Repairing Effect of Platelet Enriched Plasma on Tendon Healing

To explore the repairing effect of platelet-rich plasma (PRP) on tendon (AT) healing, and provide evidence for PRP therapy to treat tendon-related diseases, 32 New Zealand white rabbits were selected to construct tendinopathy animal model. Leukocyte-rich Platelet-Rich Fibrin (Lr-PRP) and Leukocyte-poor Platelet-Rich Fibrin (Lp-PRP) were prepared, whose biological effects on tendon stem cells (TSCs) were explored. Rabbits were divided into control group, low, medium, and high dose groups regrading concentration of Lp-PRP. The number of fibroblasts, collagen fiber content, tubuloglomerular feedback-β1 (TGF-β1) expression, and biomechanical properties were compared at 15 and 30 days after operation. The results showed that Collagen-III (CoI-III) protein expression levels, interleukin-β (IL-β), and interleukin-6 (IL-6) levels in the Lp-PRP group were significantly higher than Lr-PRP group (P < 0.05). Fibroblasts and collagen fibers in group II and III were significantly higher versus group C 15 and 30 days after operation (P < 0.05). Fibroblasts and of collagen fibers in group III were significantly higher versus group II (P < 0.05). Expression of TGF-β1 in groups II and III was significantly higher than that in group C 15 days after operation (P < 0.05). Tensile load of AT repair site in group III was significantly higher than group C 30 days after operation (P < 0.05). Platelet plasma concentration had a certain repair effect on tendon injury and can effectively improve the quality of healing. In addition, Lp-PRP was better than Lr-PRP in tissue healing. When the concentration of Lp-PRP was 100%, the repair effect was the best.

Safety and efficacy of dendritic cell-based immunotherapy DCVAC/OvCa added to first-line chemotherapy (carboplatin plus paclitaxel) for epithelial ovarian cancer: a phase 2, open-label, multicenter, randomized trial

BackgroundMost patients with epithelial ovarian cancer (EOC) relapse despite primary debulking surgery and chemotherapy (CT). Autologous dendritic cell immunotherapy (DCVAC) can present tumor antigens to elicit a durable immune response. We hypothesized that adding parallel or sequential DCVAC to CT stimulates antitumor immunity and improves clinical outcomes in patients with EOC. Based on the interim results of sequential DCVAC/OvCa administration and to accommodate the increased interest in maintenance treatment in EOC, the trial was amended by adding Part 2.MethodsPatients with International Federation of Gynecology and Obstetrics stage III EOC (serous, endometrioid, or mucinous), who underwent cytoreductive surgery up to 3 weeks prior to randomization and were scheduled for first-line platinum-based CT were eligible. Patients, stratified by tumor residuum (0 or <1 cm), were randomized (1:1:1) to DCVAC/OvCa parallel to CT (Group A), DCVAC/OvCa sequential to CT (Group B), or CT alone (Group C) in Part 1, and to Groups B and C in Part 2. Autologous dendritic cells for DCVAC were differentiated from patients’ CD14+ monocytes, pulsed with two allogenic OvCa cell lines (SK-OV-3, OV-90), and matured in the presence of polyinosinic:polycytidylic acid. We report the safety outcomes (safety analysis set, Parts 1 and 2 combined) along with the primary (progression-free survival (PFS)) and secondary (overall survival (OS)) efficacy endpoints. Efficacy endpoints were assessed in the modified intention-to-treat (mITT) analysis set in Part 1.ResultsBetween November 2013 and March 2016, 99 patients were randomized. The mITT (Part 1) comprised 31, 29, and 30 patients in Groups A, B, and C, respectively. Baseline characteristics and DCVAC/OvCa exposure were comparable across the treatment arms. DCVAC/OvCa showed a good safety profile with treatment-emergent adverse events related to DCVAC/OvCa in 2 of 34 patients (5.9%) in Group A and 2 of 53 patients (3.8%) in Group B. Median PFS was 20.3, not reached, and 21.4 months in Groups A, B, and C, respectively. The HR (95% CI) for Group A versus Group C was 0.98 (0.48 to 2.00; p=0.9483) and the HR for Group B versus Group C was 0.39 (0.16 to 0.96; p=0.0336). This was accompanied by a non-significant trend of improved OS in Groups A and B. Median OS was not reached in any group after a median follow-up of 66 months (34% of events).ConclusionsDCVAC/OvCa and leukapheresis was not associated with significant safety concerns in this trial. DCVAC/OvCa sequential to CT was associated with a statistically significant improvement in PFS in patients undergoing first-line treatment of EOC.Trial registration numberNCT02107937, EudraCT2010-021462-30.

Cardiovascular Risk in Patients with COPD: Cardiovascular Comorbidities in Patients with COPD Increase CAT and mMRC Dyspnea Scores

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with a number of different comorbidities. Cardiovascular diseases (CVD) are the most frequent comorbidities in COPD. The economic burden associated with cardiovascular comorbidity (CVC) in this population of patients is considerable. The COPD patients are related to the increased systemic inflammation, reduced capacity for physical activity, and airflow obstruction. AIM: The aim of our investigation was to evaluate the dyspnea as a disabling symptom in COPD patients with cardiovascular comorbidity (CVC) especially heart failure. The main aim of this study is to evaluate its intensity in patients with COPD in stages II according to GOLD. METHODS: The investigation was conducted from December 2019 to January 2020, on pulmonology and allergology clinic and cardiology clinic of medical faculty in Skopje. We investigated 65 outpatients with COPD, 44 with different type of CVD, Group I, and 21 without CVD, Group II. All patients were with partial chronic respiratory failure (In type 1 respiratory failure hypoxemic). Patients, according GOLD initiative, were in COPD stadium II, 70% < forced expiratory volume in 1 s (FEV1)>50%. Heart condition was diagnosed on the basis of clinical examination, electrocardiography, and echocardiography of the heart. Included patients with CVD were with ejection fraction (EF) <65%. Dyspnea was measured with modified MRC (mMRC) dyspnea scale. RESULTS: The forced vital capacity and forced expiratory volume in 1 s were statically significantly higher in Group II with CVD. Dyspnea measured with Modified Medical Research Council (MRC) dyspnea scale showed statistically significantly higher values in Group I COPD patients with CVC (2.9 ± 1.4) versus Group II without CVC (1.7 ± 1.4), (p < 0.05). The perception of the higher dyspnea in Group I was associated with increased COPD assessment test-scores, in Group I: Group I (19.8 ± 9.1) versus Group II: (9.8 ± 9.1), (p < 0.001). The number of exacerbations and what is more important the number of severe exacerbation leading to hospitalizations was statistically higher in patients of Group I with CVC than in Group II without CVC (3.0 ± 1.1 vs. 1.0 ± 2.1), (p < 0.001) and the number of hospitalizations (1.0 ± 1.1 vs. 0.3 ± 2.1) (p < 0.001). CONCLUSION: We can conclude that patients with COPD who have CVC have an increased risk of high symptoms, which mean poor quality of life and increased morbidity.

Fetal Renal Volume and Fetal Renal Artery Doppler in Normal and Intrauterine Growth Restricted Fetuses

Background: Human fetal kidney undergoes constant changes throughout the pregnancy to attain final maturity in terms of structural and functional aspect. Approximately one million nephrons are seen on either side at birth in term fetuses. Many factors both maternal and fetal affect nephrogenesis viz. maternal malnutrition, maternal hyperglycemia, Intrauterine Growth Restriction (IUGR), vitamin A deficiency, and fetal exposure to some drugs. The aim of this study was to evaluate changes in the fetal renal artery Doppler parameter and fetal kidney volume measured by 3D ultrasound system with (VOCAL) method in normally grown and growth restricted fetuses after 26 weeks of gestation. Methods: This prospective study include 60 pregnant women divided in to two groups, first one (A) contains 30 pregnant women with intrauterine growth restricted fetuses, and the second one (B) contains 30 pregnant women with normally grown fetuses. Results: There was insignificant differences between two groups as regard gestational age by date but gestational age by US there was significant decrease in group A. There were insignificant differences between two groups as regard length of kidney either right or left. There was significant decrease in kidney width right and left side in group A versus group B. There was significant decrease in kidney depth right and left side in group A versus group B. There was significant decrease in kidney volume right and left side in group A versus group B. There was significant decrease in combined kidney volume in group A versus group B. There was significant increase in renal artery PI, RI in group A versus group B. Conclusions: Fetal hypoxemia which occurs in growth restricted fetuses leads to reduction in the percentage of the cardiac output reaching the kidneys which was reflected on Doppler as increase in the renal artery pulsatility index causing reduced renal perfusion. This reduction in the renal perfusion was responsible for impaired nephrogenesis and thus decreased kidney volume in growth restricted fetuses as compared to normal fetuses.

People are more tolerant of inequality when it is expressed in terms of individuals rather than groups at the top

Despite the ever-growing economic gap between the very wealthy and the rest of the population, support for redistributive policies tends to be low. This research tested whether people’s tolerance of inequality differs when it is represented in terms of a successful individual versus a group of people at the top of the economic ladder. We propose that drawing people’s attention to wealthy individuals undermines support for redistribution by leading people to believe that the rich person’s wealth is well deserved. Across eight studies (n = 2,800), survey participants rated unequal distributions of resources as more fair when presented with an individual, rather than a group, at the top of the distribution. Participants also expressed lower support for redistributive policies after considering inequality represented by successful individuals compared to groups. This effect was driven by people’s different attributions for individual versus group success. Participants thought that individuals at the top were more deserving of their successes and, in turn, were less likely to support redistribution when inequality was represented by individual success. These findings suggest that support for inequality, and policies to reduce it, may depend on who people are led to consider when they think about the top of the economic distribution.

283 Precision versus Group Supplementation at Two Levels on Growth and Development of Replacement Heifers

Two experiments were conducted to evaluate use of the Super SmartFeeder (SSF; C-Lock, Inc.) for individual versus group supplementation of heifers grazing stockpiled, novel tall fescue. In experiment 1, Angus heifers (n = 64; 267 + 31.7 kg) had access to the SSF and were allowed 3.6 kg/d of grower supplement. Individual intake was recorded daily and analyzed to determine adoption. Twenty-four percent of the heifers did not adopt to individual SSF supplementation (P &lt; 0.05). In experiment 2, heifers (n = 64; BW= 275 + 31.3 kg) were allotted, based on adoption to SSF, to supplementation system of group feeding (n = 2 reps/level; GRP) or SSF precision feeding (n =16/level; PRE) at two levels (0.5% or 1% of BW) for 127-d in a 2 x 2 factorial. Data were analyzed using Mixed procedure. The interaction between supplementation level and feeding system tended to be significant (P = 0.10) for overall ADG. Average daily gain was greater for 1% BW than 0.5% BW (0.81 vs. 0.47 kg/d) for PRE but did not differ for GRP (0.69 kg/d). Daily supplement dry matter intake differed (P &lt; 0.05) by supplementation level and total BW gain was greater (P &lt; 0.05) by 24.3 kg for 1% versus 0.5% supplementation level. Ultrasound ribeye area and fat thickness measures were greater (P &lt; 0.05) for 1% BW supplement compared to 0.5% BW at the end of the 127d study. When PRE was analyzed independently, heifer BW differed (P &lt; 0.05) on d 91, 117 and 127 between supplement levels. The correlation between individual heifer daily supplement intake and overall ADG for PRE was 0.68 (P &lt; 0.0001). The use of technology to precisely control intake in a grazing system created greater divergence in growth by supplementation level compared to group feeding systems.

Do Different Types of Anaesthesia for Cesarean Delivery cause Subacute Low Back Pain ?

Background: Low back pain is a common complaint after cesarean delivery, different causes may be involved however they are poorly understood due to many confounders. Methodology: We performed this retrospective cohort study to assess the intensity of low back pain among 38 women (26 of them underwent cesarean delivery, assessed after 6 to 12 weeks from delivery date, they were classified into: epidural anaesthetic group (Group A) n.=6, spinal anaesthetic group (Group B) n.=13, general anaesthetic group (Group C) n.=7 and they were either primiparous or multiparous who did not receive any type of anaesthesia for at least one year prior to the last obstetric anaesthesia while the other 12 women were the control group (Group D) who didn’t experience any pregnancy or anaesthesia. Results: The mean values of visual analogue scale (VAS) in Group A, Group B, Group C, and Group D were 5.00 ±1.67, 4.62 ±1.12, 5.14 ±1.21, and 2.17 ±0.71, respectively. The ANOVA test revealed a significant difference in VAS among groups A, B, C, and D. Despite, the post-hoc test revealed a significant difference in VAS between group A versus group D, group B versus group D, and group C versus group D, but there were no significant differences between group A versus group B, group A versus group C, and group B versus group C. Conclusion: Cesarean delivery with different anaesthetic types as: epidural, spinal and general anaesthesia was associated with subacute low back pain without significant differences in pain intensity between these anaesthetic types. Key words: Neuraxial Anaesthesia, General Anaesthesia,Cesarean Delivery, Subacute Period, Low Back Pain.

A COMMUNITY SURVEY ON EFFECT OF STEP AEROBIC EXERCISES AND MUSIC THERAPY ON MENTAL HEALTH IN MENOPAUSAL WOMEN

To evaluate the effect of Step aerobic exercises and music therapy on mental health in menopausal women. Menopausal women of selected areas of Belagavi city were screened in a door to door survey using Menopause Quality Of Life (MENQOL) questionnaire. 69 menopausal women who fulfilled the inclusion criteria were divided randomly into 3 groups Group A was administrated Music therapy, for Group B Step Aerobic Exercises was given and Group C was administrated combination of Music therapy and step aerobic exercises. All three groups showed significant changes from pre and post intervention. The p-value for Group A versus Group B between pre-test and post-test was 0.001*.For Group A versus Group C was 0.001* and for Group B versus Group C between pre-test and post-test was 0.906 which was not significant. Step aerobics, music therapy and a combination of both were equally effective in improving the mental health status of post-menopausal women. Any one or combination of them can be used to help improve quality of life in these women.