Anti-Inflammatory Effect of Cross-Linked Hyaluronic Acids in Osteoarthritic Knee, Detected by Ultrasonography

Abstract Background: Synovial hypertrophy is one of the pathological characteristics of knee osteoarthritis (OA), which is associated with the inflammation process and disease severity. Ultrasonography (US) is a practical tool to monitor disease progression and the response to treatment. Intra-articular hyaluronic acid (IAHA) is one of the commonly-used alternative treatments for knee OA. In this study, we used US to assess the effects of cross-linked hyaluronic acid, in terms of minimizing inflammation, by comparing synovial thickness before and after IAHA.Methods: Seventy-nine OA patients (107 knees, KL II-III and KL IV with surgery refusal) were treated with cross-linked IAHA and underwent US before IAHA at 4-week and 3-month follow-up visits after injection. Comparisons of synovial thickness before and after injection were analyzed. Clinical outcomes were also evaluated by the recording of the visual analog scale for pain (pain VAS).Results: The overall synovial thickness was significantly decreased after IAHA at 4 weeks (p=0.01). The thickness was significantly reduced in KL II (p=0.01), but not significant in KL III and IV (p=0.096 and 0.083, respectively). In KL IV, the thickness was significantly increased at 3 months after IAHA (p=0.02).The pain VAS improved gradually at 4 weeks and 3 months after IAHA, significantly (p < 0.001) in all KL stages.Conclusion: Cross-linked hyaluronic acid injection provided pain relief in all KL stages at 4 weeks and lasted at least 3 months. However, its anti-inflammation action was temporary and predominated only in patients with early-stage OA knee. Concerning inflammation as a major risk factor for OA progression, adjunct intervention after IAHA should be added to enhance the therapeutic effect and prevent further joint destruction. IRBRTA: R074h/62

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A Comparative Study of Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana in the Management of Shweta Pradara

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i4.9322 ◽

2017 ◽

Vol 2 (4) ◽

Author(s):

Renuka M. Tenahalli

Keyword(s):

Vitamin C ◽

Early Stage ◽

Pathological Condition ◽

Before And After ◽

Group A ◽

Phosphorus Iron ◽

Group B ◽

Busy Schedule ◽

Iron And Calcium

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.

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Serum C-reactive protein metabolite (CRPM) is associated with incidence of contralateral knee osteoarthritis

Scientific Reports ◽

10.1038/s41598-021-86064-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Anne-Christine Bay-Jensen ◽

Asger Bihlet ◽

Inger Byrjalsen ◽

Jeppe Ragnar Andersen ◽

Bente Juhl Riis ◽

...

Keyword(s):

Phase Iii ◽

Response To Treatment ◽

C Reactive Protein ◽

Two Phase ◽

Knee Oa ◽

Reactive Protein ◽

Inflammatory Phenotype ◽

The Mean ◽

Using Data

AbstractThe heterogeneous nature of osteoarthritis (OA) and the need to subtype patients is widely accepted in the field. The biomarker CRPM, a metabolite of C-reactive protein (CRP), is released to the circulation during inflammation. Blood CRPM levels have shown to be associated with disease activity and response to treatment in rheumatoid arthritis (RA). We investigated the level of blood CRPM in OA compared to RA using data from two phase III knee OA and two RA studies (N = 1591). Moreover, the association between CRPM levels and radiographic progression was investigated. The mean CRPM levels were significantly lower in OA (8.5 [95% CI 8.3–8.8] ng/mL, n = 781) compared to the RA patients (12.8 [9.5–16.0] ng/mL, n = 60); however, a significant subset of OA patients (31%) had CRPM levels (≥ 9 ng/mL) comparable to RA. Furthermore, OA patients (n = 152) with CRPM levels ≥ 9 ng/mL were more likely to develop contra-lateral knee OA assessed by X-ray over a two-year follow-up period with an odds ratio of 2.2 [1.0–4.7]. These data suggest that CRPM is a blood-based biochemical marker for early identification OA patients with an inflammatory phenotype.

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Clinical study of mucosa-associated lymphoid tissue lymphomas of the head and neck

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002192 ◽

2011 ◽

Vol 126 (3) ◽

pp. 271-275

Author(s):

S Hosokawa ◽

J Okamura ◽

Y Takizawa ◽

G Takahashi ◽

K Hosokawa ◽

...

Keyword(s):

Head And Neck ◽

Surgical Resection ◽

Lymphoid Tissue ◽

Early Stage ◽

Local Treatment ◽

Response To Treatment ◽

Limited Information ◽

Early Stage Disease ◽

First Choice

AbstractBackground:Limited information is available on mucosa-associated lymphoid tissue lymphomas arising in the head and neck.Method:A retrospective analysis was conducted of 20 patients who were histologically diagnosed with mucosa-associated lymphoid tissue lymphoma and treated at our institution between January 1990 and December 2009.Results:Treatment consisted of surgical resection alone in two patients (10 per cent), surgical resection with consecutive radiotherapy in one (5 per cent), and radiotherapy alone in eight (40 per cent). Three patients (15 per cent) were treated with systemic chemotherapy, and three (15 per cent) received chemoradiotherapy. Three patients (15 per cent) were informed of the diagnosis but not treated for their condition.Conclusion:All of the 20 patients were still alive after a mean follow-up period of 50.8 months. Local treatment for mucosa-associated lymphoid tissue lymphoma of the head and neck should be the first choice in early-stage disease. However, prolonged follow up is important to determine these patients' long-term response to treatment.

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Whether Keratectasia Area Shown in Corneal Topography Is Appropriate for Evaluating the Effect of Corneal Cross-Linking for Keratoconus: A 12-Month Follow-Up Study

BioMed Research International ◽

10.1155/2019/1762537 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Jia Wang ◽

Zhiwei Li ◽

Huankai Zhang ◽

Ning Gao ◽

Guoying Mu

Keyword(s):

Endothelial Cell ◽

Linear Regression ◽

Early Stage ◽

Morphological Changes ◽

Corneal Thickness ◽

Corneal Topography ◽

Cross Linking ◽

Follow Up Study ◽

Before And After

Purpose. To analyze the keratectasia area (KEA) shown in corneal topography before and after corneal cross-linking (CXL) in patients with progressive keratoconus (KC) and figure out whether KEA is appropriate for evaluating the effect of CXL. Methods. A retrospective analysis was conducted in 34 eyes from 24 progressive KC patients who have underwent CXL from 2015 to 2017. Area with K-value more than 47D shown in the corneal topography was marked and identified as KEA. Keratometry (K1, K2, and Kmax), KEA, thinnest corneal thickness (TCT), and endothelial cell density (ECD) were evaluated preoperatively or at months 3, 6, and 12 postoperatively. The changes of KEA before and after operation were evaluated. The relation of KEA and other parameters, including Kmax and TCT, was analyzed. Results. Linear regression model revealed the KEA, Kmax, K1, and K2 decreased after CXL in model y = 0.9622 -0.02408 x (P<0.05), y = 0.9982 -0.003469 x(P<0.05), y = 0.9977 + -0.001347 x(P<0.05), y = 0.9992 + -0.001779 x(P<0.05) (y represents KEA, Kmax, K1, or K2; x represents time (month)). The KEA is significantly decreased in early stage (before month 3) (P<0.05); however, the Kmax, K1, and K2 have no significant decrease in early stage (P= 0.09, 0.19, 0.32). Conclusions. The KEA is more sensitive than K-value in describing the morphological changes of cornea after CXL, especially in early stage after treatment.

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Evaluation of a national lung cancer symptom awareness campaign in Wales

British Journal of Cancer ◽

10.1038/s41416-019-0676-2 ◽

2019 ◽

Vol 122 (4) ◽

pp. 491-497 ◽

Cited By ~ 2

Author(s):

Grace McCutchan ◽

Stephanie Smits ◽

Lucy Ironmonger ◽

Ciarán Slyne ◽

Amanda Boughey ◽

...

Keyword(s):

Lung Cancer ◽

Early Stage ◽

Routine Data ◽

X Rays ◽

Before And After ◽

Symptom Awareness ◽

Gp Visits ◽

Symptom Recall ◽

The Impact

Abstract Background Lung cancer is the leading cause of cancer mortality in Wales. We conducted a before- and after- study to evaluate the impact of a four-week mass-media campaign on awareness, presentation behaviour and lung cancer outcomes. Methods Population-representative samples were surveyed for cough symptom recall/recognition and worry about wasting doctors’ time pre-campaign (June 2016; n = 1001) and post-campaign (September 2016; n = 1013). GP cough symptom visits, urgent suspected cancer (USC) referrals, GP-ordered radiology, new lung cancer diagnoses and stage at diagnosis were compared using routine data during the campaign (July–August 2016) and corresponding control (July–August 2015) periods. Results Increased cough symptom recall (p < 0.001), recognition (p < 0.001) and decreased worry (p < 0.001) were observed. GP visits for cough increased by 29% in the target 50+ age-group during the campaign (p < 0.001) and GP-ordered chest X-rays increased by 23% (p < 0.001). There was no statistically significant change in USC referrals (p = 0.82), new (p = 0.70) or early stage (p = 0.27) diagnoses, or in routes to diagnosis. Conclusions Symptom awareness, presentation and GP-ordered chest X-rays increased during the campaign but did not translate into increased USC referrals or clinical outcomes changes. Short campaign duration and follow-up, and the small number of new lung cancer cases observed may have hampered detection effects.

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Evaluation of Histopathological Changes in Control Biopsies Which Taken 48 Sessions after NBUVB Phototherapy for Early-Stage Mycosis Fungoides

The Scientific World JOURNAL ◽

10.1100/2012/426732 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Ebru Zemheri ◽

Seyma Ozkanli ◽

Ilkin Zindanci ◽

Serkan Senol ◽

Ozge Akbulak ◽

...

Keyword(s):

Stratum Corneum ◽

Early Stage ◽

Response To Treatment ◽

Epidermal Thickness ◽

Dermal Fibrosis ◽

Narrowband Uvb ◽

Before And After ◽

Histomorphological Changes ◽

Skin Biopsies ◽

Perivascular Infiltration

Background.There are not many studies investigating histomorphological changes in 48 sessions in patients with early-stage MF after narrowband UVB (NBUVB) treatment. Our purpose is to evaluate histological features of phototherapy after 48 sessions and determine which parameters are more reliable for controlling skin biopsies.Methods.Biopsies of 32 patients with early stage of MF, who were treated with NBUVB phototherapy, were histologically evaluated before and after the treatments, including epidermotropism, stratum corneum, epidermal thickness, dermal infiltration, papillary dermal fibrosis, vascular alterations, and other dermal changes. We discuss the histomorphological effects of NBUVB phototherapy on skin biopsies by comparing the responders with nonresponders, with before and after the treatment.Results.9 patients (28%) did not give any response to treatment. Alleviation in epidermotropism, increases in parakeratosis and normal keratosis, perivascular infiltration, and melanophages, decrease in the lichenoid/patchy lichenoid infiltration pattern after the treatment was statistically significant. Comparing by response, normalization of stratum corneum and epidermis, orthohyperkeratosis, decrease in linearly arranged cells, the lichenoid/patchy lichenoid infiltration, the loss of inflammation were statistically significant in responders group.Conclusion.We detected a significant decrease in linearly arranged cells after phototherapy, indicating that it is an “important diagnostic parameter" in evaluation of therapeutic response.

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Clinicians’ Perspectives on the Use of Intra-Articular Hyaluronic Acid as a Treatment for Knee Osteoarthritis: A North American, Multidisciplinary Survey

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.4137/cmamd.s34496 ◽

2016 ◽

Vol 9 ◽

pp. CMAMD.S34496 ◽

Cited By ~ 3

Author(s):

Jeffrey Rosen ◽

Victoria Avram ◽

Anke Fierlinger ◽

Faizan Niazi ◽

Parag Sancheti ◽

...

Keyword(s):

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Patient Outcomes ◽

Current Literature ◽

Early Stage ◽

Sodium Hyaluronate ◽

Cross Linking ◽

Product Characteristics ◽

Knee Oa ◽

Orthopedic Surgeons

Introduction This study aims to describe the perceptions of orthopedic surgeons on the efficacy of intra-articular hyaluronic acid (IA-HA), the influence of IA-HA product characteristics on its efficacy, and to identify patterns and factors related to the use of IA-HA. Additionally, this study examines factors that influence IA-HA brand selection, focusing on Euflexxa¯ (1% sodium hyaluronate). Methods We developed survey questions by reviewing the current literature and consulting with experts on the use of IA-HA in the management of knee osteoarthritis (OA). The survey included questions on demographics, previous experience with knee OA treatment, opinions on different treatment methods, and where information regarding treatments is obtained. Additionally, questions specific to opinions regarding IA-HA and the reasoning behind these opinions were asked. Results A total of 117 orthopedic surgeons and physicians completed the survey. IA-HA is most frequently prescribed to patients with early-stage (82%) or mid-stage (82.8%) OA, while fewer orthopedic surgeons and physicians use IA-HA for patients with late-stage OA (57.4%). Respondents were generally uncertain of the effects that intrinsic characteristics, such as molecular weight, cross-linking, and production process, had on patient outcomes. Respondents typically use their own clinical experience and results as a deciding factor in utilizing IA-HA treatment, as well as in choosing an IA-HA brand. Conclusion Uncertainty regarding the efficacy of IA-HA treatments is likely due to inconsistency within clinical guidelines and the current literature. Additional research investigating the efficacy of IA-HA treatment and how product characteristics affect outcome and safety is required to provide clarity to the controversy surrounding IA-HA treatment for knee OA.

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Local Use of Dexamethasone in the Treatment of Ocular Myasthenia Gravis

10.21203/rs.3.rs-25812/v2 ◽

2020 ◽

Author(s):

Minghua Shi ◽

Yingjia Ye ◽

Junping Zhou ◽

Aijiao Qin ◽

Jing Cheng ◽

...

Keyword(s):

Myasthenia Gravis ◽

Extraocular Muscle ◽

Direct Injection ◽

Response To Treatment ◽

Ocular Myasthenia ◽

Ocular Myasthenia Gravis ◽

Before And After ◽

Local Use ◽

Symptom Recurrence

Abstract Background: At present, patients with ocular myasthenia gravis (OMG) are typically treated with systemic drugs. We investigated the use of dexamethasone injected in the peribulbar region or extraocular muscle to treat patients with OMG. Methods: Patients with OMG were given dexamethasone via peribulbar injection or direct injection into the main paralyzed extraocular muscles, once a week, for 4-6 weeks. The severity of diplopia, blepharoptosis, eye position, and eye movement were evaluated before and after treatment. The duration of follow-up time was ≥6 months. Results: Among the 14 patients with OMG who received this treatment, mean age was 38.7 ± 29.7 years. After treatment, symptoms were relieved in 12 patients (85.7%), 1 patient (7.1%) had partial response to treatment, and 1 patient (7.1%) had no response. Two patients (14.2%) experienced symptom recurrence during the follow-up period.Conclusions: Dexamethasone peribulbar or extraocular muscle injection is effective in the treatment of patients with OMG and may replace systemic drug therapy.

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Local Use of Dexamethasone in the Treatment of Ocular Myasthenia Gravis

10.21203/rs.3.rs-25812/v3 ◽

2020 ◽

Author(s):

Minghua Shi ◽

Yingjia Ye ◽

Junping Zhou ◽

Aijiao Qin ◽

Jing Cheng ◽

...

Keyword(s):

Myasthenia Gravis ◽

Extraocular Muscle ◽

Direct Injection ◽

Response To Treatment ◽

Clinical Trial Registry ◽

Ocular Myasthenia ◽

Ocular Myasthenia Gravis ◽

Before And After ◽

Local Use

Abstract Background: At present, patients with ocular myasthenia gravis (OMG) are typically treated with systemic drugs. We investigated the use of dexamethasone injected in the peribulbar region or extraocular muscle to treat patients with OMG.Methods: Patients with OMG were given dexamethasone via peribulbar injection or direct injection into the main paralyzed extraocular muscles, once a week, for 4-6 weeks. The severity of diplopia, blepharoptosis, eye position, and eye movement were evaluated before and after treatment. The duration of follow-up time was ≥6 months.Results: Among the 14 patients with OMG who received this treatment, mean age was 38.7 ± 29.7 years. After treatment, symptoms were relieved in 12 patients (85.7%), 1 patient (7.1%) had partial response to treatment, and 1 patient (7.1%) had no response. Two patients (14.2%) experienced symptom recurrence during the follow-up period.Conclusions: Dexamethasone peribulbar or extraocular muscle injection is effective in the treatment of patients with OMG and may replace systemic drug therapy.Trial registration: Chinese Clinical Trial Registry, ChiCTR2000038863, October 7, 2020.Retrospectively registered.

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P14.92 Study of Glutaminergic and Glutamatergic Metabolism in 1H-MRS Monovoxel in the Most Aggressive Part of 62 Glioblastoma Before and After 18 months Treatment

Neuro-Oncology ◽

10.1093/neuonc/noz126.327 ◽

2019 ◽

Vol 21 (Supplement_3) ◽

pp. iii89-iii89

Author(s):

A Heintz ◽

J Chombar ◽

S Boussida ◽

Z Saidak ◽

M Lefranc ◽

...

Keyword(s):

Nmr Spectra ◽

Response To Treatment ◽

Tumor Proliferation ◽

Progressive Decrease ◽

Concomitant Chemotherapy ◽

1H Mrs ◽

Before And After ◽

Metabolic Activities ◽

Stupp Protocol

Abstract BACKGROUND To study the relationships between glutaminergic metabolism (Glx/tCr), tumor proliferation (tCho/tCr) and other metabolic activities in patients with glioblastoma (GBM). MATERIAL AND METHODS Patients: 62 patients with glioblastoma, all having a STUPP Protocol (radiotherapy and concomitant chemotherapy), were selected and separated into 2 groups: Biopsies (30) and resections (32). In total, 269 NMR spectra (PRESS at GE 1.5T and 3T; multi-TEs TE=35ms and TE=144ms) were acquired. Processing: MRS data were processed with jMRUI software and quantitated using HLSVD and QUEST algorithms. Statistical analysis of longitudinal MRS data (every 3 months) RESULTS Glx/tCr and Lac/tCr ratios are correlated with the tumoral proliferation (tCho/tCr) before the beginning of treatment. This correlations decreases over time in biopsied and resected patients. In biopsied patients, the evolution of lactate (Lac/tCr) and Glx (Glx/tCr) ratios is similar along the follow-up with a progressive decrease in tumor proliferation (tCho/tCr). However, in resected patients, the evolution of lactate (Lac/tCr) and Glx (Glx/tCr) ratios is similar until 6 months and differ above: a progressive decrease of Lac/tCr and Glx/tCr until 18 months with a higher level of Glx/tCr. CONCLUSION Despite the difficulties to separate glutamine from glutamate (post-processing improvement is ongoing), spectroscopic measurements of Glx changes before clinical deterioration. The increase of Glx is longer (in time) than the Lactate increase after 6 months of treatment in the resected patients could be predictive of the observed increase of tumor proliferation at 12 months of treatment.The study of glutaminergic metabolism in the GBM could be used to evaluate the response to treatment. Being able to predict the increase of tumor proliferation in resected patients could allow a faster treatment adaptation.

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