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Dell’Aquila AM, dos Reis GNB, Cuba GT, Targa WHDC, Bongiovanni JC, Durigon TS, Salles MJ, dos Reis FB. Outcome and Predictors of Treatment Failure in Chronic Osteomyelitis Using Bioactive Glass Granules and Putty Formulations. Antibiotics (Basel) 2023; 12:1720. [PMID: 38136754 PMCID: PMC10740565 DOI: 10.3390/antibiotics12121720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/04/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The aim of this study is to evaluate the outcome of patients with cavitary chronic osteomyelitis undergoing adjuvant treatment with bioactive glass (BAG) S53P4 and identify the independent risk factors (RFs) for recurrence in 6- and 12-month patient follow-up. METHODS A retrospective, multicentre observational study conducted in tertiary specialised hospitals among patients undergoing the surgical treatment of chronic cavitary osteomyelitis using BAG-S53P4 in a granule and/or putty formulation to assess the clinical outcome and RFs for failure in 6- and 12-month patient follow-up. RESULTS Of the 92 and 78 patients with 6-month and 12-month follow-ups, infection was eradicated in 85.9% and 87.2%, respectively. In the 6-month follow-up, BAG-S53P4 in the granule formulation presented a greater risk of recurrence compared to the bioactive glass putty formulation or combined granules and putty (prevalence ratio (PR) = 3.04; confidence interval 95% [CI95%]: 1.13-10.52) and neoplasia (PR = 5.26; CI95%: 1.17-15.52). In the 12-month follow-up cohort of 78 patients, smoking (PR = 4.0; 95% CI: 1.03-15.52) and nonfermenting GNB infection (PR = 3.87; CI95%: 1.09-13.73) presented a greater risk of recurrence. CONCLUSIONS BAG-S53P4 is a viable option for bone-void filling and the treatment of chronic cavitary osteomyelitis. Formulations of BAG with putty or in combination with granules showed better results.
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Affiliation(s)
- Adriana Macedo Dell’Aquila
- Infectious Diseases Discipline, Department of Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-900, Brazil; (A.M.D.); (G.T.C.)
| | - Gabriela Nagy Baldy dos Reis
- Department of Orthopedics and Traumatology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-900, Brazil; (G.N.B.d.R.); (T.S.D.); (F.B.d.R.)
| | - Gabriel Trova Cuba
- Infectious Diseases Discipline, Department of Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-900, Brazil; (A.M.D.); (G.T.C.)
| | | | - José Carlos Bongiovanni
- Department of Orthopedics and Traumatology, Universidade de Mogi das Cruzes, Mogi das Cruzes 08780-911, Brazil;
| | - Thomas Stravinskas Durigon
- Department of Orthopedics and Traumatology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-900, Brazil; (G.N.B.d.R.); (T.S.D.); (F.B.d.R.)
| | - Mauro José Salles
- Infectious Diseases Discipline, Department of Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-900, Brazil; (A.M.D.); (G.T.C.)
| | - Fernando Baldy dos Reis
- Department of Orthopedics and Traumatology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-900, Brazil; (G.N.B.d.R.); (T.S.D.); (F.B.d.R.)
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Marques GL, Durigon TS, Sarti FCDESE, Moretto RTS, Jana Neto FC, Falótico GG. RELATIONSHIP BETWEEN PARVOVIRUS B19 AND OSTEOARTHRITIS: LITERATURE REVIEW. Acta Ortop Bras 2023; 31:e267046. [PMID: 37469492 PMCID: PMC10353865 DOI: 10.1590/1413-785220233103e267046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/26/2023] [Indexed: 07/21/2023]
Abstract
Osteoarthritis and Parvovirus B19 infection present silent and gradual evolution, since the former is a degenerative process while the latter is often asymptomatic and may persist in the individual's body during their life. This study aims to analyze clinical studies that establish a correlation between degenerative osteoarthritis and Parvovirus B19 infection. Of the 62 studies found, 25 were chosen for reading in full. Analyzing only the studies that establish the correlation between the pathologies, seven confirm this relationship between Parvovirus B19 and Osteoarthritis, while one reports no relationship. No objective correlation could be found between the other articles studied. Our findings suggest that there is a close relationship between Parvovirus B19 and Osteoarthritis, with a higher prevalence of acquired causes, women and older adults, but it can manifest during life. However, it is essential to carry out new studies involving family history of patients with Osteoarthritis with positivity of Parvovirus B19, cohort studies between childhood and adult-old adult, so that it can elucidate this duality of congenital-acquired cause and, finally, raise treatment alternatives. Level of Evidence II, Systematic Review of Level II Studies.
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Falótico GG, Tucunduva V, Brito G, Durigon TS, Arliani GG, Ferreira GF. Assessment of Predictors of Infection in Primary Knee and Hip Arthroplasty: A Case-control Study. Rev Bras Ortop 2022; 57:1009-1013. [PMID: 36540746 PMCID: PMC9757958 DOI: 10.1055/s-0042-1750753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/31/2021] [Indexed: 10/17/2022] Open
Abstract
Objective This study assesses risk factors for periprosthetic joint infection after elective primary total knee or hip arthroplasty. Methods The study included 706 medical records of patients undergoing elective primary total hip or knee arthroplasty from January to December 2018. We used a multivariate analysis of infection predictors through a logistic regression model. The R software performed all statistical analysis. Results The prevalence of infection in the sample was 2.0% (14 cases). Most patients were women (79.6%), with an afflicted right side (50.6%), and underwent a total knee arthroplasty (61.3%). Significant risk factors ( p < 0.05) for infection included surgical time greater than 120 minutes ( p = 0.009) and a history of diabetes ( p = 0.025). Conclusion The risk of infection after elective primary total knee or hip arthroplasty is higher when the surgical procedure is lengthy (over 120 minutes), or the patient has a history of diabetes mellitus. Level of Evidence IIIB, retrospective, case-control study.
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Affiliation(s)
- Guilherme Guadagnini Falótico
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, São Paulo, Brasil,Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil
| | - Vitor Tucunduva
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil
| | - Gustavo Brito
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil
| | | | | | - Gabriel Ferraz Ferreira
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil,Endereço para correspondência Gabriel Ferraz Ferreira, MD, MSc Rua Cerro Corá585, Sala 605, Torre 1, São Paulo, SPBrasil
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Arliani GG, Durigon TS, Pedroso JP, Ferreira GF, Oksman D, Oliveira VO. Infiltração intraarticular de plasma rico em plaquetas versus ácido hialurônico em pacientes com osteoartrose primária do joelho: Ensaio clínico randomizado com resultados preliminares. Rev Bras Ortop 2022; 57:402-408. [PMID: 35785122 PMCID: PMC9246520 DOI: 10.1055/s-0041-1724082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/17/2020] [Indexed: 11/29/2022] Open
Abstract
Objective
The present study aimed to compare the effects of intraarticular infiltration of platelet-rich plasma with those of hyaluronic acid infiltration in the treatment of patients with primary knee osteoarthritis.
Methods
A randomized clinical trial was conducted with 29 patients who received an intraarticular infiltration with hyaluronic acid (control group) or platelet-rich plasma. Clinical outcomes were assessed using the visual analog scale for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before and after the intervention. In addition, the posttreatment adverse effects were recorded. Categorical variables were analyzed using the chi-square and Fisher exact tests, whereas continuous variables were analyzed using the Student
t
test, analysis of variance, and the Wilcoxon test; all calculations were performed with the Stats package of the R software.
Results
An independent analysis of each group revealed a statistical difference within the first months, with improvement in the pain and function scores, but worsening on the 6
th
month after the procedure. There was no difference in the outcomes between the groups receiving hyaluronic acid or platelet-rich plasma. There was no serious adverse effect or allergic reaction during the entire follow-up period.
Conclusion
Intraarticular infiltration with hyaluronic acid or platelet-rich plasma in patients with primary knee gonarthrosis resulted in temporary improvement of functional symptoms and pain. There was no difference between interventions.
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Affiliation(s)
| | | | - João Paulo Pedroso
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
| | | | - Daniel Oksman
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
| | - Victor Otávio Oliveira
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
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Stravinskas Durigon T, MacKenzie B, Carneiro Oliveira-Junior M, Santos-Dias A, De Angelis K, Malfitano C, Kelly da Palma R, Moreno Guerra J, Damaceno-Rodrigues NR, Garcia Caldini E, de Almeida FM, Aquino-Santos HC, Rigonato-Oliveira NC, Leal de Oliveira DB, Aimbire F, Ligeiro de Oliveira AP, Franco de Oliveira LV, Durigon EL, Hiemstra PS, Vieira RP. Aerobic Exercise Protects from Pseudomonas aeruginosa-Induced Pneumonia in Elderly Mice. J Innate Immun 2018; 10:279-290. [PMID: 29843140 DOI: 10.1159/000488953] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/04/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Pseudomonas aeruginosa (PS) infection results in severe morbidity and mortality, especially in immune-deficient populations. Aerobic exercise (AE) modulates the immune system, but its effects on the outcomes of pulmonary PS infection in elderly mice are unknown. METHODS BALB/c mice (24 weeks old) were randomized to sedentary, exercise (EX), PS, and PS + EX groups for the acute experimental setting, and PS and PS + EX groups for the chronic setting. Low-intensity AE was performed for 5 weeks, 60 min/day; 24 h after the final AE session, mice were inoculated with 5 × 104 colony-forming units (CFU) of PS, and 24 h and 14 days after PS inoculation, mice were studied. RESULTS AE inhibited PS colonization (p < 0.001) and lung inflammation (total cells, neutrophils, lymphocytes [p < 0.01] in bronchoalveolar lavage [BAL]), with significant differences in BAL levels of IL-1β (p < 0.001), IL-6 (p < 0.01), CXCL1 (p < 0.001), and TNF-α (p < 0.001), as well as parenchymal neutrophils (p < 0.001). AE increased BAL levels of IL-10 and parenchymal (p < 0.001) and epithelial (p < 0.001) IL-10 expression, while epithelial (p < 0.001) and parenchymal (p < 0.001) NF-κB expression was decreased. AE diminished pulmonary lipid peroxidation (p < 0.001) and increased glutathione peroxidase (p < 0.01). Pre-incubation of BEAS-2B with IL-10 inhibited PS-induced epithelial cell expression of TNF-α (p < 0.05), CD40 (p < 0.01), and dichlorodihydrofluorescein diacetate (p < 0.05). CONCLUSIONS AE inhibits PS-induced lung inflammation and bacterial colonization in elderly mice, involving IL-10/NF-κB, and redox signaling.
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Affiliation(s)
- Thomas Stravinskas Durigon
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | - BreAnne MacKenzie
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | | | - Alana Santos-Dias
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | - Kátia De Angelis
- Department of Physiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Christiano Malfitano
- Science Department of Health, Federal University of Lavras (UFLA), Lavras, Brazil
| | - Renata Kelly da Palma
- Department of Health Sciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | - Juliana Moreno Guerra
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | | | - Elia Garcia Caldini
- Department of Pathology (LIM 59), University of São Paulo, São Paulo, Brazil
| | - Francine Maria de Almeida
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | | | | | - Danielle Bruna Leal de Oliveira
- Laboratory of Virology, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Flavio Aimbire
- Institute of Science and Technology, Federal University of São Paulo (UNIFESP), São José dos Campos, Brazil
| | | | | | - Edison Luiz Durigon
- Laboratory of Virology, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rodolfo P Vieira
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil.,Postgraduation Program in Bioengineering, Universidade Brasil, São Paulo, Brazil.,Postgraduation Program in Sciences of Human Movement and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos, Brazil
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