scholarly journals A White Paper on Collagen Hydrolyzates and Ultrahydrolyzates: Potential Supplements to Support Joint Health in Osteoarthritis?

2021 ◽  
Vol 23 (11) ◽  
Author(s):  
Ali Mobasheri ◽  
Armaghan Mahmoudian ◽  
Ursule Kalvaityte ◽  
Ilona Uzieliene ◽  
Christina E. Larder ◽  
...  
Keyword(s):  
Functional Disability ◽  
Musculoskeletal Diseases ◽  
Relevant Literature ◽  
Nutritional Supplements ◽  
White Paper ◽  
Joint Disease ◽  
Small Scale ◽  
Disease Modifying Drugs ◽  
Published Evidence ◽  
Joint Health

Abstract Purpose of Review Osteoarthritis (OA) is the most common forms of arthritis in the general population, accounting for more pain and functional disability than any other musculoskeletal disease. There are currently no approved disease modifying drugs for OA. In the absence of effective pharmacotherapy, many patients with OA turn to nutritional supplements and nutraceuticals, including collagen derivatives. Collagen hydrolyzates and ultrahydrolyzates are terms used to describe collagens that have been broken down into small peptides and amino acids in the presence of collagenases and high pressure. Recent Findings This article reviews the relevant literature and serves as a White Paper on collagen hydrolyzates and ultrahydrolyzates as emerging supplements often advertised to support joint health in OA. Collagen hydrolyzates have demonstrated some evidence of efficacy in a handful of small scale clinical trials, but their ability to treat and reverse advanced joint disease remains highly speculative, as is the case for other nutritional supplements. Summary The aim of this White Paper is to stimulate research and development of collagen-based supplements for patients with OA and other musculoskeletal diseases at academic and industrial levels. This White Paper does not make any treatment recommendations for OA patients in the clinical context, but simply aims to highlight opportunities for scientific innovation and interdisciplinary collaboration, which are crucial for the development of novel products and nutritional interventions based on the best available and published evidence.

Modeling the cost-effectiveness of a new treatment for MS (natalizumab) compared with current standard practice in Sweden

2008 ◽  
Vol 14 (5) ◽  
pp. 679-690 ◽  
Author(s):  
G Kobelt ◽  
J Berg ◽  
P Lindgren ◽  
B Jonsson ◽  
L Stawiarz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cost Effectiveness ◽  
Societal Perspective ◽  
Functional Disability ◽  
Health Benefit ◽  
Base Case ◽  
Current Standard ◽  
Disease Modifying Drugs ◽  
New Treatment ◽  
The Cost

Objective To estimate the cost-effectiveness of a new treatment (natalizumab) for multiple sclerosis (MS) compared with current standard therapy with disease-modifying drugs (DMDs) in Sweden. Methods A Markov model was constructed to illustrate disease progression based on functional disability (the Expanded Disability Status Scale (EDSS)). The effectiveness of natalizumab was based on a 2-year clinical trial in 942 patients (AFFIRM). The effectiveness of current DMDs was estimated from a matched sample of 512 patients in the Stockholm MS registry. Patients withdrawing from treatment were assumed to follow the disease course of 824 patients with relapsing–remitting disease at onset in the Ontario natural history cohort. Costs and utilities are based on a recent observational study in 1339 patients. All data sets were available at the patient level. Main results are presented from the societal perspective, over a 20-year time frame, in 2005 Euros (€1 = 9.25 SEK). Results In the base case, treatment with natalizumab was less expensive and more effective than treatment with current DMDs. When only healthcare costs were considered, the cost per quality-adjusted life year gained with natalizumab was €38 145. Results are sensitive only to the time horizon of the analysis and assumptions about effectiveness of natalizumab beyond the trial. Conclusions This cost-effectiveness analysis used registry data, cohort and observational studies to extrapolate the efficacy findings of natalizumab from the AFFIRM clinical trial to measure effectiveness in clinical practice. The analysis results suggest that for the population considered, natalizumab provides an additional health benefit at a similar cost to current DMDs from a societal perspective.

scholarly journals Improvement of Biogas Quality and Quantity for Small-Scale Biogas-Electricity Generation Application in off-Grid Settings: A Field-Based Study

Energies ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 3088
Author(s):  
Henry Wasajja ◽  
Saqr A. A. Al-Muraisy ◽  
Antonella L. Piaggio ◽  
Pamela Ceron-Chafla ◽  
Purushothaman Vellayani Aravind ◽  
...  
Keyword(s):  
Electricity Generation ◽  
Relevant Literature ◽  
Electrical Power ◽  
Process Efficiency ◽  
Electricity Production ◽  
Small Scale ◽  
Buffer System ◽  
Biogas Plants ◽  
Operational Practices ◽  
Pre Treatment

Small-scale electrical power generation (<100 kW) from biogas plants to provide off-grid electricity is of growing interest. Currently, gas engines are used to meet this demand. Alternatively, more efficient small-scale solid oxide fuel cells (SOFCs) can be used to enhance electricity generation from small-scale biogas plants. Most electricity generators require a constant gas supply and high gas quality in terms of absence of impurities like H2S. Therefore, to efficiently use the biogas from existing decentralized anaerobic digesters for electricity production, higher quality and stable biogas flow must be guaranteed. The installation of a biogas upgrading and buffer system could be considered; however, the cost implication could be high at a small scale as compared to locally available alternatives such as co-digestion and improved digester operation. Therefore, this study initially describes relevant literature related to feedstock pre-treatment, co-digestion and user operational practices of small-scale digesters, which theoretically could lead to major improvements of anaerobic digestion process efficiency. The theoretical preamble is then coupled to the results of a field study, which demonstrated that many locally available resources and user practices constitute frugal innovations with potential to improve biogas quality and digester performance in off-grid settings.

scholarly journals Inflammation in the hippocampus affects IGF1 receptor signaling and contributes to neurological sequelae in rheumatoid arthritis

2018 ◽  
Vol 115 (51) ◽  
pp. E12063-E12072 ◽  
Author(s):  
Karin M. E. Andersson ◽  
Caroline Wasén ◽  
Lina Juzokaite ◽  
Lovisa Leifsdottir ◽  
Malin C. Erlandsson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Functional Disability ◽  
Hippocampal Neurogenesis ◽  
Joint Disease ◽  
Neurological Sequelae ◽  
Molecular Features ◽  
Igf1r Signaling ◽  
Igf1 Receptor ◽  
The Brain

Rheumatoid arthritis (RA) is an inflammatory joint disease with a neurological component including depression, cognitive deficits, and pain, which substantially affect patients’ quality of daily life. Insulin-like growth factor 1 receptor (IGF1R) signaling is one of the factors in RA pathogenesis as well as a known regulator of adult neurogenesis. The purpose of this study was to investigate the association between IGF1R signaling and the neurological symptoms in RA. In experimental RA, we demonstrated that arthritis induced enrichment of IBA1+ microglia in the hippocampus. This coincided with inhibitory phosphorylation of insulin receptor substrate 1 (IRS1) and up-regulation of IGF1R in the pyramidal cell layer of the cornus ammoni and in the dentate gyrus, reproducing the molecular features of the IGF1/insulin resistance. The aberrant IGF1R signaling was associated with reduced hippocampal neurogenesis, smaller hippocampus, and increased immobility of RA mice. Inhibition of IGF1R in experimental RA led to a reduction of IRS1 inhibition and partial improvement of neurogenesis. Evaluation of physical functioning and brain imaging in RA patients revealed that enhanced functional disability is linked with smaller hippocampus volume and aberrant IGF1R/IRS1 signaling. These results point to abnormal IGF1R signaling in the brain as a mediator of neurological sequelae in RA and provide support for the potentially reversible nature of hippocampal changes.

Do Radiographic Joint Damage and Disease Activity Influence Functional Disability Through Different Mechanisms? Direct and Indirect Effects of Disease Activity in Established Rheumatoid Arthritis

2013 ◽  
Vol 40 (9) ◽  
pp. 1505-1512 ◽  
Author(s):  
Sandhya C. Nair ◽  
Johannes W.J. Bijlsma ◽  
Jacobien H. van der Werf ◽  
Maaike J. van der Veen ◽  
Suzanne P. Linn-Rasker ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Disability ◽  
Functional Decline ◽  
Joint Damage ◽  
Treatment Strategies ◽  
Joint Disease ◽  
Influence Functional ◽  
Over Time ◽  
Predictive Effect

Objective.To explore the relationship between rheumatoid arthritis (RA) disease activity and functional disability over time, considering indirect (predictive) and direct (concurrent) associations as well as the influence of radiographic joint damage and treatment strategy.Methods.Functional disability [Health Assessment Questionnaire (HAQ)], disease activity [28-joint Disease Activity Score (DAS28)], and radiographic joint damage [Sharp/van der Heijde score (SHS)] were measured in 4 consecutive randomized controlled trials with increasingly intensive (tight control) treatment strategies. Average followup time for the 3 cohorts was 97, 53, and 50 months, respectively. Next to current DAS28, the previous DAS28 was used to study the predictive effect of a change in DAS28 on progression of functional disability (HAQ). Finally, it was investigated whether SHS mediated the predictive effect of DAS28.Results.In patients treated with intensive treatment strategies, the progression of HAQ over time was statistically significantly less (p < 0.0001). The predictive influence of DAS28 on HAQ progression increased over the duration of the disease. SHS was not found to influence HAQ progression and did not mediate the predictive effect of DAS28. In the less intensively treated patients, the direct effect of disease activity decreased with disease duration, and contrarily, SHS did influence HAQ progression, but was not found to (fully) mediate the predictive effect of DAS28.Conclusion.In patients with RA treated with modern treatment strategies, there is less functional decline over time. Further, disease activity does predict functional decline but joint damage does not. This might indicate that factors associated with cumulative disease activity but not visible on radiographs can influence functional decline in patients with RA. This further underlines the importance of disease activity as a treatment target in early RA and in established RA.

scholarly journals NXY-059, the free radical trapping nitrone-based agent, reduces hemiparesis and reduces grey and white matter damage after focal cerebral ischemia in monkeys

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 327-327
Author(s):  
J Wb Marshall ◽  
K J Duffin ◽  
A R Green ◽  
R M Ridley
Keyword(s):  
Free Radical ◽  
White Matter ◽  
Acute Stroke ◽  
Functional Disability ◽  
Focal Cerebral Ischemia ◽  
Spatial Neglect ◽  
Histopathological Analysis ◽  
White Matter Damage ◽  
Radical Trapping ◽  
Published Evidence

60 There is little published evidence for protection of white matter with neuroprotective drugs in animal models of stroke, yet white matter protection may be important in achieving clinical efficacy. We have examined the effects of NXY-059, a nitrone-based free radical trapping agent, on long-term functional disability in a primate model of stroke. We also examined histopathological effects, including analyses of grey and white matter damage. Five minutes after unilateral permanent middle cerebral artery occlusion, marmosets received a 1 ml i.v. infusion of saline (n=5) or NXY-059 (28 mg/kg) (n=6) and osmotic minipumps (model 2001D) were implanted s.c. to provide continuous drug or saline infusion for 48 h. Drug-filled pumps released NXY-059 at a rate of approximately 16 mg/kg/h. The plasma unbound drug concentration at 24 h was 76.3 ± 5.7 μM, a level well tolerated in acute stroke patients. The monkeys had been trained and tested on a variety of behavioral tasks before surgery. NXY-059-treated monkeys were significantly better at reaching with their contralesional arm than were saline-treated monkeys when re-tested 3 (p<0.01) and 10 weeks (p<0.01) after surgery. NXY-059-treatment also significantly reduced spatial neglect measured 3 weeks after surgery (p<0.01) compared with the saline group. After behavioral testing was complete, histopathological analysis showed NXY-059-treated monkeys had significantly smaller infarcts than saline-treated monkeys (F (1, 10)=5.21, p<0.05). NXY-059 reduced overall infarct size by 51%, damage to the cortex was reduced by 54%, white matter by 52%, caudate by 49%, and putamen by 33% compared with saline-treated monkeys. In conclusion, NXY-059 substantially lessened the functional disability in these monkeys. This drug protects not only cortical tissue, but also white matter and subcortical structures against ischemic damage. Together these findings bode well for advancing this drug to further clinical trials for its use in acute stroke.

scholarly journals Indigenous and faith healing for mental health in Ghana: An examination of the literature on reported beliefs, practices and use of alternative mental health care in Ghana

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Lily Kpobi ◽  
Leslie Swartz
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Beliefs ◽  
Relevant Literature ◽  
Faith Healing ◽  
Small Scale ◽  
Health Seeking ◽  
African Countries ◽  
Mental Health Beliefs

Background: For many people in African countries, various forms of health care are utilised for the treatment of illness. This pluralistic nature of health seeking includes the use of indigenous, faith and allopathic medicines for care.Aim: In this article, our aim was to gain insight into the existing knowledge on indigenous and faith healing in Ghana, with a particular focus on mental health care. We first examine the reported mental health beliefs and practices of Ghanaian alternative healers. Following this, we look at the use and purported preference for non-biomedical mental health care by patients.Methods: Relevant literature was examined to explore the beliefs, practices and use of non-biomedical mental health care systems in GhanaResults: Evidence for the use and preference for non-biomedical mental health care is largely anecdotal. Similarly, the mental health beliefs of alternative healers have been documented in various small-scale studies. However, such information is important if mental health services in Ghana are to be improved.Conclusion: Integration of the different healthcare systems must be built on knowledge of beliefs and methods. A clearer understanding of the work of non-biomedical healers is important if appropriate recommendations are to be made for collaboration between biomedical and non-biomedical systems in Ghana.

Musculoskeletal Pathologies in Children with Haemophilia Evaluated using a Standardised Physical Joint Scoring System to Assess Disability

2011 ◽  
Vol 07 (01) ◽  
pp. 76 ◽  
Author(s):  
Sonata Saulyte Trakymiene ◽  
Keyword(s):  
Treatment Efficacy ◽  
Scoring System ◽  
Joint Damage ◽  
Joint Disease ◽  
Severe Haemophilia ◽  
International Consensus ◽  
Health Score ◽  
Haemophilic Arthropathy ◽  
Joint Health ◽  
Joint Assessment

Repeated bleeding into the joints leads to the development of chronic and progressive joint disease in 90% of people with severe haemophilia. Owing to recurrent haemarthroses, musculoskeletal outcome remains an important hallmark of treatment efficacy in haemophilia. Physical joint assessment is commonly used to measure structural and functional joint damage. With the development and introduction of prophylaxis, the most widely used instruments for the assessment of haemophilic arthropathy were found to lack sensitivity to detect the earliest signs of joint disease. To address these inadequacies, a new international consensus tool, the Haemophilia Joint Health Score (HJHS), was developed. The HJHS appears to be a sensitive, reliable and valid tool. However, the HJHS needs further evaluation in various patient populations to assess its applicability and usefulness.

Assessing the Coverage of E-Health Services in Sub-Saharan Africa

2017 ◽  
Vol 56 (03) ◽  
pp. 189-199 ◽  
Author(s):  
Taiwo Adigun ◽  
Sanjay Misra ◽  
Nicholas Omoregbe ◽  
Davies Adeloye
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Relevant Literature ◽  
Sub Saharan Africa ◽  
Medical Specialties ◽  
Technical Problems ◽  
Positive Feedbacks ◽  
Published Evidence ◽  
Health Initiatives ◽  
Sub Saharan

SummaryBackground: E-Health has attracted growing interests globally. The relative lack of facilities, skills, funds and information on existing e-Health initiatives has affected progress on e-Health in Africa.Objectives: To review publicly available literature on e-Health in sub-Saharan Africa (sSA) towards providing information on existing and ongoing e-Health initiatives in the region.Methods: Searches of relevant literature were conducted on Medline, EMBASE and Global Health, with search dates set from 1990 to 2016. We included studies on e-Health initiatives (prototypes, designs, or completed projects) targeting population groups in sSA.Results: Our search returned 2322 hits, with 26 studies retained. Included studies were conducted in 14 countries across the four sub-regions in sSA (Central, East, South and West) and spreading over a 12-year period, 2002-2014. Six types of e-Health interventions were reported, with 17 studies (65%) based on telemedicine, followed by mHealth with 5 studies (19%). Other e-Health types include expert system, electronic medical records, e-mails, and online health module. Specific medical specialties covered include dermatology (19%), pathology (12%) and radiology (8%). Successes were ‘widely reported’ (representing 50% overall acceptance or positive feedbacks in a study) in 10 studies (38%). The prominent challenges reported were technical problems, poor internet and connectivity, participants’ selection biases, contextual issues, and lack of funds.Conclusion: E-Health is evolving in sSA, but with poorly published evidence. While we call for more quality research in the region, it is also important that population-wide policies and on-going e-Health initiatives are contex- tually feasible, acceptable, and sustainable.

Bruising in older adults: what do social workers need to know?

2015 ◽  
Vol 17 (6) ◽  
pp. 351-359
Author(s):  
Sarah A. O. Matthews ◽  
Janet Reynolds
Keyword(s):  
Older Adults ◽  
Social Work ◽  
Older People ◽  
Research Study ◽  
Relevant Literature ◽  
Small Scale ◽  
Accidental Injury ◽  
Content Type ◽  
Social Work Practitioners ◽  
Non Accidental Injury

Purpose – The purpose of this paper is to discuss a research study exploring one aspect of adult safeguarding, that of non-accidental injury in older adults, specifically bruising. The study was undertaken with a view to analysing the current relevant literature and examining current practitioners’ views concerning bruising in older adults in order to understand social work practitioners’ awareness of and training in bruising. Design/methodology/approach – The paper describes a small-scale research study including two focus groups of social work and nursing practitioners. Themes arising from transcripts are coded by the analyst and are discussed in light of the summary and explanation of the literature reviewed following an initial scoping and exclusion exercise. Findings – The paper found that there is some evidence of typical and atypical non-accidental bruising emerging in older adults similar to that of children, but this tends to be treated as a clinical matter and mostly directed at medical staff. Research limitations/implications – Because of the chosen research aim, the research results focus on social work practitioners. Researchers are encouraged to explore other constituents further and to extend the scope of the literature review in terms of date and type. Practical implications – This paper will be of interest to all those concerned with the effective understanding of bruising as a sign of non-accidental injury in older people and especially the extent to which social work practitioners and others have to consider bruising during the course of their work with older people. Originality/value – This paper fulfils an identified need to study what social work practitioners and others need to know during the course of their work with older adults.

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