EP.FRI.154 Could Antiangiogenic Drugs be the Solution to Tendon Injury? A Literature Review on the use of Antiangiogenic Drugs for Tendon Regeneration

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Chris Kirchhoff
Keyword(s):  
Literature Review ◽  
Surgical Intervention ◽  
Healing Process ◽  
Intervention Group ◽  
Tendon Healing ◽  
Flow Diagram ◽  
Current Evidence ◽  
Control Group ◽  
Cross Sectional ◽  
Antiangiogenic Drugs

Abstract Background Tendinopathy accounts for more than half of reported musculoskeletal injuries worldwide. The subsequent healing process results in a disorganised tendon structure secondary to neovascularisation, forming a bulky tendon with overall reduced strength. Current treatment options remain controversial as re-rupture rates following surgical intervention are high. It has been proposed that the use of anti-vascular endothelial growth factors could improve tendon healing. Methods This literature review employed a systematic approach. The search strategy incorporated an adjusted PICO format and PRISMA flow diagram. Search findings were critically appraised using the CASP tool checklist. Identified studies investigated the effect of injectable anti-angiogenic drugs on tendon healing.  Results Three final studies were identified. Tempfer et al. showed a reduction in cross sectional tendon area in the intervention group (5.6mm²+1.8), comparatively to the control group (9.1mm² +2.0), and increased tendon strength in the intervention group (47.7N+6.41) comparatively to the control group(32.41N+9.23). Dallaudiere (2014) et al. showed reduced cross-sectional area in the intervention group (0.95mm²+0.01) compared with the control group (0.75mm²+0.01). Dallaudiere (2013) et al. also showed reduced cross sectional areas in the intervention group (1.10mm²+0.01) compared with the control group (1.11mm²+0.03).  Conclusion All studies supported the use of anti-angiogenic drugs to support tendon healing. The use of injectable anti-angiogenic drugs may potentially serve in conjunction with surgical intervention or as an alternative minimally invasive intervention to improve tendon rehabilitation. This review recommends that further randomised control studies will be needed to strengthen the current evidence. 

scholarly journals 1298 Could Antiangiogenic Drugs Be the Solution to Tendon Injury? A Literature Review on The Use of Antiangiogenic Drugs for Tendon Regeneration

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Kirchhoff
Keyword(s):  
Literature Review ◽  
Intervention Group ◽  
Tendon Healing ◽  
Tendon Injury ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Antiangiogenic Drugs

Abstract Aim Tendinopathy accounts for more than half of reported cases of musculoskeletal injuries worldwide. The subsequent healing process results in a disorganised tendon structure secondary to increased neovascularisation, forming a bulky tendon with overall reduced strength. Current treatment options remain controversial as re-rupture rates following surgical interventions are high. It has been proposed that the use of anti-vascular endothelial growth factors could improve tendon healing. Method This literature review employed a systematic approach. The search strategy incorporated an adjusted PICO format and PRISMA flow diagram. Search findings were critically appraised using the CASP tool checklist. Identified studies investigated the effects of injectable anti-angiogenic drugs following tendon injury. Results Three final studies were identified. Tempfer et al. showed a reduction in cross sectional tendon area in the intervention group (5.6mm² +1.8), comparatively to the control group (9.1mm² +2.0), and increased tensile tendon strength in the intervention group (47.7N+6.41) comparatively to the control group(32.41N+9.23). Dallaudiere (2014) et al. showed a reduced cross-sectional area in the intervention group (0.95mm²+0.01) compared with the control group (0.75mm²+0.01). Dallaudiere (2013) et al. also showed a reduced cross-sectional area in the intervention group (1.10mm²+0.01) compared with the control group (1.11mm²+0.03). Conclusions All studies supported the use of anti-angiogenic drugs to support tendon healing. The use of injectable anti-angiogenic drugs may potentially serve in conjunction with surgical interventions or as an alternative minimally invasive intervention to improve tendon rehabilitation. This review recommends that further randomised control studies could be used to strengthen the current promising evidence base.

scholarly journals THE IMPACT OF COMBINATION OF BREASTFEEDING AND EFFLEURAGE MASSAGE IN REDUCING PAIN RESPONSE IN INFANTS INDUCED BY BLOOD SAMPLING IN C-REACTIVE PROTEIN TEST: AN OBSERVATIONAL CROSS-SECTIONAL STUDY

2018 ◽  
Vol 4 (2) ◽  
pp. 242-248
Author(s):  
Alfi Maziyah ◽  
Diyah Fatmasari ◽  
Desak Made Wenten Parwati ◽  
Rr. Sri Endang Pujiastuti
Keyword(s):  
Intervention Group ◽  
Cross Sectional Study ◽  
Blood Sampling ◽  
Control Group ◽  
Pain Response ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Massage Group

Background: C-reactive protein test is one of clinical assessments to minimize risks of infection in infants. However, its procedure may cause pain. Pain in the infant may result in negative metabolic behavior, physiology and metabolic response. Objective: This study was to describe the infant's pain response by administering a combination of breastfeeding and an effleurage massage on the blood sampling procedure of C-reactive protein examination.         Methods: This was a descriptive observational cross-sectional study. There were 30 infants selected using consecutive sampling technique, which 15 samples assigned in an intervention group (combination of breastfeeding and effleurage massage) and a control group. Premature Infant Pain Profile (PIPP) instrument was used to measure pain. Univariate analysis was performed with the aim to describe data in mean and median.Results: The average of pain response at 1-minute observation in the combination of breastfeeding and effleurage massage group was 7.47 ± 1.356, and the average of pain response in the control group was 10.80 ± 1.897. The average pain at 5-minutes in the intervention group was 3.53 ± 1.922 and control group was 6.00 ± 1.852. Conclusions: Pain responses in the combination of breastfeeding and effleurage massage group were lower than the pain response in the control group.

scholarly journals The effect of postoperative early mobilization on healing process and quality of life following radical cystectomy and ileal conduit: A randomized prospective controlled trial

2021 ◽  
Author(s):  
Sevgi Peker ◽  
Özgür Çakmak ◽  
Talha Muezzinoglu ◽  
Guven Aslan ◽  
Hakan Baydur
Keyword(s):  
Quality Of Life ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Healing Process ◽  
Intervention Group ◽  
Early Mobilization ◽  
Controlled Study ◽  
Control Group ◽  
Sf 36

Aim: This study was conducted to evaluate the effect of postoperative early mobilization in patients who underwent radical cystectomy (RC) and ileal conduit in terms of healing process and QOL. Methods: This multicenter prospective randomized controlled study was conducted with 40 patients who were randomly divided into two groups. The intervention group was mobilized within the first 16 hours postoperatively in accordance with the mobilization procedure which determined according to literature. Data were collected using the case report form, HADS and SF-36 QoL scale. Results: Postoperative hospitalization, duration of narcotic analgesic administration, first oral food intake, flatus, defecation and NG tube termination time were shorter in the intervention group. In the control group blood glucose and pulse values were higher after mobilization. SF-36 physical function, physical role difficulty and general perception of health were higher in intervention group at the postoperative first and third month (p <0.05). Conclusion: Our study showed that early mobilization contributed to the healing process positively and improved the quality of life in the patients who underwent radical cystectomy (RC) and ileal conduit surgery. Keywords: Early Mobilization, Radical Cystectomy, Ileal conduit, Quality of Life, Convalescence

Biological effects of amniotic membrane on diabetic foot wounds: a systematic review

2018 ◽  
Vol 27 (Sup2) ◽  
pp. S19-S25 ◽  
Author(s):  
André Oliveira Paggiaro ◽  
Andriws Garcia Menezes ◽  
Alexandra Donizetti Ferrassi ◽  
Viviane Fernandes De Carvalho ◽  
Rolf Gemperli
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Amniotic Membrane ◽  
Diabetic Foot ◽  
Biological Effects ◽  
Meta Analysis ◽  
Healing Process ◽  
Intervention Group ◽  
Risk Of Bias ◽  
Control Group

Objective: The amniotic membrane has biological properties that are beneficial to the wound healing process of diabetic foot ulcers (DFU). Our aim is to analyse the scientific evidence found in literature on the use of the amniotic membrane to stimulate DFU healing. Method: A systematic review of amniotic membrane's influence was undertaken, using the search terms ‘placenta’ ‘diabetic foot’ ‘amnion’ and biological dressing’, assessing the outcomes ‘wound healing’ and ‘wound healing time’, in DFU. Following the inclusion and exclusion criteria, randomised controlled trials (RCT) were identified, and the risk of bias was analysed according to the Cochrane risk of bias tool. We conducted a meta-analysis of the two outcomes to evaluate the level of evidence. Results: We identified six clinical trials, with a total of 331 patients. The most common risks of bias in the studies were selection, attrition, and detection biases. From the meta-analysis, the difference of the intervention group (amnion) in relation to the control group was statistically significant. We found that wound healing in the group treated with amniotic membrane occurs 2.32 times more often and is 32 days faster in comparison with the group that used conventional dressings. Conclusion: There is statistical evidence to support the effectiveness of amniotic membrane in comparison with other conventional dressings. In addition, there is a clear tendency for the use of amniotic membrane treatment to result in a larger number of DFUs healing at a quicker rate.

Cost-effectiveness of adjunct haemoglobin spray in the treatment of hard-to-heal wounds in a UK NHS primary care setting

2019 ◽  
Vol 28 (12) ◽  
pp. 844-849
Author(s):  
Fredrik Elg ◽  
Gerhard Bothma
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Clinical Evaluation ◽  
Standard Care ◽  
Healing Process ◽  
Intervention Group ◽  
Community Setting ◽  
Control Group ◽  
Care Protocol

Objective: To evaluate the cost-effectiveness of topical haemoglobin spray as adjunct therapy in the treatment of hard-to-heal wounds within a UK National Health Service (NHS) community setting. Method: In a previously published comparative clinical evaluation, 50 consecutive patients treated with topical haemoglobin spray, as adjunct to standard care and followed up over 26 weeks, were compared with 50 consecutive retrospective controls from the same clinic treated with the same standard care protocol in the year prior to the introduction of adjunct topical haemoglobin spray. A de novo cost-effectiveness and break-even analysis were performed, using data from the previously published clinical evaluation, for all patients (intent-to-treat) and for patients with complete follow-up using a micro-costing approach and considering only wound care dressing costs. Results: At 26 weeks, the total cost of dressings for all patients in the intervention group was £6953 with 874 cumulative weeks healed, compared with £9547 with 278 cumulative weeks healed for all patients in the control group. The incremental cost-effectiveness ratio (ICER), the incremental cost per additional week healed with adjunct topical haemoglobin spray, is therefore negative (dominant). Total treatment costs per week were lower from week six onwards, with break-even estimated to be at week 10.2. When considering only patients with complete follow-up, the results were similarly dominant, with a mean 10.9 more weeks healed, a mean dressing cost saving per patient of £81.83 by week 26 (–37%). Cost savings were realised from week five, and a break-even was estimated to occur at week 8.0. Conclusion: Topical haemoglobin spray has the potential to restore the healing process, reduce healing times and reduce dressing costs in a NHS community setting, within a few weeks of adoption.

Application of a Purified Protein From Natural Latex and the Influence of Suture Type on Achilles Tendon Repair in Rats

2019 ◽  
Vol 47 (4) ◽  
pp. 901-914 ◽  
Author(s):  
Diego Pulzatto Cury ◽  
Bárbara Tavares Schäfer ◽  
Sonia Regina Yokomizo de Almeida ◽  
Marta Maria da Silva Righetti ◽  
Ii-sei Watanabe
Keyword(s):  
Healing Process ◽  
Tendon Healing ◽  
Healing Time ◽  
Suture Technique ◽  
Collagen Fibrils ◽  
Control Group ◽  
Slight Reduction ◽  
Type I ◽  
Sprague Dawley ◽  
Normal Tendon

Background: The prolonged tendon-healing process, the high costs associated with treatment, the increase in the number of injuries over the past decades, and the lack of consensus on the optimal treatment of tendon injuries are a global problem. Restoring the normal tendon anatomy and decreasing the healing time are key factors for treatment advancement. Hypothesis: Application of a purified protein from natural latex (PPNL) accelerates the healing process, increasing collagen synthesis and decreasing metalloproteinases. PPNL associated with a simpler suture technique should decrease the healing time. Study Design: Controlled laboratory study. Methods: Injury, surgery, and treatment with PPNL were conducted with male Sprague-Dawley rats. Two suture techniques were used: U-suture, a simpler and lesser traumatic technique, and Kessler-Tajima, to avoid strangulation of the microcirculation. Achilles tendons were completely sectioned, and 100 µL of 0.1% PPNL was applied on the tendon during surgery. Tendon morphology, distribution, and quantity of collagen types I and III, as well as expression of TIMP-1, TIMP-2, MMP-2, and MMP-9 and ultrastructural aspects of cells and collagen fibrils, were assessed after 2 and 4 weeks. Results: PPNL treatment improved collagen type I synthesis and reduced MMP-2 expression. All groups showed a 6.8-times increase in tendon weight as compared with the control group after 2 weeks and a 5.2-times increase after 4 weeks. All groups showed an increase in diameter after 4 weeks, except for the ones treated with PPNL, which showed a slight reduction in diameter. The peak of concentration of collagen fibrils with a 80-nm diameter was 27.79% in the control group; all other experimental groups presented fibrils between 50 and 60 nm. However, the best results were observed with Kessler-Tajima suture associated with PPNL. Conclusion/Clinical Relevance: There are no known medicines or substances capable of aiding the tendon healing process besides surgery. The discovery of a substance able to improve this process and decrease its duration represents an important advancement in orthopaedic medicine.

150 Falls in Malaysia: Magnitude, Risk, Disparities, and Solutions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Maw Pin Tan ◽  
Sumaiyah Mat ◽  
Deepa Alex ◽  
Shahrul Bahyah Kamaruzzaman
Keyword(s):  
Ethnic Differences ◽  
Cultural Practices ◽  
Longitudinal Research ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychological Status ◽  
Control Group ◽  
Cross Sectional ◽  
One Year ◽  
Risk Factors For Falls

Abstract The Malaysian Elders Longitudinal Research (MELoR) study found 1 in 4 residents aged 65 years and over living in the Klang Valley of Malaysia fall at least once a year in their survey conducted between 2013 and 2015. Recent figures obtained from the First Older Persons’ National Health and Morbidity Survey conducted in 2018 revealed that 15% of Malaysians aged 60 years and over fall at least once a year. In a 10-year follow-up study involving 200 individuals who presented to the emergency department over a six-month period in 2002, 22% were no longer alive at one year, and 80% had died at 10 years. Older age, indoor falls, subsequent hospital admission and functional impairment predicted death at one year. Cross-sectional data from MELoR revealed ethnic differences in fall prevalence, with the ethnic Indians more likely to report falls in the past 12 months compared to the ethnic Malays. Independent risk factors for falls identified from MELoR were urinary incontinence, reduced grip strength, hearing impairment, comorbidities and reducing walking speed. The ethnic differences in falls in our population remain unexplained. Lifestyle and cultural practices may well be the underlying rationale, but genetic influences cannot currently be ruled out. The results of a randomized controlled trial on multifactorial interventions, the Malaysian Falls Assessment and Intervention Trial (MyFAIT), was published last year. Mo differences in falls outcomes with an individualized multifactorial intervention were observed, despite improvements in physical performance and psychological status in the intervention group compared to the control group. The research group has now secured two-year funding to evaluate post-fall behavior in our setting in the Life After Falls (LiAF) study. In addition, dissemination and upskilling efforts are underway through training workshops, formation of the Malaysian Falls Network (MyFalls) and collaborations with the private sector to increase awareness on falls and increase fall prevention efforts throughout the country.

scholarly journals Histological study of tendon healing in malnourished Wistar rats treated with ultrasound therapy

2006 ◽  
Vol 21 (suppl 4) ◽  
pp. 13-17 ◽  
Author(s):  
Paulo de Tarso Camillo de Carvalho ◽  
Iandara Schettert Silva ◽  
Filipe Abdalla dos Reis ◽  
Ana Carulina Guimarães Belchior ◽  
Ricardo Dutra Aydos ◽  
...  
Keyword(s):  
Histological Study ◽  
Healing Process ◽  
Statistical Treatment ◽  
Tendon Healing ◽  
Tendon Injuries ◽  
Control Group ◽  
Test Results ◽  
Leukocyte Counts ◽  
Student’S T ◽  
Student’S T Test

PURPOSE: To investigate the effects of therapeutic ultrasound on the healing of tendon injuries in malnourished rats. METHODS: After the intended nutritional states had been attained, the animals (N=36) were distributed into three groups, named: G1(N=12), control group; G2(N=12), malnourished rats treated with 3 MHz ultrasound at an intensity of 0.5 W/cm²; and G3 (N=12), normal animals treated with 3 MHz at 0.5 W/cm². The injuries were induced by means of an operation to expose the heel tendon and crush it using Allis forceps. RESULTS: The data obtained relating to leukocyte counts, fibroblasts, vessel neoformation, fibrosis and collagen were subjected to statistical treatment using analysis of variance (ANOVA) and Student's t test. Results of p < 0.05 were obtained for fibrosis and collagen. CONCLUSION: The ultrasound was shown to be effective in repairing the tendon, even in malnourished animals whose healing process was retarded.

scholarly journals Effect of Red Fruit Oil Soap (Pandanus Conoideus Lam.) as Wound Cleansing on Wound Healing and the Number of Bacterial Colonies among Grade II Diabetic Ulcer Patients at Griya Wound Care Clinic Kudus, Indonesia

2019 ◽  
Vol 3 (2) ◽  
pp. 55
Author(s):  
Hevny Kartika Dewi ◽  
Mardiyono Mardiyono ◽  
Diyah Fatmasari ◽  
Sudirman Sudirman ◽  
Djenta Saha
Keyword(s):  
Wound Healing ◽  
Healing Process ◽  
Intervention Group ◽  
Control Group ◽  
Wound Healing Process ◽  
Nacl Solution ◽  
Diabetic Ulcer ◽  
Grade Ii ◽  
The Mean ◽  
Fruit Oil

Background: Diabetic ulcer is an open wound on the skin layer to the dermis due to hyperglycemia and neuropathy. This condition often causes infection and becomes an inhibitor in the wound healing process. Red fruit oil soap can be used as an alternative cleansing to reduce the number of bacterial colonies and accelerate the wound healing process.Aims: This present study aimed to observe the effect of red fruit oil soap in the cleansing process to reduce the number of bacterial colonies and the wound healing process in grade II Diabetic ulcer patientsMethods: This is a quasi-experimental study with the pre-test post-test non-equivalent control group design. Wound cleansing in the intervention group used 0.9% NaCl solution and red fruit oil soap with a pH of 5.74, while the wound cleansing in the control group used 0.9% NaCl solution. Bacterial colonies were assessed and the type of bacteria was observed by the swab method. The wound healing was assessed with Bates-Jensen Wound Assessment Tool (BWAT) instrument for 14 days with observations every 3 days. Analysis test used Mann Whitney and Repeated Measure ANOVA.Results: There was no difference in the mean of the number of bacterial colonies between the wounds that were cleansed with 0.9% NaCl solution and red fruit oil soap and the wounds which were cleansed by using 0.9% NaCl solution (p> 0.05). The mean of the number of colonies in the intervention group until the 14th day reduced by 3.14x106 and in the control group was reduced h 1.40x106. There was a significant decrease in the wound healing scores in each group, in each assessment for 14 days.Conclusion: This study found that the wound cleansing using red fruit oil soap and 0.9% NaCl solution could reduce the number of bacterial colonies on the wound surface and accelerate the wound healing process among patients with grade II diabetic ulcer.

scholarly journals MOBILISASI DINI TERHADAP PEMULIHAN PERISTALTIK USUS DAN SKALA NYERI PASIEN POST PEMBEDAHAN

2020 ◽  
Vol 7 (1) ◽  
pp. 21-31
Author(s):  
Arianti Arianti ◽  
Nadila Putri Mayna ◽  
Yuda Hidayat
Keyword(s):  
Health Workers ◽  
Intervention Group ◽  
Early Mobilization ◽  
Sampling Technique ◽  
Pain Scale ◽  
Control Group ◽  
Cross Sectional ◽  
Adult Age ◽  
Comparison Research ◽  
Intestinal Peristalsis

Postoperative complications such as pain, malnutrition, delayed wound healing and ileus were frequently found and become a challenge for health workers. Early mobilization is recognized as an approach that may help in preventing as well as decreasing the further effect of those complications. However, the implementation of early mobilization in hospitals were still limited to verbal commands without providing direct assistance to postoperative patients. Therefore, this study tries to give evidence-based nursing in PKU Muhammadiyah Gamping Hospital in improving nursing care to postoperative patient outcomes by giving early mobilization. The purpose of this study was to find the effect of early mobilization on the recovery time of intestinal peristalsis and pain scale in post-operative patients. This research was pre-experimental research using a static group comparison research design with a cross-sectional approach. The sampling technique used purposive sampling with specific criteria who was in adult age and received regional anesthesia. This study found 40 subjects consisting of 20 subjects in the intervention group and 20 subjects in the control group. The Mann-Whitney statistical test proved a significant effect on early mobilization on intestinal peristalsis recovery (p = 0.000) Gand pain scale (p = 0.001).

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