Mid-term outcomes after distally locked-to-standard primary stem exchange in 29 hip-prosthesis patients

AbstractBackgroundCementless locked femoral stems are used for revision surgery in patients with bone loss to induce spontaneous bone reconstruction, allowing subsequent replacement by a standard primary stem. The small number of patients and short follow-ups available to date preclude a valid assessment of this strategy.HypothesisAfter distally locked stem revision, replacement by a standard primary stem does not induce complications, and the quality of the bone reconstruction allows strong fixation of a regular primary stem.Materials and methodsWe retrospectively evaluated 29 patients in whom a distally locked femoral stem was replaced by a standard primary stem between 1998 and 2010 (cemented in 27, cementless in 2 cases). The reason for the procedure was stem breakage, stem migration, or thigh pain. Mean patient age was 63years (range, 39–78years). Outcomes were evaluated based on the Postel-Merle d’Aubigné [PMA] score and Harris Hip Score [HHS]. In addition, radiographs were obtained to assess prosthesis fixation and the Hofmann cortical index measured the bone reconstruction.ResultsThe distally locked stem was removed via a postero-lateral approach without femoral osteotomy in all the 29 cases. In one patient, an intra-operative fracture occurred during femoral preparation. Mean follow-up after the exchange procedure was 75months (range, 3–188months). Postoperative ccomplications occurred in 9 (32%) patients and consisted of chronic infection in 2 patients (after 3 and 76months), post-traumatic peri-prosthetic fractures treated with internal fixation in 3 patients (after 100, 138, and 182months), aseptic loosening in 3 patients (after 13, 39, and 122months), and recurrent instability in one patient (after 63months). All cause revision stem survival after 75months was 72% (95% confidence interval, 47%–87%). In the 19 patients who still had their revision stem at last follow-up, the mean PMA score was 16.7 (range, 13–18) and the mean HHS was 88.2 (range, 59–99). The Hofmann index remained unchanged [36.5% (range, 28%–58%) before the exchange and 32.9% (range, 20%–57%) after the exchange; P=0.129].DiscussionThis study confirms the feasibility of substituting a distally locked stem with a standard primary stem. No specific complications occurred and no technical difficulties arose when extracting the long stems. However, the 32% complication rate and, more specifically, the occurrence of loosening in 10% (3/29) of patients mandates caution in the use of this technique, which should not be proposed routinely, and suggests a need for considering cementless fixation of the standard primary stem.Level of evidenceLevel IV, retrospective study

A shared future:Chemistry's engagement is essential for resilience of people and planet

Strengthening resilience—elasticity or adaptive capacity—is essential in responding to the wide range of natural hazards and anthropogenic changes humanity faces. Chemistry's roles in resilience are explored for the first time, with its technical capacities set in the wider contexts of cross-disciplinary working and the intersecting worlds of science, society and policy. The roles are framed by chemistry's contributions to the sustainability of people and planet, examined via the human security framework's four material aspects of food, health, economic and environmental security. As the science of transformation of matter, chemistry is deeply involved in these material aspects and in their interfacing with human security's three societal and governance aspects of personal, community and political security. Ultimately, strengthening resilience requires making choices about the present use of resources as a hedge against future hazards and adverse events, with these choices being co-determined by technical capacities and social and political will. It is argued that, to intensify its contributions to resilience, chemistry needs to take action along at least three major lines: (i) taking an integrative approach to the field of ‘chemistry and resilience’; (ii) rethinking how the chemical industry operates; and (iii) engaging more with society and policy-makers

Role of Histamine H4 Receptor ligands in Bleomycin-induced pulmonary fibrosis

Fibrosis of lung tissue is a disease where a chronic inflammatory process determines a pathological remodelling of lung parenchyma. The animal model obtained by intra-tracheal administration of bleomycin in C57BL/6 mice is one of the most validated murine model. Bleomycin stimulates oxidative stress and the production of pro-inflammatory mediators. Histamine H4R have recently been implicated in inflammation and immune diseases. This study was focused to investigate the effects of H4R ligands in the modulation of inflammation and in the reduction of lung fibrosis in C57BL/6 mice treated with bleomycin. C57BL/6 mice were treated with vehicle, JNJ7777120 (JNJ, selective H4R antagonist) or ST-1006 (partial H4R agonist), ST-994 (H4R neutral antagonist) and ST-1012 (inverse H4R agonist) at equimolar doses, released by micro-osmotic pumps for 21 days. Airway resistance to inflation was assayed and lung samples were processed to measure malondialdehyde (TBARS); 8-hydroxy-2'-deoxyguanosine (8OHdG); myeloperoxidase (MPO); COX-2 expression and activity as markers of oxidative stress and inflammation. Fibrosis and airway remodelling were evaluated throughout transforming growth factor-β (TGF-β), percentage of positive Goblet cells, smooth muscle layer thickness determination. Our results indicated that JNJ, ST-994 and ST-1012 decreased inflammation and oxidative stress markers, i.e. the number of infiltrating leukocytes evaluated as lung tissue MPO, COX-2 expression and activity, TBARS and 8OHdG production. They also reduced the level of TGF-β, a pro-fibrotic cytokine, collagen deposition, thickness of smooth muscle layer, Goblet cells hyperplasia; resulting in a decrease of airway functional impairment. The results here reported clearly demonstrated that H4R ligands have a beneficial effect in a model of lung fibrosis in the mouse, thus indicating that H4R antagonists or inverse agonists could be a novel therapeutic strategy for lung inflammatory diseases

From Khoi-San indigenous knowledge to bioengineered CeO2 nanocrystals to exceptional UV-blocking green nanocosmetics

Single phase CeO2 nanocrystals were bio-synthesized using Hoodia gordonii natural extract as an effective chelating agent. The nanocrystals with an average diameter of 〈Ø〉 ~ 5–26 nm with 4+ electronic valence of Ce displayed a remarkable UV selectivity and an exceptional photostability. The diffuse reflectivity profile of such CeO2 exhibited a unique UV selectivity, in a form of a Heaviside function-like type profile in the solar spectrum. While the UV reflectivity is significantly low; within the range of 0.7%, it reaches 63% in the VIS and NIR. Their relative Reactive Oxygen Species (ROS) production was found to be < 1 within a wide range of concentration (0.5–1000 μg/ml). This exceptional photostability conjugated to a sound UV selectivity opens a potential horizon to a novel family of green nano-cosmetics by green nano-processing

Molecular characterization of the intact mouse muscle spindle using a multi-omics approach

The proprioceptive system is essential for the control of coordinated movement, posture and skeletal integrity. The sense of proprioception is produced in the brain using peripheral sensory input from receptors such as the muscle spindle, which detects changes in the length of skeletal muscles. Despite its importance, the molecular composition of the muscle spindle is largely unknown. In this study, we generated comprehensive transcriptomic and proteomic datasets of the entire muscle spindle isolated from the murine deep masseter muscle. We then associated differentially expressed genes with the various tissues composing the spindle using bioinformatic analysis. Immunostaining verified these predictions, thus establishing new markers for the different spindle tissues. Utilizing these markers, we identified the differentiation stages the spindle capsule cells undergo during development. Together, these findings provide comprehensive molecular characterization of the intact spindle as well as new tools to study its development and function in health and disease

Boron isotope sensitivity to seawater pH change in a species of Neogoniolithon coralline red alga

The increase in atmospheric carbon dioxide (CO2) observed since the industrial revolution has reduced surface ocean pH by ∼0.1 pH units, with further change in the oceanic system predicted in the coming decades. Calcareous organisms can be negatively affected by extreme changes in seawater pH (pHsw) such as this due to the associated changes in the oceanic carbonate system. The boron isotopic composition (δ11B) of biogenic carbonates has been previously used to monitor pH at the calcification site (pHcf) in scleractinian corals, providing mechanistic insights into coral biomineralisation and the impact of variable pHsw on this process. Motivated by these investigations, this study examines the δ11B of the high-Mg calcite skeleton of the coralline red alga Neogoniolithon sp. to constrain pHcf, and investigates how this taxon’s pHcf is impacted by ocean acidification. δ11B was measured in multiple algal replicates (n = 4–5) cultured at four different pCO2 scenarios – averaging (±1σ) 409 (±6), 606 (±7), 903 (±12) and 2856 (±54) μatm, corresponding to average pHsw (±1σ) of 8.19 (±0.03), 8.05 (±0.06), 7.91 (±0.03) and 7.49 (±0.02) respectively. Results show that skeletal δ11B is elevated relative to the δ11B of seawater borate at all pHsw treatments by up to 18‰. Although substantial variability in δ11B exists between replicate samples cultured at a given pHsw (smallest range = 2.32‰ at pHsw 8.19, largest range = 6.08‰ at pHsw 7.91), strong correlations are identified between δ11B and pHsw (R2 = 0.72, p < 0.0001, n = 16) and between δ11B and B/Ca (R2 = 0.72, p < 0.0001, n = 16). Assuming that skeletal δ11B reflects pHcf as previously observed for scleractinian corals, the average pHcf across all experiments was 1.20 pH units (0.79 to 1.56) higher than pHsw, with the magnitude of this offset varying parabolically with decreasing pHsw, with a maximum difference between pHsw and pHcf at a pHsw of 7.91. Observed relationships between pHsw and calcification rate, and between pHsw and pHcf, suggest that coralline algae exhibit some resilience to moderate ocean acidification via increase of pHcf relative to pHsw in a similar manner to scleractinian corals. However, these results also indicate that pHcf cannot be sufficiently increased by algae exposed to a larger reduction in pHsw, adversely impacting calcification rates of coralline red algae

The Origin of Malarial Parasites in Orangutans

Background Recent findings of Plasmodium in African apes have changed our perspectives on the evolution of malarial parasites in hominids. However, phylogenetic analyses of primate malarias are still missing information from Southeast Asian apes. In this study, we report molecular data for a malaria parasite lineage found in orangutans. Methodology/Principal Findings We screened twenty-four blood samples from Pongo pygmaeus (Kalimantan, Indonesia) for Plasmodium parasites by PCR. For all the malaria positive orangutan samples, parasite mitochondrial genomes (mtDNA) and two antigens: merozoite surface protein 1 42 kDa (MSP-142) and circumsporozoite protein gene (CSP) were amplified, cloned, and sequenced. Fifteen orangutans tested positive and yielded 5 distinct mitochondrial haplotypes not previously found. The haplotypes detected exhibited low genetic divergence among them, indicating that they belong to one species. We report phylogenetic analyses using mitochondrial genomes, MSP-142 and CSP. We found that the orangutan malaria parasite lineage was part of a monophyletic group that includes all the known non-human primate malaria parasites found in Southeast Asia; specifically, it shares a recent common ancestor with P. inui (a macaque parasite) and P. hylobati (a gibbon parasite) suggesting that this lineage originated as a result of a host switch. The genetic diversity of MSP-142 in orangutans seems to be under negative selection. This result is similar to previous findings in non-human primate malarias closely related to P. vivax. As has been previously observed in the other Plasmodium species found in non-human primates, the CSP shows high polymorphism in the number of repeats. However, it has clearly distinctive motifs from those previously found in other malarial parasites. Conclusion The evidence available from Asian apes indicates that these parasites originated independently from those found in Africa, likely as the result of host switches from other non-human primates