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.

Cervical injury in head trauma

Abstract: Criteria for excluding cervical spine injury in patients who have sustained blunt head or neck trauma were prospectively studied at four hospitals in the Chicago area. The authors attempted to define a subset of these adult patients who, based on clinical criteria, could reliably be excluded from cervical spine radiography, thus avoiding unnecessary radiation and saving considerable time and money in their evaluation. Patients fell into four groups: (1) patients who were awake, alert, and had no complaint of neck pain or tenderness on physical examination: (2) patients who were awake, alert, but had complaint of neck pain or tenderness on physical examination laterally over the trapezius muscle only: (3) patients who were awake, alert, but had complaint of central neck pain or tenderness on physical examination over the cervical spine or center of the neck; and (4) patients who were not fully awake or alert, were clinically intoxicated, had other painful or distracting injuries, or had focal neurologic findings. Patients in group 4 had significantly more fractures (21/387) when compared with all other patients (7/478). Patients with central neck pain or tenderness (group 3) had significantly more fractures ( 7 237 ) than patients without pain or tenderness or with these findings limited to the trapezius area (0/236). It is clear that patients who have altered mental status, abnormal examination findings, distracting injury, or pain or tenderness over the cervical spine must have cervical spine radiographs. In a patient who is awake, alert, has normal physical examination findings, is undistracted by other painful injuries, and has no pain or tenderness in the neck or these findings are limited to the trapezius area, there is less than 1% chance of a cervical spine fracture, with a 90% confidence limit. Our data strongly suggest we can modify our use of cervical spine radiographs in patients sustaining blunt head trauma without subjecting patients to undue risk.

Rationale and Design of the CONCERT-HF Trial (Combination of Mesenchymal and c-kit+ Cardiac Stem Cells As Regenerative Therapy for Heart Failure).

Abstract: Rationale: Autologous bone marrow (BM) mesenchymal stem cells (MSCs) and c-kit + cardiac progenitor cells (CPCs) are two promising cell types being evaluated for patients with heart failure (HF) secondary to ischemic cardiomyopathy. No information is available in humans regarding the relative efficacy of MSCs and CPCs and whether their combination is more efficacious than either cell type alone. Objective: CONCERT-HF (Combination Of meseNchymal and c-kit + Cardiac stEm cells as Regenerative Therapy for Heart Failure) is a Phase II trial aimed at elucidating these issues by assessing the feasibility, safety, and efficacy of transendocardial administration of autologous MSCs and CPCs, alone and in combination, in patients with HF caused by chronic ischemic cardiomyopathy (coronary artery disease and old myocardial infarction). Methods and Results: Using a randomized, double-blinded, placebo-controlled, multi-center, multi-treatment, and adaptive design, CONCERT-HF examines whether administration of MSCs alone, CPCs alone, or MSCs + CPCs in this population alleviates left ventricular (LV) remodeling and dysfunction, reduces scar size, improves quality of life, or augments functional capacity. The four-arm design enables comparisons of MSCs alone with CPCs alone and with their combination. CONCERT-HF consists of 162 patients, 18 in a safety lead-in phase (Stage 1) and 144 in the main trial (Stage 2). Stage 1 is complete and Stage 2 is currently randomizing patients from seven centers across the US. Conclusions: CONCERT-HF will provide important insights into the potential therapeutic utility of MSCs and CPCs, given alone and in combination, for patients with HF secondary to ischemic cardiomyopathy. Clinicaltrials.gov : NCT02501811.

The ternary IGF complex influences postnatal bone acquisition and the skeletal response to intermittent parathyroid hormone

Abstract: The role of circulating IGF-I in skeletal acquisition and the anabolic response to PTH is not well understood. We generated IGF-I-deficient mice by gene deletions of IGF ternary complex components including: (1) liver-specific deletion of the IGF-I gene (LID), (2) global deletion of the acid-labile (ALS) gene (ALSKO), and (3) both liver IGF-I and ALS inactivated genes (LA). Twelve-week-old male control (CTL), LID, ALSKO, and LA mice were treated with vehicle (VEH) or human PTH(1-34) for 4 weeks. VEH-treated IGF-I-deficient mice (i.e. LID, ALSKO and LA mice) exhibited reduced cortical cross-sectional area (P = 0.001) compared with CTL mice; in contrast, femoral trabecular bone volume fractions (BV/TV) of the IGF-I-deficient mice were consistently greater than CTL (P < 0.01). ALSKO mice exhibited markedly reduced osteoblast number and surface (P < 0.05), as well as mineral apposition rate compared with other IGF-I-deficient and CTL mice. Adherent bone marrow stromal cells, cultured in beta-glycerol phosphate and ascorbic acid, showed no strain differences in secreted IGF-I. In response to PTH, there were both compartment- and strain-specific effects. Cortical bone area was increased by PTH in CTL and ALSKO mice, but not in LID or LA mice. In the trabecular compartment, PTH increased femoral and vertebral BV/TV in LID, but not in ALSKO or LA mice. In conclusion, we demonstrated that the presentation of IGF-I as a circulating complex is essential for skeletal remodeling and the anabolic response to PTH. We postulate that the ternary complex itself, rather than IGF-I alone, influences bone acquisition in a compartment-specific manner (i.e. cortical vs trabecular bone).

Decompressive surgery for typical lumbar spinal stenosis.

Abstract: Between 1991 and 1992, 103 consecutive patients (average age, 65 years) underwent decompressive surgery for treatment of typical lumbar spinal stenosis. Clinical results at 1-year followup revealed that four patients had revision surgery. At 2- to 5-years followup, there were no additional revision surgeries. Two patients underwent revision surgery for a deep infection, and two underwent revision surgery for a superficial infection. Outcome results showed that 77 patients completed the questionnaire, 15 were lost to followup and 11 died. Postoperative results showed that 64 of 77 patients had no or mild pain, 72 of 77 patients stated that they were satisfied or somewhat satisfied with their overall results of surgery, and 73 of 77 were satisfied with pain relief. Younger patients had greater improvement in function and a greater reduction in severity scores. However, satisfaction was similar in both groups. Survivorship results (failure was revision surgery) showed at the end of 4 years, a patient had a 95% chance of not having revision surgery. Statistically, there was no association between outcome and cofactors such as scoliosis, spondylolisthesis, number of levels decompressed, discectomy, or smoking. Satisfaction rates for older patients were similar to patients younger than 65 years although physical function scores and severity scores were less.