Referral Efficiency for Veterans with Osteoarthritis: A Quality Improvement Project.

Management of osteoarthritis, a common disease among veterans, includes referrals to orthopedic specialists. This requires an effective referral system. The aim of this study was to evaluate a quality improvement project addressing inefficiencies in the osteoarthritis referral process between primary care providers and orthopedic specialists.

Impaired complex-I-linked respiration and ATP synthesis in primary open-angle glaucoma patient lymphoblasts.

Purpose: Following the recent demonstration of increased mitochondrial DNA mutations in lymphocytes of POAG patients, the authors sought to characterize mitochondrial function in a separate cohort of POAG.

Methods: Using similar methodology to that previous applied to Leber's hereditary optic neuropathy (LHON) patients, maximal adenosine triphosphate (ATP) synthesis and cellular respiration rates, as well as cell growth rates in glucose and galactose media, were assessed in transformed lymphocytes from POAG patients (n = 15) and a group of age- and sex-matched controls (n = 15).

Results: POAG lymphoblasts had significantly lower rates of complex-I-driven ATP synthesis, with preserved complex-II-driven ATP synthesis.

Mitochondrial dysfunction in glaucoma and emerging bioenergetic therapies.

The similarities between glaucoma and mitochondrial optic neuropathies have driven a growing interest in exploring mitochondrial function in glaucoma. The specific loss of retinal ganglion cells is a common feature of mitochondrial diseases - not only the classic mitochondrial optic neuropathies of Leber's Hereditary Optic Neuropathy and Autosomal Dominant Optic Atrophy - but also occurring together with more severe central nervous system involvement in many other syndromic mitochondrial diseases. The retinal ganglion cell, due to peculiar structural and energetic constraints, appears acutely susceptible to mitochondrial dysfunction.