RESUMEN
BACKGROUND: Platelet-derived lyophilized growth factors (L-GFs) use a standardized number of allogenic pathogen-free platelets instead of autologous platelets used in PRP as a source of growth factors. This study aimed to evaluate the efficacy of L-GF injection versus placebo in subacromial impingement (SIS) treatment. METHODS: The current randomized double-blind placebo-controlled study included sixty patients (40 females and 20 males, aged between 24 and 75 years) diagnosed with SIS (both clinically and sonographically). Patients were randomly assigned to two equal groups. Under ultrasound guidance, group 1 received subacromial saline injection, and group 2 received L-GF injection. Clinical examination, pain visual analogue scale (VAS), shoulder pain and disability index (SPADI) and shoulder ultrasound were performed before and at the 8th week after injection. RESULTS: Follow-up assessment showed statistically significant improvement in the L-GF group regarding active flexion, active and passive internal rotation and extension, SPADI-disability scale, VAS and thickness of the supraspinatus tendon by US. Regression analysis showed that group 1 was approximately 30 times more likely than the L-GF group to experience painful arc at follow-up. Both groups showed statistically significant improvement in SPADI-pain scale and SPADI-total, flexion and abduction (still the mean value of abduction was significantly higher in the L-GF group). CONCLUSIONS: L-GF injection resulted in clinically significant reductions in pain and functional disability outcomes in patients with SIS. An objective significant reduction in the thickness of the supraspinatus tendon, measured by ultrasound, in the L-GF group hopefully encourages proper healing and functioning in SIS. TRIAL REGISTRATION: The identification number is NCT04330027, date of first registration (01/04/2020). Unique on 21/11/2019, Protocol ID: 0106178.
Asunto(s)
Factor de Crecimiento Derivado de Plaquetas , Síndrome de Abducción Dolorosa del Hombro , Dolor de Hombro , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Factor de Crecimiento Derivado de Plaquetas/administración & dosificación , Estudios Prospectivos , Manguito de los Rotadores , Síndrome de Abducción Dolorosa del Hombro/diagnóstico por imagen , Síndrome de Abducción Dolorosa del Hombro/tratamiento farmacológico , Dolor de Hombro/tratamiento farmacológico , Inyecciones IntralesionesRESUMEN
Various therapeutic modalities have been tried for female pattern hair loss (FPHL) treatment. To our knowledge, no previous studies had evaluated the therapeutic effect of lyophilized growth factor (L-GF) intralesional injection in FPHL. The current study aimed to evaluate the efficacy and safety of intralesional L-GF injection in FPHL by clinical and trichoscopic evaluation. This study included 20 patients with FPHL. All patients received three treatment sessions of intralesional injection of L-GF 4 weeks apart. Patients were followed-up for further 3 months. The outcome was evaluated by trichoscopy, photography score, patient's satisfaction score and side effects were reported. Trichoscopic evaluation showed significant posttreatment increase in all hair parameters associated with a significant decrease in vellus hair count. Ludwig's grade II showed posttreatment significant differences in all trichoscopic parameters from the baseline. No significant differences were detected regarding all trichoscopic parameters between the two Ludwig's grades posttreatment. 80% of patients showed photography score improvement that was significantly higher in Ludwig's grade II than in grade I. 100% of patients showed improvement in patient's satisfaction score with insignificant difference between Ludwig's grades. Intralesional injection of L-GF is safe and improved various trichoscopic hair parameters and clinical scores in FPHL.
Asunto(s)
Alopecia , Cabello , Alopecia/diagnóstico , Alopecia/tratamiento farmacológico , Femenino , Humanos , Inyecciones Intralesiones , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , FotograbarRESUMEN
BACKGROUND: Different studies had evaluated the efficacy of fractional CO2 laser and platelet-rich plasma (PRP) in treating striae distensae (SD). Lyophilized growth factors (LGF) represent another form of delivering growth factors similar to PRP with a more standardized method. To the best of our knowledge, no previous trials have been reported using LGF in SD. AIMS: We aimed to compare the efficacy of ablative fractional CO2 laser vs intralesional injection of LGF vs combination of both modalities for SD treatment. METHODS: This study included 20 female patients with SD. All patients received three modalities of treatment in separate three areas: area A: received fractional CO2 laser, area B: received combination of fractional CO2 laser and intradermal injection of LGF, and area C: received intradermal injection of LGF. Each area received three sessions with 6-week intervals. The outcome was evaluated clinically and histopathologically before treatment and six weeks after the last session. RESULTS: There was a statistically significant clinical and histopathological improvement of SD both in areas A and B after treatment. Area C exhibited nonsignificant clinical and histopathological improvement. Area B showed the best improvement results as compared to areas A and C. CONCLUSION: We reported that fractional CO2 laser combined with LGF injection was more effective than fractional CO2 laser alone in SD treatment based on clinical and histopathological assessment. We do not advocate LGF as a monotherapy for SD treatment; instead, LGF can be used as a combined therapy with fractional CO2 laser to improve its outcome.
Asunto(s)
Dióxido de Carbono , Estrías de Distensión , Femenino , Humanos , Inyecciones Intralesiones , Péptidos y Proteínas de Señalización Intercelular , Satisfacción del Paciente , Estrías de Distensión/terapia , Resultado del TratamientoRESUMEN
Lyophilized-growth factors (L-GFs), is a new platelet rich plasma (PRP) preparation that is standardized in growth factors concentrations. The aim of this study was to compare the therapeutic efficacy of ablative fractional CO2 laser in combination with L-GFs vs PRP in post-acne scars. This study was conducted on 45 patients presented with facial post-acne scars. Each patient received three sessions of fractional CO2 laser on both sides of the face followed by topical application of L-GFs on one side and conventional PRP on the other side. Assessment was done before and after treatment semiquantitatively by Echella d'Èvaluation Clinique des Cicatrices d'Acné (ECCA) score and qualitatively by Goodman and Baron's qualitative scar (GBQS) scale, in addition to dermoscopic evaluation. The current study reported significant clinical improvement of post-acne scars on both sides of the face evidenced by significant reduction of both ECCA score and GBQS scale with minimal side effects. The degree of clinical improvement and patients' satisfaction were significantly higher with shorter downtime in response to fractional CO2 laser combined with L-GFs rather than its combination with PRP. In conclusion, laser assisted delivery of L-GFs via fractional CO2 laser could be considered a novel successful therapeutic modality for post-acne scars.