Two or four injections of platelet-rich plasma for osteoarthritic knee did not change synovial biomarkers but similarly improved clinical outcomes

AbstractWe compared two and four intra-articular injections of platelet-rich plasma (PRP) in terms of changes of synovial cytokines and clinical outcomes. One hundred twenty-five patients having knee osteoarthritis (OA) underwent PRP injections at a 6-week interval. Before each PRP injection, synovial fluid aspiration was collected for investigation. Patients were divided into two or four intra-articular PRP injections (group A and B, respectively). Changes in synovial biomarkers were compared with the baseline levels of both groups, and clinical outcomes were evaluated until one year. Ninety-four patients who had completed synovial fluid collection were included for final evaluation, 51 in group A and 43 in group B. There were no differences in mean age, gender, body mass index (BMI), and radiographic OA grading. The average platelet count and white blood cell count in PRP were 430,000/µL and 200/ µL, respectively. There were no changes of synovial inflammatory cytokines (IL-1β, IL-6, IA-17A, and TNF-alpha), anti-inflammatory cytokines (IL-4, IL-10, IL-13, and IL-1RA), and growth factors (TGF-B1, VEGF, PDGF-AA, and PDGF-BB) between baseline levels and six weeks in group A, and 18 weeks in group B. Both groups had significantly improved clinical outcomes from six weeks including visual analog scale (VAS), patient-reported outcome measures [PROMs; Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and Short Form-12 (SF-12)], with a significant delayed improvement of performance-based measures [PBMs; time up and go (TUG), 5-time sit to stand test (5 × SST), and 3-min walk test (3-min WT)]. In conclusion, two- or four-PRP intra-articular injection at a 6-week interval for knee OA demonstrated no changes of synovial cytokines and growth factors but similarly improved clinical outcomes from 6 weeks until 1 year.

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Two or four injections of leukocyte-poor platelet-rich plasma for osteoarthritic knee did not affect changes of synovial cytokines and growth factors but similarly improved clinical outcomes

10.21203/rs.3.rs-745615/v1 ◽

2021 ◽

Author(s):

Srihatach Ngarmukos ◽

Chotetawan Tanavalee ◽

Chavarin Amarase ◽

Suphattra Phakham ◽

Warayapa Mingsiritham ◽

...

Keyword(s):

Growth Factors ◽

Synovial Fluid ◽

Clinical Outcomes ◽

Inflammatory Cytokines ◽

Platelet Rich Plasma ◽

Knee Oa ◽

Group A ◽

Baseline Levels ◽

One Year ◽

Group B

Abstract We compared two and four intra-articular injections of platelet-rich plasma (PRP) in terms of changes of synovial cytokines and clinical outcomes. One hundred twenty-five patients having knee OA underwent leukocyte-poor PRP with a 6-week interval. Before each PRP injection, synovial fluid aspiration was collected for investigation. Patients were divided into two or four intra-articular PRP injections (group A and B, respectively). Changes in synovial cytokines and growth factors were compared with the baseline levels of both groups, and clinical outcomes were evaluated until one year. Ninety-four patients who had completed synovial fluid collection were included for final evaluation, 51 in group A and 43 in group B. There were no differences in mean age, gender, BMI, and OA grading. The average platelet count in PRP was 430,000/µL. There were no changes of synovial inflammatory cytokines (IL-1ß, IL-6, IA-17A, and TNF-alpha), anti-inflammatory cytokines (IL-4, IL-10, IL-13, and IL-1RA), and growth factors (TGF-B1, VEGF, PDGF-AA, and PDGF-BB) between baseline levels and six weeks in group A, and 18 weeks in group B. Both groups had significantly improved clinical outcomes from six weeks including visual analog scale (VAS), patient-reported outcome measure (PROM; WOMAC and SF-12), with a significant delayed improvement of performance-based measure [PBM; time up and go (TUG), 5-time sit to stand test (5×SST), and 3-minute walk test (3-min WT)]. In conclusion, two- or four-PRP injection at a 6-week interval for knee OA demonstrated no changes of synovial cytokines and growth factors but similarly improved clinical outcomes from 6 weeks until one year.

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Laser for post acne scars with or without growth factors: a comparative clinical trial

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200601 ◽

2020 ◽

Vol 6 (2) ◽

pp. 224

Author(s):

Lakkireddygari Sujana ◽

Balachandra S. Ankad ◽

Savitha L. Beergouder

Keyword(s):

Growth Factors ◽

Platelet Rich Plasma ◽

Objective Assessment ◽

Subjective Assessment ◽

Primary Objective ◽

Treatment Modalities ◽

Acne Scars ◽

New Strategy ◽

Group A ◽

Group B

Background: Treatment of acne scars presents a considerable challenge to dermatologists. But with advent of fractional CO2 (FCO2) laser and platelet-rich plasma (PRP), new avenues can be explored. PRP provides various growth factors, so that the healing of laser-damaged skin is accelerated. The aim of this study was to assess the efficacy and safety of FCO2 laser alone and in combination with PRP in patients with post-acne scars.Methods: Eighty patients with acne scars were counseled and randomly assigned into two groups of 40 each. Group A was treated with FCO2 laser alone, while Group B was treated with FCO2 laser and PRP for 6 months. Primary objective was assessment of efficacy of both treatment modalities. Secondary objective was evaluation of safety of treatments.Results: At the end of 6 months, group A showed about 18% reduction, while group B showed about 33% reduction in acne scars on objective assessment. Patient satisfaction as assessed by subjective assessment was greater in group B than in group A. Duration of erythema, edema and crusting was lesser in group B compared to group A.Conclusions: Combination of FCO2 and PRP was found to be more efficacious as compared to FCO2 laser alone. Combining the treatment modalities can provide a new strategy for treating the post-acne scars.

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Screw Fixation of the Posterior Malleolus Fragment in Ankle Fracture

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00318 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0031

Author(s):

Gi-Soo Lee ◽

Jaehwang Song

Keyword(s):

Fracture Healing ◽

Clinical Outcomes ◽

Ankle Joint ◽

Screw Fixation ◽

Short Form ◽

Articular Surface ◽

Ankle Fractures ◽

Posterior Malleolus ◽

Group A ◽

Group B

Category: Ankle; Trauma Introduction/Purpose: This study aimed to evaluate the outcomes of ankle fractures with posterior malleolus fragments (PMFs)involving <25% of the articular surface treated with or without screw fixation. Methods: Among patients with ankle fractures and PMFs who underwent surgery between March 2014 and February2017, 62 with type 1 PMFs involving <25% of the articular surface were included. Of these 62 patients, 32 underwent screw fixation for PMFs and lateral and/or medial malleolar fracture fixation (group A) and 30 underwent internal fixation for malleolar fractures without screw fixation for PMFs (group B). Ankle joint alignment and fracture healing were measured using plain radiography and computed tomography (CT). Clinical outcomes were determined using the American Academy of Orthopaedic Surgeons Foot and Ankle Questionnaire, Short Form-36, and American Orthopaedic Foot & Ankle Society Scale. Results: Nonunion was not noted in either group. However, we detected union with a step-off of 2 mm or more in2 cases from group B. With regard to ankle joint alignment, 1 case in group A and 3 cases in group B showed mild asymmetry of the medial and lateral clear spaces on CT at 12 months. Clinical outcomes at 6 and 12 months after surgery were better in group A than in group B. Conclusion: Screw fixation of PMFs was effective for fracture healing and maintaining ankle alignment. Additionally, it improved short-term clinical outcomes, which we believe was due to stabilization of ankle fractures with PMFs involving <25% of the articular surface.

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Incomplete footprint coverage under tension in repair of isolated supraspinatus full-thickness tear

Scientific Reports ◽

10.1038/s41598-021-86800-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tae-Hwan Yoon ◽

Sung-Jae Kim ◽

Yun-Rak Choi ◽

Du-Seong Kim ◽

Yong-Min Chun

Keyword(s):

Clinical Outcomes ◽

Structural Integrity ◽

Statistical Significance ◽

Radiographic Evaluation ◽

Full Thickness ◽

Limited Mobility ◽

Significant Difference ◽

Patient Reported ◽

Group A ◽

Group B

AbstractAlthough it is well known that repairing large or massive tears under tension may have an adverse effect on healing of the repaired tendons, only few studies have addressed this issue in medium-sized isolated supraspinatus full-thickness tear. The purpose of this study was to compare the clinical outcomes and structural integrity of arthroscopic rotator cuff repair with tension versus without it. This study retrospectively investigated 90 patients who underwent arthroscopic repair in a single-row for medium-sized isolated supraspinatus full-thickness tear. The patients were assigned to either repaired under tension (Group A, n = 38) or repaired without tension (Group B, n = 52) groups. Functional outcomes were assessed using the patient reported subjective values and the active range of motion (ROM). Postoperative radiographic evaluation was performed 6 months after the surgery to assess the structural integrity of the repaired tendons. Changes in the subjective shoulder scores from initial to 2 years after surgery showed no statistical significance between the two groups. The ROMs measured at initial and 2 years after surgery also showed no statistical difference between the two groups. Postoperative radiological evaluations found a significantly higher re-tear rate in Group A (28.9%, 11/38) than in Group B (9.6%, 5/52). The torn cuff tendons that were repaired under tension as retraction with limited mobility had significantly higher re-tear rate despite having immobilized for 6 weeks after surgery, but their clinical outcomes showed no significant difference from the outcomes of repaired tendons without tension.

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Stem Cell Surgery and Growth Factors in Retinitis Pigmentosa Patients: Pilot Study After Literature Review

10.20944/preprints201907.0347.v1 ◽

2019 ◽

Author(s):

Paolo Giuseppe Limoli ◽

Enzo Maria Vingolo ◽

Marco Ulises Morales ◽

Celeste Limoli ◽

Marcella Nebbioso

Keyword(s):

Growth Factors ◽

Retinitis Pigmentosa ◽

Platelet Rich Plasma ◽

Functional Results ◽

Point Of View ◽

Foveal Thickness ◽

Restoration Technique ◽

Number Of Patients ◽

Group A ◽

Group B

To evaluate whether autologous mesenchymal cells, adipose derived stem cells and platelet-rich plasma, grafted into the supracoroideal space by surgical treatment according to Limoli retinal restoration technique (LRRT), can produce growth factors in order to exert a beneficial effect in retinitis pigmentosa (RP) patients. Twenty-one eyes underwent surgery and divided based on retinal foveal thickness ≤ 190 or >190 µm into group A and group B, respectively. The specific LRRT triad was grafted in a deep scleral pocket above the choroid of each eye. At 6-month follow-up, group B showed an improvement in residual close-up visus and sensitivity at microperimetry compared to group A. After an in-depth review of molecular biology studies concerning degenerative phenomena underlying the etiopathogenesis of RP, it can be confirmed that further research is needed on tapeto-retinal degenerations both from a clinical and molecular point of view to obtain better functional results. In particular, it is necessary to increase the number of patients, extend observation times, and treat subjects in the presence of still trophic retinal tissue to allow adequate biochemical and functional catering.

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Screw Fixation of the Posterior Malleolus Fragment in Ankle Fracture

Foot & Ankle International ◽

10.1177/1071100719865895 ◽

2019 ◽

Vol 40 (11) ◽

pp. 1288-1294 ◽

Cited By ~ 7

Author(s):

Chan Kang ◽

Deuk-Soo Hwang ◽

Jeong-Kil Lee ◽

Yougun Won ◽

Jae-Hwang Song ◽

...

Keyword(s):

Fracture Healing ◽

Clinical Outcomes ◽

Ankle Joint ◽

Screw Fixation ◽

Short Form ◽

Articular Surface ◽

Ankle Fractures ◽

Posterior Malleolus ◽

Group A ◽

Group B

Background: This study aimed to evaluate the outcomes of ankle fractures with posterior malleolus fragments (PMFs) involving <25% of the articular surface treated with or without screw fixation. Methods: Among patients with ankle fractures and PMFs who underwent surgery between March 2014 and February 2017, 62 with type 1 PMFs involving <25% of the articular surface were included. Of these 62 patients, 32 underwent screw fixation for PMFs and lateral and/or medial malleolar fracture fixation (group A) and 30 underwent internal fixation for malleolar fractures without screw fixation for PMFs (group B). Ankle joint alignment and fracture healing were measured using plain radiography and computed tomography (CT). Clinical outcomes were determined using the American Academy of Orthopaedic Surgeons Foot and Ankle Questionnaire, Short Form-36, and American Orthopaedic Foot & Ankle Society Scale. Results: Nonunion was not noted in either group. However, we detected union with a step-off of 2 mm or more in 2 cases from group B. With regard to ankle joint alignment, 1 case in group A and 3 cases in group B showed mild asymmetry of the medial and lateral clear spaces on CT at 12 months. Clinical outcomes at 6 and 12 months after surgery were better in group A than in group B. Conclusion: Screw fixation of PMFs was effective for fracture healing and maintaining ankle alignment. Additionally, it improved short-term clinical outcomes, which we believe was due to stabilization of ankle fractures with PMFs involving <25% of the articular surface. Level of Evidence: Level II, prospective comparative study.

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Soluble Intercellular Adhesion Molecule-1 and Serum Cytokines in Melanoma Patients Treated with Liposomes Containing Muramyl Tripeptide

Tumori Journal ◽

10.1177/030089169508100306 ◽

1995 ◽

Vol 81 (3) ◽

pp. 185-190 ◽

Cited By ~ 1

Author(s):

Daniela Favaro ◽

Manuela Santarosa ◽

Michele Quaia ◽

Antonella Spada ◽

Andrea Freschi ◽

...

Keyword(s):

Cancer Patients ◽

Inflammatory Cytokines ◽

Intercellular Adhesion Molecule ◽

Intercellular Adhesion Molecule 1 ◽

Tnf Α ◽

Group A ◽

Melanoma Patients ◽

Ifn Γ ◽

Baseline Levels ◽

Group B

Aims and Background A soluble form of intercellular adhesion molecule-1 (sICAM-1) has been recently identified in patients with malignant melanoma. It has been demonstrated that inflammatory cytokines can modulate the cellular expression of ICAM-1 and the shedding of this molecule by cells. To our knowledge, few data exist on serum sICAM-1 levels in cancer patients treated with immunomodulators. Liposomes containing muramyl tripeptide (MLV MTP-PE) can activate monocytes from cancer patients in vitro and in vivo, making them cytotoxic such as tumor necrosis factor- α (TNF-α) and Interleukin-6 (IL-6). The purpose of the present study was to evaluate the levels of sICAM-1 and their possible correlation with serum inflammatory cytokine levels in melanoma patients treated with MLV MTP-PE. Methods The sera from 9 patients with metastatic melanoma treated with MLV MTP-PE, 4 mg i.v. twice a week for 12 weeks, were tested in ELISA system to detect sICAM-1, TNF-α, IL-6, Interleukin-1 β (IL- β) and Interferon-γ (IFN-γ) before, and 2 and 24 h after the 1st, 12th and 24th infusion of MLV MTP-PE. Results Baseline levels of sICAM-1 were elevated in all patients (median 540 ng/ml: range 400-1030 ng/ml). Twenty-four h after the 1st infusion of MLV MTP-PE, we observed 6 increases in sICAM-1 levels, 1 decrease and 2 stable values (median 720 ng/ml: range 410-1820; P = 0.060). Twenty-four h after the 12th infusion, sICAM-1 increased in 3 patients and did not change in 4 (median 790 ng/ml: range 495-1650 ng/ml; P = 0.069). At the 24th infusion, sICAM-1 increased in 4 of 6 evaluable patients and remained stable in 2 (median 802 ng/ml: range 510-1450 ng/ml; P = 0.045). To better analyze the variations in sICAM-1, the patients were arbitrarily divided into two groups according to their clinical behavior: 4 presented stabilization (all lesions, n = 2; some lesions, n = 2) (Group A); 5 presented progressive disease (Group B). In Group A, sICAM-1 levels remained stable or showed a modest increase during treatment (except in 1 patient, who exhibited a substantial variation after the 12th infusion). In contrast, in Group B very high levels of sICAM-1 were observed at the beginning of the study therapy in 1 patient and after the 1st infusion in 3 patients; these values remained high until the 24th infusion. In most of the patients, TNF-α and IL-6 increased after the 1st infusion, but not thereafter. IFN-γ was never detected; IL-1 β was detectable in a few cases, but only before the infusions. Conclusions baseline levels of sICAM-1 were elevated in all patients and further increased during treatment only in patients with more aggressive disease. No correlation was found between sICAM-1 and inflammatory cytokines. It would therefore seem that in patients with advanced disease, higher levels and a progressive increase in sICAM-1 may be unfavorable prognostic factors.

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Outcome of staged injection of autologous platelet rich plasma in treatment of mild to moderate knee osteoarthritis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20195160 ◽

2019 ◽

Vol 6 (1) ◽

pp. 26

Author(s):

Rajat Gupta ◽

Ram Avtar ◽

Krishan Kumar

Keyword(s):

Growth Factors ◽

Single Injection ◽

Platelet Rich Plasma ◽

Low Cost ◽

Biologically Active ◽

Plasma Injection ◽

Group A ◽

Autologous Platelet Rich Plasma ◽

Group B ◽

Autologous Platelet

Background: Autologous platelet-rich plasma (PRP) offers an easy solution for delivering multiple growth factors needed for tissue repair. Intra-articular injections of PRP have been proposed as a simple low cost minimally invasive way to obtain the concentration of growth factors and biologically active molecules to promote cartilage healing in osteoarthritic (OA) knee joint. The objective of the present study was designed to evaluate the clinical efficacy of autologous platelet rich plasma injection in mild to moderate osteoarthritic knee and to assess the role of serial staged autologous platelet rich plasma injection.Methods: 50 patients with mild to moderate osteoarthritis of knee were divided into two groups. Group A was given staged injection of freshly prepared autologous PRP in the affected knee. Group B was given single injection of PRP. The Results were evaluated on the basis of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire and visual analog scale (VAS) before treatment and 3 weeks, 8 weeks, 16 weeks and 24 weeks after treatment.Results: At 24-weeks follow up the following observations were made; the MeanVAS in Group A decreased to 3.30 whereas in Group B it increased to 4.54. The Mean WOMAC score in Group A was reduced to a mere28.64 in Group A and in Group B it was 39.76.Conclusions: It is concluded from our study that concomitant use of serial staged injection (two) of PRP over four months is more effective than single injection in patients with mild to moderate OA of knee.

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Effects of stent generation on clinical outcomes after acute myocardial infarction compared between prediabetes and diabetes patients

Scientific Reports ◽

10.1038/s41598-021-88593-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yong Hoon Kim ◽

Ae-Young Her ◽

Myung Ho Jeong ◽

Byeong-Keuk Kim ◽

Sung-Jin Hong ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Clinical Outcomes ◽

Secondary Outcome ◽

Drug Eluting Stent ◽

Diabetes Group ◽

Repeat Revascularization ◽

Group A ◽

Group B ◽

Diabetes Patients

AbstractWe investigated the effects of stent generation on 2-year clinical outcomes between prediabetes and diabetes patients after acute myocardial infarction (AMI). A total of 13,895 AMI patients were classified into normoglycemia (group A: 3673), prediabetes (group B: 5205), and diabetes (group C: 5017). Thereafter, all three groups were further divided into first-generation (1G)-drug-eluting stent (DES) and second-generation (2G)-DES groups. Patient-oriented composite outcomes (POCOs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcome. Stent thrombosis (ST) was the secondary outcome. In both prediabetes and diabetes groups, the cumulative incidences of POCOs, any repeat revascularization, and ST were higher in the 1G-DES than that in the 2G-DES. In the diabetes group, all-cause death and cardiac death rates were higher in the 1G-DES than that in the 2G-DES. In both stent generations, the cumulative incidence of POCOs was similar between the prediabetes and diabetes groups. However, in the 2G-DES group, the cumulative incidences of Re-MI and all-cause death or MI were significantly higher in the diabetes group than that in the prediabetes group. To conclude, 2G-DES was more effective than 1G-DES in reducing the primary and secondary outcomes for both prediabetes and diabetes groups.

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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