Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Activin-A binding and biochemical effects in osteoblast-enriched cultures from fetal-rat parietal bone.

Abstract: Activin, a disulfide-linked polypeptide dimer first isolated from gonadal tissue extracts, has amino acid sequence and structural homology with transforming growth factor beta (TGF beta). Along with other activities, TGF beta regulates replication and differentiation and interacts with a defined set of binding sites on isolated bone cells. To determine if activin shares these properties, recombinant human activin-A (A-chain homodimer) was examined in osteoblast-enriched cultures obtained from fetal-rat parietal bone. After 23 h of treatment, 60 to 6,000 pM activin-A increased the rate of [3H]thymidine incorporation into DNA 1.5- to 4.0-fold, and at 600 to 6,000 pM, it enhanced the rate of [3H]proline incorporation into collagen and noncollagen protein by up to 1.7-fold. Like earlier studies with TGF beta in primary osteoblast-enriched cultures, the stimulatory effects of activin-A on DNA and protein synthesis were opposed by parathyroid hormone, and the influence of activin-A on collagen synthesis was independent of cell replication. Binding studies with 125I-activin-A indicated approximately 8,000 high-affinity (Kd = 0.4 nM) and 300,000 low-affinity (Kd = 40 to 50 nM) binding sites per cell. Polyacrylamide gel analysis revealed 125I-activin-A-binding complexes of Mr greater than 200,000 and 73,000 which did not appear to correspond to primary TGF beta-binding sites. These results indicate that activin-A produces TGF beta-like effects in bone and that some of these effects may be mediated, at least in part, by distinct activin receptors on bone cells.

Transcriptional repression of insulin-like growth factor I by glucocorticoids in rat bone cells.

Abstract: Insulin-like growth factor I (IGF-I) is an abundant autocrine and paracrine growth factor secreted by osteoblasts. It promotes osteoblast proliferation and expression of their differentiated phenotype. Glucocorticoids decrease IGF-I production by osteoblasts, which may mediate some actions of the steroid on bone in both normal and pathological states. The mechanisms by which the glucocorticoid cortisol down-regulates IGF-I transcripts were explored using cultures of osteoblast-enriched cells derived from fetal rat calvaria (Ob cells). Repression of IGF-I transcripts was apparent after 8 h of treatment, was sustained for at least 24 h, and was not altered by cotreatment with cycloheximide. Cortisol did not alter the stability of IGF-I messenger RNAs in transcriptionally arrested Ob cells. Cortisol decreased IGF-I heterogeneous nuclear RNA and gene transcription, as determined by reverse transcription-linked polymerase chain reaction and nuclear run-on assay, respectively. Transient transfection of Ob cells with constructs containing portions of the rat IGF-I exon 1 promoter and 5'-flanking DNA linked to the reporter gene luciferase were performed to determine glucocorticoid-responsive region of the rat IGF-I exon 1 promoter was localized to 34 to 192 relative to the first start site of transcription. In conclusion, cortisol inhibits the transcription of IGF-I in osteoblasts, an effect that may be relevant to the actions of cortisol in bone.

Direct clinician-to-patient feedback discussion of inhaled steroid use: its effect on adherence.

Abstract: Study Objectives To evaluate whether direct feedback discussion on inhaled steroid use might influence subsequent adherence with this therapy. Design and Setting A 10-week, single-blind, randomized trial in asthma patients. Inclusion criteria included forced expiratory volume in 1 second Measures Mean weekly inhaled steroid adherence [(number of actuations/prescribed number of actuations) · 100]; 2) number of days with overuse of inhaled steroids; 3) 24-hour and nighttime albuterol use; 4) included forced expiratory volume in 1 second; and 5) Asthma Quality of Life Questionnaire total score. Results Ten treatment and nine control patients completed the study. Mean weekly inhaled steroid adherence over the first week was not significantly different in the treatment and control groups: 61 ± 9% versus 51 ± 5%, respectively. However, by the second week, adherence increased to 81 ± 7% in the treatment group, whereas it decreased to 47 ± 7% in the control group ( P = 0.003). Adherence remained above 70% in the treatment group for the entire trial, but continued to decrease in the control group. Overuse of inhaled steroids was low in both groups. There were no group differences in any of the asthma outcomes. Conclusions Direct clinician-to-patient feedback discussion on inhaled steroid use using electronic printouts did improve adherence in the short-term in asthma patients at high-risk for poor adherence.

Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries.

Abstract: Importance Meta-analyses have suggested that initiating pulmonary rehabilitation after an exacerbation of chronic obstructive pulmonary disease (COPD) was associated with improved survival, although the number of patients studied was small and heterogeneity was high. Current guidelines recommend that patients enroll in pulmonary rehabilitation after hospital discharge. Objective To determine the association between the initiation of pulmonary rehabilitation within 90 days of hospital discharge and 1-year survival. Design, Setting, and Patients This retrospective, inception cohort study used claims data from fee-for-service Medicare beneficiaries hospitalized for COPD in 2014, at 4446 acute care hospitals in the US. The final date of follow-up was December 31, 2015. Exposures Initiation of pulmonary rehabilitation within 90 days of hospital discharge. Main Outcomes and Measures The primary outcome was all-cause mortality at 1 year. Time from discharge to death was modeled using Cox regression with time-varying exposure to pulmonary rehabilitation, adjusting for mortality and for unbalanced characteristics and propensity to initiate pulmonary rehabilitation. Additional analyses evaluated the association between timing of pulmonary rehabilitation and mortality and between number of sessions completed and mortality. Results Of 197 376 patients (mean age, 76.9 years; 115 690 [58.6%] women), 2721 (1.5%) initiated pulmonary rehabilitation within 90 days of discharge. A total of 38 302 (19.4%) died within 1 year of discharge, including 7.3% of patients who initiated pulmonary rehabilitation within 90 days and 19.6% of patients who initiated pulmonary rehabilitation after 90 days or not at all. Initiation within 90 days was significantly associated with lower risk of death over 1 year (absolute risk difference [ARD], –6.7% [95% CI, –7.9% to –5.6%]; hazard ratio [HR], 0.63 [95% CI, 0.57 to 0.69];P Conclusions and Relevance Among fee-for-service Medicare beneficiaries hospitalized for COPD, initiation of pulmonary rehabilitation within 3 months of discharge was significantly associated with lower risk of mortality at 1 year. These findings support current guideline recommendations for pulmonary rehabilitation after hospitalization for COPD, although the potential for residual confounding exists and further research is needed.