Clinical comparison of platelet-rich plasma injection and daily celecoxib administration in the treatment of early knee osteoarthritis: A randomized clinical trial.

BACKGROUND: Oral and topical nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics and intra-articular corticosteroid injections are the recommended first line of treatment for knee osteoarthritis (OA); however, they have serious side effects. Platelet-rich plasma (PRP) has been posited as an effective and safer alternative treatment for knee OA. Hitherto, there is only one study comparing the effectiveness of PRP against an NSAID. AIM OF THE STUDY: The aim of this study was to determine the effectiveness of PRP against celecoxib in the treatment of early knee OA. METHODS: 60 patients with knee OA grade II and III were randomly alocated in two groups. Group 1 received one injection of autologous PRP in each affected knee, with a reinjection after 15 days; Group 2 received 200 mg of oral celecoxib each 24 h for a year. Visual Analogue Scale (VAS), total Western Ontario and McMaster Universities Arthritis Index (WOMAC) and WOMAC subscales for pain, stiffness and function were measured at baseline and at 1, 3, 6 and 12 months after the start of the treatment. RESULTS: At the end of the study PRP was significantly better than celecoxib (p < 0.05) in improving VAS (40.40%), total WOMAC (58.95%) and WOMAC subscales of pain (50.60%), stiffness (34.13%) and function (51.90%). Significant differences remained after adjusting for age, sex or knee OA grade II or III. CONCLUSIONS: Intra-articular PRP is significantly better than celecoxib in improving pain, function and stiffness in early knee OA. This significant difference is independent of age, sex or knee OA grade II or III.

[Cat scratch disease as fever of unknown origin]. / Enfermedad por arañazo de gato como causa de fiebre de origen desconocido.

The cat scratch disease is a relatively rare disease caused by Bartonella henselae. Only a small proportion of the cases that described extranodal involvement occurs. We report a 11 year old male patient with persistent fever, liver and osteoarticular involvement with a predominance of dorsolumbar spine. Evolution was satisfactory with complete clinical and imaging evidenced recovery in several months of monitoring. Case was analyzed considering EAG published literature, emphasizing the need to include this condition in the differential diagnoses in patients with bone involvement suggestive of systemic disease.

A cross-sectional study on Campylobacter fetus subsp. venerealis prevalence and associated factors in Brazilian southern cattle farms.

Cattle farming is a major livestock activity with economic relevance in Rio Grande do Sul (RS), Brazil. However, this activity is still considered of intermediate to low technological level, and in this region, there are few epidemiologic reports of Campylobacter fetus subsp. venerealis (Cfv), the causative agent of bovine genital campylobacteriosis (BGC). Thus, we designed a cross-sectional study to assess the prevalence and Cfv-associated factors in cattle farms in RS, Brazil. In total, 99 farms were randomly selected to participate in the survey. Preputial mucus samples from selected bulls were collected twice (within a 15-day interval) and subjected to Cfv molecular detection. A farm was considered positive when at least one sample was positive for Cfv. Our findings indicate that the farm-level Cfv prevalence in RS is 67.67%. On average, the chance of a farm using natural service to be Cfv-positive increased approximately twice compared to farms that do not use natural service. We also determined that Cfv routine tests reduce the chance of a farm being positive by 92%. Therefore, both Cfv detection tests and the reduction of natural services decrease the chance of a farm being positive for Cfv. Finally, we conclude that Cfv is widely spread in Southern Brazil cattle farms and it is urgent the implementation of control measures to reduce Cfv prevalence in the target population.

Enfermedad por arañazo de gato como causa de fiebre de origen desconocido / Cat scratch disease as fever of unknown origin

The cat scratch disease is a relatively rare disease caused by Bartonella henselae. Only a small proportion of the cases that described extranodal involvement occurs. We report a 11 year old male patient with persistent fever, liver and osteoarticular involvement with a predominance of dorsolumbar spine. Evolution was satisfactory with complete clinical and imaging evidenced recovery in several months of monitoring. Case was analyzed considering EAG published literature, emphasizing the need to include this condition in the differential diagnoses in patients with bone involvement suggestive of systemic disease.

La enfermedad por arañazo de gato (EAG) es una enfermedad infecciosa aguda usualmente benigna, relativamente común, causada por Bartonella henselae. De los casos descritos una pequeña proporción presenta compromiso extranodal. Presentamos el caso clínico de un niño de 11 años con un sindrome febril prolongado, compromiso hepático y óseo múltiple, con predominio en la columna vertebral dorsolumbar. Su evolución fue satisfactoria con resolución clínica y de las imágenes, después de varios meses de seguimiento. Se realiza una revisión de la bibliografía sobre EAG, enfatizando la necesidad de incluir esta enfermedad en el diagnóstico diferencial en pacientes con síndrome febril prolongado con compromiso óseo sugerente de una enfermedad sistémica.

Divalproato de sodio como profil xis medicamentosa en migraña infantil / Infant migraine prophylaxis using sodic divalproate

Objetivo.Determinar la efectividad y seguridad del divalproato de sodio como profil xis medicamentosa de migraña infantil.Diseño. Estudio descriptivo a través de encuestas.Población. Treinta pacientes de ambos sexos.Metodología. A los pacientes que asistieron a la consulta externa y se les diagnósticó de migraña, se les inició divalproato de sodio a una dosificación de 30-50 mg/kg/día, dividido en dos dósis, por 4-6 meses. Resultados. En promedio la duración del tratamiento fue de 4.5 meses. La respuesta que se obtuvo en el 90/100 de los pacientes (27 casos) fue buena, ya que disminuyó la intensidad y la frecuencia de las crisis, hasta desaparecer los síntomas. En dos casos la respuesta fue moderada y en un caso mala, por lo que se asoció flunarazina al tratamiento. Dos casos presentaron n useas al iniciar el medicamento, que luego desapareció y un caso alopecia que abandonó el tratamiento tres meses después de iniciado. Conclusiones. El divalproato de sodio es efectivo y seguro como terapia en migraña infantil