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1.
Nat Commun ; 14(1): 3204, 2023 06 02.
Article in English | MEDLINE | ID: mdl-37268630

ABSTRACT

Lipid droplets (LDs) are dynamic organelles that contain an oil core mainly composed of triglycerides (TAG) that is surrounded by a phospholipid monolayer and LD-associated proteins called perilipins (PLINs). During LD biogenesis, perilipin 3 (PLIN3) is recruited to nascent LDs as they emerge from the endoplasmic reticulum. Here, we analyze how lipid composition affects PLIN3 recruitment to membrane bilayers and LDs, and the structural changes that occur upon membrane binding. We find that the TAG precursors phosphatidic acid and diacylglycerol (DAG) recruit PLIN3 to membrane bilayers and define an expanded Perilipin-ADRP-Tip47 (PAT) domain that preferentially binds DAG-enriched membranes. Membrane binding induces a disorder to order transition of alpha helices within the PAT domain and 11-mer repeats, with intramolecular distance measurements consistent with the expanded PAT domain adopting a folded but dynamic structure upon membrane binding. In cells, PLIN3 is recruited to DAG-enriched ER membranes, and this requires both the PAT domain and 11-mer repeats. This provides molecular details of PLIN3 recruitment to nascent LDs and identifies a function of the PAT domain of PLIN3 in DAG binding.


Subject(s)
Diglycerides , Perilipin-3 , Diglycerides/metabolism , Endoplasmic Reticulum/metabolism , Lipid Droplets/metabolism , Lipid Metabolism/physiology , Perilipin-1/metabolism , Perilipin-3/metabolism , Triglycerides/metabolism
2.
Cell Rep ; 42(3): 112172, 2023 03 28.
Article in English | MEDLINE | ID: mdl-36842083

ABSTRACT

Class IB phosphoinositide 3-kinase (PI3Kγ) is activated in immune cells and can form two distinct complexes (p110γ-p84 and p110γ-p101), which are differentially activated by G protein-coupled receptors (GPCRs) and Ras. Using a combination of X-ray crystallography, hydrogen deuterium exchange mass spectrometry (HDX-MS), electron microscopy, molecular modeling, single-molecule imaging, and activity assays, we identify molecular differences between p110γ-p84 and p110γ-p101 that explain their differential membrane recruitment and activation by Ras and GPCRs. The p110γ-p84 complex is dynamic compared with p110γ-p101. While p110γ-p101 is robustly recruited by Gßγ subunits, p110γ-p84 is weakly recruited to membranes by Gßγ subunits alone and requires recruitment by Ras to allow for Gßγ activation. We mapped two distinct Gßγ interfaces on p101 and the p110γ helical domain, with differences in the C-terminal domain of p84 and p101 conferring sensitivity of p110γ-p101 to Gßγ activation. Overall, our work provides key insight into the molecular basis for how PI3Kγ complexes are activated.


Subject(s)
Phosphatidylinositol 3-Kinases , Signal Transduction , Signal Transduction/physiology , Phosphatidylinositol 3-Kinases/metabolism , Receptors, G-Protein-Coupled , Models, Molecular , Phosphatidylinositol 3-Kinase
3.
Mol Cell Biol ; 42(11): e0017022, 2022 11 17.
Article in English | MEDLINE | ID: mdl-36190236

ABSTRACT

Trimer Independent of NuA4 involved in Transcription Interactions with Nucleosomes (TINTIN) is an integral module of the essential yeast lysine acetyltransferase complex NuA4 that plays key roles in transcription regulation and DNA repair. Composed of Eaf3, Eaf5, and Eaf7, TINTIN mediates targeting of NuA4 to chromatin through the chromodomain-containing subunit Eaf3 that is shared with the Rpd3S histone deacetylase complex. How Eaf3 mediates chromatin interaction in the context of TINTIN and how is it different from what has been observed in Rpd3S is unclear. Here, we reconstituted recombinant TINTIN and its subassemblies and characterized their biochemical and structural properties. Our coimmunoprecipitation, AlphaFold2 modeling, and hydrogen deuterium exchange mass spectrometry (HDX-MS) analyses revealed that the Eaf3 MRG domain contacts Eaf7 and this binding induces conformational changes throughout Eaf3. Nucleosome-binding assays showed that Eaf3 and TINTIN interact non-specifically with the DNA on nucleosomes. Furthermore, integration into TINTIN enhances the affinity of Eaf3 toward nucleosomes and this improvement is a result of allosteric activation of the Eaf3 chromodomain. Negative stain electron microscopy (EM) analysis revealed that TINTIN binds to the edge of nucleosomes with increased specificity in the presence of H3K36me3. Collectively, our work provides insights into the dynamics of TINTIN and the mechanism by which its interactions with chromatin are regulated.


Subject(s)
Nucleosomes , Saccharomyces cerevisiae Proteins , Nucleosomes/metabolism , Allosteric Regulation , Saccharomyces cerevisiae Proteins/metabolism , Histones/metabolism , Acetyltransferases/chemistry , Saccharomyces cerevisiae/metabolism , Chromatin/metabolism , Histone Acetyltransferases/metabolism
4.
Nat Commun ; 13(1): 1874, 2022 04 06.
Article in English | MEDLINE | ID: mdl-35387990

ABSTRACT

3-phosphoinositide-dependent kinase 1 (PDK1) is an essential serine/threonine protein kinase, which plays a crucial role in cell growth and proliferation. It is often referred to as a 'master' kinase due to its ability to activate at least 23 downstream protein kinases implicated in various signaling pathways. In this study, we have elucidated the mechanism of phosphoinositide-driven PDK1 auto-activation. We show that PDK1 trans-autophosphorylation is mediated by a PIP3-mediated face-to-face dimer. We report regulatory motifs in the kinase-PH interdomain linker that allosterically activate PDK1 autophosphorylation via a linker-swapped dimer mechanism. Finally, we show that PDK1 is autoinhibited by its PH domain and that positive cooperativity of PIP3 binding drives switch-like activation of PDK1. These results imply that the PDK1-mediated activation of effector kinases, including Akt, PKC, Sgk, S6K and RSK, many of whom are not directly regulated by phosphoinositides, is also likely to be dependent on PIP3 or PI(3,4)P2.


Subject(s)
Phosphatidylinositols , Protein Serine-Threonine Kinases , 3-Phosphoinositide-Dependent Protein Kinases/metabolism , Phosphorylation , Protein Kinases/metabolism , Protein Serine-Threonine Kinases/genetics
5.
Structure ; 29(12): 1371-1381.e6, 2021 12 02.
Article in English | MEDLINE | ID: mdl-34348129

ABSTRACT

There is considerable interest in developing antibodies as modulators of signaling pathways. One of the most important signaling pathways in higher eukaryotes is the phosphoinositide 3-kinase (PI3K) pathway, which plays fundamental roles in growth, metabolism, and immunity. The class IB PI3K, PI3Kγ, is a heterodimeric complex composed of a catalytic p110γ subunit bound to a p101 or p84 regulatory subunit. PI3Kγ is a critical component in multiple immune signaling processes and is dependent on activation by Ras and G protein-coupled receptors (GPCRs) to mediate its cellular roles. Here we describe the rapid and efficient characterization of multiple PI3Kγ binding single-chain camelid nanobodies using hydrogen-deuterium exchange (HDX) mass spectrometry (MS) for structural and biochemical studies. We identify nanobodies that stimulated lipid kinase activity, block Ras activation, and specifically inhibited p101-mediated GPCR activation. Overall, our work reveals insight into PI3Kγ regulation and identifies sites that may be exploited for therapeutic development.


Subject(s)
Phosphatidylinositol 3-Kinases/metabolism , Signal Transduction/physiology , Single-Domain Antibodies/metabolism , Animals , Catalytic Domain/physiology , Humans , Phosphorylation
6.
Nat Commun ; 12(1): 4718, 2021 08 05.
Article in English | MEDLINE | ID: mdl-34354069

ABSTRACT

Phospholipid synthesis and fat storage as triglycerides are regulated by lipin phosphatidic acid phosphatases (PAPs), whose enzymatic PAP function requires association with cellular membranes. Using hydrogen deuterium exchange mass spectrometry, we find mouse lipin 1 binds membranes through an N-terminal amphipathic helix, the Ig-like domain and HAD phosphatase catalytic core, and a middle lipin (M-Lip) domain that is conserved in mammalian and mammalian-like lipins. Crystal structures of the M-Lip domain reveal a previously unrecognized protein fold that dimerizes. The isolated M-Lip domain binds membranes both in vitro and in cells through conserved basic and hydrophobic residues. Deletion of the M-Lip domain in lipin 1 reduces PAP activity, membrane association, and oligomerization, alters subcellular localization, diminishes acceleration of adipocyte differentiation, but does not affect transcriptional co-activation. This establishes the M-Lip domain as a dimeric protein fold that binds membranes and is critical for full functionality of mammalian lipins.


Subject(s)
Phosphatidate Phosphatase/chemistry , 3T3-L1 Cells , Adipogenesis , Amino Acid Sequence , Animals , Cell Membrane/metabolism , Conserved Sequence , Crystallography, X-Ray , HEK293 Cells , Humans , Hydrogen Deuterium Exchange-Mass Spectrometry , Membrane Proteins/chemistry , Membrane Proteins/genetics , Membrane Proteins/metabolism , Mice , Models, Molecular , Molecular Dynamics Simulation , Phosphatidate Phosphatase/genetics , Phosphatidate Phosphatase/metabolism , Protein Binding , Protein Domains , Protein Folding , Protein Multimerization , Recombinant Proteins/chemistry , Recombinant Proteins/genetics , Recombinant Proteins/metabolism , Sequence Deletion , Sequence Homology, Amino Acid , Transcription, Genetic
7.
Proc Natl Acad Sci U S A ; 118(33)2021 08 17.
Article in English | MEDLINE | ID: mdl-34385319

ABSTRACT

The protein kinase Akt is one of the primary effectors of growth factor signaling in the cell. Akt responds specifically to the lipid second messengers phosphatidylinositol-3,4,5-trisphosphate [PI(3,4,5)P3] and phosphatidylinositol-3,4-bisphosphate [PI(3,4)P2] via its PH domain, leading to phosphorylation of its activation loop and the hydrophobic motif of its kinase domain, which are critical for activity. We have now determined the crystal structure of Akt1, revealing an autoinhibitory interface between the PH and kinase domains that is often mutated in cancer and overgrowth disorders. This interface persists even after stoichiometric phosphorylation, thereby restricting maximum Akt activity to PI(3,4,5)P3- or PI(3,4)P2-containing membranes. Our work helps to resolve the roles of lipids and phosphorylation in the activation of Akt and has wide implications for the spatiotemporal control of Akt and potentially lipid-activated kinase signaling in general.


Subject(s)
Phosphatidylinositol Phosphates/metabolism , Proto-Oncogene Proteins c-akt/metabolism , Pyruvate Dehydrogenase Acetyl-Transferring Kinase/metabolism , Animals , Binding Sites , Humans , Insecta , Lipid Metabolism , Phosphatidylinositol Phosphates/genetics , Protein Binding , Protein Conformation , Protein Domains , Proto-Oncogene Proteins c-akt/genetics , Pyruvate Dehydrogenase Acetyl-Transferring Kinase/genetics , Sf9 Cells
8.
Sci Adv ; 7(35)2021 Aug.
Article in English | MEDLINE | ID: mdl-34452907

ABSTRACT

The class IB phosphoinositide 3-kinase (PI3K), PI3Kγ, is a master regulator of immune cell function and a promising drug target for both cancer and inflammatory diseases. Critical to PI3Kγ function is the association of the p110γ catalytic subunit to either a p101 or p84 regulatory subunit, which mediates activation by G protein-coupled receptors. Here, we report the cryo-electron microscopy structure of a heterodimeric PI3Kγ complex, p110γ-p101. This structure reveals a unique assembly of catalytic and regulatory subunits that is distinct from other class I PI3K complexes. p101 mediates activation through its Gßγ-binding domain, recruiting the heterodimer to the membrane and allowing for engagement of a secondary Gßγ-binding site in p110γ. Mutations at the p110γ-p101 and p110γ-adaptor binding domain interfaces enhanced Gßγ activation. A nanobody that specifically binds to the p101-Gßγ interface blocks activation, providing a novel tool to study and target p110γ-p101-specific signaling events in vivo.

9.
J Mol Biol ; 433(18): 167145, 2021 09 03.
Article in English | MEDLINE | ID: mdl-34229011

ABSTRACT

Transport Protein Particle complexes (TRAPP) are evolutionarily conserved regulators of membrane trafficking, with this mediated by their guanine nucleotide exchange factor (GEF) activity towards Rab GTPases. In metazoans evidence suggests that two different TRAPP complexes exist, TRAPPII and TRAPPIII. These two complexes share a common core of subunits, with complex specific subunits (TRAPPC9 and TRAPPC10 in TRAPPII and TRAPPC8, TRAPPC11, TRAPPC12, TRAPPC13 in TRAPPIII). TRAPPII and TRAPPIII have distinct specificity for GEF activity towards Rabs, with TRAPPIII acting on Rab1, and TRAPPII acting on Rab1 and Rab11. The molecular basis for how these complex specific subunits alter GEF activity towards Rab GTPases is unknown. Here we have used a combination of biochemical assays, hydrogen deuterium exchange mass spectrometry (HDX-MS) and electron microscopy to examine the regulation of TRAPPII and TRAPPIIII complexes in solution and on membranes. GEF assays revealed that TRAPPIII has GEF activity against Rab1 and Rab43, with no detectable activity against the other 18 Rabs tested. The TRAPPIII complex had significant differences in protein dynamics at the Rab binding site compared to TRAPPII, potentially indicating an important role of accessory subunits in altering the active site of TRAPP complexes. Both the TRAPPII and TRAPPIII complexes had enhanced GEF activity on lipid membranes, with HDX-MS revealing numerous conformational changes that accompany membrane association. HDX-MS also identified a membrane binding site in TRAPPC8. Collectively, our results provide insight into the functions of TRAPP complexes and how they can achieve Rab specificity.


Subject(s)
Cell Membrane/metabolism , Guanine Nucleotide Exchange Factors/metabolism , Mammals/metabolism , Vesicular Transport Proteins/metabolism , rab GTP-Binding Proteins/metabolism , Animals , Binding Sites , Guanine Nucleotide Exchange Factors/genetics , Humans , Mammals/genetics , Protein Conformation , Protein Transport , Vesicular Transport Proteins/chemistry , Vesicular Transport Proteins/genetics , rab GTP-Binding Proteins/genetics
10.
J Biol Chem ; 297(2): 100919, 2021 08.
Article in English | MEDLINE | ID: mdl-34181950

ABSTRACT

Serum- and glucocorticoid-regulated kinase 3 (Sgk3) is a serine/threonine protein kinase activated by the phospholipid phosphatidylinositol 3-phosphate (PI3P) downstream of growth factor signaling via class I phosphatidylinositol 3-kinase (PI3K) signaling and by class III PI3K/Vps34-mediated PI3P production on endosomes. Upregulation of Sgk3 activity has recently been linked to a number of human cancers; however, the precise mechanism of activation of Sgk3 is unknown. Here, we use a wide range of cell biological, biochemical, and biophysical techniques, including hydrogen-deuterium exchange mass spectrometry, to investigate the mechanism of activation of Sgk3 by PI3P. We show that Sgk3 is regulated by a combination of phosphorylation and allosteric activation. We demonstrate that binding of Sgk3 to PI3P via its regulatory phox homology (PX) domain induces large conformational changes in Sgk3 associated with its activation and that the PI3P-binding pocket of the PX domain of Sgk3 is sequestered in its inactive conformation. Finally, we reconstitute Sgk3 activation via Vps34-mediated PI3P synthesis on phosphatidylinositol liposomes in vitro. In addition to identifying the mechanism of Sgk3 activation by PI3P, our findings open up potential therapeutic avenues in allosteric inhibitor development to target Sgk3 in cancer.


Subject(s)
Class I Phosphatidylinositol 3-Kinases/metabolism , Endosomes/metabolism , Liposomes/chemistry , Neoplasms/pathology , Phosphatidylinositol Phosphates/metabolism , Protein Serine-Threonine Kinases/metabolism , Class III Phosphatidylinositol 3-Kinases/metabolism , Humans , In Vitro Techniques , Liposomes/metabolism , Mass Spectrometry/methods , Neoplasms/enzymology , Phosphatidylinositol Phosphates/chemistry , Protein Serine-Threonine Kinases/chemistry , Protein Structural Elements , Signal Transduction
11.
Elife ; 102021 03 04.
Article in English | MEDLINE | ID: mdl-33661099

ABSTRACT

Class I Phosphoinositide 3-kinases (PI3Ks) are master regulators of cellular functions, with the class IB PI3K catalytic subunit (p110γ) playing key roles in immune signalling. p110γ is a key factor in inflammatory diseases and has been identified as a therapeutic target for cancers due to its immunomodulatory role. Using a combined biochemical/biophysical approach, we have revealed insight into regulation of kinase activity, specifically defining how immunodeficiency and oncogenic mutations of R1021 in the C-terminus can inactivate or activate enzyme activity. Screening of inhibitors using HDX-MS revealed that activation loop-binding inhibitors induce allosteric conformational changes that mimic those in the R1021C mutant. Structural analysis of advanced PI3K inhibitors in clinical development revealed novel binding pockets that can be exploited for further therapeutic development. Overall, this work provides unique insights into regulatory mechanisms that control PI3Kγ kinase activity and shows a framework for the design of PI3K isoform and mutant selective inhibitors.


Subject(s)
Class Ib Phosphatidylinositol 3-Kinase/genetics , Immunologic Deficiency Syndromes/genetics , Mutation , Class Ib Phosphatidylinositol 3-Kinase/chemistry , Class Ib Phosphatidylinositol 3-Kinase/metabolism , Humans
12.
Commun Biol ; 3(1): 735, 2020 12 04.
Article in English | MEDLINE | ID: mdl-33277614

ABSTRACT

The TRAnsport Protein Particle (TRAPP) complexes act as Guanine nucleotide exchange factors (GEFs) for Rab GTPases, which are master regulators of membrane trafficking in eukaryotic cells. In metazoans, there are two large multi-protein TRAPP complexes: TRAPPII and TRAPPIII, with the TRAPPII complex able to activate both Rab1 and Rab11. Here we present detailed biochemical characterisation of Rab-GEF specificity of the human TRAPPII complex, and molecular insight into Rab binding. GEF assays of the TRAPPII complex against a panel of 20 different Rab GTPases revealed GEF activity on Rab43 and Rab19. Electron microscopy and chemical cross-linking revealed the architecture of mammalian TRAPPII. Hydrogen deuterium exchange MS showed that Rab1, Rab11 and Rab43 share a conserved binding interface. Clinical mutations in Rab11, and phosphomimics of Rab43, showed decreased TRAPPII GEF mediated exchange. Finally, we designed a Rab11 mutation that maintained TRAPPII-mediated GEF activity while decreasing activity of the Rab11-GEF SH3BP5, providing a tool to dissect Rab11 signalling. Overall, our results provide insight into the GTPase specificity of TRAPPII, and how clinical mutations disrupt this regulation.


Subject(s)
Guanine Nucleotide Exchange Factors/metabolism , rab GTP-Binding Proteins/metabolism , Animals , Cell Line , Chromatography, Liquid , Humans , Insecta , Models, Molecular , Protein Conformation , Protein Isoforms , Substrate Specificity , Tandem Mass Spectrometry , rab GTP-Binding Proteins/genetics
13.
Water Sci Technol ; 58(3): 629-37, 2008.
Article in English | MEDLINE | ID: mdl-18725732

ABSTRACT

A pilot-scale activated sludge wastewater treatment plant (WWTP) operated with nitrification and pre-denitrification was monitored with a set of on-line sensors for over 3 years. Wet-chemistry ex-situ analyzers, UV and UV-Visible in-situ sensors and in-situ sensors based on ion-selective electrodes (ISE) were used. New ISE sensors for ammonium, nitrate and nitrite, adapted to water and wastewater matrices, have been released in recent years, With adequate quality control they proved to be highly accurate and reliable in WWTP influents and activated sludge (AS) reactors even at the end of the biological treatment zone, working at low ammonium concentrations (1-2 mgN/l). The ammonium measurement was used to test several feed-forward and feed-back aeration control strategies. The first aim was to keep inorganic nitrogen compounds, i.e. ammonium, nitrate and particularly nitrite, as low as possible in the effluent, and within Swiss national standards (<2.0 mgNH(4)-N/l, <0.3 mgNO(2)-N/l, 24 h average). All the strategies were successful at keeping ammonium low and subsequently at gaining denitrification capacity to significantly reduce the total nitrogen discharge. Some control strategies however generated temporary peaks of ammonium or even accumulation of nitrite.


Subject(s)
Waste Disposal, Fluid/instrumentation , Waste Disposal, Fluid/methods , Ammonia/metabolism , Biodegradation, Environmental , Bioreactors/microbiology , Electrodes , Nitrates/metabolism , Nitrites/metabolism , Nitrogen/metabolism , Pilot Projects
14.
Water Sci Technol ; 57(10): 1563-9, 2008.
Article in English | MEDLINE | ID: mdl-18520013

ABSTRACT

A spectral in-situ UV sensor was investigated to measure nitrite and nitrate concentrations in the effluent of the EAWAG pilot-scale plant. The sensor was used with a calibration that was based on data from another WWTP and was operated over a period of 1.5 years. The results showed constant accuracy although the sensor was operated with minimal maintenance (manual cleaning once a month). It could be shown that the sensor was able to accurately predict the nitrite and nitrate concentration with a precision of 0.32 mg N/l (95% prediction interval at mean lab value of 1.15 mg N/l) and 1.08 mg N/l (at 5.55 mg N/l) for nitrite and nitrate, respectively. The UV sensor showed good results for nitrite in the low concentration range and very accurate results for higher concentrations (up to 10 mg N/l). This allows using the sensor for alarm systems as well as for control concepts at WWTPs.


Subject(s)
Environmental Monitoring/methods , Nitrates/analysis , Nitrites/analysis , Spectrophotometry, Ultraviolet/methods , Waste Disposal, Fluid/instrumentation , Water Pollutants, Chemical/analysis , Calibration , Reproducibility of Results , Ultraviolet Rays , Waste Disposal, Fluid/methods
17.
Am J Phys Med Rehabil ; 80(3): 218-24, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11237276

ABSTRACT

Medical specialty training has undergone dramatic changes in the last 5 yr. This article was prepared by the Undergraduate Education Committee of the Association of Academic Physiatrists in an attempt to help guide medical students who are considering a career in physical medicine and rehabilitation. This report is an update of two previous articles addressing medical students' questions to assist them in making educated decisions about residency training and medical practice.


Subject(s)
Career Choice , Physical and Rehabilitation Medicine/education , Physical and Rehabilitation Medicine/organization & administration , Rehabilitation/education , Rehabilitation/organization & administration , Students, Medical/psychology , Career Mobility , Curriculum , Education, Medical, Graduate/organization & administration , Forecasting , Humans , Internship and Residency/organization & administration , Job Description , Job Satisfaction , United States
18.
Arch Phys Med Rehabil ; 81(3 Suppl 1): S55-9; quiz S78-86, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10721761

ABSTRACT

This self-directed learning module reviews and summarizes recent literature on osteoporosis. It is part of the chapter on rehabilitation of orthopedic and rheumatologic disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. The areas covered include pathophysiology of primary and secondary osteoporosis, effects of various pharmacologic treatments on bone metabolism, and the utility of available diagnostic tests. Management strategies for perimenopausal women as compared with postmenopausal women with established osteoporosis are discussed. This is followed by an evaluation and management plan for the older man with acute osteoporotic fracture.


Subject(s)
Osteoporosis/metabolism , Osteoporosis/rehabilitation , Bone and Bones/metabolism , Diagnosis, Differential , Female , Humans , Male , Osteoporosis/diagnosis , Osteoporosis/drug therapy , Patient Care Planning , Risk Factors
19.
Arch Phys Med Rehabil ; 81(3 Suppl 1): S60-6; quiz S78-86, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10721762

ABSTRACT

This self-directed learning module highlights assessment and therapeutic options in the rehabilitation of patients with connective tissue diseases. It is part of the chapter on rehabilitation of orthopedic and rheumatologic disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. New advances covered in this article include the management of patients who have polymyalgia rheumatica, juvenile rheumatoid arthritis, ankylosing spondylitis, rheumatoid cervical spine, and rheumatoid hand.


Subject(s)
Arthritis/diagnosis , Arthritis/rehabilitation , Connective Tissue Diseases/diagnosis , Connective Tissue Diseases/rehabilitation , Arthritis/physiopathology , Connective Tissue Diseases/physiopathology , Diagnosis, Differential , Humans , Patient Care Planning , Polymyalgia Rheumatica/diagnosis , Polymyalgia Rheumatica/physiopathology , Polymyalgia Rheumatica/rehabilitation , Spondylitis, Ankylosing/diagnosis , Spondylitis, Ankylosing/physiopathology , Spondylitis, Ankylosing/rehabilitation
20.
Arch Phys Med Rehabil ; 81(3 Suppl 1): S67-72; quiz S78-86, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10721763

ABSTRACT

This self-directed learning module highlights assessment and therapeutic options in the rehabilitation of patients with osteoarthritis. It is part of the chapter on rehabilitation of orthopedic and rheumatologic disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. New advances covered in this article include updates on conservative and operative treatment of lumbar spinal stenosis and pediatric hip diseases, prophylactic therapy for thromboembolic disease after lower limb joint replacement, new therapies for osteoarthritis, and the impact of exercise on outcome following hip replacement in active persons.


Subject(s)
Osteoarthritis/diagnosis , Osteoarthritis/rehabilitation , Arthroplasty/adverse effects , Exercise Therapy , Hip Fractures/etiology , Hip Fractures/rehabilitation , Humans , Osteoarthritis/physiopathology , Osteoarthritis/surgery , Patient Care Planning , Venous Thrombosis/etiology , Venous Thrombosis/prevention & control
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