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1.
Sheng Wu Gong Cheng Xue Bao ; 36(2): 332-340, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32148005

RESUMO

In order to further improve the hemostatic performance of wound dressings, human platelet-rich plasma (PRP) containing various growth factors was introduced into chitosan solution. The silk fibroin solutions with different volume ratios (1:1, 1:3, 3:1 and 1:0) were added to improve the porosity and hemostasis of materials. The hPRP-chitosan/silk wound dressings with different ratios was prepared by freeze-drying and pure chitosan dressing was considered as the control group to study the effects of PRP and silk fibroin in different proportions on the hemostasis properties and the growth factors burst release. The hemostasis of chitosan dressing was improved by introducing PRP, but the porous structure and water absorption were not significantly improved. If silk fibroin solution was added in the ratio of 1:1, the more uniform porous structure and better hemostatic performance could be obtained. The porosity and water absorption could reach 86.83%±3.84% and 1 474%±114% respectively. In addition, the dressings with ratio of 1:1 had positive effects on reducing the burst release of growth factors on initial stage. Therefore, PRP-chitosan/silk fibroin composite dressing can become a kind of wound dressing that can achieve rapid hemostasis and promote wound healing.


Assuntos
Bandagens , Hemostáticos , Quitosana , Fibroínas , Hemostasia , Humanos , Plasma Rico em Plaquetas , Porosidade
2.
Medicine (Baltimore) ; 99(11): e19388, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176063

RESUMO

BACKGROUND: This meta-analysis focuses on the controversial efficacy and safety of platelet-rich plasma (PRP) as compared with hyaluronic acid (HA) in the clinical treatment of knee osteoarthritis. We have attempted to provide an evidence-based medicine protocol for the conservative treatment of knee osteoarthritis. In addition, we included the latest relevant literature in this meta-analysis, and a staging study was conducted to compare the therapeutic effects of PRP and HA for knee osteoarthritis over different time periods. METHODS: An online computer search with "platelet-rich plasma" and "knee osteoarthritis" as search terms was conducted in the PubMed, EMBASE, and Cochrane Library databases. We conducted a quality assessment of the retrieved literature and extracted the following indicators: visual analog scale (VAS) score, subjective International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities (WOMAC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and adverse events. RevMan5.3 software was used to determine the effect sizes, and indicators were compared across studies at three different time points from the administration of treatment. RESULTS: A total of 14 randomized controlled trials (RCTs) involving 1350 patients were included. Long-term VAS, IKDC, WOMAC-Pain, WOMAC-Stiffness, WOMAC-Physical Function, and WOMAC-Total scores at each time point were higher in the PRP group than in the HA group. There were no significant differences in the remaining indicators between the two groups. CONCLUSION: Compared with HA, PRP offers obvious advantages in the conservative treatment of knee osteoarthritis. Treatment with PRP can reduce long-term pain and improve knee joint function with no additional risks. Therefore, PRP can be widely used for the conservative treatment of knee osteoarthritis.


Assuntos
Tratamento Conservador/métodos , Ácido Hialurônico/uso terapêutico , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/terapia , Plasma Rico em Plaquetas , Amplitude de Movimento Articular/efeitos dos fármacos , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Medição da Dor , Prognóstico , Amplitude de Movimento Articular/fisiologia , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Viscossuplementos/uso terapêutico
3.
Medicine (Baltimore) ; 99(3): e18848, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011503

RESUMO

BACKGROUND: Endometrial thickness has been identified as a prognostic factor for pregnancy rate for patients with female infertility. Thin endometrium is defined as <7 mm on the day of ovulation, or on the day of human chorionic gonadotrophin (HCG) injection in fresh in vitro fertilization (IVF) cycles, or the day to start progesterone in frozen-thaw embryo transfer cycles, as stated in the guideline of thin endometrium from the Canadin Fertility and Andrology Society and Chinese expert consensus from the Society of Reproductive Medicine, Chinese Medical Association. Many medicines are used for improving the endometrial thickness and embryo implantation rate of the patients with thin endometirum, but thin endometrium remains a major troublesome clinical problem with limited efficacy.Platelet-rich plasma (PRP), as a growing and robust therapeutic option in musculoskeletal medicine, is a preparation of autologous plasma with a high concentration of platelets, and the therapeutic mechanism is based on the capacity to supply supra physiologic amounts of essential growth factors to provide a regenerative stimulus for promoting repair in tissues with low healing potential. Some randomized controlled trials have reported the application of PRP for patients with thin endometrium with satisfactory effect. However, there is no systematic review on efficacy and safety of PRP as a treatment of thin endometrium. METHODS: The data and information will be retrieved from the databases of MEDLINE, Embase, Web of Science, Clinicaltrials.org., Cochrane Library, China Biology Medicine Database, Wan Fang Database, China National Knowledge Infrastructure Database, VIP Science Technology Periodical Database, and OpenGrey for gray literature. The randomized controlled clinical trials are going to be selected before December 20, 2019, in English or Chinese language, with the search terms including "thin endometrium,""platelet-rich plasma," "endometrial thickness," "hemorheology of endometrium," "pregnancy rate," and "adverse reactions." RevMan 5.3 will be used for systematic review and meta-analysis. This protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported with the PRISMA statement. RESULTS AND CONCLUSION: The efficacy and safety of PRP for the treatment of thin endometrium will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with thin endometirum.


Assuntos
Endométrio/patologia , Infertilidade Feminina/terapia , Plasma Rico em Plaquetas , Feminino , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto
4.
Instr Course Lect ; 69: 273-288, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32017733

RESUMO

The frequency of use of "biologics," including platelet-rich plasma (PRP), bone morphogenetic protein (BMP), and stem cell therapies in the treatment of orthopaedic conditions has significantly increased over the past few decades. The use of PRP and stem cells has been proposed for a wide variety of conditions including knee and hip osteoarthritis (OA), tendon strains and tendinopathies, muscle strains, and acute and chronic soft-tissue injuries. It has also been proposed for use in the enhancement of healing during surgical treatments. BMP has seen use in promoting fracture union and spinal fusion and has been researched as an adjunct in other procedures as well. The current state of the literature in the use and support of these biologics is outlined here.


Assuntos
Proteínas Morfogenéticas Ósseas , Plasma Rico em Plaquetas , Células-Tronco , Humanos , Lesões dos Tecidos Moles , Tendinopatia
5.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(1): 53-56, 2020 Jan 15.
Artigo em Chinês | MEDLINE | ID: mdl-31939235

RESUMO

Objective: To investigate the effectiveness of micro-fracture therapy combined with intra-articular injection of platelet-rich plasma (PRP) in the treatment of small sized osteochondral lesion of the talus (OLT). Methods: Between September 2014 and October 2017, 43 patients with small sized OLT met the inclusive criteria were admitted and randomly divided into micro-fracture group (21 cases) and combined group (22 cases). Patients in the micro-fracture group were treated with micro-fracture therapy, and patients in the combined group were treated with micro-fracture therapy combined with intra-articular injection of PRP. There was no significant difference in gender, age, disease duration, side of OLT, injured position, lesion area, Mintz classification, and preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot score and visual analogue scale (VAS) score between the two groups ( P>0.05). After treatment, MRI, VAS score, and AOFAS ankle-hind foot score were used to evaluate the recovery of OLT and the ankle function. Results: All incisions healed by first intention, and no complications such as venous thrombosis and ankle joint infection occurred. All patients were followed up 12-18 months after operation, with an average of 15.6 months. The VAS scores and the AOFAS ankle-hind foot scores were significantly improved at 6 and 12 months after operation in the two groups ( P<0.05), and the scores at 12 months were significantly improved when compared with postoperative scores at 6 months ( P<0.05). Compared with the micro-fracture group, the VAS score and the AOFAS ankle-hind foot score were significantly improved in the combined group at 6 and 12 months after operation ( P<0.05). MRI showed that OLT was well filled in both groups at 12 months after operation. Conclusion: Compared with micro- fracture therapy, micro-fracture therapy combined with intra-articular injection of PRP can effectively reduce pain, improve ankle function, and has a good effectiveness in the treatment of small sized OLT.


Assuntos
Cartilagem Articular , Tálus , Articulação do Tornozelo , Humanos , Injeções Intra-Articulares , Plasma Rico em Plaquetas , Resultado do Tratamento
6.
J Surg Res ; 246: 284-291, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31622885

RESUMO

BACKGROUND: Platelet-rich plasma (PRP) improves the healing of refractory wounds, and its application is receiving more attention in the field of wound repair. However, when a patient's condition is very poor, it may be difficult to provide whole blood to harvest autologous PRP. METHODS: We evaluated the efficacy and safety of allogeneic PRP in the field of chronic refractory wound repair. Sixty patients (39 males and 21 females, 57 ± 10 y old) with chronic wounds were enrolled in this prospective, randomized, single-center study during January 2014 to January 2018. Their wounds were treated by standard care. The patients with chronic refractory wounds were divided into allogeneic PRP treatment and control groups on the basis of the presence or absence of allogeneic PRP in wounds after debridement, respectively. Allogeneic PRP was prepared by collecting whole blood from healthy individuals and two-step centrifugation. Clinical effects were evaluated by visually observing wound conditions and objectively assessing wound surfaces. RESULTS: After 30 d of treatment, the allogeneic PRP-treated group showed bright red granulation that bled easily with reduced inflammatory exudation. No rejection reactions were observed. The rate of chronic wound healing was much faster in the allogeneic PRP-treated group than that in the control group. CONCLUSIONS: The present study shows that combined treatment of chronic wounds by standard care and allogeneic PRP significantly shortens healing time, suggesting that allogeneic PRP is an effective, safe adjuvant treatment for chronic wounds.


Assuntos
Transfusão de Plaquetas/métodos , Plasma Rico em Plaquetas , Úlcera Cutânea/terapia , Pele/lesões , Cicatrização , Adulto , Idoso , Doença Crônica/terapia , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Desbridamento , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Transplante Homólogo/efeitos adversos , Transplante Homólogo/métodos , Resultado do Tratamento
7.
Sports Health ; 12(1): 94-98, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31665613

RESUMO

BACKGROUND: Mixed results exist regarding the benefit of orthobiologic injections. The purpose of this study was to assess the variability in costs for platelet-rich plasma (PRP) and stem cell (SC) injections and evaluate for variables that influence pricing. HYPOTHESIS: There will be significant variability in the cost of PRP and SC injections throughout the United States. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 3. METHODS: Calls were made to 1345 orthopaedic sports medicine practices across the United States inquiring into the availability of PRP or SC knee injections and associated costs. In addition to pricing, the practice type, number of providers, and population and income demographics were recorded. Univariate statistical analyses were used to identify differences in availability and cost between variables. RESULTS: Of the contacted offices that provided information on both PRP and SC availability (n = 1325), 268 (20.2%) offered both treatments, 550 (41.5%) offered only PRP injections, 20 (1.5%) offered only SC injections, and 487 (36.8%) did not offer either treatment. The mean ± SD cost of a PRP injection was $707 ± $388 (range, $175-$4973), and the mean cost of an SC injection was $2728 ± $1584 (range, $300-$12,000). Practices offering PRP and SC injections tended to be larger (PRP, 12.0 physicians per practice vs. 8.1 [P < 0.001]; SC, 13.6 vs 9.7 [P < 0.001]). Practices that offered PRP injections were located in areas with higher median household income (P = 0.047). Variables associated with higher cost of PRP injections included city population (P < 0.001) and median income of residents (P < 0.001). CONCLUSION: While the majority of sports medicine practices across the United States offer some type of orthobiologic injection, there exists significant variability in the cost of these injections. CLINICAL RELEVANCE: This study demonstrates the significant variability in costs of orthobiologic injections throughout the country, which will allow sports medicine physicians to appreciate the value of these injections when counseling patients on available treatment options.


Assuntos
Custos de Cuidados de Saúde , Traumatismos do Joelho/economia , Traumatismos do Joelho/terapia , Plasma Rico em Plaquetas , Células-Tronco , Mão de Obra em Saúde , Humanos , Renda , Injeções Intra-Articulares , Traumatismos do Joelho/epidemiologia , Cirurgiões Ortopédicos/estatística & dados numéricos , Estados Unidos/epidemiologia
8.
Eur J Ophthalmol ; 30(1): 94-103, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30585084

RESUMO

PURPOSE: To evaluate the efficacy and safety of plasma rich in growth factors eye drops for the treatment of corneal and ocular surface disorders in patients with graft versus host disease. METHODS: This retrospective and longitudinal study included graft versus host disease patients with ocular disorders. The resolution of corneal ulcers (area and density staining) was evaluated as primary outcome. Best corrected visual acuity, intraocular pressure, tear film breakup time, Schirmer test, ocular surface disease index, and visual analog score were evaluated as secondary outcomes. All variables were analyzed before and after plasma rich in growth factors treatment. The safety of plasma rich in growth factors treatment was also assessed. RESULTS: Twelve patients (23 eyes) with ocular graft versus host disease were evaluated. Statistically significant improvement in the area (75.7%) and density (73.3%) of the corneal staining, in best corrected visual acuity (74.7%), in ocular surface disease index scale (75.4%), visual analog score frequency (81.4%) and visual analog score severity (81.9%), and an increase of 3.8 s in tear film breakup time and 6 mm in Schirmer test was observed after plasma rich in growth factors treatment (p < 0.001). Some potential modifiers of the therapeutic effect were identified. All patients achieved corneal stability without perforation risk. No adverse events associated with the plasma rich in growth factors were observed. CONCLUSION: Immunosafe plasma rich in growth factors eye drops for the treatment of patients with ocular graft versus host disease could be safe and effective, showing a high rate of corneal ulcer resolution and dry eye disease control. Plasma rich in growth factors eye drops may help to maintain corneal stability and prevent it against higher ocular complications.


Assuntos
Síndromes do Olho Seco/terapia , Doença Enxerto-Hospedeiro/complicações , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Plasma Rico em Plaquetas , Adulto , Idoso , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/metabolismo , Feminino , Seguimentos , Doença Enxerto-Hospedeiro/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/uso terapêutico , Estudos Retrospectivos , Lágrimas/metabolismo
9.
Clin Sports Med ; 39(1): 125-163, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767102

RESUMO

Meniscus injuries are among the most common athletic injuries and result in functional impairment in the knee. Repair is crucial for pain relief and prevention of degenerative joint diseases like osteoarthritis. Current treatments, however, do not produce long-term improvements. Thus, recent research has been investigating new therapeutic options for regenerating injured meniscal tissue. This review comprehensively details the current methodologies being explored in the basic sciences to stimulate better meniscus injury repair. Furthermore, it describes how these preclinical strategies may improve current paradigms of how meniscal injuries are clinically treated through a unique and alternative perspective to traditional clinical methodology.


Assuntos
Meniscos Tibiais/fisiologia , Regeneração , Lesões do Menisco Tibial/cirurgia , Engenharia Tecidual , Tecidos Suporte , Tecido Adiposo/citologia , Fenômenos Biomecânicos , Células da Medula Óssea , Cartilagem/citologia , Condrócitos/transplante , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Meniscos Tibiais/citologia , Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Transplante de Células-Tronco , Membrana Sinovial/citologia
10.
Clin Plast Surg ; 47(1): 139-145, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739890

RESUMO

Fat grafting is as a unique regenerative filler with soluble factors and progenitor cells that may remodel scar tissue in an easy yet effective way. A combination of microfat grafting, lipococoncentrate injection, scar subcision, and platelet-rich plasma supplementation may be used to treat the majority of facial scars. The lipoconcentrate technique condenses the lipoaspirate to a progenitor cell-rich fluid of low volume by a combination of centrifugation and emulsification steps. In this article, the authors' methods for scar treatment by fat grafting are discussed. Choice of technique for facial scars, precise indications, and contraindications are introduced.


Assuntos
Tecido Adiposo/transplante , Cicatriz/cirurgia , Traumatismos Faciais/cirurgia , Lipectomia/métodos , Plasma Rico em Plaquetas , Cicatriz/etiologia , Traumatismos Faciais/complicações , Humanos , Rejuvenescimento , Células-Tronco
11.
Rev Lat Am Enfermagem ; 27: e3221, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31826162

RESUMO

OBJECTIVE: to estimate the direct cost of producing autologous platelet rich plasma gel. METHOD: an economic, prospective, longitudinal study with direct cost estimation, from the perspective of the Unified Health System, conducted in a university hospital in the state of Rio de Janeiro, over a period of 12 weeks. It was approved by the Ethics Committee of the School of Medicine. Direct observation of 18 participants was conducted. Material and human resources categories were analyzed for production costs. RESULTS: the cost of producing platelet rich plasma gel was US $4.88 per session, for a total of US $5.16, when the material resources per unit were considered in the Unified Health System. The time to complete the procedure was approximately 22 minutes. CONCLUSION: the production of platelet rich plasma gel involves low cost material resources for both blood collection and preparation, enabling universal access to treatment. The procedure requires trained staff in an appropriate location; it is a safe and inexpensive technology.


Assuntos
Géis/economia , Plasma Rico em Plaquetas , Custos e Análise de Custo , Humanos , Estudos Longitudinais , Estudos Prospectivos , Cicatrização/efeitos dos fármacos
12.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(12): 1527-1531, 2019 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-31823552

RESUMO

Objective: To investigate the effectiveness of extracorporeal shock wave therapy combined with platelet-rich plasma (PRP) injection in treatment of knee osteoarthritis (KOA) by prospective clinical study. Methods: Between June 2015 and June 2018, 180 patients with KOA met the inclusion criteria were included in study and randomly allocated to group A (n=60), group B (n=60), and group C (n=60). The patients were treated with autologous PRP intra-articular injection in group A, extracorporeal shock wave therapy in group B, and extracorporeal shock wave therapy combined with autologous PRP intra-articular injection in group C, once a week and 5 times a duration of treatment. There was no significant difference in age, gender, disease duration, side of KOA, and Kellgren-Lawrence grading between groups (P>0.05). The pain and function of knee joint were assessed by visual analogue scale (VAS) score, Lequesne Index score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee joint activity before treatment and at 1, 3, and 5 weeks after the first treatment. Results: There were significant differences in VAS score, Lequesne Index score, WOMAC score, and knee joint activity between pre- and post-treatment in all groups (P<0.05). VAS score, Lequesne Index score, and WOMAC score gradually decreased with the prolongation of treatment time (P<0.05); but there was no significant difference in knee joint activity between different time points (P>0.05). There was no significant difference in VAS score, Lequesne Index score, WOMAC score, and knee joint activity between groups before treatment (P>0.05); the scores of group C were superior to groups A and B (P< 0.05) at different time points after treatment; while the knee joint activities of 3 groups were similar (P>0.05). Conclusion: The extracorporeal shock wave therapy combined with PRP injection can relieve the pain synergistically for KOA.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Osteoartrite do Joelho , Plasma Rico em Plaquetas , Humanos , Ácido Hialurônico , Injeções Intra-Articulares , Osteoartrite do Joelho/terapia , Estudos Prospectivos , Resultado do Tratamento
13.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(12): 1547-1551, 2019 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-31823556

RESUMO

Objective: To investigate the effectiveness of local injection of autologous platelet-rich plasma (PRP) in treatment of diabetic foot ulcer. Methods: Between October 2017 and October 2018, 90 diabetic foot ulcer patients who met the selection criteria were randomly divided into 3 groups: PRP injection group (group A, PRP was injected and hydrogel dressing covered the wounds), PRP covered group (group B, PRP gel and hydrogel dressing covered the wounds), and the control group (group C, hydrogel dressing covered the wounds), 30 cases in each group. There was no significant difference in gender, age, injured side, disease duration, preoperative glycosylated hemoglobin, wound size, and Wagner grading between groups (P>0.05). The frequency of treatments and hospitalization day in all groups and the total amount of PRP application in groups A and B were recorded. The wound healing condition was recorded during the treatment, and the wound healing rate was calculated at 3 months after the first debridement. Results: The frequency of treatments in groups A, B, and C were (10.2±0.8), (11.4±0.6), (12.5±0.5) times, respectively. The total amount of PRP application of groups A and B were (306±24) and (342±18) mL, respectively. There was no significant difference in the frequency of treatments and the total amount of PRP application between groups (P>0.05). The hospitalization days of groups A, B, and C were (40.5±1.8), (62.1±2.3), and (88.6±1.4) days, respectively, showing significant differences between groups (P<0.05). In the course of treatment, the necrosis and exudation of the wounds gradually reduced, the areas of wounds gradually reduced; and the above conditions of group A were significantly better than groups B and C, and group B was better than group C. At 3 months after the first debridement, the wound healing rates of groups A, B, and C were 93.2%±0.8%, 52.1%±1.1%, and 21.3%±1.3%, respectively, with significant differences between groups (P<0.05). Conclusion: PRP can effectively promote the repair of diabetic foot ulcer. The effectiveness of local injection of PRP is superior to the local coverage.


Assuntos
Pé Diabético , Plasma Rico em Plaquetas , Bandagens , Pé Diabético/terapia , Humanos , Injeções , Cicatrização
14.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(6): 660-665, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31875447

RESUMO

Platelet-rich plasma and platelet-rich fibrin (PRF) are widely used in the field of stomatology. Advance-ments in preparation techniques and basic research have enabled the use of PRF derivatives in oral clinical applications. The evolution, preparation techniques, biological properties, and medical research progress of PRF derivatives are reviewed in this paper.


Assuntos
Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Plaquetas , Leucócitos , Medicina Bucal/tendências
15.
J Contemp Dent Pract ; 20(10): 1171-1178, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31883252

RESUMO

AIM: Aim of the study was to investigate the effect of PRP and MTA individually and combined on in vitro human bone marrow mesenchymal stem cells' (MSCs) proliferation and osteo/odontogenic differentiation potential. MATERIALS AND METHODS: MSCs were cultured in vitro with MTA, 5% PRP, 10% PRP, MTA with 5%PRP, and MTA with 10% PRP. Fetal calf serum (FCS) was used as control. Cell viability and proliferative efficiency were tested with cell adhesion and MTT assay. Osteo/odontogenic differentiation was assessed and quantified with alizarin red staining. RESULTS: MTA alone, MTA with 5% PRP, and MTA with 10% PRP showed significantly high proliferation at day 7 and 14 when compared to the control group. Enhanced differentiation and the highest calcium deposition was observed in MTA with the 10% PRP group. CONCLUSION: Within limitations of the in vitro environment, results imply an increased proliferation and induction of MSCs into osteo/odontogenic differentiation by the combination rather than a mere sealing of PRP by MTA. CLINICAL SIGNIFICANCE: PRP and MTA have the potential for true regeneration of the pulp tissue. Moreover, the combination of PRP and MTA can be utilized to expand the MSCs to generate adequate numbers for clinical applications, without xenogenic contamination. How to cite this article: Vanka A, Vishwakarma SK, Bhat MK, et al. Osteo/odontogenic Differentiation of Human Mesenchymal Stem Cells with Platelet-rich Plasma and Mineral Trioxide Aggregate. J Contemp Dent Pract 2019;20(10):1171-1178.


Assuntos
Células-Tronco Mesenquimais , Plasma Rico em Plaquetas , Compostos de Alumínio , Compostos de Cálcio , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Combinação de Medicamentos , Humanos , Óxidos , Silicatos
16.
Pol J Vet Sci ; 22(4): 743-751, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31867928

RESUMO

Tendinopathy treatment poses a current challenge for sport medicine due to unique physiology and biomechanics of tendons. The goal of this work was to compare the efficacy of the addition of the radial pressure wave therapy (RPWT) treatment to injection of autologous Adipose Derived Stem Cells (ADSCs) or Platelet Rich Plasma (PRP) in the therapeutic procedure for collagenase induced Achilles tendinopathy in sheep. 14 sheep (aged 5 and 6 years, Polish Mountain Sheep breed, weight 60-70 kg) were injected bacterial collagenase type 1A-S (Clostridium histolyticum, C-5894, Sigma Aldrich, Poznan, Poland) bilaterally to Achilles tendons. Subsequently, the animals were injected with PRP (7 sheep) or ADSCs (7 sheep) to previously induced tendinopathy foci. Left limbs of all the animals were additionally treated with RPWT focused above the tendinopathy origins. Treatment progress was controlled by ultrasound scans, and tendon samples were taken on the 126th day of the experiment. Tendon samples taken from the sheep treated with RPWT+ADSCs showed lower cellularity and the highest number of thick collage fibers. Samples taken from the sheep treated with RPWT+PRP showed an elevated rate of neovascularization. Addition of the RPWT to ADSCs injections in the treatment of induced Achilles tendinopathy in sheep resulted in good quality of the tissue regeneration. Dual therapy with RPWT+PRP injection can lead to neovascularization in the tendon tissue.


Assuntos
Células-Tronco Mesenquimais , Plasma Rico em Plaquetas , Doenças dos Ovinos/etiologia , Tendinopatia/veterinária , Terapia por Ultrassom/veterinária , Animais , Colagenases/toxicidade , Ovinos , Doenças dos Ovinos/terapia , Tendinopatia/induzido quimicamente , Tendinopatia/terapia , Terapia por Ultrassom/efeitos adversos
17.
Pol J Vet Sci ; 22(4): 735-742, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31867936

RESUMO

Novel tendinopathy treatment protocols should be assessed for safety. The goal of this work was to compare differences in selected systemic inflammatory marker concentrations after two treatment protocols for collagenase induced Achilles tendinopathy in sheep. 14 sheep (aged 5 and 6 years, Polish Mountain Sheep breed, weight 60-70kg) were injected with bacterial collagenase type 1A-S (Clostridium histolyticum, C-5894, Sigma Aldrich, Poznan, Poland) bilaterally to Achilles tendons. Subsequently, the animals were injected with Platelet Rich Plasma (7 sheep) or Adipose Derived Stem Cells (7 sheep) to induced tendinopathy foci. Left limbs of all sheep were additionally treated with Radial Pressure Wave Therapy (RPWT) focused above the tendinopathy origins. Treatment progress was controlled by ultrasound scans, and tendon samples were taken on the 126th day of the experiment. Serum Amyloid A (SAA) concentration showed mild elevation before the experiment (2 sheep from group I, 4 sheep from group II) and two days after the intratendinous growth factors injection ( 4 sheep from group I, 3 sheep from group II) combined with RPWT (mean 22,63 mg/L and 53, 6 mg/L respectively). Haptoglobine (Hp) concentration increased from 0 to 0,01 g/L in 2 animals from group I two days after injection. These values declined to 0 during the course of the treatment. Fibrinogen (Fb) concentrations were within reference levels throughout the research, although mild elevation was observed before the treatment course in 6 sheep from group I and 1 sheep from group II. In conclusion, addition of RPWT to growth factors injections in the treatment of yatrogenic Achilles tendinopathy in sheep did not induce systemic inflammatory response.


Assuntos
Células-Tronco Mesenquimais , Plasma Rico em Plaquetas , Doenças dos Ovinos/etiologia , Síndrome de Resposta Inflamatória Sistêmica/veterinária , Tendinopatia/veterinária , Terapia por Ultrassom/veterinária , Animais , Colagenases/toxicidade , Ovinos , Doenças dos Ovinos/terapia , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Tendinopatia/induzido quimicamente , Tendinopatia/terapia , Terapia por Ultrassom/efeitos adversos
18.
Artigo em Russo | MEDLINE | ID: mdl-31851168

RESUMO

AIM: To analyze clinical results of the surgical treatment of patients with isolated facet-syndrome of the lumbar spine using platelet-rich plasma (PRP) therapy for arcuate spine joints. MATERIAL AND METHODS: The study included 49 patients, aged 39.5 (34; 45), who, after provocative tests, were diagnosed with isolated facet syndrome and operated on from 2015 to 2018 using PRP therapy. A visual analogue pain scale (VAS), Oswestry questionnaire (ODI), Macnab subjective satisfaction scale, and the presence of complications were used to evaluate clinical efficacy. Dynamic evaluation was made on average 18 months after surgery. RESULTS AND CONCLUSION: PRP therapy is a highly effective method for treatment of patients with isolated facet syndrome caused by degenerative diseases of the facet joints. Clinical efficacy is confirmed by the persistent significant reduction of pain symptoms and restoration of functional status in the early and late postoperative periods with low risks of adverse outcomes.


Assuntos
Plasma Rico em Plaquetas , Doenças da Coluna Vertebral , Articulação Zigapofisária , Adulto , Humanos , Vértebras Lombares , Doenças da Coluna Vertebral/terapia , Síndrome , Resultado do Tratamento
19.
Medicine (Baltimore) ; 98(51): e18358, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860992

RESUMO

OBJECTIVE: The aim of this meta-analysis was to compare the effectiveness of platelet-rich plasma (PRP) vs corticosteroids for treatment of patients with lateral elbow epicondylitis. METHODS: A literature search was performed in EMBASE, Medline, the Cochrane Library and PubMed. Randomized controlled studies comparing PRP with corticosteroids for the treatment of epicondylitis were included. The Cochrane Collaboration's tool for assessing the risk of bias was used to evaluate the methodological quality of the included trials. The Cochrane Collaboration's Review Manager software was used to perform the meta-analyses. The overall effect size of each anesthetic was calculated as the weighted average of the inverse variance of the study-specific estimates. RESULTS: Seven randomized controlled trials were included in this review. The data from 2 studies were unavailable for meta-analysis, and the systematic review criteria were just achieved. Local corticosteroid injection yielded a significantly superior Disabilities of the Arm, Shoulder and Hand (DASH) score at 4 weeks (WMD, 11.90; 95% CI: 7.72 to 16.08; P < .00001; heterogeneity, χ = 0, I = 0%, P = 1.00) and 8 weeks (WMD, 6.29; 95% CI: 2.98 to 9.60; P = .0002, χ = 0, I = 0%, P = 1.00). Otherwise, it was noteworthy that a significantly lower VAS score (WMD, -2.61; 95% CI: -5.18 to -0.04; P = .05; heterogeneity, χ = 29.85, I = 97%, P < .00001) and DASH score (WMD, -7.73; 95% CI: -9.99 to -5.46; P < .00001, χ = 0.20, I = 0%, P = .66) existed in the PRP regimen than in the steroid regimen at the 24-week follow-up. More effective treatments were achieved in the PRP-treated patients than in the patients treated with corticosteroids (WMD, 3.33; 95% CI: 1.81 to 6.14; P = .000; heterogeneity, χ = 0.43, I = 0%, P = .51). CONCLUSIONS: Local corticosteroid injections demonstrated favorable outcomes compared with those of local PRP treatments for lateral elbow epicondylitis during the short-term follow-up period (4 weeks and 8 weeks post-treatment). Otherwise, at the long-term follow-up (24 weeks post-treatment), PRP injections had improved pain and function more effectively than corticosteroid injections.


Assuntos
Glucocorticoides/uso terapêutico , Plasma Rico em Plaquetas , Cotovelo de Tenista/terapia , Avaliação da Deficiência , Humanos , Injeções Intra-Articulares , Ensaios Clínicos Controlados Aleatórios como Assunto , Escala Visual Analógica
20.
Rev. cuba. angiol. cir. vasc ; 20(2)jul.-dic. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1003857

RESUMO

Introducción: El pie diabético isquémico y la enfermedad arterial periférica, son dos enfermedades que ocasionan dolor por isquemia crítica y ponen en peligro la viabilidad de las extremidades inferiores. Objetivo: Demostrar la efectividad de la terapia regenerativa con plasma rico en plaquetas en pacientes con las enfermedades citadas. Métodos: Estudio longitudinal, prospectivo y aleatorizado realizado en el Servicio de Angiología del Hospital: Julio Trigo López, entre enero 2016-diciembre 2017. Se incluyeron 26 pacientes en dos grupos de estudios, 10 pacientes no diabéticos con claudicación intermitente y 16 pacientes con lesiones isquémicas en el pie del diabético. Se aplicó plasma rico en plaquetas por vía intramuscular en la pierna afectada, en el primer grupo y de forma intra- y perilesional en el pie del diabético isquémico. Resultados: Se obtuvo alivio del dolor y mejoría en más del 70 por ciento de los pacientes en la distancia de claudicación por encima o cerca de los 200 metros. En los pacientes con pie diabético isquémico, alivio del dolor y cierre de las lesiones isquémicas en el 81,3 por ciento, solo 3 pacientes requirieron amputaciones mayores de los miembros inferiores. Conclusiones: La terapia regenerativa resulta efectiva en el salvataje de las extremidades inferiores en los pacientes estudiados, asociada a los procedimientos convencionales empleados en la cirugía revascularizadora; disminuye la amputación mayor de miembros inferiores y es una posibilidad terapéutica más en manos de especialistas entrenados, por su impacto social y en la calidad de vida de pacientes y familiares(AU)


Introduction: Ischemic diabetic foot and peripheral arterial disease are two conditions that cause pain and put in danger the functionality of lower limbs. Objective: To demonstrate the effectiveness of regenerative therapy with platelet-rich plasma in patients with the above mentioned diseases. Methods: Longitudinal, prospective and randomized study that was conducted in the Angiology Service of Julio Trigo López Hospital, from January 2016 to December 2017. There were 26 patients included in 2 groups: 10 non-diabetic patients with intermittent claudication and 16 patients with ischemic lesions in the diabetic foot. Platelet-rich plasma was used instramuscularly in an affected legs of the first group, and intraperilesional and perilesional in the diabetic foot. Results: There was pain relief and improvement in more than 70 percent of patients in the claudication distance higher or near to 200 meters. In the patients presenting ischemic diabetic foot, pain relief and closing of ischemic lesions in the 81,3 percent , just 3 patients required major amputations of lower limbs. Conclusions: Regenerative therapy results effective in the rescue of lower limbs in patients presenting peripheral arterial disease and ischemic diabetic foot. It also reduces major amputations of lower limbs and it is another therapeutic option in the hands of trained specialists due to its social impact and in the life quality of patients and their families(AU)


Assuntos
Humanos , Masculino , Feminino , Plasma Rico em Plaquetas , Doença Arterial Periférica/terapia , Proloterapia/métodos , Estudos Prospectivos , Estudos Longitudinais , Cuba
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