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Bone marrow-derived products: A classification proposal – bone marrow aspirate, bone marrow aspirate concentrate or hybrid?

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World Journal of Stem Cells 2020年第4期12卷 241-250页

作者： joseph Purita joséfábio santos duarte lana Morey Kolber Bruno Lima Rodrigues Tomas Mosaner Gabriel Silva santos Carolina Caliari-Oliveira Stephany Cares Huber Institute of Regenerative Medicine Boca RatonFL 33432United States Institute of Bone and Cartilage IndaiatubaSP 13334-170Brazil Department of Physical Therapy Nova Southeastern UniversityFort LauderdaleFL 33314United States University of Campinas CampinasSP 13083-970Brazil In Situ Cell Therapy Ribeirao PretoSP 14056-680Brazil

Degenerative musculoskeletal disorders are one of the top causes of pain and disability in the adult *** available alternatives to mitigate symptoms include conservative treatments such as the administration of pharmacological agents and an educative approach towards lifestyle *** use of certain analgesics,such as opiates and corticosteroids,delivers short term results but do not address the etiological source of pain and ***,prolonged use of such medications may cause additional ***,the demand for musculoskeletal tissue regeneration has led to an alternative approach referred to as“orthobiologics”.This alternative is based on cellular and molecular components capable of inducing and promoting tissue *** marrow(BM)aspirate(BMA)and concentrate are well-known orthobiologics used to treat musculoskeletal *** derived from the BM have been discussed in the literature;however,the lack of standardization regarding collection and processing protocols presents a challenge for generalization of study outcomes and determination of *** BM-derived orthobiologics have not yet been classified,to our knowledge,this manuscript proposes the ACH classification system,which speaks to BMA(A),BMA and concentrate(C)and hybrid(H),which combines A and *** classification proposes and describes 8 parameters that are relevant for the quality of biological *** more parameters used would imply greater characterization and complexity of the evaluation of the biological product *** ACH classification envisages a necessary contribution to the comprehension of both clinical procedures and research outcomes,ultimately ushering in a standardization of best practice.

关键词： Bone-marrow classification Bone-marrow aspirate concentrate Regenerativemedicine Stem cells Musculoskeletal disorders Orthobiologics

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Platelet-rich plasma vs bone marrow aspirate concentrate:An overview of mechanisms of action and orthobiologic synergistic effects

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World Journal of Stem Cells 2021年第2期13卷 155-167页

作者： joséfábio santos duarte lana Lucas furtado da fonseca Rafael da Rocha Macedo Tomas Mosaner William Murrell Ashok Kumar joseph Purita Marco Antonio Percope de Andrade Department of Orthopedics The Bone and Cartilage InstituteIndaiatuba 13334-170SPBrazil Department of Orthopedics The Federal University of São PauloSão Paulo 04023-062SPBrazil Department of Orthopedics Rede D’Or Unit IFOR HospitalSão Bernardo do Campo 09715-021SPBrazil Department of Orthopaedics Healthpoint UAEAbu Dhabi 00000United Arab Emirates Department of Orthopaedics My Doc Specialist Medical CentreDubai 00000United Arab Emirates Department of Orthopedics Institute of Regenerative MedicineBoca RatonFL 33432United States Department of Orthopaedic Federal University of Minas GeraisBelo Horizonte 31270-901MGBrazil

The use of orthobiologics as a novel therapy for the treatment of numerous musculoskeletal disorders has increased considerably over the past ***,there are multiple alternatives available as suitable treatments;however,the use of autologous blood-derived products such as platelet-rich plasma(PRP),bone marrow aspirate(BMA)and BMA concentrate(BMAC),specifically,is *** many investigations attempted to demonstrate the effectiveness of these therapies,even with positive results,the literature lacks standardized protocols and overall accuracy in study designs,which leads to variance and difficulty in reproducibility of *** efficacy of PRP for the treatment of cartilage,bone and muscle tissues is well *** BMAC has generated optimistic results for the same purposes,its applicability in clinical trials is still relatively recent when compared to *** products demonstrate the potential to set forth reparative processes,each in their own distinct *** combination of these biological products has been previously proposed,yet little is known about their *** indicates that growth factor,cytokine,and chemokine profiles seen in both PRP and BMAC vary but are likely to work synergistically to enhance musculoskeletal *** products seem to work well without PRP;however,the addition of PRP to BMAC has been shown to act as a rich and natural source of culture medium for stem cells located either peripherally or in the bone marrow ***,additional variables associated with the use of BMAC and PRP in orthopedics must be further evaluated in order to consolidate the efficacy of this therapeutic strategy.

关键词： Orthobiologics Platelet-rich plasma Bone-marrow aspirate Regenerative medicine Musculoskeletal diseases Stem cells

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Gut microbiome:A revolution in typeⅡdiabetes mellitus

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World Journal of Diabetes 2024年第9期15卷 1874-1888页

作者： Madhan Jeyaraman Tejaswin Mariappan Naveen Jeyaraman Sathish Muthu Swaminathan Ramasubramanian Gabriel Silva santos Lucas furtado da fonseca joséfábio lana Department of Orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia Department of Orthopaedics Brazilian Institute of Regenerative MedicineIndaiatuba 13334-170São PauloBrazil Department of Orthopaedics Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Department of Community Medicine Government Stanley Medical College and HospitalChennai 600001Tamil NaduIndia Department of Orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia Department of biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Department of Orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia

TypeⅡdiabetes mellitus(T2DM)has experienced a dramatic increase globally across countries of various income levels over the past three *** persistent prevalence of T2DM is attributed to a complex interplay of genetic and environmental *** numerous pharmaceutical therapies have been developed,there remains an urgent need for innovative treatment approaches that offer effectiveness without significant adverse *** this context,the exploration of the gut microbiome presents a promising *** has increasingly shown that the gut microbiome of individuals with T2DM exhibits distinct differences compared to healthy individuals,suggesting its potential role in the disease’s pathogenesis and *** emerging field offers diverse applications,particularly in modifying the gut environment through the administration of prebiotics,probiotics,and fecal microbiome *** interventions aim to restore a healthy microbiome balance,which could potentially alleviate or even reverse the metabolic dysfunctions associated with *** current results from clinical trials have not yet shown dramatic effects on diabetes management,the groundwork has been laid for deeper *** and future clinical trials are critical to advancing our understanding of the microbiome’s impact on *** further elucidating the mechanisms through which microbiome alterations influence insulin resistance and glucose metabolism,researchers can develop more targeted *** potential to harness the gut microbiome in developing new therapeutic strategies offers a compelling prospect to transform the treatment landscape of T2DM,potentially reducing the disease’s burden significantly with approaches that are less reliant on traditional pharmaceuticals and more focused on holistic,systemic health improvements.

关键词： TypeⅡdiabetes Gut microbiome Probiotics Prebiotics fecal microbiota transplantation

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Platelet-rich plasma application in diabetic ulcers:A review

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World Journal of Dermatology 2022年第1期10卷 1-9页

作者： Victoria Pereira Simão Carolina Souza Cury Gabriel Mota Zamariolli Tavares Gabriel Calixto Ortega Arthur Cichetto Ribeiro Gabriel Silva santos joséfábio santos duarte lana Medical School Centro Universitário LusíadaSantos 11045-101São PauloBrazil biomedical Science Brazilian Institute of Regenerative MedicineIndaiatuba 13334-170São PauloBrazil Department ofOrthopedics Brazilian Institute of Regenerative MedicineIndaiatuba 13334-170São PauloBrazil

There are 422 million diabetic people in the world.25%of these individuals are diagnosed with diabetic foot ulcer(DfU).20%of patients with DfU will suffer amputation of the lower *** amputation procedures,the mortality rate of patients is over 70%in 5 *** has no cure and,therefore,treatment aims to prevent and treat its *** platelet-rich plasma(PRP)has been shown to be a therapeutic tool for many types of disorders,including the treatment of *** manuscript aims to carry out a review to provide more knowledge about the efficacy and safety of autologous PRP for wound closure in patients with *** majority of studies included in this review state that PRP promotes improvement of DfU lesions by accelerating tissue healing ***,many studies have a small sample size and thus require larger sample range in order to improve robustness of data in the literature.

关键词： Diabetic foot ulcer Platelet-rich plasma Wound healing Tissue regeneration Inflammation

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Photobiomodulation therapy for osteoarthritis: Mechanisms of action

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World Journal of Translational Medicine 2022年第3期10卷 29-42页

作者： fábio Pericinoto Giolo Gabriel Silva santos Victor fontes Pacheco Stephany Cares Huber Kaue franco Malange Bruno Lima Rodrigues fernanda Bassora Tomas Mosaner Gabriel Azzini Lucas Leite Ribeiro Carlos Amilcar Parada joséfábio santos duarte lana Department of Physical Therapy Brazilian Institute of Regenerative MedicineIndaiatuba 13334-170Brazil biomedical Science Brazilian Institute of Regenerative MedicineIndaiatuba 13334-170Brazil Department of Orthopedics Brazilian Institute of Regenerative MedicineIndaiatuba 13334-170Brazil Neurobiology of Pain and Regenerative Medicine The University of CampinasCampinas 13083-862Brazil Department of Hematology The University of CampinasCampinas 13083-878Brazil

Photobiomodulation(PBM)is a non-invasive therapeutic modality with demonstrated effects in many fields related to regenerative *** the field of orthopedics,in particular,PBM at various wavelengths has demonstrated the capacity to trigger multiple biological effects associated with protective mechanisms in musculoskeletal *** articles cited in this review show that devices operating close to or within the near infrared range at low intensities can provoke responses which favor the shift in the predominant catabolic microenvironment typically seen in degenerative joint diseases,especially osteoarthritis(OA).These responses include proliferation,differentiation and expression of proteins associated with stable cell ***,PBM can also modulate oxidative stress,inflammation and pain by exerting regulatory effects on immune cells and blocking the transmission of pain through sensory neuron fibers,without adverse ***,these effects are essential in order to control the progression of OA,which is in part attributed to exacerbated inflammation and degradative enzymatic reactions which gradually contribute to the destruction of joint *** may offer medical experts ease of application,financial viability,efficacy and lack of serious adverse ***,it may prove to be a suitable ally in the management of mild to moderate degrees of *** review explores and discusses the principal biological mechanisms of PBM and how the produced effects may contribute to the amelioration of osteoarthritic *** was reviewed using PubMed and Google Scholar in order to find studies describing the mechanisms of *** investigation included a combination of nomenclature such as:“photobiomodulation”,“phototherapy”,“laser therapy”,“PBM”,“osteoarthritis”,low level light therapy”,“inflammation”and“cartilage”.We considered only articles written in English,with access to the full text.

关键词： Photobiomodulation Low-level laser therapy Osteoarthritis Inflammation Regenerative medicine

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biofat grafts as an orthobiologic tool in osteoarthritis:An update and classification proposal

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World Journal of Meta-Analysis 2021年第1期9卷 29-39页

作者： Rafael da Rocha Macedo Lucas furtado da fonseca joséfábio santos duarte lana Tomas Mosaner joseph Purita MAP de Andrade Luciano Miller Rodrigues Patricio Centurion Department of Orthopedics Rede D’Or unidade IFOR HospitalSão Bernardo do Campo 09715-021São PauloBrazil Department of Orthopedics Escola Paulista de Medicina da Universidade Federal de São PauloSão Paulo 04024-002Brazil Department of Orthopedics The Bone and Cartilage InstituteIndaiatuba 13334-170São PauloBrazil Department of Orthopedics Institute of Regenerative MedicineBoca RatonFL 33432United States Department of Orthopedics Federal University of Minas GeraisBelo Horizonte 30130-100Minas GeraisBrazil Orthopedic Department Faculdade de Medicina do ABCSanto André09060-870São PauloBrazil Aesthetic and Reconstructive Plastic Surgery Ricardo Palma UniversityLima 15023Peru

Among degenerative musculoskeletal disorders,osteoarthritis remains one of the main causes of pain and disability in the adult *** available alternatives to alleviate symptoms include conservative treatments such as physical therapy,anti-inflammatory drugs and an educational approach to lifestyle *** use of certain analgesics,such as opiates and corticosteroids offer short-term results but does not address the etiological source of pain and *** addition,prolonged use of such medications can cause additional ***,the demand for regeneration of joint cartilage has led to an alternative approach called"orthobiologics".This alternative is based on cellular and molecular components capable of inducing and promoting tissue *** derived from adipose tissue have been studied as an excellent source of orthobiologics in an attempt to promote joint cartilage ***,the lack of standardization regarding collection and processing protocols presents a challenge for the generalization of study results and determination of *** the best of our knowledge,orthobiologics derived from fat have not yet been ***,this manuscript proposes the HGS classification system which aims to describe certain parameters that are relevant to the quality of organic products regarding harvesting techniques(H),graft type(G),and number of centrifugations(S).The more parameters used would imply greater characterization and complexity of the evaluation of the biological product *** HGS classification may provide a valuable contribution to the understanding of clinical procedures and research results,aiming to ultimately usher in a standardization of optimal practice.

关键词： Orthobiologics Adipose tissue Mesenchymal stem cells Regenerative medicine Musculoskeletal disorders Orthopedics

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Orthobiologics in the treatment of hip disorders

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World Journal of Stem Cells 2021年第4期13卷 304-316页

作者： Andre Vinicius Saueressig Kruel Lucas Leite Ribeiro Paulo David Gusmao Stephany Cares Huber jose fabio santos duarte lana Department of Orthopedics Regenesis Clínica MédicaBento GonçalvesRS 95700-066Brazil Department of Orthopedics Instituto Médico SalusSão PauloSP 01308-050Brazil Department of Hematology University of CampinasCampinasSP 13334-170Brazil Department of Orthopedics the Bone and Cartilage InstituteIndaiatubaSP 13334-170Brazil

Orthobiologics are biological materials that are intended for the regeneration or healing of bone,cartilage and soft *** this review we discuss the use of orthobiologics for hip disorders providing an *** orthobiologics included in this article are hyaluronic acid,platelet rich plasma,bone marrow,adipose tissue and expanded mesenchymal stem *** explain the concepts and definitions of each orthobiological product,and the literature regarding its use in the hip *** paucity of guidelines for the production and characterization of the biological products leads to uneven results across the *** biologic therapy has indications and benefits;however,noteworthy are the characterization of the orthobiologics,the application method and outcome analysis for further improvement of each technique.

关键词： Orthobiologics Hip disorders Platelet-rich plasma Mesenchymal stem cells Bone marrow Adipose tissue

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Endodontic irrigants from a comprehensive perspective

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World Journal of Clinical Cases 2024年第21期12卷 4460-4468页

作者： Rayana duarte Khoury Lara Steffany de Carvalho Mauro felipe Rios do Nascimento fadi Alhussain AmjadAbu Hasna Department of Restorative Dentistry Endodontics DivisionInstitute of Science and TechnologySão Paulo State UniversitySão Josédos Campos 12245000SPBrazil Department of biosciences and Oral Diagnosis Institute of Science and TechnologySão Paulo State UniversitySão Josédos Campos 12245000SPBrazil School of Dentistry The National Institute of Higher Education and Postgraduate Studies Padre Gervásio-INAPÓSPouso Alegre 37550-121MGBrazil School of Dentistry Syrian Private UniversityAl Kiswah 877C+P2DamascusSyria School of Dentistry Universidad Espíritu SantoSamborondón 092301Ecuador

This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and *** reviews commonly used endodontic irrigant,namely sodium hypochlorite(NaOCl),herbal extracts,chlorhexidine(CHX),and chelating agents,highlighting their properties,applications,and potential ***,a key antimicrobial agent,demonstrates effectiveness against various microorganisms but poses challenges such as high *** extracts,gaining recognition in endodontics,present an alternative with potential advantages in preserving dentin ***,known for its broad-spectrum antimicrobial activity,is discussed in both liquid and gel formulations,emphasizing its role in reducing smear layer formation and preserving hybrid layer *** agents,specifically ethylenediaminetetraacetic acid and citric acid,play a vital role in removing the smear layer,enhancing dentin permeability,and facilitating the penetration of antimicrobial *** review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic *** serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.

关键词： Root canal irrigants Sodium hypochlorite Chlorhexidine Chelating agents Plant extracts

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A numerical assessment of two geometries for reducing elbow erosion

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Particuology 2020年第2期18卷 117-133页

作者： Carlos Antonio Ribeiro duarte francisco joséde Souza Diego Nei Venturi Martin Sommerfeld Department of Engineering Federal University of Goiás-Regional Catal(a)oAv.Dr.Lamartine Pinto de Avelar1120Catal(a)oGoiásBrazil School of Mechanical Engineering Federal University of Uberl(a)ndiaAv.Joāo Naves de(A)vila2121 Bloco 5PUberl(a)ndiaMinas GeraisBrazil Multiphase flow Systems(MPS) Otto-von-Guericke-University MagdeburgZeppelinstraβe 1D-06130 Halle(Saale)Germany

Elbows in pneumatic conveying systems are normally prone to the erosive effects of conveyed *** are a number of solutions available to reduce such damage.A widely used geometric alternative for replacing the 90°elbow and reducing erosive wear is the plugged *** option,although less commonly used,is the vortex-chamber *** both cases,the effective reduction in erosion brought about is unclear,as it strongly depends on the operating *** present study assesses relative erosion among the plugged tee,vortex-chamber elbow,and standard elbow for a dilute gas-solid multiphase flow.A numerical model is employed to predict the penetration ratio and validated using experimental data for the plugged *** are run for the standard and vortex-chamber elbows and plugged tee under the same conditions to compare the mechanics involved and the relative erosion *** analysis uses variables relating to particle-wall interactions(impact angle,impact velocity,impact frequency)to illustrate the nature of the erosive process in each pipe *** general,the geometric configurations of both the plugged tee and vortex-chamber elbow promote changes in particle dynamics that reduce the rate of *** the basis of the relative erosion of the standard elbow,the plugged tee proves to be an interesting option in cases of a low mass loading,while the vortex-chamber elbow demonstrates its erosion reduction potential for higher mass loading ***,the advantages and disadvantages of each fitting are highlighted.

关键词： Relative erosion Plugged tee Erosion reduction Pipe fitting Computational fluid dynamics

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Road map for pain management in pancreatic cancer: A review

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World Journal of Gastrointestinal Oncology 2016年第8期8卷 599-606页

作者： Marie josé Lahoud Hampig Raphael Kourie Joelle Antoun lana El Osta Marwan Ghosn Department of Anesthesiology and Critical Care Faculty of Medicine Saint Joseph University Department of Oncology Faculty of Medicine Saint Joseph University

Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief.

关键词： Pain management Interventional Medical Treatment Pancreatic cancer

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