Monday, October 11, 2010

Embryonic Stem Cells used to Treat Spinal Cord Injury Patient



For the first time in history, embryonic stem cells have been used to treat a patient with an acute spinal cord injury.  According to several reports the protocol calls for using the treatment within two weeks of the initial injury.  Geron, the company sponsoring the trial has spent years and tens of millions of dollars just to get to this first patient.  The hope is for this first phase that safety can be demonstrated.

We have officially entered the era of biologic medicine.  For quite some time there has been promise, now there is action.  It is hard to compute the amount of effort that has likely gone into getting to just this point.  It is the researchers and especially this first brave but tragic patient that deserve the credit for this advancement.

In the future, the use of either adult stem cells or induced pluripotent stem cells may become a better option.  For now, regardless of your stance on the ethics of embryonic stem cells this day must be marked as a milestone.

AM
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Sunday, October 03, 2010

Sports Illustrated Platelet Rich Plasma Article

Sports Illustrated recently published an article about platelet rich plasma.



"While Galea's use of PRP on Tiger Woods and other athletes has stirred debate, the technique is not particularly new. Allan Mishra, adjunct clinical assistant professor of orthopedic surgery at the Stanford University Medical Center and a pioneer of PRP therapy, has been using it for nearly a decade. In a breakthrough study last year based on work by Mishra, PRP therapy performed significantly better than cortisone -- and with fewer side effects since it makes use of the patient's own blood -- in the treatment of chronic lateral elbow tendinosis, aka tennis elbow. "I can say pretty definitively that PRP is a reasonable choice for tendon [injuries]," Mishra says. "Now it needs to be studied in other applications."


The breakthrough study was actually performed by Dr. Taco Gosens from the Netherlands.  He and his colleagues have published the best clinical data to date on the use of platelet rich plasma for tendinopathy.  
To read more of the SI article, click here



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AAOS Discussion about Platelet Rich Plasma

The American Academy of Orthopaedic Surgery recently published a expert panel discussion about platelet rich plasma (PRP).  Its goal was to help clarify the many issues surrounding this novel therapy.  Dr. Allan Mishra, Dr. Freddie Fu, Dr. Steven Arnoczky and Dr. Jo Hannafin participated.  Below is an excerpt from the article:




Dr. Hannafin: I did a Google search and found more than 400,000 citations for PRP treatment, including YouTube videos on how the procedure is performed. Clearly, patients, physicians, and scientists are interested in the use of PRP. What conditions is PRP being used for?
Dr. Mishra: I use it almost exclusively in treating tendinopathy, particularly chronic tendinopathy that has failed to respond to other treatment modalities. That would include conditions such as chronic, recalcitrant lateral epicondylitis, patellar tendinopathy, and Achilles tendinopathy. I think the data—and the work that I have been doing for almost a decade now—provide the greatest support for its use in that area.


To read more of the article, click here.

AM

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