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Prado-Novoa M, Perez-Sanchez L, Estebanez B, Moreno-Vegas S, Perez-Blanca A. Influence of Loading Conditions on the Mechanical Performance of Multifilament Coreless UHMWPE Sutures Used in Orthopaedic Surgery. Materials (Basel) 2022; 15:ma15072573. [PMID: 35407907 PMCID: PMC9000354 DOI: 10.3390/ma15072573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 02/05/2023]
Abstract
This work studies the influence of loading velocity and previous cyclic loading history on the stiffness and strength of a multifilament coreless ultra-high-molecular-weight polyethylene (UHMWPE) surgical suture. Thread samples (n = 8) were subjected to a load-to-failure test at 0.1, 0.5, 1, 5, and 10 mm/s without previous loading history and after 10 cycles of loading at 1-10 N, 1-30 N, and 1-50 N. The experimental data were fitted to mathematical models to compute the stress-strain relation and the strength of the suture. The bilinear model involving two stress-strain ratios for low- and high-strain intervals was the best fit. The ratio in the low-strain range rose with loading speed, showing mean increases of 5.9%, 6.5%, 7.9%, and 7.3% between successive loading speeds. Without a previous loading history, this ratio was less than half than that at high strain. However, 10 cycles of 1-30 N or 1-50 N significantly increased the stress-strain ratio at a low strain level by 135% and 228%, respectively. The effect persisted after 2 min but vanished after 24 h. No influence was found on the suture strength. In conclusion, the stiffness of the studied suture was influenced by the strain level, loading velocity, and recent cyclic loading history. Conversely, the suture strength was not affected.
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Affiliation(s)
- Maria Prado-Novoa
- Clinical Biomechanics Laboratory of Andalusia, University of Malaga, Calle Dr. Ortiz Ramos s/n, 29071 Malaga, Spain; (L.P.-S.); (B.E.); (S.M.-V.); (A.P.-B.)
- Correspondence:
| | - Laura Perez-Sanchez
- Clinical Biomechanics Laboratory of Andalusia, University of Malaga, Calle Dr. Ortiz Ramos s/n, 29071 Malaga, Spain; (L.P.-S.); (B.E.); (S.M.-V.); (A.P.-B.)
- Telecomunication Research Institute (TELMA), University of Malaga, E.T.S. Ingenieria de Telecomunicaciones, Bulevar Louis Pasteur 35, 29010 Malaga, Spain
| | - Belen Estebanez
- Clinical Biomechanics Laboratory of Andalusia, University of Malaga, Calle Dr. Ortiz Ramos s/n, 29071 Malaga, Spain; (L.P.-S.); (B.E.); (S.M.-V.); (A.P.-B.)
| | - Salvador Moreno-Vegas
- Clinical Biomechanics Laboratory of Andalusia, University of Malaga, Calle Dr. Ortiz Ramos s/n, 29071 Malaga, Spain; (L.P.-S.); (B.E.); (S.M.-V.); (A.P.-B.)
- Biomedical Research Institute of Malaga, Calle Dr. Miguel Díaz Recio, 28, 29010 Malaga, Spain
| | - Ana Perez-Blanca
- Clinical Biomechanics Laboratory of Andalusia, University of Malaga, Calle Dr. Ortiz Ramos s/n, 29071 Malaga, Spain; (L.P.-S.); (B.E.); (S.M.-V.); (A.P.-B.)
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Prieto-Peña D, Bernabeu P, Vela P, Narváez J, Fernández-López JC, Freire-González M, González-Álvarez B, Solans-Laqué R, Callejas Rubio JL, Ortego N, Fernández-Díaz C, Rubio E, García-Morillo S, Minguez M, Fernández-Carballido C, de Miguel E, Melchor S, Salgado E, Bravo B, Romero-Yuste S, Salvatierra J, Hidalgo C, Manrique S, Romero-Gómez C, Moya P, Álvarez-Rivas N, Mendizabal J, Ortiz-Sanjuán F, Pérez de Pedro I, Alonso-Valdivielso JL, Perez-Sanchez L, Roldán R, Fernandez-Llanio N, Gómez de la Torre R, Suarez S, Montesa Cabrera MJ, Delgado Sánchez M, Loricera J, Atienza-Mateo B, Castañeda S, González-Gay MA, Blanco R. Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review. Ther Adv Musculoskelet Dis 2021; 13:1759720X211020917. [PMID: 34211589 PMCID: PMC8216399 DOI: 10.1177/1759720x211020917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/10/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu’s arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5–50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0–31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5–50.0) to 5.0 (0.0–5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0–14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0–46.0) versus 45.0 (38.0–57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0–38.0) versus 6.0 (1.0–23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7–5.6) versus 1.3 (0.3–3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.
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Affiliation(s)
- Diana Prieto-Peña
- Department of Rheumatology, Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Pilar Bernabeu
- Department of Rheumatology, Hospital General de Alicante, Alicante, Spain
| | - Paloma Vela
- Department of Rheumatology, Hospital General de Alicante, Alicante, Spain
| | - Javier Narváez
- Department of Rheumatology, Hospital de Bellvitge, Barcelona, Spain
| | | | | | | | - Roser Solans-Laqué
- Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain
| | | | - Norberto Ortego
- Autoimmune Disease Unit, Hospital San Cecilio, Granada, Spain
| | - Carlos Fernández-Díaz
- Department of Rheumatology, H. Universitario de La Princesa, IIS-Princesa, Madrid, Spain
| | - Esteban Rubio
- Autoimmune Disease Unit, Hospital Virgen del Rocío, Sevilla, Spain
| | | | - Mauricio Minguez
- Department of Rheumatology, Hospital San Juan de Alicante, Alicante, Spain
| | | | - Eugenio de Miguel
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | - Sheila Melchor
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Eva Salgado
- Department of Rheumatology, Complejo H. Universitario de Ourense, Ourense, Spain
| | - Beatriz Bravo
- Department of Rheumatology, Hospital Virgen de las Nieves, Granada, Spain
| | - Susana Romero-Yuste
- Department of Rheumatology, Complejo H. Universitario de Pontevedra, Pontevedra, Spain
| | | | - Cristina Hidalgo
- Department of Rheumatology, Complejo Universitario de Salamanca, Salamanca, Spain
| | - Sara Manrique
- Autoimmune Disease Unit, Hospital Regional de Málaga, Málaga, Spain
| | | | - Patricia Moya
- Department of Rheumatology, Hospital Sant Pau, Barcelona, Spain
| | | | - Javier Mendizabal
- Department of Rheumatology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | | | | | - Laura Perez-Sanchez
- Department of Rheumatology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Rosa Roldán
- Department of Rheumatology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | | | - Silvia Suarez
- Autoimmune Disease Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Javier Loricera
- Department of Rheumatology, Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Belén Atienza-Mateo
- Department of Rheumatology, Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Santos Castañeda
- Department of Rheumatology, H. Universitario de La Princesa, IIS-Princesa, Madrid, Spain
| | - Miguel A González-Gay
- Rheumatology Division, Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla s/n, Santander, 39008, Spain
| | - Ricardo Blanco
- Department of Rheumatology, Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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Cecchi I, Perez-Sanchez C, Sciascia S, Radin M, Arias de la Rosa I, Barbarroja Puerto N, Scudeler L, Perez-Sanchez L, Patiño Trives AM, Aguirre Zamorano MA, Menegatti E, Roccatello D, Lopez-Pedrera C. Circulating microRNAs as potential biomarkers for monitoring the response to in vivo treatment with Rituximab in systemic lupus erythematosus patients. Autoimmun Rev 2020; 19:102488. [PMID: 32062026 DOI: 10.1016/j.autrev.2020.102488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Irene Cecchi
- Center of Research of Immuno-pathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni BoscoHospital, Turin, Italy
| | - Carlos Perez-Sanchez
- Rheumatology service, IMIBIC/Reina SofiaHospital/University of Cordoba, Cordoba, Spain
| | - Savino Sciascia
- Center of Research of Immuno-pathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni BoscoHospital, Turin, Italy.
| | - Massimo Radin
- Center of Research of Immuno-pathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni BoscoHospital, Turin, Italy
| | - Ivan Arias de la Rosa
- Rheumatology service, IMIBIC/Reina SofiaHospital/University of Cordoba, Cordoba, Spain
| | | | - Luca Scudeler
- Center of Research of Immuno-pathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni BoscoHospital, Turin, Italy
| | - Laura Perez-Sanchez
- Rheumatology service, IMIBIC/Reina SofiaHospital/University of Cordoba, Cordoba, Spain
| | | | | | - Elisa Menegatti
- Center of Research of Immuno-pathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni BoscoHospital, Turin, Italy
| | - Dario Roccatello
- Center of Research of Immuno-pathology and Rare Diseases- Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni BoscoHospital, Turin, Italy
| | - Chary Lopez-Pedrera
- Rheumatology service, IMIBIC/Reina SofiaHospital/University of Cordoba, Cordoba, Spain
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Ruiz-Limon P, Ortega-Castro R, Barbarroja N, Perez-Sanchez C, Jamin C, Patiño-Trives AM, Luque-Tevar M, Ibáñez-Costa A, Perez-Sanchez L, de la Rosa IA, Abalos-Aguilera M, Jimenez-Gomez Y, Calvo-Gutierrez J, Font P, Escudero-Contreras A, Alarcon-Riquelme ME, Collantes-Estevez E, López-Pedrera C. Molecular Characterization of Monocyte Subsets Reveals Specific and Distinctive Molecular Signatures Associated With Cardiovascular Disease in Rheumatoid Arthritis. Front Immunol 2019; 10:1111. [PMID: 31169830 PMCID: PMC6536567 DOI: 10.3389/fimmu.2019.01111] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/01/2019] [Indexed: 12/21/2022] Open
Abstract
Objectives: This study, developed within the Innovative Medicines Initiative Joint Undertaking project PRECISESADS framework, aimed at functionally characterize the monocyte subsets in RA patients, and analyze their involvement in the increased CV risk associated with RA. Methods: The frequencies of monocyte subpopulations in the peripheral blood of 140 RA patients and 145 healthy donors (HDs) included in the PRECISESADS study were determined by flow cytometry. A second cohort of 50 RA patients and 30 HDs was included, of which CD14+ and CD16+ monocyte subpopulations were isolated using immuno-magnetic selection. Their transcriptomic profiles (mRNA and microRNA), proinflammatory patterns and activated pathways were evaluated and related to clinical features and CV risk. Mechanistic in vitro analyses were further performed. Results: CD14++CD16+ intermediate monocytes were extended in both cohorts of RA patients. Their increased frequency was associated with the positivity for autoantibodies, disease duration, inflammation, endothelial dysfunction and the presence of atheroma plaques, as well as with the CV risk score. CD14+ and CD16+ monocyte subsets showed distinctive and specific mRNA and microRNA profiles, along with specific intracellular signaling activation, indicating different functionalities. Moreover, that specific molecular profiles were interrelated and associated to atherosclerosis development and increased CV risk in RA patients. In vitro, RA serum promoted differentiation of CD14+CD16− to CD14++CD16+ monocytes. Co-culture with RA-isolated monocyte subsets induced differential activation of endothelial cells. Conclusions: Our overall data suggest that the generation of inflammatory monocytes is associated to the autoimmune/inflammatory response that mediates RA. These monocyte subsets, -which display specific and distinctive molecular signatures- might promote endothelial dysfunction and in turn, the progression of atherosclerosis through a finely regulated process driving CVD development in RA.
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Affiliation(s)
- Patricia Ruiz-Limon
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex (Virgen de la Victoria), Malaga, Spain
| | - Rafaela Ortega-Castro
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Nuria Barbarroja
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Carlos Perez-Sanchez
- Department of Medicine, School of Clinical Medicine, Addenbroke's Hospital, and Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Christophe Jamin
- U1227, Université de Brest, Inserm, Labex IGO, CHU de Brest, Brest, France
| | - Alejandra Maria Patiño-Trives
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Maria Luque-Tevar
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Alejandro Ibáñez-Costa
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Laura Perez-Sanchez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Iván Arias de la Rosa
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - MaCarmen Abalos-Aguilera
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Yolanda Jimenez-Gomez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Jerusalem Calvo-Gutierrez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Pilar Font
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Marta E Alarcon-Riquelme
- Medical Genomics, Center for Genomics and Oncology Research: Pfizer, Andalusian Autonomous Government of Genomics and Oncological Research (GENYO), and University of Granada, Granada, Spain
| | - Eduardo Collantes-Estevez
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Chary López-Pedrera
- Rheumatology Service, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
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