Effect of acetaminophen and nonsteroidal anti-inflammatory drugs on gene expression of human mesenchymal stem cells

A major drawback of cartilage tissue engineering is that human mesenchymalStem cells (MSCs) from patients with osteoarthritis (OA) express high levels of type X collagen. Type X collagen is a marker of late stage chondrocyte hypertrophy, linked with endochondral ossification. Also, MSCs from OA patients express osteogenic marker genes such as alkaline phosphatase (ALK), bone sialoprotein (BSP), and osteocalcin (OC) as well as aggrecan (ACAN), a marker of chondrogenesis, but not type II collagen. OA patients, in an attempt to relieve pain and other symptoms, often take NSAIDs and pain relievers like acetaminophen. The aim of this present study was to determine how these drugs influence human MSC gene expression of different chondrogenic and osteogenic markers. MSCs isolated from the bone marrow of osteoarthritic patients or from normal donors were cultured in Dulbecco's Modified Eagle Medium (DMEM) supplemented with 10% fetal bovine serum (FBS) without or with Acetaminophen (Acet) or non-steroidal anti-inflammatory drugs (NSAIDs), Ibuprofen (Ibu), Diclofenac (Dic), Naproxen (Npx) and Celecoxib (Cele). After 3 days of culture, the cells were collected and gene expression was measured using quantitative PCR for type X collagen (COL10A1), aggrecan (ACAN) and type 1 collagen，as well as osteogenic marker genes such as alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OC) and Runt-related transcription factor 2 (RUNX2). Acet and Npx supplementation led to a significant increase in COL10A1 & RUNX2 expression when compared to control. Furthermore, with Ibu, Acet and Npx supplementation, aggrecan message levels were decreased. In contrast, addition of Cele significantly increased aggrecan gene expression. Finally, Ibu, Acet and Npx decreased type I collagen expression while Cele had a tendency to increase type I collagen expression. The present study showed that NSAIDs and Acet could affect Osteogenic and chondrogenic differentiation of human MSCs. These are features that could interfere with intervertebral disc (IVD) or cartilage repair. Thus, caution must be exercised when using MSCs from OA patients in biological repair of articular cartilage or disc.Un des principaux problèmes de l'ingénierie tissulaire du cartilage réside dans le fait que les cellules souches mésenchymateuses humaines (hCSMs) de patients osteoarthritiques (OA) expriment fortement le collagène de type X (Col X) qui est un marqueur de l'hypertrophie des chondrocvytes, hypertrophie qui est associée à l'ossification. Les hCSMs de patients OA expriment également des marqueurs de l'ostéogénèse tels que la phosphatase alcaline (ALK), une sialoprotéine de l'os (BSP) et l'ostéocalcine (OC), ainsi que l'aggrécane (AGG), un marqueur de la chondrogenèse. Dans le but de diminuer la douleur et autres symptômes reliés à leur maladie, les patients OA consomment des drogues anti-inflammatoires non-stéroïdiennes (NSAIDs). Le but de la présente étude était de déterminer si ces drogues pouvaient influencer l'expression de gènes associés à la chondrogenèse ou à l'ostéogénèse dans les hCSMs. Les CSMs isolées de la moelle osseuse de patients OA ou de donneurs normaux ont été cultivées dans du milieu Eagle modifié selon Dulbecco (DMEM) supplémenté avec 10% de sérum de veau fétal (SVF), sans ou avec Acétominophène (Acét), Ibuprofène (Ibu), Dichlorofenac (Dic), Naproxen (Npx) et Célécoxib (célé). L'expression des marqueurs ostéogéniques et du Col X a été mesurée par PCR quantitatif après 3 jours en culture. Les résultats montrent que l'Acét et le Npx induisaient significativement l'expression du Col X et diminuaient, tout comme l'Ibu, l'expression de l'AGG et du Col de type I (Col I). Cependant, Célé stimulait de façon significative l'expression de l'AGG et inhibait, mais de façon non significative, l'expression du Col I. En résumé, la présente étude montre que les NSAIDs peuvent moduler l'expression de gènes associés à l'ostéogénèse et à la chondrogenèse dans les hCSMs, indiquant qu'ils pourraient interférer dans la réparation du cartilage. L'utilisation de hCSMs de patients OA devrait donc être faite avec prudence pour la réparation biologique du cartilage articulaire et même du disque intervertébral

Prevalence of knee injuries among male college students in Riyadh, Kingdom of Saudi Arabia

Abstract Background The knee is considered the most common injured joint between young sport participants. However, there is lack of proper prevalence estimation in our population. The purpose of this study was to identify the prevalence of knee injuries among male college students and to observe the demographic data associated with it. Our secondary objective was to evaluate the awareness and knowledge about these injuries. Methods This is a cross-sectional study. A survey was distributed to collect the data among male college students, King Saud University, Riyadh, Saudi Arabia. Out of 688 students who participated and completed the questionnaire, a total of 482 were considered valid and met the inclusion criteria. Data were analyzed using Statistical Package for Social Sciences (SPSS). Results The overall prevalence of knee injury was 23.2% (n = 112). Most of them injured during sport activities especially soccer and 68.7% involved in a non-contact mechanism of injury. Among those who went to a hospital mostly were diagnosed as contusion (31.4%) then as meniscus tear, ACL, and collateral ligament injury, respectively. Majority was treated conservatively and only 10.7% needed surgery surprisingly. There was no statistically significant difference between those who are injured and whether they were warmed up and stretched or not (P = 0.619). Low level of knowledge about knee injuries was noticed among the participants 57.7%. Conclusion Our study has highlighted the high prevalence of knee injuries and the need to raise the level of awareness and knowledge about these injuries in our population. Soccer was the most common sport associated with knee injuries; most of these injuries were treated conservatively. </jats:sec

Predictors and Risk Factors of Surgical Site Infection (SSI) Following Adult Spine Surgery: A Cross-sectional Study

Introduction: Surgical site infection (SSI) is a major cause of morbidity and mortality as it is known to increase the length of hospital stay, revision surgery, and re-operation. Identifying patients at risk of developing SSI before surgery is the key to prevent SSI. Methodology: This cross-sectional study was performed at the orthopedic department in King Khalid University Hospital, Riyadh, Saudi Arabia. SSIs were defined according to the Centers for Disease Control (CDC) case definition for SSI. Potential risk factors for postoperative wound infection were collected. Data were analyzed using the SPSS, version 23.0, and p-value < 0.05 was considered to be statistically significant. Result: A total of 214 patients were included in the study and the incidence of SSI following spine surgery was 9.81% (N = 21). Obesity, diabetes, location of surgery, ASA score, duration of surgery, length of hospital stay, and location/level of operated vertebrae were all found to have a significant correlation with the SSI (p < 0.05). Conclusion: Having a strong background of SSI risk factors and predictors is core to preventing the incidence of SSI and further enhance and optimize operative outcomes, as well as increasing the cost-effectiveness of the surgical intervention

Predictors and Risk Factors of Surgical Site Infection (SSI) Following Adult Spine Surgery: A Cross-sectional Study

Introduction: Surgical site infection (SSI) is a major cause of morbidity and mortality as it is known to increase the length of hospital stay, revision surgery, and re-operation. Identifying patients at risk of developing SSI before surgery is the key to prevent SSI.&#x0D; Methodology: This cross-sectional study was performed at the orthopedic department in King Khalid University Hospital, Riyadh, Saudi Arabia. SSIs were defined according to the Centers for Disease Control (CDC) case definition for SSI. Potential risk factors for postoperative wound infection were collected. Data were analyzed using the SPSS, version 23.0, and p-value &lt; 0.05 was considered to be statistically significant.&#x0D; Result: A total of 214 patients were included in the study and the incidence of SSI following spine surgery was 9.81% (N = 21). Obesity, diabetes, location of surgery, ASA score, duration of surgery, length of hospital stay, and location/level of operated vertebrae were all found to have a significant correlation with the SSI (p &lt; 0.05).&#x0D; Conclusion: Having a strong background of SSI risk factors and predictors is core to preventing the incidence of SSI and further enhance and optimize operative outcomes, as well as increasing the cost-effectiveness of the surgical intervention.</jats:p

Foot health and quality of life among adults in Riyadh, Saudi Arabia: a cross-sectional study

Abstract Background Foot conditions are frequent among the Saudi population. However, little is known regarding the effects of foot health on quality of life among the general Saudi population. This study aimed to assess foot health status, general health, and quality of life among the population of Riyadh using the Foot Health Status Questionnaire (FHSQ). Methods In this cross-sectional study, out of the total number of participants approached, using a preset questionnaire, by trained medical students to participate in this study, 398 met the inclusion criteria. The questionnaire started with an informed consent followed by a set of questions regarding the sociodemographic and past medical characteristics of the participants. Foot health and overall health were assessed using a FHSQ. Results A statistically significant positive correlation was observed between all the FHSQ domains, except for footwear. The strongest correlation was observed between foot pain and foot function, foot pain and general foot health, and foot function and general foot health. A statistically significant positive correlation was observed between general foot health and general health, vitality, social function. Our results also showed that foot pain, general foot health, vitality, and social function scores were significantly lower in women as compared to men. Conclusion Significant positive correlation was observed between poor foot health and declining quality of life; thus, it is crucial to increase society’s awareness of the importance of medical foot care and continuous follow-up and consequences if left unrecognized and untreated. This is a major domain that can improve the well-being and quality of life of a population. </jats:sec