Platelet-Rich Preparations to Improve Healing. Part I: Workable Options for Every Size Practice

2014 ◽  
Vol 40 (4) ◽  
pp. 500-510 ◽  
Author(s):  
Vicki L Davis ◽  
Alaeddin B Abukabda ◽  
Nicholas M Radio ◽  
Paula A Witt-Enderby ◽  
William P Clafshenkel ◽  
...  
Keyword(s):  
Bone Growth ◽  
Platelet Rich Plasma ◽  
Adverse Outcomes ◽  
Clinical Practices ◽  
Long Term Outcomes ◽  
Advantages And Disadvantages ◽  
Tissue Healing ◽  
Lifestyle Choices ◽  
Selection Of

Numerous studies have demonstrated that platelet-rich preparations applied to surgical sites, injuries, or wounds are a safe and effective way to promote soft tissue healing and bone growth. Various protocols have been developed for preparing platelet-rich preparations, with subtle but important differences between them. Unfortunately, only a minority of clinicians use platelet-rich preparations, such as platelet-rich plasma and platelet-rich fibrin, in their practice, possibly due to confusion about the different methods and their advantages and disadvantages. Therefore, the different types of preparations are described to help guide the selection of the best method for any size practice. Classic methods generally require large volumes of blood and can be expensive, complicated, and time-intensive. Simpler protocols have been developed recently, which require relatively inexpensive equipment and small blood volumes and, thus, may be more applicable for small clinical practices. Platelet-rich preparations accelerate healing at earlier time points to reduce discomfort and the potential for adverse outcomes, including infection, poor wound closure, and delays in forming strong bone for subsequent procedures (such as implants). However, platelet-rich preparations may also improve long-term outcomes in patients expected to have impaired healing, such as with lifestyle choices (eg, smoking), medications (eg, steroids), diseases (eg, diabetes, osteoporosis, atherosclerosis), and aging, by supplementing the deficient wound environment to restore proper healing. Therefore, both large and small clinical practices would benefit from utilizing platelet-rich preparations to enhance healing in their patients.

Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence

2020 ◽  
Vol 48 (4) ◽  
pp. 329-334
Author(s):  
Soo Jin Han ◽  
Seung Mi Lee ◽  
Sohee Oh ◽  
Subeen Hong ◽  
Jeong Won Oh ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Control Group ◽  
Long Term Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Monochorionic Twin ◽  
Increased Risk ◽  
Study Population

AbstractBackgroundIn monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.MethodsThe study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.ResultsDuring the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.ConclusionThe spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.

scholarly journals Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

2021 ◽  
Vol 10 (8) ◽  
pp. 1730
Author(s):  
Hiroshi Miyama ◽  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Ayumi Goda ◽  
Yosuke Nishihata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Adverse Outcomes ◽  
Long Term Outcomes ◽  
Function Tests ◽  
Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

scholarly journals Case of ventricular septal rupture following acute myocardial infarction

Ultrasound ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 196-201
Author(s):  
Natasha M Amorosi ◽  
Alison White
Keyword(s):  
Myocardial Infarction ◽  
Point Of Care ◽  
Initial Point ◽  
Signs And Symptoms ◽  
Adverse Outcomes ◽  
Point Of Care Ultrasound ◽  
Ventricular Septal Rupture ◽  
Long Term Outcomes

Ventricular septal rupture is a rare and potentially fatal complication of transmural myocardial infarction. Early identification utilising transthoracic echocardiography significantly improves long term outcomes in these patients. We report on a case of a 77-year-old male who presented with signs and symptoms of cardiac failure and a loud systolic murmur. The patient underwent an initial point-of-care ultrasound which revealed evidence of a transmural myocardial infarction and a high suspicion of an apical ventricular septal rupture. A complete transthoracic echocardiogram confirmed the septal rupture diagnosis and the patient subsequently underwent surgical repair of the ventricular rupture. This case highlights the role of echocardiography in decreasing adverse outcomes in patients with ventricular septal rupture.

Feeding of Low Birth Weight Neonates

2020 ◽  
Vol 34 (1-2) ◽  
pp. 28-51
Author(s):  
Nishanth Banait ◽  
Sriparna Basu ◽  
Prakash Desai ◽  
Sourabh Dutta ◽  
Ashok Kumar ◽  
...  
Keyword(s):  
Guideline Development ◽  
Adverse Outcomes ◽  
World Health ◽  
Long Term Outcomes ◽  
Infancy And Childhood ◽  
Recommendations For Practice ◽  
Health Organization ◽  
Practice Questions ◽  
Development Group

Nutrition in this critical period is essential for immediate outcomes such as changes in anthropometry (weight, length, and head circumference) as well as adverse effects like necrotizing enterocolitis. Nutrition also affects long-term adverse outcomes such as developmental delay, diplegic cerebral palsy, and death during infancy and childhood. This review has looked for the effects of nutrition in these areas. Further long-term outcomes like risk of adult onset diseases like myocardial infarction and stroke may also be related to the nutrition of the LBW neonate but have not been included in this review. The guideline has been developed using standard methods adapted by National Neonatology Forum in accordance with the process described in the World Health Organization handbook for guideline development. The detailed methods are described elsewhere in this compilation of guidelines. Table 1 summarizes the recommendations for practice questions prioritized by the guideline development group in consultation with a wider group of National Neonatology Forum members. The recommendations made by this group are summarized in Table 1 .

scholarly journals Postoperative atrial fibrillation: Target for stroke prevention?

2017 ◽  
Vol 2 (3) ◽  
pp. 222-228 ◽  
Author(s):  
Vincent Thijs ◽  
Robin Lemmens ◽  
Omar Farouque ◽  
Geoffrey Donnan ◽  
Hein Heidbuchel
Keyword(s):  
Atrial Fibrillation ◽  
Lifestyle Changes ◽  
Adverse Outcomes ◽  
Postoperative Atrial Fibrillation ◽  
Long Term Outcomes ◽  
Number Of Patients ◽  
History Of ◽  
Long Term Mortality

Purpose A substantial number of patients without a history of atrial fibrillation who undergo surgery develop one or more episodes of atrial fibrillation in the first few days after the operation. We studied whether postoperative transient atrial fibrillation is a risk factor for future atrial fibrillation, stroke and death. Method We performed a narrative review of the literature on epidemiology, mechanisms, risk of atrial fibrillation, stroke and death after postoperative atrial fibrillation. We reviewed antithrombotic guidelines on this topic and identified gaps in current management. Findings Patients with postoperative atrial fibrillation are at high risk of developing atrial fibrillation in the long term. Mortality is also increased. Most, but not all observational studies report a higher risk of stroke. The optimal antithrombotic regimen for patients with postoperative atrial fibrillation has not been defined. The role of lifestyle changes and of surgical occlusion of the left atrial appendage in preventing adverse outcomes after postoperative atrial fibrillation is not established. Conclusion Further studies are warranted to establish the optimal strategy to prevent adverse long-term outcomes after transient, postoperative atrial fibrillation.

scholarly journals Platelet-Rich Fibrin Used in Regenerative Endodontics and Dentistry: Current Uses, Limitations, and Future Recommendations for Application

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sohaib Arshad ◽  
Fatima Tehreem ◽  
Muhammad Rehab khan ◽  
Fatima Ahmed ◽  
Anand Marya ◽  
...  
Keyword(s):  
Bone Growth ◽  
Cell Attachment ◽  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Permanent Teeth ◽  
Clinical Practices ◽  
Platelet Rich Fibrin ◽  
Regenerative Endodontics

Regenerative endodontics has introduced numerous procedures such as pulp implantation, revascularization, and postnatal stem cell therapy. Revascularization has been successfully implemented clinically nowadays, thus providing dentists with outrageous results. Platelet-rich fibrin (PRF) used either alone or along with bone graft promotes bone growth and vascularization. This matrix promotes migration, cell attachment, and proliferation of osteoblast that leads to bone formation. PRF consists of a packed fibrin complex consisting of leukocytes, cytokines, and glycoproteins such as thrombospondin. The usage of PRF has reported high success rates in surgical cases such as sinus lift procedures, healing of extraction sockets, and management of periapical abscesses. Compared to platelet-rich plasma, PRF is more economical, easy to prepare, and feasible to use in daily clinical practices. Revascularization compromised the induction of a blood clot into the root canal space, which emerged as a clinical triumph. This further led to platelet concentrates as an autologous scaffold on which revascularization could occur. The applications of PRF in regenerative endodontics are numerous, such as an agent for repairing iatrogenic perforation of the pulpal floor and for the revascularization of immature permanent teeth with necrotic pulps. It acts as a matrix for tissue ingrowth. Evidence of progressive thickening of dentinal walls, root lengthening, regression in the periapical lesion, and apical closure was reported. Further studies are needed to clarify the precise mechanism of action of PRF for dental pulp regeneration both in vitro and in vivo. The current review aims at the present uses of PRF in regenerative endodontics dentistry and its application with future recommendations and limitations.

Multidisciplinary selection of pulmonary nodules for surgical resection: Diagnostic results and long-term outcomes

2020 ◽  
Vol 159 (4) ◽  
pp. 1558-1566.e3 ◽  
Author(s):  
Maria Lucia Madariaga ◽  
Inga T. Lennes ◽  
Till Best ◽  
Jo-Anne O. Shepard ◽  
Florian J. Fintelmann ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Pulmonary Nodules ◽  
Long Term Outcomes ◽  
Selection Of

scholarly journals LO58: Long-term outcomes among emergency department syncope patients: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S27-S27
Author(s):  
C. Leafloor ◽  
P. Jiho Hong ◽  
L. Sikora ◽  
J. Elliot ◽  
M. Mukarram ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Phase 1 ◽  
Adverse Outcomes ◽  
Cochrane Central Register ◽  
Phase 2 ◽  
Long Term Outcomes ◽  
One Year

Introduction: Approximately 50% of patients discharged from the Emergency Department (ED) after syncope have no cause found. Long-term outcomes among syncope patients are not well studied, to guide physicians regarding outpatient testing and follow-up. The objective of this study was to conduct a systematic review for long-term (one year) outcomes among ED patients with syncope. We aim to use the results of this review to guide us in prospective analysis of one year outcomes with our large database of syncope patients. Methods: We searched Cochrane Central Register of Controlled Trials, Medline and Medline in Process, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from the inception to June, 2017. We included studies that reported long-term outcomes among adult ED patients (16 years or older) with syncope. We excluded studies on pediatric patients, and studies that included syncope mimickers: pre-syncope, seizure, intoxication, loss of consciousness after head trauma. We also excluded case reports, letters to the editor and review articles. Outcomes included death, syncope recurrence requiring hospitalization, arrhythmias and procedural interventions for arrhythmias. We selected articles based on title and abstract review during phase-1 and conducted full article review during phase-2. Meta-analysis was performed by pooling the outcomes using random effects model (RevMan v.5.3; Cochrane Collaboration). Results: Initial literature search generated 2094 articles after duplicate removal. 50 articles remained after phase-1 (=0.85) and 16 articles were included in the systematic review after phase-2 (=0.86). The 16 included studies enrolled a total of 44,755 patients. Pooled analysis at 1-year follow-up showed the following outcomes: 7% mortality; 14% recurrence of syncope requiring hospitalization; one study reported that 0.6% of patients had a pacemaker inserted; and two studies reported 0.8 11.5% of patients suffered new arrhythmias. Conclusion: An important proportion of ED patients with syncope suffer outcomes at 1-year. Appropriate follow-up is needed to prevent long-term adverse outcomes. Further prospective research to identify patients at risk for long-term important cardiac outcomes and death is needed.

Why Is There No Statement Regarding Partial Intracapsular Tonsillectomy (Tonsillotomy) in the New Guidelines?

2019 ◽  
Vol 160 (2) ◽  
pp. 213-214 ◽  
Author(s):  
Sanjay R. Parikh ◽  
Sanford Archer ◽  
Stacey L. Ishman ◽  
Ron B. Mitchell
Keyword(s):  
Neck Surgery ◽  
Perioperative Outcomes ◽  
Future Research ◽  
Tonsillar Hypertrophy ◽  
Long Term Outcomes ◽  
Advantages And Disadvantages ◽  
New Guidelines ◽  
Few Data ◽  
Intracapsular Tonsillectomy

Partial intracapsular tonsillectomy (PIT) was revisited in 2003 as an alternate surgical option to total tonsillectomy for the treatment of tonsillar hypertrophy. However, evaluation of the existing literature on PIT reveals that it is largely focused on comparing perioperative outcomes after PIT and total tonsillectomy, with few data regarding long-term outcomes. The goal of this commentary is to explain why PIT was not incorporated into the 2019 American Academy of Otolaryngology–Head and Neck Surgery Foundation clinical practice guideline for tonsillectomy, while acknowledging its use and potential advantages and disadvantages and outlining future research opportunities.

BIOCHEMICAL PREDICTORS OF EARLY AND LONG-TERM OUTCOMES OF TRAUMATIC BRAIN INJURY IN CHILDREN

2021 ◽  
Author(s):  
Elena Sorokina ◽  
◽  
Zhanna Semenova ◽  
Valery Ivanovich Lukianov ◽  
Olga Karaseva ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Serum ◽  
Glutamate Receptors ◽  
Severe Traumatic Brain Injury ◽  
Adverse Outcomes ◽  
Long Term Outcomes ◽  
Damage Repair

In children with mild and severe traumatic brain injury (TBI), the role of various damage/repair neuromarkers in the outcomes of trauma was studied. It has been shown that in the first days after TBI with adverse outcomes, there was a significant increase in NSE, S100b, NO products and a decrease in the content of BDNF and autoantibodies to NMDA (NR2) glutamate receptors (Glu) in the blood serum. After 6 months with unfavorable outcomes, there was an increase in aAb to S100b and a decrease in BDNF.

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