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Donovan RL, Edwards TA, Judge A, Blom AW, Kunutsor SK, Whitehouse MR. Effects of recurrent intra-articular corticosteroid injections for osteoarthritis at 3 months and beyond: a systematic review and meta-analysis in comparison to other injectables. Osteoarthritis Cartilage 2022; 30:1658-1669. [PMID: 36108937 DOI: 10.1016/j.joca.2022.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 03/08/2022] [Revised: 06/08/2022] [Accepted: 07/16/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Intra-articular corticosteroid injections (IACIs) provide temporary symptom relief in osteoarthritis (OA). This meta-analysis investigated the effects of recurrent IACIs at 3 months and beyond. DESIGN We searched Medline, Embase and Cochrane from inception to January 2021 for randomised controlled trials (RCTs) of patients with OA who received recurrent IACIs compared with other injectables, placebo or no treatment (primary outcomes: pain, function). Mean differences (MDs) with 95% confidence intervals were reported. RESULTS Ten RCTs were included (eight knee OA (n = 763), two trapeziometacarpal OA (n = 121)). Patients received between 2 and 8 injections, varying by trial. Trials compared recurrent IACIs with hyaluronic acid (HA), platelet-rich plasma (PRP), saline or orgotein (follow-up 3-24 months). Greater improvements in pain, function and QoL at 3-24 months were noted for the comparators than with IACIs, with comparators demonstrating an equal or superior effect, or the intervention effect attenuated during follow-up. Recurrent IACIs demonstrated no benefits in pain or function over placebo at 12-24 months. No serious adverse events were recorded. No studies reported on time-to-future interventions, risk of future prosthetic joint infection or other adverse events associated with subsequent joint replacement. CONCLUSIONS Recurrent IACIs often provide inferior (or non-superior) symptom relief compared with other injectables (including placebo) at 3 months and beyond. Other injectables (HA, PRP) often yielded greater improvements in pain and function up to 24 months post-injection. Existing RCTs on recurrent IACIs lack sufficient follow-up data to assess disease progression and time-to-future interventions.
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Affiliation(s)
- R L Donovan
- Musculoskeletal Research Unit, University of Bristol, Level 1 Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK; North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK.
| | - T A Edwards
- North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK.
| | - A Judge
- Musculoskeletal Research Unit, University of Bristol, Level 1 Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - A W Blom
- Musculoskeletal Research Unit, University of Bristol, Level 1 Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK; North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - S K Kunutsor
- Musculoskeletal Research Unit, University of Bristol, Level 1 Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - M R Whitehouse
- Musculoskeletal Research Unit, University of Bristol, Level 1 Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK; North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
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Fuller J, Surtees RA, Shaw AB, Álvarez-Rodríguez B, Slack GS, Bell-Sakyi L, Mankouri J, Edwards TA, Hewson R, Barr JN. Hazara nairovirus elicits differential induction of apoptosis and nucleocapsid protein cleavage in mammalian and tick cells. J Gen Virol 2019; 100:392-402. [PMID: 30720418 DOI: 10.1099/jgv.0.001211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The Nairoviridae family within the Bunyavirales order comprise tick-borne segmented negative-sense RNA viruses that cause serious disease in a broad range of mammals, yet cause a latent and lifelong infection in tick hosts. An important member of this family is Crimean-Congo haemorrhagic fever virus (CCHFV), which is responsible for serious human disease that results in case fatality rates of up to 30 %, and which exhibits the most geographically broad distribution of any tick-borne virus. Here, we explored differences in the cellular response of both mammalian and tick cells to nairovirus infection using Hazara virus (HAZV), which is a close relative of CCHFV within the CCHFV serogroup. We show that HAZV infection of human-derived SW13 cells led to induction of apoptosis, evidenced by activation of cellular caspases 3, 7 and 9. This was followed by cleavage of the classical apoptosis marker poly ADP-ribose polymerase, as well as cellular genome fragmentation. In addition, we show that the HAZV nucleocapsid (N) protein was abundantly cleaved by caspase 3 in these mammalian cells at a conserved DQVD motif exposed at the tip of its arm domain, and that cleaved HAZV-N was subsequently packaged into nascent virions. However, in stark contrast, we show for the first time that nairovirus infection of cells of the tick vector failed to induce apoptosis, as evidenced by undetectable levels of cleaved caspases and lack of cleaved HAZV-N. Our findings reveal that nairoviruses elicit diametrically opposed cellular responses in mammalian and tick cells, which may influence the infection outcome in the respective hosts.
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Affiliation(s)
- J Fuller
- 1School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - R A Surtees
- 1School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK
- ‡Present address: Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Seestrasse 10, Berlin, 13353, Germany
| | - A B Shaw
- 1School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - B Álvarez-Rodríguez
- 1School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - G S Slack
- 2National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JG, UK
| | - Lesley Bell-Sakyi
- 3Department of Infection Biology, Institute of Infection and Global Health, University of Liverpool, Liverpool Science Park IC2, Liverpool, L3 5RF, UK
| | - J Mankouri
- 1School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK
- 4Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - T A Edwards
- 1School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK
- 4Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - R Hewson
- 2National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JG, UK
| | - J N Barr
- 1School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK
- 4Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
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Abstract
PURPOSE The purpose of this study is to evaluate a surgical technique that aims to address the multi-planar deformities occurring in early onset Blount's disease. METHODS Seven patients (eight lower limbs) with early onset Blount's disease were treated with a surgical technique that used an external fixator to simultaneously address all aspects of deformity. Presenting radiographic parameters including mechanical axis deviation (MAD), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA) and medial plateau angle (MPA) were compared with final follow-up and the unaffected limb. Data was also collected on surgical complications and functional outcomes. RESULTS After a mean interval of 4.6 years (2.2 to 9), the MAD of the affected limb improved from 4.85 cm to 1.88 cm, MPTA from 43.58° to 75.46° and MPA from 43.41° to 20.71°. The mean time in the external fixator was 5.6 months (3.5 to 10.4). Recurrence was noted in three patients; two had evidence of nerve injury and one patient had premature fibular consolidation. CONCLUSION The surgical technique described in this study has attempted to address the complex multiaxial deformity that is encountered in Blount's disease. It identifies difficulties and limitations in developing a comprehensive surgical protocol and highlights complications associated with this approach.
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Affiliation(s)
| | - R. Hughes
- Cardiff and Vale University Health Board, Cardiff, UK
| | - F. Monsell
- Department of Orthopaedics, Royal Hospital for Children, Bristol, UK
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Carter SD, Barr JN, Edwards TA. Expression, purification and crystallization of the Crimean-Congo haemorrhagic fever virus nucleocapsid protein. Acta Crystallogr Sect F Struct Biol Cryst Commun 2012; 68:569-73. [PMID: 22691790 PMCID: PMC3374515 DOI: 10.1107/s1744309112009736] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 03/05/2012] [Indexed: 02/02/2023]
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is a member of the Nairovirus genus within the Bunyaviridae family of segmented negative-sense RNA viruses. This paper describes the expression, purification and crystallization of full-length CCHFV nucleocapsid (N) protein and the collection of a 2.1 Å resolution X-ray diffraction data set using synchrotron radiation. Crystals of the CCHFV N protein belonged to space group C2, with unit-cell parameters a = 150.38, b = 72.06, c = 101.23 Å, β = 110.70° and two molecules in the asymmetric unit. Circular-dichroism analysis provided insight into the secondary structure, whilst gel-filtration analysis revealed possible oligomeric states of the N protein. Structural determination is ongoing.
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Affiliation(s)
- S. D. Carter
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, and Astbury Centre for Molecular and Structural Biology, University of Leeds, Leeds LS2 9JT, England
| | - J. N. Barr
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, and Astbury Centre for Molecular and Structural Biology, University of Leeds, Leeds LS2 9JT, England
| | - T. A. Edwards
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, and Astbury Centre for Molecular and Structural Biology, University of Leeds, Leeds LS2 9JT, England
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Sussner KM, Edwards TA, Thompson HS, Jandorf L, Kwate NO, Forman A, Brown K, Kapil-Pair N, Bovbjerg DH, Schwartz MD, Valdimarsdottir HB. Ethnic, racial and cultural identity and perceived benefits and barriers related to genetic testing for breast cancer among at-risk women of African descent in New York City. Public Health Genomics 2011; 14:356-70. [PMID: 21540561 DOI: 10.1159/000325263] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 02/09/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Due to disparities in the use of genetic services, there has been growing interest in examining beliefs and attitudes related to genetic testing for breast and/or ovarian cancer risk among women of African descent. However, to date, few studies have addressed critical cultural variations among this minority group and their influence on such beliefs and attitudes. METHODS We assessed ethnic, racial and cultural identity and examined their relationships with perceived benefits and barriers related to genetic testing for cancer risk in a sample of 160 women of African descent (49% self-identified African American, 39% Black-West Indian/Caribbean, 12% Black-Other) who met genetic risk criteria and were participating in a larger longitudinal study including the opportunity for free genetic counseling and testing in New York City. All participants completed the following previously validated measures: (a) the multi-group ethnic identity measure (including ethnic search and affirmation subscales) and other-group orientation for ethnic identity, (b) centrality to assess racial identity, and (c) Africentrism to measure cultural identity. Perceived benefits and barriers related to genetic testing included: (1) pros/advantages (including family-related pros), (2) cons/disadvantages (including family-related cons, stigma and confidentiality concerns), and (3) concerns about abuses of genetic testing. RESULTS In multivariate analyses, several ethnic identity elements showed significant, largely positive relationships to perceived benefits about genetic testing for breast and/or ovarian cancer risk, the exception being ethnic search, which was positively associated with cons/disadvantages, in general, and family-related cons/disadvantages. Racial identity (centrality) showed a significant association with confidentiality concerns. Cultural identity (Africentrism) was not related to perceived benefits and/or barriers. CONCLUSIONS Ethnic and racial identity may influence perceived benefits and barriers related to genetic testing for breast and/or ovarian cancer risk among at-risk women of African descent. Genetic counseling services may want to take into account these factors in the creation of culturally-appropriate services which best meet the needs of this heterogenous population.
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Affiliation(s)
- K M Sussner
- Division of Cancer Prevention and Control, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Aggarwal AK, Nair DT, Trincao J, Uljon SN, Johnson RE, Escalante CR, Edwards TA, Prakash S, Prakash L. Eukaryotic translesion synthesis DNA polymerases: structure and function. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305097503] [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: 11/10/2022] Open
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Abstract
Translation regulation plays an essential role in the differentiation and development of animal cells. One well-studied case is the control of hunchback mRNA during early Drosophila embryogenesis by the trans-acting factors Pumilio, Nanos, and Brain Tumor. We report here a crystal structure of the critical region of Pumilio, the Puf domain, that organizes a multivalent repression complex on the 3' untranslated region of hunchback mRNA. The structure reveals an extended, rainbow shaped molecule, with tandem helical repeats that bear unexpected resemblance to the armadillo repeats in beta-catenin and the HEAT repeats in protein phosphatase 2A. Based on the structure and genetic experiments, we identify putative interaction surfaces for hunchback mRNA and the cofactors Nanos and Brain Tumor. This analysis suggests that similar features in helical repeat proteins are used to bind extended peptides and RNA.
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Affiliation(s)
- T A Edwards
- Structural Biology Program, Department of Physiology and Biophysics, Mount Sinai School of Medicine, Box 1677, 1425 Madison Avenue, New York, NY 10029, USA
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Abstract
Axis determination in early Drosophila embryos is controlled, in part, by regulation of translation of mRNAs transcribed in maternal cells during oogenesis. The Pumilio protein is essential in posterior determination, binding to hunchback mRNA in complex with Nanos to suppress hunchback translation. In order to understand the structural basis of RNA binding, Nanos recruitment, and translational control, we have crystallized a domain of the Drosophila Pumilio protein that binds RNA. The crystals belong to the space group P6(3) with unit cell dimensions of a = b = 94.5 A, c = 228.9 A, alpha = beta = 90 degrees, gamma = 120 degrees and diffract to 2.6 A with synchrotron radiation. We show that the purified protein actively binds RNA and is likely to have a novel RNA binding fold due to a very high content of alpha-helical secondary structure.
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Affiliation(s)
- T A Edwards
- Department of Physiology and Biophysics, Mount Sinai School of Medicine, New York, NY 10029, USA
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Abstract
Declining enrollments in nursing programs, coupled with the current shortage of practicing registered nurses, prompted this investigation of 306 high school students' beliefs about nurses and nursing. The study also identifies potential numbers of future nursing students from high school populations and their primary source of information about nursing. Using an investigator questionnaire, subjects responded to statements about educational requirements for registered nurses along with their working conditions, earning power, and social status. Findings reveal a projected continuing shortage of nurses based on the very small percentage of subjects even considering nursing as a career. Additional findings show that whereas some perceptions about nursing seem congruent with those of nurses themselves, other beliefs held by high school students are not consistent with the realities of professional nursing today. Results of this study can be used by nurse recruiters to correct misconceptions about nursing and to help high school students perceive the profession in a more positive way. Expanding the informational sources about nursing can facilitate the recruitment process.
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Affiliation(s)
- P A Kohler
- School of Nursing, Florida State University, Tallahassee 32306
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Abstract
Treatment programs have based their treatment approach on the premise that alcoholics should exert internal control over situations and events that affect them. Since chronic alcohol use affects the health of an individual, Walston and Walston's Multidimensional Health Locus of Control Scale was administered to 47 alcoholics in a treatment program. The population reflected a higher belief that health status is more under their own control than under the control of chance or powerful others. However, the results indicated that recovering alcoholics with a more powerful other health orientation tended to maintain membership longer with Alcoholics Anonymous, would seek help sooner, would begin heavy drinking at a later age, and would attempt formal treatment more often.
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Affiliation(s)
- P R Dean
- School of Nursing, Florida State University, Tallahassee 32306
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Andrews HJ, Edwards TA, Cawston TE, Hazleman BL. Transforming growth factor-beta causes partial inhibition of interleukin 1-stimulated cartilage degradation in vitro. Biochem Biophys Res Commun 1989; 162:144-50. [PMID: 2787634 DOI: 10.1016/0006-291x(89)91974-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.6] [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: 01/02/2023]
Abstract
We show that purified human transforming growth factor-beta (1-10ng/ml) inhibits interleukin 1-stimulated loss of proteoglycan from cartilage in vitro. Inhibition is incomplete, as interleukin 1 retains the ability to cause a dose dependent stimulation of proteoglycan release in the presence of high levels of transforming growth factor-beta (100ng/ml) although both basal and interleukin 1-stimulated levels can be reduced by up to 50 per cent. This observation, together with its ability to stimulate proteoglycan synthesis and to stimulate proteinase inhibitor production, suggests a possible role for transforming growth factor-beta in limiting cartilage proteoglycan loss in inflammatory conditions such as rheumatoid arthritis.
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Affiliation(s)
- H J Andrews
- Rheumatology Research, Addenbrooke's Hospital, Cambridge, UK
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Jaffe HW, Kraus SJ, Edwards TA, Weinberger SS, Zubrzycki L. Diagnosis of gonorrhea using a genetic transformation test on mailed clinical specimens. J Infect Dis 1982; 146:275-9. [PMID: 6809844 DOI: 10.1093/infdis/146.2.275] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The genetic transformation test (GTT), a technique used for the detection of gonococcal DNA in clinical specimens, was compared with culture testing for the diagnosis of gonorrhea. At the De Kalb County Venereal Disease Clinic, Decatur, Ga., 454 cervical and 160 rectal specimens from women and 191 urethral specimens from men were collected in duplicate. One of each of the two specimens from each anatomic site was immediately plated on Martin-Lewis medium and incubated; the other specimen was mailed to Philadelphia for a GTT. Using culture results as a standard, the GTT had a specificity of 98.1% although some "false-positive" GTT results were probably a reflection of false-negative culture results. The sensitivity of the GTT was greater than 96% except when specimens were collected with Culturettes (Marion Laboratories, Kansas City, Mo.). In situations where Gram staining is not appropriate or where on-site culture facilities are not available, GTT may be the method of choice for the diagnosis of gonorrhea.
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Dean PR, Edwards TA. A Multidimensional Approach to Evaluation. J Nurs Educ 1982; 21:18-23. [PMID: 6279547 DOI: 10.3928/0148-4834-19820201-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Potter DJ, Johnson KE, Markovitz M, Waldmann EB, Edwards TA, Davis LP, Dozer WE, Maroko C. Maintenance home dialysis and the organ replacement era. Ariz Med 1969; 26:29-32. [PMID: 5763226] [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: 01/16/2023]
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