RESUMEN

BACKGROUND Diabetes mellitus (DM) is one of the most prevalent diseases worldwide and is associated with increased morbidity and mortality. One of the microvascular complications of DM is diabetic foot ulcer (DFU), which is associated with increased mortality from serious infections and decreased functional capacity of the patient due to amputation. Uncontrolled diabetes is a significant risk factor for poor wound healing. There is a need for alternative treatments that can promote wound healing in these patients. Several studies have shown the effect of low-level laser therapy (LLLT) on wound healing in patients with DFU. LLLT is a potential therapeutic approach in patients with DFU. CASE REPORT A 55-year-old male patient presented with a history of DM, diabetic neuropathy, and diabetic foot. The patient had uncontrolled blood sugar levels, with an HbA1C of 9.3%. The patient received therapy in the form of wound care with normal saline, topical antibiotics, and LLLT, with a dose of 10 J/cm² with a frequency of therapy 3 times per week. After 12 weeks of therapy, there was improvement, characterized by wound tissue growth and no significant adverse effects during therapy. CONCLUSIONS LLLT can provide benefits in patients with DFU and uncontrolled diabetes. The wound showed improvement after 12 weeks of therapy, and there were no significant adverse effects during therapy. LLLT is a minimally invasive, easy-to-use, and inexpensive therapeutic option to induce wound healing in patients with DFU and uncontrolled diabetes.

Asunto(s)

RESUMEN

OBJECTIVE: Current treatments for osteoarthritis do not resolve the underlying cause. Dextrose prolotherapy is an alternative method that has been proposed for treatment of osteoarthritis, due to its ability to aid tissue regeneration, improve clinical manifestations, and repair damaged tissue structures, which are pathological conditions in osteoarthritis. The aim of this systematic review was to evaluate the efficacy of dextrose prolotherapy compared with other interventions in the management of osteoarthritis. METHODS: Electronic databases PubMed, Google Scholar, Cochrane, and BioMed Central were searched from inception to October 2021. Search terms included [(prolotherapy) OR (prolotherapies) OR (dextrose prolotherapy)] AND [(osteoarthritis) OR (osteoarthritides) OR (knee osteoarthritis) OR (hip osteoarthritis) OR (hand osteoarthritis) OR (shoulder osteoarthritis)]. Randomized controlled trials that compared the use of dextrose prolotherapy with other interventions (injection, placebo, therapy, or conservative treatment) in the treatment of osteoarthritis were included. Potential articles were screened for eligibility, and data were extracted by all authors. Risk of bias was assessed using the Cochrane Risk of Bias tool. Study population, methods, and results data were extracted and tabulated by 3 authors. RESULTS: 12 studies reported that DPT was as effective or even more effective in improving functional outcomes compared with other interventions whilst others found that HA, PRP, EP, and ACS were more effective. 14 studies assessed the effectiveness of DPT and ten of them reported that DPT was more effective in reducing pain compared with other interventions. CONCLUSION: Dextrose prolotherapy in osteoarthritis confers potential benefits for pain and functional outcomes, but this systematic review found that the studies to date are at high risk of bias.

Asunto(s)

RESUMEN

BACKGROUND Coronavirus disease 2019 (COVID-19) is an emerging infectious disease first reported in Wuhan, China in December 2019 that has subsequently become pandemic worldwide. The more severe the symptoms, the more comprehensive and complex are the methods needed to treat patients. The World Health Organization (WHO) has highlighted the role of rehabilitation as one of the pillars in COVID-19 management, considering its advantages. It has been implemented in some countries' guidelines, but it is not stated in Indonesia's guideline. Thus, rehabilitation intervention is sometimes neglected or delayed. This case report aims to describe the possible benefit of optimizing the rehabilitation program during hospitalization. CASE REPORT We describe 2 patients with severe COVID-19: Patient A was a 53-year-old man without comorbidities and Patient B was a 68-year-old man with several comorbidities. Patient A was discharged from the hospital with respiratory sequelae (dyspnea, cough, and desaturation) and muscle weakness in both limbs after 2 months of hospitalization without rehabilitation intervention. Then, he returned to work 3 months after rehabilitation. Patient B was discharged without any significant sequelae after undergoing rehabilitation during hospitalization. CONCLUSIONS Early physical rehabilitation in severe cases of COVID-19 has several potential benefits, including improved muscle strength, physical function, and quality of life, as well as reduced health care costs and length of stay (LOS). We believe that an early rehabilitation program in severe cases of COVID-19 is needed, but the physician still has to consider the patients' condition and capacity into to decide what kind of exercise should be programmed by the team.

Asunto(s)

RESUMEN

BACKGROUND: The clinical utility of cartilage oligomeric matrix protein (COMP) as a diagnostic and prognostic biomarker is currently under intense study. COMP has been associated primarily with musculoskeletal disorders such as rheumatoid and osteoarthritis (OA) or muscular and ligament trauma. Aside from its established role as a biomarker of arthritis, an increasing number of studies have also suggested the role of COMP in tumorigenesis, based on findings of its expression in breast, prostate, and colon cancers. CASE PRESENTATION: We described the case of a 61-year-old man with knee osteoarthritis and was prescribed physical therapy and a course of prolotherapy injection. We found elevated sCOMP levels in our patient (twice higher than average). After a month of follow-up, he was diagnosed with colorectal cancer. CONCLUSION: It makes us wonder about other conditions of the patients. There is no standard COMP parameter to differentiate OA patients from colorectal cancer patients, but it considers the increase is higher in colorectal cancer patients. We suggest to clinicians who use the COMP level to monitor OA condition to be aware of other conditions when the level is much higher than average OA patients.

RESUMEN

OBJECTIVE: To assess the effects of dextrose prolotherapy in patients with knee osteoarthritis on the levels of serum cartilage oligomeric proteinase and urinary C-terminal telopeptide of type II collagen, and on the Western Ontario McMaster Universities Index and numerical rating scale score for pain. METHODS: A randomized controlled trial, in which participants were randomly allocated into 2 groups, receiving injections of either hyaluronic acid or dextrose prolotherapy. The hyaluronic acid group received 5 injections, 1 each on weeks 1, 2, 3, 4 and 5, and the dextrose prolotherapy group received 3 injections, 1 each on weeks 1, 5 and 9. Serum cartilage oligomeric proteinase, urinary C-terminal telopeptide of type II collagen, Western Ontario McMaster Universities Index score, and numerical rating scale score for pain were measured at baseline and 3 weeks after the last injection. Comparative analysis was conducted using Wilcoxon test within groups and analysis of covariance (ANCOVA) test between groups. RESULTS: A total of 47 participants (21 allocated to hyaluronic acid, 26 allocated to dextrose prolotherapy) completed the protocol. Both interventions resulted in significant improvements in numerical rating scale scores for pain, total Western Ontario McMaster Universities Index scores, and its subscales score. However, the dextrose prolotherapy outperformed hyaluronic acid in numerical rating scale score for pain and level of urinary C-terminal telopeptide of type II collagen, with score changes differences of 0.93 (p = 0.042) and 0.34 (p = 0.048), respectively. No significant changes in level of serum cartilage oligomeric proteinase were found in either group. CONCLUSION: Dextrose prolotherapy is an alternative injection therapy for knee osteoarthritis, which was found to be associated with a significant reduction in urinary C-terminal telopeptide of type II collagen compared with hyaluronic acid injection. Neither injection method resulted in reduced serum cartilage oligomeric proteinase.

Asunto(s)