scholarly journals Efficacy and safety of autologous adipose-derived stromal vascular fraction enriched with platelet-rich plasma in flap repair of transsphincteric cryptoglandular fistulas

2021 ◽  
Author(s):  
W. R. Schouten ◽  
J. H. C. Arkenbosch ◽  
C. J. van der Woude ◽  
A. C. de Vries ◽  
H. P. Stevens ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Clinical Signs ◽  
Stromal Vascular Fraction ◽  
Fistula Tract ◽  
Internal Opening ◽  
Efficacy And Safety ◽  
Total Study Population ◽  
Tertiary Referral Center ◽  
Flap Repair ◽  
Fistula Healing

Abstract Background Transanal advancement flap repair of transsphincteric fistulas is a sphincter-preserving procedure, which frequently fails, probably due to ongoing inflammation in the remaining fistula tract. Adipose-derived stromal vascular fraction (SVF) has immunomodulatory properties promoting wound healing and suppressing inflammation. Platelet-rich plasma (PRP) reinforces this biological effect. The aim of this study was to evaluate the efficacy and safety of autologous adipose-derived SVF enriched with PRP in flap repair of transsphincteric cryptoglandular fistulas. Methods A prospective cohort study was conducted including consecutive patients with transsphincteric cryptoglandular fistula in a tertiary referral center. During flap repair, SVF was obtained by lipoharvesting and mechanical fractionation of adipose tissue and combined with PRP was injected around the internal opening and into the fistulous wall. Endpoints were fistula healing at clinical examination and fistula closure on postoperative magnetic resonance imaging (MRI). Adverse events were documented. Results Forty-five patients with transsphincteric cryptoglandular fistula were included (29 males, median age 44 years [range 36–53 years]). In the total study population, primary fistula healing was observed in 38 patients (84%). Among the 42 patients with intestinal continuity at time of surgery, primary fistula healing was observed in 35 patients (84%). In one patient, the fistula recurred, resulting in a long-term healing rate of 82%. MRI, performed in 37 patients, revealed complete closure of the fistula tract in 33 (89.2%). In the other patients, the tract was almost completely obliterated by scar tissue. During follow-up, none of these patients showed clinical signs of recurrence. The postoperative course was uneventful, except for three cases; venous thromboembolism in one patient and bleeding under the flap, necessitating intervention in two patients. Conclusions Addition of autologous SVF enriched with PRP during flap repair is feasible, safe and might improve outcomes in patients with a transsphincteric cryptoglandular fistula. Trial registration Dutch Trial Register, Trial Number: NL8416, https://www.trialregister.nl/

627-P: Efficacy and Safety of Allogeneic Platelet Rich Plasma in Treatment of Diabetic Patients with Lower Limb Ulcers: A Pilot Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 627-P
Author(s):  
WUQUAN DENG ◽  
MIN HE ◽  
BING CHEN ◽  
YU MA ◽  
DAVID ARMSTRONG ◽  
...  
Keyword(s):  
Pilot Study ◽  
Lower Limb ◽  
Platelet Rich Plasma ◽  
Diabetic Patients ◽  
Efficacy And Safety

Immune-Mediated Neutropenia in a Miniature Poodle

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Benjamin Brunson
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Tertiary Referral Center ◽  
Immune Mediated ◽  
Specialized Equipment ◽  
History Of ◽  
Light Sedation ◽  
The Right

ABSTRACT A 10 yr old spayed female toy poodle was presented to a tertiary referral center for a 10 day history of waxing and waning lethargy, vomiting, diarrhea, and anorexia. An immune-mediated neutropenia (IMN) was suspected to be the underlying cause of her clinical signs. A bone marrow aspirate was obtained from the chostochondral junction of the 11th and 12th ribs on the right side and provided a definitive diagnosis of IMN. A positive response to therapy and repeat blood work further confirmed the diagnosis. Obtaining bone marrow aspirates from the chostochondral junction is a safe, cheap, and reliable method of diagnosing IMN and can be performed in the private practice setting with light sedation and minimal need for specialized equipment.

scholarly journals Use of Seton in Management of High Variety of Anal Fistula

2017 ◽  
Vol 8 (2) ◽  
pp. 100-104
Author(s):  
Mohammad Noor A Alam ◽  
Sharmin Abbasi
Keyword(s):  
Anal Fistula ◽  
Low Cost ◽  
Dentate Line ◽  
Internal Opening ◽  
Efficacy And Safety ◽  
Medical College ◽  
Small Channel ◽  
A Prospective Study ◽  
Low Rate

Background: Anal fistula is an abnormal communicative small channel that has an internal opening and an external opening and connected by the primary track. Our study evaluate the effectiveness of seton in high variety anal fistula.Objectives: Evaluation the efficacy and safety of seton as surgical management of high anal fistula. Methods: This is a prospective study done on 57 patients in BIRDEM hospital and some other clinic of Dhaka city in 3 years period with high variety of anal fistula which is above the dentate line and were treated with seton .Outcome measured during follow up period were- successfully healed, recurrence, incontinence, percentage of complications and patients satisfaction.Result: Among 57 patients mean age was 38.2+_6.8 years. Overall outcome of the patients showed-fistula completely healed in 51 patients, incontinence occurred in 2 patients and recurrence occurred in 4 patients.Conclusion: Seton is relatively safe, effective and low cost for the management of high anal fistula with low rate of incontinence. It can therefore, be recommended as the standard of treatment for high variety fistula in ano.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 100-104

scholarly journals Efficacy and safety of treatment of hyposecretory dry eye with platelet‐rich plasma

2018 ◽  
Vol 97 (2) ◽  
Author(s):  
Víctor García‐Conca ◽  
Marta Abad‐Collado ◽  
Jose R Hueso‐Abancens ◽  
Encarna Mengual‐Verdú ◽  
David P Piñero ◽  
...  
Keyword(s):  
Dry Eye ◽  
Platelet Rich Plasma ◽  
Efficacy And Safety

scholarly journals A comparative study in the management of fistula in ANO using various modalities

2018 ◽  
Vol 5 (6) ◽  
pp. 2223 ◽  
Author(s):  
Ramachandra M. L. ◽  
Mayank Garg
Keyword(s):  
Fistulous Tract ◽  
Selection Method ◽  
Fistula Tract ◽  
Internal Opening ◽  
Necrotic Tissue ◽  
Fistula In Ano ◽  
Sphincter Function ◽  
Medical College ◽  
Operative Complications ◽  
Comparative Prospective Study

Background: Fistula in ano is a track that connects deeply the anal canal or rectum to the skin around the anus. Fistula in ano most commonly follows an anorectal sepsis1. The main principles of management of anal fistula are closure of internal opening of fistula tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post-operative complications, mean hospital stay in the treatment of fistula in ano using various modalities like fistulotomy, fistulectomy, setons and lift procedure.Methods: This is a randomised, comparative, prospective study of 80 cases of fistula in ano, presenting at surgical opd of K.R. Hospital, Mysore attached to Mysore Medical College and research Institute. Out of which, 20 cases are treated by fistulectomy, 20 by seton, 20 by fistulotomy and the rest 20 cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2016 to 31st October 2017.Results: Most common age of presentation is 31-40 years and more common in males then females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients undergoing fistulectomy. Per operative course of LIFT procedure patients was complication free. Postoperative pain seen more in patients undergoing setons procedure.Conclusions: we conclude that LIFT procedure and Fistulotomy were acceptable procedures for simple, uncomplicated low lying and high lying fistula.

scholarly journals Long-Term Control of Urinary Free Cortisol With Osilodrostat in Patients With Cushing’s Disease: Final Results From the LINC 2 Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A521-A522
Author(s):  
Maria Fleseriu ◽  
Beverly M K Biller ◽  
Jerome Bertherat ◽  
Jacques Young ◽  
Giorgio Arnaldi ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Cushing’S Disease ◽  
Clinical Signs ◽  
Urinary Free Cortisol ◽  
Cushing's Disease ◽  
Efficacy And Safety ◽  
Entire Treatment Period ◽  
Free Cortisol ◽  
Long Term Treatment

Abstract Introduction: During the 22-week core LINC 2 study, the oral 11β-hydroxylase inhibitor osilodrostat normalized mean urinary free cortisol (mUFC) in 79% (15/19) of patients with Cushing’s disease. This report describes long-term LINC 2 efficacy and safety results following an optional extension. Methods: Patients receiving clinical benefit at week 22 could enter the extension (that ran until Oct 22, 2019), continuing the same osilodrostat dose; dose adjustments were permitted based on efficacy and safety. Response rate (mUFC ≤ULN [controlled] or mUFC >ULN but ≥50% decrease from baseline [BL; partially controlled]) was assessed over time. Efficacy/safety were assessed for all patients from core BL until study end. Results: Of 19 enrolled patients (female:male 14:5; mean [SD] age 36.8 years [8.4]), 16 entered the optional extension and 8 of them remained on treatment until study end. Median (range) osilodrostat exposure was 282 weeks (2-351). Mean mUFC decreased from BL (9.9 x ULN) to ≤ULN by week 4 and remained stable throughout the study. All 19 patients achieved mUFC ≤ULN at least once during the study. At each assessment up to month 70 of the extension phase, 50-88% of ongoing patients were controlled, and up to 18% were partially controlled. Mean percentage change in clinical signs from BL (mean [SD]) to last assessment were: fasting plasma glucose, -10.8% (22.1) (from BL: 105.6 mg/dL [49.2]); HbA1c, -2.1% (9.0) (from BL: 5.7% [0.7]); systolic BP, -3.3% (12.6) (from BL: 132.6 mmHg [11.6]); diastolic BP, -2.0% (10.4) (from BL: 85.0 mmHg [6.5]); BMI, -5.9% (8.8) (from BL: 30.7 kg/m2 [7.0]). Overall, 9 patients discontinued treatment (n=2 core and n=7 extension), mostly because of AEs or no longer requiring treatment (n=3 each). The most common AEs during the entire treatment period were nausea (n=10), adrenal insufficiency, and headache (both n=9). AEs related to hypocortisolism and adrenal hormone precursor accumulation occurred in 11 (mostly adrenal insufficiency, n=9) and 12 patients (mostly hypertension, n=4), respectively; most were grade 1/2 and managed with dose adjustment/interruption and/or concomitant medication. Mean (SD) plasma ACTH increased from 1.8 x ULN (0.9) at BL to 7.1 x ULN (12.3) at week 22 and 6.9 x ULN (12.6) at last assessment. Mean (SD) 11-deoxycortisol increased from 1.2 x ULN (1.3) at BL to 13.6 x ULN (12.2) at week 22 and 3.6 x ULN (4.2) at last assessment. In females, mean (SD) testosterone increased from 0.8 x ULN (0.4) at BL to 2.4 x ULN (2.1) at week 22 and 1.0 x ULN (0.9) at last assessment. Two patients, both female, reported an AE of hirsutism. Conclusions: Rapid reductions in mUFC were sustained for up to 6 years of osilodrostat treatment and were accompanied by improvements in clinical signs of hypercortisolism. Osilodrostat was well tolerated, with no new safety signals during long-term treatment.

scholarly journals Efficacy and safety of selamectin of flea infestation in dags

2018 ◽  
Vol 53 (1) ◽  
pp. 78
Author(s):  
S. SOTIRAKI (Σ. ΣΩΤΗΡΑΚΗ) ◽  
C. HIMONAS (Χ. ΧΕΙΜΩΝΑΣ) ◽  
P. DEBOUCK ◽  
G. BITSAS (Γ. ΜΠΙΤΖΑΣ)
Keyword(s):  
Adverse Drug Reactions ◽  
Clinical Signs ◽  
Untreated Group ◽  
Field Conditions ◽  
Efficacy And Safety ◽  
Drug Reactions ◽  
Flea Infestation ◽  
Highly Effective ◽  
Monthly Dose ◽  
Adult Flea

The study was conducted at three dog shekers in Thessaloniki Greece, το confirm die efficacy and safety of selamectin aτ a minimum dosage of 6 mg/kg adminisτered topically as a monthly dose repeaτed three times in die treatment of natural i n f l a t i o n s of Ctenocephalides spp. Twenty (20) dogs, with confirmed naturally acquired flea inflations, were enrolled in die sttidy as primary patiems. All animals completed the study on day 90. Twenty-two in cornai dogs were also treated but not evaluated for efficacy (secondary patiems). There was no untreated group. Only one live adult flea was recovered on only one animal on study day 30, a reduction of die geomettical mean of 99.7 % (p < 0.0001) compared to the sτarτ of die study. Dead fleas were found on 3 animals aτ day 30 (1 or 2 per animal). No live or dead fleas were found on day 60 or on day 90. Ατ sttidy beginning on Day 0, seventy percem of sttidy animals had various clinical signs of flea inflation. These signs gradually decreased and by die end of die sttidy on day 90, only one animal remained widi a score of 1, indicating a low imensity in a single area of die body. All odier animals were free of clinical signs. No abnormal clinical signs or suspend adverse drug reactions were observed after treatment of die 20 primary or die 22 secondary patiems. The daτa collected confirm that under field conditions diree consecutive mondily doses of selamectin are highly effective and safe in die treatment and comrol of fleas in dogs.

scholarly journals Adipose tissue derived stromal vascular fraction transplantation can recover spinal cord injury in mice

2016 ◽  
Vol 3 (04) ◽  
pp. 144 ◽  
Author(s):  
Hau Thi-My Lam ◽  
Minh Nguyen-Thu Tran ◽  
Khoa Anh Bui ◽  
Thao Thi-Thu Le ◽  
Khanh Hong-Thien Bui ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adipose Tissue ◽  
Mouse Model ◽  
Platelet Rich Plasma ◽  
Stromal Vascular Fraction ◽  
Paracrine Factors ◽  
Diabetic Ulcer ◽  
Motor Test ◽  
Cord Injury

Introduction: Stem cell therapy is one of the most promising therapies for degenerative diseases and related injuries. Adipose tissue derived stem cells (ADSCs) exhibit some particular properties such as high production of paracrine factors. Indeed, ADSCs have been successfully used to treat diseases, including osteoarthritis, diabetic ulcer, etc. Methods: In this study, ADSCs were used to treat spinal cord injury (SCI) in a mouse model. Non-expanded ADSCs, from stromal vascular fractions (SVFs) isolated from both autologous and allogeneic adipose tissues, were injected into injured sites of mice at a specified dose. The SCI mouse model were generated by transection of spinal cord at vertebrae T8 - T10. After 1 week of transection, mice exhibiting completed SCI were divided into 4 groups: group 1 was control (mice without any treatment), group 2 was placebo (mice treated with platelet rich plasma (PRP)), group 3 was allogeneic SVF transplantation (mice treated with allogeneic SVFs), and group 4 was autologous SVF transplantation (mice treated with autologous SVFs). For the treatment groups, mice were transplanted with 20 µL of activated PRP or/and with 106 cells of SVF (allogeneic or autologous) into the injured position through laminectomy. The recovery of SCI was evaluated by locomotor test, sensory test and sensory-motor test at 5 weeks after transplantation. The histology of the spinal cord also was checked after 5 weeks. Results: The results showed that in all groups with PRP injected with or without SVFs, the inflammation was efficiently controlled. The glial scar as well as myelin defragmentation were clearly reduced. However, a significant improvement of BBB score was only recorded in mice transplanted with autologous SVFs. Conclusion: The results of our study show that autologous SVF transplantation in combination with PRP can be a promising therapy for SCI.

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