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The effect of oral pentoxifylline, administered 1,200 mg/day (400 mg slow-release tablets tid) through six weeks, was studied in 10 patients with established deep venous incompetence and persisting venous ulcers. The following parameters were used for verification of the therapeutic result: venous patency (VP) and valvular competence (VC) assessed by means of Doppler ultrasound; venous refilling time (VRT) assessed by photoplethysmography; skin blood flow (SBF) at rest and after tiptoeing exercise, as well as skin perfusion pressure (SPP), both assessed by means of 99mtechnetium clearance technique. Finally, photo documentation of the tissue lesion was obtained, using a two-dimensional (max and min diameter = Dmax, Dmin) metered scale photo. There was an overall good response to the treatment, the studied parameters showing the following changes: VP and VC remained unchanged; VRT improved in 8 patients, SBF increased in 10; SPP slightly improved in 5; and Dmax, and Dmin in all 10 patients. Removal or substantial diminution of the ulcers was obtained in 8 patients. These findings indicate that oral administration of pentoxifylline over a period of six weeks supports the conservative treatment and improves considerably the condition of patients with persisting venous ulcers. [ABSTRACT FROM AUTHOR]

With its main features of cartilage degeneration, subchondral bone sclerosis and osteophyte formation, osteoarthritis represents a multifactorial disease with no effective treatment options. As biomechanical shift in the trabecular network may be a driver for further cartilage degeneration, bone enhancement could possibly delay OA progression. Magnesium is known to be osteoconductive and already showed positive effects in OA models. We aimed to use magnesium cylinders to enhance subchondral bone quality, condition of cartilage and pain sensation compared to sole drilling in vivo . After eight weeks of implantation in rabbits, significant increase in subchondral bone volume and trabecular thickness with constant bone mineral density was found indicating favored biomechanics. As representative for pain, a higher number of CD271+ vessels were present in control samples without magnesium. However, this result could not be confirmed by sensitive, objective lameness evaluation using a pressure sensing mat and no positive effect could be shown on either cartilage degeneration evaluated by OARSI score nor the presence of regenerative cells in CD271-stained samples. The presented results show a relevant impact of implanted magnesium on key structures in OA pain with missing clinical relevance regarding pain. Further studies with shifted focus should examine additional structures as joint capsule or osteophytes., Competing Interests: All authors declare that they have no conflicts of interest., (© 2024 The Authors.)

In orthopaedic research, the analysis of the gait pattern is an often-used evaluation method. It allows an assessment of changes in motion sequence and pain level during postoperative follow up periods. Visual assessments are highly subjective and dependent on the circumstances. Particular challenge in rabbits is their hopping gait pattern. The aim of the present study was to establish a more objective and sensitive lameness evaluation using a pressure sensing mat. Twelve NZW rabbits were implemented in the study. They got an artificial anterior cruciate ligament transection of the right knee in connection with an experimental study, which investigated PTOA treatment. Rabbits were examined by a visual lameness score. Additionally, load of the hindlimbs was measured by the use of a pressure sensing mat and a video was recorded. Peak pressure and time force integral, defined as cumulated integral of all sensors associated to a hind paw, were evaluated. Preoperative data were collected on three independent days. As postoperative measurement time points, week 1 and week 12 after surgery were chosen. The subjective visual scoring was compared to the objective data of the pressure sensing mat. Following the visual score, lameness in week one was mild to moderate. In week twelve, rabbits were evaluated as lame free bar one. Contrary, following the values of the sensor mat, lameness in week one appeared to be more pronounced and almost all rabbits still showed low-grade lameness in week twelve. Consequently, the pressure sensing mat is more sensitive than the visual score and captures the grade of lameness much more accurately. For specific orthopaedic issues, where subtle differences in lameness are important to detect, the used system is a good supplementary evaluation method., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 von der Ahe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The aim of this study was to understand the possible mechanisms by which deep venous insufficiency and venous hypertension are associated with trophic skin changes and ulceration and to explain the therapeutic effect of Pentoxifylline in patients with leg ulcers due to deep venous incompetence. Twenty patients were included in this pilot study. They were graded into two groups: group 1, included 10 patients (5 F and 5 M) with deep venous incompetence and normal arteries; group 2, included 10 patients (1 F and 9 M) with deep venous incompetence and moderate arterial disease. Skin and muscle biopsies were carried out before and after the oral administration of 1,200 mg of Pentoxifylline daily (400 mg t.d.s). The following parameters were investigated by means of light microscopy and immunofluorescence tests: engorgement of venous stroma; decrease of intimal elastica; hyaline degeneration; floccular degeneration; pericapillary fibrin deposits and fibrin degradation products; inflammation and fat necrosis; myofibril degeneration; fibrous scar; regeneration and reconstitution of muscle fibres. The results indicated that local inflammation at the ulcer's area cause accumulation of white blood cells in the capillaries and the interstitial fluid, where there is also accumulation of fibrinogen. These changes may lead to chronic tissue ischaemia and ulceration. The known favourable effect of Pentoxifylline on red cells and leucocyte function as well as its lowering effect on plasma fibrinogen level, may be responsible for the observed therapeutic effect of Pentoxifylline on venous leg ulcers.

Frequent painful sickle cell crisis leads to a high number of active days lost due to morbidity or mortality. Only one of the specific drugs has been shown to be efficacious in a controlled clinical trial in the USA. The efficacy and the appropriateness of a drug acting on the erythrocytic membrane, pentoxiphyllin, was investigated in a randomised, double blinded clinical trial in the treatment of acute incapacitating crisis. In the 36 patients studied in a rural hospital in Togo (West Africa) where sickle cell disease is frequent (0.51% of all births), the mean (standard deviation = SD) duration of inpatient treatment was significantly shorter in the actively treated group active drug: 77.6 (40.19) hours, placebo: 102.4 (25.31) hours, difference between means: 24.8 (95% confidence intervals (= 95% CI) 2.02-47.5) hours); p = 0.03. This marked effect of active treatment was evident during the first 48 hours only. The suitability of this therapeutic regime within the studied area is discussed.

In a series of 14,080 cases in which either median or mediolateral episiotomy was used to facilitate delivery, third degree extension occurred in 75 cases (0.5 per cent). In related data extension of laceration was observed to occur in an inordinately high proportion of cases in association with use of forceps, greater than normal anterior pelvic depth, delivery of a large baby, primiparity, abnormal position and presentation, use of median incision (although extension also occurred in some cases in which mediolateral episiotomy was done), and hyperflexion and extreme abduction of the thighs. The method of immediate postpartum repair employed was associated with a minimal amount of postpartum discomfort, and late complications were almost nil.