Background: Regional cardiac sympathetic denervation is predictive of sudden cardiac arrest in patients with ischemic cardiomyopathy. The reproducibility of denervation scores between automated software programs has not been evaluated. This study seeks to: 1) compare the interrater reliability of regional denervation measurements using two analysis programs: FlowQuant® and Corridor4DM®; 2) evaluate test-retest repeatability of regional denervation scores.Methods: N=190 dynamic [ 11 C]meta-hydroxyephedrine (HED) PET scans were reviewed from the PAREPET trial in ischemic cardiomyopathy patients with reduced left ventricular ejection fraction(LVEF≤35%). N=12 scans were excluded due to non-diagnostic quality. N=178 scans were analyzed using FlowQuant and Corridor4DM software, each by two observers. Test-retest scans from n=20 patients with stable heart failure were utilized for test-retest analysis. Denervation scores were defined as extent×severity of relative uptake defects in LV regions with <75% of maximal uptake. Results were evaluated using intraclass correlation coefficient(ICC) and Bland-Altman coefficient of repeatability(RPC).
Introduction: Platelet-rich plasma (PRP) is an increasingly used unconventional treatment option for erectile dysfunction (ED). The validity of PRP as a potential treatment for ED has been proposed in limited human trials. Furthermore, the costs associated with PRP for ED treatment are not readily promoted to patients. The goal of this review was to determine the efficacy and costs of PRP based on currently available literature and Canadian data.
Methods: A comprehensive literature review of available PRP studies and current published data pertaining to cost, availability, and provider clinics globally was conducted using the PubMed database. Physicians offering genital PRP in Canada were identified using internet searches and PRP provider directories. Physician qualifications, clinic locations, and cost information were obtained from provider websites and telephone calls to identified clinics.
Results: Availability of PRP injections offered for treating ED is increasing globally. There are currently no peer-reviewed publications to substantiate anecdotal evidence pertaining to the efficacy of PRP as a viable treatment option for ED patients. Our results indicate 19 providers for PRP injections in Canada, costing on average $1777 CAD per injection. No providers were affiliated with academic institutions and providers varied in their area of clinical speciality and training.
Conclusions: To our knowledge, there is currently no research underway investigating the clinical efficacy of PRP for ED treatment despite its broad availability and significant cost. Patients should be informed of the lack of substantiated efficacy and safety data, as the reliability of PRP treatments requires further evaluation.
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