Platelet-rich Plasma for Refractory Coccydynia: A Case Report

2021 ◽  
pp. 44
Author(s):  
Abdulaziz Hazazi
Keyword(s):  
Case Report ◽  
Platelet Rich Plasma ◽  
Pain Clinic ◽  
Injection Pain ◽  
Pain Medications ◽  
Radiofrequency Therapy ◽  
Patient Reported ◽  
Medical City ◽  
Male Patients ◽  
Ganglion Impar Block

Introduction: Coccydynia is a common syndrome characterized by pain localized to the tailbone that radiates into the lower sacrum and perinium. Coccydynia affects female patients more frequently than male patients. It occurs more commonly after direct trauma from fall directly onto the coccyx. The pain is caused commonly by the strain of sacrococcygeal ligament or fracture of the coccyx and less commonly secondary to arthritis. Conservative treatment of coccydynia include simple analgesics and foam donut to prevent irritation to sacrococcygeal ligament. If pain persist, usually ganglion impar block and radiofrequency are alterative options. There are no strong evidence to support coccygectomy. Case Report: A 40-year-old presented with coccygeal pain for more than six months. The patient was seen at the pain clinic in Prince Sultan Military Medical City after failure of conservative and multiple steroid injections followed by radiofrequency therapy. We discussed with the patient a trial of a platelet-rich plasma (PRP) injection into the sacrococcygeal ligament under fluoroscopic guidance with full details endorsed to the patient including the risks and benefits of the procedures and informed consent signed before the injection. Pain severity score was taken before and about one month after each injection. The patient received a total of three PRP injections. Result: The patient reported about 30%, 70%, and 85% pain reduction after the first, second, and third injection, respectively. At six months, the patient continued to experience the same level of reduced pain without the use of regular pain medications. Conclusion: PRP can be considered as an option for the treatment of patients with refractory coccydynia.

scholarly journals AB0858 SUCCESSFUL TERM PREGNANCY IN A PATIENT WITH GRANULOMATOSIS WITH POLYANGIITIS AFTER UNDERGOING RITUXIMAB THERAPY - CASE REPORT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1452.2-1453
Author(s):  
O. Sirenko ◽  
O. Kuryata ◽  
T. Lysunets ◽  
A. Legkobyt ◽  
H. Mostova
Keyword(s):  
Case Report ◽  
Granulomatosis With Polyangiitis ◽  
Disease Onset ◽  
Biological Agents ◽  
Term Pregnancy ◽  
Aseptic Necrosis ◽  
Azathioprine Therapy ◽  
Disease Remission ◽  
Obstetric Medicine ◽  
Patient Reported

Background:Granulomatosis with polyangiitis (GWP) is a relatively rare disease with the lack of experience in the management of pregnancy currently. Potentially negative factors of pregnancy prognosis are both disease-related and teratogenic effects of specific vasculitis therapy [1].Objectives:To describe a clinical case of Successful term pregnancy in a patient with Granulomatosis with polyangiitis after undergoing rituximab therapy.Methods:19 years-old woman was admitted to the rheumatology department of Clinical Regional Hospital After Mechnicov in 2013 with the debut of Granulomatosis with polyangiitis. Her disease course included recurrent rhinitis and sinusitis, Granulomatosis of the eye orbits. Positive ANCA titers were present in the disease onset. In the preceding 7 years she had been treated with corticosteroids, cyclophospan (discontinuated in 2017 because of lack of efficiency), than azathioprine. Aseptic necrosis of the both femoral head was estimated on fifth disease year. In 2018 azathioprine therapy had been discontinued owing to the disease progression and biological agents were prescribed – rituximab with positive effect. The disease remission was achived by rituximab therapy, the patient was warned about the need for contraception. The last dose of rituximab was introduced in February 2020. However, in March 2020, the patient reported pregnancy and therapy was discontinued. At the onset of pregnancy she was treated with 6 mg oral methylprednisolone. Daily and this dose was stable till all pregnancy period. Fetal growth assessment, congenital abnormalities screening test, and laboratory tests for gestational diabetes and preeclampsia were unremarkable during all gestational trimesters. The ANCA titers remained negative and renal function was normal and there was no flare during all pregnancy period.Results:At 38 weeks’ gestation a spontataneous labor started without induction. A 3270-g healthy boy delivered with APGAR score of 9 at 1 minute and 5 minutes. Postpartum the disease remained in remission, and the patient was maintained on corticosteroids. The infant was healthy, with normal development.Conclusion:Thus, the use of biological agents therapy in patients with GWP shows possible ways to safe reproductive potential with disease remission achievement.References:[1]Daher A, Sauvetre G, Girszyn N, Verspyck E, Levesque H, Le Besnerais M. Granulomatosis with polyangiitis and pregnancy: A case report and review of the literature. Obstetric Medicine. 2020;13(2):76-82. doi:10.1177/1753495X18822581Disclosure of Interests:None declared

Treating Knee Osteoarthritis With Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy: A Systematic Review

2021 ◽  
pp. 036354652199801
Author(s):  
Michael R. Baria ◽  
W. Kelton Vasileff ◽  
James Borchers ◽  
Alex DiBartola ◽  
David C. Flanigan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Combination Therapy ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Final Analysis ◽  
Preparation Technique ◽  
Randomized Studies ◽  
Patient Reported

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are injectable treatments for knee osteoarthritis. The focus of previous studies has compared their efficacy against each other as monotherapy. However, a new trend of combining these 2 injections has emerged in an attempt to have a synergistic effect. Purpose: To systematically review the clinical literature examining the combined use of PRP + HA. Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed and Embase. The following search terms were used: knee osteoarthritis AND platelet rich plasma AND hyaluronic acid. The review was performed by 2 independent reviewers who applied the inclusion/exclusion criteria and independently extracted data, including methodologic scoring, PRP preparation technique, HA composition, and patient-reported outcomes (PROs). Results: A total of 431 articles were screened, 12 reviewed in full, and 8 included in the final analysis: 2 case series, 3 comparative, and 3 randomized studies. Average follow-up was 9 months. The modified Coleman Methodology Score was 38.13 ± 13.1 (mean ± SD). Combination therapy resulted in improved PROs in all studies. Of the comparative and randomized studies, 2 demonstrated that combination therapy was superior to HA alone. However, when PRP alone was used as the control arm (4 studies), combination therapy was not superior to PRP alone. Conclusion: Combination therapy with PRP + HA improves PROs and is superior to HA alone but is not superior to PRP alone.

scholarly journals In vitro responses to platelet-rich-plasma are associated with variable clinical outcomes in patients with knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Habib Zahir ◽  
Bijan Dehghani ◽  
Xiaoning Yuan ◽  
Yurii Chinenov ◽  
Christine Kim ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Inflammatory Responses ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Limited Information ◽  
Knee Oa ◽  
Patient Reported ◽  
Treatment Comparisons

AbstractAutologous blood-derived products such as platelet-rich plasma (PRP) are widely used to treat musculoskeletal conditions, including knee osteoarthritis (OA). However, the clinical outcomes after PRP administration are often variable, and there is limited information about the specific characteristics of PRP that impact bioactivity and clinical responses. In this study, we aimed to develop an integrative workflow to evaluate responses to PRP in vitro, and to assess if the in vitro responses to PRP are associated with the PRP composition and clinical outcomes in patients with knee OA. To do this, we used a coculture system of macrophages and fibroblasts paired with transcriptomic analyses to comprehensively characterize the modulation of inflammatory responses by PRP in vitro. Relying on patient-reported outcomes and achievement of minimal clinically important differences in OA patients receiving PRP injections, we identified responders and non-responders to the treatment. Comparisons of PRP from these patient groups allowed us to identify differences in the composition and in vitro activity of PRP. We believe that our integrative workflow may enable the development of targeted approaches that rely on PRP and other orthobiologics to treat musculoskeletal pathologies.

scholarly journals Concurrent Glossopharyngeal Neuralgia and Hemi-Laryngopharyngeal Spasm (HeLPS): A Case Report and a Review of the Literature

Neurosurgery ◽  
2019 ◽  
Vol 87 (5) ◽  
pp. E573-E577
Author(s):  
C Michael Honey ◽  
Marie T Krüger ◽  
Alan R Rheaume ◽  
Josue M Avecillas-Chasin ◽  
Murray D Morrison ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Microvascular Decompression ◽  
Medical Condition ◽  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Conversion Disorder ◽  
Glossopharyngeal Neuralgia ◽  
Neurovascular Compression ◽  
Patient Reported

Abstract BACKGROUND AND IMPORTANCE Hemi-laryngopharyngeal spasm (HeLPS) has been recently described but is not yet widely recognized. Patients describe intermittent coughing and choking and can be cured following microvascular decompression of their Xth cranial nerve. This case report and literature review highlight that HeLPS can co-occur with glossopharyngeal neuralgia (GN) and has been previously described (but not recognized) in the neurosurgical literature. CLINICAL PRESENTATION A patient with GN and additional symptoms compatible with HeLPS is presented. The patient reported left-sided, intermittent, swallow-induced, severe electrical pain radiating from her ear to her throat (GN). She also reported intermittent severe coughing, throat contractions causing a sense of suffocation, and dysphonia (HeLPS). All her symptoms resolved following a left microvascular decompression of a loop of the posterior inferior cerebellar artery that was pulsating against both the IXth and Xth cranial nerves. A review of the senior author's database revealed another patient with this combination of symptoms. An international literature review found 27 patients have been previously described with symptoms of GN and the additional (but not recognized at the time) symptoms of HeLPS. CONCLUSION This review highlights that patients with symptoms compatible with HeLPS have been reported since 1926 in at least 4 languages. This additional evidence supports the growing recognition that HeLPS is another neurovascular compression syndrome. Patients with HeLPS continue to be misdiagnosed as conversion disorder. The increased recognition of this new medical condition will require neurosurgical treatment and should alleviate the suffering of these patients.

scholarly journals Recalcitrant Cutaneous Ulcer of Comorbid Patient Treated with Platelet Rich Plasma: A Case Report

2012 ◽  
Vol 27 (12) ◽  
pp. 1604 ◽  
Author(s):  
Dai Hyun Kim ◽  
Jong Yeob Kim ◽  
Soo Hong Seo ◽  
Hyo Hyun Ahn ◽  
Young Chul Kye ◽  
...  
Keyword(s):  
Case Report ◽  
Platelet Rich Plasma ◽  
Cutaneous Ulcer

Preenchimento facial com uso de material autólogo plasma gel - relato de caso

2021 ◽  
Vol 2 (6) ◽  
pp. 28-35
Author(s):  
Viviane Rozeira Crivellaro ◽  
Ane Micheline M. Oliveira ◽  
Julyana Gois ◽  
Paula Ferreira Martelozzo
Keyword(s):  
Case Report ◽  
Platelet Rich Plasma ◽  
Low Risk ◽  
Filling Material ◽  
Safe Option ◽  
Subsequent Heating

This case report demonstrates the use of plasma gelas a chin filler. Plasma gel is a material obtained from platelet-rich plasma (PRP) and its subsequent heating in an incubator.It is a safe option in relation to other fillers because it is an autologous biomaterial and therefore with low risk of immunoreaction. The chin was filled in bollus in the central part and with the tunneling technique on the sides. 0.2 mL of plasma gelwere used at each point, totaling 0.6 mL of the biomaterial. The protocol for this case was one session, with a reassessment after 28 days. Plasma gel proved to be effective as a temporary facial filling material. However, studies on its durability are lacking.

scholarly journals Apexification Using Mineral Trioxide Aggregate and Modified Internal Matrix: A Case Report

2021 ◽  
Vol 33 (2) ◽  
Keyword(s):  
Case Report ◽  
Mineral Trioxide Aggregate ◽  
Tissue Formation ◽  
Enamel Hypoplasia ◽  
Hard Tissue ◽  
Radiographic Evidence ◽  
Radiographic Findings ◽  
Immature Teeth ◽  
Patient Reported ◽  
Treatment Alternatives

When pulpal necrosis occurs in immature teeth, one of the treatment alternatives is the creation of an artificial apical barrier through the placement of an apical plug. However, controlling the mineral trioxide aggregate (MTA) during placement has proven difficult. Several studies evaluated the use of resorbable barriers to act as an internal matrix to prevent accidental extrusion of MTA. The aim of this case report was to document the effectiveness of Surgicel as a modified internal matrix for proper placement of MTA during management of immature teeth with necrotic pulp using the apical plug technique. A 12-year-old female patient reported with the chief complaint of a badly mutilated lower right second premolar. The tooth suffered enamel hypoplasia and had a defective coronal structure. It was asymptomatic except for slight tenderness to percussion. Based on the clinical and radiographic findings, a diagnosis of pulpal necrosis with symptomatic apical periodontitis was made. The 3- and 6-month followup showed radiographic evidence of continued root and hard tissue formation. Based on these findings, we infer that Surgicel can be used as a modified internal matrix to prevent extrusion of the MTA into the periapical area and allow for proper MTA placement. Keywords: Apexification; Apical plug; Mineral trioxide aggregate; Calcium hydroxide; Surgicel; Modified internal matrix

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