Liquid and gel Platelet Rich Plasma as skin healing adjuvant / Plasma Rico em Plaquetas em suas frações líquida e em gel como adjuvantes da cicatrização cutânea

Background: In recent decades, many researches have been conducted on processes involved in tissue repairing, mainly in the development of resources and technology designed to improve the wound healing progress. Platelet rich plasma (PRP) derived from autologous blood is defined as a plasma volume with platelet concentration higher than physiological level. It is an autogenous and low cost source of growth factors, which are essential for tissue regeneration due to their angiogenic, mitogenic, and chemotactic properties. The aim of this study was evaluate two forms of PRP- liquid and gel - regarding their capacity to influence quality and repair time of standardized skin injuries. Materials, Methods & Results: New Zealand healthy rabbits were distributed in three groups (n = 6): control group (CG), liquid platelet rich plasma group (LIQPRP), and gel platelet rich plasma group (GELPRP). Acute skin lesions were inducted in two areas approximately 2 cm close to scapular edge and depth including epidermis, dermis, and hypodermis to external muscular fascia. Animals received treatment according to each group. Injuries were measured with digital pachymeter in two directions: longer length (l) and longer width (w), every two days. Areas and healing rates were calculated. Microscopic analysis samples were collected on days seven and 14 and evaluated through hematoxylin and eosin [...](AU)

Liquid and gel Platelet Rich Plasma as skin healing adjuvant / Plasma Rico em Plaquetas em suas frações líquida e em gel como adjuvantes da cicatrização cutânea

Background: In recent decades, many researches have been conducted on processes involved in tissue repairing, mainly in the development of resources and technology designed to improve the wound healing progress. Platelet rich plasma (PRP) derived from autologous blood is defined as a plasma volume with platelet concentration higher than physiological level. It is an autogenous and low cost source of growth factors, which are essential for tissue regeneration due to their angiogenic, mitogenic, and chemotactic properties. The aim of this study was evaluate two forms of PRP- liquid and gel - regarding their capacity to influence quality and repair time of standardized skin injuries. Materials, Methods & Results: New Zealand healthy rabbits were distributed in three groups (n = 6): control group (CG), liquid platelet rich plasma group (LIQPRP), and gel platelet rich plasma group (GELPRP). Acute skin lesions were inducted in two areas approximately 2 cm close to scapular edge and depth including epidermis, dermis, and hypodermis to external muscular fascia. Animals received treatment according to each group. Injuries were measured with digital pachymeter in two directions: longer length (l) and longer width (w), every two days. Areas and healing rates were calculated. Microscopic analysis samples were collected on days seven and 14 and evaluated through hematoxylin and eosin [...]

Comparação entre três protocolos de obtenção de plasma rico em plaquetas (PRP) utilizando o coelho como modelo experimental / Comparison of Three Protocols to Obtain Platelet Rich Plasma (PRP) with Rabbits as Experimental Model

Background: Platelet rich plasma (PRP) is a blood-derived source of growth factors and several cytokines, which are essential for tissue regeneration and important for wound healing due to their angiogenic, mitogenic, and chemotactic activities. To date no protocol has been established for PRP production. Standardization of this technique should consider fundamental factors such as experimental model used, blood collection method, anticoagulant choice, rotation and amount of centrifugations, elapsed time between sample activation and its clinical use in order to ensure quality and biological effects of the product. This study aimed to compare three protocols for PRP achievement in order to evaluate platelet enrichment ability and method reproducibility for further use in clinical investigations regarding PRP therapeutic properties. Materials, Methods & Results: New Zealand higid rabbit's whole blood was collected in tubes containing sodium citrate. Samples were obtained through exsanguination, via abdominal aortic puncture, and separated in four aliquots designed for PRP processing and basal platelet count. The count was conducted at the time blood was collected and after every concentration protocol. Methods were tested in triplicates, and three different individuals repeated each technique for three times, reaching 27 repetitions. Selected methodologies consisted in two centrifugations protocols: protocol A used 250 g for 10 min for the first separation, and another 10 min at 2000 g during the second centrifugation; protocol B proposed that first centrifugation would last 20 min at 160 g, and the second would last 15 min at 400 g, and protocol C consisted of 10 min at 400 g for the first separation, and 10 min at 800 g during second separation. Protocols were performed at the same time in three similar centrifuges, in order to standardize the variables (operator, time, environment, equipments), and also to diminish biases. Comparison objects in this study include: ability of raising platelet concentration, time required for preparing the final product, reproduction handiness, and need for equipment for proper hemoconcentrated production. Achieved platelet count in each protocol and basal value were analyzed following randomized complete. Kurskal-Wallis test was used for independent samples comparison, considering a 5% significance level. For each tested sample, elapsed time for product preparation was evaluated. Subjective analyzes comprehended execution easiness and the need for special material, and were evaluated through questionnaire after each protocol. Protocol A showed a 25-fold increase in platelet count, whereas protocols B and C had 13 and 7-fold, respectively. Results indicate all protocols were efficient in concentrating the samples at least 3 times more than basal count. Elapsed time for product preparation in each protocol was 35, 52, and 41 min for A, B, and C methods, respectively. Subjective analyzes considered protocols A and C as low complexity, and protocol B was defined as medium complexity in regards to execution. With reference to material accessibility for protocols, all were considered of easy reproducibility. Discussion: Besides analyzing experimental model and most proper way to access blood collection, this study was limited to verify in a quantitative manner the platelet concentration in specific protocols, without evaluating their biological effects. Therefore, in regards to proposed objectives - relation between platelet concentration increase, spent time, and easiness of protocol - we conclude that protocol A, formulated by Nagae et al. (2007), was the method that most fitted the work needs, and greatly suited the challenges posed.

Células-tronco mesenquimais e plasma rico em plaquetas como adjuvantes da cicatrização de lesões cutâneas experimentais em coelhos Nova Zelândia

Muito se tem investido em pesquisa na compreensão dos processos e fenômenos envolvidos nas diversas fases da reparação tissular e, principalmente, no desenvolvimento de recursos e tecnologias com o objetivo de favorecer os avanços no tratamento de feridas. Este trabalho foi realizado com o objetivo de avaliar os efeitos biológicos da associação células-tronco mesenquimais (CTMs) e plasma rico em plaquetas (PRP) como adjuvantes da cicatrização cutânea de feridas padronizadas em coelhos. Foram utilizados 37 coelhos Nova Zelândia, dentre os quais, 36 foram distribuídos em seis grupos: grupo controle (GC), grupo células-tronco mesenquimais (GCTM), grupo plasma rico em plaquetas na forma líquida (GPRPLIQ), grupo plasma rico em plaquetas na forma de gel (GPRPGEL), grupo associação células-tronco mesenquimais e plasma rico em plaquetas na forma liquida (GCTM+PRPLIQ), grupo associação células-tronco mesenquimais e plasma rico em plaquetas na forma de gel (GCTM+PRPGEL). Após indução de lesões cutâneas agudas e padronizadas, os animais receberam o tratamento de acordo com o grupo que compunham. Macroscopicamente, a cada dois dias, foram analisadas as medidas das lesões e calculadas a área e a taxa de cicatrização das mesmas. Amostras para análise microscópica foram coletadas em sete e 14 dias e avaliadas quanto à presença de células inflamatórias, angiogênese, formação de fibrose colagênica, proliferação epitelial e fibroblástica. Com base nos resultados obtidos foi possível concluir que: 1) a associação CTM e PRP em suas frações terapêuticas (CTM+PRPGEL e CTM+PRPLIQ) não acelerou o processo de cicatrização de feridas cutâneas agudas, na avaliação morfométrica aos 14 dias de pós-operatório; 2) a aplicação local da CTM e das frações de PRP quando utilizadas de maneira isolada não conseguiram acelerar o tempo necessário ao processo cicatricial na avaliação morfométrica aos 14 dias de pósoperatório; 3) a utilização do PRP na sua forma líquida obteve índices de epitelização menores em relação ao controle em avaliações histopatológicas aos 14 dias de pósoperatório; 4) à exceção do ocorrido com o grupo PRP líquido, os demais tratamentos não alteraram significativamente as fases inflamatória, proliferativa e inicial do remodelamento, segundo dados histopatológicos; 5) a terapia com as células-tronco mesenquimais promoveu cicatrizes esteticamente melhores na avaliação clínica, especialmente aos 14 dias de observação. Sugere-se a necessidade de novos estudos e a utilização de outras ferramentas diagnósticas para melhores subsídios de interpretação sobre os resultados encontrados

Much has been invested on research regarding comprehension of the processes and phenomena that are involved in several stages of tissue repairing and mainly on resources and technologies development in order to support advances on wound healing. This study has been performed in order to evaluate the biological effects of mesenchymal stem cells (CTM) and platelet rich plasma (PRP) association as adjuvants on skin healing of standardized wounds in rabbits. Thirty-seven New Zealand rabbits have been used and, among these animals, 36 were allocated into six groups: control group (GC), mesenchymal stem cells group (GCTM), liquid platelet rich plasma group (GPRPLIQ), gel platelet rich plasma group (GPRPGEL), mesenchymal stem cells associated with liquid platelet rich plasma group (GCTM+PRPLIQ) and mesenchymal stem cells associated with gel platelet rich plasma group (GCTM+PRPGEL). After the induction of acute and standardized skin wounds, animals received the treatment according to the group they belonged to. Macroscopically, every two days, wounds measures were taken to calculate their area and healing rate. Samples for microscopically analysis were collected on day 7 and on day 14 and were evaluated for the presence of inflammatory cells, angiogenesis, collagen fibrosis formation, epithelial and fibroblastical proliferation. Basing on the results it was concluded that: 1) CTM and PRP in its two therapeutic fractions association (GCTM+PRPLIQ and GCTM+PRPGEL) did not accelerate the healing process of acute skin wounds, on morphometric assessment at 14 days after surgery; 2) local injection of CTM and PRP fractions when isolated did not accelerate the time required for wound healing on morphometric assessment at 14 days after surgery; 3) PRP application on its liquid fraction showed lower levels of epithelization related to control on histopathological evaluation at 14 days after surgery; 4) except GPRPLIQ, other treatments did not alter significantly inflammatory, proliferative nor initial remodeling phases, based on histopathological data; 5) CTM therapy promoted aesthetically better scars on clinical evaluation, especially at 14 days of observation. It is suggested the requirement of further studies and use of different diagnostic tools to obtain better interpretation of the achieved results

Bases anatômicas e neurofisiológicas da analgesia por acupuntura / Anatomical and neurophysiological bases of acupunture analgesia

Desde a antiguidade remota chinesa, a acupuntura, método que utiliza a inserção de agulhas no corpo para o tratamento de desequilíbrios e doenças, vem se constituindo num recurso terapêutico extremamente eficaz. A acupuntura pode conseguir efeitos analgésicos importantes em pacientes submetidos a cirurgias. Esta técnica tem sido proposta com várias finalidades no período peri-operatório: sedação pré-operatória, redução do uso intra-operatório de opióides e diminuição da dor pós-operatória. Os estudos sobre esta temática têm permitido, além de uma compreensão maior dos mecanismos de ação da acupuntura, fazer com que esta se torne mais aceitável nos meios acadêmicos ocidentais. Essa terapia apresenta bons resultados diante de muitas enfermidades e possui vantagens acentuadas sobre outras, como, por exemplo, o fato de os instrumentos utilizados serem simples e de fácil domínio, de ser econômica e segura. Dessa forma, esse estudo tem como objetivo mostrar, do ponto de vista teórico, a partir de uma revisão dos mecanismos de percepção da dor; a eficácia terapêutica da acupuntura no tratamento da dor, condizente com os mecanismos neurohumorais desta técnica(AU)

Since chinese remote antiquity, the acupuncture, a method that uses the insertion of needles into the body to treat this imbalance, is becoming an extremely effective therapeutic use. Scientific works show that acupuncture could achieve significant analgesic effects in patients undergoing surgery.This technique has been proposed with different purposes in the peri-operative period: preoperative sedation, reduction of intra-operative use of opioids and decreased postoperative pain. These studies have allowed a greater understanding of the mechanisms of action of acupuncture, to ensure that it becomes more acceptable in western academic circles. This therapy gives good results in front of many diseases and has marked advantages over others, for example, the instruments used are simple and easy to field, economic and safe. Thus, this study aims to show, from the theoretical point of view, by a review of the mechanisms of perception of pain, the therapeutic efficacy of acupuncture in the treatment of pain, consistent with the neurohumoral mechanisms of this technique(AU)

Bases anatômicas e neurofisiológicas da analgesia por acupuntura / Anatomical and neurophysiological bases of acupunture analgesia

Desde a antiguidade remota chinesa, a acupuntura, método que utiliza a inserção de agulhas no corpo para o tratamento de desequilíbrios e doenças, vem se constituindo num recurso terapêutico extremamente eficaz. A acupuntura pode conseguir efeitos analgésicos importantes em pacientes submetidos a cirurgias. Esta técnica tem sido proposta com várias finalidades no período peri-operatório: sedação pré-operatória, redução do uso intra-operatório de opióides e diminuição da dor pós-operatória. Os estudos sobre esta temática têm permitido, além de uma compreensão maior dos mecanismos de ação da acupuntura, fazer com que esta se torne mais aceitável nos meios acadêmicos ocidentais. Essa terapia apresenta bons resultados diante de muitas enfermidades e possui vantagens acentuadas sobre outras, como, por exemplo, o fato de os instrumentos utilizados serem simples e de fácil domínio, de ser econômica e segura. Dessa forma, esse estudo tem como objetivo mostrar, do ponto de vista teórico, a partir de uma revisão dos mecanismos de percepção da dor; a eficácia terapêutica da acupuntura no tratamento da dor, condizente com os mecanismos neurohumorais desta técnica

Since chinese remote antiquity, the acupuncture, a method that uses the insertion of needles into the body to treat this imbalance, is becoming an extremely effective therapeutic use. Scientific works show that acupuncture could achieve significant analgesic effects in patients undergoing surgery.This technique has been proposed with different purposes in the peri-operative period: preoperative sedation, reduction of intra-operative use of opioids and decreased postoperative pain. These studies have allowed a greater understanding of the mechanisms of action of acupuncture, to ensure that it becomes more acceptable in western academic circles. This therapy gives good results in front of many diseases and has marked advantages over others, for example, the instruments used are simple and easy to field, economic and safe. Thus, this study aims to show, from the theoretical point of view, by a review of the mechanisms of perception of pain, the therapeutic efficacy of acupuncture in the treatment of pain, consistent with the neurohumoral mechanisms of this technique

Tratamento de tumor venéreo transmissível extragenital resistente à vincristina: quimioterapia antineoplásica e cirurgia reconstrutiva / Treatment of transmissible venereal extragenital tumor vincristine resistant: antineoplastic chemotherapy and reconstructive surgery

O Tumor Venéreo Transmissível (TVT) é uma neoplasia transmitida por células transplantáveis, com localização predominantemente venérea, podendo ainda ser encontrado em regiões extragenitais. Os agentes quimioterápicos são a opção mais utilizada no tratamento do TVT, sendo o sulfato de vincristina a droga de eleição e o sulfato de vimblastina uma alternativa de tratamento. O objetivo deste trabalho é relatar o tratamento de um caso de TVT nasal sem comprometimento genital, com destruição de tecidos moles e perda óssea, resistente à vincristina. Foi instituído inicialmente tratamento quimioterápico com sulfato de vincristina e posterior substituição por sulfato de vimblastina. Com a evolução do tratamento, houve regressão do tecido neoplásico e surgiram fístulas no local antes ocupado pelo tumor. Assim, quando já se havia obtido cura clínica e citologia negativa para células tumorais, realizou-se cirurgia reconstrutiva no palato e na maxila. Até o 180° dia de observação,o cão encontrava-se bem, com deformidade óssea na face mas sem alterações funcionais. Esse relato demonstra que o uso do sulfato de vimblastina foi um protocolo eficaz para o tratamento de TVT delocalização extragenital e que a utilização da quimioterapia antineoplásica seguida por cirurgia reconstrutiva é efetiva,capaz de proporcionar cura e qualidade de vida ao paciente(AU)

The transmissible venereal tumor (TVT) is a neoplasm transmitted by transplantable cells, with predominant venereal location, but also found in extragenital regions. Antineoplasic chemotherapy is the most used treatment for TVT. The vincristine sulphate is the drug of choice and vinblastine sulphate, an alternative chemotherapeutic agent. This work aims to report a case of nasal TVT without compromised genital areas, destroying tissue and bone loss, resistant to vincristine. Chemotherapic treatment with vincristine sulphate was initially established and subsequently replaced by vinblastine sulphate. After treatment, there was regression of the tumor and fistulas appeared on the areas previously occupied by the tumor. When clinical cure and negative cytology for tumor cells were achieved, reconstructive surgery was proceded on the palate and jaw. After 180 days of observation, the dog was healthy, presenting bone deformity in the face but without functional changes. This report demonstrates that vinblastine sulphate was an effective protocol for the treatment of extragenital TVT and that the use of anticancer chemotherapy followed by reconstructive surgery is effective, capable of inducing healing and quality of life for patients(AU)

Tratamento de tumor venéreo transmissível extragenital resistente à vincristina: quimioterapia antineoplásica e cirurgia reconstrutiva / Treatment of transmissible venereal extragenital tumor vincristine resistant: antineoplastic chemotherapy and reconstructive surgery

O Tumor Venéreo Transmissível (TVT) é uma neoplasia transmitida por células transplantáveis, com localização predominantemente venérea, podendo ainda ser encontrado em regiões extragenitais. Os agentes quimioterápicos são a opção mais utilizada no tratamento do TVT, sendo o sulfato de vincristina a droga de eleição e o sulfato de vimblastina uma alternativa de tratamento. O objetivo deste trabalho é relatar o tratamento de um caso de TVT nasal sem comprometimento genital, com destruição de tecidos moles e perda óssea, resistente à vincristina. Foi instituído inicialmente tratamento quimioterápico com sulfato de vincristina e posterior substituição por sulfato de vimblastina. Com a evolução do tratamento, houve regressão do tecido neoplásico e surgiram fístulas no local antes ocupado pelo tumor. Assim, quando já se havia obtido cura clínica e citologia negativa para células tumorais, realizou-se cirurgia reconstrutiva no palato e na maxila. Até o 180° dia de observação,o cão encontrava-se bem, com deformidade óssea na face mas sem alterações funcionais. Esse relato demonstra que o uso do sulfato de vimblastina foi um protocolo eficaz para o tratamento de TVT delocalização extragenital e que a utilização da quimioterapia antineoplásica seguida por cirurgia reconstrutiva é efetiva,capaz de proporcionar cura e qualidade de vida ao paciente

The transmissible venereal tumor (TVT) is a neoplasm transmitted by transplantable cells, with predominant venereal location, but also found in extragenital regions. Antineoplasic chemotherapy is the most used treatment for TVT. The vincristine sulphate is the drug of choice and vinblastine sulphate, an alternative chemotherapeutic agent. This work aims to report a case of nasal TVT without compromised genital areas, destroying tissue and bone loss, resistant to vincristine. Chemotherapic treatment with vincristine sulphate was initially established and subsequently replaced by vinblastine sulphate. After treatment, there was regression of the tumor and fistulas appeared on the areas previously occupied by the tumor. When clinical cure and negative cytology for tumor cells were achieved, reconstructive surgery was proceded on the palate and jaw. After 180 days of observation, the dog was healthy, presenting bone deformity in the face but without functional changes. This report demonstrates that vinblastine sulphate was an effective protocol for the treatment of extragenital TVT and that the use of anticancer chemotherapy followed by reconstructive surgery is effective, capable of inducing healing and quality of life for patients