Explore the vast range of titles available.

Objectives To investigate cartilage tissue turnover in response to a supervised 12-week exercise-related joint loading training program followed by a 6-month period of unsupervised training in patients with knee osteoarthritis (OA). To study the difference in cartilage tissue turnover between high- and low-resistance training. Method Patients with knee OA were randomized into either high-intensity or low-intensity resistance supervised training (two sessions per week) for 3 months and unsupervised training for 6 months. Blood samples were collected before and after the supervised training period and after the follow-up period. Biomarkers huARGS, C2M, and PRO-C2, quantifying cartilage tissue turnover, were measured by ELISA. Changes in biomarker levels over time within and between groups were analyzed using linear mixed models with baseline values as covariates. Results huARGS and C2M levels increased after training and at follow-up in both low- and high-intensity exercise groups. No changes were found in PRO-C2. The huARGS level in the high-intensity resistance training group increased significantly compared to the low-intensity resistance training group after resistance training ( p = 0.029) and at follow-up ( p = 0.003). Conclusion Cartilage tissue turnover and cartilage degradation appear to increase in response to a 3-month exercise-related joint loading training program and at 6-month follow-up, with no evident difference in type II collagen formation. Aggrecan remodeling increased more with high-intensity resistance training than with low-intensity exercise. These exploratory biomarker results, indicating more cartilage degeneration in the high-intensity group, in combination with no clinical outcome differences of the VIDEX study, may argue against high-intensity training.

(1) Background: Mechanical loading is an essential part of the function and maintenance of the joint. Despite the importance of intermittent mechanical loading, this factor is rarely considered in preclinical models of cartilage, limiting their translatability. The aim of this study was to investigate the effects of intermittent dynamic compression on the extracellular matrix during long-term culture of bovine cartilage explants. (2) Methods: Bovine articular cartilage explants were cultured for 21 days and subjected to 20 min of 1 Hz cyclic compressive loading five consecutive days each week. Cartilage remodeling was investigated in the presence of IGF-1 or TGF-β1, as well as a TGF-β receptor 1 (ALK5) kinase inhibitor and assessed with biomarkers for type II collagen formation (PRO-C2) and fibronectin degradation (FBN-C). (3) Results: Compression of cartilage explants increased the release of PRO-C2 and FBN-C to the conditioned media and, furthermore, IGF-1 and compression synergistically increased PRO-C2 release. Inhibition of ALK5 blocked PRO-C2 and FBN-C release in dynamically compressed explants. (4) Conclusions: Dynamic compression of cartilage explants increases both type II collagen formation and fibronectin degradation, and IGF-1 interacts synergistically with compression, increasing the overall impact on cartilage formation. These data show that mechanical loading is important to consider in translational cartilage models.

Background An altered level of consciousness (ALOC) in emergency patients is linked to poor outcomes. Glasgow Coma Scale (GCS), initially made for head injury patients, but often used in both trauma and other patients. GCS assesses consciousness, with scores ranging from 15 (fully aware) to 3 (deep coma). Assessing GCS is quickly done and does not require technical equipment, unlike other vital signs. This study aims to characterize unselected prehospital ALOC patients brought to a hospital and assess their mortality. Design Retrospective observational cohort study. Methods Patients transported by ambulance to a hospital in the North Denmark Region between 2017 and 2021, with a first registered GCS of 3–14, were included. The reason for calling the emergency number, subsequent ICD-10 diagnoses given at hospital, and raw and adjusted mortality, were reported. Results Fifteen thousand two hundred thirty-five patients were included. One in eight ambulance patients had ALOC, most with a GCS score of 14. The primary reason for calling the emergency number was decreased consciousness or paralysis, except for those with a GCS score of 3–8, where the most common reason was unconsciousness/possible cardiac arrest . Most patients received non-specific diagnoses at hospital, which covers a wide range of symptoms and abnormal findings. Those with a GCS score of 3, most frequently were diagnosed with circulatory diseases, especially cardiac arrest and more diverse diagnostic picture among the others, including trauma, strokes, syncope, seizures and poisoning as the most frequent. Among patients with a GCS score of 3, 60% had died within 30 days, whereas 10% had died among patients with a GCS score of 14. The odds of mortality increased as GCS scores decreased, with a decrease from 14 to 9–13 more than doubled the odds of dying (OR 2.3, p  < 0.001). Conclusion Among unselected prehospital emergency patients brought to a hospital, every eight had ALOC. The patient group was heterogenic concerning the reasons for calling the emergency number and diagnoses given at hospital. ALOC was associated with high 30 days mortality, including 10% for GCS of 14. ALOC, also in milder degree, is a serious sign in a broad prehospital patient population.