What Is the Evidence Surrounding the Cost-Effectiveness of Osteobiologic Use in ACDF Surgery? A Systematic Review of the Literature.

STUDY DESIGN This study constitutes a systematic review of the literature. OBJECTIVE The aim of this study was to identify and present all available studies that report on the costs of osteobiologics used in anterior cervical discectomy and fusion (ACDF). METHODS The literature was systematically reviewed to identify studies with specific inclusion criteria: (1) randomized controlled trials and observational studies, (2) in adult patients, (3) with herniated disc(s) or degenerative cervical spine disease, (4) reporting on either direct or indirect costs of using specific osteobiologics in an ACDF operation. (5) Only studies in English were included. The quality of the included studies was assessed using the MINORS and RoB 2.0 tools. RESULTS Overall, 14 articles were included; one randomized controlled trial and 13 observational studies. The most commonly used osteobiologics other than autograft/iliac crest bone graft (ICBG) were allograft and bone morphogenetic protein (BMP). None of the studies was reported to be industry-supported. There was considerable heterogeneity on the reported costs. Overall, most studies reported on surgery-related costs, such as anesthesia, operating room, surgical materials and surgeon's fee. Only two studies, both using allograft, reported the exact cost of the osteobiologic used (450 GBP, $700). Some of the studies reported on the cost of care during hospitalization for the surgical operation, such as radiology studies, emergency room costs, cardiologic evaluation, laboratory studies, pharmacy costs, and room costs. Only a few studies reported on the cost of follow-up, reoperation, and physical therapy and rehabilitation. CONCLUSION Based on the data of this current systematic review, no recommendations can be made regarding the cost-effectiveness of using osteobiologics in ACDF. Given the high costs of osteobiologics, this remains a topic of importance. The design of future studies on the subject should include cost effectiveness

Entwicklung von Methoden zum Nachweis von ökologisch erzeugten Produkten am Beispiel der Lachszucht

Zur Zeit stehen der Lebensmittelüberwachung keine analytischen Methoden zur Verfügung mit denen Deklarationen wie „Bio-Fisch“, „Bio-Lachs“ oder „Organic Salmon“ am Erzeugnis überprüft werden können. Das Ziel dieses Projektes bestand in der Entwicklung von objektiven, praxistauglichen Analysenverfahren zur Identifizierung von Lachserzeugnissen aus der ökologischen Aquakultur. Die Verfügbarkeit solcher Verfahren ermöglicht einen verbesserten Verbraucherschutz und eine Stärkung des redlichen Handels. Es kann aber auch der Tierschutz von den Ergebnissen des Projektes profitieren, wenn man berücksichtigt, dass die ökologische Aquakultur eine artgerechte Haltung der Fische besonders fördern soll. In einem umfangreichen Untersuchungsprogramm wurden biologische und chemische Methoden, sowie ganzheitliche Verfahren eingesetzt. Zum Vergleich wurden auch Wildlachse und einige Lachsfutter analysiert. Probenziehungen fanden in den Jahren 2002 und 2003 statt; der Ökolachs und Wildlachs stammte aus Irland, Farmlachse hoher Qualität wurden aus Irland und Norwegen bezogen. Insgesamt wurden 100 Lachsproben analysiert. Folgende Methoden kamen u.a. zum Einsatz: Beurteilung des Ausgangsmaterials (Aussehen, Kondition der Lachse), DNA Analyse, Bildverarbeitung (Muskelstruktur), Aromaprofil Bestimmung, Messung der Gehalte an Eiweiß und Fett, Bestimmung von Stoffwechselprodukten und Stressparametern, Stabil-Isotopen-Analyse (15-N, 13-C), Bestimmung der Astaxanthin-Isomere und Canthaxanthingehalte, Bestimmung von organischen und anorganischen Rückständen. Aus den vielfältigen Ergebnissen ist zu schließen, dass Öko- und Farmlachs sich in Aussehen, Zusammensetzung (z.B. im Fettgehalt) und Schadstoffgehalten generell nicht unterscheiden. Nur mit Hilfe einer Methode, der Bestimmung der Astaxanthin-Isomere, konnte der Ökolachs aus Irland sicher identifiziert werden

Protective effects of alpha phenyl-tert-butyl nitrone and ascorbic acid in human adipose derived mesenchymal stem cells from differently aged donors.

Adipose-derived mesenchymal stem cells (ADSCs) are multipotent stem cells that promote therapeutic effects and are frequently used in autologous applications. Little is known about how ADSCs respond to genotoxic stress and whether or not donor age affects DNA damage and repair. In this study, we used the comet assay to assess DNA damage and repair in human ADSCs derived from young (20-40 years), middle-aged (41-60 years), and older (61+ years) donors following treatment with H2O2 or UV light. Tail lengths in H2O2-treated ADSCs were substantially higher than the tail lengths in UV-treated ADSCs. After 30 minutes of treatment with H2O2, ADSCs preconditioned with alpha phenyl-tert-butyl nitrone (PBN) or ascorbic acid (AA) showed a significant reduction in % tail DNA. The majority of ADSCs treated with PBN or AA displayed low olive tail movements at various timepoints. In general and indicative of DNA repair, % tail length and % tail DNA peaked at 30 minutes and then decreased to near-control levels at the 2 hour and 4 hour timepoints. Differently aged ADSCs displayed comparable levels of DNA damage in the majority of these experiments, suggesting that the age of the donor does not affect the DNA damage response in cultured ADSCs

Posterior Cerebral Artery Aneurysms : Treatment and Outcome Analysis in 121 Patients

Peer reviewe

Protective effects of alpha phenyl-tert-butyl nitrone and ascorbic acid in human adipose derived mesenchymal stem cells from differently aged donors

Adipose-derived mesenchymal stem cells (ADSCs) are multipotent stem cells that promote therapeutic effects and are frequently used in autologous applications. Little is known about how ADSCs respond to genotoxic stress and whether or not donor age affects DNA damage and repair. In this study, we used the comet assay to assess DNA damage and repair in human ADSCs derived from young (20-40 years), middle-aged (41-60 years), and older (61+ years) donors following treatment with H2O2 or UV light. Tail lengths in H2O2-treated ADSCs were substantially higher than the tail lengths in UV-treated ADSCs. After 30 minutes of treatment with H2O2, ADSCs preconditioned with alpha phenyl-tert-butyl nitrone (PBN) or ascorbic acid (AA) showed a significant reduction in % tail DNA. The majority of ADSCs treated with PBN or AA displayed low olive tail movements at various timepoints. In general and indicative of DNA repair, % tail length and % tail DNA peaked at 30 minutes and then decreased to near-control levels at the 2 hour and 4 hour timepoints. Differently aged ADSCs displayed comparable levels of DNA damage in the majority of these experiments, suggesting that the age of the donor does not affect the DNA damage response in cultured ADSCs