Computed Tomographic Evaluation of Bone Quality of the Mandible Reconstructed by Particular Cellular Bone and Marrow Combined with Platelet Rich Plasma

This study aimed to investigate the effect of combining an innovative bioceramic α-calcium sulfate hemihydrate (α-CSH, CaSO4⋅0.5H2O) bone graft and platelet-rich plasma (PRP) to accelerate bone healing and regeneration in a rabbit model. The bone graft material was implanted bilaterally on rabbit’s artificially maxillary sinus defects: the right maxillary sinus received α-CSH, while α-CSH combine with PRP (α-CSH/PRP) was grafted in left site. The quantity and quality of bone formation after implantation were analyzed radiographically and histologically at 1, 2, and 3 weeks. The micro-computed tomographic results indicated that the bone density of sinus implanted with α-CSH increased and defect volume decreased most after 2 weeks. In histological analysis, both hematoxylin and eosin and Masson trichrome staining of α-CSH/PRP displays better bone healing and regeneration progress than α-CSH after 2 weeks implantation. Therefore, the innovative α-CSH combined with PRP was revealed to be useful in accelerating bone healing and regeneration for the successful defect treatment.

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Evaluating the efficacy of intra-articular injections of platelet rich plasma (PRP) in rheumatoid arthritis patients and its impact on inflammatory cytokines, disease activity and quality of life.

Current Rheumatology Reviews ◽

10.2174/1573397116666201113090629 ◽

2020 ◽

Vol 16 ◽

Author(s):

Dalia S. Saif ◽

Nagwa N. Hegazy ◽

Enas S. Zahran

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Inflammatory Cytokines ◽

Platelet Rich Plasma ◽

Joint Inflammation ◽

Monthly Interval ◽

Post Injection ◽

Tnf Α

Background: Among rheumatoid arthritis patients (RA), general disease activity is well regulated by diseasemodifying anti-rheumatic medications (DMARDS), but sometimes local inflammation still persists among a few joints. Adjuvant modern molecular interventions as Platelet Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a proven effect in management of RA. We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and their impact on inflammatory cytokines IL1B , TNF α, local joint inflammation, disease activity and quality of life (QL). Methods: Open labeled parallel randomized control clinical trial was carried out on 60 RA patients randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections of PRP at monthly interval, Group 2: included 30 patients received single intra-articular injection of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline and at 3, 6 months post injection. Results: Patients of both groups showed improvements in their scores of evaluating tools at 3months post injection and this improvement was persistent in the PRP group up to 6 months post injection while it was continued only for 3 months in the steroid group. Conclusions: PRP is a safe, effective and useful therapy in treating RA patients who had insufficient response and persistent pain and inflammation in just one or two joints through its down regulating effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint inflammation, disease activity and QL.

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Microsurgical Anatomy of the Anterior Circulation of the Brain Adjusted to the Neurosurgeon’s Daily Practice

Brain Sciences ◽

10.3390/brainsci11040519 ◽

2021 ◽

Vol 11 (4) ◽

pp. 519

Author(s):

Tomas Poblete ◽

Daniel Casanova ◽

Miguel Soto ◽

Alvaro Campero ◽

Jorge Mura

Keyword(s):

Daily Practice ◽

Computed Tomographic Angiography ◽

Poor Quality ◽

Surgical Anatomy ◽

Microsurgical Anatomy ◽

Anterior Circulation ◽

Computed Tomographic ◽

Intrinsic Complexity ◽

Tomographic Angiography

The study of cerebrovascular anatomy can be difficult and may take time due to its intrinsic complexity. However, it can also be difficult for the following reasons: the excessive description of neuroanatomy making articles hard to read, the unclear clinical application of what is written, the use of simplified or intricate schematic drawings that are not always appropriate for effective teaching, the poor quality of neuroanatomy dissections and the use of unusual views of figures that are not strictly related to the most frequent neuroimages to be interpreted in daily practice. Because of this, we designed an article that incorporates original and accurate anatomical dissections in an attempt to improve its comprehensibility. Five formalin-fixed adult cadaveric heads, whose vessels were injected with a colored silicone mixture (red for arteries and blue for veins), were dissected and examined under a microscope with magnifications from 3× to 40×. Special emphasis has been placed on correlating topographic anatomy with routine neuroimaging studies from computed tomographic angiography (CTA) and digital subtraction angiography (DSA). The essential surgical anatomy in a neurosurgeon’s daily practice is also described. The cadaveric dissections included in this study contribute to the understanding of the cerebrovascular anatomy necessary for the neurosurgeon’s daily practice.

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Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies’ Guidelines

Pharmaceuticals ◽

10.3390/ph14030205 ◽

2021 ◽

Vol 14 (3) ◽

pp. 205

Author(s):

Dragan Primorac ◽

Vilim Molnar ◽

Vid Matišić ◽

Damir Hudetz ◽

Željko Jeleč ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Platelet Rich Plasma ◽

Symptom Relief ◽

Topical Administration ◽

Symptomatic Therapy ◽

Therapy Options ◽

Professional Societies ◽

Inflammatory Drugs ◽

The Right

Osteoarthritis is the most common musculoskeletal progressive disease, with the knee as the most commonly affected joint in the human body. While several new medications are still under research, many symptomatic therapy options, such as analgesics (opioid and non-opioid), nonsteroid anti-inflammatory drugs, symptomatic slow-acting drugs in osteoarthritis, and preparations for topical administration, are being used, with a diverse clinical response and inconsistent conclusions across various professional societies guidelines. The concept of pharmacogenomic-guided therapy, which lies on principles of the right medication for the right patient in the right dose at the right time, can significantly increase the patient’s response to symptom relief therapy in knee osteoarthritis. Corticosteroid intra-articular injections and hyaluronic acid injections provoke numerous discussions and disagreements among different guidelines, even though they are currently used in daily clinical practice. Biological options, such as platelet-rich plasma and mesenchymal stem cell injections, have shown good results in the treatment of osteoarthritis symptoms, greatly increasing the patient’s quality of life, especially when combined with other therapeutic options. Non-inclusion of the latter therapies in the guidelines, and their inconsistent stance on numerous therapy options, requires larger and well-designed studies to examine the true effects of these therapies and update the existing guidelines.

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Dietary hybrid phytase and carbohydrases on nutrient digestibility and bone quality of broiler chickens

Pesquisa Agropecuária Brasileira ◽

10.1590/s1678-3921.pab2021.v56.01668 ◽

2021 ◽

Vol 56 ◽

Author(s):

Caroline Bavaresco ◽

Everton Luis Krabbe ◽

Diego Surek ◽

Edenilse Gopinger ◽

Fernando Nicolas Martinez ◽

...

Keyword(s):

Bone Quality ◽

Broiler Chickens ◽

Basal Diet ◽

Positive Control ◽

Nutrient Digestibility ◽

Metabolizable Energy ◽

Available P ◽

Available Phosphorus ◽

Poultry Diets

Abstract The objective of this work was to evaluate the effect of the use of hybrid phytase, alone or combined with carbohydrases, in poultry diets with nutritional reductions of calcium, available phosphorus, and metabolizable energy on the nutrient digestibility and bone quality of broiler chickens. A total of 1,875 broilers were distributed in five treatments in a completely randomized design, with 15 replicates of 25 chickens each. The treatments consisted of a positive control feed (T1) and of four negative controls (T2 to T5): T1, basal diet (BD) with corn and soybean; T2 and T3, BDs with reductions of 70 and 100 kcal kg-1 metabolizable energy, respectively, and both with reductions of 0.16% Ca and 0.15% available P; and T4 and T5, BDs with the same nutritional reductions, but supplemented with enzymes, i.e., T4 = T2 + 500 phytase units (FTU) per kilogram and T5 = T3 + 500 FTU kg-1 + 560 xylanase units (TXU) per kilogram + 250 glucanase units (TGU) per kilogram. The use of 500 FTU kg-1 hybrid phytase in pelleted corn-soybean meal diets allows a good digestive performance by broilers and replaces the nitrogen-corrected apparent metabolizable energy at 70 kcal kg-1, as well as 0.16% Ca and 0.15% available P.

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Impact of radiofrequency ablation (RFA) on bone quality in a murine model of bone metastases

PLoS ONE ◽

10.1371/journal.pone.0256076 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256076

Author(s):

Soroush Ghomashchi ◽

Cari M. Whyne ◽

Tricia Chinnery ◽

Fayez Habach ◽

Margarete K. Akens

Keyword(s):

Radiofrequency Ablation ◽

Bone Metastases ◽

Tumor Cells ◽

Bone Quality ◽

Second Harmonic ◽

Local Treatment ◽

Skeletal Metastases ◽

The Impact ◽

Surrounding Bone

Thermal therapies such as radiofrequency ablation (RFA) are gaining widespread clinical adoption in the local treatment of skeletal metastases. RFA has been shown to successfully destroy tumor cells, yet the impact of RFA on the quality of the surrounding bone has not been well characterized. RFA treatment was performed on femora of rats with bone metastases (osteolytic and osteoblastic) and healthy age matched rats. Histopathology, second harmonic generation imaging and backscatter electron imaging were used to characterize changes in the structure, organic and mineral components of the bone after RFA. RFA treatment was shown to be effective in targeting tumor cells and promoting subsequent new bone formation without impacting the surrounding bone negatively. Mineralization profiles of metastatic models were significantly improved post-RFA treatment with respect to mineral content and homogeneity, suggesting a positive impact of RFA treatment on the quality of cancer involved bone. Evaluating the impact of RFA on bone quality is important in directing the growth of this minimally invasive therapeutic approach with respect to fracture risk assessment, patient selection, and multimodal treatment planning.

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Hope, Hype, Hurdles & Future Perspective for PRP, PRP versus Hyaluronic Acid Injection in Osteoarthritis of Knee: A Review Article.

Biologic Orthopedics Journal ◽

10.22374/boj.v2i1.6 ◽

2020 ◽

Vol 2 (1) ◽

pp. e1-e12

Author(s):

Ashok Kumar ◽

Anikait Ghosh Kadamb ◽

Krish Ghosh Kadamb

Keyword(s):

Hyaluronic Acid ◽

Knee Joint ◽

Platelet Rich Plasma ◽

Future Perspective ◽

Osteoarthritis Of The Knee ◽

Stiff Knee ◽

Injection Interval ◽

One Year

BackgroundComparative studies of platelet-rich plasma (PRP) and hyaluronic acid show variable results. PurposeA review was conducted to understand the current role of PRP and its efficacy versus hyaluronic acid in osteoarthritis (OA) of the knee joint. MethodsOut of 170 identified studies, 14 studies involving 1575 patients with 637 males and 938 females were selected based on PRISMA flow chart guidelines and were analyzed for the study. ResultsA standard PRP regimen consisting of 2–3 intra-articular injections (IA) of 4–6 mL of leucocyte poor PRP at 1–2 weekly intervals provides a better result than HA during the first 3–6 months, and which may continue up to one year. PRP and HA may have synergistic effect; pain and swelling are the two most com-mon complications with PRP, the incidence is more with leucocyte rich PRP (LP-PRP) and intra-osseous PRP treatment.ConclusionPRP provides hope and is more effective than hyaluronic acid in pain relief and improving the quality of life in mild to moderate osteoarthritis of the knee joint. However, hype, that is effective in all, irrespective of grades of OA, mal-aligned or stiff knee, ligamentous laxity, and can avoid joint replacement is a big hindrance in establishing it as a preferred treatment in OA knee. The author follows the above-mentioned PRP regimen; and recommends to combine leucocyte poor PRP with HA for IA injections & with LP-PRP injections along with the two most common painful points (medial collateral ligament, pesanisernius) in a highly painful OA knee. PRP may not address extra-articular causes of knee pain (mal-alignment, muscle wasting, tendinosis), should be corrected for optimum outcome. Contact sports, running, exercises putting pressure on knee and NSAID should be avoided during PRP treatment. Also, more randomized controlled trials are required to further standardize the PRP preparation, administration, injection interval & proper documentation of efficacy and complications in the regenerative registry.

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Comparison between ultra-high-resolution computed tomographic angiography and conventional computed tomographic angiography in the visualization of the subcallosal artery

Surgical Neurology International ◽

10.25259/sni_887_2021 ◽

2021 ◽

Vol 12 ◽

pp. 528

Author(s):

Yoshimichi Sato ◽

Toshiki Endo ◽

Shingo Kayano ◽

Hitoshi Nemoto ◽

Kazuki Shimada ◽

...

Keyword(s):

High Resolution ◽

Evaluation Method ◽

Computed Tomographic Angiography ◽

Anterior Communicating Artery ◽

Exact Test ◽

Computed Tomographic ◽

Small X ◽

Tomographic Angiography ◽

Better Than

Background: The subcallosal artery (ScA) is a single dominant artery arising from the anterior communicating artery. Its injury causes amnesia and cognitive disturbance. The conventional computed tomographic angiography (C-CTA) is a common evaluation method of the intracranial artery. However, to image tinny perforating arteries such as the ScA is technically demanding for C-CTA. The purpose of this study is to investigate whether the ultra-high-resolution CTA (UHR-CTA) could image the ScA better than C-CTA. UHR-CTA became available in clinical practice in 2017. Its novel features are the improvement of the detector system and a small X-ray focus. Methods: Between April 2019 and May 2020, 77 and 49 patients who underwent intracranial UHR-CTA and C-CTA, respectively, were enrolled in this study. Two board-certified neurosurgeons participated as observers to identify the ScA based on UHR-CTA and C-CTA images. Results: UHR-CTA and C-CTA detected the ScA in 56–58% and 30–40% of the patients, respectively. In visualization of the ScA, UHR-CTA was better than C-CTA (P < 0.05, Fisher’s exact test). Between the two observers, the Cohen’s kappa coefficient was 0.77 for UHR-CTA and 0.78 for C-CTA. Conclusions: UHR-CTA is a simple and accessible method to evaluate intracranial vasculature. Visualization of the ScA with UHR-CTA was better than that with C-CTA. The high quality of UHR-CTA could provide useful information in the neurosurgery field.

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