Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.932
Filtrar
1.
Medicine (Baltimore) ; 100(5): e24252, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592868

RESUMO

BACKGROUND: The popularity of dietary supplements for knee osteoarthritis (OA) management is on the rise; however, their effects are still debated. METHODS: This study aimed to investigate the effect of an oral low molecular weight liquid hyaluronic acid supplement in the treatment of knee OA patients with mild knee pain (visual analogue scale [VAS] ≤ 3) in Taiwan population. This was a randomized, double-blind, placebo-controlled study. Forty-seven subjects were enrolled and randomly allocated to either the A+HA or the placebo groups. The subjects were required to drink a bottle contained 20 mL of A+HA or placebo daily throughout an 8-week study period. The efficacy was assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 36-item Short Form Survey (SF-36). RESULTS: At Week 8, significant reductions from baseline in the WOMAC pain (-2.6 ±â€Š1.68, P < .0001), stiffness (-1.2 ±â€Š1.50, P = .007), physical function (-5.8 ±â€Š4.39, P < .0001), and total (-9.4 ±â€Š5.82, P < .0001) scores were observed in the A+HA group but not in the placebo group. Significant differences in the mean change of WOMAC scores from baseline at Week 8 between groups were detected (P < .01). At Week 8, the A+HA group also showed significant improvements in SF-36 physical functioning (2.7 ±â€Š3.10, P = .001) and bodily pain (0.7 ±â€Š1.50, P < .05) domains. Although the A+HA group had a higher increase in the SF-36 total score than the placebo group but the difference was not statistically significant (2.1 ±â€Š12.75 vs 0.3 ±â€Š19.66, P = .12). CONCLUSIONS: Oral administration of low molecular weight liquid HA appeared to be effective for knee OA patients with mild knee pain (VAS ≤ 3) in the relief of knee OA symptoms, particularly in pain and physical function.Clinical Trial Registration: NCT04352322.


Assuntos
Artralgia , Condroitina/administração & dosagem , Glucosamina/administração & dosagem , Ácido Hialurônico/administração & dosagem , Osteoartrite do Joelho , Administração Oral , Artralgia/diagnóstico , Artralgia/tratamento farmacológico , Artralgia/etiologia , Misturas Complexas/administração & dosagem , Suplementos Nutricionais , Método Duplo-Cego , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/fisiopatologia , Medição da Dor/métodos , Resultado do Tratamento , Viscossuplementos/administração & dosagem
2.
Medicine (Baltimore) ; 100(2): e23881, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33466131

RESUMO

BACKGROUND: In recent years, intra articular injection of platelet rich plasma has attracted increasing attention. The major aim of our current randomized controlled double-blind study was to compare long-term outcomes of intra-articular injection of hyaluronic acid or platelet rich plasma in the treatment of the patients with knee osteoarthritis. METHODS: This is a kind of double-blind, randomized, prospective, and comparative clinical investigation with the allocation ratio of 1:1 and was approved by our institutional review Committee. Between 2020 and 2021, altogether 2 hundred patients will be selected to participate in our present study. We will report the randomized experiments in accordance with the guidelines of Consolidated Standards of Reporting Trials and then offer the Consolidated Standards of Reporting Trials flow chart. The inclusion criteria were: patients aged from 40 to 70 years old, patients with chief complaint history of at least 1 month and knee joint pain for nearly 6 months, need the analgesic drug treatment, and radiology confirmed knee osteoarthritis. The eligible patients would be randomly divided into 2 groups through applying the random numbers generated by computer before surgery. Outcomes after treatment were assessed using the Western Ontario and McMaster University and the scoring systems of visual analogue scale which were recorded through questionnaires accomplished via the patients prior to the first injection and then at three and six months, 1 and 2 years follow-up. Any adverse events occurred within 1 year after surgery were recorded during follow-up. RESULTS: This should suggest whether biological methods can offer more lasting outcomes than the viscosification. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry6265).


Assuntos
Ácido Hialurônico/uso terapêutico , Osteoartrite do Joelho/terapia , Plasma Rico em Plaquetas , Viscossuplementos/uso terapêutico , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Amplitude de Movimento Articular , Viscossuplementos/administração & dosagem
3.
J Dermatolog Treat ; 32(1): 95-100, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31195857

RESUMO

Background: Multiple types of fillers have been developed for soft tissue augmentation.Objective: We investigated the efficacy and safety of the novel filler BM-PHA.Methods: In this multicenter, randomized, split-face study, 91 participants received injections of BM-PHA and Restylane Perlane (PER) into the nasolabial folds. Efficacy was determined by the improvements in the Wrinkle Severity Rating Score (WSRS) and Global Esthetic Improvement Scale (GAIS), and safety by adverse events, laboratory tests, and a check of vital signs.Results: WSRS scores assessed by independent evaluators at Week 24, the primary efficacy measure, showed no significant difference between the two treatments. The treatments also showed no significant differences in WSRS scores assessed by the evaluators at Week 8 and WSRS and GAIS scores assessed by the treating investigators and participants at Weeks 8 and 24. The proportion of nasolabial folds whose WSRS scores improved by at least one grade at Week 24 was similar between the treatments. Only minor local side effects were reported without sequelae.Conclusion: BM-PHA was not inferior to PER in the treatment of moderate to severe nasolabial folds and may be an appropriate alternative product for their improvement. Further studies are needed to confirm the long-term safety of BM-PHA.


Assuntos
Preenchedores Dérmicos/administração & dosagem , Sulco Nasogeniano/patologia , Adulto , Técnicas Cosméticas , Preenchedores Dérmicos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/efeitos adversos , Injeções Intradérmicas , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Envelhecimento da Pele , Resultado do Tratamento
4.
Medicine (Baltimore) ; 99(46): e23242, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181712

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) is a worldwide disease and more and more people are suffered from it. With the increasing number of patients, it brings a huge burden on social economy and security system. There are varieties of methods to cure KOA, such as Traditional Chinese Medicine and surgery. Needle knife therapy plus Sodium hyaluronate Injection is one of the prevalent treatments for KOA. Therefore, we perform a systematic review and meta-analysis to evaluate the evidence for the treatment of needle knife therapy plus sodium hyaluronate Injection. METHODS: Randomized controlled trials will be used to compare the effect of needle knife therapy plus sodium hyaluronate injection with needle knife alone for KOA patients. Six studies will be included in this meta-analysis, and the relative risk and weight mean difference with 95% CI for the Lysholm knee score, visual analogue scale, and effective rate will be evaluated by using RevMan 5.3 software. Besides, the bias assessment of the included studies will be evaluated using the Cochrane risk of bias tool, and the Grading of Recommendations, Assessment Development, and Evaluation system will be applied to assess the overall quality of the evidence. RESULTS: From the study we will assess the effectiveness, safety of needle knife therapy plus sodium hyaluronate injection on joint pain relief and functional improvement in patients with KOA. CONCLUSION: The study will provide a new evidence to confirm the effect of needle knife therapy plus sodium hyaluronate injection on KOA, which can further guide the selection of therapy. PROSPERO REGISTRATION NUMBER: CRD42020169602.


Assuntos
Terapia por Acupuntura/métodos , Ácido Hialurônico/uso terapêutico , Osteoartrite do Joelho/tratamento farmacológico , Terapia por Acupuntura/normas , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares/métodos , Injeções Intra-Articulares/normas , Metanálise como Assunto , Manejo da Dor/métodos , Manejo da Dor/normas , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Resultado do Tratamento
6.
Yakugaku Zasshi ; 140(9): 1141-1150, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879246

RESUMO

Osteoarthritis is the most common joint disorder worldwide and one of the leading causes of disability in the elderly. We have reported that the novel sodium hyaluronate derivative chemically linked with diclofenac (DF), diclofenac etalhyaluronate (SI-613), exerted a potent and long-lasting analgesic effect in experimental arthritis models. In this study, we evaluated the properties of residual SI-613 in the knee joint after an intra-articular (IA) administration. After IA administration of fluorescent labeled SI-613 (FA-SI-613) or fluorescent labeled hyaluronic acid (FA-HA) to rabbits, fluorescence intensities in the synovial membrane and cartilage were higher in the FA-SI-613 group until 7 d after administration than in the FA-HA group. After IA administration of radiolabeled SI-613 (14C-SI-613) to rabbits, the radioactivity remained in the joint cavity and the joint tissues such as synovial membrane and cartilage until 84 d after administration. This residual radioactivity was identified mainly as HA linked with DF, since 14C-SI-613 was labeled at the benzene ring of DF and since more DF-linked HA oligomer was detected on metabolite analysis than free DF in the synovial membrane and synovial lavage fluid up to 28 d after administration. These results suggested that intra-articularly administered SI-613 remained for a longer time in the joint as HA linked with DF than when HA was administered. Therefore, SI-613 was considered to prolong the pharmacological effects of both HA and DF by remaining in the joint as HA linked with DF.


Assuntos
Diclofenaco/administração & dosagem , Diclofenaco/metabolismo , Ácido Hialurônico/análogos & derivados , Articulação do Joelho , Osteoartrite/tratamento farmacológico , Animais , Cartilagem/metabolismo , Modelos Animais de Doenças , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/metabolismo , Injeções Intra-Articulares , Articulação do Joelho/metabolismo , Masculino , Coelhos , Membrana Sinovial/metabolismo , Fatores de Tempo
7.
PLoS One ; 15(9): e0238284, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966294

RESUMO

PURPOSE: Restricted shoulder mobility is a major upper extremity dysfunction associated with lower quality of life and disability after breast cancer surgery. We hypothesized that a poloxamer and sodium alginate mixture (Guardix-SG®) applied after axillary lymph node dissection (ALND) would significantly improve shoulder range of motion (ROM) in patients with breast cancer. METHODS: We conducted a double-blind, randomized, prospective study to evaluate the clinical efficacy and safety of Guardix-SG® for the prevention of upper extremity dysfunction after ALND. The primary outcome measure was shoulder ROM at baseline (T0) and 3 (T1), 6 (T2), and 12 months (T3) after surgery. Secondary outcome measures were the Disabilities of the Arm, Shoulder, and Hand score(DASH), pain associated with movement, which was assessed using a numeric rating scale, and lymphedema assessed using body composition analyzer. RESULTS: A total of 83 women with breast cancer were randomly assigned to either the Guardix-SG® group or the control group. In the Guardix-SG® group (n = 37), Guardix-SG® was applied to the axillary region after ALND. In the control group (n = 46), ALND was performed without using Guardix-SG®. Comparing ROM for shoulder flexion before surgery (178.2°) and 12 months after surgery (172.3°), that was restored 12 months after surgery in the Guardix-SG® group, and there was no statistically significant difference between that at before surgery and 12 months after surgery (p = 0.182). No adverse effect was observed in either group. CONCLUSIONS: The results of this study have shown that Guardix-SG® help improve shoulder ROM without causing adverse effects in patients who underwent breast cancer surgery. However, there was no statistically significant difference from the control group. A further large-scale study is needed to obtain a more conclusive conclusion. TRIAL REGISTRATION: CRISKCT0003386; https://cris.nih.go.kr (20181207).


Assuntos
Neoplasias da Mama/cirurgia , Carboximetilcelulose Sódica/administração & dosagem , Ácido Hialurônico/administração & dosagem , Excisão de Linfonodo/efeitos adversos , Mastectomia/efeitos adversos , Poloxâmero/administração & dosagem , Amplitude de Movimento Articular/efeitos dos fármacos , Ombro/patologia , Axila , Neoplasias da Mama/patologia , Estudos de Casos e Controles , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Projetos Piloto , Prognóstico , Estudos Prospectivos , Tensoativos/administração & dosagem
8.
Yonsei Med J ; 61(10): 868-874, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32975061

RESUMO

PURPOSE: To investigate the efficacy and safety of a newly developed thermo-responsive sol-gel, ABT13107, for reducing the formation of intrauterine adhesions (IUAs) after hysteroscopic surgery. MATERIALS AND METHODS: In this multicenter, prospective, randomized trial (Canadian Task Force classification I), 192 women scheduled to undergo a hysteroscopic surgery at one of the eight university hospitals in South Korea were randomized into the ABT13107 group or the comparator (Hyalobarrier®) group in a 1:1 ratio. During hysteroscopic surgery, ABT13107 or Hyalobarrier® was injected to sufficiently cover the entire intrauterine cavity. RESULTS: The patients returned to their respective sites for safety assessments at postoperative weeks 1 and 4 and for efficacy assessments at postoperative week 4. The post-surgery incidence of IUAs was 23.4% in the ABT13107 group and 25.8% in the comparator group; this difference met the criteria for ABT13107 to be considered as not inferior to the comparator. No differences were found in the extent of adhesions, types of adhesions, or the cumulative American Fertility Society score between the two treatment groups. Most adverse events were mild in severity, and no serious adverse events occurred. CONCLUSION: ABT13107, a new anti-adhesive barrier containing hyaluronic acid, was not inferior to the highly viscous hyaluronic acid anti-adhesive barrier, Hyalurobarrier® in IUA formation after hysteroscopic surgery (Clinical trial registration No. NCT04007211).


Assuntos
Géis/administração & dosagem , Ácido Hialurônico/administração & dosagem , Histeroscopia/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Aderências Teciduais/prevenção & controle , Doenças Uterinas/cirurgia , Adulto , Feminino , Géis/uso terapêutico , Humanos , Ácido Hialurônico/uso terapêutico , Incidência , Gravidez , Estudos Prospectivos , República da Coreia , Índice de Gravidade de Doença , Aderências Teciduais/etiologia , Resultado do Tratamento , Doenças Uterinas/etiologia
9.
Medicine (Baltimore) ; 99(37): e21813, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925717

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) is a common chronic disease with worldwide prevalence of 10% to 79%, with costs ranging from $560 to $635 billion for year in United States of America. The main guidelines recommend interventions with undesirable adverse events (AE) or highly dependent on the patient's persistence. Thus, intra-articular (IA) therapies appear to be attractive in patients with KOA, as well as a valid therapy by maximizing effects locally in the joint and limiting systemic AE. Presently, the main available IA therapies are corticosteroids and hyaluronic acid.As several meta-analyses about the efficacy of intra-articular hyaluronic acid (IAHA) for treatment of KOA with discordant results were published, we decided to conduct an umbrella review to summarize this efficacy METHODS:: We will search MEDLINE/PubMed, EMBASE, Cochrane Library, and Virtual Health Library (BVS) from inception to February 2020 for systematic reviews with meta-analyses of randomized clinical trials that investigate IAHA for therapy of KOA. Grey literature will be searched in Opengray platform, Research Gate, and Google Scholar. The reference lists of eligible studies will be screened. The search will be performed without language restriction.We will include any type of IAHA as experimental intervention and different types of oral or intra-articular placebo or medications as controls. The primary outcome will be measures of efficacy as the Western Ontario and McMaster Universities Osteoarthritis Index.A synthesis of the evidence will be conducted and data will be presented in tables.Two reviewers will independently appraise the quality of included meta-analyses using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool and will classify the included systematic reviews into high, moderate, low, or critically low levels of confidence. RESULTS: The results of this study will be published in a peer-reviewed journal. ETHICS AND DISSEMINATION: No ethical approval is required since this study data is based on published literature. PROTOCOL REGISTRATION NUMBER: PROSPERO CRD42019120269 (https://www.crd.york.ac.uk/PROSPERO/#joinuppage).


Assuntos
Ácido Hialurônico/administração & dosagem , Osteoartrite do Joelho/tratamento farmacológico , Viscossuplementação/estatística & dados numéricos , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento , Viscossuplementação/métodos
10.
Plast Reconstr Surg ; 146(2): 147e-155e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740576

RESUMO

BACKGROUND: As one of the most commonly used soft-tissue fillers, hyaluronic acid is generally considered safe and efficacious. However, evident bone resorption in mentum was observed. In this study, the authors analyzed the impact of hyaluronic acid on bone resorption in mentum and the influencing factors. METHODS: The authors retrospectively compared the computed tomographic scans of patients with or without mentum augmentation using hyaluronic acid. The body mass index- and sex-matched control group was selected randomly. Semimandibular bone resorption index was calculated as the ratio of bone thickness in the incisive fossa to that in the mandibular symphysis. Injection volume, injection interval, the number of injections, product, complication were also recorded. RESULTS: From January of 2014 to June of 2019, 80 patients (160 cases) and 80 controls were recruited. The bone resorption index in the hyaluronic acid injection cohort was significantly lower than in the controls (75.25 ± 10.02 versus 82.86 ± 6.38; p = 0.000). Patients injected with greater than or equal to 1 ml per time were more susceptible to bone erosion compared with patients injected with less (68.89 ± 10.84 versus 76.49 ± 9.42; p = 0.000). There was no significant difference between one- versus multiple-injection groups and short-injection-interval versus long-injection-interval (≥6 months) groups. Furthermore, no reduced aesthetics were realized. CONCLUSIONS: Hyaluronic acid injection could induce bone resorption in the mentum; nevertheless, the aesthetics were not impaired. The severity of the bone loss was positively correlated with the injection volume per time; therefore, large-volume injection of hyaluronic acid should be performed with caution. The patients should be fully informed about this complication preoperatively. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Reabsorção Óssea/induzido quimicamente , Queixo/diagnóstico por imagem , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Ácido Hialurônico/efeitos adversos , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático , Doenças Assintomáticas/epidemiologia , Doenças Assintomáticas/terapia , Reabsorção Óssea/diagnóstico , Reabsorção Óssea/epidemiologia , Reabsorção Óssea/cirurgia , Preenchedores Dérmicos/administração & dosagem , Estética , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Incidência , Masculino , Satisfação do Paciente , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
AAPS PharmSciTech ; 21(6): 235, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32803528

RESUMO

Development of a delivery system to lower systemic toxicity and enhance doxorubicin (DOX) antitumor efficacy against multi-drug resistant (MDR) tumors is of great clinical significance. Here, lipid/hyaluronic acid (HA)-coated DOX-Fe3O4 was characterized to determine its optimal safety and efficacy on a tumor. DOX was first conjugated onto the Fe3O4 NPs surface, which was subsequently coated with phosphatidylcholine (PC) lipids, which consisted of a tumor cell-targeting HA ligand, to generate a dual-targeting nanoparticle (NP). DOX-Fe3O4 synthesis was validated by the Fourier-transform infrared (FT-IR) analysis results. Core-shell PC/HA@DOX-Fe3O4 formation, which had an average particle size of 48.2 nm, was observed based on the transmission electron microscopy (TEM) and dynamic laser light scattering (DLS) results. The saturation magnetization value of PC/HA@DOX-Fe3O4 was discovered to be 28 emu/g using vibrating-sample magnetometry. Furthermore, the designed PC/HA@DOX-Fe3O4 achieved greater MCF-7/ADR cellular uptake and cytotoxicity as compared with DOX. In addition, PC/HA@DOX-Fe3O4 exhibited significant DOX tumor-targeting capabilities and enhanced tumor growth inhibition activity in the xenograft MCF-7/ADR tumor-bearing nude mice following magnetic attraction and ligand-mediated targeting, with less cardiotoxicity. Therefore, PC/HA@DOX-Fe3O4 is a potential candidate for MDR tumor chemotherapy. Graphical abstract.


Assuntos
Antibióticos Antineoplásicos/administração & dosagem , Doxorrubicina/administração & dosagem , Sistemas de Liberação de Medicamentos/métodos , Compostos Férricos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Nanopartículas/administração & dosagem , Animais , Antibióticos Antineoplásicos/síntese química , Doxorrubicina/síntese química , Compostos Férricos/síntese química , Humanos , Ácido Hialurônico/síntese química , Lipídeos , Células MCF-7 , Camundongos , Camundongos Nus , Nanopartículas/química , Tamanho da Partícula , Distribuição Aleatória , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Ensaios Antitumorais Modelo de Xenoenxerto/métodos
13.
Khirurgiia (Mosk) ; (7): 76-81, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32736467

RESUMO

OBJECTIVE: To evaluate symptom-modifying effects of a two-month parenteral therapy with chondroitin sulfate («Mucosat¼) in patients with knee and/or hip osteoarthritis (OA) in various combinations of adjuvant therapy. MATERIAL AND METHODS: There were 70 patients with primary and/or post-traumatic unilateral/bilateral knee and/or hip osteoarthritis (Kellgren-Lawrence grade I-II). Pain syndrome severity was assessed as ≥ 50 mm (100-mm VAS), total Leken's index - ≥ 5 points. The main group comprised 40 patients who received Mucosat for 60 days. NSAIDs were additionally prescribed in 9 (22.5%) of these patients. The control group included 30 patients with intra-articular injection of hyaluronic acid. All patients underwent clinical and functional examination (rating scales VAS, Leken's total index, WOMAC index, EQ-5D health questionnaire), laboratory diagnosis (IL-1, IL-6, TNF-α), X-ray examination, assessment of adverse events at 5 visits. RESULTS AND CONCLUSION: Administration of chondroitin sulfate is associated with reduced local pain syndrome and functional normalization of musculoskeletal system. Prolonged pain-free period with high safety profile due to reduced need for NSAIDs is an advantage of Mucosat therapy. Thus, this drug may be recommended for initial therapy. A combination of chondroitin sulfate with intra-articular injection of hyaluronic acid may be perspective for optimization of therapy and secondary prevention of exacerbations of OA. Further research is required.


Assuntos
Sulfatos de Condroitina/uso terapêutico , Ácido Hialurônico/uso terapêutico , Osteoartrite do Quadril/tratamento farmacológico , Osteoartrite do Joelho/tratamento farmacológico , Substâncias Protetoras/uso terapêutico , Artralgia/tratamento farmacológico , Artralgia/etiologia , Sulfatos de Condroitina/administração & dosagem , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares , Osteoartrite do Quadril/complicações , Osteoartrite do Joelho/complicações , Substâncias Protetoras/administração & dosagem , Resultado do Tratamento
15.
Surgery ; 168(4): 578-585, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32605836

RESUMO

BACKGROUND: Iatrogenic unilateral vocal fold paralysis caused by thyroid surgery induces profound physical and psychosocial distress in patients. The natural course of functional recovery over time differs substantially across subjects, but the mechanisms underlying this difference remain unclear. In this study, we examined whether the anatomic site of the lesion affected the trajectory of recovery. METHODS: In this prospective case series study in a single medical center, patients with thyroid surgery-related unilateral vocal fold paralysis were evaluated using quantitative laryngeal electromyography, videolaryngostroboscopy, voice acoustic analysis, the Voice Outcome Survey, and the Short Form-36 quality-of-life questionnaire. Patients with and without superior laryngeal nerve injuries were compared. RESULTS: Forty-two patients were recruited, among whom 15 and 27 were assigned to the with and without superior laryngeal nerve injury groups, respectively. Compared with the group without superior laryngeal nerve injury, the group with superior laryngeal nerve injury group demonstrated less improvement in the recruitment of vocal fold adductors, and the group also had more severe impairment of vocal fold vibration, maximum phonation time, jitter, shimmer, and harmony-to-noise ratio at the first evaluation. This difference was also found in the glottal gap and maximum phonation time 12 months after the injury. CONCLUSION: Among patients with thyroid surgery-related unilateral vocal fold paralysis, superior laryngeal nerve injury induces a distinctively different recovery trajectory compared with those without superior laryngeal nerve injury characterized by less reinnervation of vocal fold adductors and worse presentation in terms of the glottal gap and maximum phonation time. This study emphasizes the importance of superior laryngeal nerve function and its preservation in thyroid surgery.


Assuntos
Traumatismos do Nervo Laríngeo/etiologia , Traumatismos do Nervo Laríngeo/fisiopatologia , Recuperação de Função Fisiológica , Tireoidectomia/efeitos adversos , Paralisia das Pregas Vocais/etiologia , Paralisia das Pregas Vocais/fisiopatologia , Adulto , Eletromiografia , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Traumatismos do Nervo Laríngeo/terapia , Laringoplastia/métodos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/fisiopatologia , Estudos Prospectivos , Qualidade de Vida , Acústica da Fala , Estroboscopia , Paralisia das Pregas Vocais/terapia
16.
Ann Otol Rhinol Laryngol ; 129(11): 1063-1070, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32484033

RESUMO

OBJECTIVES: To assess voice outcomes using the novel technique of in-office laryngeal electromyography-guided vocal fold injections (LEVFI) with hyaluronic acid to treat glottal insufficiency. Secondary objectives included determining the complication/completion rates and if any factors were associated with improved voice outcomes. METHODS: Retrospective review of patients who received their first LEVFI from August 2017 to December 2018. Three- and six-month voice outcomes were assessed. Outcomes included voice handicap index-10 (VHI-10), maximum phonation time (MPT), perceptual analysis of voice (GRBAS), fundamental frequency, and stroboscopy. RESULTS: Of the 121 eligible patients (55.4% male, age 63.7 years), 94 (77.7%) had complete 3-month data and 59 (48.8%) had complete 6-month data. VHI-10 was significantly improved from 25.7 ± 7.5 to 20.9 ± 10.9 at 3 months (P < .001) and to 19.1 ± 11.5 at 6 months (P < .001). MPT improved from 6.2 ± 5.4 seconds to 9.4 ± 7.1 seconds at 3 months (P < .001) and to 11.3 ± 8.2 seconds at 6 months (P < .001). GRBAS was improved in 74.8% of patients ([65.2, 82.8] 95% CI) at 3 months and 80.8% ([69.9, 89.1]) 95% CI) at 6 months. Stroboscopy showed a glottic gap improvement in 74.8% of patients ([65.8, 82.4] 95% CI) at 3 months and in 80.3% ([65.9, 88.5] 95% CI) at 6 months. Fundamental frequency was unchanged, as expected. Multivariate analysis reported that no factors were associated with better voice outcomes. Overall, 177/181 (97.8%) injections were completed. There were no complications. CONCLUSION: In-office LEVFI is an effective, novel technique to treat glottic insufficiency with improved voice outcomes, high completion rate, and no significant complications.


Assuntos
Eletromiografia/métodos , Ácido Hialurônico/administração & dosagem , Laringoplastia/métodos , Paralisia das Pregas Vocais/diagnóstico , Qualidade da Voz/fisiologia , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Viscossuplementos/administração & dosagem , Paralisia das Pregas Vocais/fisiopatologia , Paralisia das Pregas Vocais/terapia , Prega Vocal
17.
Medicine (Baltimore) ; 99(24): e20394, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541459

RESUMO

INTRODUCTION: Hyaluronic acid injections is relatively safe with little risk of complications. Although herpes reactivation after the injection of hyaluronic acid is rare, it produces quite a huge pressure and panic on patients. Quite a lot cosmetic practitioners have no awareness of preventing, diagnosing, and giving correct treatment in time due to lack of experience. PATIENT CONCERNS: A 24-year-old woman presented with erythema, crusted papules, pain and swelling on the nose after receiving the injection of hyaluronic acid. A swab of the discharge fluid was obtained for bacterial and viral culture, showing positive for herpes simplex virus. DIAGNOSIS: The patient was diagnosed as herpes reactivation after the injection of hyaluronic acid. INTERVENTIONS: The patient underwent antiviral therapy with acyclovir 400 mg, 3 times daily for seven days. OUTCOMES: After a week of antiviral treatment, the clinical signs improved. CONCLUSION: Herpes reactivation after the injection of hyaluronic acid is quite rare but needed sufficient attention of cosmetic practitioners to make the proper diagnosis, prevention and treatment.


Assuntos
Preenchedores Dérmicos/efeitos adversos , Herpes Simples/induzido quimicamente , Ácido Hialurônico/efeitos adversos , Nariz/virologia , Simplexvirus/isolamento & purificação , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Administração Oral , Adulto , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Preenchedores Dérmicos/administração & dosagem , Feminino , Herpes Simples/patologia , Herpes Simples/prevenção & controle , Humanos , Ácido Hialurônico/administração & dosagem , Nariz/patologia , Resultado do Tratamento , Adulto Jovem
18.
Medicine (Baltimore) ; 99(24): e20689, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541518

RESUMO

BACKGROUND: The reduced range of motion and pain are the most characteristic clinical features of osteoarthritis (OA). Hyaluronic acid (HA), which is one of the infiltrative therapies for OA treatment, and polynucleotides (PNs), which is a DNA-derived macromolecule favored cell growth and collagen production, are an ongoing debate in clinical effectiveness. METHODS: We plan to perform a systematic review and meta-analysis of randomized clinical trial to evaluate efficacy of intra-articular polynucleotides associated with hyaluronic acid versus hyaluronic acid alone in the treatment of knee osteoarthritis. We will search PubMed, EMBASE, Cochrane Library using a comprehensive strategy. The related conference proceedings and reference lists of the included studies will also be checked to identify additional studies. Two reviewers will screen retrieved records, extract information and assess the risk of bias independently. Stata v15.1 software will be used to conduct data synthesis. RESULTS: This study will be submitted to a peer-reviewed journal for publication. CONCLUSION: We hope it will provide a relatively comprehensive reference for clinical practice and future relevant clinical trials. ETHICS AND DISSEMINATION: Ethics approval and patient consent are not required, as this study is a systematic review and meta-analysis. PROSPERO REGISTRATION NUMBER: CRD42020167678.


Assuntos
Artralgia/tratamento farmacológico , Ácido Hialurônico/administração & dosagem , Metanálise como Assunto , Osteoartrite do Joelho/complicações , Polinucleotídeos/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Combinação de Medicamentos , Humanos , Injeções Intra-Articulares , Resultado do Tratamento
19.
Biomater Sci ; 8(11): 3202-3211, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32374304

RESUMO

Preventing surgical site infections (SSIs) of implants has drawn significant attention in both basic and clinical research. Implants with convenient preparation methods and intelligent drug release capabilities are highly needed to resist bacterial infection. Herein, we designed an intelligent drug-release system, which can be instantly incorporated with implants during the surgical process. The drug-release system involves ß-glycerophosphate (ß-GP) and chitosan (CS) as a thermosensitive hydrogel for instant construction onto implants and hyaluronic acid (HA) as a trigger to release vancomycin hydrochloride (VH) on demand. Tertiary calcium phosphate (TCP) scaffolds (implants) are vacuum-adsorbed in a solution of the intelligent vancomycin-release system (VH-HA-CS/ß-GP), followed by heating for 40 min at 80 °C to form VH-HA-CS/ß-GP@TCP. The drug-release hydrogel intelligently releases vancomycin depending on the concentration of hyaluronidase, which is secreted by Staphylococcus aureus (S. aureus) in infection sites. Furthermore, VH-HA-CS/ß-GP@TCP showed effective antibacterial properties in vitro and in vivo. The VH-HA-CS/ß-GP drug-release system can be conveniently prepared during surgery for intelligently preventing SSIs in bone tissue.


Assuntos
Antibacterianos/administração & dosagem , Doenças Ósseas/prevenção & controle , Sistemas de Liberação de Medicamentos , Implantes de Medicamento , Infecções Estafilocócicas/prevenção & controle , Infecção da Ferida Cirúrgica/prevenção & controle , Vancomicina/administração & dosagem , Animais , Antibacterianos/química , Osso e Ossos/cirurgia , Linhagem Celular , Quitosana/administração & dosagem , Quitosana/química , Liberação Controlada de Fármacos , Feminino , Glicerofosfatos/administração & dosagem , Glicerofosfatos/química , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/química , Hialuronoglucosaminidase/química , Hialuronoglucosaminidase/metabolismo , Hidrogéis/administração & dosagem , Hidrogéis/química , Masculino , Camundongos , Coelhos , Staphylococcus aureus/enzimologia , Vancomicina/química
20.
Am J Otolaryngol ; 41(4): 102502, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32460989

RESUMO

BACKGROUND: Sodium hyaluronate has been proposed as a treatment for improving the symptoms of chronic rhinosinusitis. The present study evaluated the effect of the intranasal administration of hyaluronic acid in a group of patients affected by chronic rhinosinusitis without nasal polyps (CRSsNP). MATERIALS AND METHODS: Thirty subjects aged 18-65 years affected by CRSsNP were enrolled. The subjects were randomly administered hyaluronic acid or isotonic saline solution by nasal nebulizer twice per day for 30 days. They were evaluated before (T0) and after the treatment (T1) with Sino-Nasal Outcome Test-22, visual analogue scale for rhinorrhea, nasal obstruction, facial pain and hyposmia/hypogeusia, nasal endoscopy, active anterior rhinomanometry, peak nasal inspiratory flow and nasal cytology. RESULTS: Comparing the study and the control group, at T1 no significant differences were observed in both objective and subjective parameters. Being included in the study group rather than in the control group did not have a significant effect on the variation of the considered parameters between T0 and T1. Considering the effects of the micronized douches independently from the type of solution used (either hyaluronic acid or isotonic saline solution), although no difference emerged between study and control group for any of the objective parameters, there was an improvement of Sino-Nasal Outcome Test-22 scores (p = .0005), visual analogue scale for nasal obstruction (p = .0006) and for hyposmia/hypogeusia (p = .04). CONCLUSIONS: The treatment with micronized nasal douches can improve the sino-nasal symptoms of CRSsNP, in particular nasal obstruction and olfactory ability. No advantage of the use of hyaluronic acid over isotonic saline solution emerged.


Assuntos
Ácido Hialurônico/administração & dosagem , Soluções Isotônicas/administração & dosagem , Lavagem Nasal/métodos , Solução Salina/administração & dosagem , Sinusite/terapia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA