Wachstums- und Differenzierungsfaktor 5 beladener Gewebekleber zur verbesserten Integration von Knorpelersatzmaterialien zu subchondralem Knochen

Artikulärer Knorpel weist ein geringes Selbstheilungspotential auf und aktuelle Methoden zur Therapie von Knorpeldefekten resultieren meist im Aufbau fibrösen, mechanisch inferioren Regenerationsgewebes. Deshalb wird stetig versucht neue Therapiemethoden zu entwickeln, die häufig auf Tissue Engineering basieren. Ein Ansatz sind biogedruckte Tissue Engineering Konstrukte, die es ermöglichen durch das „Eindrucken“ vitaler Zellen die komplexen zellulären Strukturen des Knorpelgewebes nachzubilden. Trotz vielsprechender Ergebnisse in vitro, scheitert die langfristige Regeneration von Knorpeldefekten mittels Tissue Engineering jedoch häufig an der mangelnden Fixierung und Integration der Konstrukte in das umliegende Gewebe. Besonders um biogedruckte Hydrogelkonstrukte, für die viele gängigen Fixierungsoptionen ungeeignet sind, für das Knorpel Tissue Engineering nutzbar zu machen, müssen daher neue Fixierungs- und Integrationsmethoden entwickelt werden. Als Ansatz zur Verbesserung der osteochondralen Integration von Knorpelersatzmaterialien wurde im Rahmen dieser Arbeit ein GDF-5 beladener Gewebekleber getestet. GDF-5, ein Knorpelmorphogenetisches Protein, kann die chondrogene Differenzierung sowie die Hypertrophie von Vorläuferzellen fördern. Durch den Einsatz eines GDF-5 beladenen Gewebeklebers sollen in den Defekt einwandernde, wirtseigene Progenitorzellen zur chondrogenen Differenzierung und Mineralisierung angeregt werden, mit dem Ziel eine mineralisierte Knorpelgewebsschicht zwischen der subchondralen Knochen-platte und dem implantierten Tissue Engineering Konstrukt zu generieren und so dessen Integration zu verbessern

Preclinical Testing of New Hydrogel Materials for Cartilage Repair: Overcoming Fixation Issues in a Large Animal Model

Reinforced hydrogels represent a promising strategy for tissue engineering of articular cartilage. They can recreate mechanical and biological characteristics of native articular cartilage and promote cartilage regeneration in combination with mesenchymal stromal cells. One of the limitations of in vivo models for testing the outcome of tissue engineering approaches is implant fixation. The high mechanical stress within the knee joint, as well as the concave and convex cartilage surfaces, makes fixation of reinforced hydrogel challenging. Methods. Different fixation methods for full-thickness chondral defects in minipigs such as fibrin glue, BioGlue®, covering, and direct suturing of nonenforced and enforced constructs were compared. Because of insufficient fixation in chondral defects, superficial osteochondral defects in the femoral trochlea, as well as the femoral condyle, were examined using press-fit fixation. Two different hydrogels (starPEG and PAGE) were compared by 3D-micro-CT (μCT) analysis as well as histological analysis. Results. Our results showed fixation of below 50% for all methods in chondral defects. A superficial osteochondral defect of 1 mm depth was necessary for long-term fixation of a polycaprolactone (PCL)-reinforced hydrogel construct. Press-fit fixation seems to be adapted for a reliable fixation of 95% without confounding effects of glue or suture material. Despite the good integration of our constructs, especially in the starPEG group, visible bone lysis was detected in micro-CT analysis. There was no significant difference between the two hydrogels (starPEG and PAGE) and empty control defects regarding regeneration tissue and cell integration. However, in the starPEG group, more cell-containing hydrogel fragments were found within the defect area. Conclusion. Press-fit fixation in a superficial osteochondral defect in the medial trochlear groove of adult minipigs is a promising fixation method for reinforced hydrogels. To avoid bone lysis, future approaches should focus on multilayered constructs recreating the zonal cartilage as well as the calcified cartilage and the subchondral bone plate

omega-3 fatty acids contribute to the asthma-protective effect of unprocessed cow's milk

Background: Living on a farm has repeatedly been shown to protect children from asthma and allergies. A major factor involved in this effect is consumption of unprocessed cow's milk obtained directly from a farm. However, this phenomenon has never been shown in a longitudinal design, and the responsible milk components are still unknown. Objectives: We sought to assess the asthma-protective effect of unprocessed cow's milk consumption in a birth cohort and to determine whether the differences in the fatty acid (FA) composition of unprocessed farm milk and industrially processed milk contributed to this effect. Methods: The Protection Against Allergy-Study in Rural Environments (PASTURE) study followed 1133 children living in rural areas in 5 European countries from birth to age 6 years. In 934 children milk consumption was assessed by using yearly questionnaires, and samples of the ``usually'' consumed milk and serum samples of the children were collected at age 4 years. Doctor-diagnosed asthma was parent reported at age 6 years. In a nested case-control study of 35 asthmatic and 49 nonasthmatic children, 42 FAs were quantified in milk samples. Results: The risk of asthma at 6 years of age was reduced by previous consumption of unprocessed farm milk compared with shop milk (adjusted odds ratio for consumption at 4 years, 0.26; 95% CI,0.10-0.67). Part of the effect was explained by the higher fat content of farm milk, particularly the higher levels of omega-3 polyunsaturated FAs (adjusted odds ratio, 0.29; 95% CI,0.11-0.81). Conclusion: Continuous farm milk consumption in childhood protects against asthma at school age partially by means of higher intake of omega-3 polyunsaturated FAs, which are precursors of anti-inflammatory mediators.Peer reviewe

Guideline for management of septic arthritis in native joints (SANJO).

This clinical guideline is intended for use by orthopedic surgeons and physicians who care for patients with possible or documented septic arthritis of a native joint (SANJO). It includes evidence and opinion-based recommendations for the diagnosis and management of patients with SANJO

One-year follow-up of young people with ME/CFS following infectious mononucleosis by Epstein-Barr virus

BackgroundInfectious mononucleosis after primary infection with Epstein-Barr virus (EBV-IM) has been linked to the development of myalgic encephalomyelitis/chronic fatigue-syndrome (ME/CFS) in children, adolescents, and young adults. Here, we present clinical phenotypes and follow-up data from a first German cohort of young people with ME/CFS following EBV-IM.Methods12 adolescents and 13 young adults were diagnosed with IM-triggered ME/CFS at our specialized tertiary outpatient service by clinical criteria requiring post-exertional malaise (PEM) and a history of confirmed EBV primary infection as triggering event. Demographic information, laboratory findings, frequency and severity of symptoms, physical functioning, and health-related quality of life (HRQoL) were assessed and re-evaluated 6 and 12 months later.ResultsYoung adults displayed more severe symptoms as well as worsening of fatigue, physical and mental functioning, and HRQoL throughout the study, compared to adolescents. After one year, 6/12 (54%) adolescents no longer met the diagnostic criteria for ME/CFS while all young adults continued to fulfill the Canadian consensus criteria. Improvement in adolescents was evident in physical functioning, symptom frequency and severity, and HRQoL, while young adults showed little improvement. EBV serology and EBV DNA load did not correlate with distinct clinical features of ME/CFS, and clinical chemistry showed no evidence of inflammation. Remarkably, the median time from symptom onset to ME/CFS diagnosis was 13.8 (IQR: 9.1–34.9) months.ConclusionsME/CFS following EBV-IM is a severely debilitating disease often diagnosed late and with limited responses to conventional medical care, especially in adults. Although adolescents may have a better prognosis, their condition can fluctuate and significantly impact their HRQoL. Our data emphasize that biomarkers and effective therapeutic options are also urgently needed to improve medical care and pave the way to recovery

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Wachstums- und Differenzierungsfaktor 5 beladener Gewebekleber zur verbesserten Integration von Knorpelersatzmaterialien zu subchondralem Knochen

Artikulärer Knorpel weist ein geringes Selbstheilungspotential auf und aktuelle Methoden zur Therapie von Knorpeldefekten resultieren meist im Aufbau fibrösen, mechanisch inferioren Regenerationsgewebes. Deshalb wird stetig versucht neue Therapiemethoden zu entwickeln, die häufig auf Tissue Engineering basieren. Ein Ansatz sind biogedruckte Tissue Engineering Konstrukte, die es ermöglichen durch das „Eindrucken“ vitaler Zellen die komplexen zellulären Strukturen des Knorpelgewebes nachzubilden. Trotz vielsprechender Ergebnisse in vitro, scheitert die langfristige Regeneration von Knorpeldefekten mittels Tissue Engineering jedoch häufig an der mangelnden Fixierung und Integration der Konstrukte in das umliegende Gewebe. Besonders um biogedruckte Hydrogelkonstrukte, für die viele gängigen Fixierungsoptionen ungeeignet sind, für das Knorpel Tissue Engineering nutzbar zu machen, müssen daher neue Fixierungs- und Integrationsmethoden entwickelt werden. Als Ansatz zur Verbesserung der osteochondralen Integration von Knorpelersatzmaterialien wurde im Rahmen dieser Arbeit ein GDF-5 beladener Gewebekleber getestet. GDF-5, ein Knorpelmorphogenetisches Protein, kann die chondrogene Differenzierung sowie die Hypertrophie von Vorläuferzellen fördern. Durch den Einsatz eines GDF-5 beladenen Gewebeklebers sollen in den Defekt einwandernde, wirtseigene Progenitorzellen zur chondrogenen Differenzierung und Mineralisierung angeregt werden, mit dem Ziel eine mineralisierte Knorpelgewebsschicht zwischen der subchondralen Knochen-platte und dem implantierten Tissue Engineering Konstrukt zu generieren und so dessen Integration zu verbessern

Wachstums- und Differenzierungsfaktor 5 beladener Gewebekleber zur verbesserten Integration von Knorpelersatzmaterialien zu subchondralem Knochen

Artikulärer Knorpel weist ein geringes Selbstheilungspotential auf und aktuelle Methoden zur Therapie von Knorpeldefekten resultieren meist im Aufbau fibrösen, mechanisch inferioren Regenerationsgewebes. Deshalb wird stetig versucht neue Therapiemethoden zu entwickeln, die häufig auf Tissue Engineering basieren. Ein Ansatz sind biogedruckte Tissue Engineering Konstrukte, die es ermöglichen durch das „Eindrucken“ vitaler Zellen die komplexen zellulären Strukturen des Knorpelgewebes nachzubilden. Trotz vielsprechender Ergebnisse in vitro, scheitert die langfristige Regeneration von Knorpeldefekten mittels Tissue Engineering jedoch häufig an der mangelnden Fixierung und Integration der Konstrukte in das umliegende Gewebe. Besonders um biogedruckte Hydrogelkonstrukte, für die viele gängigen Fixierungsoptionen ungeeignet sind, für das Knorpel Tissue Engineering nutzbar zu machen, müssen daher neue Fixierungs- und Integrationsmethoden entwickelt werden. Als Ansatz zur Verbesserung der osteochondralen Integration von Knorpelersatzmaterialien wurde im Rahmen dieser Arbeit ein GDF-5 beladener Gewebekleber getestet. GDF-5, ein Knorpelmorphogenetisches Protein, kann die chondrogene Differenzierung sowie die Hypertrophie von Vorläuferzellen fördern. Durch den Einsatz eines GDF-5 beladenen Gewebeklebers sollen in den Defekt einwandernde, wirtseigene Progenitorzellen zur chondrogenen Differenzierung und Mineralisierung angeregt werden, mit dem Ziel eine mineralisierte Knorpelgewebsschicht zwischen der subchondralen Knochen-platte und dem implantierten Tissue Engineering Konstrukt zu generieren und so dessen Integration zu verbessern

Influence of Sports on Cortical Connectivity in Patients with Spinal Cord Injury-A High-Density EEG Study

Background: Minutes after an injury to the spinal cord, structural and functional reorganization of the connected brain areas may be initiated. Exercise enhances this neuroplasticity in the further course of the condition, which might modulate the connectivity patterns in brain regions responsible for movement execution and imagination. However, connectivity patterns have not been analyzed as a correlate for activity effects on neuroplasticity after spinal cord injury (SCI). We hypothesize that wheelchair sport has a modulating effect on the cortical connectivity in patients with SCI, such that distinguished activity patterns can be observed between sportive and non-sportive individuals with SCI and healthy participants. Methods: Sportive (n = 16) and non-sportive (n = 7) patients with SCI as well as sportive (n = 16) and non-sportive (n = 14) healthy participants were instructed to either observe, imagine, or conduct an observed movement while high-density EEG (HD-EEG) was recorded. Functional connectivity was computed from the recorded signals, and the coefficients were compared between groups and conditions using a non-parametric repeated measures analysis. Results: We found that depending on being sportive or not, patients with SCI and controls would react differently to the conditions, but the effects depended on the location in the brain as well as the analyzed frequency range (p < 0.05). Further analysis indicates that non-sportive patients showed higher connectivity received by the right posterior parietal cortex and a lower connectivity received by the left M1 compared to sportive patients. These effects were mainly observed during movement imagination, not during movement. Sportive and non-sportive participants in the healthy control group showed smaller differences than the patients. Conclusions: The results suggest a modulative effect of sports on connectivity patterns during movement imagination and to some extent during movement. This effect was predominantly found in patients with SCI, and to a lesser extent in healthy participants with opposing connectivity patterns. We suggest that this might be due to increased cortical excitability and the elevated brain derived neurotrophic factor (BDNF) level in patients with SCI that is enhanced by exercise