Estudio de la biocompatibilidad de una nueva aleación beta-titanio de bajo módulo de elasticidad

Peer Reviewe

Optimization of a new Ni-free Ti alloy for applications in the implant field

Three new Ni-free Ti alloys, Ti-16.2Hf-24.8Nb-1Zr, Ti-5.2Hf-31.2Nb-0.4Zr and Ti-16Hf-36.2Nb-1Zr (wt%), were designed and produced in order to obtain shape memory and/or low elastic modulus materials in order to avoid stress shielding and to enhance bone regeneration in the load transfer implant field. The alloys were microstructurally and mechanically characterized, cytotoxicity was evaluated using MG63 osteoblast-like cells. The elastic modulus of the new alloys (between 67-90 GPa) are smaller than those of the commercial alloys employed for implantation. The lowest elastic modulus alloy, Ti-16.2Hf-24.8Nb-1Zr (wt %), with 67.5 GPa, was optimized by cold work in order to determine the key factor that promotes the desired shape memory properties and/or low elastic modulus. A higher proportion of martensite was observed by optical and electron transmission microscopy in the low cold work samples compared to the quenched alloy. The elastic modulus for each cold work condition was evaluated by nanoindentation tests using a spherical tip. The elastic modulus decreases when increasing the cold work level. The lowest value corresponds to the 99% cold work condition, with 44 GPa, closer to that of cortical bone and smaller than the quenched alloy (67.5 GPa).Tres nuevas aleaciones de Ti libres de Ni, Ti-16.2Hf-24.8Nb-1Zr, Ti-5.2Hf-31.2Nb-0.4Zr y Ti-16Hf-36.2Nb-1Zr, porcentajes en peso, fueron diseñadas y fabricadas con el fin de obtener memoria de forma y/o bajo módulo elástico con el objetivo de evitar el apantallamiento de cargas y mejorar la regeneración ósea en el campo de la implantología de transferencia de carga. Las aleaciones fueron caracterizadas microestructural y mecánicamente y la citotoxicidad fue evaluada utilizando osteoblastos MG63. El módulo elástico de las nuevas aleaciones (entre 67-90 GPa) es menor que el de las aleaciones comerciales utilizadas en implantología. El menor módulo elástico corresponde a la aleación Ti-16.2Hf-24.8Nb-1Zr, con 67.5 GPa y fue optimizado mediante trabajo en frío con el objetivo de determinar el factor responsable de la obtención de las propiedades deseadas de bajo módulo elástico y/o memoria de forma. Una mayor proporción de martensita fue observada por microscopía óptica y microscopía electrónica de transmisión en las muestras con bajo porcentaje de trabajo en frío en comparación con la muestra templada. El módulo elástico correspondiente a cada condición de trabajo en frío fue evaluado mediante nanoindentación con punta esférica. El módulo elástico disminuye al aumentar el porcentaje de trabajo en frío. El menor valor corresponde a la condición de 95% de trabajo en frío, con 44 GPa, valor cercano al del hueso cortical y menor que el del material templado (67.5 GPa).Peer Reviewe

Mejora de la resistencia al desgaste de titanio y sus aleaciones utilizados para prótesis articulares

Se han estudiado los endurecimientos superficiales que se producen en la aleación Ti 6Al 4V, mediante los procesos de anodización electroquímica y mediante diferentes tratamientos térmicos a distintas microestructuras de dicha aleación, así como los procesos de nitruración mediante difusión gaseosa.. Los resultados de la combinación de la anodización y los tratamientos térmicos producen endurecimientos superiores a 1000 HV lo que mejorará la resistencia al desgaste de estas aleaciones en sus aplicaciones para prótesis articulares. Mejores resultados ofrecen los valores de nitruración que pueden alcanzar las 1400 unidades Vickers

Characterization of IHF Binding to DNA Four-Way Junctions and Forks

The objective of the study is to characterise the mechanical properties of Ti-15Zr binary alloy dental implants and to describe their biomechanical behaviour as well as their osseointegration capacity compared with the conventional Ti-6Al-4V (TAV) alloy implants. The mechanical properties of Ti-15Zr binary alloy were characterised using Roxoli

Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry

Altres ajuts: Spanish Agency of Medicines and Medical Devices (AEMPS); Biogen; Bristol Myers-Squibb (BMS); Celltrion Healthcare; Lilly; Merck; Novartis; Pfizer; Regeneron Pharmaceuticals; Samsung Bioepis.Biologic and targeted synthetic disease-modifying antirheumatic drugs (ts/bDMARDs) play a pivotal role in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Persistence of therapy provides an index of a drug's overall effectiveness. The objective of the study was to identify factors associated with discontinuation of ts/bDMARDs in a real-world dataset. The study population comprised patients diagnosed with RA, PsA, and AS included in the BIOBADASER registry for whom follow-up data were available until November 2019. Patient features and treatment data were included in the analysis. The Kaplan-Meier method was used to study survival of the different drugs according to the reason for discontinuation. Factors associated with discontinuation were studied using Cox regression models and bivariate and multivariate analyses. P values of less than 0.05 were regarded as statistically significant. The study population comprised 4,752 patients who received a total of 8,377 drugs, of which 4,411 (52.65%) were discontinued. The Kaplan-Meier curves showed that survival for first-line treatment was greater in all 3 groups (p < 0.001). Patients with RA had a greater risk of discontinuation if they were younger (HR, 0.99; 95% CI 0.99-1.00), if they were receiving anti-TNFα agents (HR, 0.61; 95% CI 0.54-0.70), and if they had more comorbid conditions (HR, 1.09; 95% CI 1.00-1.17). Patients with PsA had a higher risk if they were women (HR, 1.36; 95% CI 1.15-1.62) and if they were receiving other ts/bDMARDs (HR, 1.29; 95% CI 1.05-1.59). In patients with AS, risk increased with age (HR, 1.01; 95% CI 1.00-1.02), as did the number of comorbid conditions (HR, 1.27; 95% CI 1.12-1.45). The factors that most affected discontinuation of ts/bDMARDs were line of treatment, age, type of drug, sex, comorbidity and the year of initiation of treatment. The association with these factors differed with each disease, except for first-line treatment, which was associated with a lower risk of discontinuation in all 3 diseases

Propuesta de un nuevo modelo microquirúrgico para el estudio de la endometriosis inducida en rata Wistar. Resultados preliminares

The current knowledge status on the patogenesis of endometriosis as well as devastating consequences of disease evolution in women's reproductive health, have promoted researchers advances in a great manner during last years. The immunologic and neangiogenesis systems implication have opened new ways of knowledge over classic theories from the beginning of the xx century. The experimental resesearch, using animal induction models. Below we explain the first steps a new induction model ("PGR1-HotDog"), based on Wistar rats using a new disease autogeneration system, created for te study of the early stages of the endometriosis

Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis

The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR''s