Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid

Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren–Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane®) and Group II with HA (Go-ON®). Patient’s evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA

Rb regulates fate choice and lineage commitment in vivo

February 1, 2011Mutation of the retinoblastoma gene (RB1) tumour suppressor occurs in one-third of all human tumours and is particularly associated with retinoblastoma and osteosarcoma[superscript 1]. Numerous functions have been ascribed to the product of the human RB1 gene, the retinoblastoma protein (pRb). The best known is pRb’s ability to promote cell-cycle exit through inhibition of the E2F transcription factors and the transcriptional repression of genes encoding cell-cycle regulators[superscript 1]. In addition, pRb has been shown in vitro to regulate several transcription factors that are master differentiation inducers[superscript 2]. Depending on the differentiation factor and cellular context, pRb can either suppress or promote their transcriptional activity. For example, pRb binds to Runx2 and potentiates its ability to promote osteogenic differentiation in vitro[superscript 3]. In contrast, pRb acts with E2F to suppress peroxisome proliferator-activated receptor γ subunit (PPAR-γ), the master activator of adipogenesis[superscript 4, 5]. Because osteoblasts and adipocytes can both arise from mesenchymal stem cells, these observations suggest that pRb might play a role in the choice between these two fates. However, so far, there is no evidence for this in vivo. Here we use mouse models to address this hypothesis in mesenchymal tissue development and tumorigenesis. Our data show that Rb status plays a key role in establishing fate choice between bone and brown adipose tissue in vivo.National Cancer Institute (U.S.) (Grant)National Institutes of Health (U.S.) (Grant

Conservation of birds in fragmented landscapes requires protected areas

For successful conservation of biodiversity, it is vital to know whether protected areas in increasingly fragmented landscapes effectively safeguard species. However, how large habitat fragments must be, and what level of protection is required to sustain species, remains poorly known. We compiled a global dataset on almost 2000 bird species in 741 forest fragments varying in size and protection status, and show that protection is associated with higher bird occurrence, especially for threatened species. Protection becomes increasingly effective with increasing size of forest fragments. For forest fragments >50 ha our results show that strict protection (International Union for Conservation of Nature [IUCN] categories I–IV) is strongly associated with higher bird occurrence, whereas fragments had to be at least 175 ha for moderate protection (IUCN categories V and VI) to have a positive effect. This meta-analysis quantifies the importance of fragment size, protection status, and their interaction for the conservation of bird species communities, and stresses that protection should not be limited to large pristine areas

Habitat selection by Torrent Ducks (Merganetta armata armata) in Central Chile: Conservation implications of hydropower production

The Torrent Duck (Merganetta armata) inhabits the torrential rivers of the Andean mountains. As part of a long-term study, two rivers important for hydroelectric production were surveyed in Central Chile. Monthly indices of Torrent Duck abundance and reproduction were recorded at 74 sampling points distributed along 35.4 km of river between 2007 and 2009. Habitat variables were measured to determine the factors that influence species abundance. The number of rapids, gradient, total flow, water velocity, relative position to hydropower intakes and abundance of conspecifics were identified as important attributes in Torrent Duck habitat preferences. Torrent Ducks were observed in selected sections of rivers where the presence of rapids, high slopes and high water velocity occurred. These conditions were influenced by the width and shape of the river bed. Spatial segregation among individuals suggests the effect of territoriality. Torrent Ducks tended to avoid the presence of high vehicu