Elvira De Luna-Bertos

Effect and Clinical Implications of the Low-Energy Diode Laser on Bone Cell Proliferation

Laser is a simple, noninvasive technique that has proven useful for treating damaged tissue. However, its effects on bone regeneration and the mechanisms involved are poorly understood. The objective of this study was to evaluate the effects on MG-63 cell proliferation of application of a pulsed diode laser (Ezlase) of 940 nm at low energy levels. After 24 hr of culture, osteoblasts underwent pulsed laser radiation at 0.5, 1, 1.5, and 2 W and fluences of 1–5 J. A control group was not irradiated. After the treatment, cells were incubated for 24 hr, and cell proliferation was analyzed using a spectrophotometric measure of cell respiration (MTT assay). Results were expressed as percentage proliferation versus controls. At 24-hr culture, cell proliferation was increased in laser-treated cells at intensities of 0.5, 1, and 1.5 W/cm2 versus controls; the energy density was positively correlated with cell growth, which reached a peak at 3 J and decreased at higher fluences. The use of pulsed low-level laser with low-energy density range thus appears to exert a biostimulatory effect on bone tissue. Although the data on cell proliferation are robust, in-depth investigation is required into the effect of these irradiation doses on other cell parameters. The present findings demonstrate that laser therapy could be highly useful in tissue regeneration in different clinical settings, including nursing, physical therapy, dentistry, and traumatology.

Effect of acetaminophen, ibuprofen and methylprednisolone on different parameters of human osteoblast-like cells

UNLABELLED Anti-inflammatories are divided between steroidal and non-steroidal drugs according to their chemical nature. They are frequently used in combination to achieve analgesia and reduce inflammation after surgery, especially when bone tissue is affected. However, their effects on bone level are not well known, and results of the scant studies in humans have been contradictory. OBJECTIVE To study the short-term effect of ibuprofen, acetaminophen and methylprednisolone at therapeutic doses on different cell parameters of human osteoblasts in culture. DESIGN Osteoblasts were derived from samples of human bone sections obtained during third molar surgery. Cell lines were incubated in culture medium with different concentrations of anti-inflammatories (5 or 25 μM of ibuprofen or acetaminophen, 10(-6) or 10(-8)M of methylprednisolone) for 24 or 48h. Flow cytometry was used to study proliferation, antigenic profile, phagocytic activity and cell cycle. RESULTS All three anti-inflammatories inhibited osteoblastic proliferation, but no significant cell cycle changes were observed. The drugs had no effect on antigenic profile or phagocytic capacity. CONCLUSION These results suggest that ibuprofen, acetaminophen and methylprednisolone at therapeutic doses reduce osteoblast growth without affecting other cell parameters, such as antigenic profile or cell cycle. Use of these drugs should be reconsidered in clinical situations that require a rapid healing of bone defects.

Effectiveness of Platelet-Rich Plasma and Hyaluronic Acid for the Treatment and Care of Pressure Ulcers

Platelet-rich growth factor (PRGF) is a natural source of growth factors (GF), while hyaluronic acid (HA) is a biopolymer present in the extracellular matrix of skin, cartilage, bone, and brain, among other tissues. Both are involved in the pathophysiological mechanisms underlying wound healing. The objective of this study was to evaluate the clinical efficacy (as measured by ulcer area) and safety (as measured by signs of infection) of PRGF and PRGF plus HA in the treatment of pressure ulcers (PUs). Patients (N = 100) with 124 Stage II–III PUs were randomized to a control group (n = 25 PUs) for standard care or to case groups for treatment with one (n = 34 PUs) or two (n = 25 PUs) doses of PRGF from their own peripheral blood, or two doses of PRGF plus HA (n = 40 PUs). All ulcers were followed up every 3 days for a 36-day period. At 36 days, a significant reduction in ulcer area (p ≤ .001) was observed in all treatment groups, with a mean reduction of more than 48.0% versus baseline. The greatest mean reduction (80.4% vs. baseline) was obtained with the PRGF plus HA regimen. Complete wound healing was observed in 32.0% of PUs treated with two doses of PRGF (p ≤ .002) and in 37.5% of those treated with two doses of PRGF plus HA (p ≤ .004). There were no signs of infection in any PUs during the 36-day follow-up period. The degree of wound healing was inversely correlated with the consumption of drugs such as statins and with the peripheral blood platelet levels of patients at baseline.

Multifunctional capacity and therapeutic potential of lactoferrin

Lactoferrin (LF) is a glycoprotein with high functional versatility that is found in most body fluids. The objective of this study was to gather and update information on the properties attributed to LF. According to this review, LF is a good immunomodulatory agent that acts on both innate and adaptive immune responses. It possesses antimicrobial activity against parasites, fungi, and viruses and also has regenerative properties at tissue level and anti-carcinogenic activity. All of these properties endow LF with major therapeutic potential of which little advantage has been taken to date.

The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section

Introduction: Epidural analgesia (EA) is the most widespread pharmacologic method of labor pain relief. There remains disagreement, however, regarding its adverse effects. The objective of this study was to determine the effect of EA administration on the risk of cesarean delivery and its causes (e.g., stalled labor, risk of loss of fetal well-being, among others) and the degree to which this effect may be modulated by mother-, newborn-, and labor-related variables. Method: A retrospective cohort observational study was conducted including all deliveries in a Spanish public hospital between March 2010 and March 2013 (N = 2,450; EA = 562, non-EA = 1,888). Results: Risk of a cesarean section was significantly increased by EA administration (odds ratio [OR] = 2.673; p < .0001). The percentage of cesarean deliveries due to the risk of loss of fetal well-being was significantly higher in the EA (47.8%) versus non-EA group (27.5%; OR = 1.739; p = 0.0012,). The EA-associated risk of cesarean section was not significantly modified as a function of maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration alone. However, these variables in combination may increase the risk. We present multivariate models for each group that account for these variables, allowing for estimation of the risk of a cesarean delivery if EA is administered. Conclusion: EA is associated with an increased risk of cesarean delivery. Other variables in combination (maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration) may increase this risk.

Effect of olive oil phenolic compounds on osteoblast differentiation

Osteoporosis is a skeletal disorder characterized by compromised bone strength that predisposes individuals to an increased risk of fracture. Previous in vivo and in vitro studies have reported that phenolic compounds present in extra virgin olive oil have a beneficial effect on osteoblasts in terms of increase cell proliferation. The aim of this study was to determine whether phenolic compounds present in olive oil could modify the expression of cell differentiation markers on osteoblasts.

Risk Assessments of Epidural Analgesia During Labor and Delivery

Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies. However, women with EA were not and increased risk for perineal laceration or the condition of the membranes at the delivery or with the type of placental expulsion. Thus, the administration of EA should be assessed in each case by the health care professional.