RESUMO
BACKGROUND: Platelet-rich plasma (PRP) seeks to meet the multifaceted demand of degenerated tendons providing several molecules capable of boosting healing. AREAS TIMELY FOR DEVELOPING RESEARCH: PRP is used for managing tendinopathy, but its efficacy is controversial. SOURCES OF DATA: Electronic databases were searched for clinical studies assessing PRP efficacy. Methodological quality was evaluated using the methods described in the Cochrane Handbook for systematic reviews. AREAS OF AGREEMENT: Thirteen prospective controlled studies, comprising 886 patients and diverse tendons were included; 53.8% of studies used identical PRP protocol. AREAS OF CONTROVERSY: Sources of heterogeneity included different comparators, outcome scores, follow-up periods and diverse injection protocols, but not PRP formulation per se. GROWING POINTS: Pooling pain outcomes over time and across different tendons showed that L-PRP injections ameliorated pain in the intermediate-long term compared with control interventions, weighted mean difference (95% CI): 3 months, -0.61 (-0.97, -0.25); 1 year, -1.56 (-2.27, -0.83). However, these findings cannot be applied to the management of individual patients given low power and precision. RESEARCH: Further studies circumventing heterogeneity are needed to reach firm conclusions. Available evidence can help to overcome hurdles to future clinical research and bring forward PRP therapies.
Assuntos
Plasma Rico em Plaquetas , Tendinopatia/terapia , Viés , Humanos , Injeções Intra-Articulares/métodos , Manejo da Dor/métodos , Transfusão de Plaquetas/métodos , Projetos de Pesquisa , Resultado do TratamentoRESUMO
BACKGROUND: The aim of study was to define risk factors (age, body mass index, height, weight, systolic and diastolic blood pressure) associated to non insulin dependent diabetes mellitus (NIDDM) and abnormal glucose tolerance (AGT). PATIENTS, MATERIAL AND METHODS: This study was carried out in people > or = 30 years old in Lejona (Vizcaya) by randomized sampling of population, stratified by pyramids of age and sex (N = 862), with a low rate of non-responders (12.6%). An oral glucose tolerance test was done following the criteria recommended by the Committee of Experts of the World Health Organization (WHO). A multivariate analysis was performed, with presence/absence of NIDDM and/or AGT, as dependent variable in several models of logistic regression. RESULTS: The prevalence of NIDDM was 6.4% (56% previously unknown). Strong association of NIDDM with age, BMI, and systolic blood pressure (SBP) was observed both in univariate, as well as multivariate analysis. However, SBP lost its value in the multivariate study. Multivariate analysis showed that NIDDM was 8.2 fold more frequent in the population > or = 60 years than in the < or = 45 years old group. NIDDM was 8.3 fold more frequent when BMI > or = 30 kg/m2 compared to < or = 25. NIDDM was 3.8 fold more frequent in the population with SBP > or = 140 mmHg than in the group with SBP < or = 120 mmHg. The prevalence of AGT in women is almost double than in men (13.4% vs 7.3%). Risk factors were also associated with AGT. CONCLUSIONS: Weight and SBP are important risk factors for NIDDM and AGT prediction. The possibility of modifying these factors could possibly allow interventions in order to decrease the prevalence of NIDDM and AGT.
Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Adulto , Idoso , Feminino , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , EspanhaRESUMO
BACKGROUND: Diabetes mellitus presents a high prevalence and morbimortality. The aim of the present study was to know the number of newly diagnosed diabetic patients in addition to those who present abnormal glucose tolerance and possible presence of associated risk factors. METHODS: This study was carried out in Lejona (Vizcaya) from 1984-1985. The prevalence of non insulin-dependent diabetes mellitus (NIDDM) and abnormal glucose tolerance (AGT) in people older than or equal to 30 years of age by a randomized sample stratified by pyramids of age and sex (n = 862). The following data were collected: age, sex, height, weight, medications taken, family and personal history of diabetes mellitus (DM) and blood pressure. A glycemia curve was made following the criteria recommended by the Committee of Experts of the World Health Organization (WHO). RESULTS: The prevalence of DM observed in the sample was of 6.4% (confidence interval of 95%: 4.75-8.01%) of which 3.6% corresponded to unknown DM and 2.8% to known DM. The prevalence of AGT was 10.4% (confidence interval 95%: 8.40-12.48%). Greater association was observed between DM and obesity, lower height, high blood pressure and age over 50. CONCLUSIONS: More than half of the diabetics were unaware of the disease. Given the association of non insulin-dependent diabetes mellitus with modifiable factors (obesity, high blood pressure) control of risk factors would be useful with the aim of decreasing the prevalence of diabetes mellitus and avoid the associated chronic complications of the disease.
