Efficacy of prolotherapy in pain control and function improvement in individuals with lateral epicondylitis: A Systematic Review and Meta-analysis.

AIM: The objective of this study was to evaluate the efficacy of prolotherapy when treating individuals with lateral epicondylitis through a systematic review and meta-analysis. METHODS: The search for articles was carried out in electronic databases including PUBMED, CENTRAL, WEB OF SCIENCE, SCIELO and Google Scholar, published up to July 2021. We used the following keywords: prolotherapy OR proliferation therapy OR hypertonic dextrose injections AND tennis elbow OR lateral epicondylitis. The effectiveness was expressed as mean difference or standardized mean difference ((d) and 95% CI). MAJOR RESULTS: Nine clinical trials that used prolotherapy in the treatment of lateral epicondylitis were included. In the pooled analysis, prolotherapy was effective in pain control in the medium (d = -0.85, 95% CI -1.29 to -0.41, p (z) 0.0001) and long terms (d = -1.05, 95% CI -2.06 to -0.03, p (z) 0.04). It was also effective in improving function in the medium term (d = -1.21, 95% CI -1.64 to -0.78, p (z) 0.00001). CONCLUSIONS: Prolotherapy was effective for reducing pain in the medium and long terms, as well as for improving function in the medium term, in individuals with lateral epicondylitis. However, the risk of bias of the studies caused that the quality of evidence was moderate; more studies with a low risk of bias are necessary to corroborate the efficacy of prolotherapy in patients with lateral epicondylitis.

Hypertonic Dextrose Prolotherapy, an Alternative to Intra-Articular Injections With Hyaluronic Acid in the Treatment of Knee Osteoarthritis: Systematic Review and Meta-analysis.

ABSTRACT: Intra-articular injections with hyaluronic acid are recommended in the treatment of knee osteoarthritis; however, hypertonic dextrose prolotherapy has been reported as effective and safe. The aim was to evaluate the effectiveness of hypertonic dextrose prolotherapy for pain reduction and improvement of function in individuals with knee osteoarthritis in comparison with hyaluronic acid by meta-analysis. The search was performed in electronic databases. Six studies were included (395 participants). No statistically significant differences were found between prolotherapy and hyaluronic acid in pain control in the short-term; however, in the subanalysis that included only the studies that used intra-articular injection within the prolotherapy scheme, an effect was found in favor of the prolotherapy groups ( d = -1.33; 95% confidence interval, -2.50 to -0.16; P ( z ) = 0.03). Also, an effect was found in favor of the prolotherapy group in the improvement in function ( d = -1.05; 95% confidence interval, -2.03 to -0.08; P ( z ) = 0.03). No major adverse reactions or side effects were reported in any of the studies. Hypertonic dextrose prolotherapy seems to be an effective intervention to decrease pain and improve function in knee osteoarthritis, with efficacy similar to intra-articular injections with hyaluronic acid in the short-term follow-up. Nonetheless, better-quality clinical trials are necessary.

Efficacy of hypertonic dextrose infiltrations for pain control in rotator cuff tendinopathy: systematic review and meta-analysis.

INTRODUCTION: The aim of our study was to assess the efficacy of hypertonic dextrose infiltrations for pain control in individuals with rotator cuff tendinopathy and to assess the characteristics of the treatment and the presence of side effects or adverse reactions through a systematic review and meta-analysis. METHODS: The search for the articles was performed in the electronic databases PUBMED, EMBASE, SCOPUS, SCIELO, DIALNET and Google Scholar, published up to August 2020. The keywords used were "prolotherapy" or "proliferation therapy" or "hypertonic dextrose infiltrations" or "hypertonic dextrose injection" and "Rotator Cuff" or "Rotator Cuff Injury" or "Rotator Cuff Tear" or "Rotator Cuff Tendinosis" or "supraspinatus". The effectiveness of hypertonic dextrose infiltrations was expressed as standardized mean difference (d) and 95% CI. RESULTS: In the pooled analysis, hypertonic dextrose infiltrations were an effective intervention to reduce long-term pain in patients with rotator cuff tendinopathy when compared to controls; furthermore, in the individual analyses, hypertonic dextrose infiltrations were more effective in the short, medium and long terms than non-invasive treatments, and more effective in the long-term than infiltrations with local anesthetics. On the other hand, hypertonic dextrose infiltrations were not more effective than injections with corticosteroids or PRP. Finally, no complications or serious adverse effect were observed when hypertonic dextrose infiltrations were used. CONCLUSIONS: We found that hypertonic dextrose infiltrations reduced pain in individuals with rotator cuff in the long-term. Hypertonic dextrose infiltrations could be an alternative to non-invasive treatments when no favorable results can be achieve. However, due to the small number of studies included in this meta-analysis, new studies are necessary to clarify the efficacy and safety of this intervention.

Efficacy of electrotherapy in Bell's palsy treatment: A systematic review.

BACKGROUND: Up to now there is not enough evidence that supports the use of electrotherapy in the treatment of Bell's palsy. OBJECTIVE: Through a systematic review, we aimed to verify whether the use of electrotherapy is effective for treating Bell's palsy or peripheral paralysis. METHODS: Publications were searched in PubMed, EBSCO and Web of Science. The present systematic review included studies that analyzed the electrotherapy as a therapeutic method for treating individuals with Bell's palsy, in order to recover the function of facial muscles. RESULTS: Seven studies involving a total of 131 cases and 113 controls were included in this systematic review. In the studies analyzed, patients received electrotherapy combined with other treatments such as hot-wet facial napkins, massages and muscle reeducation. Although the effect of electrotherapy alone was not evaluated, the use of electrotherapy combined with other treatments produced a significant improvement in the individuals evaluated. CONCLUSIONS: Due to the diverse methodologies used and the small number of individuals included in the studies, we could not fully prove the efficacy of electrotherapy for treating Bell's Palsy. Future studies with larger samples and homogenous populations should be performed to obtain conclusive results.

Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials.

BACKGROUND: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. MAIN BODY: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. CONCLUSIONS: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials

Abstract Background: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. Main body: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. Conclusions: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

Lack of Association of Coffee Consumption with the Prevalence of Self-Reported Type 2 Diabetes Mellitus in a Mexican Population: A Cross-Sectional Study.

It is estimated that almost 366 million people are currently suffering from diabetes mellitus worldwide. However, it has been suggested that coffee consumption has a protective effect against the development of type 2 diabetes mellitus. This association has been observed in many regions around the world. Today, there are no reports in Mexico regarding this association. Therefore, the aim of this study was to assess the association between coffee intake and self-reported type 2 diabetes mellitus in the southeastern part of Mexico. This study included 1277 residents of Comalcalco, a municipality of Tabasco State, Mexico. We calculated the prevalence for diabetes and performed multivariate analysis using multiple logistic regressions to evaluate the combined association with type 2 diabetes mellitus. The prevalence of the diabetes was 12.52% (95% CI: 10.67⁻14.38). The majority of people surveyed (77.29%; 95% CI: 74.95⁻79.60) indicated they were coffee drinkers. The results of multivariate analysis showed a non-significant relationship between the number of cups of coffee drank and type 2 diabetes mellitus. The adjusted odds ratio gave the following values: 1.20, (95% CI: 0.59⁻2.41) for non-daily consumption; 1.66 (0.82⁻3.34), for 1 cup of coffee peer day, and 1.49 (0.78⁻2.86) for 2⁻3 cups. Subsequently, an adjustment was made for age, gender, marital status, education, alcohol consumption, and cigarette smoking. In our population, we did not observe an association between coffee intake and its protective relationship with self-reported type 2 diabetes mellitus.

Potential drug-drug interaction in Mexican patients with schizophrenia.

OBJECTIVE: The aim of this study was to observe potential drug-drug interactions in the medication of Mexican schizophrenic patients. METHODS: We performed a retrospective and cross-sectional study that was carried out in a psychiatric clinic. Only the prescriptions of patients with schizophrenia whose diagnoses were based on the DSM-IV instrument were included in this study. The Drug Interactions Checker software ( http://www.drugs.com/drug_interactions.html ) was used in this study to analyse potential drug-drug interactions. RESULTS: In total, 86 of 126 patients were at risk of potential drug-drug interactions. Haloperidol and biperiden was the most common drug pair of 232 pairs evaluated. In our study, 13.8% of drug-drug interaction showed a major level of severity, whereas in 83.2%, the interaction was moderate. Finally, central nervous system (CNS) depression and anticholinergic effect were the main possible effects of drug-drug interaction. CONCLUSIONS: Our results revealed a high number of patients with schizophrenia receiving two or more drugs. The potential drug-drug interactions observed in the Mexican population are consistent with the concomitant use of antipsychotics, benzodiazepines, and antidepressants prescribed in schizophrenia that could cause central nervous system (CNS) depression and anticholinergic effect. Drug-drug interaction must be considered when the patient with schizophrenia is medicated.

No effect of magnesium supplementation on metabolic control and insulin sensitivity in type 2 diabetic patients with normomagnesemia.

There are limited and conflicting data from clinical trials concerning the beneficial effects of magnesium supplementation on diabetic patients. We investigated the effects of magnesium supplementation on metabolic control and insulin sensitivity in type 2 diabetic patients with normomagnesemia. A total of 98 normomagnesemic subjects with type 2 diabetes were enrolled in a randomized, crossover, double-blind, placebo-controlled trial. Participants were randomly assigned to receive magnesium lactate (360 mg elemental magnesium) or placebo for three months, followed by a three-month washout period. Treatment assignments were then reversed over an additional three months of follow-up. The primary endpoint was a reduction in fasting glucose and HbA1c. A total of 56 subjects completed the follow-up in the magnesium and placebo supplementation groups. Urinary magnesium excretion was increased following magnesium supplementation in the intervention group compared with the placebo group (p = 0.0002). Fasting glucose, HbA1c, insulin and HOMA-IR, as well as lipid profile, did not change significantly during treatment. We concluded that magnesium supplementation does not improve metabolic control or insulin sensitivity in diabetic subjects with normomagnesemia.