Sensitivity of serum concentration of cartilage biomarkers to 21‐days of bed rest

The objective of the study was to test the hypothesis that serum levels of cartilage oligomeric matrix protein (COMP) would decrease and serum levels of tumor‐necrosis factor alpha (TNF‐α) and selected matrix metalloproteinases (MMPs) would increase in response to bed rest (BR) and that these changes are unaffected by the intake of potassium bicarbonate or whey protein. Seven and nine healthy male subjects participated in two 21‐day 6° head down tilt crossover BR‐studies with nutrition interventions. Serum samples were taken before, during, and after BR and biomarker concentrations were measured using commercial enzyme‐linked immunosorbent assays. MMP‐3 during BR was significantly lower than at baseline (reduction greater 20%; p < 0.001). MMP‐3 increased significantly from 14 to 21 days of BR (+7%; p = 0.049). COMP during BR was significantly lower than at baseline (reduction greater 20%; p < 0.001). MMP‐3 and COMP returned to baseline within 1 day after BR. MMP‐9 on day 3 of BR was significantly lower than at baseline (?31%; p < 0.033) and on days 3, 5, and 14 of BR significantly lower than at the end of and after BR (reduction greater 35%; p < 0.030). The nutritional countermeasures did not affect these results. The observed changes in cartilage biomarkers may be caused by altered cartilage metabolism in response to the lack of mechanical stimulus during BR and inflammatory biomarkers may play a role in changes in biomarker levels. Clinical relevance: Immobilization independently from injury can cause altered cartilage biomarker concentration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1465–1471, 2018.

     

Adaptive patterns of movement during stair climbing in patients with knee osteoarthritis

The purpose of this study was to determine if there is a distinctive characteristic in the pattern of movement (forward trunk lean to reduce demand on the quadriceps muscle) during stair climbing in patients with knee osteoarthritis (OA) that is associated with the severity of the disease. Twenty‐three patients with radiographically diagnosed knee OA and 20 physically active adults performed stair ascending trials without support at their self‐selected speed. Standard gait analysis was used to calculate three‐dimensional lower extremity joint kinematics and kinetics. Forward trunk lean, or trunk flexion, was defined as the sagittal plane projection of the angle between a line connecting the midpoint of the trans‐acromion line and the midpoint of the trans‐iliac crest line and the global vertical axis. Patients with more severe knee OA (KL ≥ 3) had greater forward trunk lean (+6.3°, p = 0.045) and lower knee net quadriceps moments (?35.2%, p = 0.001) than controls. In more severe patients, the forward trunk lean was correlated with a reduction in the net quadriceps moment during stair climbing (R² = 0.590, p = 0.006). The results of this study identified a distinctive compensatory pattern of movement to reduce the quadriceps demand during stair climbing in patients with more severe knee OA by increasing forward trunk lean. Assessing forward trunk lean during stair climbing may be a useful functional marker for evaluating osteoarthritis status and quadriceps function that appears to be a more sensitive indicator of disease severity than perceived pain. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:325–329, 2009     

Dizziness: Anxiety, health care utilization and health behavior—: Results from a representative German community survey

Background

Due to the lack of epidemiological data on the relation of dizziness and anxiety, we investigated the prevalence of dizziness and anxiety in a representative sample of the German population. We explored the consequences of comorbid anxiety for emotional distress, functional impairment, health care utilization, and health behavior in dizziness.

Methods

By the end of 2006, we surveyed a total of 1287 persons between 14 and 90 years of age in their homes by trained interviewers with standardized self-rating questionnaires on anxiety (Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Mini-Social Phobia Inventory) and dizziness (Vertigo Symptom Scale). The sample was representative for the German population in terms of age, sex, and education.

Results

Symptoms of dizziness were reported by 15.8% of the participants. Of the participants with dizziness, 28.3% reported symptoms of at least one anxiety disorder (generalized anxiety, social phobia, panic). Persons with dizziness reported more somatic problems such as hypertension, migraine, diabetes, etc. Comorbid anxiety was associated with increased health care use and impairment.

Conclusion

Dizziness is a highly prevalent symptom in the general population. A subgroup with comorbid anxiety is characterized by an increased subjective impairment and health care utilization due to their dizziness. Because treatment options for distinct neurotologic disorders are also known to reduce psychological symptoms, and in order to avoid unnecessary medical treatment, early neurologic and psychiatric/psychotherapeutic referral may be indicated.     

Fluorescent bacterial magnetic nanoparticles as bimodal contrast agents

OBJECTIVES: The purpose of this study was to assess whether fluorochrome-coupled bacterial magnetic nanoparticles can be used as bimodal contrast agent for both magnetic resonance imaging (MRI) and near-infrared fluorescence optical (NIRF) imaging of cultured macrophages. MATERIALS AND METHODS: Bacterial magnetic nanoparticles (magnetosomes, particle diameter: 42 nm) were harvested from Magnetospirillum gryphiswaldense and characterized by using MRI. After covalent coupling to the fluorescent dye DY-676 (lambdaabs./lambdaem.= 676 nm/701 nm, Dyomics, Jena, Germany), the fluorescent magnetosomes were analyzed by fluorescence-activated cell sorting. Subsequently, murine macrophages J774 were incubated with the bimodal contrast agent (3 hours) and examined by a whole-body near infrared small animal imaging system as well as by using a 1.5 T clinical MR system. Moreover, labeled cells were characterized using confocal laser scanning microscopy (CLSM) and ultrathin section transmission electron microscopy. RESULTS: Characterization of the nanoparticles by MRI revealed R1 and R2 relaxivities of 3.2 mMs and 526 mMs, respectively. Fluorochrome-coupled magnetosomes exhibited increased fluorescence intensities at wavelengths >670 nm. Macrophages that were incubated with the contrast agent showed a significant fluorescence emission in the near infrared range as imaged with a whole body NIR imaging system, FACS analysis and CLSM. Moreover, CLSM data showed the greatest fluorescence intensities within intracellular compartments and colocalized with the magnetosomes. With MRI, both T1 and T2 relaxation times were substantially shortened at concentrations greater than 600 cells/microL. DISCUSSION AND CONCLUSION: Macrophages could be labeled with fluorescent magnetosomes, and they were successfully imaged using both a 1.5 T MR scanner as well as with NIRF optical methods. The use of this bimodal contrast agent for diagnostic purposes may benefit from the excellent spatial resolution of the MRI and the high sensitivity of the fluorescence imaging.     

Toxicity of Tungsten Carbide and Cobalt-Doped Tungsten Carbide Nanoparticles in Mammalian Cells in Vitro

Background

Tungsten carbide nanoparticles are being explored for their use in the manufacture of hard metals. To develop nanoparticles for broad applications, potential risks to human health and the environment should be evaluated and taken into consideration.

Objective

We aimed to assess the toxicity of well-characterized tungsten carbide (WC) and cobaltdoped tungsten carbide (WC-Co) nanoparticle suspensions in an array of mammalian cells.

Methods

We examined acute toxicity of WC and of WC-Co (10% weight content Co) nanoparticles in different human cell lines (lung, skin, and colon) as well as in rat neuronal and glial cells (i.e., primary neuronal and astroglial cultures and the oligodendro cyte precursor cell line OLN-93). Furthermore, using electron microscopy, we assessed whether nanoparticles can be taken up by living cells. We chose these in vitro systems in order to evaluate for potential toxicity of the nanoparticles in different mammalian organs (i.e., lung, skin, intestine, and brain).

Results

Chemical–physical characterization confirmed that WC as well as WC-Co nanoparticles with a mean particle size of 145 nm form stable suspensions in serum-containing cell culture media. WC nanoparticles were not acutely toxic to the studied cell lines. However, cytotoxicity became apparent when particles were doped with Co. The most sensitive were astrocytes and colon epithelial cells. Cytotoxicity of WC-Co nanoparticles was higher than expected based on the ionic Co content of the particles. Analysis by electron microscopy demonstrated presence of WC nanoparticles within mammalian cells.

Conclusions

Our findings demonstrate that doping of WC nanoparticles with Co markedly increases their cytotoxic effect and that the presence of WC-Co in particulate form is essential to elicit this combinatorial effect.     

Hospital antibiotic management in Austria – results of the ABS maturity survey of the ABS International group

BACKGROUND: The ABS International group conducted a survey to estimate the prevalence and characteristics of country-specific hospital antibiotic management programs. This paper summarizes the results for Austria. METHODS: The survey was conducted in April and May 2007. A questionnaire with various items related to hospital antibiotic management was sent to 160 Austrian hospitals. MAIN FINDINGS: Of 160 questionnaires sent, 80 were returned and evaluable. The mean total score for all items and all hospitals was 3.29 (median: 3.42; range 1.35-4.74). The larger the hospital the higher were the reported scores concerning diagnostics, antibiotic-related organization and antibiotic-consumption control, but the lower the scores for antibiotic-related personnel development and antibiotic-related relationships to relevant environments. The maturity figure for large hospitals (>500 beds) was 3.57, for medium hospitals 3.34, and for small hospitals (<200 beds) 3.01. CONCLUSIONS: The self-reported results of our questionnaire-based survey clearly show that there is still need for improvement. In all five categories surveyed, Austrian hospitals scored their antibiotic maturity lower than the international averages. The establishment of an antibiotic officer enables the development of antibiotic stewardship tools such as antibiotic lists. Such tools can be seen as quality indicators.     

Promoting parental competence by video councelling: The Marte Meo method

Marte Meo, that is a low-levelled outpatient form of councelling parents and other persons to whom children relate most closely in order to achieve educational competence and help them to assume responsibility for the developement of children. The article gives a short summary how this method has developed and has been applied in the field of youth care.     

Amblyopia—A novel virtual round table to explore the caregiver perspective

Purpose

A survey aimed to capture the caregiver's perspective on the impact of amblyopia and its treatment on the child and family, as well as caregivers' views on the design and feasibility of clinical trials investigating dichoptic binocular therapies for amblyopia.

Methods

Parents of amblyopic children, patient advocates and healthcare professionals took part in a moderated, structured discussion on a novel virtual advisory-board platform.

Results

Seven parents of children with amblyopia, two patient organisation representatives, one ophthalmologist and one optometrist participated in the survey. A total of 645 posts were entered on the platform over a 14-day period in September 2021. There was widespread agreement that the management of amblyopia poses more of a burden on the child and family than the condition itself, with treatment burden accentuated when treatment is unsuccessful. Parents expressed uncertainty and frustration in relation to the duration of patching, success of patching and alternative treatment options, and felt there was inadequate readily available, easy-to-understand information on the condition. Parents reported that a new treatment for amblyopia, such as dichoptic binocular therapy using video games, should be safe, non-invasive and engaging compared with an eye patch. Treating at home, potentially for a shorter treatment duration, and with an entertaining game were the main reasons parents would join a clinical study with this type of novel therapy. However, due to a limited critical period treatment window, parents would feel more comfortable joining a clinical trial if traditional therapies were offered in conjunction with those under investigation.

Conclusion

Patient perspectives and the role of caregivers in the acceptance of any interventional treatments are increasingly recognised. Understanding how amblyopia and its treatment impacts a child and family should be an important premise to guide therapy and evaluate treatment value, both in clinical trials and in routine medical practice.