Immunogenic and reactogenic efficacy of Covaxin and Covishield: a comparative review

Immunologic Research - SARS-CoV-2 is an RNA virus that was identified for the first time in December 2019 in Wuhan, China. The World Health Organization (WHO) labeled the novel coronavirus...     

2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative

Objective

The 1987 American College of Rheumatology (ACR; formerly, the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticized for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA.

Methods

A joint working group from the ACR and the European League Against Rheumatism developed, in 3 phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease—this being the appropriate current paradigm underlying the disease construct “rheumatoid arthritis.”

Results

In the new criteria set, classification as “definite RA” is based on the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in 4 domains: number and site of involved joints (score range 0–5), serologic abnormality (score range 0–3), elevated acute‐phase response (score range 0–1), and symptom duration (2 levels; range 0–1).

Conclusion

This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late‐stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease‐suppressing therapy to prevent or minimize the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct “rheumatoid arthritis.”

     

Discectomy combined with isolated facet joint fusion—as an alternative fusion technique. Our clinical experience

Objective  The purpose of the present study is to present our experience and clinical results with surgical technique of discectomy and facet joint fusion. Our goal was to achieve pain free and stable back (segmental stability) after lumbar disc surgery and to assess the status of fusion and its relationship with clinical results. Study design  The proposed study is a prospective clinical study of low back pain/leg pain due to prolapse intervertebral disc treated with discectomy with facet joint fusion (using titanium screws) A case of symptomatic disc prolapse not improving on at least 6 weeks of conservative management. Clinical and radiological follow up was done up to average of five years. Method  After laminectomy and disc removal. Denude the facet joint cartilage with help of fine curved curette and fine slivers of bone graft taken from spinous processes are impacted into facet joint space after distracting them with help of spreader. Titanium partially threaded cancellous screws with 2.7 mm drill bit without taping. Results  Complete fusion across bilateral facets was achieved in 56.2% levels. Partial fusion was achieved in 34.3% levels. No fusion at all was seen in only 3 levels (9.3%). On applying chi square test between the 4 groups, chi square value came to be 44.92 with P value of <0.001. This implied that Post-op Oswestry score and clinical results have statistically significant association with status of fusion Conclusion  This study demonstrates that facet screw fixation has multiple advantages. The technique is not only easy to implement by placing a small screw through a facet joint without any excessive retraction of neural structures and any distraction of posterior elements thus preserving the segmental stability. It produces excellent clinical results that are comparable to other exhaustive surgical procedures and more bulky spinal instrumentation systems     

Does facility-based newborn care improve neonatal outcomes? A review of evidence

Context  

Facility based newborn care is gaining importance as an intervention aiming at reduction of neonatal mortality.     

Cartilage Matrix Formation by Bovine Mesenchymal Stem Cells in Three-dimensional Culture Is Age-dependent

Background

Cartilage degeneration is common in the aged, and aged chondrocytes are inferior to juvenile chondrocytes in producing cartilage-specific extracellular matrix. Mesenchymal stem cells (MSCs) are an alternative cell type that can differentiate toward the chondrocyte phenotype. Aging may influence MSC chondrogenesis but remains less well studied, particularly in the bovine system.

Questions/purposes

The objectives of this study were (1) to confirm age-related changes in bovine articular cartilage, establish how age affects chondrogenesis in cultured pellets for (2) chondrocytes and (3) MSCs, and (4) determine age-related changes in the biochemical and biomechanical development of clinically relevant MSC-seeded hydrogels.

Methods

Native bovine articular cartilage from fetal (n = 3 donors), juvenile (n = 3 donors), and adult (n = 3 donors) animals was analyzed for mechanical and biochemical properties (n = 3–5 per donor). Chondrocyte and MSC pellets (n = 3 donors per age) were cultured for 6 weeks before analysis of biochemical content (n = 3 per donor). Bone marrow-derived MSCs of each age were also cultured within hyaluronic acid hydrogels for 3 weeks and analyzed for matrix deposition and mechanical properties (n = 4 per age).

Results

Articular cartilage mechanical properties and collagen content increased with age. We observed robust matrix accumulation in three-dimensional pellet culture by fetal chondrocytes with diminished collagen-forming capacity in adult chondrocytes. Chondrogenic induction of MSCs was greater in fetal and juvenile cell pellets. Likewise, fetal and juvenile MSCs in hydrogels imparted greater matrix and mechanical properties.

Conclusions

Donor age and biochemical microenvironment were major determinants of both bovine chondrocyte and MSC functional capacity.

Clinical Relevance

In vitro model systems should be evaluated in the context of age-related changes and should be benchmarked against human MSC data.