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Luo Y, He Y, Reker D, Gudmann NS, Henriksen K, Simonsen O, Ladel C, Michaelis M, Mobasheri A, Karsdal M, Bay-Jensen AC. A Novel High Sensitivity Type II Collagen Blood-Based Biomarker, PRO-C2, for Assessment of Cartilage Formation. Int J Mol Sci 2018; 19:ijms19113485. [PMID: 30404167 PMCID: PMC6275061 DOI: 10.3390/ijms19113485] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 11/01/2018] [Accepted: 11/03/2018] [Indexed: 01/07/2023] Open
Abstract
N-terminal propeptide of type II collagen (PIINP) is a biomarker reflecting cartilage formation. PIINP exists in two main splice variants termed as type IIA and type IIB collagen NH₂-propeptide (PIIANP, PIIBNP). PIIANP has been widely recognized as a cartilage formation biomarker. However, the utility of PIIBNP as a marker in preclinical and clinical settings has not been fully investigated yet. In this study, we aimed to characterize an antibody targeting human PIIBNP and to develop an immunoassay assessing type II collagen synthesis in human blood samples. A high sensitivity electrochemiluminescence immunoassay, hsPRO-C2, was developed using a well-characterized antibody against human PIIBNP. Human cartilage explants from replaced osteoarthritis knees were cultured for ten weeks in the presence of growth factors, insulin-like growth factor 1 (IGF-1) or recombinant human fibroblast growth factor 18 (rhFGF-18). The culture medium was changed every seven days, and levels of PIIBNP, PIIANP, and matrix metalloproteinase 9-mediated degradation of type II collagen (C2M) were analyzed herein. Serum samples from a cross-sectional knee osteoarthritis cohort, as well as pediatric and rheumatoid arthritis samples, were assayed for PIIBNP and PIIANP. Western blot showed that the antibody recognized PIIBNP either as a free fragment or attached to the main molecule. Immunohistochemistry demonstrated that PIIBNP was predominately located in the extracellular matrix of the superficial and deep zones and chondrocytes in both normal and osteoarthritic articular cartilage. In addition, the hsPRO-C2 immunoassay exhibits acceptable technical performances. In the human cartilage explants model, levels of PIIBNP, but not PIIANP and C2M, were increased (2 to 7-fold) time-dependently in response to IGF-1. Moreover, there was no significant correlation between PIIBNP and PIIANP levels when measured in knee osteoarthritis, rheumatoid arthritis, and pediatric serum samples. Serum PIIBNP was significantly higher in controls (KL0/1) compared to OA groups (KL2/3/4, p = 0.012). The hsPRO-C2 assay shows completely different biological and clinical patterns than PIIANP ELISA, suggesting that it may be a promising biomarker of cartilage formation.
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Affiliation(s)
- Yunyun Luo
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, 2730 Herlev, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 København, Denmark.
| | - Yi He
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, 2730 Herlev, Denmark.
| | - Ditte Reker
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, 2730 Herlev, Denmark.
| | - Natasja Stæhr Gudmann
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, 2730 Herlev, Denmark.
| | - Kim Henriksen
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, 2730 Herlev, Denmark.
| | - Ole Simonsen
- Department Orthopedic Surgery, Aalborg University Hospital, 9000 Aalborg, Denmark.
| | | | | | - Ali Mobasheri
- D-BOARD EU Consortium for Biomarker Discovery, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, Surrey, UK.
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Queen's Medical Centre, Nottingham NG7 2UH, Nottinghamshire, UK.
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-01102 Vilnius, Lithuania.
| | - Morten Karsdal
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, 2730 Herlev, Denmark.
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Reker D, Kjelgaard-Petersen CF, Siebuhr AS, Michaelis M, Gigout A, Karsdal MA, Ladel C, Bay-Jensen AC. Sprifermin (rhFGF18) modulates extracellular matrix turnover in cartilage explants ex vivo. J Transl Med 2017; 15:250. [PMID: 29233174 PMCID: PMC5727954 DOI: 10.1186/s12967-017-1356-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/04/2017] [Indexed: 12/19/2022] Open
Abstract
Background Sprifermin (recombinant human fibroblast growth factor 18) is in clinical development as a potential disease-modifying osteoarthritis drug (DMOAD). In vitro studies have shown that cartilage regenerative properties of sprifermin involve chondrocyte proliferation and extracellular matrix (ECM) production. To gain further insight into the process of sprifermin in the cartilage tissue, this study aimed at investigating the ECM turnover of articular cartilage explants in a longitudinal manner. Methods Bovine full-depth articular cartilage explants were stimulated with sprifermin or placebo at weekly intervals, similar to the dosing regimen used in clinical trials. Pre-culturing with oncostatin M and tumour necrosis factor-α, was also used to induce an inflammatory state before treatment. Metabolic activity was measured using AlamarBlue, and chondrocyte proliferation was visualized by immuno-histochemical detection of proliferating cell nuclear antigen. ECM turnover was quantified by biomarker ELISAs; ProC2 reflecting type II collagen formation, CS846 reflecting aggrecan formation, active MMP9, C2M and AGNx2 reflecting matrix metalloproteinase activity, and AGNx1 reflecting aggrecanase activity. Results Sprifermin was able to reach the chondrocytes through the extracellular matrix, as it increased cell proliferation and metabolic activity of explants. ProC2 and CS846 was dose-dependently increased (P < 0.05) by sprifermin compared to placebo, while C2M and AGNx2 were unaffected, active MMP9 was slightly decreased, and AGNx1 was slightly increased. Over the course of treatment, the temporal order of ECM turnover responses was AGNx1, then ProC2, followed by CS846 and MMP9. Pro-inflammatory activation of the explants diminished the ECM turnover responses otherwise observed under non-inflammatory conditions. Conclusions The data suggest that sprifermin has chondrogenic effects on articular cartilage ex vivo, exerted through a sequential process of ECM turnover; aggrecan degradation seems to occur first, while type II collagen and aggrecan production increased at a later time point. In addition, it was observed that these chondrogenic effects are dependent on the inflammatory status of the cartilage prior to treatment. Electronic supplementary material The online version of this article (10.1186/s12967-017-1356-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ditte Reker
- Biomarkers and Research Rheumatology, Nordic Bioscience A/S, Herlev Hovedgade 205-207, 2730, Herlev, Denmark. .,Department of Biology, University of Copenhagen, Universitetsparken 13, 2100, Copenhagen Ø, Denmark.
| | - Cecilie F Kjelgaard-Petersen
- Biomarkers and Research Rheumatology, Nordic Bioscience A/S, Herlev Hovedgade 205-207, 2730, Herlev, Denmark.,Technical University of Denmark, Anker Engelunds Vej 1, 2800, Kgs. Lyngby, Denmark
| | - Anne Sofie Siebuhr
- Biomarkers and Research Rheumatology, Nordic Bioscience A/S, Herlev Hovedgade 205-207, 2730, Herlev, Denmark
| | - Martin Michaelis
- Osteoarthritis Research, Merck-KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Anne Gigout
- Osteoarthritis Research, Merck-KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Morten A Karsdal
- Biomarkers and Research Rheumatology, Nordic Bioscience A/S, Herlev Hovedgade 205-207, 2730, Herlev, Denmark
| | - Christoph Ladel
- Osteoarthritis Research, Merck-KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Anne C Bay-Jensen
- Biomarkers and Research Rheumatology, Nordic Bioscience A/S, Herlev Hovedgade 205-207, 2730, Herlev, Denmark.
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Gigout A, Guehring H, Froemel D, Meurer A, Ladel C, Reker D, Bay-Jensen AC, Karsdal MA, Lindemann S. Sprifermin (rhFGF18) enables proliferation of chondrocytes producing a hyaline cartilage matrix. Osteoarthritis Cartilage 2017; 25:1858-1867. [PMID: 28823647 DOI: 10.1016/j.joca.2017.08.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 07/24/2017] [Accepted: 08/08/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Fibroblast growth factor (FGF) 18 has been shown to increase cartilage volume when injected intra-articularly in animal models of osteoarthritis (OA) and in patients with knee OA (during clinical development of the recombinant human FGF18, sprifermin). However, the exact nature of this effect is still unknown. In this study, we aimed to investigate the effects of sprifermin at the cellular level. DESIGN A combination of different chondrocyte culture systems was used and the effects of sprifermin on proliferation, the phenotype and matrix production were evaluated. The involvement of MAPKs in sprifermin signalling was also studied. RESULTS In monolayer, we observed that sprifermin promoted a round cell morphology and stimulated both cellular proliferation and Sox9 expression while strongly decreasing type I collagen expression. In 3D culture, sprifermin increased the number of matrix-producing chondrocytes, improved the type II:I collagen ratio and enabled human OA chondrocytes to produce a hyaline extracellular matrix (ECM). Furthermore, we found that sprifermin displayed a 'hit and run' mode of action, with intermittent exposure required for the compound to fully exert its anabolic effect. Finally, sprifermin appeared to signal through activation of ERK. CONCLUSIONS Our results indicate that intermittent exposure to sprifermin leads to expansion of hyaline cartilage-producing chondrocytes. These in vitro findings are consistent with the increased cartilage volume observed in the knees of OA patients after intra-articular injection with sprifermin in clinical studies.
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Affiliation(s)
- A Gigout
- Osteoarthritis Research, Merck KGaA, Darmstadt, Germany.
| | - H Guehring
- Osteoarthritis Research, Merck KGaA, Darmstadt, Germany.
| | - D Froemel
- Orthopaedic University Hospital Friedrichsheim, Frankfurt, Germany.
| | - A Meurer
- Orthopaedic University Hospital Friedrichsheim, Frankfurt, Germany.
| | - C Ladel
- Osteoarthritis Research, Merck KGaA, Darmstadt, Germany.
| | - D Reker
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.
| | - A C Bay-Jensen
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.
| | - M A Karsdal
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.
| | - S Lindemann
- Osteoarthritis Research, Merck KGaA, Darmstadt, Germany.
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Abstract
The promiscuous binding behavior of bioactive compounds forms a mechanistic basis for understanding polypharmacological drug action. We present the development and prospective application of a computational tool for identifying potential promiscuous drug-like ligands. In combination with computational target prediction methods, the approach provides a working concept for rationally designing such molecular structures. We could confirm the multi-target binding of a de novo generated compound in a proof-of-concept study relying on the new method.
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Affiliation(s)
- P Schneider
- Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg 4, 8093 Zürich, Switzerland. and inSili.com LLC, Segantinisteig 3, 8049 Zürich, Switzerland.
| | - M Röthlisberger
- Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg 4, 8093 Zürich, Switzerland.
| | - D Reker
- Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg 4, 8093 Zürich, Switzerland.
| | - G Schneider
- Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg 4, 8093 Zürich, Switzerland.
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Reker D, Schneider P, Schneider G. Multi-objective active machine learning rapidly improves structure-activity models and reveals new protein-protein interaction inhibitors. Chem Sci 2016; 7:3919-3927. [PMID: 30155037 PMCID: PMC6013791 DOI: 10.1039/c5sc04272k] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/27/2016] [Indexed: 11/21/2022] Open
Abstract
Active machine learning puts artificial intelligence in charge of a sequential, feedback-driven discovery process. We present the application of a multi-objective active learning scheme for identifying small molecules that inhibit the protein-protein interaction between the anti-cancer target CXC chemokine receptor 4 (CXCR4) and its endogenous ligand CXCL-12 (SDF-1). Experimental design by active learning was used to retrieve informative active compounds that continuously improved the adaptive structure-activity model. The balanced character of the compound selection function rapidly delivered new molecular structures with the desired inhibitory activity and at the same time allowed us to focus on informative compounds for model adjustment. The results of our study validate active learning for prospective ligand finding by adaptive, focused screening of large compound repositories and virtual compound libraries.
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Affiliation(s)
- D Reker
- Department of Chemistry and Applied Biosciences , ETH Zürich , Vladimir-Prelog Weg 4 , 8093 Zürich , Switzerland .
| | - P Schneider
- Department of Chemistry and Applied Biosciences , ETH Zürich , Vladimir-Prelog Weg 4 , 8093 Zürich , Switzerland .
| | - G Schneider
- Department of Chemistry and Applied Biosciences , ETH Zürich , Vladimir-Prelog Weg 4 , 8093 Zürich , Switzerland .
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Bay-Jensen AC, Reker D, Kjelgaard-Petersen CF, Mobasheri A, Karsdal MA, Ladel C, Henrotin Y, Thudium CS. Osteoarthritis year in review 2015: soluble biomarkers and the BIPED criteria. Osteoarthritis Cartilage 2016; 24:9-20. [PMID: 26707988 DOI: 10.1016/j.joca.2015.10.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/16/2015] [Accepted: 10/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review and summarize biomarker data published from April 2014 to May 2015 to provide insight to the ongoing work in the field of osteoarthritis (OA). Furthermore, to summarize the BIPED criteria and set it in context of the medical needs of 2015. METHODS PubMed was used as searching machine: Time period 2014/04/01-2015/05/01, MeSH term [Biomarker] AND [Osteoarthritis], Language; English, Full text available. Reviews were excluded. Only papers describing protein based biomarkers measured in human body fluids from OA patients were included. RESULTS Biomarkers of joint tissue turnover, cytokines, chemokines and peptide arrays were measured in different cohorts and studies. Amongst those were previously tested biomarkers such as osteocalcin, Carboxy-terminal cross-linked fragment of type II collagen (CTX-II) and cartilage oligomeric matrix protein (COMP). A majority of the biomarker were classified as I, B or B biomarkers according to the BIPED criteria. Work is continuing on testing biomarkers in OA. There is still a huge, unmet medical need to identify, test, validate and qualify novel and well-known biomarkers. A pre-requisite for this is better characterization and classification of biomarkers to their needs, which may not be reached before higher understanding of OA phenotypes has been gained. In addition, we provide some references to some recent guidelines from Food and Drug Administration (FDA) and European Medicines Agency (EMA) on qualification and usage of biomarkers for drug development and personalized medicine, which may provide value to the field.
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Affiliation(s)
- A C Bay-Jensen
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.
| | - D Reker
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | | | - A Mobasheri
- Faculty of Health and Medical Sciences, University of Surrey, United Kingdom; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Arthritis Research UK Pain Centre, Medical Research Council and Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, United Kingdom; Center of Excellence in Genomic Medicine Research (CEGMR), King Fahd Medical Research Center (KFMRC), King AbdulAziz University, Jeddah, Saudi Arabia
| | - M A Karsdal
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | - C Ladel
- OA Research & Early Clinical Development, Merck KGaA, Darmstadt, Germany
| | - Y Henrotin
- Bone and Cartilage Research Unit, Arthropole Liège, University of Liège, Institute of Pathology, Liège, Belgium
| | - C S Thudium
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
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Reker D, Hjuler S, Andreassen K, Karsdal M, Henriksen K, Bay-Jensen A. THU0205 Targeting the Bone-Driven Phenotype of OA by A Novel Calcitonin Analogue, Kbp088, Affecting Both Bone and Cartilage Turnover as Well as Metabolic Health. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hother C, Rasmussen PK, Joshi T, Reker D, Ralfkiær U, Workman CT, Heegaard S, Ralfkiær E, Grønbæk K. MicroRNA Profiling in Ocular Adnexal Lymphoma: A Role for MYC and NFKB1 Mediated Dysregulation of MicroRNA Expression in Aggressive Disease. ACTA ACUST UNITED AC 2013; 54:5169-75. [DOI: 10.1167/iovs.13-12272] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Peter Kristian Rasmussen
- Department of Neuroscience and Pharmacology, Eye Pathology Institute, University of Copenhagen, Copenhagen, Denmark
| | - Tejal Joshi
- Center for Biological Sequence Analysis, Technical University of Denmark, Lyngby, Denmark
| | - Ditte Reker
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Ralfkiær
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Christopher T. Workman
- Center for Biological Sequence Analysis, Technical University of Denmark, Lyngby, Denmark
| | - Steffen Heegaard
- Department of Neuroscience and Pharmacology, Eye Pathology Institute, University of Copenhagen, Copenhagen, Denmark 4Department of Ophthalmology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark
| | | | - Kirsten Grønbæk
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
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Reker D, Stermann A, Huebener N, Siebert N, Lode HN. Development of dual function MYCN-DNA vaccines for anti-neuroblastoma immunotherapy. Klin Padiatr 2013. [DOI: 10.1055/s-0033-1343655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Reker D, Stermann A, Huebener N, Westermann F, Siebert N, Lode HN. Development of an IL-21 enhanced MYCN-DNA vaccine for anti-neuroblastoma immunotherapy. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1277095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bates B, Kurichi J, Marshall C, Reker D, Stineman M. Poster 12. Arch Phys Med Rehabil 2006. [DOI: 10.1016/j.apmr.2006.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Stineman M, Kwong P, Kurichi J, Bates B, Reker D. Article 4. Arch Phys Med Rehabil 2006. [DOI: 10.1016/j.apmr.2006.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hoenig H, Sloane R, Horner RD, Zolkewitz M, Reker D. Differences in rehabilitation services and outcomes among stroke patients cared for in veterans hospitals. Health Serv Res 2001; 35:1293-318. [PMID: 11221820 PMCID: PMC1089191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVE To examine the relationship of services for post-acute care (PAC) to stroke patient outcomes. DATA SOURCES/STUDY SETTING Veterans Health Administration (VHA) hospitals from two facility-level surveys and extant data files. STUDY DESIGN Cross-sectional study of veterans hospitalized with acute stroke during the period June 1995 through May 1996 in one of 182 geographically distinct locations within the VHA. Study variables included (1) a typological classification of hospitals according to the level of PAC; (2) a taxonomy of rehabilitation characteristics, including personnel, physical facilities, coordination of care, and hospital characteristics; and (3) patient outcomes (discharge destination, length of stay). DATA COLLECTION/EXTRACTION METHODS Data were collected from two mailed surveys and extant data files. Rehabilitation variables were identified for the study in conjunction with a panel of expert rehabilitation researchers and clinicians, using an a priori model for measuring rehabilitation characteristics. Two sets of variables were derived to categorize these rehabilitation characteristics: (1) a rehabilitation typology, classifying the VA hospitals according to the continuum of PAC settings in the facility, and (2) a rehabilitation taxonomy that used an empirical approach to derive a list of key rehabilitation characteristics. PRINCIPAL FINDINGS Twenty-seven percent of veterans with acute stroke were cared for in VA hospitals with neither a geriatric nor a rehabilitation unit, and 50 percent were cared for in hospitals without a rehabilitation unit. Hospitals with rehabilitation units had the greatest sophistication, and those with geriatric units had intermediate sophistication in rehabilitation organization and resources. Statistically significant differences were found in outcomes for stroke patients cared for in hospitals classified according to the continuum of post-acute care on site. Exploratory multivariable analyses revealed independent associations between stroke patient outcomes and (1) staffing ratios for nurses and physicians, (2) the diversity of physician and rehabilitation staff, (3) presence of a simulated home environment, and (4) the total number of care settings on site. CONCLUSIONS The PAC continuum defines an important hierarchy of stroke rehabilitation services.
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Affiliation(s)
- H Hoenig
- Durham Veterans Administration Medical Center, NC 27705, USA
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Reker D, Webb E. Multiple blood samples without multiple sticks. RN 1986; 49:39-41. [PMID: 3634476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Leon-Andrade C, Volavka J, Anderson B, Yackulic CF, Reker D. Tardive dyskinesia in lobotomized patients. Biol Psychiatry 1983; 18:1329-32. [PMID: 6140033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Yackulic CF, Anderson BG, Reker D, Webb E, Volavka J. The safety of lecithin diet supplementation in schizophrenic patients. Biol Psychiatry 1982; 17:1445-8. [PMID: 6130801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
The subjects were 13 psychiatric inpatients with tardive dyskinesia. Each subject participated in two sessions. Either naloxone (10 mg) or placebo was administered intravenously during each session. In a subset of subjects (n = 7), blood samples for beta-endorphin were drawn before and at 30 and 60 minutes after the injection. The Abnormal Involuntary Movement Scale was administered before and at 10, 20, 40, 60, 120, and 360 minutes after the injection. Double-blind procedures were maintained throughout the experiment. Neither naloxone nor placebo had any appreciable effect on the involuntary movements. Naloxone elicited a significant increase in the plasma beta-endorphin.
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Abstract
Chromatographic separation of aqueous brain extracts yields a peptide containing fraction which competitively inhibits 3H-diazepam binding to its receptor. An intracerebral-ventricular injection of this isolated fraction results in altered responses in pharmacological and behavioral tests which are similar to those observed when diazepam is administered in the same fashion. The most pronounced effect was obtained in the conflict test. Changes observed in other tests, such as blocking pentylenetetrazole convulsions, altering motility or reducing hyperthermia, were also consistent with the actions of diazepam. At the dose used, neither diazepam nor the brain extract altered muscular co-ordination in two ataxia evaluations. Thus, the animals' performance in the other paradigms would not be adversely influenced by immobilization side-effects. The results reported here support the notion that an endogenous factor does exist in brain which can act like the benzodiazepine drugs when tested for bioactivity in animal studies.
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Abstract
Piracetam was compared with placebo in a double-blind cross-over study of 30 learning disabled boys. Power spectral analyses revealed that piracetam caused a decrease in the amount of delta activity and an increase in the average EEG frequency. This result is in agreement with those obtained by other workers in adult patients. Some clinical effects of piracetam may be mediated by increased alertness and/or decreased fatigue.
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Jackson IV, Volavka J, James B, Reker D. The respiratory components of tardive dyskinesia. Biol Psychiatry 1980; 15:485-7. [PMID: 6103719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
Spontaneously occurring mood states and various physiological indices were evaluated on three occasions in a group of eight healthy males. Results reveal that significant positive correlations exist among five of the six factors comprising the Profile of Mood States (POMS). This finding is related to previous research on the POMS and varied methodologies utilized in those reports. Reliable positive correlations of the POMS factors Depression and Tension with heart rate and diastolic blood pressure were obtained. The Anger factor of the POMS also correlated positively and significantly with heart rate. These findings are discussed in terms of the relationship between POMS factors and anxiety.
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Volavka J, Mallya A, Bauman J, Pevnick J, Cho D, Reker D, James B, Dornbush R. Hormonal and other effects of naltrexone in normal men. Adv Exp Med Biol 1979; 116:291-305. [PMID: 224675 DOI: 10.1007/978-1-4684-3503-0_17] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Volavka J, James B, Reker D, Mallya A, Cho D, Pevnick J. EEG and other effects of naltrexone and heroin in man. Pharmakopsychiatr Neuropsychopharmakol 1979; 12:79-85. [PMID: 570272 DOI: 10.1055/s-0028-1094597] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This paper reviews older results on EEG and behavioral effects of heroin and opiate antagonists in exaddicts, and presents new findings on the effects of naltrexone in men who have never been addicted. Ten normal volunteers were given on three separate occasions placebo, 50 mg or 100 mg of naltrexone. The average alpha frequency was significantly slower after naltrexone than after placebo. Naltrexone elicited a significant reduction of breathing rate and oral temperature. Those results indicate that naltrexone does not act as a pure narcotic antagonist in non-addicted men.
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