structural osteoarthritic changes (P = 0.032) or acute septic inflammation (P = 0.006). In articular cartilage with severe osteoarthritic changes, there was more abundant positive immunohistochemistry staining for NGF and its receptors than in normal articular cartilage. Further studies should focus on identifying precursor forms of NGF, and on receptor expression and downstream signalling of TrkA and P75NTR in health and disease.


Asunto(s)
Enfermedades de los Caballos/metabolismo , Articulaciones/química , Animales , Artritis Infecciosa/metabolismo , Artritis Infecciosa/veterinaria , Cartílago Articular/química , Ensayo de Inmunoadsorción Enzimática/veterinaria , Caballos , Inmunohistoquímica/veterinaria , Inflamación/metabolismo , Inflamación/veterinaria , Cojera Animal/metabolismo , Factor de Crecimiento Nervioso/análisis , Osteoartritis/metabolismo , Osteoartritis/veterinaria , Líquido Sinovial/química
12.
Infect Prev Pract ; 3(4): 100178, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34642658

RESUMEN

BACKGROUND: Isolation precautions are essential prevent spread of COVID-19 infection but may have a negative impact on inpatient care. The impact of these measures on non-COVID-19 patients remains largely unexplored. AIM: This study aimed to investigate diagnostic and treatment delays related to isolation precautions, the associated patient outcome, and the predisposing risk factors for delays. METHODS: This observational study was conducted in seven Helsinki region hospitals during the first wave of the COVID-19 pandemic in Finland. The study used data on all non-COVID-19 inpatients, who were initially isolated due to suspected COVID-19, to estimate whether isolation precautions resulted in diagnostic or treatment delays. RESULTS: Out of 683 non-COVID-19 patients, 33 (4.8%) had delays related to isolation precautions. Clinical condition deteriorated non-fatally in seven (1.0%) patients. The following events were associated with an increased risk of treatment or a diagnostic delay: more than three ward transfers (P = 0.025); referral to an incorrect speciality in the emergency department (P = 0.004); more than three SARS-CoV-2 RT-PCR tests performed (P = 0.022); and where cancer was the final diagnosis (P = 0.018). In contrast, lower respiratory tract symptoms (P = 0.013) decreased the risk. CONCLUSIONS: The use of isolation precautions for patients who did not have COVID-19 had minor negative effects on patient outcomes. The present study underlines the importance of targeting diagnostic efforts to patients with unspecified symptoms and to those with a negative SARS-CoV-2 test result. Thorough investigations to achieve an accurate diagnosis improves the prognosis of patients and facilitates appropriate targeting of hospital resources.

13.
Cartilage ; 13(1_suppl): 767S-779S, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34836478

RESUMEN

OBJECTIVE: To evaluate the morphological and biochemical quality of cartilage transplants and surrounding articular cartilage of patients 25 years after perichondrium transplantation (PT) and autologous chondrocyte transplantation (ACT) as measured by ultra-high-field 7-Tesla (7T) magnetic resonance imaging (MRI) and to present these findings next to clinical outcome. DESIGN: Seven PT patients and 5 ACT patients who underwent surgery on the femoral condyle between 1986 and 1996 were included. Patient-reported outcome measures (PROMs) were assessed by the clinical questionnaires: Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and Visual Analogue Scale (VAS) for knee pain. The morphological (MOCART score) and biochemical quality (glycosaminoglycans [GAGs] content and collagen integrity) of cartilage transplants and surrounding articular cartilage were analyzed by 7T MRI. The results of the PT and ACT patients were compared. Finally, a detailed morphological analysis of the grafts alone was performed. RESULTS: No statistically significant difference was found for the PROMs and MOCART scores of PT and ACT patients. Evaluation of the graft alone showed poor repair tissue quality and high prevalence of intralesional osteophyte formation in both the PT and ACT patients. Penetration of the graft surface by the intralesional osteophyte was related to biochemically damaged opposing tibial cartilage; GAG content was significantly lower in patients with an osteophyte penetrating the graft surface. CONCLUSIONS: Both PT and ACT patients have a high incidence of intralesional osteophyte formation 25 years after surgery. The resulting biochemical damage to the opposing tibial cartilage might be dependent on osteophyte morphology.


Asunto(s)
Cartílago Articular , Osteofito , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/lesiones , Cartílago Articular/cirugía , Condrocitos/trasplante , Humanos , Imagen por Resonancia Magnética/métodos , Osteofito/diagnóstico por imagen , Osteofito/cirugía , Trasplante Autólogo/métodos
14.
Osteoarthritis Cartilage ; 18(4): 581-92, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20060954

RESUMEN

INTRODUCTION: Although the extracellular matrix (ECM) is the functional element in articular cartilage and its degradation is central in the pathogenetic process in osteoarthritis (OA), increasing the knowledge about the cellular OA phenotype is essential. The aim of this study is therefore to provide a more complete picture of the cellular and molecular alterations detected in OA cartilage. MATERIAL AND METHODS: Human articular cartilage biopsies were collected from donors with macroscopical and microscopical signs of OA as well as donors with no previous history of OA and with microscopically intact cartilage. RNA was isolated from the biopsies and subjected to whole genome microarray analysis. Important results from the microarray analysis were verified using real-time PCR and immunohistochemistry. RESULTS: Our results reveal several new candidate genes not previously associated with OA to display significantly higher expression in OA cartilage than in normal donor cartilage, including genes involved in bone formation (CLEC3B, CDH11, GPNMB, CLEC3A, CHST11, MSX1, MSX2) and genes encoding collagens (COL13A1, COL14A1, COL15A1, COL8A2). DISCUSSION: This study is the first to report a comprehensive gene expression analysis of human OA cartilage compared to control cartilage from donors lacking macroscopical and microscopical signs of OA using recently developed microarrays containing the whole human genome. Our results could broadly confirm previously published data on many characteristic features of OA as well as adding a panel of genes to the list of genes known to be differentially expressed in OA. Elucidation of the phenotypical alterations occurring in OA chondrocytes is important for the development of effective treatments for OA.


Asunto(s)
Cartílago Articular/metabolismo , Perfilación de la Expresión Génica , Osteoartritis/genética , Anciano , Anciano de 80 o más Años , Cartílago Articular/patología , Femenino , Humanos , Masculino , Análisis por Micromatrices , Persona de Mediana Edad , Osteoartritis/metabolismo , Fenotipo , Reacción en Cadena de la Polimerasa/métodos , ARN/análisis
15.
Cells Tissues Organs ; 192(1): 17-27, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20134146

RESUMEN

Notch signalling, via its downstream mediators HES1 and HES5, regulates development of several different tissues. In vitro studies suggest that these genes are also involved in chondrogenesis and endochondral bone formation. In order to investigate the importance of HES1 and HES5 for these developmental processes, mice lacking chondrogenic expression of HES1 and HES5 were constructed by interbreeding HES5(-/-) mice homozygous for the floxed HES1 allele (HES1(flox/flox)) with COL2A1-Cre transgenic mice, creating conditional HES1;HES5 double mutant mice. The formation of cartilage and endochondral bone was studied in these mice using histological and immunohistochemical stainings, including Alcian Blue van Gieson, Safranin-O, modified Mallory Aniline Blue, tartrate-resistant acid phosphatase and collagen type II stainings. The mice were also studied using several different morphometrical analyses and the differentiation potential of the chondrocytes was evaluated in vitro. Unexpectedly, the conditional HES1;HES5 double mutant mice did not display impaired development of cartilage or endochondral bone. Lack of altered phenotype in the conditional HES1;HES5 double mutant mice can be explained either by the HES1 and HES5 genes not being involved in cartilage and endochondral bone development or by functional redundancy between the genes belonging to the family of HES genes: that is, disruption of one gene could be compensated for by the activity of another. Our results further shed light on the compensatory reserves available during the developing cartilage and bone.


Asunto(s)
Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/fisiología , Desarrollo Óseo/fisiología , Cartílago/fisiología , Condrogénesis/fisiología , Proteínas de Homeodominio/fisiología , Proteínas Represoras/fisiología , Animales , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/genética , Desarrollo Óseo/genética , Cartílago/crecimiento & desarrollo , Cartílago/metabolismo , Condrocitos/metabolismo , Condrocitos/patología , Colágeno Tipo II/genética , Colágeno Tipo II/fisiología , Femenino , Expresión Génica , Regulación de la Expresión Génica , Genotipo , Proteínas de Homeodominio/genética , Masculino , Ratones , Ratones Transgénicos , Proteínas Represoras/genética , Factor de Transcripción HES-1
16.
Cells Tissues Organs ; 191(1): 2-11, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-19494482

RESUMEN

Transplantation of mesenchymal stem cells (MSCs) has been suggested for disk degeneration, which is characterized by dysfunctional cells and low proteoglycan production. The aim of this study was to examine the effects of a 3D co-culture system using human disk cells (DCs) and MSCs on collagen and proteoglycan production. DCs and MSCs were expanded in monolayer and grown in pellet cultures for 7, 14 and 28 days and analyzed for hydroxyproline (HP), reflecting total collagen production, and glycosaminoglycan (GAG) accumulation. DCs and MSCs co-cultured at different ratios (25/75, 50/50 and 75%/25%) were examined for GAG accumulation. Collagen type II expression was analyzed immunohistochemically. In a second series, conditioned media were added to pellet cultures of degenerated DCs or MSCs. DCs from degenerated disks and MSCs demonstrated lower total collagen production than non-degenerated DC pellets. GAG production was comparable in DCs and MSCs, except in the youngest donor, with MSC producing about 10 times higher GAG/DNA. Co-cultures resulted in approximately 1.5 times higher GAG/DNA production than DCs. Increased collagen type II expression was seen in co-cultures compared to DC or MSC culture alone, except in the case with highly active MSCs. No positive effect of conditioned media was seen. In conclusion, co-culture of MSCs with degenerated DCs increased proteoglycan and collagen-type ceII production, indicating that in future clinical therapy MSCs can be transplanted without pre-differentiation in vitro. The lack of effect of conditioned media suggests that the positive effect of co-culture on matrix production is not due to soluble factors.


Asunto(s)
Comunicación Celular , Colágeno Tipo II/biosíntesis , Matriz Extracelular/metabolismo , Glicosaminoglicanos/biosíntesis , Disco Intervertebral/metabolismo , Células Madre Mesenquimatosas/metabolismo , Células de la Médula Ósea/citología , Técnicas de Cocultivo , Medios de Cultivo Condicionados , Humanos , Hidroxiprolina/metabolismo , Disco Intervertebral/patología , Degeneración del Disco Intervertebral/patología , Células Madre Mesenquimatosas/citología , Proteoglicanos/metabolismo
17.
BJS Open ; 4(4): 637-644, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32315119

RESUMEN

BACKGROUND: Reliable, easily accessible metrics of surgical quality are currently lacking. The HARM (HospitAl length of stay, Readmission and Mortality) score is a composite measure that has been validated across diverse surgical cohorts. The aim of this study was to validate the HARM score in a national population of patients undergoing abdominal surgery. METHODS: Data on all abdominal surgery in Norwegian hospitals from 2011 to 2017 were obtained from the Norwegian Patient Registry. Readmissions and 30-day postoperative complications as well as deaths in and out of hospital were evaluated. The HARM scoring algorithm was tested after adjustment by establishing a newly proposed length of stay score. The correlation between the HARM score and complications, as well as the ability of aggregated HARM scores to discriminate between hospitals, were analysed. Risk adjustment models were developed for nationwide hospital comparisons. RESULTS: The data consisted of 407 113 primary operations on 295 999 patients in 85 hospitals. The HARM score was associated with complications and complication severity (Goodman-Kruskal γ value 0·59). Surgical specialty was the dominating variable for risk adjustment. Based on 1-year data, the risk-adjusted score classified 16 hospitals as low HARM score and 16 as high HARM score of the 53 hospitals that had at least 30 operations. CONCLUSION: The HARM score correlates with major outcomes and is associated with the presence and severity of complications. After risk adjustment, the HARM score discriminated strongly between hospitals in a European population of abdominal surgery.


ANTECEDENTES: En la actualidad no se dispone de un sistema de cuantificación numérica confiable y accesible para evaluar la calidad quirúrgica. La puntuación HARM es una medida compuesta basada en la duración de la estancia hospitalaria, los reingresos y la mortalidad postoperatoria que se ha validado en varias cohortes quirúrgicas. El objetivo de este estudio fue validar la puntuación HARM en una población nacional de pacientes sometidos a cirugía abdominal. MÉTODOS: Se obtuvieron los datos de todas las cirugías abdominales realizadas en hospitales noruegos entre 2011 y 2017 a través del registro noruego de pacientes. Se evaluaron los reingresos y las complicaciones postoperatorias a los 30 días, así como la mortalidad intra- y extra-hospitalaria. Se utilizó el algoritmo de puntuación HARM tras el ajuste con la nueva propuesta de puntuación para la duración de la estancia hospitalaria. Se analizó la correlación entre HARM y complicaciones, así como la capacidad de las puntuaciones HARM agregadas para discriminar entre hospitales. Se desarrollaron modelos de ajuste de riesgo para las comparar hospitales en todo el país. RESULTADOS: Se incluyeron 407.113 intervenciones primarias llevadas a cabo en 295.999 pacientes en 85 hospitales. La puntuación HARM se asoció con las complicaciones y la gravedad de la complicación (Goodman-Kruskal γ de 0,59). La especialidad quirúrgica fue la variable dominante para el ajuste del riesgo. Utilizando los datos de un período anual, la puntuación ajustada al riesgo clasificó a 16 hospitales como de baja puntuación y a 16 de alta puntuación de los 53 hospitales en los que se habían realizado al menos 30 intervenciones. CONCLUSIÓN: La puntuación HARM se correlaciona con los resultados principales y con la presencia y la gravedad de las complicaciones. La puntuación HARM, después del ajuste de riesgo, discrimina de forma sólida entre hospitales en una población europea de cirugía abdominal. This article is protected by copyright. All rights reserved.


Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo/mortalidad , Mortalidad Hospitalaria , Tiempo de Internación , Evaluación del Resultado de la Atención al Paciente , Readmisión del Paciente , Abdomen/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Benchmarking , Estudios de Cohortes , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Noruega/epidemiología , Complicaciones Posoperatorias , Reproducibilidad de los Resultados , Ajuste de Riesgo
18.
Eur J Pharm Biopharm ; 152: 236-247, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32446960

RESUMEN

OrBiTo was a precompetitive collaboration focused on the development of the next generation of Oral Biopharmaceutics Tools. The consortium included world leading scientists from nine universities, one regulatory agency, one non-profit research organisation, three small/medium sized specialist technology companies together with thirteen pharmaceutical companies. The goal of the OrBiTo project was to deliver a framework for rational application of predictive biopharmaceutics tools for oral drug delivery. This goal was achieved through novel prospective investigations to define new methodologies or refinement of existing tools. Extensive validation has been performed of novel and existing biopharmaceutics tools using historical datasets supplied by industry partners as well as laboratory ring studies. A combination of high quality in vitro and in vivo characterizations of active drugs and formulations have been integrated into physiologically based in silico biopharmaceutics models capturing the full complexity of gastrointestinal drug absorption and some of the best practices has been highlighted. This approach has given an unparalleled opportunity to deliver transformational change in European industrial research and development towards model based pharmaceutical product development in accordance with the vision of model-informed drug development.


Asunto(s)
Biofarmacia/métodos , Preparaciones Farmacéuticas/química , Administración Oral , Animales , Sistemas de Liberación de Medicamentos/métodos , Desarrollo de Medicamentos/métodos , Tracto Gastrointestinal/metabolismo , Humanos , Absorción Intestinal , Estudios Prospectivos
19.
Science ; 233(4763): 571-4, 1986 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-3523759

RESUMEN

Whether growth hormone stimulates longitudinal bone growth by a direct effect at the site of the growth plate or indirectly by increasing the concentration of circulating somatomedins (insulin-like growth factors) has been the subject of controversy. Immunohistochemical methods were used to explore the localization and distribution of insulin-like growth factor I (IGF-I) immunoreactivity in the epiphyseal growth plate of the proximal tibia of male rats. Cells in the proliferative zone of the growth plate of normal rats exhibited a bright immunofluorescence, whereas cells in the germinal and hypertrophic zones stained only weakly. In rats subjected to hypophysectomy, the number of fluorescent cells was markedly reduced. When the hypophysectomized rats were treated with growth hormone, either systemically or at the site of the growth plate, the number of IGF-I-immunoreactive cells in the proliferative zone was increased. The results show that IGF-I is produced in proliferative chondrocytes in the growth plate and that the number of IGF-I-containing cells is directly regulated by growth hormone. These findings suggest that IGF-I has a specific role in the clonal expansion of differentiated chondrocytes and exerts its function locally through autocrine or paracrine mechanisms.


Asunto(s)
Hormona del Crecimiento/fisiología , Placa de Crecimiento/citología , Factor I del Crecimiento Similar a la Insulina/fisiología , Somatomedinas/fisiología , Animales , Técnica del Anticuerpo Fluorescente , Hormona del Crecimiento/farmacología , Placa de Crecimiento/efectos de los fármacos , Placa de Crecimiento/crecimiento & desarrollo , Hipofisectomía , Factor I del Crecimiento Similar a la Insulina/farmacología , Masculino , Ratas , Ratas Endogámicas , Tibia
20.
Equine Vet J ; 51(5): 674-680, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30739342

RESUMEN

BACKGROUND: Molecular serum markers that can identify early reversible osteoarthritis (OA) in horses are lacking. OBJECTIVES: We studied serum concentrations of a novel cartilage oligomeric matrix protein (COMP) neo-epitope in horses subjected to short-term exercise and with acute lameness. The effects of circadian rhythm and age were also evaluated. STUDY DESIGN: Longitudinal studies in healthy horses and cross-sectional comparison of lame and non-lame horses. METHODS: Sera were collected from five horses before and after short-term interval exercise and during full-day box rest. Sera from 32 acutely lame horses were used to evaluate age-related effects. Independent samples from control horses (n = 41) and horses with acute lameness (n = 71) were included. COMP neo-epitope concentrations were analysed using custom-developed inhibition ELISAs validated for equine serum. The presence of COMP neo-epitope was delineated in healthy and osteoarthritic articular cartilage with immunohistochemistry. RESULTS: COMP neo-epitope concentrations decreased after speed training but returned to baseline levels post-exercise. No correlations between age and serum COMP neo-epitope concentrations were found (r = 0.0013). The mean (±s.d.) serum concentration of COMP neo-epitope in independent samples from non-lame horses was 0.84 ± 0.38 µg/mL, and for lame horses was 5.24 ± 1.83 µg/mL (P<0.001). Antibodies against COMP neo-epitope did not stain normal articular cartilage, but intracytoplasmic staining was found in superficial chondrocytes of mild OA cartilage and in the extracellular matrix of moderately osteoarthritic cartilage. MAIN LIMITATIONS: ELISA was based on polyclonal antisera rather than a monoclonal antibody. There is a sex and breed bias within the groups of horses, also it could have been of value to include horses with septic arthritis and tendonitis and investigated joint differences. CONCLUSIONS: This COMP neo-epitope can be measured in sera, and results indicate that it could be a biomarker for pathologic fragmentation of cartilage in connection with acute joint lameness.


Asunto(s)
Envejecimiento , Proteína de la Matriz Oligomérica del Cartílago/metabolismo , Ritmo Circadiano , Enfermedades de los Caballos/metabolismo , Cojera Animal , Condicionamiento Físico Animal , Animales , Biomarcadores , Proteína de la Matriz Oligomérica del Cartílago/sangre , Proteína de la Matriz Oligomérica del Cartílago/genética , Epítopos/genética , Epítopos/metabolismo , Femenino , Enfermedades de los Caballos/sangre , Enfermedades de los Caballos/diagnóstico , Caballos , Estudios Longitudinales , Masculino
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