Biomechanical Characteristics of the Knee Joint during Gait in Obese versus Normal Subjects

Knee osteoarthritis (OA) is a growing source of pain and disability. Obesity is the most important avoidable risk factor underlying knee OA. The processes by which obesity impacts osteoarthritis are of tremendous interest to osteoarthritis researchers and physicians, where the joint mechanical load is one of the pathways generally thought to cause or intensify the disease process. In the current work, we developed a hybrid framework that simultaneously incorporates a detailed finite element model of the knee joint within a musculoskeletal model to compute lower extremity muscle forces and knee joint stresses in normal-weight (N) and obese (OB) subjects during the stance phase gait. This model accounts for the synergy between the active musculature and passive structures. In comparing OB subjects and normal ones, forces significantly increased in all muscle groups at most instances of stance. Mainly, much higher activation was computed with lateral hamstrings and medial gastrocnemius. Cartilage contact average pressure was mostly supported by the medial plateau and increased by 22%, with a larger portion of the load transmitted via menisci. This medial compartment experienced larger relative movement and cartilage stresses in the normal subjects and continued to do so with a higher level in the obese subjects. Finally, the developed bioengineering frame and the examined parameters during this investigation might be useful clinically in evaluating the initiation and propagation of knee OA.

Monitoring of bone fractured healing using biochemical markers among patients attending federal teaching hospital abakaliki and bone setter home in onueke ebonyi state, Nigeria

The monitoring of bone fractured healing using Alkaline phosphatase, calcium ion and inorganic phosphate was evaluated among patients with fractured bone in two different centers, Alex Ekwueme Federal University Teaching Hospital Abakaliki and Bone Setters Home, Onueke, Ezza in Ebonyi State between August 2017 and September 2018. : A total of 90 adults patients from 18 years to 78 years were examined using phenolphthalein monophosphate colorimetric end point method. Out of the 90 patients, 30 were healthy normal subjects, another 30 were patients in AE-FUTHA while the remaining 30 patients were in bone setter home. : Patients without bone fracture had the least mean serum level of alkaline phosphatase, 28.5 ± 9.0µl followed by those admitted in bone setter home with a mean serum level of 38.2±17.9µl while patients admitted in AE-FUTHA had the highest mean serum level of 41.4±6.5µl (P<0.05). The mean serum level of calcium was significantly higher 10.9± 2.6mg/dl in healthy normal patients compared to mean serum level of 9.2 ± 3.3mg/dl and 7.4 ± 1.3mg/dl for patients admitted in AE-FUTHA and bone setter home respectively. The mean serum level of inorganic phosphate indicate that patients admitted in bone setter home had the highest mean of 4.1 ± 1.0mg/dl followed by patients admitted in AE-FUTHA 3.4 ± 0.2mg/dl while that of healthy normal individuals had the least mean serum level of 3.2 ± 0.5mg/dl. : Out of the three parameters examined, alkaline phosphatase test was more precise, reliable and patient doctor friendly; hence it can be used as a veritable tool to monitor the process of bone fracture healing effectively.

Optic Nerve Ultrasound Evaluation in Animals and Normal Subjects

In recent years, ultrasonographic measurement of the optic nerve sheath diameter (ONSD) has been widely used to identify the presence of increased intracranial pressure (ICP). Intracranial hypertension is a life-threatening condition that can be caused by various neurological and non-neurological disorders, and it is associated to poor clinical results. Ultrasonography could be used to qualitatively and efficiently detect ICP increases, but to reach this purpose, clear cut-off values are mandatory. The aim of this review is to provide a wide overview of the most important scientific publications on optic nerve ultrasound normal values assessment published in the last 30 years. A total of 42 articles selected from PubMed medical database was included in this review. Our analysis showed that ocular ultrasonography is considered to be a valuable diagnostic tool, especially when intracranial hypertension is suspected, but unfortunately this research provided conflicting results that could be due to the different ultrasound protocols. This is mainly caused by the use of B scan alone, which presents several limitations. The use of B-scan coupled with the standardized A-scan approach could give more accurate, and reliable ultrasound evaluation, assuring higher data objectivity.

The Red and Orange Complex Subgingival Microbiome of Cognitive Impairment and Cognitively Normal Elderly with Periodontitis

Increasing evidence has shown an association between periodontitis and cognitive impairment. Subgingival microbiota play a great role in periodontitis pathogenesis. However, the correlation between the subgingival microbiome and cognitive impairment remains unclear. This study aimed to evaluate the red and orange complex subgingival microbiome of cognitively impaired and cognitively normal elderly Indonesian subjects with periodontitis. Twenty-eight elderly subjects diagnosed with periodontitis underwent two cognitive examinations using the Hopkins Verbal Learning Test and the Mini-Mental State Examination. Gingival crevicular fluid taken from the periodontal pocket, at a depth between 5 and 7 mm, using a paper point was used as the subgingival samples. The subgingival microbiome in the cognitive impairment group (n = 14) and cognitively normal group (n = 14) was compared using the 16S rRNA Metagenomic iSeq™ 100 Sequencing System. There was β-diversity in the subgingival microbiota between the cognitively impaired and cognitively normal subjects. The metagenomic analysis showed a higher abundance of Porphyromonas and Treponema bacteria in the cognitive impairment group than in the normal cognitive group (p < 0.05). The abundance of Porphyromonas gingivalis and Treponema denticola was higher in the cognitively impaired elderly subjects. The role of P. gingivalis and T. denticola in the pathogenesis of cognitive impairment needs further investigation.

Rehin Mitigates Chronic Kidney Injury by Decreasing the Release of Perforin and IFN-γ from Immune Cells Via Inhibiting the STING/TBK1/IRF3 Pathway Activation

Shenkang suppository (SKS), a Chinese medicinal preparation rich in various natural ingredients, has not been reported in any studies related to fibrosis. Our experiments validated the anti-fibrotic and anti-inflammatory effects of Rhein (Rh), which is a major component of SKS, and explored its potential immune mechanisms. Tissue and serum specimens from chronic kidney disease (CKD) patients and normal subjects were collected in 30 cases each, and the expression differences of perforin and IFN-γ were analyzed by ELISA. Further, the CKD mice model constructed with folic acid (FA) was used to validate these differences by WB and qRT-PCR to explore the potential nephroprotective mechanism of Rh. Besides, in vitro experiments were conducted to identify the release sources of perforin and IFN-γ. ELISA showed that perforin and IFN-γ were upregulated in CKD patients, and this phenomenon was also corroborated in CKD mice. WB and qRT-PCR data showed that Rh reversed perforin and IFN-γ upregulation, inflammatory factor recruitment, and extracellular matrix (ECM) protein upregulation. Results from in vitro experiments demonstrate that the upregulation of perforin and IFN-γ originates from the stress response of CD4+ T lymphocytes (CD4+ cells), CD8+ T lymphocytes (CD8+ cells) and natural killer cells (NK cells), which can be suppressed by Rh. More importantly, the activated STING/TBK1/IRF3 pathway in CKD was also inhibited by Rh. Our data suggest that Rh possesses anti-fibrotic and nephroprotective effects, which mechanistically are associated with decreased release of perforin and IFN-γ from immune cells, which may be achieved by suppressing the STING/TBK1/IRF3 pathway.

Correlation of CA 19-9 with HbA1c in prediabetic and diabetic groups

Introduction and Aim: Carbohydrate antigen19-9 (CA 19-9) is a marker of pancreatic cancer. In diabetics, pancreatic beta cell dysfunction can lead to elevated serum CA19-9 level. This study was designed for estimation of CA19-9 in diabetes and its correlation with glucose levels and glycosylated hemoglobin. Materials and Methods: The includes diabetic, pre diabetic with no history of malignancies and healthy normal subjects (n=50 each). Ca19-9 was estimated using ELISA, HbA1c by D10-Biorad variant turbo and the Lipid profile in Roche COBAs 6000 auto analyzer. Statistical analysis was done by Statistical Package for Social Sciences software version17 (SPSS 17). P <0.05 was considered significant. Results: Serum CA19-9 level was high in diabetics compared to normal, (p=0.38) however it was decreased in pre diabetic group (P=0.06). There was significant difference in comparison of CA19-9 levels between pre diabetic and diabetics(p=0.001). A significant increase in triglycerides was observed both in diabetics (p<0.01) and pre-diabetics(p=0.04). There was a significant positive correlation of CA19-9 with TC/HDL (p=0.022) and non-HDL(p) in control group. Conclusion: CA19-9 levels can be influenced by glycemic status, hence assessment of pancreatic cancer in diabetic patients must be interpreted carefully in consideration with CA19-9 levels. CA19-9 level was decreased in prediabetics when compared to normal and diabetics. This is a novel finding, the cause for which must ascertained, and this will open further avenues for research.

Evaluating TNF-α and Interleukin-2 (IL-2) Levels in African American Primary Open-Angle Glaucoma Patients

Purpose: To establish if SNPs in TNF-α and IL-2 genes are associated with Primary Open-Angle Glaucoma (POAG) in African Americans (AA). We also determined whether plasma TNF-α and IL-2 levels could serve as biomarkers for POAG in African Americans using Sandwich enzyme-linked immunosorbent assay. Methods: A single SNP association analysis was performed to investigate the association between potential gene variants in TNF-α and IL-2 genes and POAG in the AA population. Plasma samples from 190 African Americans (72 from normal subjects and 118 POAG cases) were obtained for TNF- α studies and 367 samples (135 from normal subjects and 232 from POAG cases) were obtained for IL-2 studies. TNF-α levels and IL-2 levels were measured by sandwich enzyme-linked immunosorbent assays (ELISA) and analyzed to see if they reached significance in cases with POAG and endophenotypes when compared to normal subjects. Results: The SNP, rs1800630, in TNF-α gene was found to be marginally associated with POAG. SNPs in IL-2 gene were not associated with POAG in the case-control analysis. No significant difference was found between TNF-α levels and IL-2 levels in normal and POAG case subjects in our study. IL-2 levels were inversely correlated with high IOP in POAG cases. Conclusions: Although we found a marginal SNP association of TNF-α, assessing the expression levels of TNF-α and IL-2 may serve as promising biomarkers for African American POAG. Further investigation is needed to determine if POAG can be subdivided into more specified cohorts of the disease, which may affect plasma cytokine levels differently.

Hemoglobin H Disease and Beta Thalassemia Major Demonstrated Higher Leucocytic DNA Damage

Hemoglobin H disease and beta thalassemia major are the more severe forms of thalassemia with frequent blood transfusion may be required. Iron chelation therapy is usually needed with blood transfusion to avoid iron overload. Oxidative stress mediated by excess iron via Fenton reaction may contribute to cellular DNA damage. This study was to investigate whether HbH and beta thalassemia major patients were suffered from higher oxidative stress in leucocytes. Comet assay was performed to investigate the DNA damage of 40 normal subjects, 40 hemoglobin H disease patients and beta thalassemia major patients. The UV-induced DNA damages of leucocytes were measured. The comet scores calculated by visual scoring under light microscope represented DNA damage. The mean ± standard deviation comet score for normal subjects; HbH disease and beta thalassemia major were 262.9 ± 8.1, 293.9 ± 15.4 and 293.5 ± 7.2 respectively. Results showed that both HbH disease and beta thalassemia major patients had higher DNA damage in white blood cells.

Association between Brachycephaly, Chiari Malformation, and Basilar Invagination

Background There is evidence that Chiari malformation (CM) and basilar invagination (BI) are largely due to disproportion between the content and volume of the posterior fossa. A recent study identified an increased association between brachycephaly and BI. In several types of craniosynostosis, the posterior fossa volume is smaller than normal, and this is more pronounced in coronal synostosis. The aim of this study is to evaluate the association between CM and BI. Methods The cephalic index (CI) measured on magnetic resonance imaging (MRI) from a sample of patients with craniocervical malformation was compared with that of normal subjects. Results The average CI in the craniovertebral junction malformation (CVJM) group was significantly higher in BI patients than in normal subjects. The BI patients also had the highest CI among the whole sample of patients (p = 0.009). Conclusions In this study, BI patients had the highest CI among patients with CVJM and a significantly higher CI than those in the control group. Our data confirm the association between BI and brachycephaly.