Tr-1 conversion depends on TCR signaling and a direct T-/B-intera

Tr-1 conversion depends on TCR signaling and a direct T-/B-interaction through CD40/CD40L and B7-1/CD28. B cell-induced Tr-1 cells RAD001 in vitro acquire suppressive activity in vitro and in vivo. In addition, systemic injection of Pam2 lipopeptides (a TLR-2 ligand) induced IL-10 in a TLR2-dependent manner [31]. The Pam2 lipopeptides increased the frequencies of Foxp3+CD4+ regulatory T (T reg) cells in a TLR2- and IL-10-dependent manner.

Then, the possibility that human OMV vaccination induced T regulatory cells which suppressed B cell activation cannot be ruled out and further investigation may be conducted in the future. Interesting enough, we have previously reported a negative dose-effect on booster bactericidal antibody response, in that mice immunised with four doses of VA-MENGOC-BC®, but not with two or three AZD8055 chemical structure doses, responded less well to the booster dose compared with the primary series [14]. In conclusion, this study suggests that vaccination with the VA-MENGOC-BC® induced a robust immune response after three injections of vaccine. Vaccination induced the generation and activation of memory T-cells

after primary and booster schedules but failed to maintain a memory B-cell population at a stable size and/or functionality. The weak boosting antibody response reinforces suboptimal recall functions of the remaining memory B-cell population. More studies are needed in view of the scarce knowledge about cellular mechanisms of antibody response and development of immunological memory by meningococcal vaccines. We are thankful to Ricardo da Costa Cruz for proof-reading the manuscript. We acknowledge FAPERJ/SR2-UERJ/CAPES very and CNPq for financial support.

This study would not be possible without the consent of the volunteers. “
“The first barriers that microorganisms including viruses must breach for being successful pathogens are imposed by the innate immune system of which the complement system constitutes a major arm [1], [2], [3] and [4]. The complement system comprises of an intricate group of both soluble and cell-associated proteins activated through three major pathways, the classical, alternative and lectin pathways. Complement activation results in the generation of active components, including C3b and C4b, which aid in the assembly of enzymes called as C3/C5-convertases that facilitate downstream cleavage and formation of the membrane attack complex (MAC) capable of lysing pathogens. Additionally, the activation products C3a and C5a show anaphylatoxic and chemotactic properties [5] and also play a role in T cell activation [6], and surface bound complement components derived from C3 interact with specific immune receptors, thus acting as a connecting link with the adaptive immune system [7]. Hence, the complement system exerts assault on pathogens directly by lysis and indirectly by boosting the pathogen-specific immune responses [8].

3, Table 2) Evidence on indirect impact in low-coverage (<70%) s

3, Table 2). Evidence on indirect impact in low-coverage (<70%) settings

is mixed, with significant impact seen in some populations and not others. Data on indirect effect of PCV on AT–IPD showed a trend toward increasing impact with time (median decrease: 33%; IQR: 7–42%), though this website with lower overall impact compared to that on VT-IPD (Appendix B.3, Table 3). This impact on AT-IPD was observed in all non-target age-groups (Fig. 5) and is also noted in pneumococcal pneumonia [10] and [29]. Data from mixed target and non-target groups show a greater decrease in VT-IPD rates than that in pure non-targeted groups, reflecting a mix of direct and indirect effect (Appendix B.3, Table 4). However, studies with 1-dose coverage data suggest a vaccine impact on VT-IPD that cannot be entirely accounted for by direct effect. Data were available for six unique populations: Australian aboriginals, Alaska Natives, American Indians, Gambians, Israelis and Portuguese PF-01367338 nmr (Appendix B.3, Table 5). Studies in children were primarily RCTs; those in adults were primarily observational. The median decrease

in VT-carriage prevalence (among either the study sample or, rarely, the subset who were carriers of any pneumococcal strain) was 77% (IQR 64–80%). Data points did not span a sufficient time range to evaluate time-related trends. The majority of carriage data is drawn from high-risk populations. Few additional supporting data points were identified for NP carriage. Supporting data are listed for pre- vs. post-introduction all-type NP in non-target groups and pre- vs. post-introduction VT-carriage in mixed groups in Appendix B.3, Tables 6 and 7; a discussion is provided in Appendix B.4. A relevant data point not eligible for inclusion due to publication

date comes from an observational study including Native American adults shortly after PCV introduction Ketanserin (2001–2002) and subsequently (2006–2008), finding a relative decrease of 97.5% and an absolute reduction of 4.0% in VT-NP [46]. Most individual data points were categorized as low or very-low quality by GRADE criteria because nearly all data were from observational studies, and over half the primary evidence sources were further downgraded for including only high-risk populations, but few for methodological issues (Appendix B.5). While GRADE methodology categorizes observational studies as ‘low quality’, the GRADE system was designed to assess individual patient treatments, not to assess public health benefit. Furthermore, only observational, or community randomized studies can assess population-level post-introduction effects. An additional 14 studies published after the PCV Dosing Landscape Review search met primary evidence inclusion criteria.

Finally, applications of this delivery mechanism to vaccines for

Finally, applications of this delivery mechanism to vaccines for other pathogens where CTL targeting is potentially relevant, such as hepatitis C [35], [36], [37] and [38], and influenza [39] and [40], should be investigated. We thank Darrell Irvine of the Ragon Institute for helping www.selleckchem.com/products/OSI-906.html us review previous research in the area, Nicole Frahm of the Fred Hutchinson Cancer Research Center for immunochemistry advice, Dan Barouch of the Beth Israel Hospital for his interest and support, Niraj Patil for assistance with illustration preparation, Craig Rouskey for

helpful comments and Jonathan Carlson of Microsoft Research who helped review the manuscript. This work was supported in part by a Qualifying Therapeutic Drug Discovery Project Grant from the United States Government and a grant from Microsoft Research. Conflict of interest: RMR, CVH, and PML are employees of shareholders of Flow Pharma Inc., and DEH is an employee and shareholder of Microsoft. “
“All children worldwide should be fully vaccinated against polio, and every country should seek to achieve and maintain high levels of coverage with polio vaccine in support of the global commitment to eradicate polio.

WHO no longer recommends an OPV-only vaccination schedule. For all countries currently using OPV only, at least 1 dose of IPV should be added to the schedule. The primary purpose of the IPV dose is to maintain immunity against type 2 poliovirus during almost and after the planned global withdrawal SCH727965 purchase of OPV2 and switch from tOPV to bOPV. Depending on the timing of the IPV administration, the introduction of IPV may reduce VAPP risks. Adding an IPV dose will boost

both humoral and mucosal immunity against poliovirus types 1 and 3, which may also hasten the eradication of these WPVs. In polio-endemic countries and in countries at high risk for importation and subsequent spread [3], WHO recommends an OPV birth dose (a zero dose) followed by a primary series of 3 OPV and at least 1 IPV doses. The birth dose of OPV should be administered at birth, or as soon as possible after birth, to maximize the seroconversion rates with subsequent doses and to induce mucosal protection before enteric pathogens may interfere with the immune response. Also, administering the first dose of OPV while infants are still protected by maternally derived antibodies may, at least theoretically, prevent VAPP. Even in cases of perinatal HIV infection, early OPV vaccination seems to be well tolerated, and no additional risk of VAPP has been documented in such children. The primary series consisting of 3 OPV doses plus 1 IPV dose can be initiated from the age of 6 weeks with a minimum interval of 4 weeks between the OPV doses. If 1 dose of IPV is used, it should be given from 14 weeks of age (when maternal antibodies have diminished and immunogenicity is significantly higher) and can be co-administered with an OPV dose.

Tout comme l’obésité, les prévalences du SMet et du DT2 s’élèvent

Tout comme l’obésité, les prévalences du SMet et du DT2 s’élèvent avec l’âge. Et fait de nombreuses fois démontré par les études épidémiologiques, elles restent

supérieures chez l’homme à ce qui est observé dans le sexe féminin. A découlé fort logiquement AC220 cost de ce constat, la question du rôle éventuel des stéroïdes sexuels dans cette différence liée au genre. De nombreuses études ont mis en évidence, chez l’homme adulte, un lien indiscutable entre abaissement du taux de testostérone plasmatique et syndrome d’insulino-résistance. Insulino-résistance et hypotestostéronémie sont par ailleurs impliqués dans la physiopathologie de plusieurs facteurs de risque vasculaire : hypertension artérielle, trouble de l’équilibre glycémique, dyslipidémie [1], [2], [3] and [4]. Deux constations supplémentaires ont amené à évaluer plus précisément l’équilibre androgénique des hommes suivis pour obésité, SMet ou DT2 : • la fréquence de ces anomalies métaboliques s’élève avec l’âge tandis que parallèlement la sécrétion testiculaire endocrine décline ; Chez l’homme, une baisse de la testostéronémie a été démontrée dans chacun des Ibrutinib chemical structure trois cadres pathologiques que constituent obésité, SMet et DT2. Il s’agit donc bien

là d’un point commun supplémentaire à ces trois entités, point commun dont l’identification a amené à s’interroger sur son implication physiopathologique, sa valeur pronostique et l’intérêt thérapeutique d’un rééquilibrage du statut androgénique. Une réduction du taux de testostérone plasmatique, dont l’ampleur est inversement corrélée à l’index de masse corporelle (IMC), a été mise en évidence chez l’homme adulte en surcharge pondérale. Dans le surpoids simple ou l’obésité non morbide, le taux de testostérone libre reste others situé dans les limites de la normale pour la tranche d’âge considérée. Dans ces deux situations, l’abaissement de la testostérone totale est en effet liée à la diminution du taux de la Sex Hormone-Binding Globulin (SHBG), protéine porteuse des stéroïdes sexuels encore dénommée Testosterone-estradiol-Binding Globulin (TeBG) dont le taux est négativement corrélé

à l’IMC ( figure 1) [5]. L’obésité massive s’accompagne, par contre, d’une réduction de l’ensemble des fractions, libre et liée, de la testostérone plasmatique [6]. L’obésité androïde s’associe à une insulino-résistance. Testostéronémie totale et taux de SHBG plasmatique en représenteraient des marqueurs, susceptibles également d’être impliqués dans son développement et, à un stade évolutif ultérieur, à celui d’un DT2. Il a été montré que le taux de testostérone plasmatique était fréquemment plus bas dans la population d’hommes atteints d’insulino-résistance que dans une population du même âge indemne de pathologie quelconque [2], [7] and [8]. Les résultats de ces études font même l’hypothèse qu’un taux bas de testostérone plasmatique exposerait à un risque plus élevé de développement d’un DT2.

While global economic data from WHO or from other countries are o

While global economic data from WHO or from other countries are often used as a reference, data from Korea are always preferred, and local studies are sometimes recommended, since the economic and disease burden parameters change from country to country. The results

of economic evaluations conducted by vaccine producers usually are not considered, because of the obvious concern of bias. The KACIP and sub-committees do not have set rules on ranking the various factors and types of data (e.g., disease burden vs. vaccine cost-effectiveness) in order of importance when making recommendations. This is because specific factors, such as the potential for disease outbreaks, whether the disease has seasonal peaks, and the groups most affected by the disease (e.g., children vs. adults), differ for each disease and thus the committee considers the preponderance of data when making FK228 supplier recommendations. Sub-committees also make recommendations concerning measures selleck compound for controlling the disease they focus on that go beyond immunization. For example, in response to an outbreak of pertussis among infants, in 2009, the Sub-committee on Diphtheria/Tetanus/Pertussis and Polio held meetings

to develop recommendations concerning case management and surveillance, as well as immunization. These recommendations included the isolation of pertussis patients and the distribution of antibiotics for prophylactic use among the patient’s contacts; polymerase chain reaction testing to diagnose all suspected pertussis patients, where available; a survey to determine what proportion of patients

with chronic cough have pertussis; and the replacement of the tetanus–diphtheria (Td) Bay 11-7085 booster for adolescents with the new tetanus–diphtheria–acellular pertussis (Tdap) vaccine. The KCDC ordered the implementation of the medical-related recommendations immediately in public health facilities, while the vaccine-related recommendations have been sent to the KACIP to address at its next meeting in 2010. The launch and successful implementation of Korea’s Hepatitis B Perinatal Transmission Prevention Program illustrates the important role of both the World Health Organization in setting goals for the National Immunization Program, and the KACIP and ancillary working groups in developing practical recommendations to achieve these goals. In 2002, the Western Pacific Office of WHO (WPRO) set the goal for the region to reduce hepatitis B transmission from mothers to their infants, with a benchmark for countries to achieve a seroprevalence rate of hepatitis B surface antigen (HBsAg) in children 5 years and older of <2% by 2012 [2]. In response, the KACIP established the following goals: (1) reduce the seroprevalence rate of HbsAg in the total population to <1% within 10 years; (2) achieve 95% coverage of the 3rd dose of hepatitis B vaccine in infants; and (3) strengthen the disease surveillance system to monitor and evaluate progress with hepatitis B control.

Phylogenetic dendrograms based on nucleotide sequences were const

Phylogenetic dendrograms based on nucleotide sequences were constructed and compared to previously reported G1, G2, G9 and G12 strains. Kolkata G1 strains

clustered in two subsets within two different lineages. One subset of G1 strains (BCK-2129/2011, BCK-2304/2011 and IDK-4418/2012) exhibited maximum similarities (>97%) with Thailand, India and Bangladesh G1 strains during BLAST analysis. Those strains remained in the same cluster within lineage I in phylogenetic dendrogram, though these were distant from the vaccine strains RotaTeq W179-9 and Rotarix A41CB052A (Fig. 3A). The other subset of G1 strains (IDK-4226/2011, BCK-2644/2012 and IDK-5042/2013) exhibited maximum similarities (>98%) with strains from Australia and Thailand. http://www.selleckchem.com/autophagy.html These G1 strains clustered with Rotarix

vaccine strain within lineage II (Fig. 3A), while the VP7 (G1) of Rotateq vaccine strain clusters in lineage III (Fig. 3A). All G2 strains (BCK-2601/2012, BCK-2409/2012, BCK-2953/2013, BCK-2852/2013, IDK-4292/2011, IDK-4599/2012 and IDK-5034/2013) showed 98–99% nucleotide similarities with previously reported strains from India, Nepal and Bangladesh Everolimus price and clustered in lineage IV. The G2 strains from this study were distant to RotaTeq vaccine strains in lineage II (Fig. 3B). Phylogenetic analysis showed all G9 strains from this study were in lineage III. Six of eight G9 strains (BCK-2168/2011, BCK-2679/2012, BCK-2934/2013, IDK-4321/2011, IDK-4957/2012

and IDK-5033/2013) revealed maximum identities (>96%) with previously reported human G9 strains from India and USA. These six G9 strains were in one subcluster, whereas, IDK-4176/2011 shared maximum homology with South African human G9 strain and BCK-2295/2011 was more similar with an American G9 strain. These two strains were placed in two other subclusters of lineage III (Fig. 4A). All the G9 strains from this study were found to be genetically distant from G9 vaccine strain 116E, which was in lineage II (Fig. 4A). The current G12 strains shared close nucleotide similarity (>95%) with previously reported Indian human lineage III G12 strains. Sample IDK-5082/2013 formed distant too subcluster, whereas other three (BCK-2783/2012, BCK-2907/2013 and IDK-5095/2013) formed another subcluster with Indian, Nepalese and Belgian G12 strains within lineage III (Fig. 4B). The amino acid homology of the current circulating strains was compared to the vaccine strains. The lineage II G1 strains were similar (92–95%) to Rotarix-G1 strain which also clustered in lineage II (Fig. 3A), but lineage I G1 strains had 91–94% homology to either Rotarix-G1 or RotaTeq-G1 strains (Table 3). Amino acid homology of G2 strains with RotaTeq G2 was ∼91%, whereas Kolkata G9 strains showed 89–92% amino acid homology with 116E-G9 vaccine strains (Table 3). The VP7 trimer contains two structurally defined antigenic epitopes: 7-1 and 7-2.

In the third trial a multimodal physiotherapy program was studied

In the third trial a multimodal physiotherapy program was studied involving taping and massage in addition to exercise (Bennell et al 2005). Moreover aerobic activity was not incorporated in the exercise program. The individual treatment arm in the study of Fransen and colleagues (2001) was excluded because aerobic activity was not incorporated in the exercise program and because heat, ultrasound, laser or interferential therapy were also part of the individual treatment. Moreover the use of

manual techniques was not specified. We were unable to find any study that directly compared any of the three intervention types to each other. Therefore LY294002 in vivo the mixed-effects meta-regression was used to analyse the relative effects of the three interventions.

Quality: The methodological quality of the studies ranged from 2 to 7 on a scale from 0 to 9 points. Four studies scored 4 points ( Maurer et al 1999, Peloquin et al 1999, Thorstensson et al 2005, Topp et al 2002) and four studies scored 5 points ( Deyle et al 2000, Ettinger et al 1997, Fransen et al 2001, Huang et al 2005). The scores of the remaining studies were 2 ( Hughes et al 2006), 3 ( Schilke et al 1996), 6 ( Hay et al 2006), and 7 points ( van Baar et al 1998). Table 1 provides an overview of the methodological quality of the included studies. Participants: In 8 of the 12 studies, the participants had clinical evidence of osteoarthritis according to the American College of Rheumatology (ACR) criteria ( Altman et al 1986). find protocol Two studies recruited patients with radiographic evidence of osteoarthritis. One study used volunteers with osteoarthritis and one study recruited adults older than 55 years who had consulted their general practitioner with pain, stiffness, or both. The mean age of participants in 11 of the 12 studies ranged from 65 to 70

years. In 10 of the 12 studies the majority were female (mean 75%; range 64% to 85%). In one study ( Thorstensson et al 2005) mean age was 56 years and 50% were female. In the study of Maurer and colleagues (1999) 58% of the patients were male. Duration of the disease ranged from 5 months to more than 10 years. Intervention type: From one study ( Ettinger click here et al 1997) we took the trial arm that examined resistance training versus a control group. From another study we took the trial arm that examined isokinetic exercise (group I) versus control ( Huang et al 2005), and in one study ( Fransen et al 2001) we classified the ‘group therapy’ as Code 2. One study examined two different strength training programs ( Topp et al 2002). The mean effects of these programs were combined and compared with the control group. Six studies were group-based, while the other six used individually delivered treatment. Five studies offered additional education and seven studies incorporated a home exercise program in the intervention.

The investigated study was performed on the extracellular synthes

The investigated study was performed on the extracellular synthesis of silver nanoparticles using a soil bacterium, B. subtilis A1. The silver nanoparticles showed a significant antibacterial activity toward the pathogens

and a significant geno-toxic effect within 12 h. This approach might serve as an alternate method in reducing the uptake of DNA by non-susceptible bacteria preventing the resurgence of resistant strains. All authors have none to declare. The authors thank the Department of Biotechnology (DBT), Government of India for the financial aid and Management of Sathyabama University for providing infrastructural facilities. The authors also acknowledge Mr. V. Naveen Kumar, Dept. of Microbiology, University Temozolomide in vivo of Madras for his valuable suggestions. “
“Heterocyclic systems with 3-azabicyclolnonane nucleus are present in the molecular structure of various diterpenoid/norditerpenoid alkaloids such as kobusine, hetisine, etc., and it has been isolated

from a range of plants including aconitum, thalictrum and spiraca species. 1 They are exhibits important biological actions such as antibacterial, antimycobacterial, anti-inflammatory, antifungal, Olaparib ic50 antiprotozoan, antitumor, anticonvulsant, antiviral, antimalarial, local anesthetic, cytotoxic, muscle relaxant, tyrosinase inhibitor, tranquilizer and nicotinic acetylcholine receptor activity. 2 Similarly, the biological activities of oxime ether pharmacophore –C N–O–R Cediranib (AZD2171) is also well documented. 3 The resistance towards available drugs is rapidly becoming a major worldwide problem. Nowadays the necessity to design new compounds to overcome this resistance has become one of the most important areas of research. Recently, we exploited the synthesis of 2,6-diarylpiperidin-4-one derivatives

with a view to combines various other bioactive heterocyclic nucleus such as1,2,3-thiadiazoles,4 diazepans,5 and 1,2,3-selenadiazoles6 intact for evaluation of related antibacterial and antifungal activities. In the view of the above mentioned facts and in continuation of our earlier interest in the synthesis of novel heterocycles, we cerebrated to design a system, which combines both bioactive azabicyclic oxime and cyclohexadienone components together to give a new series of compounds namely, 2,4-diaryl-3-azabicyclo[3.3.1]nonane-9-one-O-[2,4,6-tritertiarybutylcyclohexa-2,5-dienon-4-yl]oximes [9–12]. The aim of this work is to synthesize a novel series of compounds 9–12 and to investigate their antimicrobial and antioxidant activities by the modification of the para substitution on the phenyl rings. The structure of the synthesized compounds [9–12] is discussed with the help of melting points, elemental analysis, FT-IR, MS, 1H and 13C NMR spectra.

The effluent was analysed by APHA, 1981 3 The fresh material of p

The effluent was analysed by APHA, 1981.3 The fresh material of plant was collected from both sites non-polluted (ALTT Centre) and polluted (cycles manufacturing unit) area of Ghaziabad, UP, India. For colour reaction test Cromwell, 19554 & Trease and Evans, 19835 were followed. TLC was done According to the WHO, Geneva, 1998.6 Chlorophyll a, b and total chlorophyll (a + b) were determined according to Arnon, 1949.7 The effluent was analysed and the results are given in Table 1. The result shows the presence of alkaloids, saponin, tannin, lignin, protein, carbohydrate, suberin, glucoside, oil, sugars, steroids and absence of flavanoids in both the cases. Degree of change in colour reaction tests are

tabulated in Table 2. From the observation of TLC, it is found that the number of spots were higher in non-polluted plants than the polluted plants (Plate 1). The RF values are tabulated in Table 3. Chlorophyll a, chlorophyll b and R428 order total chlorophyll were observed 76.98%, 86.29% and 80.10% of control leaves samples (Plate 2). The results are tabulated in Table 4. The effluent samples collected from the industry selected for this study was

analysed for different physico-chemical parameters which showed higher values as compared to the standard values recommended by the Indian Standard Institute (I.S.I.; 1974, 1974 and 1977). Similar results were also obtained by Kumar, et al,1988.8 A critical observation on the data studied clearly indicate that plants growing at polluted sites were badly affected and there were a significant reduction INCB024360 nmr in number of parameters studied as compared to the plants growing at the control sites. Major qualitative changes, noticed under the impact of industrial effluent, are reduction in chlorophyll level, photosynthesis rate, accumulation of heavy metals, alternation in pH, BOD, COD, Colour, Temp, Odour, TS, TDS. Heavy metals resulted into reduced growth and yield in comparison to plant species growing at non-polluted sites. The impact of industrial effluent on the qualitative and quantitative

values of medicinal plants does not appear to have been undertaken much till now. Colour reaction tests showed the degree of changes in plants of polluted sites. From the observations some alteration in the bio-chemical parameters were also recorded in plants growing Dipeptidyl peptidase near the industrial effluent. The amount of chemical constituents found to have decreased in those plants which were growing in polluted areas. From the observations of TLC, it was seen that the number of spots were decreased in the plant samples of polluted sites. From the findings of this investigation it may be ascertained that there had been qualitative and quantitative alternations in the chemical constituents in the plants growing in industrial areas. It can also be stated that industrial pollution may also have lowered the drug potency of the plants growing in the vicinity of industries.

To our knowledge no literature is available in which research is

To our knowledge no literature is available in which research is described to what extent (older) adults who fulfil the recommendation of a minimum of 30 min on five days also meet the recommendation of vigorous intensity aerobic activity for a minimum of 20 min on three days each week. In our study population, 51% complied with the health recommendation. In comparison in the general Dutch population this is 60%. In our study population, 46% complied with both norms, compared to 62% of the Dutch and 49% of the US population (TNO 2008, CDC 2007).

More men than women fulfilled both norms, which is in accordance with data from the general Dutch population. Because Apoptosis Compound Library 42% of our study population did not fulfil one of the two recommendations, we hypothesise that this group is more prone to health problems, deterioration of their fitness and consequently losing their independence. In view of this, these people should be stimulated to become more physically active. In the latest ACSM recommendations (Franklin et al 2007), it is advised that every older adult should have an activity plan in consultation with a physician or health care provider. With respect to patients after total knee arthroplasty, this means that postoperative therapeutic and preventive recommendations should be integrated into management. With respect

to patients after total knee arthroplasty, regular physical activity is associated with improvement in strength, balance, and co-ordination, which has proven to be an effective

strategy in the prevention of falls. Adenylyl cyclase In the presence Selleck Buparlisib of a total knee arthroplasty, falls may result in periprosthetic fracture, implant loosening and/or dislocation of the prosthesis. Furthermore, there are indications that increased bone density due to physical activity improves prosthetic fixation, reducing the risk of loosening. Finally, physical activity might minimise bone loss due to stress shielding, facilitating future revision surgery if needed. On the other hand, preventive recommendations should include not only the stimulation of physical activity but also the education of patients regarding the risks of physical activity associated with a prosthetic knee – in particular the risks of athletic high-impact, high-demand activities (Healy et al 2000.) In general it can be stated that activities with highpeak loading, like running, cause more mechanical loading compared to low- and moderate-impact activities (such as walking, bicycling, and yoga/tai-chi), and may therefore cause more wear of the prosthesis (Stevens et al 2011). In this study 51% of people at least one year after total knee arthroplasty were physically active for a minimum of 30 min on five days a week and 53% undertook activity of vigorous intensity for a minimum of 20 min on three days a week. Although 46% complied with both recommendations, 42% did not fulfil either of the two recommendations. In stimulating physical activity emphasis should be laid on this latter group.