Proposal of a New Standardized Freeze-Thawing Technical Protocol for Leucocyte-Poor Platelet-Rich Plasma Preparation and Cryopreservation

A human platelet-rich plasma (PRP) concentrate can be defined as a preparation of autologous human plasma with increased platelet concentration produced by centrifugation of a larger volume of a patient's own blood. Platelets contain a plethora of growth factors in their α-granules that are concentrated through the centrifugation process in order to then be injected in supraphysiologic amounts to an injury site with the final aim of augmenting the natural healing process. Preparations of PRP concentrates can be further classified as leucocyte-rich (LR-PRP), defined as having a leucocyte concentration above baseline, and leucocyte-poor (LP-PRP), defined as having a leucocyte concentration below baseline. Although many preclinical and clinical trials have shown the ability of leucocyte-poor PRP concentrates to significantly improve symptomatic mild to moderate hip and/or knee osteoarthritis, to date there is no consensus on the optimal way of obtaining PRP preparations, specifically with respect to the concentration of blood components. In this technical report, we describe a new standardized freeze-thawing technique for leucocyte-poor PRP preparation and cryopreservation, which has been shown to be superior to currently available techniques based solely on centrifugation. By describing this technical protocol, which we have been using on a daily basis in the setting of a Regenerative Medicine Outpatient Clinic in a European tertiary university hospital center, we aim to contribute to a future consensus on the optimal way of obtaining and preserving leucocyte-poor PRP concentrates.info:eu-repo/semantics/publishedVersio

Prognostic Implications of Tissue Doppler in Patients with Dilated Cardiomyopathy

Previous studies have shown that a ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/E') of > 15, obtained by tissue Doppler imaging (TDI), correlates with left ventricular filling pressure. OBJECTIVE: The aim of our study was to assess whether E/E' provides prognostic information in patients with dilated cardiomyopathy. METHODS: We studied 33 patients with dilated cardiomyopathy and mean ejection fraction of 31%. All the patients underwent routine two-dimensional and Doppler echocardiographic examination and TDI to determine early peak velocity of the mitral annulus. Pro-B-type natriuretic peptide (pro-BNP) and peak oxygen consumption (VO2max) were also measured. Patients were divided into two groups according to the value of E/E': Group I (n = 15 patients) with E/E' > or = 15 and Group II (n = 18 patients) with E/E' < 15. Patients were followed for 12+/-4 months; new hospital admission due to heart failure, heart transplantation and death were considered as cardiac events. RESULTS: There were significant differences between the two groups in conventional two-dimensional echocardiographic measurements (dimensions and ejection fraction) and Doppler parameters (mitral inflow). With regard to mitral annular velocities obtained by TDI at two different points (septum and lateral wall), the E', A' and S' velocities differed significantly between the two groups, with lower velocities in Group I. Systolic velocity measured in the lateral portion of the mitral annulus showed the most significant difference: Group I - 4.46 cm/sec versus Group II - 7.19 cm/sec, p < 0.00001. Pro-BNP was 5622 pg/ml in Group I, and 1254 pg/ml in Group II, p = 0.004. VO2 max was significantly different between the two groups: Group I - 17.6 ml/kg/min versus Group II - 22.8 ml/kg/min, p = 0.004. During follow-up, events were more common in Group I, with 9 patients (60%) having events, while in Group II, the event rate was 11.1% (2 patients), p = 0.004. CONCLUSION: The ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus is a powerful predictor of clinical outcome. Lower velocities of mitral annulus on TDI are expected in patients with E/E' > or = 15. Systolic velocities of under 5 cm/sec measured in the lateral portion of the mitral annulus appeared to be strongly related to prognosis

Aplicação de dejetos suínos na produção de Tifton 85 em assentamento rural, São Gabriel do Oeste, MS.

Este trabalho teve por objetivo avaliar o crescimento do Tifton 85, com diferentes doses de dejetos suínos, em uma pequena propriedade rural no Assentamento Campanário, no município de São Gabriel do Oeste, MS. Os trabalhos de pesquisa desenvolvidos na área de manejo de dejetos da suinocultura indicam que nenhum tratamento em uso no Brasil permite que o resíduo final seja lançado diretamente nos cursos d?água.bitstream/item/79856/1/COT84.pd

Síndrome Dolorosa Regional Complexa do Tipo I - da Prevenção ao Tratamento

A Síndrome Dolorosa Regional Complexa do tipo I é uma entidade clínica que se caracteriza por um quadro de dor neuropática intensa associada a múltiplas alterações sensitivomotoras e autonómicas. Afecta principalmente as extremidades, estando especialmente associada a eventos traumáticos como as fracturas. O seu diagnóstico é clínico e o tratamento não é orientado por guidelines, facto que reflete um conhecimento imperfeito da sua fisiopatologia. O diagnóstico deve ser precoce e a abordagem multidisciplinar, com recurso a tratamento farmacológico, programa de reabilitação e – em caso de falência dos anteriores – técnicas invasivas, com o objectivo de promover a funcionalidade dos segmentos atingidos reduzindo o risco de manutenção ou agravamento do quadro. A mobilização precoce e a administração de vitamina C têm assumido, cada vez mais, um papel de relevo na sua prevenção.info:eu-repo/semantics/publishedVersio

Echocardiographic Variables Predictive of Appropriate Therapies for Ventricular Tachyarrhythmia in Patients Undergoing Combined Cardiac Resynchronization Therapy

INTRODUCTION: The significant risk of sudden arrhythmic death in patients with congestive heart failure and electromechanical ventricular dyssynchrony has led to increased use of combined cardiac resynchronization therapy defibrillator (CRT-D) devices. OBJECTIVES: To evaluate the echocardiographic variables in patients undergoing CRT-D that predict the occurrence of appropriate therapies (AT) for ventricular tachyarrhythmia. METHODS: We analyzed 38 consecutive patients (mean age 60 +/- 12 years, 63% male) with echocardiographic evaluation before and 6 months after CRT-D implantation. Patients with AT were identified in a mean follow-up of 471 +/- 323 days. A standard echocardiographic study was performed including tissue Doppler imaging (TDI). Responders were defined as patients with improvement in NYHA class of 25%. RESULTS: The responder rate was 74%, and the reverse remodeling rate was 55%. AT occurred in 21% of patients, who presented with greater left ventricular end-diastolic internal diameter (LVEDD) before implantation (86 +/- 8 vs. 76 +/- 11 mm, p = 0.03) and at 6 months (81 +/- 8 vs. 72 +/- 14 mm, p = 0.08), and increased left ventricular end-systolic internal diameter (66 +/- 14 vs. 56 +/- 14 mm, p = 0.03) and lower ejection fraction (24 +/- 6 vs. 34 +/- 14%, p = 0.08) at 6 months. In the group with AT, the responder rate was lower (38 vs. 83%, p = 0.03), without significant differences in reverse remodeling (38% for the AT group vs. 60%, p = 0.426) or in the other variables. By univariate analysis, predictors of AT were LVEDD before implantation and E' after implantation. Age, gender, ischemic etiology, use of antiarrhythmic drugs, reverse remodeling and the other echocardiographic parameters did not predict AT. In multivariate logistic regression analysis, both LVEDD before implantation (OR 1.24, 95% CI 1.04-1.48, p = 0.019) and postimplantation E' (OR 0.27, 95% CI 0.09-0.76, p = 0.014) remained as independent predictors of AT. CONCLUSIONS: In patients undergoing CRT-D, episodes of ventricular tachyarrhythmia occur with high incidence, independently of echocardiographic response, with LVEDD before implantation and E' after implantation as the only independent predictors of AT in the medium-term. These results highlight the importance of combined devices with defibrillation capability

`Natural Masslessness Conservation' for neutrinos in two Higgs-doublet models

We present a model which supplements the Standard Electroweak Model with three right-handed neutrinos and one extra scalar doublet which does not develop a vacuum expectation value. With the aid of a discrete symmetry the neutrinos are kept strictly massless. This model has several interesting features. It has unsuppressed lepton flavour violating processes, in particular $\mu \rightarrow e \gamma$, hinting at the possibility that these may soon be within experimental reach. The $Z$ and $W$ interactions become non-diagonal at one loop level. In particular, a non-trivial leptonic mixing matrix is seen to arise from the clash between the charged gauge boson and the charged scalar interactions.Comment: (Latex file, 12 pages. Two figures available upon request). CMU-preprin

Constraining Models of New Physics in Light of Recent Experimental Results on aψKSa_{\psi K_S}

We study extensions of the Standard Model where the charged current weak interactions are governed by the CKM matrix and where all tree-level decays are dominated by their Standard Model contribution. We constrain both analytically and numerically the ratio and the phase difference between the New Physics and the Standard Model contributions to the mixing amplitude of the neutral $B$ system using the experimental results on $R_u$, $\Delta m_{d,s}$, $\epsilon_K$ and $a_{\psi K_S}$. We present new results concerning models with minimal flavor violation and update the relevant parameter space. We also study the left-right symmetric model with spontaneously broken CP, probing the viability of this model in view of the recent results for $a_{\psi K_S}$ and other observables.Comment: 32 pages, including 9 figures, typos and error in fig. 1 corrected, minor modificiation in the text, conclusions unchanged, to appear in PR