orlando pompei - Academia.edu (original) (raw)

Papers by orlando pompei

Research paper thumbnail of Ultrasound-guided plasma rich in growth factors injections and scaffolds hasten motor nerve functional recovery in an ovine model of nerve crush injury

Journal of Tissue Engineering and Regenerative Medicine, 2015

In the present study we evaluated the motor recovery process of peripheral nerve injury (PNI), ba... more In the present study we evaluated the motor recovery process of peripheral nerve injury (PNI), based on electrophysiological and histomorphometric criteria, after treatment with plasma rich in growth factors (PRGF) injections and scaffolds in an ovine model. Three groups of sheep underwent a nerve crush lesion: the first group (n = 3) was left to recover spontaneously (SR); the second group was administered saline injections (SI; n = 5) and a third group (n = 6) received PRGF injections and scaffolds immediately after the crush injury. At post-intervention week 8, 70% of sheep in the PRGF group were CMAP-positive, with no electrophysiological response in the rest of the groups. Histomorphometric analysis 12 weeks after the surgical intervention revealed that the average axonal density of the SR (1184 ± 864 axons/µm(2) ) and SI (3109 ± 2450 axons/µm(2) ) groups was significantly inferior to the control (8427 ± 2433 axons/µm(2) ) and also inferior to the PRGF group (5276 ± 4148 axons/µm(2) ), showing no significant differences between the control and PRGF groups. The axonal size of the SR and SI groups was significantly smaller compared with the control group (18 ± 4 µm(2) ), whereas the axonal size of the PRGF group (6 ± 5 µm(2) ) did not show statistical differences from the control. Morphometry of the target muscles indicated that the PRGF group had the lowest percentage volume reduction 12 weeks after the crush injury. The PRGF group had larger muscle fibre areas than the SI and SR groups, although the differences did not reach statistical significance. Overall, these data suggest that the PRGF injections and scaffolds hastened functional axon recovery and dampened atrophy of the target muscles in an ovine model. Copyright © 2015 John Wiley & Sons, Ltd.

Research paper thumbnail of The Scientific Rationale to Apply Plasma Rich in Growth Factors in Joint Tissue Pathologies: Knee Osteoarthritis

Knee osteoarthritis (KOA) is a mechanically induced, cytokine and enzyme-mediated disorder with d... more Knee osteoarthritis (KOA) is a mechanically induced, cytokine and enzyme-mediated disorder with different biochemical, inflammatory, and genetic signatures undergoing distinct phases and phenotypes, and encompassing all joint tissues, with pain and inflammation as the clinical and biochemical hallmarks of the disease.

Research paper thumbnail of Combination of Intra-Articular and Intraosseous Injections of Platelet Rich Plasma for Severe Knee Osteoarthritis: A Pilot Study

The aim of this study was to assess a novel approach to treating severe knee osteoarthritis by ta... more The aim of this study was to assess a novel approach to treating severe knee osteoarthritis by targeting synovial membrane, superficial articular cartilage, synovial fluid, and subchondral bone by combining intra-articular injections and intraosseous infiltrations of platelet rich plasma. We explored a new strategy consisting of intraosseous infiltrations of platelet rich plasma into the subchondral bone in combination with the conventional intra-articular injection in order to tackle several knee joint tissues simultaneously. We assessed the clinical outcomes through osteoarthritis outcome score (KOOS) and the inflammatory response by quantifying mesenchymal stem cells in synovial fluid. There was a significant pain reduction in the KOOS from baseline (61.55 ± 14.11) to week 24 (74.60 ± 19.19), after treatment (p = 0.008), in the secondary outcomes (symptoms, p = 0.004; ADL, p = 0.022; sport/rec., p = 0.017; QOL, p = 0.012), as well as VAS score (p < 0.001) and Lequesne Index (p...

Research paper thumbnail of Isolation, Activation, and Mechanism of Action of Platelet-Rich Plasma and Its Applications for Joint Repair

Regenerative Medicine [Working Title], Dec 17, 2019

Platelet-Rich Plasma (PRP) is a biologic therapy that uses the patient's own blood to obtain prod... more Platelet-Rich Plasma (PRP) is a biologic therapy that uses the patient's own blood to obtain products with a higher platelet concentration than in blood. This technology provides a controlled drug delivery system of growth factors suitable for regenerative medicine. The biological effects of PRP mimic and influence biological processes such as inflammation, analgesia, and cell stimulation, providing this therapy with promising therapeutic potential. All these processes participate in maintenance, correct function, and homeostasis of the joint, where all tissues are involved. Alterations in one joint element have impact on the rest, outstanding the cellular and molecular interaction between the cartilage and subchondral bone. Therefore, the joint is an optimal therapeutic target for PRP therapy, which favors biological environment for joint repair. This chapter collects the basic concepts of joint function and the biological processes that participate in its degeneration, the definition and obtention of PRP, as well as its therapeutic potential and clinical translation.

Research paper thumbnail of Giant cell arteritis: epidemiology, diagnosis, and management

Current rheumatology reports, 2010

Giant cell arteritis (GCA), also called temporal arteritis, is a vasculitis that affects large an... more Giant cell arteritis (GCA), also called temporal arteritis, is a vasculitis that affects large and middle-sized blood vessels--with predisposition to the involvement of cranial arteries derived from the carotid artery--in individuals older than 50 years of age. Familial aggregation of GCA has been observed. Incidence of GCA is higher in white individuals than those of other ethnicities, particularly those of Scandinavian background. A temporal artery biopsy is the gold standard test for the diagnosis of GCA. Several imaging modalities, in particular ultrasonography, are useful in the diagnosis of GCA. Corticosteroids are the cornerstone of treatment in GCA. Alternative, steroid-sparing drugs, particularly methotrexate, should be considered in GCA patients with severe corticosteroid-related side effects and/or in those who require prolonged corticosteroid therapy due to relapses of the disease.

Research paper thumbnail of Treating Severe Knee Osteoarthritis with Combination of Intra-Osseous and Intra-Articular Infiltrations of Platelet-Rich Plasma: An Observational Study

CARTILAGE, Feb 15, 2018

ObjectiveAssessing the therapeutic effects of a combination of intra-articular and intra-osseous ... more ObjectiveAssessing the therapeutic effects of a combination of intra-articular and intra-osseous infiltrations of platelet-rich plasma (PRP) to treat severe knee osteoarthritis (KOA) using intra-articular injections of PRP as the control group.DesignIn this observational study, 60 patients suffering from severe KOA were treated with intra-articular infiltrations of PRP (IA group) or with a combination of intra-osseous and intra-articular infiltrations of PRP (IO group). Both groups were matched for sex, age, body mass index, and radiographic severity (III and IV degree according to Ahlbäck scale). Clinical outcome was evaluated at 2, 6, and 12 months, using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires.ResultsAt 2, 6 and 12 months after treatment, IO group had a significant improvement in all KOOS and WOMAC subscales (P < 0.05). On the contrary, patients of the IA group did not improve in any of the scores. Sixteen out of 30 IO group patients showed minimal clinically important improvement (MCII) whereas 8 out of 30 IA group patients showed this response at 6 months (26.7%; 95% CI −0.4 to 49.9; P = 0.037). At 12 months, 14 patients of IO group and 5 patients of the IA group showed MCII (30%; 95% CI 4.3 to 51.9; P = 0.013). No differences between groups were observed at 2 months.ConclusionsPRP intra-articular injections in severe KOA were not effective and did not provide any benefit. Combination of intra-articular and intra-osseous infiltrations of PRP was not clinically superior at 2 months, but it showed superior clinical outcomes at 6 and 12 months when compared with intra-articular injections of PRP.

Research paper thumbnail of Medical management of polymyalgia rheumatica

Expert Opinion on Pharmacotherapy, 2010

Importance of the field: Polymyalgia rheumatica (PMR) is a relatively frequent condition in indiv... more Importance of the field: Polymyalgia rheumatica (PMR) is a relatively frequent condition in individuals older than 50 who originate from Western countries. Corticosteroids constitute the cornerstone therapy in the management of patients with PMR. Areas covered in this review: This review summarizes the current literature on clinical clues for the diagnosis of PMR, conditions mimicking PMR, relapses in the setting of PMR and the main therapeutic strategies. What the reader will gain: With this information, the reader receives an overview on the current available data on clinical diagnosis and treatment options in PMR. Take-home messages: An initial dose of prednisone of 10-20 mg/day yields clinical improvement in the majority of patients with PMR. This is generally achieved within 7 days of the onset of this therapy. Conditions different from isolated PMR should be considered in atypical cases or when a good response to 20 mg/day of prednisone is not achieved. Relapses of PMR are not uncommon when the dose of prednisone is equal to or below than 5 mg/day. Methotrexate is the most commonly used corticosteroid sparing agent. Osteoporosis prophylaxis is also recommended.

Research paper thumbnail of Ultrasound-guided plasma rich in growth factors injections and scaffolds hasten motor nerve functional recovery in an ovine model of nerve crush injury

Journal of Tissue Engineering and Regenerative Medicine, 2015

In the present study we evaluated the motor recovery process of peripheral nerve injury (PNI), ba... more In the present study we evaluated the motor recovery process of peripheral nerve injury (PNI), based on electrophysiological and histomorphometric criteria, after treatment with plasma rich in growth factors (PRGF) injections and scaffolds in an ovine model. Three groups of sheep underwent a nerve crush lesion: the first group (n = 3) was left to recover spontaneously (SR); the second group was administered saline injections (SI; n = 5) and a third group (n = 6) received PRGF injections and scaffolds immediately after the crush injury. At post-intervention week 8, 70% of sheep in the PRGF group were CMAP-positive, with no electrophysiological response in the rest of the groups. Histomorphometric analysis 12 weeks after the surgical intervention revealed that the average axonal density of the SR (1184 ± 864 axons/µm(2) ) and SI (3109 ± 2450 axons/µm(2) ) groups was significantly inferior to the control (8427 ± 2433 axons/µm(2) ) and also inferior to the PRGF group (5276 ± 4148 axons/µm(2) ), showing no significant differences between the control and PRGF groups. The axonal size of the SR and SI groups was significantly smaller compared with the control group (18 ± 4 µm(2) ), whereas the axonal size of the PRGF group (6 ± 5 µm(2) ) did not show statistical differences from the control. Morphometry of the target muscles indicated that the PRGF group had the lowest percentage volume reduction 12 weeks after the crush injury. The PRGF group had larger muscle fibre areas than the SI and SR groups, although the differences did not reach statistical significance. Overall, these data suggest that the PRGF injections and scaffolds hastened functional axon recovery and dampened atrophy of the target muscles in an ovine model. Copyright © 2015 John Wiley &amp;amp;amp;amp;amp;amp;amp;amp;amp; Sons, Ltd.

Research paper thumbnail of The Scientific Rationale to Apply Plasma Rich in Growth Factors in Joint Tissue Pathologies: Knee Osteoarthritis

Knee osteoarthritis (KOA) is a mechanically induced, cytokine and enzyme-mediated disorder with d... more Knee osteoarthritis (KOA) is a mechanically induced, cytokine and enzyme-mediated disorder with different biochemical, inflammatory, and genetic signatures undergoing distinct phases and phenotypes, and encompassing all joint tissues, with pain and inflammation as the clinical and biochemical hallmarks of the disease.

Research paper thumbnail of Combination of Intra-Articular and Intraosseous Injections of Platelet Rich Plasma for Severe Knee Osteoarthritis: A Pilot Study

The aim of this study was to assess a novel approach to treating severe knee osteoarthritis by ta... more The aim of this study was to assess a novel approach to treating severe knee osteoarthritis by targeting synovial membrane, superficial articular cartilage, synovial fluid, and subchondral bone by combining intra-articular injections and intraosseous infiltrations of platelet rich plasma. We explored a new strategy consisting of intraosseous infiltrations of platelet rich plasma into the subchondral bone in combination with the conventional intra-articular injection in order to tackle several knee joint tissues simultaneously. We assessed the clinical outcomes through osteoarthritis outcome score (KOOS) and the inflammatory response by quantifying mesenchymal stem cells in synovial fluid. There was a significant pain reduction in the KOOS from baseline (61.55 ± 14.11) to week 24 (74.60 ± 19.19), after treatment (p = 0.008), in the secondary outcomes (symptoms, p = 0.004; ADL, p = 0.022; sport/rec., p = 0.017; QOL, p = 0.012), as well as VAS score (p < 0.001) and Lequesne Index (p...

Research paper thumbnail of Isolation, Activation, and Mechanism of Action of Platelet-Rich Plasma and Its Applications for Joint Repair

Regenerative Medicine [Working Title], Dec 17, 2019

Platelet-Rich Plasma (PRP) is a biologic therapy that uses the patient's own blood to obtain prod... more Platelet-Rich Plasma (PRP) is a biologic therapy that uses the patient's own blood to obtain products with a higher platelet concentration than in blood. This technology provides a controlled drug delivery system of growth factors suitable for regenerative medicine. The biological effects of PRP mimic and influence biological processes such as inflammation, analgesia, and cell stimulation, providing this therapy with promising therapeutic potential. All these processes participate in maintenance, correct function, and homeostasis of the joint, where all tissues are involved. Alterations in one joint element have impact on the rest, outstanding the cellular and molecular interaction between the cartilage and subchondral bone. Therefore, the joint is an optimal therapeutic target for PRP therapy, which favors biological environment for joint repair. This chapter collects the basic concepts of joint function and the biological processes that participate in its degeneration, the definition and obtention of PRP, as well as its therapeutic potential and clinical translation.

Research paper thumbnail of Giant cell arteritis: epidemiology, diagnosis, and management

Current rheumatology reports, 2010

Giant cell arteritis (GCA), also called temporal arteritis, is a vasculitis that affects large an... more Giant cell arteritis (GCA), also called temporal arteritis, is a vasculitis that affects large and middle-sized blood vessels--with predisposition to the involvement of cranial arteries derived from the carotid artery--in individuals older than 50 years of age. Familial aggregation of GCA has been observed. Incidence of GCA is higher in white individuals than those of other ethnicities, particularly those of Scandinavian background. A temporal artery biopsy is the gold standard test for the diagnosis of GCA. Several imaging modalities, in particular ultrasonography, are useful in the diagnosis of GCA. Corticosteroids are the cornerstone of treatment in GCA. Alternative, steroid-sparing drugs, particularly methotrexate, should be considered in GCA patients with severe corticosteroid-related side effects and/or in those who require prolonged corticosteroid therapy due to relapses of the disease.

Research paper thumbnail of Treating Severe Knee Osteoarthritis with Combination of Intra-Osseous and Intra-Articular Infiltrations of Platelet-Rich Plasma: An Observational Study

CARTILAGE, Feb 15, 2018

ObjectiveAssessing the therapeutic effects of a combination of intra-articular and intra-osseous ... more ObjectiveAssessing the therapeutic effects of a combination of intra-articular and intra-osseous infiltrations of platelet-rich plasma (PRP) to treat severe knee osteoarthritis (KOA) using intra-articular injections of PRP as the control group.DesignIn this observational study, 60 patients suffering from severe KOA were treated with intra-articular infiltrations of PRP (IA group) or with a combination of intra-osseous and intra-articular infiltrations of PRP (IO group). Both groups were matched for sex, age, body mass index, and radiographic severity (III and IV degree according to Ahlbäck scale). Clinical outcome was evaluated at 2, 6, and 12 months, using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires.ResultsAt 2, 6 and 12 months after treatment, IO group had a significant improvement in all KOOS and WOMAC subscales (P < 0.05). On the contrary, patients of the IA group did not improve in any of the scores. Sixteen out of 30 IO group patients showed minimal clinically important improvement (MCII) whereas 8 out of 30 IA group patients showed this response at 6 months (26.7%; 95% CI −0.4 to 49.9; P = 0.037). At 12 months, 14 patients of IO group and 5 patients of the IA group showed MCII (30%; 95% CI 4.3 to 51.9; P = 0.013). No differences between groups were observed at 2 months.ConclusionsPRP intra-articular injections in severe KOA were not effective and did not provide any benefit. Combination of intra-articular and intra-osseous infiltrations of PRP was not clinically superior at 2 months, but it showed superior clinical outcomes at 6 and 12 months when compared with intra-articular injections of PRP.

Research paper thumbnail of Medical management of polymyalgia rheumatica

Expert Opinion on Pharmacotherapy, 2010

Importance of the field: Polymyalgia rheumatica (PMR) is a relatively frequent condition in indiv... more Importance of the field: Polymyalgia rheumatica (PMR) is a relatively frequent condition in individuals older than 50 who originate from Western countries. Corticosteroids constitute the cornerstone therapy in the management of patients with PMR. Areas covered in this review: This review summarizes the current literature on clinical clues for the diagnosis of PMR, conditions mimicking PMR, relapses in the setting of PMR and the main therapeutic strategies. What the reader will gain: With this information, the reader receives an overview on the current available data on clinical diagnosis and treatment options in PMR. Take-home messages: An initial dose of prednisone of 10-20 mg/day yields clinical improvement in the majority of patients with PMR. This is generally achieved within 7 days of the onset of this therapy. Conditions different from isolated PMR should be considered in atypical cases or when a good response to 20 mg/day of prednisone is not achieved. Relapses of PMR are not uncommon when the dose of prednisone is equal to or below than 5 mg/day. Methotrexate is the most commonly used corticosteroid sparing agent. Osteoporosis prophylaxis is also recommended.