Platelet-rich plasma injections are used as a treatment for chronic midportion Achilles tendinopathy, but evidence for this treatment is limited.
In adults with midportion Achilles tendinopathy, to ...assess the effects of a single platelet-rich plasma injection, compared with sham injection, on the outcome of the Victorian Institute of Sport Assessment-Achilles (VISA-A) score (a single composite measure of Achilles tendinopathy severity).
A participant-blinded, multicenter randomized clinical trial that included 240 people from 24 sites assigned to either a platelet-rich plasma injection or a sham injection between April 2016 and February 2020. Final follow-up was July 2020. Participants were older than 18 years with midportion Achilles tendon pain for more than 3 months as confirmed by ultrasound, magnetic resonance imaging, or both.
A single intratendinous platelet-rich plasma injection (n = 121) or a single sham injection (insertion of a subcutaneous dry needle not entering the tendon) (n = 119).
The primary outcome was the VISA-A score, measured 6 months after treatment allocation. The VISA-A score contains 8 questions that cover 3 domains of pain, function, and activity, analyzed as a composite score (range, 0 worst symptoms to 100 no symptoms; minimal clinically important difference in score, 12 points). The primary analysis was adjusted for laterality, age, sex, and baseline VISA-A score.
Among 240 patients assigned to a platelet-rich plasma or sham injection (mean age, 52 years; 138 58% women), 221 (92%) completed the trial. At 6-month follow-up, mean VISA-A score values in the plasma-rich plasma group vs the sham injection group were 54.4 vs 53.4 (adjusted mean difference, -2.7 95% CI, -8.8 to 3.3). The most common adverse events compared between patients in the platelet-rich plasma group vs the sham group were injection site discomfort (97 vs 73 patients), swelling (56 vs 52 patients) and bruising (48 vs 49 patients).
Among patients with chronic midportion Achilles tendinopathy, treatment with a single injection of intratendinous platelet-rich plasma, compared with insertion of a subcutaneous dry needle, did not reduce Achilles tendon dysfunction at 6 months. These findings do not support the use of this treatment for chronic midportion Achilles tendinopathy.
isrctn.org Identifier: ISRCTN13254422.
IntroductionBronchiectasis is a worldwide chronic lung disorder where exacerbations are common. It affects people of all ages, but especially Indigenous populations in high-income nations. Despite ...being a major contributor to chronic lung disease, there are no licensed therapies for bronchiectasis and there remain relatively few randomised controlled trials (RCTs) conducted in children and adults. Our RCT will address some of these unmet needs by evaluating whether the novel mucoactive agent, erdosteine, has a therapeutic role in children and adults with bronchiectasis.Our primary aim is to determine in children and adults aged 2–49 years with bronchiectasis whether regular erdosteine over a 12-month period reduces acute respiratory exacerbations compared with placebo. Our primary hypothesis is that people with bronchiectasis who regularly use erdosteine will have fewer exacerbations than those receiving placebo.Our secondary aims are to determine the effect of the trial medications on quality of life (QoL) and other clinical outcomes (exacerbation duration, time-to-next exacerbation, hospitalisations, lung function, adverse events). We will also assess the cost-effectiveness of the intervention.Methods and analysisWe are undertaking an international multicentre, double-blind, placebo-RCT to evaluate whether 12 months of erdosteine is beneficial for children and adults with bronchiectasis. We will recruit 194 children and adults with bronchiectasis to a parallel, superiority RCT at eight sites across Australia, Malaysia and Philippines. Our primary endpoint is the rate of exacerbations over 12 months. Our main secondary outcomes are QoL, exacerbation duration, time-to-next exacerbation, hospitalisations and lung function.Ethics and disseminationThe Human Research Ethics Committees (HREC) of Children’s Health Queensland (for all Australian sites), University of Malaya Medical Centre (Malaysia) and St. Luke’s Medical Centre (Philippines) approved the study. We will publish the results and share the outcomes with the academic and medical community, funding and relevant patient organisations.Trial registration numberACTRN12621000315819.
During routine operation of the Facility for Rare Isotope Beams (FRIB), radionuclides will accumulate in both the aqueous beam dump and along the beamline in the process of beam purification. These ...byproduct radionuclides, many of which are far from stability, can be collected and purified for use in other scientific applications in a process called isotope harvesting. In this work, the viability of 88Zr harvesting from solid components was investigated at the National Superconducting Cyclotron Laboratory. A secondary 88Zr beam was stopped in a series of collectors comprised of Al, Cu, W, and Au foils. This work details irradiation of the collector foils and the subsequent radiochemical processing to isolate the deposited 88Zr (and its daughter 88Y) from them. Total average recovery from the Al, Cu, and Au collector foils was (91.3 ± 8.9) % for 88Zr and (95.0 ± 5.8) % for 88Y, respectively, which is over three times higher recovery than in a previous aqueous-phase harvesting experiment. The utility of solid-phase isotope harvesting to access elements such as Zr that readily hydrolyze in near-neutral pH aqueous conditions has been demonstrated for application to harvesting from solid components at FRIB.
•Proof-of-concept solid-phase isotope harvesting demonstrated at the NSCL.•Solid-phase isotope harvesting for improved recoveries of Zr.•High recoveries of 88Zr and 88Y from Al, Cu, and Au foils irradiated with 88Zr beam.•Provides a framework for harvesting group IV elements from FRIB.
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