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1.
J Chem Phys ; 161(5)2024 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-39109908

RESUMEN

We have performed classical molecular dynamics simulations using the fully polarizable Atomic Multipole Optimized Energetics for Biomolecular Applications (AMOEBA) forcefield implemented within the Tinker package to determine whether a more adequate treatment of electrostatics is sufficient to correctly describe the mixing of methane with water under high pressure conditions. We found a significant difference between the ability of AMOEBA and other classical, computationally cheaper forcefields, such as TIP3P, simple point charge-extended, TIP4P, and optimized potentials for liquid simulations-all atom. While the latter models fail to detect any effect of pressure on the miscibility of methane in water, AMOEBA qualitatively captures the experimental observation of the increased solubility of methane in water with pressure. At higher temperatures, the solubility of water in methane also increases; this seems to be associated with the breakdown of the fourfold hydrogen-bonded water network structure: bonding in water is weaker, so the energy cost of solution is lowered.

2.
Am Heart J ; 245: 100-109, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34932999

RESUMEN

BACKGROUND: Tricuspid valve disease (TVD) is presumed common, however, little is known about its prevalence or the impact of tricuspid valve surgery (TVS) on healthcare resource use. METHODS: To describe the prevalence of TVD and assess the impact of TVS on resource utilization, Medicare Fee-For-Service beneficiaries from 2011 -2019 were assessed for the prevalence of non-rheumatic TVD. Hospital costs and rates of all-cause, cardiovascular (CV), and heart failure (HF) hospitalizations were compared in the 3 months pre TVS to acute (0-3 months) and chronic (3 -12 months) post TVS periods. RESULTS: Among 80.3 million beneficiaries from 2011 - 2019 Q1, over 700,000 (0.9%) had non-rheumatic TVD with 1.4% undergoing TVS. Thirty-day and 1 year mortality after TVS was 5.5% to15.5%. Compared with pre-surgery, CV and HF hospitalizations decreased from 0.12 to 0.08 per patient-month (P <.001), and 0.06 to 0.04 (P <.001) acutely. All-cause hospitalizations increased from 0.18 per patient-month to 0.23 per patient-month acutely post-surgery (P <.001), before decreasing to 0.09 per patient-month chronically (P <.001). Hospital costs increased from $2,174 per patient-month to $4,171 per patient-month acutely (P < .001), before falling to $1,441 per patient-month (P < .001) chronically. Lower costs for HF and CV hospitalization in both acute (P = .028 and P < .001, respectively) and chronic (P < .001 for both) periods were observed. CONCLUSIONS: TVS is associated with reduced CV and HF hospitalizations and associated hospital costs. Future work should determine whether transcatheter tricuspid valve repair offers similar or additional benefits.


Asunto(s)
Enfermedades de las Válvulas Cardíacas , Válvula Tricúspide , Anciano , Enfermedades de las Válvulas Cardíacas/epidemiología , Enfermedades de las Válvulas Cardíacas/cirugía , Hospitales , Humanos , Medicare , Prevalencia , Estudios Retrospectivos , Válvula Tricúspide/cirugía , Estados Unidos/epidemiología
3.
Phys Rev Lett ; 129(7): 071101, 2022 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-36018684

RESUMEN

The existence of a "knee" at energy ∼1 PeV in the cosmic-ray spectrum suggests the presence of Galactic PeV proton accelerators called "PeVatrons." Supernova remnant (SNR) G106.3+2.7 is a prime candidate for one of these. The recent detection of very high energy (0.1-100 TeV) gamma rays from G106.3+2.7 may be explained either by the decay of neutral pions or inverse Compton scattering by relativistic electrons. We report an analysis of 12 years of Fermi-LAT gamma-ray data that shows that the GeV-TeV gamma-ray spectrum is much harder and requires a different total electron energy than the radio and x-ray spectra, suggesting it has a distinct, hadronic origin. The nondetection of gamma rays below 10 GeV implies additional constraints on the relativistic electron spectrum. A hadronic interpretation of the observed gamma rays is strongly supported. This observation confirms the long-sought connection between Galactic PeVatrons and SNRs. Moreover, it suggests that G106.3+2.7 could be the brightest member of a new population of SNRs whose gamma-ray energy flux peaks at TeV energies. Such a population may contribute to the cosmic-ray knee and be revealed by future very high energy gamma-ray detectors.

4.
Proc Natl Acad Sci U S A ; 116(4): 1404-1413, 2019 01 22.
Artículo en Inglés | MEDLINE | ID: mdl-30617071

RESUMEN

A person's decisions vary even when options stay the same, like when a gambler changes bets despite constant odds of winning. Internal bias (e.g., emotion) contributes to this variability and is shaped by past outcomes, yet its neurobiology during decision-making is not well understood. To map neural circuits encoding bias, we administered a gambling task to 10 participants implanted with intracerebral depth electrodes in cortical and subcortical structures. We predicted the variability in betting behavior within and across patients by individual bias, which is estimated through a dynamical model of choice. Our analysis further revealed that high-frequency activity increased in the right hemisphere when participants were biased toward risky bets, while it increased in the left hemisphere when participants were biased away from risky bets. Our findings provide electrophysiological evidence that risk-taking bias is a lateralized push-pull neural system governing counterintuitive and highly variable decision-making in humans.


Asunto(s)
Corteza Cerebral/fisiología , Adulto , Sesgo , Mapeo Encefálico/métodos , Toma de Decisiones , Femenino , Juego de Azar/fisiopatología , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Asunción de Riesgos
5.
Angew Chem Int Ed Engl ; 61(30): e202201843, 2022 07 25.
Artículo en Inglés | MEDLINE | ID: mdl-35583940

RESUMEN

Porphyromonas gingivalis is a keystone pathogen in periodontal disease. We herein report a dual-modal fluorescent and photoacoustic imaging probe for the detection of gingipain proteases secreted by P. gingivalis. Upon proteolytic cleavage by Arg-specific gingipain (RgpB), five-fold photoacoustic enhancement and >100-fold fluorescence activation was measured with detection limits of 1.1 nM RgpB and 5.0E4 CFU mL-1 bacteria in vitro. RgpB activity was imaged in porcine jaws with low-nanomolar sensitivity. Diagnostic efficacy was evaluated in gingival crevicular fluid samples from subjects with and without periodontal disease, wherein activation was correlated to qPCR-based detection of P. gingivalis (Pearson's r=0.71). Finally, photoacoustic imaging of RgpB-cleaved probe was achieved in murine brains ex vivo, with relevance and potential utility for disease models of general infection by P. gingivalis, motivated by the recent biological link between gingipain and Alzheimer's disease.


Asunto(s)
Enfermedades Periodontales , Porphyromonas gingivalis , Adhesinas Bacterianas , Animales , Cisteína Endopeptidasas , Colorantes Fluorescentes , Cisteína-Endopeptidasas Gingipaínas , Humanos , Ratones , Porcinos
6.
Proc Biol Sci ; 288(1962): 20211534, 2021 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-34753352

RESUMEN

Latitudinal diversity gradients are among the most striking patterns in nature. Despite a large body of work investigating both geographic and environmental drivers, biogeographical provinces have not been included in statistical models of diversity patterns. Instead, spatial studies tend to focus on species-area and local-regional relationships. Here, we investigate correlates of a latitudinal diversity pattern in Australian coastal molluscs. We use an online database of greater than 300 000 specimens and quantify diversity using four methods to account for sampling variation. Additionally, we present a biogeographic scheme using factor analysis that allows for both gradients and sharp boundaries between clusters. The factors are defined on the basis of species composition and are independent of diversity. Regardless of the measure used, diversity is not directly explained by combinations of abiotic variables. Instead, transitions between regions better explain the observed patterns. Biogeographic gradients can in turn be explained by environmental variables, suggesting that environmental controls on diversity may be indirect. Faunas within provinces are homogeneous regardless of environmental variability. Thus, transitions between provinces explain most of the variation in diversity because small-scale factors are dampened. This explanation contrasts with the species-energy hypothesis. Future work should more carefully consider biogeographic gradients when investigating diversity patterns.


Asunto(s)
Biodiversidad , Moluscos , Animales , Australia , Moluscos/clasificación , Filogeografía
7.
Magn Reson Med ; 85(6): 2978-2991, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33538063

RESUMEN

PURPOSE: Phosphorus saturation-transfer experiments can quantify metabolic fluxes noninvasively. Typically, the forward flux through the creatine kinase reaction is investigated by observing the decrease in phosphocreatine (PCr) after saturation of γ-ATP. The quantification of total ATP utilization is currently underexplored, as it requires simultaneous saturation of inorganic phosphate ( Pi ) and PCr. This is challenging, as currently available saturation pulses reduce the already-low γ-ATP signal present. METHODS: Using a hybrid optimal-control and Shinnar-Le Roux method, a quasi-adiabatic RF pulse was designed for the dual saturation of PCr and Pi to enable determination of total ATP utilization. The pulses were evaluated in Bloch equation simulations, compared with a conventional hard-cosine DANTE saturation sequence, before being applied to perfused rat hearts at 11.7 T. RESULTS: The quasi-adiabatic pulse was insensitive to a >2.5-fold variation in B1 , producing equivalent saturation with a 53% reduction in delivered pulse power and a 33-fold reduction in spillover at the minimum effective B1 . This enabled the complete quantification of the synthesis and degradation fluxes for ATP in 30-45 minutes in the perfused rat heart. While the net synthesis flux (4.24 ± 0.8 mM/s, SEM) was not significantly different from degradation flux (6.88 ± 2 mM/s, P = .06) and both measures are consistent with prior work, nonlinear error analysis highlights uncertainties in the Pi -to-ATP measurement that may explain a trend suggesting a possible imbalance. CONCLUSIONS: This work demonstrates a novel quasi-adiabatic dual-saturation RF pulse with significantly improved performance that can be used to measure ATP turnover in the heart in vivo.


Asunto(s)
Adenosina Trifosfato , Miocardio , Animales , Creatina Quinasa , Espectroscopía de Resonancia Magnética , Fosfocreatina , Ratas
8.
Diabetes Spectr ; 34(2): 184-189, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34149259

RESUMEN

BACKGROUND: Glycemic control is suboptimal in many individuals with type 2 diabetes. Although use of flash continuous glucose monitoring (CGM) has demonstrated A1C reductions in patients with type 2 diabetes treated with a multiple daily injection or insulin pump therapy regimen, the glycemic benefit of this technology in patients with type 2 diabetes using nonintensive treatment regimens has not been well studied. METHODS: This retrospective, observational study used the IBM Explorys database to assess changes in A1C after flash CGM prescription in a large population with suboptimally controlled type 2 diabetes treated with nonintensive therapy. Inclusion criteria were diagnosis of type 2 diabetes, age <65 years, treatment with basal insulin or noninsulin therapy, naive to any CGM, baseline A1C ≥8%, and a prescription for the FreeStyle Libre flash CGM system during the period between October 2017 and February 2020. Patients served as their own control subject. RESULTS: A total of 1,034 adults with type 2 diabetes (mean age 51.6 ± 9.2 years, 50.9% male, baseline A1C 10.1 ± 1.7%) were assessed. More patients received noninsulin treatments (n = 728) than basal insulin therapy (n = 306). We observed a significant reduction in A1C within the full cohort: from 10.1 ± 1.7 to 8.6 ± 1.8%; Δ -1.5 ± 2.2% (P <0.001). The largest reductions were seen in patients with a baseline A1C ≥12.0% (n = 181, A1C reduction -3.7%, P <0.001). Significant reductions were seen in both treatment groups (basal insulin -1.1%, noninsulin -1.6%, both P <0.001). CONCLUSION: Prescription of the flash CGM system was associated with significant reductions in A1C in patients with type 2 diabetes treated with basal insulin or noninsulin therapy. These findings provide evidence for expanding access to flash CGM within the broader population of people with type 2 diabetes.

9.
NMR Biomed ; 32(7): e4099, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31090979

RESUMEN

Hypoxia plays a role in many diseases and can have a wide range of effects on cardiac metabolism depending on the extent of the hypoxic insult. Noninvasive imaging methods could shed valuable light on the metabolic effects of hypoxia on the heart in vivo. Hyperpolarized carbon-13 magnetic resonance spectroscopy (HP 13 C MRS) in particular is an exciting technique for imaging metabolism that could provide such information. The aim of our work was, therefore, to establish whether hyperpolarized 13 C MRS can be used to assess the in vivo heart's metabolism of pyruvate in response to systemic acute and chronic hypoxic exposure. Groups of healthy male Wistar rats were exposed to either acute (30 minutes), 1 week or 3 weeks of hypoxia. In vivo MRS of hyperpolarized [1-13 C] pyruvate was carried out along with assessments of physiological parameters and ejection fraction. Hematocrit was elevated after 1 week and 3 weeks of hypoxia. 30 minutes of hypoxia resulted in a significant reduction in pyruvate dehydrogenase (PDH) flux, whereas 1 or 3 weeks of hypoxia resulted in a PDH flux that was not different to normoxic animals. Conversion of hyperpolarized [1-13 C] pyruvate into [1-13 C] lactate was elevated following acute hypoxia, suggestive of enhanced anaerobic glycolysis. Elevated HP pyruvate to lactate conversion was also seen at the one week timepoint, in concert with an increase in lactate dehydrogenase (LDH) expression. Following three weeks of hypoxic exposure, cardiac metabolism of pyruvate was comparable with that observed in normoxia. We have successfully visualized the effects of systemic hypoxia on cardiac metabolism of pyruvate using hyperpolarized 13 C MRS, with differences observed following 30 minutes and 1 week of hypoxia. This demonstrates the potential of in vivo hyperpolarized 13 C MRS data for assessing the cardiometabolic effects of hypoxia in disease.


Asunto(s)
Espectroscopía de Resonancia Magnética con Carbono-13 , Hipoxia/metabolismo , Miocardio/metabolismo , Animales , Hipoxia/sangre , Masculino , Oxígeno/sangre , Ratas Wistar
10.
Biochim Biophys Acta ; 1857(1): 14-22, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26453935

RESUMEN

Mitochondrial ADP/ATP carriers catalyze the equimolar exchange of ADP and ATP across the mitochondrial inner membrane. Structurally, they consist of three homologous domains with a single substrate binding site. They alternate between a cytoplasmic and matrix state in which the binding site is accessible to these compartments for binding of ADP or ATP. It has been proposed that cycling between states occurs by disruption and formation of a matrix and cytoplasmic salt bridge network in an alternating way, but formation of the latter has not been shown experimentally. Here, we show that state-dependent formation of the cytoplasmic salt bridge network can be demonstrated by measuring the effect of mutations on the thermal stability of detergent-solubilized carriers locked in a specific state. For this purpose, mutations were made to increase or decrease the overall interaction energy of the cytoplasmic network. When locked in the cytoplasmic state by the inhibitor carboxyatractyloside, the thermostabilities of the mutant and wild-type carriers were similar, but when locked in the matrix state by the inhibitor bongkrekic acid, they correlated with the predicted interaction energy of the cytoplasmic network, demonstrating its formation. Changing the interaction energy of the cytoplasmic network also had a profound effect on the kinetics of transport, indicating that formation of the network is a key step in the transport cycle. These results are consistent with a unique alternating access mechanism that involves the simultaneous rotation of the three domains around a central translocation pathway.


Asunto(s)
Citoplasma/metabolismo , Translocasas Mitocondriales de ADP y ATP/metabolismo , Transporte Biológico , Cinética , Translocasas Mitocondriales de ADP y ATP/química , Pliegue de Proteína
11.
Clin Sci (Lond) ; 131(16): 2079-2094, 2017 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-28739841

RESUMEN

Fatty acids (FA) are the main fuel used by the healthy heart to power contraction, supplying 60-70% of the ATP required. FA generate more ATP per carbon molecule than glucose, but require more oxygen to produce the ATP, making them a more energy dense but less oxygen efficient fuel compared with glucose. The pathways involved in myocardial FA metabolism are regulated at various subcellular levels, and can be divided into sarcolemmal FA uptake, cytosolic activation and storage, mitochondrial uptake and ß-oxidation. An understanding of the critical involvement of each of these steps has been amassed from genetic mouse models, where forcing the heart to metabolize too much or too little fat was accompanied by cardiac contractile dysfunction and hypertrophy. In cardiac pathologies, such as heart disease and diabetes, aberrations in FA metabolism occur concomitantly with changes in cardiac function. In heart failure, FA oxidation is decreased, correlating with systolic dysfunction and hypertrophy. In contrast, in type 2 diabetes, FA oxidation and triglyceride storage are increased, and correlate with diastolic dysfunction and insulin resistance. Therefore, too much FA metabolism is as detrimental as too little FA metabolism in these settings. Therapeutic compounds that rebalance FA metabolism may provide a mechanism to improve cardiac function in disease. Just like Goldilocks and her porridge, the heart needs to maintain FA metabolism in a zone that is 'just right' to support contractile function.


Asunto(s)
Ácidos Grasos/metabolismo , Miocardio/metabolismo , Animales , Ciclo del Ácido Cítrico/fisiología , Citosol/metabolismo , Diabetes Mellitus/metabolismo , Modelos Animales de Enfermedad , Glucosa/metabolismo , Cardiopatías/metabolismo , Humanos , Mitocondrias Cardíacas/metabolismo , Contracción Miocárdica/fisiología
12.
Proc Natl Acad Sci U S A ; 111(52): 18727-32, 2014 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-25512550

RESUMEN

Reinstatement of neural activity is hypothesized to underlie our ability to mentally travel back in time to recover the context of a previous experience. We used intracranial recordings to directly examine the precise spatiotemporal extent of neural reinstatement as 32 participants with electrodes placed for seizure monitoring performed a paired-associates episodic verbal memory task. By cueing recall, we were able to compare reinstatement during correct and incorrect trials, and found that successful retrieval occurs with reinstatement of a gradually changing neural signal present during encoding. We examined reinstatement in individual frequency bands and individual electrodes and found that neural reinstatement was largely mediated by temporal lobe theta and high-gamma frequencies. Leveraging the high temporal precision afforded by intracranial recordings, our data demonstrate that high-gamma activity associated with reinstatement preceded theta activity during encoding, but during retrieval this difference in timing between frequency bands was absent. Our results build upon previous studies to provide direct evidence that successful retrieval involves the reinstatement of a temporal context, and that such reinstatement occurs with precise spatiotemporal dynamics.


Asunto(s)
Corteza Cerebral/fisiopatología , Electroencefalografía , Memoria , Convulsiones/fisiopatología , Transmisión Sináptica , Femenino , Humanos , Masculino
14.
J Orthop Trauma ; 2024 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-39137065

RESUMEN

OBJECTIVES: The objective of this study was to report outcomes of the Retrograde Femoral Nail-Advanced with Lateral Attachment Washer (RFNA-LAW) (Synthes; Paoli, PA) compared to laterally locked plates (LLP) when treating AO/OTA type 33 distal femoral fractures. METHODS: Design: Retrospective chart review. SETTING: Single, academic, Level-1 Trauma Center. PATIENT SELECTION CRITERIA: All adult patients who had fixation of an AO/OTA type 33 distal femoral fracture with the RFNA-LAW combination or LLP from 2018-2023 with follow-up to union or a minimum of one year. immediately post-operatively and at final follow-up. OUTCOME MEASURES AND COMPARISONS: The main outcome measure was union. Secondary outcomes included implant failure, infection, and alignment immediately post-operatively and at final follow-up. Patients were followed for a minimum of 1-year or to skeletal healing. RESULTS: Forty-eight patients (19 female) with a mean age of 56 years (range 19-94 years) were in the RFNA-LAW group. Fifty-three patients (29 female) with a mean age of 66 years (24-91 years) were in the LLP group. There were no significant differences when comparing Body Mass Index, diabetes, smoking status, mechanism of injury, or fracture classification between groups (p>0.05). There was no difference in immediate, post-operative alignment (p = 0.49). When comparing aLDFA measurements at final follow-up, there was significantly more malalignment in the LLP group (p = 0.005). There were 8 implant failures (15%) in the LLP group compared to 1 in the RFNA-LAW group (2%) (p = 0.02). There were 14 reoperations (26%) in the LLP group compared to 4 (8%) in the RFNA-LAW group (p = 0.02). CONCLUSIONS: The Retrograde Nail Advanced - Lateral Attachment Washer combination demonstrated a high union rate when treating complex fractures of the distal femur. When compared to lateral locked plating, this implant combination demonstrated significantly lower rates of nonunion and reoperation. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

15.
Meat Sci ; 214: 109522, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38692014

RESUMEN

Verification of beef production systems and authentication of origin is becoming increasingly important as consumers base purchase decisions on a greater number of perceived values including the healthiness and environmental impact of products. Previously Raman spectroscopy has been explored as a tool to classify carcases from grass and grain fed cattle. Thus, the aim of the current study was to validate Partial Least Squares Discriminant Analysis (PLS-DA) models created using independent samples from carcases sampled from northern and southern Australian production systems in 2019, 2020 and 2021. Validation of the robustness of discrimination models was undertaken using spectral measures of fat from 585 carcases which were measured in 2022 using a Raman handheld device with a sample excised for fatty acid analysis. PLS-DA models were constructed and then employed to classify samples as either grass or grain fed in a two-class model. Overall, predictions were high with accuracies of up to 95.7% however, variation in the predictive ability was noted with models created for southern cattle yielding an accuracy of 73.2%. While some variation in fatty acids and therefore models can be attributed to differences in genetics, management and diet, the impact of duration of feeding is currently unknown and thus further work is warranted.


Asunto(s)
Alimentación Animal , Dieta , Ácidos Grasos , Carne Roja , Espectrometría Raman , Animales , Bovinos , Espectrometría Raman/métodos , Carne Roja/análisis , Australia , Ácidos Grasos/análisis , Alimentación Animal/análisis , Dieta/veterinaria , Análisis Discriminante , Grano Comestible , Poaceae , Análisis de los Mínimos Cuadrados
16.
ACS Nano ; 18(3): 1892-1906, 2024 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-38016062

RESUMEN

Disease-modifying drugs have improved the treatment for autoimmune joint disorders, such as rheumatoid arthritis, but inflammatory flares are a common experience. This work reports the development and application of flare-modulating poly(lactic-co-glycolic acid)-poly(ethylene glycol)-maleimide (PLGA-PEG-MAL)-based nanoparticles conjugated with joint-relevant peptide antigens, aggrecan70-84 and type 2 bovine collagen256-270. Peptide-conjugated PLGA-PEG-MAL nanoparticles encapsulated calcitriol, which acted as an immunoregulatory agent, and were termed calcitriol-loaded nanoparticles (CLNP). CLNP had a ∼200 nm hydrodynamic diameter with a low polydispersity index. In vitro, CLNP induced phenotypic changes in bone marrow derived dendritic cells (DC), reducing the expression of costimulatory and major histocompatibility complex class II molecules, and proinflammatory cytokines. Bulk RNA sequencing of DC showed that CLNP enhanced expression of Ctla4, a gene associated with downregulation of immune responses. In vivo, CLNP accumulated in the proximal lymph nodes after intramuscular injection. Administration of CLNP was not associated with changes in peripheral blood cell numbers or cytokine levels. In the collagen-induced arthritis and SKG mouse models of autoimmune joint disorders, CLNP reduced clinical scores, prevented bone erosion, and preserved cartilage proteoglycan, as assessed by high-resolution microcomputed tomography and histomorphometry analysis. The disease protective effects were associated with increased CTLA-4 expression in joint-localized DC and CD4+ T cells but without generalized suppression of T cell-dependent immune response. The results support the potential of CLNP as modulators of disease flares in autoimmune arthropathies.


Asunto(s)
Enfermedades Autoinmunes , Lactatos , Nanopartículas , Polietilenglicoles , Ratones , Animales , Bovinos , Calcitriol/metabolismo , Brote de los Síntomas , Microtomografía por Rayos X , Citocinas/metabolismo , Inmunidad , Nanopartículas/química , Células Dendríticas
17.
JBJS Case Connect ; 13(3)2023 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-37527396

RESUMEN

CASE: Nail-patella syndrome (NPS) is a genetic disorder causing anatomical abnormalities about the knee, including significant patellar hypoplasia. We present a case of a patient with NPS and severe knee osteoarthritis undergoing computer-assisted total knee arthroplasty (TKA). Several intraoperative anatomical challenges were appreciated. Postoperatively, the patient developed arthrofibrosis requiring manipulation; however, his final outcome was favorable. CONCLUSION: Computer assistance may improve precision in patients with NPS undergoing TKA, but surgeons must be aware of the associated anatomic abnormalities and potentially increased risk of arthrofibrosis. Patellar resurfacing is often not feasible because of lack of bone stock.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Síndrome de la Uña-Rótula , Osteoartritis de la Rodilla , Humanos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Síndrome de la Uña-Rótula/complicaciones , Síndrome de la Uña-Rótula/cirugía , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Osteoartritis de la Rodilla/cirugía , Rótula/cirugía
18.
Arthroplast Today ; 24: 101253, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38023647

RESUMEN

Introduction: The use of traditional, image intensifier fluoroscopy with a radiopaque grid during direct anterior total hip arthroplasty (DA THA) has demonstrated reduced variability in component positioning and operative time compared to fluoroscopy without a grid. A disadvantage of image intensifier fluoroscopy is spatial distortion, particularly compared to flat-panel fluoroscopy systems. The purpose of this study is to determine whether flat-panel fluoroscopy decreases variability in component positioning during DA THA compared to the use of traditional grid fluoroscopy. Methods: We retrospectively reviewed 70 consecutive DA THAs between February 2020 and February 2021: 36 using flat-panel fluoroscopy, and 34 using traditional fluoroscopy with a grid. Radiographs were independently reviewed by 2 authors to identify components exceeding goal parameters: cup abduction of 40 ± 10 degrees, as well as offset and limb lengths within 10 mm of the contralateral side. Binary values for goal parameter achievement were assigned for each THA. Results: No significant difference was observed in the number of hips that met goals for cup abduction (100% vs 97%, P = 1.00), hip offset (88% vs 88%, P = 1.00), limb length (91% vs 94% [ ±10 mm], P = .669, 65% vs 72% [±5 mm], P = .498), or for the number of hips that met all 3 component goals (79% vs 80%, P = 1.00). No significant difference in operative time was noted between the 2 groups (110.2 minutes vs 100.9, P = .76). Conclusions: We demonstrated no significant difference in component positioning in DA THAs utilizing flat-panel fluoroscopy as compared to using traditional fluoroscopy with a grid.

19.
JBJS Case Connect ; 13(4)2023 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-38064577

RESUMEN

CASE: We present a case of an anteroposterior compression (APC) type pelvic ring injury that occurred after chiropractic manipulation in a patient with a history of quadriplegia. Emergent surgical stabilization was undertaken, and he had an excellent outcome with no complications at 3.5-year follow-up. CONCLUSION: APC type pelvic ring injuries usually occur to high-energy mechanisms. We describe a case of a patient with quadriplegia and osteopenia that suffered a pelvic ring injury because of a unique mechanism. Practitioners performing pelvic manipulation should be aware of this type of injury in at-risk patients.


Asunto(s)
Lesiones por Aplastamiento , Fracturas Óseas , Manipulación Quiropráctica , Huesos Pélvicos , Masculino , Humanos , Fracturas Óseas/cirugía , Huesos Pélvicos/cirugía , Pelvis , Cuadriplejía
20.
Bioeng Transl Med ; 8(6): e10591, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38023723

RESUMEN

Sustained release of vaccine components is a potential method to boost efficacy compared with traditional bolus injection. Here, we show that a biodegradable hyaluronic acid (HA)-scaffold, termed HA cryogel, mediates sustained antigen and adjuvant release in vivo leading to a durable immune response. Delivery from subcutaneously injected HA cryogels was assessed and a formulation which enhanced the immune response while minimizing the inflammation associated with the foreign body response was identified, termed CpG-OVA-HAC2. Dose escalation studies with CpG-OVA-HAC2 demonstrated that both the antibody and T cell responses were dose-dependent and influenced by the competency of neutrophils to perform oxidative burst. In immunodeficient post-hematopoietic stem cell transplanted mice, immunization with CpG-OVA-HAC2 elicited a strong antibody response, three orders of magnitude higher than dose-matched bolus injection. In a melanoma model, CpG-OVA-HAC2 induced dose-responsive prophylactic protection, slowing the tumor growth rate and enhancing overall survival. Upon rechallenge, none of the mice developed new tumors suggesting the development of robust immunological memory and long-lasting protection against repeat infections. CpG-OVA-HAC2 also enhanced survival in mice with established tumors. The results from this work support the potential for CpG-OVA-HAC2 to enhance vaccine delivery.

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