New therapies that accelerate musculoskeletal tissue recovery are highly desirable. Platelet-rich fibrin (PRF) is a leukocyte- and platelet-rich fibrin biomaterial that acts as a binding site for both platelets and growth factors. Through increasing the local concentration of growth factors at specific tissues, PRF promotes tissue regeneration. PRF has been frequently used in combination with bone graft materials to reduce healing times and promote bone regeneration during maxillofacial surgery. However, its benefits during muscle repair and recovery are less well-documented. Here, we perform a narrative review on PRF therapies and muscle injuries to ascertain its beneficial effects. We reviewed the factors that contribute to the biological activity of PRF and the published pre-clinical and clinical evidence to support its emerging use in musculoskeletal therapy. We include in vitro studies, in vivo animal studies and clinical articles highlighting both the success and failures of PRF treatment. PRF can promote the healing process when used in a range of orthopaedic and sports-related injuries. These include cartilage repair, rotator cuff surgery and anterior cruciate ligament surgery. However, conflicting data for these benefits have been reported, most likely due to inconsistencies in both PRF preparation protocols and dosing regimens. Despite this, the literature generally supports the use of PRF as a beneficial adjuvant for a range of chronic muscle, tendon, bone or other soft tissue injuries. Further clinical trials to confirm these benefits require consistency in PRF preparation and the classification of a successful clinical outcome to fully harness its potential.
The biocompatibility of materials in contact with a living tissue becomes a puzzle in the overall picture of assessing the toxic effects of chemicals that come into contact with us. Allergic reactions to substances are a significant and growing health problem affecting large parts of the population in Europe. Wristwatches are objects worn in prolonged contact with the skin, being subject to localized corrosion, especially pitting and crevice types, in sulfide-chloride medium, and high wear in the bracelets joints. Watches of medium quality are usually made of stainless steels. The X2 CrNiMo 17-12-2 316L grade as well as X1 CrNiMo 20-25-5 Cu 1 or 904L are commonly used, having good resistance to generalized corrosion. The passive layer is nevertheless insufficient to ensure complete immunity in all cases of localized corrosion encountered during wear. For this reason, a high-corrosion-resistant steel: X1 CrNiMo 18-15-4 N 0.15 or 317LMN, from three different suppliers was evaluated. Metallographic characterization was carried out. The corrosion behavior evaluation was performed for the generalized corrosion, pitting and crevice corrosion and galvanic corrosion. Galvanic couples steel 317LMN-gold 18K alloy 3N and gold 18K 5M were used. The results of the generalized and pitting corrosion test indicated three basic groups. All of the 317LMNs were similar. The 316L variants tested noticeably worse. The 904Ls were difficult to discern, but certainly easier than the 316Ls and, possibly, at least comparable to the 317LMNs.
Generally speaking, ceramic materials are insensitive to corrosion, compared to most other materials. The present study questions the fact that ceramics are inert. Two major aspects are to be considered: the stability of zirconia over time, the stable tetragonal phase transforming into an unstable monoclinic form; the multitude of manufacturing methods, using various additives, sintering additives, oxides mixing, impurities, grain boundaries, and porosities which strongly influence the corrosion behavior and chemical degradation. In case of the investigated ceramics two paths were pursued:a) Dissolutions of ceramics in a mixture of HNO3 60% and HF 40% ultrapure medium.b) Release of cations from ceramics in various mediums:dental bioceramics in a 0.07 M HCl medium and a 0.1% NaF+0.1% KF medium; ceramics used in jewelry and watchmaking applications in a HCl 0.07 M medium and an artificial sweat medium. By inductively coupled plasma-optical emission spectrometry/mass spectrometry (ICP-OES/MS), traces of significant chemical elements were assessed: Hf, Cr, Y, As, Pb, Al, Fe, Cu, Se, Sb, La, Ni, Co, Sb, Ta, Te, Ba, Sm, Nb, Hg, Cd, Sr, As and Se. In ceramics used in jewelry and watchmaking applications the concentrations found vary from one ceramic to another, including toxic elements such as Te, Ba, As, Pb, Sm, Hg and Cd, therefore being technical zirconia ceramics which are not intended for the medical field. For ceramics used in jewelry and watchmaking applications a screening identification test for Ni, Co, Cu and Fe with strips of type Merckoquant® (Merck, Kenilworth, NJ, USA) was also performed. The obtained data prove that the zirconia ceramics in question are far from being “inert”.
Recombinant monoclonal antibodies are used for treating various diseases, from asthma, rheumatoid arthritis, and inflammatory bowel disease to cancer. Although monoclonal antibodies are known to have fewer toxic reactions compared with the conventional cytotoxic antineoplastic drugs, the cases of severe systemic hypersensitivity reaction (HSR) should be acknowledged. Our aim was to assess the diagnostic accuracy of the anti-IgE for galactose-α-1,3-galactose in patients with HSRs to cetuximab. We searched in PubMed, Cochrane Library, Scopus, and World of Science databases to July 1st, 2020. We included a total of 6 studies, with 1074 patients. Meta-analysis was performed using bivariate analysis and the random-effect model. The pooled sensitivity was 73% (95% CI 62–81%) and the pooled specificity was 88% (95% CI 79–94%). We had not found significant heterogeneity and, despite some discrepancies in the nature of data available in the analysed studies, we draw the conclusion that the presence of cetuximab specific IgE (anti cetuximab antibody) and/or galactose-α-1,3-galactose shows moderate to high sensitivity and specificity of developing an HSR. More studies are needed to establish a protocol necessary for the proper prediction and avoidance of HSR related to cetuximab.
Titanium alloys are considered to be the most advanced materials for orthopedic implants due to the favorable combination of mechanical properties, low density, tissue tolerance, high strength-to-weight ratio, good resistance to corrosion by body fluids, biocompatibility, low density, nonmagnetic properties, and the ability to join with the bone. This is the reason why we decided to assess the resistance of two titanium alloys currently used for orthopedic implants, namely, Ti6Al7Nb and Ti6Al4V, as reference, to cyclic fatigue by dynamic tests with crevice corrosion stimulation. According to the results obtained, the examined electrochemical quantities, the visual and SEM observations, and EDX analysis reveal better corrosion behavior of the prostheses made of Ti6Al4V-anodized series compared to prostheses made of Ti6Al7Nb. The further comparison of two explanted proximal modules, made of Ti6Al7Nb and Ti6Al4V, to the same type of prostheses evaluated by cyclic fatigue dynamic tests with crevice corrosion stimulation reveals that there are significant similarities, in particular with regard to the electrolyte diffusion, deposition of products and corrosion. Cation extraction tests which were carried out for Ti6Al7Nb prostheses that have undergone particular surface treatments show significant differences depending on the surface treatment and demonstrate that orthopedic implant materials are not "inert."
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