102,775 research outputs found
Does scientific evidence support PRP injections as a treatment option for Achilles tendon ruptures?
No full textBasic science studies have shown the healing tendon is responsivce to local application of growth factors and describe their role in the plateled alphna granules in tendon regeneration
PRP or not PRP? That is the question.
No full textSince the introduction of platelet concentrates as a topical
adjuvant therapy to treat chronic leg ulcers in the late 1980,
the use of platelet products has been extended to many fields
of medicine, with the aim of promoting the healing process of
various pathologies in numerous kinds of tissues.
Platelet-rich plasma (PRP) and other blood derivates,
used alone or in combination with biomaterials, are under
investigation in innumerable preclinical studies or even
already used in clinical practice. Fields of application
include dermatology, ophthalmology, dentistry, cosmetic,
plastic and maxillofacial surgery, neurosurgery, urology,
cardiothoracic surgery, as well as orthopedics, sport medicine,
and recently, breakthroughs have been claimed even
for the treatment of baldness. Looking more specifically
into the orthopedic field, applications of PRP are numerous
and heterogeneous: it has been used as adjuvant to promote
the healing of bone defects and nonunions, bone fractures,
laminectomy, spinal fusion, joint arthroplasty, bone implant
osseointegration, and the treatment of various traumatic or
degenerative pathologies of tendons, ligaments, muscle, and
cartilage.
The rationale for using platelets in so many fields for the
treatment of different tissues is that platelets constitute a
reservoir of critical growth factors (GFs) and bioactive
molecules that govern and regulate the healing process,
which is quite similar in most tissues. Moreover, the
attractive possibility of using patients’ own growth factors,
concentrated and in physiologic proportions, to enhance
reparative processes in tissues with low healing potential,
promising preliminary clinical findings, and their safety
might explain the wide use of this biological approach.
However, although the popularity of PRP has reached a
peak and there is lot of enthusiasm, talking, and advertising,
it is realistic to say that nothing works for everything
Biofilm in Genital Ecosystem: A Potential Risk Factor for Chlamydia trachomatis Infection
No full textIn healthy women, the cervicovaginal microbiota is mostly populated by Lactobacillus spp., the main host defense factor of the female genital tract. In addition to Lactobacilli, other microorganisms populate the cervicovaginal microbiota, like Candida spp. and Gardnerella vaginalis. The overgrowth of Candida spp. or G. vaginalis, known as biofilm-producing microorganisms in the genital ecosystem, may lead to microbial dysbiosis that increases the risk of acquiring sexually transmitted infections, like Chlamydia trachomatis. C. trachomatis, the leading cause of bacterial sexually transmitted diseases, is still considered an important public health problem worldwide because of the impact of asymptomatic infections on long-term reproductive sequelae, including pelvic inflammatory disease and infertility. The aim of our study was to investigate the interaction between C. trachomatis and the biofilm produced by Candida albicans or Gardnerella vaginalis, evaluating whether the biofilm can harbor C. trachomatis and influence its survival as well as its infectious properties. In order to do so, we developed an in vitro coculture transwell-based biofilm model. Our findings proved, for the first time, that C. trachomatis, an intracellular obligate pathogen, survived, for up to 72 hours after exposure, inside the biofilm produced by C. albicans or G. vaginalis, retaining its infectious properties, as evidenced by the typical chlamydial inclusions observed in the cell monolayer (chlamydial inclusion-forming units at 72 h: 9255 ± 1139 and 9873 ± 1015, respectively). In conclusion, our results suggest that the biofilm related to Candida or Gardnerella genital infections may act as a reservoir of C. trachomatis and, thus, contribute to the transmission of the infection in the population as well as to its dissemination into the upper genital tract, increasing the risk of developing severe reproductive sequelae
Does patient sex influence cartilage surgery outcome? Analysis of results at 5-year follow-up in a large cohort of patients treated with Matrix-assisted autologous chondrocyte transplantation
No full textBackground: Sexual dimorphism in humans has already been documented at different levels, and preliminary findings also suggest the importance of patient sex on clinical outcome in the treatment of cartilage lesions. Purpose: To document and analyze the influence of sex on clinical outcome in a large cohort of patients treated with a cartilage regenerative procedure for knee chondral lesions and prospectively followed at midterm follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 250 knees were treated with matrix-assisted autologous chondrocyte transplantation (MACT) and prospectively evaluated with International Knee Documentation Committee (IKDC), EuroQol visual analog scale (EQ-VAS), and Tegner scores at 1-, 2-, and minimum 5-year follow-ups to compare results obtained in men and women. The lesions were focal International Cartilage Repair Society grade III-IV chondral knee defects involving femoral condyles, trochleae, and patellae. Two homogeneous groups of 56 male patients and 56 female patients were then selected by a blinded statistician for a matched-pair analysis. Results: A statistically significant improvement in all the scores in both men and women was observed in the general population. The IKDC subjective score showed better results for men at all follow-up times: at 5 years, the mean IKDC subjective score was 79.5 ± 18.6 versus 64.3 ± 20.2 for men and women, respectively (P<.0005), and the same trend was confirmed with the EQ-VAS and Tegner scores. The matched-pair analysis confirmed the difference of final results achieved (74.1 ± 19.8 vs 63.7 ± 20.2, respectively; P = .006). However, men and women started with different preoperative levels, and the analysis of the improvement obtained was not significantly different. Finally, when scores were standardized for each patient, according to the mean score typical for the corresponding age and sex category in a healthy population, a sex-related difference was not confirmed at any of the follow-ups. Etiological factors, lesion site, and preinjury activity level differed in women and men of the general population and were the confounding factors responsible for the different outcome not confirmed by the analysis of homogeneous cohorts of patients. Conclusion: Women have a different knee chondral lesion pattern and more often have unfavorable conditions related to the cause of injury, site, and activity level, and they also have lower raw, not standardized, scores. However, a matched-pair analysis with data standardized for the specific patient categories showed that, on equal terms, women have the same possibilities for successful outcome as men after surgical treatment for knee cartilage regeneration. © 2013 The Author(s)
New evidence on the output cost of fighting inflation
No full textThe Federal Reserve has made significant progress toward price stability over the last two decades. The annual inflation rate has declined from 13 percent in the early 1980s to roughly 2 percent today. But, to be sure, the current low-inflation environment has come at a price.> One key cost of achieving low inflation is the output loss that generally accompanies a permanent decline in inflation, as occurred in the early 1980s and early 1990s. Another more subtle output cost of fighting inflation is the cost of preventing inflation from rising. As incipient inflation pressures build, tighter monetary policy can slow the economy and thereby preemptively forestall the rise in actual inflation. The slower output growth is the cost of resisting inflation pressures. Together, these two output costs of fighting inflation play important roles in determining how best to maintain low inflation and how to seek further disinflation toward price stability.> A significant factor determining the output cost of fighting inflation is the tradeoff between inflation and output, often referred to as the Phillips curve. Traditionally, estimates of this relationship assume the shape of this curve is linear. This implies that the slope of the Phillips curve is a constant and, therefore, independent of the stage of the business cycle, the speed of the disinflation, and how aggressively incipient inflation pressures are fought. Recent research, however, has begun to question whether the slope is constant. Assessing the output cost of fighting inflation may be more complicated than traditionally assumed.> Filardo investigates the shape of the Phillips curve and the associated output cost of fighting inflation. He concludes that, while the Phillips curve traditionally has been thought of as approximately linear, closer examination of the inflation-output relationship reveals important nonlinearities. This new evidence and its implications for the output cost of fighting inflation may require new policy strategies.Inflation (Finance) ; Phillips curve
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