98 Cytokine Plasma Concentrations and Bone Marrow Side Population (SP) Numbers in Non-Smokers, Prior Smokers, and Current Smokers Undergoing Hip Replacement Surgery: Effect of Age on SP Numbers and Cytokine Levels

Cytokine ◽  
2007 ◽  
Vol 39 (1) ◽  
pp. 27
Author(s):  
Timothy McGuire ◽  
John Jackson ◽  
Susan Brusnahan ◽  
Anne Kessinger ◽  
Kevin Garvin ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hip Replacement ◽  
Side Population ◽  
Plasma Concentrations ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Cytokine Levels ◽  
Cytokine Plasma ◽  
Effect Of Age

scholarly journals Bone and Joint Tissue Penetration of the Staphylococcus-Selective Antibiotic Afabicin in Patients Undergoing Elective Hip Replacement Surgery

2018 ◽  
Vol 63 (3) ◽  
Author(s):  
Annick Menetrey ◽  
Annick Janin ◽  
John Pullman ◽  
J. Scott Overcash ◽  
Amina Haouala ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Soft Tissue ◽  
Synovial Fluid ◽  
Hip Replacement ◽  
Clinical Development ◽  
Efficacy Data ◽  
Content Type ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Joint Infections

ABSTRACT Afabicin (formerly Debio 1450, AFN-1720) is a prodrug of afabicin desphosphono (Debio 1452, AFN-1252), a novel antibiotic in development which targets the staphylococcal enoyl-acyl carrier protein reductase (FabI) and exhibits selective potent antibacterial activity against staphylococcal species, including methicillin-resistant Staphylococcus aureus. As part of clinical development in bone and joint infections, a distribution study in bone was performed in 17 patients who underwent elective hip replacement surgery. Patients received 3 doses of 240 mg afabicin orally (every 12 h) at various time points before surgery. Afabicin desphosphono concentrations were measured by liquid chromatography-tandem mass spectrometry in plasma, cortical bone, cancellous bone, bone marrow, soft tissue, and synovial fluid collected during surgery at 2, 4, 6, or 12 h after the third afabicin dose. The study showed good penetration of afabicin desphosphono into bone tissues, with mean area under the curve ratios for cortical bone-, cancellous bone-, bone marrow-, soft tissue-, and synovial fluid-to-total plasma concentrations of 0.21, 0.40, 0.32, 0.35, and 0.61, respectively. When accounting for the free fraction in plasma (2%) and synovial fluid (9.4%), the mean ratio was 2.88, which is indicative of excellent penetration and which showed that the afabicin desphosphono concentration was beyond the MIC90 of S. aureus over the complete dosing interval. These findings, along with preclinical efficacy data, clinical efficacy data for skin and soft tissue staphylococcal infection, the availability of both intravenous and oral formulations, and potential advantages over broad-spectrum antibiotics for the treatment of staphylococcal bone or joint infections, support the clinical development of afabicin for bone and joint infections. (This study has been registered at ClinicalTrials.gov under identifier NCT02726438.)

Mechanisms of Hypercoagulability

1999 ◽  
Vol 82 (08) ◽  
pp. 902-906 ◽  
Author(s):  
Ola Dahl
Keyword(s):  
Bone Marrow ◽  
Hip Replacement ◽  
Low Molecular Weight ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Vein Thrombosis ◽  
Hip Replacement Surgery ◽  
Heparin Resistance ◽  
Deep Vein ◽  
The Brain

IntroductionPatients undergoing major traumas, major joint replacement surgery, and neurosurgery are at high risk for postoperative deep vein thrombosis (DVT). Even if modern low molecular weight heparin is given as prophylaxis, the frequency of DVT remains high in these patients.1-7 This may indicate that some patients possess a certain “heparin resistance,” due probably due to an overwhelming procoagulant activity and/or because the hypercoagulable state lasts for a longer time than presently assumed. Tissue factor (TF) is the primary cellular initiator of blood coagulation and the most potent trigger of blood clotting known today.8 Adventitia surrounding the major blood vessels, the brain, and the bone marrow are structures with high levels of TF.9 Elective hip replacement surgery, which is a fairly well-standardized procedure that involves a great deal of damage to the bone marrow, is therefore, well-suited as a model to study the mechanisms of hypercoagulability.

Stem Cell Numbers and Quality in a Group of Patients Undergoing Hip Replacement Surgery: Increasing Marrow Fat and Plasma IL-6 Concentrations with Aging.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4249-4249
Author(s):  
Timothy R. McGuire ◽  
Susan K. Brusnahan ◽  
John Jackson ◽  
Ann M. Berger ◽  
Kevin L. Garvin ◽  
...  
Keyword(s):  
Stem Cell ◽  
Inflammatory Cytokines ◽  
Hip Replacement ◽  
Side Population ◽  
Fat Content ◽  
Negative Effects ◽  
Marrow Fat ◽  
Cell Numbers ◽  
Replacement Surgery ◽  
Hip Replacement Surgery

Abstract Diseases such as anemia which increase with age may be indicative of a decline in stem cell numbers and quality. Anemia in many elderly patients is thought to be mediated by inflammatory cytokines. Interleukin-6 (IL-6) has been reported to increase with age and to have negative effects on myelopoiesis. Another change which may correlate with age and a related decline in stem cell quality is an increase in marrow fat content. The present investigation was designed to evaluate stem cell numbers and quality in a group of patients undergoing hip replacement surgery and correlate stem cell characteristics with the percentage of fat in the marrow and plasma IL-6 concentrations. Marrow stem cells were obtained from the femoral head and trochanter at surgery. Quality was assessed by measuring the proportion of cells in the lower tip of the marrow side population compared to the upper side population by flow cytometry. Fat content in the marrow was measured as a percentage of total volume after sedimentation. A sandwiched-type ELISA was used to measure plasma IL-6 concentrations (R and D Systems). A total of 30 patients were analyzed (36–87 years of age). The number of side-population cells (stem cell numbers) declined with increasing fat content of the marrow. No difference was seen in the ratio between lower and upper side populations (stem cell quality) with age or fat content. Plasma IL-6 concentrations significantly increased with age confirming prior reports (r=0.37; p=0.03). IL-6 concentrations did not correlate with fat content of the marrow. This data suggests that marrow conversion from red (low fat) to yellow (high fat) increases with age along with plasma IL-6 concentrations but these are independent processes. Other inflammatory cytokines are currently under evaluation as potential mediators of the decline in the stem cell compartment with age with particular emphasis on various adipokines since the decline appears to correlate with increased marrow fat content.

scholarly journals The effects of competition and bundled payment on patient reported outcome measures after hip replacement surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanny Goude ◽  
Sverre A. C. Kittelsen ◽  
Henrik Malchau ◽  
Maziar Mohaddes ◽  
Clas Rehnberg
Keyword(s):  
Hip Replacement ◽  
Health Gain ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Economic Incentives ◽  
Bundled Payment ◽  
Treatment Groups ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported

Abstract Background Competition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery. Methods Using patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects. Results The entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust. Conclusions Competition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.

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