1
|
Dreinhöfer KE, Mitchell PJ, Bégué T, Cooper C, Costa ML, Falaschi P, Hertz K, Marsh D, Maggi S, Nana A, Palm H, Speerin R, Magaziner J. A global call to action to improve the care of people with fragility fractures. Injury 2018; 49:1393-1397. [PMID: 29983172 DOI: 10.1016/j.injury.2018.06.032] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/21/2018] [Indexed: 02/02/2023]
Abstract
The ageing of society is driving an enormous increase in fragility fracture incidence and imposing a massive burden on patients, their families, health systems and societies globally. Disrupting the status quo has therefore become an obligation and a necessity. Initiated by the Fragility Fracture Network (FFN) at a "Presidents' Roundtable" during the 5th FFN Global Congress in 2016 several leading organisations agreed that a global multidisciplinary and multiprofessional collaboration, resulting in a Global Call to Action (CtA), would be the right step forward to improve the care of people presenting with fragility fractures. So far global and regional organisations in geriatrics/internal medicine, orthopaedics, osteoporosis/metabolic bone disease, rehabilitation and rheumatology were contacted as well as national organisations in five highly populated countries (Brazil, China, India, Japan and the United States), resulting in 81societies endorsing the CtA. We call for implementation of a systematic approach to fragility fracture care with the goal of restoring function and preventing subsequent fractures without further delay. There is an urgent need to improve: To address this fragility fracture crisis, the undersigned organisations pledge to intensify their efforts to improve the current management of all fragility fractures, prevent subsequent fractures, and strive to restore functional abilities and quality of life.
Collapse
Affiliation(s)
- K E Dreinhöfer
- Department of Musculoskeletal Rehabilitation, Prevention and Health Service Research, Center for Sport Science and Sport Medicine (CSSB), Center for Musculoskeletal Surgery (CMSC), Charité Universitätsmedizin, Berlin, Germany; Department of Orthopedics and Traumatology, Medical Park Berlin Humboldtmühle, Berlin, Germany; FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland.
| | - P J Mitchell
- FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland; School of Medicine, Sydney Campus, The University of Notre Dame Australia, 140 Broadway, Sydney, NSW, 2007, Australia
| | - T Bégué
- Service de Chirurgie Orthopédique, Traumatologique et Réparatrice, Hôpital Antoine Béclère, Université Paris-Sud, 157, rue de la porte de Trivaux, 92140, Clamart, France; European Federation of National Associations of Orthopaedics and Traumatology (EFORT), Chair Science Committee, EFORT, La Pièce 2, 1180, Rolle, Switzerland
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, United Kingdom; NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, United Kingdom; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, OX3 7LD, United Kingdom; IOF, 9 rue Juste-Olivier, CH-1260, Nyon, Switzerland
| | - M L Costa
- FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Clinical Trials Unit, Warwick Medical School, The University of Warwick, Coventry, United Kingdom; University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - P Falaschi
- FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland; Sapienza University of Rome, Via di Grottarossa, 1035, 00187, Rome, Italy
| | - K Hertz
- Trauma and Orthopaedic Directorate, Newcastle Road, Stoke-on-Trent, ST4 6QG, United Kingdom; International Collaboration of Orthopaedic Nursing (ICON) Chair, Sweden
| | - D Marsh
- FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland; University College London, Gower St, Bloomsbury, London, WC1E 6BT, United Kingdom
| | - S Maggi
- Aging Branch-IN, National Research Council, Via Giustiniani, 2, 35128, Padua, Italy; EuGMS Secretariat Via Roma 10, 16121, Genoa, Italy
| | - A Nana
- University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, United States; IGFS, 1215 E Robinson Street, Orlando, FL, 32801, United States
| | - H Palm
- FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland; Department of Orthopedics, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - R Speerin
- FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland; Musculoskeletal Network, NSW Agency for Clinical Innovation, Level 4, 67 Albert Avenue, Chatswood, NSW, 2067, Australia
| | - J Magaziner
- FFN, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland; University of Maryland School of Medicine, 660 West Redwood Street, Baltimore, MD, 21201 USA
| |
Collapse
|
2
|
Keating S, Zemski A, Broad E, Marsh D, Slater G. Ethnic differences in visceral adipose tissue and markers of cardiometabolic risk in elite rugby union athletes. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.09.318] [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: 10/18/2022]
|
3
|
Simpson AHRW, Keenan G, Nayagam S, Atkins RM, Marsh D, Clement ND. Low-intensity pulsed ultrasound does not influence bone healing by distraction osteogenesis: a multicentre double-blind randomised control trial. Bone Joint J 2017; 99-B:494-502. [PMID: 28385939 DOI: 10.1302/0301-620x.99b4.bjj-2016-0559.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 06/09/2016] [Accepted: 12/02/2016] [Indexed: 11/05/2022]
Abstract
AIMS The aim of this double-blind prospective randomised controlled trial was to assess whether low intensity pulsed ultrasound (LIPUS) accelerated or enhanced the rate of bone healing in adult patients undergoing distraction osteogenesis. PATIENTS AND METHODS A total of 62 adult patients undergoing limb lengthening or bone transport by distraction osteogenesis were randomised to treatment with either an active (n = 32) or a placebo (n = 30) ultrasound device. A standardised corticotomy was performed in the proximal tibial metaphysis and a circular Ilizarov frame was used in all patients. The rate of distraction was also standardised. The primary outcome measure was the time to removal of the frame after adjusting for the length of distraction in days/cm for both the per protocol (PP) and the intention-to-treat (ITT) groups. The assessor was blinded to the form of treatment. A secondary outcome was to identify covariates affecting the time to removal of the frame. RESULTS There was no difference in the time to removal of the frame between the PP (difference in favour of the control group was 10.1 days/cm, 95% confidence interval (CI) -3.2 to 23.4, p = 0.054) or ITT (difference 5.0 days/cm, 95% CI -8.2 to 18.21, p = 0.226) groups. The smoking status was the only covariate which increased the time to removal of the frame (hazard ratio 0.47, 95% CI 0.22 to 0.97, p = 0.042). CONCLUSION LIPUS does not influence the rate of bone healing in patients who undergo distraction osteogenesis. Smoking may influence bone healing. Cite this article: Bone Joint J 2017;99-B:494-502.
Collapse
Affiliation(s)
- A H R W Simpson
- Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK
| | - G Keenan
- Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK
| | - S Nayagam
- Royal Liverpool Children's and Royal Liverpool University Hospital, Prescot St, Liverpool L7 8XP, UK
| | - R M Atkins
- Bristol Royal Infirmary, Marlborough Street, Bristol, BS2 8HW, UK
| | - D Marsh
- University College London, 102 Princetown Road, Bangor, BT20 3TG, UK
| | - N D Clement
- Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK
| |
Collapse
|
4
|
Lems WF, Dreinhöfer KE, Bischoff-Ferrari H, Blauth M, Czerwinski E, da Silva J, Herrera A, Hoffmeyer P, Kvien T, Maalouf G, Marsh D, Puget J, Puhl W, Poor G, Rasch L, Roux C, Schüler S, Seriolo B, Tarantino U, van Geel T, Woolf A, Wyers C, Geusens P. EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis 2016; 76:802-810. [PMID: 28007756 DOI: 10.1136/annrheumdis-2016-210289] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/13/2016] [Accepted: 12/02/2016] [Indexed: 01/11/2023]
Abstract
The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients. According to the EULAR standard operating procedures for the elaboration and implementation of evidence-based recommendations, 7 rheumatologists, a geriatrician and 10 orthopaedic surgeons met twice under the leadership of 2 convenors, a senior advisor, a clinical epidemiologist and 3 research fellows. After defining the content and procedures of the task force, 10 research questions were formulated, a comprehensive and systematic literature search was performed and the results were presented to the entire committee. 10 recommendations were formulated based on evidence from the literature and after discussion and consensus building in the group. The recommendations included appropriate medical and surgical perioperative care, which requires, especially in the elderly, a multidisciplinary approach including orthogeriatric care. A coordinator should setup a process for the systematic investigations for future fracture risk in all elderly patients with a recent fracture. High-risk patients should have appropriate non-pharmacological and pharmacological treatment to decrease the risk of subsequent fracture.
Collapse
Affiliation(s)
- W F Lems
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - K E Dreinhöfer
- Department of Orthopedics and Traumatology, Center for Musculoskeletal Surgery (CMSC), Charité Universitätsmedizin Berlin Medical Park Berlin Humboldtmühle, Berlin, Germany
| | - H Bischoff-Ferrari
- Departemnt of Geriatrics and Aging Research, University Hospital and University of Zurich, Zurich, Switzerland
| | - M Blauth
- Department for Trauma Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - E Czerwinski
- Department of Bone and Joint Diseases, Jagiellonian University, Faculty of Health and Sciences, Krakow Medical Centre, Krakow, Poland
| | - Jap da Silva
- Department of Rheumatology, Faculdade de Medicina e Centro Hospitalar, Universidade de Coimbra, Coimbra, Portugal
| | - A Herrera
- Department of Surgery, University of Zaragoza, Zaragosa, Spain
| | - P Hoffmeyer
- Department of Surgery, Division of Orthopaedics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - T Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - G Maalouf
- Faculty of Medicine, St. Joseph University, Bellevue University Medical Center, Beirut, Lebanon
| | - D Marsh
- University College London, London, UK
| | - J Puget
- Department of Orthopaedic Surgery, Hopital Rangueil, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - W Puhl
- Past President EFORT, University Ulm, Germany
| | - G Poor
- Department of Internal Medicine III, National Institute of Rheumatology and Physiotherapy, Rheumatology Chair, Semmelweis University, Budapest, Hungary
| | - L Rasch
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - C Roux
- Department of Rheumatology, INSERM 1153, Cochin Hospital, Paris Descartes University, Paris, France
| | - S Schüler
- Department of Orthopedics and Traumatology, Center for Musculoskeletal Surgery (CMSC), Charité Universitätsmedizin Berlin Medical Park Berlin Humboldtmühle, Berlin, Germany
| | - B Seriolo
- Research Laboratory and Academic, Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy
| | - U Tarantino
- Department of Orthopedics and Traumatology, Tor Vergata University of Rome, Rome, Italy
| | - T van Geel
- Department of Family Medicine, Maastricht University, CAPHRI-School for Public Health and Primary Care, Maastricht, The Netherlands
| | - A Woolf
- Bone and Joint Research Group, Knowledge Spa, Royal Cornwall Hospital, Truro, UK
| | - C Wyers
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - P Geusens
- Department of Internal Medicine, Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.,University Hasselt, Hasselt, Belgium
| |
Collapse
|
5
|
|
6
|
Abstract
General planar motions with two degrees of freedom differ funda mentally from those with one degree of freedom, in that they may exhibit "cross-caps" singularities. At such singularities the trajec tories fail to exhibit four of the generic singularity types normally associated with such motions, namely, lips, beaks, and two of their degenerations. Provided cross-caps are avoided, the union of the bifurcation curves associated with the lips and beaks types are char acterized kinematically as envelopes of a two-parameter family of instantaneous singular lines. In the special class of composite planar motions, these lines are described in terms of the classical instanta neous centers of the constituent motions with 1 DOF, and it is shown that not all generic singularity types can appear on the trajectories. Computer-generated pictures illustrate the theory for examples of rational motions.
Collapse
Affiliation(s)
- C.G. Gibson
- Department of Mathematical Sciences University of Liverpool Liverpool L69 3BX, Great Britain
| | - D. Marsh
- Department of Mathematics Napier University Edinburgh EH14 1DJ, Scotland
| | - Y. Xiang
- Department of Mathematics University of York York, YO1 5DD, Great Britain
| |
Collapse
|
7
|
Magill L, Mosahebi A, Davidson T, Ghosh D, Hamilton S, Marsh D, Jell G, Keshtgar M. An analysis of the mechanical strength properties of retrieved silicone breast implants in a single centre. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.02.180] [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: 11/25/2022] Open
|
8
|
Saltvedt I, Sletvold O, Marsh D, Johansen A, Pioli G. S-04: Quality improvement in hip fracture care. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30561-1] [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: 11/26/2022]
|
9
|
McCloskey E, Kanis JA, Johansson H, Harvey N, Odén A, Cooper A, Cooper C, Francis RM, Reid DM, Marsh D, Selby P, Thompson F, Hewitt S, Compston J. FRAX-based assessment and intervention thresholds--an exploration of thresholds in women aged 50 years and older in the UK. Osteoporos Int 2015; 26:2091-9. [PMID: 26077380 DOI: 10.1007/s00198-015-3176-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 05/13/2015] [Indexed: 01/22/2023]
Abstract
UNLABELLED Under current guidelines, based on prior fracture probability thresholds, inequalities in access to therapy arise especially at older ages (≥70 years) depending on the presence or absence of a prior fracture. An alternative threshold (a fixed threshold from the age of 70 years) reduces this disparity, increases treatment access and decreases the need for bone densitometry. INTRODUCTION Several international guidelines set age-specific intervention thresholds at the 10-year probability of fracture equivalent to a woman of average BMI with a prior fracture. At older ages (≥70 years), women with prior fracture selected for treatment are at lower average absolute risk than those selected for treatment in the absence of prior fracture, prompting consideration of alternative thresholds in this age group. METHODS Using a simulated population of 50,633 women aged 50-90 years in the UK, with a distribution of risk factors similar to that in the European FRAX derivation cohorts and a UK-matched age distribution, the current NOGG intervention and assessment thresholds were compared to one where the thresholds remained constant from 70 years upwards. RESULTS Under current thresholds, 45.1% of women aged ≥70 years would be eligible for therapy, comprising 37.5% with prior fracture, 2.2% with high risk but no prior fracture and 5.4% selected for treatment after bone mineral density (BMD) measurement. Mean hip fracture probability was 11.3, 23.3 and 17.6%, respectively, in these groups. Under the alternative thresholds, the overall proportion of women treated increased from 45.1 to 52.9%, with 8.4% at high risk but no prior fracture and 7.0% selected for treatment after BMD measurement. In the latter group, the mean probability of hip fracture was identical to that observed in women with prior fracture (11.3%). The alternative threshold also reduced the need for BMD measurement, particularly at older ages (>80 years). CONCLUSIONS The alternative thresholds equilibrate fracture risk, particularly hip fracture risk, in those with or without prior fracture selected for treatment and reduce BMD usage at older ages.
Collapse
Affiliation(s)
- E McCloskey
- Academic Unit of Bone Metabolism and Mellanby Centre for Bone Research, University of Sheffield, Metabolic Bone Centre, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Wang J, Molvin L, Marsh D, Zorich C, Chan F, Newman B, Larson D, Phillips L, Leung A, Fleischmann D. TH-C-18A-08: A Management Tool for CT Dose Monitoring, Analysis, and Protocol Review. Med Phys 2014. [DOI: 10.1118/1.4889632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
11
|
Compston J, Bowring C, Cooper A, Cooper C, Davies C, Francis R, Kanis J, Marsh D, McCloskey E, Reid D, Selby P. Corrigendum to “Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013” [Maturitas 75 (2013) 392–396]. Maturitas 2014. [DOI: 10.1016/j.maturitas.2013.11.004] [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: 10/25/2022]
|
12
|
Åkesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Pierroz DD, Kyer C, Cooper C. Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycle. Osteoporos Int 2013; 24:2135-52. [PMID: 23589162 PMCID: PMC3706734 DOI: 10.1007/s00198-013-2348-z] [Citation(s) in RCA: 328] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 03/11/2013] [Indexed: 12/12/2022]
Abstract
UNLABELLED The International Osteoporosis Foundation (IOF) Capture the Fracture Campaign aims to support implementation of Fracture Liaison Services (FLS) throughout the world. INTRODUCTION FLS have been shown to close the ubiquitous secondary fracture prevention care gap, ensuring that fragility fracture sufferers receive appropriate assessment and intervention to reduce future fracture risk. METHODS Capture the Fracture has developed internationally endorsed standards for best practice, will facilitate change at the national level to drive adoption of FLS and increase awareness of the challenges and opportunities presented by secondary fracture prevention to key stakeholders. The Best Practice Framework (BPF) sets an international benchmark for FLS, which defines essential and aspirational elements of service delivery. RESULTS The BPF has been reviewed by leading experts from many countries and subject to beta-testing to ensure that it is internationally relevant and fit-for-purpose. The BPF will also serve as a measurement tool for IOF to award 'Capture the Fracture Best Practice Recognition' to celebrate successful FLS worldwide and drive service development in areas of unmet need. The Capture the Fracture website will provide a suite of resources related to FLS and secondary fracture prevention, which will be updated as new materials become available. A mentoring programme will enable those in the early stages of development of FLS to learn from colleagues elsewhere that have achieved Best Practice Recognition. A grant programme is in development to aid clinical systems which require financial assistance to establish FLS in their localities. CONCLUSION Nearly half a billion people will reach retirement age during the next 20 years. IOF has developed Capture the Fracture because this is the single most important thing that can be done to directly improve patient care, of both women and men, and reduce the spiralling fracture-related care costs worldwide.
Collapse
Affiliation(s)
- K. Åkesson
- Department of Orthopaedics Malmo, Skåne University Hospital, Malmo, Sweden
| | - D. Marsh
- University College London, London, UK
| | | | | | - J. Stenmark
- International Osteoporosis Foundation, Nyon, Switzerland
| | - D. D. Pierroz
- International Osteoporosis Foundation, Nyon, Switzerland
| | - C. Kyer
- International Osteoporosis Foundation, Nyon, Switzerland
| | - C. Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - IOF Fracture Working Group
- Department of Orthopaedics Malmo, Skåne University Hospital, Malmo, Sweden
- University College London, London, UK
- Synthesis Medical Limited, Auckland, New Zealand
- Gardiner Institute, Western Infirmary, Glasgow, UK
- International Osteoporosis Foundation, Nyon, Switzerland
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| |
Collapse
|
13
|
Compston J, Bowring C, Cooper A, Cooper C, Davies C, Francis R, Kanis JA, Marsh D, McCloskey EV, Reid DM, Selby P. Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas 2013; 75:392-6. [PMID: 23810490 DOI: 10.1016/j.maturitas.2013.05.013] [Citation(s) in RCA: 197] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 05/22/2013] [Accepted: 05/24/2013] [Indexed: 12/27/2022]
Abstract
Since the launch in 2008 by the National Osteoporosis Guideline Group (NOGG), of guidance for the diagnosis and management of osteoporosis in postmenopausal women and older men in the UK there have been significant advances in risk assessment and treatment. These have been incorporated into an updated version of the guideline, with an additional focus on the management of glucocorticoid-induced osteoporosis, the role of calcium and vitamin D therapy and the benefits and risks of long-term bisphosphonate therapy. The updated guideline is summarised below. The recommendations in the guideline are intended to aid management decisions but do not replace the need for clinical judgement in the care of individuals in clinical practice.
Collapse
Affiliation(s)
- J Compston
- University of Cambridge School of Clinical Medicine, Cambridge, UK.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Svedbom A, Alvares L, Cooper C, Marsh D, Ström O. Balloon kyphoplasty compared to vertebroplasty and nonsurgical management in patients hospitalised with acute osteoporotic vertebral compression fracture: a UK cost-effectiveness analysis. Osteoporos Int 2013; 24:355-67. [PMID: 22890362 PMCID: PMC3691631 DOI: 10.1007/s00198-012-2102-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Accepted: 07/25/2012] [Indexed: 01/18/2023]
Abstract
UNLABELLED The purpose of the study was to estimate the cost-effectiveness of balloon kyphoplasty compared to nonsurgical management and vertebroplasty for the treatment of hospitalised osteoporotic vertebral compression fractures in the UK. A cost-effectiveness model was constructed and used for analysis. Balloon kyphoplasty may be cost-effective compared to relevant alternatives. INTRODUCTION The objective of this study was to estimate the cost-effectiveness of balloon kyphoplasty (BKP) for the treatment of patients hospitalised with acute osteoporotic vertebral compression fracture (OVCF) compared to percutaneous vertebroplasty (PVP) and nonsurgical management (NSM) in the UK. METHODS A Markov simulation model was developed to evaluate treatment with BKP, NSM and PVP in patients with symptomatic OVCF. Data on health-related quality of life (HRQoL) with acute OVCF were derived from the FREE and VERTOS II randomised clinical trials (RCTs) and normalised to the NSM arm in the FREE trial. Estimated differences in mortality among the treatments and costs for NSM were obtained from the literature whereas procedure costs for BKP and PVP were obtained from three National Health Service hospitals. It was assumed that BKP and PVP reduced hospital length of stay by 6 days compared to NSM. RESULTS The incremental cost-effectiveness ratio was estimated at Great Britain Pound Sterling (GBP) 2,706 per quality-adjusted life year (QALY) and GBP 15,982 per QALY compared to NSM and PVP, respectively. Sensitivity analysis showed that the cost-effectiveness of BKP vs. NSM was robust when mortality and HRQoL benefits with BKP were varied. The cost-effectiveness of BKP compared to PVP was particularly sensitive to changes in the mortality benefit. CONCLUSION BKP may be a cost-effective strategy for the treatment of patients hospitalised with acute OVCF in the UK compared to NSM and PVP. Additional RCT data on the benefits of BKP and PVP compared to simulated sham surgery and further data on the mortality benefits with BKP compared to NSM and PVP would reduce uncertainty.
Collapse
Affiliation(s)
- A Svedbom
- OptumInsight, Klarabergsviadukten 90, Hus D, 111 64, Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
15
|
Kan C, Hahn M, Cowley M, Kaplan W, Howell V, Marsh D. 517 Genomic Instability is a Hallmark Feature of Serous Epithelial Ovarian Cancer and May Contribute to MicroRNA Dysregulation. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71179-6] [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: 11/29/2022]
|
16
|
Boonen S, Wahl DA, Nauroy L, Brandi ML, Bouxsein ML, Goldhahn J, Lewiecki EM, Lyritis GP, Marsh D, Obrant K, Silverman S, Siris E, Akesson K. Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures. Osteoporos Int 2011; 22:2915-34. [PMID: 21789685 DOI: 10.1007/s00198-011-1639-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 04/11/2011] [Indexed: 12/21/2022]
Abstract
Vertebral compression fractures (VCFs) are the most prevalent fractures in osteoporotic patients. The classical conservative management of these fractures is through rest, pain medication, bracing and muscle relaxants. The aim of this paper is to review prospective controlled studies comparing the efficacy and safety of minimally invasive techniques for vertebral augmentation, vertebroplasty (VP) and balloon kyphoplasty (BKP), versus non-surgical management (NSM). The Fracture Working Group of the International Osteoporosis Foundation conducted a literature search and developed a review paper on VP and BKP. The results presented for the direct management of osteoporotic VCFs focused on clinical outcomes of these three different procedures, including reduction in pain, improvement of function and mobility, vertebral height restoration and decrease in spinal curvature (kyphosis). Overall, VP and BKP are generally safe procedures that provide quicker pain relief, mobility recovery and in some cases vertebral height restoration than conventional conservative medical treatment, at least in the short term. However, the long-term benefits and safety in terms of risk of subsequent vertebral fractures have not been clearly demonstrated and further prospective randomized studies are needed with standards for reporting. Referral physicians should be aware of VP/BKP and their potential to reduce the health impairment of patients with VCFs. However, VP and BKP are not substitutes for appropriate evaluation and treatment of osteoporosis to reduce the risk of future fractures.
Collapse
Affiliation(s)
- S Boonen
- Division of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven University, Leuven, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Marsh D, Sabbagh W, Gault D. Cryptotia correction – the post-auricular transposition flap. J Plast Reconstr Aesthet Surg 2011; 64:1444-7. [DOI: 10.1016/j.bjps.2011.06.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 03/30/2011] [Accepted: 06/24/2011] [Indexed: 11/26/2022]
|
18
|
Marsh D, Akesson K, Beaton DE, Bogoch ER, Boonen S, Brandi ML, McLellan AR, Mitchell PJ, Sale JEM, Wahl DA. Coordinator-based systems for secondary prevention in fragility fracture patients. Osteoporos Int 2011; 22:2051-65. [PMID: 21607807 DOI: 10.1007/s00198-011-1642-x] [Citation(s) in RCA: 180] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 04/13/2011] [Indexed: 12/12/2022]
Abstract
The underlying causes of incident fractures--bone fragility and the tendency to fall--remain under-diagnosed and under-treated. This care gap in secondary prevention must be addressed to minimise both the debilitating consequences of subsequent fractures for patients and the associated economic burden to healthcare systems. Clinical systems aimed at ensuring appropriate management of patients following fracture have been developed around the world. A systematic review of the literature showed that 65% of systems reported include a dedicated coordinator who acts as the link between the orthopaedic team, the osteoporosis and falls services, the patient and the primary care physician. Coordinator-based systems facilitate bone mineral density testing, osteoporosis education and care in patients following a fragility fracture and have been shown to be cost-saving. Other success factors included a fracture registry and a database to monitor the care provided to the fracture patient. Implementation of such a system requires an audit of existing arrangements, creation of a network of healthcare professionals with clearly defined roles and the identification of a 'medical champion' to lead the project. A business case is needed to acquire the necessary funding. Incremental, achievable targets should be identified. Clinical pathways should be supported by evidence-based recommendations from national or regional guidelines. Endorsement of the proposed model within national healthcare policies and advocacy programmes can achieve alignment of the objectives of policy makers, professionals and patients. Successful transformation of care relies upon consensus amongst all participants in the multi-disciplinary team that cares for fragility fracture patients.
Collapse
Affiliation(s)
- D Marsh
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Stanmore, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Maclean J, punwani S, Morley S, Marsh D, Sullivan K, Moinuddin S, Stacey C, Bainbridge A, Carnell D, Mendes R. 1272 poster HIGH QUALITY MRI-CT CO-REGISTRATION WITH T2-WEIGHTED BLADE SEQUENCES FOR HEAD AND NECK RADIOTHERAPY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71394-9] [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: 11/16/2022]
|
20
|
Ström O, Leonard C, Marsh D, Cooper C. Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting. Osteoporos Int 2010; 21:1599-608. [PMID: 19924497 DOI: 10.1007/s00198-009-1096-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Accepted: 09/30/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY Balloon kyphoplasty (BKP) is a procedure used to treat vertebral compression fractures (VCFs). We developed a cost-effectiveness model to evaluate BKP in United Kingsdom patients with hospitalised VCFs and estimated the cost-effectiveness of BKP compared to non-surgical management. The results indicate that BKP provides a cost-effective alternative for treating these patients. INTRODUCTION VCFs of osteoporotic patients are associated with chronic pain, a reduction in health-related quality of life (QoL) and high healthcare costs. BKP is a minimally invasive procedure that has resulted in pain relief, vertebral body height-restoration, decreased kyphosis and improved physical functioning in patients with symptomatic VCFs. BKP was shown to improve health-related QoL in a 12-month interim analysis of a randomised phase-III trial. METHODS The objectives of this study were to develop a Markov cost-effectiveness model to evaluate BKP in patients with painful hospitalised VCFs and to estimate the cost-effectiveness of BKP compared with non-surgical management in a UK setting. It was assumed that QoL-benefits found at 12 months linearly approached zero during another 2 years, and that patients receiving BKP warranted six fewer hospital bed days compared with patients given non-surgical management. RESULTS The procedure was associated with quality-adjusted life-years (QALY)-gains of 0.17 and cost/QALY-gains at 8,800 pound sterling. The results were sensitive to assumptions about avoided length of hospital-stay and persistence of kyphoplasty-related QoL-benefits. CONCLUSION In conclusion, the results indicate that BKP provides a cost-effective alternative for treating patients with hospitalised VCFs in a UK-setting.
Collapse
Affiliation(s)
- O Ström
- i3 Innovus, Stockholm, Sweden.
| | | | | | | |
Collapse
|
21
|
Abstract
The thermotropic phase behavior of binary mixtures of dimyristoylphosphatidylcholine with dimyristoyl glycerol (DMPC-DMG) has been studied in aqueous dispersion by using differential scanning calorimetry and spin label electron spin resonance spectroscopy. Phase identifications have been made by means of (31)P nuclear magnetic resonance spectroscopy and x-ray diffraction. The binary phase diagram of DMPC-DMG mixtures displays three regions corresponding to the existence of compounds (C1 and C2, respectively) with approximately 1:1 and 1:2 mol/mol DMPC:DMG stoichiometries. The first region displays immiscibility between DMPC and C1 in the low temperature lamellar phase and miscibility of the components in the fluid phase that is lamellar. The second region displays immiscibility between C1 and C2 in the low temperature phase that is lamellar, whereas the fluid phase is of the inverted hexagonal type (H(II)). The third region displays immiscibility between C2 and DMG in the low temperature phase that is lamellar, whereas the fluid phase is isotropic. The presence of immiscible DMG in the low temperature phase of the third region is indicated by hysteresis in the temperature scans corresponding to conversion between the stable and metastable crystalline polymorphs. Analysis of the first region of the phase diagram using regular solution theory further demonstrates the existence of a DMPC:DMG complex with approximately 1:1 stoichiometry and provides parameters for the nonideality of mixing in the fluid phase.
Collapse
|
22
|
|
23
|
Páli T, Bartucci R, Horváth LI, Marsh D. Distance measurements using paramagnetic ion-induced relaxation in the saturation transfer electron spin resonance of spin-labeled biomolecules: Application to phospholipid bilayers and interdigitated gel phases. Biophys J 2010; 61:1595-602. [PMID: 19431836 DOI: 10.1016/s0006-3495(92)81963-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The saturation transfer electron spin resonance (STESR) spectra of spin-labeled phosphatidylcholines in gel phase lipid bilayers are shown to be sensitive to dipolar spin-spin interactions with paramagnetic ions in the aqueous phase. The reciprocal integrated intensity of the STESR spectrum is linearly dependent on aqueous Ni(2+) ion concentration, hence, confirming the expectation that the STESR intensity is directly proportional to the spin-lattice relaxation time of the spin label. The gradient of the relaxation rate with respect to Ni(2+) ion concentration decreases strongly with the position of the nitroxide group down the sn-2 chain of the spin-labeled lipid and is consistent with a 1/R(3) dependence on the distance, R, from the bilayer surface. The values derived for the dimensions of the bilayer and lipid molecules in the case of dipalmitoyl phosphatidylcholine (DPPC) are in good agreement with those available from x-ray diffraction studies. Allowance for the multibilayer nature of the DPPC dispersions gives an estimate of the water layer thickness that is also consistent with results from x-ray diffraction. The profile of the paramagnetic ion-induced relaxation is drastically changed with DPPC dispersions in glycerol for which the lipid chains are known to be interdigitated in the gel phase. The terminal methyl groups of the lipid chains are located approximately in register with the C-3 atoms of the sn-2 chain of the oppositely oriented lipid molecules in the interdigitated phase. The thickness of the lipid layer and the effective thickness of the lipid polar group are reduced by approximately 40% in the interdigitated phase as compared with the bilayer phase. The calibrations of the distance dependence established by use of spin labels at defined chain positions should be applicable to STESR measurements on other biological systems.
Collapse
Affiliation(s)
- T Páli
- Max-Planck-Institut für biophysikalische Chemie, Abteilung Spektroskopie, D-3400 Göttingen, Germany
| | | | | | | |
Collapse
|
24
|
Páli T, Bartucci R, Horváth LI, Marsh D. Kinetics and dynamics of annealing during sub-gel phase formation in phospholipid bilayers: A saturation transfer electron spin resonance study. Biophys J 2010; 64:1781-8. [PMID: 19431899 DOI: 10.1016/s0006-3495(93)81549-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The saturation transfer electron spin resonance (STESR) spectra of spin-labeled phosphatidylcholine have been used to follow the kinetics of conversion from the gel phase to the sub-gel phase in aqueous bilayers of dipalmitoyl phosphatidylcholine. This is a simple, well-defined model system for lipid domain formation in membranes. The integrated intensity of the STESR spectrum from the chain-labeled lipid first increases and then decreases with time of incubation in the gel phase at 0 degrees C. The first, more rapid phase of the kinetics is attributed to the conversion of germ nuclei to growth nuclei of the sub-gel phase. The increase in STESR intensity corresponds to the reduction in chain mobility of spin labels located in the gel phase at the boundaries of the growth nuclei and correlates with the increase in the diagnostic STESR line height ratios over this time range. The second, slower phase of the kinetics is attributed to growth of the domains of the sub-gel phase. The decrease in STESR intensity over this time regime corresponds to exclusion of the spin-labeled lipids from the tightly packed sub-gel phase and correlates quantitatively with calibrations of the spin label concentration dependence of the STESR intensity in the gel phase. The kinetics of formation of the sub-gel phase are consistent with the classical model for domain formation and growth. At 0 degrees C, the half-time for conversion of germ nuclei to growth nuclei is approximately 7.7 h and domain growth of the sub-gel phase is characterized by a rate constant of 0.025 h(-1). The temperature dependence of the STESR spectra from samples annealed at 0 degrees C suggests that the subtransition takes place via dissolution of sub-gel phase domains, possibly accompanied by domain fission.
Collapse
Affiliation(s)
- T Páli
- Max-Planck-Institut für biophysikalische Chemie, Abteilung Spektroskopie, WD-3400 Göttingen, Germany
| | | | | | | |
Collapse
|
25
|
Abstract
The analysis of the chain-length dependence of the chain-melting transition temperatures of bilayers composed of lipids with identical chains (Marsh, D. 1991. Biochim. Biophys. Acta. 1062: 1-6) is extended to include lipids with chains of unequal length. The bilayer transition temperatures of saturated asymmetrical phosphatidylcholines are interpreted by assuming that the transition enthalpy and transition entropy are linearly related to the absolute value of the difference in chain length between the sn-1 and sn-2 chains, with constant end contributions. Such an assumption is supported by calorimetric data on phosphatidylcholines of constant mean chainlength and varying chain asymmetry. In particular, a symmetrical linear dependence is observed on the chain asymmetry, Deltan, which is centered around a value Deltan degrees that corresponds to the conformational inequivalence of the sn-1 and sn-2 chains. The transition temperature then takes the form: T(t) = T(t) (infinity)(n - n(H) - h' Deltan + Deltan degrees )/(n - n(s) - s' Deltan + Deltan degrees ) where n(H), n(s) are the end contributions, and h', s' are fractional deficits in the incremental transition enthalpy and entropy, respectively, arising from the overlapping regions of the longer chains. Optimization on the transition temperature data for the dependence on chain asymmetry of three series of phosphatidylcholines with constant mean chainlength, n, yields parameters that are capable of predicting the dependence of the transition temperatures on chain asymmetry for other mean chainlengths. The dependence of the transition temperature on mean chainlength for phosphatidylcholines in which the chain asymmetry is maintained constant, as well as the dependence on both mean chain length and chain asymmetry for phosphatidylcholines in which one of the two chains is maintained of constant length, are also described with high accuracy by using the same parameters.
Collapse
Affiliation(s)
- D Marsh
- Max-Planck-Institut für biophysikalische Chemie, Abteilung Spektroskopie, D-3400 Göttingen, Germany
| |
Collapse
|
26
|
Degefie T, Marsh D, Gebremariam A, Tefera W, Osborn G, Waltensperger K. Community case management improves use of treatment for childhood diarrhea, malaria and pneumonia in a remote district of Ethiopia. ETHIOP J HEALTH DEV 2010. [DOI: 10.4314/ejhd.v23i2.53227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
27
|
Goldhahn J, Little D, Mitchell P, Fazzalari NL, Reid IR, Aspenberg P, Marsh D. Evidence for anti-osteoporosis therapy in acute fracture situations--recommendations of a multidisciplinary workshop of the International Society for Fracture Repair. Bone 2010; 46:267-71. [PMID: 19833244 DOI: 10.1016/j.bone.2009.10.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 10/04/2009] [Accepted: 10/05/2009] [Indexed: 11/15/2022]
Abstract
The International Society for Fracture Repair convened a multidisciplinary workshop to assess the current evidence around the interaction between anti-osteoporosis drugs and the healing of incident fractures, with a view to making recommendations for clinical practice. The consensus was that there is no evidence-based reason to withhold anti-resorptive therapy while a fracture heals, whether or not the patient was taking such therapy when the fracture occurred. The workshop also considered existing models of service provision for secondary prevention and concluded that the essential ingredient for reliable delivery is the inclusion of a dedicated coordinator role. Several unresolved issues were defined as subjects for further research, including the question of whether continuous long-term administration of anti-resorptives may impair bone quality. The rapidly changing area requires re-assessment of drugs and their interaction with fracture healing in the near future.
Collapse
Affiliation(s)
- J Goldhahn
- AO Clinical Priority Program Fracture Fixation in Osteoporotic Bone, Schulthess Klinik Zurich, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
28
|
Guzzi R, Bartucci R, Sportelli L, Esmann M, Marsh D. Conformational Heterogeneity and Spin-Labeled −SH Groups: Pulsed EPR of Na,K-ATPase. Biochemistry 2009; 48:8343-54. [DOI: 10.1021/bi900849z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R. Guzzi
- Dipartimento di Fisica and UdR CNISM, Università della Calabria, 87036 Arcavacata di Rende (CS), Italy
| | - R. Bartucci
- Dipartimento di Fisica and UdR CNISM, Università della Calabria, 87036 Arcavacata di Rende (CS), Italy
| | - L. Sportelli
- Dipartimento di Fisica and UdR CNISM, Università della Calabria, 87036 Arcavacata di Rende (CS), Italy
| | - M. Esmann
- Department of Physiology and Biophysics, Aarhus University, Aarhus, Denmark
| | - D. Marsh
- Max-Planck-Institut für biophysikalische Chemie, Abt. Spektroskopie, 37077 Göttingen, Germany
| |
Collapse
|
29
|
Affiliation(s)
- K. Willett
- John Radcliffe Hospital, University of Oxford, Headley Way, Oxford OX3 9DU, UK
| | - D. Marsh
- Royal National Orthopaedic Hospital, University College, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - C. Moran
- Queen’s Medical Centre, Nottingham University, Derby Road, Nottingham NG7 2UH, UK
| | - P. Giannoudis
- Leeds General Infirmary, University of Leeds, Great George Street, Leeds LS1 3EX, UK
| | - M. Bircher
- St George’s Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK
| |
Collapse
|
30
|
Armstrong E, Stubbs C, Bailey E, D'Souza D, Gaze M, Hoskln P, Marsh D, Polhill S, Sullivan K. A NOVEL METHOD OF IMMOBILISATION FOR PAEDIATRIC PELVIC BRACHYTHERAPY PATIENTS. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72822-0] [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: 11/27/2022]
|
31
|
Reynolds J, Marsh D, Koller H, Zenenr J, Bannister G. Cervical range of movement in relation to neck dimension. Eur Spine J 2009; 18:863-8. [PMID: 19352730 DOI: 10.1007/s00586-009-0894-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 01/19/2009] [Indexed: 11/30/2022]
Abstract
The authors investigated the effect of neck dimension upon cervical range of motion. Data relating to 100 healthy subjects, aged between 20 and 40 years, were recorded with respect to age, gender and range of motion in three planes. Additionally, two widely used methods of measuring neck motion, chin-sternal distance and uniplanar goniometer, were assessed against a validated measurement tool, the 'CROM goniometer'. Using multiple linear regression analysis it was determined that sagittal flexion (P = 0.002) and lateral rotation (P < 0.0001) were most closely related to neck circumference alone whereas lateral flexion (P < 0.0001) was most closely related to a ratio of circumference and length of neck. Hence, assessing cervical range of motion as outcome variable or as a measure at posttreatment follow-up, neck circumference was shown to be one of the factors influencing total neck motion, particularly sagittal flexion and lateral tilt. Comparison of cervical range of motion assessed with a validated measurement tool, the CROM goniometer, with results of both frequently applied clinician's instruments, the uniplanar goniometer and measurement of chin-sternal distance, showed low reliability with the latter techniques, and motion values measured with these techniques should be interpreted with caution if using them for comparison of cervical range of motion of alike groups. We demonstrated that neck dimension should be incorporated into cervical functional outcome assessment and one should be wary about recorded values for neck motion from non-validated measurement tools.
Collapse
Affiliation(s)
- Jeremy Reynolds
- Nuffield Orthopaedic Centre, Windmill Rd, Headington, Oxford, Oxfordshire, OX3 7LD, UK.
| | | | | | | | | |
Collapse
|
32
|
Bartucci R, Guzzi R, Sportelli L, Marsh D. Intramembrane water associated with TOAC spin-labeled alamethicin: electron spin-echo envelope modulation by D2O. Biophys J 2009; 96:997-1007. [PMID: 19186137 DOI: 10.1016/j.bpj.2008.10.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Accepted: 10/21/2008] [Indexed: 11/30/2022] Open
Abstract
Alamethicin is a 20-residue, hydrophobic, helical peptide, which forms voltage-sensitive ion channels in lipid membranes. The helicogenic, nitroxyl amino acid TOAC was substituted isosterically for Aib at residue positions 1, 8, or 16 in a F50/5 alamethicin analog to enable EPR studies. Electron spin-echo envelope modulation (ESEEM) spectroscopy was used to investigate the water exposure of TOAC-alamethicin introduced into membranes of saturated or unsaturated diacyl phosphatidylcholines that were dispersed in D2O. Echo-detected EPR spectra were used to assess the degree of assembly of the peptide in the membrane, via the instantaneous diffusion from intermolecular spin-spin interactions. The profile of residue exposure to water differs between membranes of saturated and unsaturated lipids. In monounsaturated dioleoyl phosphatidylcholine, D2O-ESEEM intensities decrease from TOAC(1) to TOAC(8) and TOAC(16) but not uniformly. This is consistent with a transmembrane orientation for the protoassembled state, in which TOAC(16) is located in the bilayer leaflet opposite to that of TOAC(1) and TOAC(8). Relative to the monomer in fluid bilayers, assembled alamethicin is disposed asymmetrically about the bilayer midplane. In saturated dimyristoyl phosphatidylcholine, the D2O-ESEEM intensity is greatest for TOAC(8), indicating a more superficial location for alamethicin, which correlates with the difference in orientation between gel- and fluid-phase membranes found by conventional EPR of TOAC-alamethicin in aligned phosphatidylcholine bilayers. Increasing alamethicin/lipid ratio in saturated phosphatidylcholine shifts the profile of water exposure toward that with unsaturated lipid, consistent with proposals of a critical concentration for switching between the two different membrane-associated states.
Collapse
Affiliation(s)
- R Bartucci
- Dipartimento di Fisica and Unità di Recerca Consorzio Nazionale Interuniversitario per le Scienze fisiche della Materia, Università della Calabria, Arcavacata di Rende, Italy
| | | | | | | |
Collapse
|
33
|
|
34
|
Kang N, Marsh D, Dewar D. The morbidity of the button-over-nail technique for zone 1 flexor tendon repairs. Should we still be using this technique? J Hand Surg Eur Vol 2008; 33:566-70. [PMID: 18977828 DOI: 10.1177/1753193408090118] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The button-over-nail technique is commonly used to fix the core suture to the distal phalanx for flexor digitorum profundus repairs in zone 1. We report a retrospective study of 23 consecutive patients who had a repair of the flexor digitorum profundus tendon in zone 1 using the button-over-nail technique. Fifteen patients experienced a complication, of which ten were directly related to the button-over-nail technique. Complications included nail deformities, fixed flexion deformities of the distal interphalangeal joint, infections and prolonged hypersensitivity. Two patients required amputation of the fingertip. We recommend that the button-over-nail technique should be avoided or used only with caution and with close attention to the details of the technique.
Collapse
Affiliation(s)
- N Kang
- Department of Plastic Surgery, Mount Vernon Hospital, Northwood, Middlesex, UK.
| | | | | |
Collapse
|
35
|
Anbazhagan V, Vijay N, Kleinschmidt JH, Marsh D. Protein-lipid interactions with Fusobacterium nucleatum major outer membrane protein FomA: spin-label EPR and polarized infrared spectroscopy. Biochemistry 2008; 47:8414-23. [PMID: 18642853 DOI: 10.1021/bi800750s] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
FomA, the major outer membrane protein of Fusobacterium nucleatum, was expressed and purified in Escherichia coli and reconstituted from detergent in bilayer membranes of phosphatidylcholines with chain lengths from C(12:0) to C(17:0). The conformation and orientation of membrane-incorporated FomA were determined from polarized, attenuated total reflection, infrared (IR) spectroscopy, and lipid-protein interactions with FomA were characterized by using electron paramagnetic resonance (EPR) spectroscopy of spin-labeled lipids. Approximately 190 residues of membranous FomA are estimated to be in a beta-sheet configuration from IR band fitting, which is consistent with a 14-strand transmembrane beta-barrel structure. IR dichroism of FomA indicates that the beta-strands are tilted by approximately 45 degrees relative to the sheet/barrel axis and that the order parameter of the latter displays a discontinuity corresponding to hydrophobic matching with fluid C(13:0) lipid chains. The stoichiometry ( N b = 23 lipids/monomer) of lipid-protein interaction from EPR demonstrates that FomA is not trimeric in membranes of diC(14:0) phosphatidylcholine and is consistent with a monomeric beta-barrel of 14-16 strands. The pronounced selectivity of interaction found with anionic spin-labeled lipids places basic residues of the protein in the vicinity of the polar-apolar membrane interfaces, consistent with current topology models. Comparison with similar data from the 8- to 22-stranded E. coli outer membrane proteins, OmpA, OmpG, and FhuA, supports the above conclusions.
Collapse
Affiliation(s)
- V Anbazhagan
- Max-Planck-Institut fur biophysikalische Chemie, Abt. Spektroskopie, 37070 Gottingen, Germany
| | | | | | | |
Collapse
|
36
|
Austin J, Tourpali K, Rozanov E, Akiyoshi H, Bekki S, Bodeker G, Brühl C, Butchart N, Chipperfield M, Deushi M, Fomichev VI, Giorgetta MA, Gray L, Kodera K, Lott F, Manzini E, Marsh D, Matthes K, Nagashima T, Shibata K, Stolarski RS, Struthers H, Tian W. Coupled chemistry climate model simulations of the solar cycle in ozone and temperature. ACTA ACUST UNITED AC 2008. [DOI: 10.1029/2007jd009391] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
37
|
Anbazhagan V, Qu J, Kleinschmidt JH, Marsh D. Incorporation of outer membrane protein OmpG in lipid membranes: protein-lipid interactions and beta-barrel orientation. Biochemistry 2008; 47:6189-98. [PMID: 18473482 DOI: 10.1021/bi800203g] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OmpG is an intermediate size, monomeric, outer membrane protein from Escherichia coli, with n beta = 14 beta-strands. It has a large pore that is amenable to modification by protein engineering. The stoichiometry ( N b = 20) and selectivity ( K r = 0.7-1.2) of lipid-protein interaction with OmpG incorporated in dimyristoyl phosphatidylcholine bilayer membranes was determined with various 14-position spin-labeled lipids by using EPR spectroscopy. The limited selectivity for different lipid species is consistent with the disposition of charged residues in the protein. The conformation and orientation (beta-strand tilt and beta-barrel order parameters) of OmpG in disaturated phosphatidylcholines of odd and even chain lengths from C(12:0) to C(17:0) was determined from polarized infrared spectroscopy of the amide I and amide II bands. A discontinuity in the protein orientation (deduced from the beta-barrel order parameters) is observed at the point of hydrophobic matching of the protein with lipid chain length. Compared with smaller (OmpA; n beta = 8) and larger (FhuA; n beta = 22) monomeric E. coli outer membrane proteins, the stoichiometry of motionally restricted lipids increases linearly with the number of beta-strands, the tilt (beta approximately 44 degrees ) of the beta-strands is comparable for the three proteins, and the order parameter of the beta-barrel increases regularly with n beta. These systematic features of the integration of monomeric beta-barrel proteins in lipid membranes could be useful for characterizing outer membrane proteins of unknown structure.
Collapse
Affiliation(s)
- V Anbazhagan
- Max-Planck-Institut für biophysikalische Chemie, Abt. Spektroskopie, 37070 Göttingen, Germany
| | | | | | | |
Collapse
|
38
|
Abstract
We aimed to develop a clinically relevant delayed union/non-union fracture model to evaluate a cell therapy intervention repair strategy. Histology, three-dimensional (3D) microcomputed tomography (micro-CT) imaging and mechanical testing were utilized to develop an analytical protocol for qualitative and quantitative assessment of fracture repair. An open femoral diaphyseal osteotomy, combined with periosteal diathermy and endosteal excision, was held in compression by a four pin unilateral external fixator. Three delayed union/non-union fracture groups established at 6 weeks--(a) a control group, (b) a cell therapy group, and (c) a group receiving phosphate-buffered saline (PBS) injection alone--were examined subsequently at 8 and 14 weeks. The histological response was combined fibrous and cartilaginous non-unions in groups A and B with fibrous non-unions in group C. Mineralized callus volume/total volume percentage showed no statistically significant differences between groups. Endosteal calcified tissue volume/endosteal tissue volume, at the center of the fracture site, displayed statistically significant differences between 8 and 14 weeks for cell and PBS intervention groups but not for the control group. The percentage load to failure was significantly lower in the control and cell treatment groups than in the PBS alone group. High-resolution micro-CT imaging provides a powerful tool to augment characterization of repair in delayed union/non-union fractures together with outcomes such as histology and mechanical strength measurement. Accurate, nondestructive, 3D identification of mineralization progression in repairing fractures is enabled in the presence or absence of intervention strategies.
Collapse
Affiliation(s)
- G R Dickson
- Tissue Engineering Research Team, Department of Trauma and Orthopaedic Surgery, Queen's University Belfast, Stockman's Lane, Belfast BT9 7JB, Northern Ireland.
| | | | | | | | | |
Collapse
|
39
|
Plasencia I, Baumgart F, Andreu D, Marsh D, Pérez-Gil J. Effect of acylation on the interaction of the N-Terminal segment of pulmonary surfactant protein SP-C with phospholipid membranes. Biochimica et Biophysica Acta (BBA) - Biomembranes 2008; 1778:1274-82. [DOI: 10.1016/j.bbamem.2008.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Revised: 01/22/2008] [Accepted: 02/07/2008] [Indexed: 02/02/2023]
|
40
|
Marsh D, Page R, Hanlon T, Bareke H, Corritone R, Jetter N, Beckman N, Gardner K, Seifert D, Cabe P. Ecological and genetic evidence that low-order streams inhibit dispersal by red-backed salamanders (Plethodon cinereus). CAN J ZOOL 2007. [DOI: 10.1139/z07-008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
While many studies have examined the barrier effects of large rivers on animal dispersal and gene flow, few studies have considered the barrier effects of small streams. We used displacement experiments and analyses of genetic population structure to examine the effects of first-order and second-order streams on the dispersal of terrestrial red-backed salamanders, Plethodon cinereus (Green, 1818). We marked red-backed salamanders from near the edges of one first-order stream and one second-order stream, and experimentally displaced them either across the stream or an equal distance farther into the forest. A comparison of return rates indicated that both streams were partial barriers to salamander movement, reducing return rates by approximately 50%. Analysis of six microsatellite loci from paired plots on the same side and on opposite sides of the second-order stream suggested that the stream did contribute to genetic differentiation of salamander populations. Collectively, our results imply that low-order streams do influence patterns of movement and gene flow in red-backed salamanders. We suggest that given the high density of first-order and second-order streams in most landscapes, these features may have important effects on species that, like red-backed salamanders, have limited dispersal and large geographic ranges.
Collapse
Affiliation(s)
- D.M. Marsh
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - R.B. Page
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - T.J. Hanlon
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - H. Bareke
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - R. Corritone
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - N. Jetter
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - N.G. Beckman
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - K. Gardner
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - D.E. Seifert
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| | - P.R. Cabe
- Department of Biology, Washington and Lee University, Lexington, VA 24450, USA
| |
Collapse
|
41
|
Livshits VA, Kurad D, Marsh D. Multifrequency simulations of the EPR spectra of lipid spin labels in membranes. J Magn Reson 2006; 180:63-71. [PMID: 16448829 DOI: 10.1016/j.jmr.2006.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Revised: 01/10/2006] [Accepted: 01/11/2006] [Indexed: 05/06/2023]
Abstract
Simulations are performed of 34- and 9-GHz EPR spectra, together with 94-GHz EPR spectra, from phospholipid probes spin-labelled at the C4-C14 positions of the sn-2 chain, in liquid-ordered and gel-phase membranes of dimyristoyl phosphatidylcholine with high and low cholesterol contents. The multifrequency simulation strategy involves: (i) obtaining partially averaged spin-Hamiltonian tensors from fast-motional simulations of the 94-GHz spectra; (ii) performing slow-motional simulations of the 34- and 9-GHz spectra by using these pre-averaged tensors with the stochastic Liouville formalism; (iii) constructing, by simulation, slow-motional calibrations for the differences, DeltaA(zz)(qx) and Deltag(zz)(qx), in effective A(zz)-hyperfine splittings and g(zz)-values between 34- (or 94-GHz) and 9-GHz spectra; (iv) using such calibrations for DeltaA(zz)(qx) and Deltag(zz)(qx) and dynamic parameters from stage (ii) as a guide to adjust the extent of pre-averaging of the spin-Hamiltonian tensors; and (v) repeating the 34- and 9-GHz simulations of stage (ii). By using this scheme it is possible to obtain consistent values of the rotational diffusion coefficients, D(R perpendicular) and D(R//), and the long-axis order parameter, S(zz), that characterize the slow axial motion of the lipid chains, from spectra at both 34 and 9GHz. Inclusion of spectra at 34GHz greatly improves precision in determining the D(R//) element of the slow diffusion tensor in these systems.
Collapse
Affiliation(s)
- V A Livshits
- Max-Planck-Institut für biophysikalische Chemie, Abt. Spektroskopie, 37077 Göttingen, Germany
| | | | | |
Collapse
|
42
|
Bartucci R, Gambacorta A, Gliozzi A, Marsh D, Sportelli L. Bipolar Tetraether Lipids: Chain Flexibility and Membrane Polarity Gradients from Spin-Label Electron Spin Resonance. Biochemistry 2005; 44:15017-23. [PMID: 16274248 DOI: 10.1021/bi051101i] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Membranes of thermophilic Archaea are composed of unique tetraether lipids in which C40, saturated, methyl-branched biphytanyl chains are linked at both ends to polar groups. In this paper, membranes composed of bipolar lipids P2 extracted from the acidothermophile archaeon Sulfolobus solfataricus are studied. The biophysical basis for the membrane formation and thermal stability is investigated by using electron spin resonance (ESR) of spin-labeled lipids. Spectral anisotropy and isotropic hyperfine couplings are used to determine the chain flexibility and polarity gradients, respectively. For comparison, similar measurements have been carried out on aqueous dispersions of diacyl reference lipid dipalmitoyl phosphatidylcholine and also of diphytanoyl phosphatidylcholine, which has methyl-branched chains. At a given temperature, the bolaform lipid chains are more ordered and less flexible than in normal bilayer membranes. Only at elevated temperatures (80 degrees C) does the flexibility of the chain environment in tetraether lipid assemblies approach that of fluid bilayer membranes. The height of the hydrophobic barrier formed by a monolayer of archaebacterial lipids is similar to that in conventional fluid bilayer membranes, and the permeability barrier width is comparable to that formed by a bilayer of C16 lipid chains. At a mole ratio of 1:2, the tetraether P2 lipids mix well with dipalmitoyl phosphatidylcholine lipids and stabilize conventional bilayer membranes. The biological as well as the biotechnological relevance of the results is discussed.
Collapse
Affiliation(s)
- R Bartucci
- Dipartimento di Fisica, Università della Calabria, I-87036 Arcavacata di Rende (CS), Italy.
| | | | | | | | | |
Collapse
|
43
|
Livshits VA, Marsh D. Application of the out-of-phase absorption mode to separating overlapping EPR signals with different T1 values. J Magn Reson 2005; 175:317-29. [PMID: 15946873 DOI: 10.1016/j.jmr.2005.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Revised: 04/27/2005] [Accepted: 05/04/2005] [Indexed: 05/02/2023]
Abstract
The use of 90 degrees-out-of-phase first-harmonic absorption (V1'-) EPR to resolve the spectra from nitroxide spin labels with differing T1-relaxation times is described. Non-linear V1'-EPR spectra recorded under moderate saturation have sharper lines compared with the in-phase V1-EPR spectra, and amplitudes that preferentially enhance components with longer T1-relaxation. Discrimination between V1'-spectral components can be increased further by means of selective paramagnetic relaxation enhancement agents. Examples are given of biophysical applications to double labelling in single-component membranes and phase separation in two-component membranes, to lipid-peptide complexes, and to binding of spin-labelled reagents. It is concluded that optimal resolution in V1'-EPR spectroscopy is obtained at relatively low Zeeman modulation frequencies (20-30 kHz) and moderate saturation (H1 approximately 0.2-0.3 G).
Collapse
Affiliation(s)
- V A Livshits
- Max-Planck-Institut für biophysikalische Chemie, Abt. Spektroskopie, 37077 Göttingen, Germany
| | | |
Collapse
|
44
|
Wright SA, McNally C, Beringer T, Marsh D, Finch MB. Osteoporosis fracture liaison experience: the Belfast experience. Rheumatol Int 2005; 25:489-90. [PMID: 15798908 DOI: 10.1007/s00296-004-0573-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Accepted: 11/13/2004] [Indexed: 10/25/2022]
|
45
|
Gimm O, Nguyen Thanh P, Bloching M, Lorenz K, Howell V, Marsh D, Dralle H. Hyperparathyroidism-jaw tumor (HPT-JT)-syndrome: three case reports. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
46
|
Nedeianu S, Páli T, Marsh D. Membrane penetration of nitric oxide and its donor S-nitroso-N-acetylpenicillamine: a spin-label electron paramagnetic resonance spectroscopic study. Biochimica et Biophysica Acta (BBA) - Biomembranes 2004; 1661:135-43. [PMID: 15003876 DOI: 10.1016/j.bbamem.2003.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2003] [Revised: 12/12/2003] [Accepted: 12/15/2003] [Indexed: 11/18/2022]
Abstract
S-nitroso-N-acetylpenicillamine (SNAP) is a pharmacological agent with diverse biological effects that are mainly attributable to its favorable characteristics as a nitric oxide (NO)-evolving agent. It is found that SNAP incorporates readily into dimyristoyl phosphatidylcholine (DMPC) bilayer membranes; and an approximate penetration profile was obtained from the depth dependence of the perturbation that it exerts on spin-labeled lipid chains. The profile of SNAP locates it deep in the hydrophobic core of both fluid- and gel-phase membranes. The spin relaxation enhancement of spin-labeled phospholipids with nitroxide group located at different depths in DMPC membranes was determined for nitric oxide (NO) and molecular oxygen (O(2)), at close to atomic spatial resolution. The relaxation enhancement, which is proportional to the corresponding vertical membrane profile of the concentration-diffusion product, was measured in the gel and fluid phases of the lipid bilayer. No significant membrane penetration was observed in the gel phase for the two water-dissolved gases. In the fluid phase, the transmembrane profiles of NO and O(2) are similar and could be well described by a sigmoidal function with a maximum in the center of the bilayer, but that of NO is less steep and is shifted toward the center of the membrane, relative to that of O(2). These differences can be attributed mainly to the difference in hydrophobicity between the two gases and the presence of the donor in the NO experiments. The biological implications of the above results are discussed.
Collapse
Affiliation(s)
- Saviana Nedeianu
- Institute of Biophysics, Biological Research Centre Szeged, P.O. Box 521, H-6701 Szeged, Hungary
| | | | | |
Collapse
|
47
|
Swamy MJ, Ramakrishnan M, Marsh D, Würz U. Miscibility and phase behaviour of binary mixtures of N-palmitoylethanolamine and dipalmitoylphosphatidylcholine. Biochimica et Biophysica Acta (BBA) - Biomembranes 2003; 1616:174-83. [PMID: 14561475 DOI: 10.1016/j.bbamem.2003.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The content of N-acylethanolamines (NAEs) increases dramatically in cell membranes when the parent organism is subjected to injury or stress. This increase has been attributed to stress-combating mechanisms of the organism. In this study, a binary phase diagram of hydrated mixtures of N-palmitoylethanolamine (NP-E)--an endogenous ligand for the peripheral cannabinoid receptor (CB-2)--with dipalmitoylphosphatidylcholine (DPPC) is established by high-sensitivity differential scanning calorimetry (DSC). The structures of the phases involved were determined by using 31P-NMR spectroscopy and low-angle X-ray scattering. DSC studies show that NP-E and DPPC mix well in the composition range DPPC/NP-E=100:0 to 40:60 (mol/mol). At higher contents of NP-E, phase separation is indicated by the presence of additional transitions in the thermograms. Characterization of the structures formed by the mixtures with 31P-NMR shows that, up to 80 mol% NP-E, DPPC remains in the lamellar phase. The low-angle X-ray diffraction data are also consistent with a lamellar gel-phase structure for DPPC/NP-E mixtures up to 60 mol% NP-E. Above 70 mol% NP-E, NP-E phase separates in the gel-phase region, while complete miscibility is observed in the fluid phase. These results provide a structural basis for understanding the membrane interactions of NAEs, which is necessary for understanding the mechanism of their putative stress-combating role in the parent organisms.
Collapse
Affiliation(s)
- Musti J Swamy
- School of Chemistry, University of Hyderabad, Hyderabad 500 046, India.
| | | | | | | |
Collapse
|
48
|
Mantipragada SB, Horváth LI, Arias HR, Schwarzmann G, Sandhoff K, Barrantes FJ, Marsh D. Lipid-protein interactions and effect of local anesthetics in acetylcholine receptor-rich membranes from Torpedo marmorata electric organ. Biochemistry 2003; 42:9167-75. [PMID: 12885251 DOI: 10.1021/bi034485q] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The selectivity of lipid-protein interaction for spin-labeled phospholipids and gangliosides in nicotinic acetylcholine receptor-rich membranes from Torpedo marmorata has been studied by ESR spectroscopy. The association constants of the spin-labeled lipids (relative to phosphatidylcholine) at pH 8.0 are in the order cardiolipin (5.1) approximately equal to stearic acid (4.9) approximately equal to phosphatidylinositol (4.7) > phosphatidylserine (2.7) > phosphatidylglycerol (1.7) > G(D1b) approximately equal to G(M1) approximately equal to G(M2) approximately equal to G(M3) approximately equal to phosphatidylcholine (1.0) > phosphatidylethanolamine (0.5). No selectivity for mono- or disialogangliosides is found over that for phosphatidylcholine. Aminated local anesthetics were found to compete with spin-labeled phosphatidylinositol, but to a much lesser extent with spin-labeled stearic acid, for sites on the intramembranous surface of the protein. The relative association constant of phosphatidylinositol was reduced in the presence of the different local anesthetics to the following extents: tetracaine (55%) > procaine (35%) approximately benzocaine (30%). For stearic acid, only tetracaine gave an appreciable reduction (30%) in association constant. These displacements represent an intrinsic difference in affinity of the local anesthetics for the lipid-protein interface because the membrane partition coefficients are in the order benzocaine >> tetracaine approximately procaine.
Collapse
Affiliation(s)
- S B Mantipragada
- Abteilung Spektroskopie, Max-Planck-Institut für biophysikalische Chemie, 37077 Göttingen, Germany
| | | | | | | | | | | | | |
Collapse
|
49
|
Elliott J, Beringer T, Kee F, Marsh D, Willis C, Stevenson M. Predicting survival after treatment for fracture of the proximal femur and the effect of delays to surgery. J Clin Epidemiol 2003; 56:788-95. [PMID: 12954472 DOI: 10.1016/s0895-4356(03)00129-x] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to evaluate the prognosis after treatment for femoral neck fracture, to assess the impact of delay to surgery, and to devise a clinical prediction rule and score. METHODS A prospective observational study was conducted in which 1780 patients treated surgically in two teaching hospitals between 1 November 1997 and 31 October 1999 were followed over 12 months. Logistic regression was used to distinguish the effects of predictor variables on survival. Using a probit transformation of the predicted posterior probabilities of death, a prognostic score was devised with scores constrained so that a nominal score of approximately 90 represented a 50:50 chance of survival over 12 months. RESULTS Mortality was 30.1% in men and 19.5% in women. Increasing age, male gender, longer pre-operative delay, a higher American Society of Anesthesiology score, a lower Mental Test score, and a lower activities of daily living (Barthel) score were associated with increased risks of death. Of those waiting between 1 and 5 days for surgery, approximately 8 medium-risk and 17 high-risk patients (with prognostic scores of 90 and 120, respectively) would have to have their delay reduced to < 24 hours to yield one additional survivor. CONCLUSION The application of prediction rules must be guided by ethical, social, and scientific concerns.
Collapse
Affiliation(s)
- J Elliott
- Department of Trauma and Orthopaedics, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Ireland
| | | | | | | | | | | |
Collapse
|
50
|
Abstract
Magnetic resonance results, principally from 2H-nuclear magnetic resonance, indicate that the mean lipid-chain ordering at the surface of transmembrane proteins is comparable to that in fluid lipid bilayers. Principally, it is the requirement for matching the hydrophobic lengths of lipid and protein that modulates the degree of chain ordering at the lipid-protein interface. The distribution of chain order parameters is, nonetheless, broader in the presence of integral proteins than in fluid lipid bi-layers. The chain configurations of the phospholipids that are resolved in crystals of integral membrane proteins display considerable conformational heterogeneity. Chain C-C dihedral angles are, however, not restricted to the energetically allowable trans and gauche rotamers.This indicates that the chains of a given lipid do not have a unique configuration in protein crystals.
Collapse
Affiliation(s)
- D Marsh
- Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany.
| |
Collapse
|