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Purpose To perform a quantitative analysis of the amount of cancellous bone in the distal radius and olecranon process by segmentation of computed tomographic scans. As a secondary analysis, the bone density by Hounsfield units was evaluated at the same sites. Methods Computed tomography angiography images of the upper extremity were analyzed using 3-D Slicer™ medical imaging software. Bone volume (cm 3 ) and density (Hounsfield units) from the cancellous bone between the distal radius and the olecranon process were compared by creating an advanced three-dimensional model. The images were analyzed in duplicate, and an intraclass correlation was performed to assess measurement consistency. Results Twenty subjects were included. A total volume of 5.01 ± 1.21 cm 3 and 5.81 ± 1.61 cm 3 for the distal radius and the olecranon process ( p < .0001), respectively, was found. Regarding Hounsfield units, the density of the olecranon process was 303.1 ± 73.26, and the distal radius was 206.5 ± 63.73 ( p < .0001). All intraclass correlation coefficients were >0.992. Conclusion These results suggest that the olecranon process has a greater volume and a higher bone mineral density than the distal radius. With these results, the surgeon will have the ability to decide the quantity and quality of bone grafts according to the surgical procedure.

Background and Objectives: Patellofemoral pain (PFP) is frequent in the young and active population. The effect of muscle strength in the lower extremities after aerobic activity in patients with this condition has yet to be detailed. Our objective was to determine if patients with PFP show alterations in lower extremity muscle strength measurements after performing a session of ten minutes of aerobic activity on a treadmill compared to people without patellofemoral pain. Materials and Methods: We conducted a prospective experimental study with a stratified, non-randomized, and non-blinded population sample with group matching, including an experimental group with PFP and a control group with no pain. Subjects completed self-reported functional questionnaires (IKDC, Kujala, KOOS, SF-12), underwent radiographic studies, and were evaluated by measuring the strength of hip and knee muscles and the Single-Leg Triple-Hop (SLTH) test before and after ten minutes of exercise on a treadmill. Results: Seventeen subjects diagnosed with PFP and seventeen control subjects were evaluated. Both groups were homogeneous and had no significant differences in the demographic variables. A wider sulcus angle at 30° (136.8 ± 3.8° vs. 132.5 ± 5.6°, p = 0.0140), a decrease strength post-exercise in the hip abductor (37.9 ± 7.1 N⋅m vs. 45.6 ± 7.7 N⋅m, p < 0.05) and knee extensor (36.0 ± 9.1 N⋅m vs. 47.7 ± 14.0 N⋅m, p < 0.05), and a shorter distance in the SLTH test (337.9 ± 74.9 cm vs. 438.6 ± 65.8 cm, p < 0.01) was recorded in subjects with patellofemoral pain. Conclusions: Subjects with PFP had an overall lower strength of hip and knee muscles, showing significant differences in the hip abductors and knee extensors between people with PFP and healthy matched controls after aerobic exercise.

Introduction: The iatrogenic effects of repairing peripheral nerve injuries (PNIs) with autografts (AGTs) encouraged the present study to involve a new approach consisting of grafting xenogeneic prerecellularized allogeneic cells instead of AGTs. Methods: We compared sheep's AGT regenerative and functional capacity with decellularized human nerves prerecellularized with allogeneic Schwann-like cell xenografts (onwards called xenografts). Mesenchymal stem cells were isolated from ovine adipose tissue and induced in vitro to differentiate into Schwann-like cells (SLCs). Xenografts were grafted in ovine sciatic nerves. Left sciatic nerves (20 mm) were excised from 10 sheep. Then, five sheep were grafted with 20 mm xenografts, and five were reimplanted with their nerve segment rotated 180° (AGT). Results: All sheep treated with xenografts or AGT progressively recovered the strength, movement, and coordination of their intervened limb, which was still partial when the study was finished at sixth month postsurgery. At this time, numerous intrafascicular axons were observed in the distal and proximal graft extremes of both xenografts or AGTs, and submaximal nerve electrical conduction was observed. The xenografts and AGT-affected muscles appeared partially stunted. Conclusions: Xenografts and AGT were equally efficacious in starting PNI repair and justified further studies using longer observation times. The hallmarks from this study are that human xenogeneic acellular scaffolds were recellularized with allogenic SCL and were not rejected by the nonhuman receptors but were also as functional as AGT within a relatively short time postsurgery. Thus, this innovative approach promises to be more practical and accessible than AGT or allogenic allografts and safer than AGT for PNI repair.

Background: The presence of side effects and low bioavailability of rhein has limited its use in the treatment of osteoarthritis. We aimed to evaluate the in vitro response of human articular chondrocytes to the presence of the combination of platelet-rich plasma (PRP) and rhein. Methods: Solutions of rhein were prepared to assess solubility and select a working concentration. A stimulus with interleukin-1β (IL-β, 10 ng/mL) was induced for 24 h on human chondrocytes. Five treatment groups were established: control, IL-β control, PRP, rhein, and PRP + rhein. Cell viability, cell migration, nitric oxide (NO) production, tumor necrosis factor-α (TNF-α), and gene expression analyses were carried out. Results: A concentration of 50 mg/L was selected after a dose–response curve assay. Both NO and tumor TNF-α production significantly decreased after PRP and PRP + rhein treatments at 24 and 48 h. The wound healing assay revealed a significant stimulation of migration after 72 h with the PRP and PRP + rhein treatments. Expression of IL-1β, IL-6, MMP-13, and ADAMTS-5 was significantly downregulated, particularly after treatment with the combination of PRP + rhein. Conclusions: Much of the determinations denoted a better performance of the combination of PRP and rhein in decreasing the levels of the different targets evaluated; however, this was not great enough to detect a significant difference in comparison with the PRP treatment alone.

Abstract Objective The aim of this meta-analysis of randomized placebo-controlled trials was to examine whether ursodeoxycholic acid treatment is an effective lipid-lowering agent. Methods PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched in order to find randomized controlled trials evaluating the effect of ursodeoxycholic acid on lipid profile. A random-effect model and the generic inverse variance weighting method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. A random-effects meta-regression model was performed to explore the association between potential confounders and the estimated effect size on plasma lipid concentrations. Results Meta-analysis of 20 treatment arms revealed a significant reduction of total cholesterol following ursodeoxycholic acid treatment (WMD: − 13.85 mg/dL, 95% CI: -21.45, − 6.25, p

Cardiovascular diseases are a leading cause of death worldwide. Current treatments directed at heart repair have several disadvantages, such as a lack of donors for heart transplantation or non-bioactive inert materials for replacing damaged tissue. Because of the natural lack of regeneration of cardiomyocytes, new treatment strategies involve stimulating heart tissue regeneration. The basic three elements of cardiac tissue engineering (cells, growth factors, and scaffolds) are described in this review, with a highlight on the role of artificial scaffolds. Scaffolds for cardiac tissue engineering are tridimensional porous structures that imitate the extracellular heart matrix, with the ability to promote cell adhesion, migration, differentiation, and proliferation. In the heart, there is an important requirement to provide scaffold cellular attachment, but scaffolds also need to permit mechanical contractility and electrical conductivity. For researchers working in cardiac tissue engineering, there is an important need to choose an adequate artificial scaffold biofabrication technique, as well as the ideal biocompatible biodegradable biomaterial for scaffold construction. Finally, there are many suitable options for researchers to obtain scaffolds that promote cell–electrical interactions and tissue repair, reaching the goal of cardiac tissue engineering.

Purpose: To compare the bone fusion of freeze-dried allograft alone versus freeze-dried allograft combined autograft in spinal instrumentation due to spondylodiscitis. Methods: A randomized prospective trial of patients with spondylodiscitis treated with surgical debridement and spinal fixation with freeze-dried bone allograft and autograft (Group 1) or freeze-dried bone allograft alone (Group 2) was performed. Patient follow-up was assessed with a CT-scan for bone fusion; consecutive serum inflammatory marker detection (C-reactive protein, [CRP], and erythrocyte sedimentation rate, [ESR]) and clinical assessment (pain, functional disability, and spinal cord injury recovery) were other outcome parameters. The primary outcome was the grade of bone allograft integration with the scale of Tan (which ranges from 1 to 4, with lower scores indicating a better fusion rate) at 1 year after surgery. Results: A total of 20 patients were evaluated, 13 (65%) men and 7 (35%) women with a mean age of 47.2 (±14.3) years. Homogeneous distribution of demographic data was observed. A similar satisfactory bone graft fusion grade was observed in both graft groups at 1 year after surgery (p = 1.0000). Serum inflammatory markers gradually decreased in both groups after surgical intervention (CRP, p < 0.001; ESR, p < 0.01). At one-year follow-up, gradual improvement of pain, functional disability, and neurological spinal injury recovery in both graft groups were achieved. Conclusion: Freeze-dried allograft alone could be a therapeutic option for spinal fixation surgery due to spondylodiscitis since it achieves a satisfactory graft fusion rate and clinical improvement. Level of Evidence: Level 1. Treatment ClinicalTrials.gov register: NCT03265561

The dream of most of us who enter medical school, in addition to finishing in the appointed time, is to complete a medical residency.

Introduction. Scapholunate instability is the most frequent carpal instability. It covers a wide spectrum of injuries and is usually associated with distal radius fractures. Objective. The aim of the study was to correlate the clinical evolution in patients with distal radius fractures with and without the opening of the scapholunate space. Methods. An observational, prospective, and comparative study was carried out at our institution. We included patients over 18 years of age with a diagnosis of distal radius fracture. The scapholunate space was measured, and pain and wrist functionality were evaluated after removing the cast and nails using the DASH and PRWE scales. Results. A total of 90 patients were included in the study. The mean age of the patients was 52.7 ± 16.8 years. About 56.7% were women, and 43.3% were men. A space < 2.5 mm was found in 34 (37.8%) and < 2 mm in 51 (56.7%). We found a decrease in scores over 8 weeks that was less than the baseline scores in patient groups with both an open and closed scapholunate space, indicating a better clinical outcome. We found a similar clinical course at 8 weeks in both groups. Conclusions. Patients with distal radius fractures present a favorable clinical evolution over the course of 8 weeks after the removal of the nails and plaster used to immobilize the fracture. The opening of the scapholunate space does not interfere with the prognosis of the patients.

Background: Platelet-rich plasma (PRP) is a biological intra-articular therapy that has shown good clinical outcomes in patients with knee osteoarthritis (OA) and has been widely studied from in vitro to pre-clinical animal models. We aimed to synthesize non-clinical evidence regarding the different effects related to PRP. Methods: A systematic literature review was conducted in the MEDLINE, EMBASE, and Google Scholar databases in December 2020. Studies were included if they were non-clinical basic science publications describing the effect of PRP treatment, studies focused on knee OA, and articles reporting the use of PRP or a similar platelet-derived product. Included articles were assessed and categorized based on the effect or the mechanism of the action described. The main findings of each study were obtained and analyzed. Results: A total of 41 articles were included to review the outcomes of interest. The most frequently reported mechanism was the modulation of genes involved in synthesizing and degrading the cartilage extracellular matrix (ECM), followed by ECM morphological analysis, inflammation, and cell proliferation. PRP preparations with low and high content of leukocytes were equally reported. Conclusions: The studies reviewed provide evidence for several ways in which PRP can act once it is present in the intra-articular environment. The vast majority of data support a beneficial effect of PRP therapy, especially for leukocyte-poor PRP formulations. The evidence collected gives us a clue as to what the mechanism of action could be. However, the great heterogeneity in the study formulations and models implies further investigation.