No Treatment Benefits of Local Administration of Insulin-like Growth Factor-1 in Addition to Heavy Slow Resistance Training in Tendinopathic Human Patellar Tendons: A Randomized, Double-Blind, Placebo-Controlled Trial With 1-Year Follow-up

2021 ◽  
pp. 036354652110210
Author(s):  
Jens L. Olesen ◽  
Mette Hansen ◽  
Ida F. Turtumoygard ◽  
Rikke Hoffner ◽  
Peter Schjerling ◽  
...  
Keyword(s):  
Growth Factor ◽  
Patellar Tendon ◽  
Collagen Synthesis ◽  
Controlled Trial ◽  
Isotonic Saline ◽  
Patellar Tendinopathy ◽  
Local Administration ◽  
Insulin Like Growth Factor ◽  
Patient Reported

Background: Heavy slow resistance (HSR) training is currently recommended as part of the treatment of patellar tendon tendinopathy. However, treatment success is not reached in all patients, and combinations of different treatments could be beneficial. Local administration of insulin-like growth factor-1 (IGF-1) in humans has been shown to quickly stimulate tendon collagen synthesis. Purpose: To study whether IGF-1 injections combined with HSR training enhance tendon synthesis, tissue structure, and patient satisfaction versus saline injection combined with HSR training in patients with patellar tendinopathy. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Forty patients (age 18-50 years) with unilateral patellar tendinopathy undertook HSR training (3 times a week for 12 weeks) and received intratendinous IGF-1 injections (1 mg IGF-1 per dose) or isotonic saline injections (sham injections) at baseline and after 1 and 2 weeks of training. The primary outcome was collagen synthesis parameters after 12 weeks (primary endpoint). The secondary outcomes were patient-reported outcomes (scores on the Victorian Institute of Sport Assessment–Patella [VISA-P] and visual analog scale [VAS] for pain) and structural changes before the initiation of treatment and at week 3, week 12, and 1 year after the initiation of treatment. Results: Analysis of the patellar tendon biopsy specimens at 12 weeks showed that collagen mRNA and total RNA were increased in the tendinopathic tendons compared with the contralateral healthy tendons regardless of treatment with IGF-1 or saline. Similarly, no difference between the groups was seen in tendon thickness and Doppler activity at week 12 or at 1-year follow-up. The combination of HSR training and IGF-1 injections significantly improved VISA-P and VAS pain scores after 3 weeks, whereas the overall responses after 12 weeks and at 1-year follow-up were identical in the 2 groups. Conclusion: Although a small, immediate clinical response to IGF-1 injections was seen when combined with training, no additional long-term effect of intratendinous IGF-1 was observed on structural and clinical outcomes in patients with patellar tendinopathy. Registration: NCT01834989 ( ClinicalTrials.gov identifier)

scholarly journals Laparoscopic sacrohysteropexy versus vaginal hysterectomy and apical suspension: 7-year follow-up of a randomized controlled trial

2021 ◽  
Author(s):  
Matthew L. Izett-Kay ◽  
Philip Rahmanou ◽  
Rufus J. Cartwright ◽  
Natalia Price ◽  
Simon R. Jackson
Keyword(s):  
Vaginal Hysterectomy ◽  
Uterine Prolapse ◽  
Controlled Trial ◽  
Apical Prolapse ◽  
Apical Suspension ◽  
Vaginal Length ◽  
Patient Reported ◽  
Laparoscopic Sacrohysteropexy ◽  
Total Vaginal Length

Abstract Introduction and hypothesis Laparoscopic mesh sacrohysteropexy offers a uterine-sparing alternative to vaginal hysterectomy with apical suspension, although randomised comparative data are lacking. This study was aimed at comparing the long-term efficacy of laparoscopic mesh sacrohysteropexy and vaginal hysterectomy with apical suspension for the treatment of uterine prolapse. Methods A randomised controlled trial comparing laparoscopic mesh sacrohysteropexy and vaginal hysterectomy with apical suspension for the treatment of uterine prolapse was performed, with a minimum follow-up of 7 years. The primary outcome was reoperation for apical prolapse. Secondary outcomes included patient-reported mesh complications, Pelvic Organ Prolapse Quantification, Patient Global Impression of Improvement in prolapse symptoms and the International Consultation on Incontinence Questionnaire Vaginal Symptoms, Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and PISQ-12 questionnaires. Results A total of 101 women were randomised and 62 women attended for follow-up at a mean of 100 months postoperatively (range 84–119 months). None reported a mesh-associated complication. The risk of reoperation for apical prolapse was 17.2% following vaginal hysterectomy (VH) and 6.1% following laparoscopic mesh sacrohysteropexy (LSH; relative risk 0.34, 95% CI 0.07–1.68, p = 0.17). Laparoscopic sacrohysteropexy was associated with a statistically significantly higher apical suspension (POP-Q point C −5 vs −4.25, p = 0.02) and longer total vaginal length (9 cm vs 6 cm, p < 0.001). There was no difference in the change in ICIQ-VS scores between the two groups (ICIQ-VS change −22 vs −25, p = 0.59). Conclusion Laparoscopic sacrohysteropexy and vaginal hysterectomy with apical suspension have comparable reoperation rates and subjective outcomes. Potential advantages of laparoscopic sacrohysteropexy include a lower risk of apical reoperation, greater apical support and increased total vaginal length.

Insulin-like growth factor I improves renal function in patients with end-stage chronic renal failure

1999 ◽  
Vol 276 (4) ◽  
pp. R929-R934 ◽  
Author(s):  
Anitha Vijayan ◽  
Samuel C. Franklin ◽  
Terry Behrend ◽  
Marc R. Hammerman ◽  
Steven B. Miller
Keyword(s):  
Renal Function ◽  
Growth Factor ◽  
Side Effects ◽  
Glomerular Filtration ◽  
Controlled Trial ◽  
Insulin Like Growth Factor ◽  
Igf I ◽  
Improved Function ◽  
Double Blinded ◽  
End Stage

There is no pharmacological treatment to increase the glomerular filtration rate in end-stage renal disease (ESRD). The administration of 100 μg/kg of insulin-like growth factor (IGF) I twice a day to patients with ESRD increases inulin clearance. However, its effect is short-lived and IGF-I has major side effects when given this way. To assess whether the use of a lower intermittent dose of IGF-I would effect sustained improved function with tolerable side effects we performed 1) a prospective open-labeled 24-day trial in which we enrolled five patients and 2) a 31-day randomized, double-blinded, placebo-controlled trial in which we enrolled 10 patients. Patients with ESRD [creatinine clearance of <15 ml ⋅ min−1 ⋅ (1.73 m2)−1] and scheduled to initiate renal replacement therapy received subcutaneous IGF-I, 50 μg ⋅ kg−1 ⋅ day−1, or vehicle. Treatment with IGF I resulted in significantly increased glomerular filtration rates (inulin clearances) during the 3rd and 4th wk of therapy in both prospective and double-blinded studies. Vehicle had no effect. No patient required discontinuation of drug secondary to side effects. We conclude that IGF-I effects sustained improvement of renal function (clearances comparable to those generally achieved by dialysis) in patients with ESRD and is well tolerated.

Circulating Insulin-Like Growth Factor-1 Is Positively Associated with Growth and Cognition in 6- to 9-Year-Old Schoolchildren from Ghana

2020 ◽  
Vol 150 (6) ◽  
pp. 1405-1412
Author(s):  
Benedikte Grenov ◽  
Anni Larnkjær ◽  
Reginald Lee ◽  
Anja Serena ◽  
Christian Mølgaard ◽  
...  
Keyword(s):  
Growth Factor ◽  
Low Income ◽  
Milk Protein ◽  
Controlled Trial ◽  
Milk Powder ◽  
Milk Intake ◽  
Fat Free Mass ◽  
Low Income Countries ◽  
Insulin Like Growth Factor ◽  
Double Blind

ABSTRACT Background Milk intake stimulates linear growth and improves cognition in children from low-income countries. These effects may be mediated through insulin-like growth factor-1 (IGF-1). Objective The objective was to assess the effect of milk supplement on circulating IGF-1 and to assess IGF-1 as a correlate of growth and cognition in children. Methods Secondary data on blood spot IGF-1 from a randomized, double-blind, controlled trial in 6–9-y-old children from rural Ghana were analyzed. Intervention groups received porridge with non–energy-balanced supplements: 8.8 g milk protein/d, 100 kcal/d (Milk8); 4.4 g milk and 4.4 g rice protein/d, 100 kcal/d (Milk/rice); 4.4 g milk protein/d, 48 kcal/d (Milk4); or a control (no protein, 10 kcal/d). IGF-1, length, body composition, and Cambridge Neuropsychological Test Automated Battery (CANTAB) were measured at 3.5 or 8.5 mo. Linear regressions were used to assess the effect of milk interventions on IGF-1 and IGF-1 as a correlate of growth and cognition. Results The increase in IGF-1 was 15.3 (95% CI: 3.3, 27.3) ng/mL higher in children receiving Milk8 compared with the control. The IGF-1 increases in the isonitrogenous, isoenergetic Milk/rice or the Milk4 groups were not different from the control (P ≥ 0.49). The increase in IGF-1 was associated with improvements in 4 out of 5 CANTAB domains. The strongest associations included reductions in “mean correct latency” from Pattern Recognition Memory and “pre-extradimensional (pre-ED) shift errors” from Intra/Extradimensional Set Shift (P ≤ 0.005). In addition, change in IGF-1 was positively associated with changes in height, weight, and fat-free mass (P ≤ 0.001). Conclusions Intake of skimmed milk powder corresponding to one, but not half a glass of milk on school days stimulates IGF-1 in 6–9-y-old Ghanian children. IGF-1 seems to mediate the effect of milk intake on growth and cognition. The association between IGF-1 and cognition in relation to milk intake is novel and opens possibilities for dietary interventions to improve cognition.

scholarly journals The Evaluation of QT Intervals During Diagnosis and After Follow-Up in Acromegaly Patients

2014 ◽  
Vol 27 (4) ◽  
pp. 428 ◽  
Author(s):  
Husniye Baser ◽  
Nihal Akar Bayram ◽  
Burcak Polat ◽  
Berna Evranos ◽  
Reyhan Ersoy ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Disease Duration ◽  
Qt Dispersion ◽  
Control Group ◽  
Insulin Like Growth Factor ◽  
Clinical Predictors ◽  
Qt Intervals ◽  
Prolonged Qt

<p><strong>Introduction:</strong> It was aimed to calculate QT intervals in patients with acromegaly and to reveal its correlation between QT intervals, and growth hormone and insulin like growth factor-1.<br /><strong>Material and Methods:</strong> Forty-one patients with acromegaly were enrolled into the study. Another 41 individuals with similar features, such as comorbid diseases, age and sex constituted the control group. The electrocardiographies of patients with acromegaly were evaluated at the baseline and after the follow- up. Only one electrocardiography was performed for controls. QT maximum, QT minimum, QT dispersion, corrected QT maximum, corrected QT minimum and corrected QT dispersion were calculated.<br /><strong>Results:</strong> Baseline QT maximum, QT dispersion, corrected QT maximum and corrected QT dispersion were significantly longer than the values of controls. Corrected QT maximum and corrected QT dispersion were significantly shorter after the follow-up, compared to the baseline in patients. QT maximum, QT dispersion, corrected QT maximum and corrected QT dispersion after the follow-up were not statistically different from the values of controls. Except the negative correlation between growth hormone and corrected QT dispersion in patients after the follow-up, no other correlation was detected between QT values and growth hormone or insulin like growth factor-1 levels. Corrected QT dispersion was found to be related with the disease duration in patients.<br /><strong>Discussion:</strong> For acromegaly patients, it is important to detect clinical predictors of cardiac arrhytmias. QT dispersion is considered a beneficial predictor for ventricular arrhytmias. When compared to controls, prolonged QT intervals were determined in our acromegalic patients.<br /><strong>Conclusion:</strong> We consider that QT intervals may also be utilized in the evaluation of increased cardiovascular risk in patients with<br />acromegaly.<br /><strong>Keywords:</strong> Acromegaly; Arrhythmias, Cardiac; Electrocardiography; Heart Rate.</p>

scholarly journals Non- or Minimally Displaced Distal Radial Fractures in Adult Patients: Three Weeks versus Five Weeks of Cast Immobilization—A Randomized Controlled Trial

2018 ◽  
Vol 08 (01) ◽  
pp. 043-048 ◽  
Author(s):  
A. Bentohami ◽  
J. Vermeulen ◽  
N. L. Sosef ◽  
N. de Korte ◽  
T. S. Bijlsma ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Reported Outcomes ◽  
Controlled Trial ◽  
Adult Patients ◽  
Cast Immobilization ◽  
Distal Radial Fractures ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Secondary Displacement

Background Patients with non- or minimally displaced distal radial fractures, that do not need repositioning, are mostly treated by a short-arm cast for a period of 4 to 6 weeks. A shorter period of immobilization may lead to a better functional outcome. Purpose We conducted a randomized controlled trial to evaluate whether the duration of cast immobilization for patients with non- or minimally displaced distal radial fractures can be safely shortened toward 3 weeks. Materials and Methods The primary outcomes were patient-reported outcomes measured by the Patient-Related Wrist Evaluation (PRWE) and Quick Disability of Arm, Shoulder and Hand (QuickDASH) score after 1-year follow-up. Secondary outcome measures were: PRWE and QuickDASH earlier in follow-up, pain (Visual Analog Scale), and complications like secondary displacement. Results Seventy-two patients (male/female, 23/49; median age, 55 years) were included and randomized. Sixty-five patients completed the 1-year follow-up. After 1-year follow up, patients in the 3 weeks immobilization group had significantly better PRWE (5.0 vs. 8.8 points, p = 0.045) and QuickDASH scores (0.0 vs. 12.5, p = 0.026). Secondary displacement occurred once in each group. Pain did not differ between groups (p = 0.46). Conclusion Shortening the period of immobilization in adult patients with a non- or minimally displaced distal radial fractures seems to lead to equal patient-reported outcomes for both the cast immobilization groups. Also, there are no negative side effects of a shorter period of cast immobilization. Therefore, we recommend a period of 3 weeks of immobilization in patients with distal radial fractures that do not need repositioning.

Serum Insulin-Like Growth Factor-1 Measurement in the Diagnosis and Follow-up of Patients with Acromegaly: Preliminary Data

2010 ◽  
pp. 145-151
Author(s):  
Mirtha Guitelman ◽  
Graciela Radczuk ◽  
Natalia García Basavilbaso ◽  
Adriana Oneto ◽  
Armando Basso
Keyword(s):  
Growth Factor ◽  
Preliminary Data ◽  
Serum Insulin ◽  
Insulin Like Growth Factor
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