Browsing by Author "Neves, Nuno"
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- Bone decade actions: are practical results measurable yet?Publication . Alves, Sandra; Oliveira, Carla; Alves, Carlos; Ribeiro, Ana I.; Neves, Nuno; Pina, Maria F.Osteoarthritis (OA) has an extremely high disease and economic burden. Despite treatments for OA pain management, data are limited on the adequacy of pain relief in OA patients. SORT will determine the adequacy of pain relief in patients with knee OA and compare patterns of clinical care and outcomes.
- Fibrinogen scaffolds with immunomodulatory properties promote in vivo bone regenerationPublication . Vasconcelos, Daniel M.; Gonçalves, Raquel M.; Almeida, Catarina R.; Pereira, Inês O.; Oliveira, Marta I.; Neves, Nuno; Silva, Andreia M.; Ribeiro, António C.; Cunha, Carla; Almeida, Ana R.; Ribeiro, Cristina C.; Gil, Ana M.; Seebach, Elisabeth; Kynast, Katharina L.; Richter, Wiltrud; Lamghari, Meriem; Santos, Susana G.; Barbosa, Mário A.The hypothesis behind this work is that fibrinogen (Fg), classically considered a pro-inflammatory protein, can promote bone repair/regeneration. Injury and biomaterial implantation naturally lead to an inflammatory response, which should be under control, but not necessarily minimized. Herein, porous scaffolds entirely constituted of Fg (Fg-3D) were implanted in a femoral rat bone defect and investigated at two important time points, addressing the bone regenerative process and the local and systemic immune responses, both crucial to elucidate the mechanisms of tissue remodelling. Fg-3D led to early infiltration of granulation tissue (6 days post-implantation), followed by bone defect closure, including periosteum repair (8 weeks post-injury). In the acute inflammatory phase (6 days) local gene expression analysis revealed significant increases of pro-inflammatory cytokines IL-6 and IL-8, when compared with non-operated animals. This correlated with modified proportions of systemic immune cell populations, namely increased T cells and decreased B, NK and NKT lymphocytes and myeloid cell, including the Mac- 1þ (CD18þ/CD11bþ) subpopulation. At 8 weeks, Fg-3D led to decreased plasma levels of IL-1b and increased TGF-b1. Thus, our data supports the hypothesis, establishing a link between bone repair induced by Fg-3D and the immune response. In this sense, Fg-3D scaffolds may be considered immunomodulatory biomaterials.
- Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective studyPublication . Alves, Sandra Maria; Economou, Theodoros; Oliveira, Carla Maria; Ribeiro, Ana Isabel; Neves, Nuno; Goméz-Barrena, Enrique; Pina, Maria de FátimaThe aim is to examine the temporal trends of hip fracture incidence in Portugal by sex and age groups, and explore the relation with anti-osteoporotic medication. From the National Hospital Discharge Database, we selected from 1st January 2000 to 31st December 2008, 77,083 hospital admissions (77.4% women) caused by osteoporotic hip fractures (low energy, patients over 49 years-age), with diagnosis codes 820.x of ICD 9-CM. The 2001 Portuguese population was used as standard to calculate direct age-standardized incidence rates (ASIR) (100,000 inhabitants). Generalized additive and linear models were used to evaluate and quantify temporal trends of age specific rates (AR), by sex. We identified 2003 as a turning point in the trend of ASIR of hip fractures in women. After 2003, the ASIR in women decreased on average by 10.3 cases/100,000 inhabitants, 95% CI (− 15.7 to − 4.8), per 100,000 anti-osteoporotic medication packages sold. For women aged 65–69 and 75–79 we identified the same turning point. However, for women aged over 80, the year 2004 marked a change in the trend, from an increase to a decrease. Among the population aged 70–74 a linear decrease of incidence rate (95% CI) was observed in both sexes, higher for women: − 28.0% (− 36.2 to − 19.5) change vs − 18.8%, (− 32.6 to − 2.3). The abrupt turning point in the trend of ASIR of hip fractures in women is compatible with an intervention, such as a medication. The trends were different according to gender and age group, but compatible with the pattern of bisphosphonates sales.
- Strontium-rich injectable hybrid system for bone regenerationPublication . Neves, Nuno; Campos, Bruno B.; Almeida, Isabel F.; Costa, Paulo C.; Cabral, Abel Trigo; Barbosa, Mário A.; Castro Ribeiro, Maria Cristina DeCurrent challenges in the development of scaffolds for bone regeneration include the engineering of materials that can withstand normal dynamic physiological mechanical stresses exerted on the bone and provide a matrix capable of supporting cellmigration and tissue ingrowth. The objective of the present workwas to develop and characterize a hybrid polymer–ceramic injectable systemthat consists of an alginatematrix crosslinked in situ in the presence of strontium(Sr), incorporating a ceramic reinforcement in the form of Sr-richmicrospheres. The incorporation of Sr in the microspheres and in the vehicle relies on the growing evidence that Sr has beneficial effects in bone remodeling and in the treatment of osteopenic disorders and osteoporosis. Sr-rich porous hydroxyapatite microspheres with a uniform size and a mean diameter of 555 μmwere prepared, and their compression strength and friability tested. A 3.5% (w/v) ultrapure sodium alginate solution was used as the vehicle and its in situ gelation was promoted by the addition of calcium (Ca) or Sr carbonate and Glucone-δ-lactone. Gelation times varied with temperature and crosslinking agent, being slower for Sr than for Ca, but adequate for injection in both cases. Injectability was evaluated using a device employed in vertebroplasty surgical procedures, coupled to a texture analyzer in compression mode. Compositions with 35%w ofmicrospheres presented the best compromise between injectability and compression strength of the system, the force required to extrude it being lower than 100 N.Micro CT analysis revealed a homogeneous distribution of themicrospheres inside the vehicle, and a mean inter-microspheres space of 220 μm. DMA results showed that elastic behavior of the hybrid is dominant over the viscous one and that the higher storage modulus was obtained for the 3.5%Alg–35%Sr-HAp-Sr formulation.
- Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in PortugalPublication . Campos, Sónia; Alves, Sandra Maria; Carvalho, Marilia Sá; Neves, Nuno; Trigo-Cabral, Abel; Pina, Maria FátimaThe objectives were to analyze one-year survival and mortality predictors in patients with fracture of the proximal femur (low/moderate trauma). A prospective cohort was formed by inviting all patients hospitalized in the Orthopedic Ward of the second largest hospital in Portugal (May 2008-April 2009). Survival was assessed at 3, 6, 9, and 12 months after fracture and related to demographic factors, lifestyle, and clinical history, as well as to data from medical records (fracture type, surgery date, surgical treatment, and preoperative risk). Of the 340 patients hospitalized, 252 were included (78.9% women). Mortality at 3, 6, 9, and 12 months was 21.2%, 25%, 28.8%, and 34.6% for men and 7.8%, 13.5%, 19.2%, and 21.4% for women, respectively. Predictors of death were male gender (HR = 2.54; 95%CI: 1.40-4.58), ASA score III/IV vs. I/II (HR = 1.95; 95%CI: 1.10-3.47), age (HR = 1.06; 95%CI: 1.03-1.10), and delay in days to surgery (HR = 1.07; 95%CI: 1.03-1.12). Factors related to death were mainly related to patients' characteristics at admission.