Wound healing in stage IV pressure injury with use of adjunct autologous activated platelet-rich plasma therapy: a case report.

INTRODUCTION: Pressure injuries remain a major burden worldwide with associated morbidity and financial implications. Patients in the ICU, such as those with severe COVID-19, are especially susceptible to PI as they remain immobile for extended durations while intubated. OBJECTIVE: This report examines a case of stage 4 PI in a senior COVID-19 survivor treated with adjunct intravenous and intralesional aaPRP therapy in addition to topical hyaluronic acid/silver sulfadiazine cream and framycetin sulphate dressing. CASE REPORT: aaPRP therapy was administered via intralesional injection and intravenous infusion 4 times with 2 weeks between therapies, while the aforementioned topical cream and dressing were applied every 2 days between visits. The patient also had controlled diabetes which may affect the wound healing process. CONCLUSIONS: This report concludes with a discussion of how COVID-19 carries important dynamics in the pathogenesis of PI and how adjunct administration of intravenous and intralesional aaPRP, which is abundant in regenerative proteins, may be beneficial in the management of PI.

Corrigendum to "The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on "Profibrotic Cytokine" IL-1ß Levels in Severe and Critical COVID-19 Patients: A Preliminary Study".

[This corrects the article DOI: 10.1155/2021/9427978.].

Photodynamic therapy in the treatment of condyloma acuminata: A systematic review of clinical trials.

INTRODUCTION: Condylomata acuminata (CA) is a sexually transmitted infection with a high prevalence associated with psychosexual morbidity in both men and women of various age. Up to now, treatment modalities yield low clearance and recurrence rate (RR) and are also deemed low quality evidence-wise. Photodynamic therapy (PDT) is a novel and promising therapy to effectively cure and prevent CA recurrence. METHOD: This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and registered to the International Prospective Register of Systematic Review (PROSPERO) (CRD42022332760). RESULTS: Ten studies were included in this systematic review. A significant value of complete response (CR) ranging from 63-100% in patients with genital warts after receiving several sessions of PDT. A relatively low recurrence rate was seen in all 10 studies, with an RR of less than 17%. Quality assessment of included studies reported mostly high-quality research. CONCLUSIONS: PDT therapy resulted in a higher CR with significantly lower RR compared to other therapies. Thus, PDT can be an alternative treatment of CA with low RR and minimal side effects. Additional research, especially randomized clinical trials in various countries, is needed to further substantiate this treatment and formulate definitive protocols.

Managing Autism Spectrum Disorder in the Face of Pandemic Using Internet-Based Parent-Mediated Interventions: A Systematic Review of Randomized Controlled Trials.

ASD is a neurodevelopmental disorder that is primarily treated with psychosocial intervention. However, it is costly and requires extensive resources to be effective. This inaccessibility is also further worsened by the ongoing COVID-19 pandemic, making the shift to a digital approach a sensible option. Among the available ASD therapies, parent-mediated interventions (PMIs) have a broad application and lower implementation cost. Hence, this systematic review aims to evaluate the potential that telehealth-based PMI holds and explore its feasibility throughout the COVID-19 pandemic. To build up this study, a systematic search through PubMed, Scopus, ProQuest, Wiley, and Cochrane was performed until 14 January 2021. Using the preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we ultimately included six studies in the review. Each study was evaluated utilizing the Cochrane Risk of Bias (ROB)-2 tool. Generally, parents' outcomes (knowledge, satisfaction, and compliance) were higher in intervention group (E-learning) compared to control (standard treatment or wait-list). Children also showed some improvements in social skill, communication skill, and intelligence after receiving the treatment. In addition, coaching or therapist sessions were found to be crucial as adjuvant to support parents during the intervention. In conclusion, internet-based parent-mediated interventions are promising and recommended for managing ASD patients, in the face of pandemic. However, more variety in study locations is also needed, particularly in low- and middle-income countries, to tackle the knowledge and clinical application gap. Further research should be conducted with a uniform measurement tool to achieve the same perception and reliable pooled analysis.

Therapeutic Effect of Autologous Activated Platelet-rich Plasma Therapy on Mid-dermal to Full-thickness Burns: A Case Series.

Although modern medicine has made great strides in the management of burn injuries, associated complications such as pain, infection, dyspigmentation, and scarring have yet to be fully dealt with. Although skin grafting and meshing are routinely performed on burn patients, this method poses a risk for adverse effects. Activated autologous platelet-rich plasma (aaPRP), which is increasingly used in the field of plastic surgery, contains growth factors beneficial for wound regeneration. Seven cases of burns with varying severity and conditions that were treated with intralesional subcutaneous injection and intravenous aaPRP are presented and discussed herein. This case series indicates that subcutaneous and intravenous aaPRP is a safe procedure with the potential to be an alternative when skin grafting cannot be done or as an adjunct treatment to skin grafting.

Comparison between the world health organization (WHO) and international society of hypertension (ISH) guidelines for hypertension.

The global burden of hypertension remains an unsolved problem, especially in low- and middle-income countries (LMICs). For this reason, clinical practice guidelines containing the latest evidence-based recommendations are crucial in the management of hypertension. It is noteworthy that guidelines simply translated from those of high-income countries (HICs) are not the solution to the problem of hypertension in LMICs. Among the numerous guidelines available, those of the World Health Organisation and the International Society of Hypertension are the latest to be published as of the writing of this article. In this review, we conducted both general and specific comparisons between the recommendations supplied by both guidelines. Differences in aspects of hypertension management such as the timing of antihypertensive initiation, assessment of comorbidities and cardiovascular risk factors, pharmacological therapy selection, and blood pressure target and reassessment are explored. Lastly, the implications of the differences found between the two guidelines in both LMICs and HICs are discussed.Key messagesCurrently, with low treatment and control rates, hypertension remains a burden in low- and middle-income countries (LMICs).The lack of customised guidelines for LMICs cannot be solved simply by adopting guidelines from high-income countries.The World Health Organisation (WHO) recently published a clinical guideline for the pharmacological management of hypertension in LMICs. We compare select recommendations from the guidelines to those published by the International Society of Hypertension.

The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on "Profibrotic Cytokine" IL-1ß Levels in Severe and Critical COVID-19 Patients: A Preliminary Study.

INTRODUCTION: Elevated concentration of proinflammatory cytokines followed by hyperinflammation is one of the hallmarks of severe and critical COVID-19. In the short term, this may result in ARDS and lung injury; subsequently, this may cause pulmonary fibrosis-a disease with poor prognosis-in the long run. Among the cytokines, interleukin-1ß (IL-1ß) is one of the most overexpressed in COVID-19. We speculate that administration of intravenous activated autologous platelet-rich plasma (aaPRP), which contains interleukin-1 receptor antagonist (IL-1RA), would lower IL-1ß levels and benefit the severe and critical COVID-19 patients. METHODS: After acquiring ethical clearance, we recruited 12 adult COVID-19 patients of both sexes from the Koja Regional Hospital (Jakarta, Indonesia) ICU. After selection, seven patients were included and divided into two groups, severe and critical. In addition to three doses of aaPRP, both groups received the same treatment of antiviral, steroid, and antibiotics. Quantification of plasma IL-1ß levels was performed by beads multiplex assay a day before the first aaPRP administration and a day after the second and third aaPRP administration. PaO2/FiO2 ratio and lung injury scores were evaluated a day before and a day after each aaPRP administration. RESULTS: Severe and critical patients' initial plasma IL-1ß concentration was 4.71 pg/mL and 3.095 pg/mL, respectively. After 2 treatments with aaPRP, severe patients' plasma IL-1ß concentration decreased 12.48 pg/mL, while critical patients' plasma IL-1ß concentration increased to 18.77 pg/mL. Furthermore, after 3 aaPRP treatments, significant amelioration of patients' PaO2/FiO2 ratio from 71.33 mmHg at baseline to 144.97 mmHg was observed (p < 0.05). However, no significant improvement in lung injury score was observed in severe and critical groups. All severe patients and one critical patient recovered. CONCLUSION: The use of aaPRP may prevent pulmonary fibrosis in severe COVID-19 patients through the reduction of patients' plasma IL-1ß concentration and the amelioration of PaO2/FiO2 ratio.