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Biomedical subjects

Richard Keen

Publications and source records attributed to Richard Keen.

11 recordsLinked to original sources
PubMed2025

Medical guidelines for fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic condition characterized by congenital malformations of the great toes and progressive heterotopic ossification (HO) in specific anatomic patterns. Present management summarized here is focused on early diagnosis, assiduous avoidance of injury and iatrogenic harm, symptomatic amelioration of painful flare-ups, and optimization of residual function. Twenty-one members of the International Clinical Council on FOP (ICC) and seven consultants from 15 countries, chosen for their clinical expertise in FOP, developed this summary statement. Further advances in therapeutics will be based on rigorous clinical trials to assess novel and emerging treatment and prevention strategies. A detailed and updated exploration of the topics outlined in this brief perspective can be found in "The Medical Management of Fibrodysplasia Ossificans Progressiva: Current Treatment Considerations" which can be found on the International Clinical Council on FOP (ICC) website (www.iccfop.org).

ACVR1↗
PubMed2024

Congenital hallux valgus occurs in Fibrodysplasia Ossificans Progressiva and BMPR1B-associated dysplasia: an important distinction.

BACKGROUND: Fibrodysplasia Ossificans Progressiva (FOP; OMIM #135100) is an ultrarare genetic disorder characterised by congenital bilateral hallux valgus (CBHV), intermittent soft tissue swellings and progressive heterotopic ossification. We report a three-month-old girl with great toe abnormalities similar to FOP, in whom comprehensive clinical workup and genetic investigations illustrates an alternative diagnosis. CASE PRESENTATION: A three-month-old girl presented with CBHV. The antenatal period was unremarkable, she was born by spontaneous vaginal delivery with an uneventful subsequent course, except for maternal concern of her bent toes which received reassurance from several health professionals. Her mother's persisting concerns were explored via the internet and social media leading her to request referral to an expert bone centre for consideration of FOP. On examination, she was thriving, there was no dysmorphism, subcutaneous lumps, skeletal or extra-skeletal deformity except for shortened great toes with lateral deviation of the proximal and distal phalanges. FOP was a feasible diagnosis, for which CBHV is highlighted as an early sign. A cautionary potential diagnosis of FOP was counselled, including advice to defer intramuscular immunisations until genetic results available. Genetic investigation was undertaken through rapid whole genomic sequencing (WGS), with analysis of data from a skeletal dysplasia gene panel, which demonstrated no ACVR1variants. The only finding was a heterozygous variant of unknown significance in BMPR1B (c1460T>A, p.(Val487Asp)), which encodes a bone morphogenic receptor involved in brachydactyly syndromes A1, A2 and D and acromesomelic dysplasia 3 (only the latter being an autosomal recessive condition). CONCLUSION: This report highlights that CBHV serves as a vital diagnostic indicator of FOP and affected infants should be considered and investigated for FOP, including precautionary management whilst awaiting genetic studies. The second educational aspect is that CBHV may not represent a generalised skeletal disorder, or one much less significant than FOP. Receptor-ligand BMP and Activins mediated interactions are instrumental in the intricate embryology of the great toe. Recognition of non-FOP conditions caused by alterations in different genes are likely to increase with new genomic technology and large gene panels, enhancing understanding of bone signaling pathways.

Humans↗
PubMed2005

How rats combine temporal cues.

The procedures for classical and operant conditioning, and for many timing procedures, involve the delivery of reinforcers that may be related to the time of previous reinforcers and responses, and to the time of onsets and terminations of stimuli. The behavior resulting from such procedures can be described as bouts of responding that occur in some pattern at some rate. A packet theory of timing and conditioning is described that accounts for such behavior under a wide range of procedures. Applications include the food searching by rats in Skinner boxes under conditions of fixed and random reinforcement, brief and sustained stimuli, and several response-food contingencies. The approach is used to describe how multiple cues from reinforcers and stimuli combine to determine the rate and pattern of response bouts.

Animals↗
PubMed2005

Loci for regulation of bone mineral density in men and women identified by genome wide linkage scan: the FAMOS study.

Osteoporosis is a common disease with a strong genetic component, characterized by reduced bone mass and an increased risk of fracture. Bone mineral density (BMD) is a highly heritable trait and a key determinant of osteoporotic fracture risk, but the genes responsible are incompletely defined. Here, we identified quantitative trait loci (QTL) for regulation of BMD by a genome wide scan involving 3691 individuals from 715 families, who were selected because of reduced BMD values at the lumbar spine (LS-BMD) or femoral neck (FN-BMD) in probands. Linkage analysis was conducted in the study group as a whole with correction for age, gender, weight and height. Further analyses were conducted for men and women separately to identify gender-specific QTL and for those under and over the age of 50 years to distinguish QTL for peak bone mass from those that influence bone mass in older people. No regions of suggestive or significant linkage were identified when data from all subjects were analyzed together. On subgroup analysis, however, we identified a significant QTL for FN-BMD on chromosome 10q21 (LOD score +4.42; men < or =50 years) and two suggestive QTL for LS-BMD on chromosomes 18p11 (LOD score +2.83; women >50 years) and 20q13 (LOD score +3.20; women < or =50 years). We identified five other QTL for BMD with LOD scores of greater than +2.20 on chromosomes 3q25, 4q25, 7p14, 16p13 and 16q23. This study provides evidence for gender-specific, site-specific and age-specific QTL, which regulate BMD in humans, and illustrates the importance of conducting subgroup analysis to detect these loci.

Bone Density↗
PubMed2005

The lack of behavioral effects of fenbendazole: a medication for pinworm infection.

Pinworm infection in rodent laboratories is common and often treated with fenbendazole, which is effective and has a low toxicity level. However, very little is known about the behavioral effects of the drug. The purpose of this study was to determine the behavioral effects of fenbendazole on rats tested by using various conditioning and timing procedures. These behavioral effects were examined both between animals (i.e., control versus medicated treatments) and within animals (baseline-treatment-baseline design). Fenbendazole reduced the detection of pinworm eggs, and it had no significant behavioral effects across multiple levels of analysis (e.g., from overall response rates to response patterns to interresponse intervals). All behavioral differences (e.g., discrimination ratios) were a result of task variables. These results suggest that behavioral studies are unlikely to be influenced by fenbendazole treatment given before or during a study.

Analysis of Variance↗
PubMed2004

Influence of LRP5 polymorphisms on normal variation in BMD.

UNLABELLED: Genetic studies based on cohorts with rare and extreme bone phenotypes have shown that the LRP5 gene is an important genetic modulator of BMD. Using family-based and case-control approaches, this study examines the role of the LRP5 gene in determining normal population variation of BMD and describes significant association and suggestive linkage between LRP5 gene polymorphisms and BMD in >900 individuals with a broad range of BMD. INTRODUCTION: Osteoporosis is a common, highly heritable condition determined by complex interactions of genetic and environmental etiologies. Genetic factors alone can account for 50-80% of the interindividual variation in BMD. Mutations in the LRP5 gene on chromosome 11q12-13 have been associated with rare syndromes characterized by extremely low or high BMD, but little is known about the contribution of this gene to the development of osteoporosis and determination of BMD in a normal population. MATERIALS AND METHODS: To examine the entire spectrum of low to high BMD, 152 osteoporotic probands, their families (597 individuals), and 160 women with elevated BMD (T score > 2.5) were recruited. BMD at the lumbar spine, femoral neck, and hip were measured in each subject using DXA. RESULTS: PAGE sequencing of the LRP5 gene revealed 10 single nucleotide polymorphisms (SNPs), 8 of which had allele frequencies of >5%, in exons 8, 9, 10, 15, and 18 and in introns 6, 7, and 21. Within families, a strong association was observed between an SNP at nucleotide C171346A in intron 21 and total hip BMD (p < 1 x 10(-5) in men only, p = 0.0019 in both men and women). This association was also observed in comparisons of osteoporotic probands and unrelated elevated BMD in women (p = 0.03), along with associations with markers in exons 8 (C135242T, p = 0.007) and 9 (C141759T, p = 0.02). Haplotypes composed of two to three of the SNPs G121513A, C135242T, G138351A, and C141759T were strongly associated with BMD when comparing osteoporotic probands and high BMD cases (p < 0.003). An SNP at nucleotide C165215T in exon 18 was linked to BMD at the lumbar spine, femoral neck, and total hip (parametric LOD scores = 2.8, 2.5, and 2.2 and nonparametric LOD scores = 0.3, 1.1, and 2.2, respectively) but was not genetically associated with BMD variation. CONCLUSION: These results show that common LRP5 polymorphisms contribute to the determination of BMD in the general population.

Adolescent↗
PubMed2003

Temporal discrimination in a long operant chamber.

Pigeons were placed in a long chamber equipped with one key and feeder at each end side and one key and houselight at the middle. To obtain food the birds had to choose one side key after a short signal and the other side key after a long signal. The signals consisted of the illumination of the center key and the houselight and were initiated by a peck at the center key. The chamber had sensitive floor panels that enabled us to measure the location of the bird during the signals. In Experiment 1, after the birds learned the discrimination we reversed the assignment of keys to signals. In Experiment 2, we examined performance on two pairs of discriminations holding the same ratio. In Experiment 3, after the pigeons learned to discriminate two signals, we changed the duration of the long signal. The results showed that (a) the birds' motion during the signal was highly stereotypical, i.e. the birds moved to the short side, waited a few seconds, and then departed to, and stayed on the long side; (b) this motion pattern predicted the results of generalization tests with novel durations; (c) the mean of the times of departure from the short side approached its steady state values quicker than the standard deviation and consequently superposition of behavioral measures became stronger with training; (d) only the duration of the short signal influenced significantly the moment the birds departed from the short side; finally (e) the times of arrival at and departure from the short side were positively correlated, but the times of arrival and residence at the short side were negatively correlated.

Journal Article↗
PubMed2003

Clinical management and algorithms in osteoporosis.

The aim of management in osteoporosis is to reduce the risk of fractures. Case-finding strategies are currently recommended to identify subjects at high risk of future fracture who will benefit most from therapy. This article reviews these approaches and discusses the current and future treatment options that are available for patients with osteoporosis.

Algorithms↗
PubMed2002

Relative numerosity discrimination in the pigeon: further tests of the linear-exponential-ratio model.

This study tested a model of how animals discriminate the relative numerosity of stimuli in successive or sequential presentation tasks. In a discrete-trials procedure, pigeons were shown one light for nf times and then another for nl times. Next they received food for choosing the light that had occurred the least-number of times during the sample. At issue were (a) how performance varies with the interval between the two stimulus sets (the interblock interval) and the interval between the end of the sample and the beginning of the choice period (the retention interval); and (b) whether a simple mathematical model of the discrimination process could account for the data. The model assumed that the influence of a stimulus on choice increases linearly when the stimulus is presented, but decays exponentially when the stimulus is absent; choice probability is given by the ratio of the influence values of the two stimuli. The model also assumed that as the retention interval elapses there is an increasing probability that the ongoing discriminative process be disrupted and then the animal responds randomly. Results showed that increasing the interblock intervals reduced the probability of choosing the last stimulus of the sample as the least-frequent one. Increasing the retention interval reduced accuracy without inducing any stimulus bias. The model accounted well for the major trends in the data.

Journal Article↗