히알루론산,
이런 도움을 줄 수 있어요.

Background Stem cells are specialised precursor cells that can replace aged or damaged cells and thereby maintain healthy tissue function. Stem cell therapy is increasingly used as a treatment for knee osteoarthritis, despite the lack of clarity around the mechanism by which stem cell therapy may slow down disease progression in osteoarthritis, and uncertainty regarding its benefits and harms. Objectives To assess the benefits and harms of stem cell injections for people with osteoarthritis of the knee. A secondary objective is to maintain the currency of the evidence, using a living systematic review approach. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase on 15 September 2023, unrestricted by date or language of publication. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) for relevant trial protocols and ongoing trials. Selection criteria We included randomised controlled trials (RCTs), or trials using quasi-randomised methods of participant allocation, comparing stem cell injection with placebo injection, no treatment or usual care, glucocorticoid injection, other injections, exercise, drug therapy, surgical interventions, and supplements and complementary therapies in people with knee osteoarthritis. Data collection and analysis Two review authors selected studies for inclusion, extracted trial characteristics and outcome data, assessed risk of bias and assessed the certainty of evidence using the GRADE approach. The primary comparison was stem cell injection compared with placebo injection. The primary time point for pain, function and quality of life was three to six months, and the end of the trial period for participant-reported success, joint structure changes and adverse event outcomes. Major outcomes were pain, function, quality of life, global assessment of success, radiographic joint progression, withdrawals due to adverse events and serious adverse events. Main results We found 25 randomised trials (1341 participants) comparing stem cell injections with placebo injection (eight trials), no treatment or usual care (analgesia, weight loss and exercise) (two trials), glucocorticoid injection (one trial), hyaluronic acid injection (seven trials), platelet-rich plasma injections (two trials), oral acetaminophen (paracetamol) (one trial), non-steroidal anti-inflammatory drugs plus physical therapy plus hyaluronic acid injection (one trial) and stem cell injection plus intra-articular co-intervention versus co-intervention alone (three trials) in people with osteoarthritis of the knee. Trials were predominantly small, with sample sizes ranging from 6 to 252 participants, with only two trials having more than 100 participants. The average age of participants across trials ranged from 51 to 66 years, and symptom duration varied from one to 10 years. Placebo-controlled trials were largely free from bias, while most trials without a placebo control were susceptible to performance and detection biases. Here, we limit reporting to the main comparison, stem cell injection versus placebo injection. Compared with placebo injection, stem cell injection may slightly improve pain and function up to six months after treatment. Mean pain (0 to 10 scale, 0 no pain) was 4.5 out of 10 points with placebo injection and 1.2 points better (2.5 points better to 0 points better) with stem cell injection (I 2 = 80%; 7 studies, 445 participants). Mean function (0 to 100 scale, 0 best function) was 46.3 points with placebo injection and 14.2 points better (25.3 points better to 3.1 points better) with stem cell injection (I 2 = 82%; 7 studies, 432 participants). We are uncertain whether stem cell injections improve quality of life or increase the number of people who report treatment success compared to placebo injection, because the certainty of the evidence was very low. Mean quality of life was 45.3 points with placebo injection and 22.8 points better (18.0 points worse to 63.7 points better) with stem cell injection (I 2 = 96%; 2 studies, 288 participants) at up to six months follow-up. At the end of follow-up, 89/168 participants (530 per 1000) in the placebo injection group reported treatment success compared with 126/180 participants (683 per 1000) in the stem cell injection group (risk ratio (RR) 1.29, 95% CI 1.10 to 1.53; I 2 = 0%; 4 trials, 348 participants). We downgraded the evidence to low certainty for pain and function due to indirectness (as the source, method of preparation and dose of stem cells varied across studies), and suspected publication bias (up to three larger RCTs have been conducted but withdrawn prior to reporting of results). For quality of life and treatment success, we further downgraded the evidence to very low certainty due to imprecision in addition to indirectness and suspected publication bias. We are uncertain of the potential harms associated with stem cell injection, as there were very low event rates for serious adverse events. At the end of follow-up, 5/219 participants (23 per 1000) in the placebo injection group experienced serious adverse events compared with 4/242 participants (16 per 1000) in the stem cell injection group (RR 0.72, 95% CI 0.20 to 2.64; I 2 = 0%; 7 trials, 461 participants) and there were no reported withdrawals due to adverse events. We downgraded the evidence to very low certainty due to indirectness, suspected publication bias and imprecision. Radiographic progression was not assessed in any of the included studies. Authors' conclusions Compared with placebo injections and based upon low-certainty evidence, stem cell injections for people with knee osteoarthritis may slightly improve pain and function. We are uncertain of the effects of stem cell injections on quality of life or the number who report treatment success. Although the putative benefits of stem cell therapies for osteoarthritis include potential regenerative effects on damaged tissues, particularly articular cartilage, we remain uncertain of the effect of stem cell injections on structural progression in the knee (measured by radiographic appearance). There is also uncertainty regarding the safety of stem cell injections. Serious adverse events were infrequently reported, although all invasive joint procedures (including injections) carry a small risk of septic arthritis. The risk of other important harms, including potential concerns related to the use of a therapy with the theoretical capacity to promote cell growth, or to the use of allogeneic cells, remains unknown.

Objective To stablish whether combined arthrocentesis with platelet-rich plasma, fibrin-rich plasma, hyaluronic acid, corticosteroids and non-steroidal anti-inflammatory drugs is more effective than exclusive arthrocentesis in patients with temporomandibular joint osteoarthritis. Study design A bibliographic search was conducted in Pubmed, Web of Science, Embase and Scopus in July 2024. RCTs were included. The PRISMA checklist was followed. The study is registered with PROSPERO, number CRD42024542631. Results Six RCTs were included with a total of 179 patients. For the variable of maximum oral opening, a better response was observed in the combined arthrocentesis group than in the arthrocentesis group at 6 months (P = .011) and at 12 months (P Conclusion Combined arthrocentesis techniques show significant improvements in maximum mouth opening at six and twelve months and in pain at twelve months pos-treatment. However, the lack of protocol development and the scarcity of similar studies highlight the heterogeneity of the results.

Background Ageing is a degenerative process that affects the entire body. Skin ageing is characterised by a decrease in the levels of collagen, elastin fibre, and hyaluronic acid (HA), resulting in a loss of skin elasticity and hydration. Prior studies suggest that oral collagen supplements can help increase collagen, elastin, and HA levels, ultimately improving skin health. Objective To assess the impact of collagen-based supplements on the signs of skin ageing and determine the effective dosage. Methods This systematic review and meta-analysis utilized PubMed, Clinical Key, ProQuest, and Cochrane Library databases to identify studies published from 2010 to 2021. It includes ten randomised controlled trials (RCTs) with a total of 646 participants. Results The findings indicate that collagen supplements were statistically effective in increasing skin hydration (SMD 1.25 (CI: 0.77-1.74)) and elasticity (SMD 0.61 (CI: 0.21-1.02)). The most commonly administered dose was 4 g/day, with a median dose of 3.5 g/ day. Limitations Most of the studies could not control for weather-related factors. The findings are more applicable to females. Moderate heterogeneity (I2 = 55.5-56.5%) may limit generalisability. The risk of bias was generally unclear, and publication bias could not be assessed due to the small number of studies. Conclusion Oral administration of collagen supplement in a dose ranging from 1-10 g/day was statistically effective in increasing the skin hydration and elasticity.

Background Recurrent aphthous stomatitis (RAS) is a common oral mucosal condition affecting over 2.5 billion people worldwide. Although 0.1% triamcinolone acetonide is a standard treatment, its comparative efficacy remains uncertain. Objective To evaluate and compare systematically the efficacy of 0.1% triamcinolone acetonide with those of alternative therapies for RAS management. Methods A systematic review and meta-analysis were conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. From December 2024 to April 2025, PubMed and the Cochrane Central Register of Controlled Trials, Semantic Scholar, and ScienceDirect were searched for randomized controlled trials (RCTs) evaluating 0.1% triamcinolone acetonide in minor RAS treatment. Eligible studies reported the outcomes of pain reduction, ulcer size, or healing time. Risk of bias was assessed by using the Cochrane Risk of Bias Tool, and meta-analysis pooled estimates were calculated by employing a random effects model. Results Twenty-five RCTs involving 1474 participants were included. Thyme honey, sumac gel, and laser therapies were significantly more effective than 0.1% triamcinolone acetonide in reducing pain and ulcer size. CBD oil, hyaluronic acid, curcumin, amlexanox, and nanoformulated triamcinolone exhibited comparable efficacies as 0.1% triamcinolone acetonide. The outcomes under chamomile, acemannan, and doxycycline benzocaine gel treatments were less favorable than those under 0.1% triamcinolone acetonide treatment. Laser therapy, sumac gel, and Punica granatum extract significantly reduced healing time compared with 0.1% triamcinolone acetonide. The meta-analysis demonstrated that 0.1% triamcinolone acetonide was significantly more effective than thyme honey, Rhus coriaria gel, and nanobased triamcinolone in reducing ulcer size and shortened healing time compared with Salvizan and P. granatum gels. However, no significant effect was observed in pain reduction when 0.1% triamcinolone acetonide was compared with either other treatments or the placebo, and no significant difference in healing time was found when 0.1% triamcinolone acetonide was compared with the placebo. Conclusion Natural agents, such as honey, sage, and sumac gel, show promise as effective, safe alternatives to 0.1% triamcinolone acetonide in the treatment of minor RAS, especially in patients intolerant to corticosteroids. While 0.1% triamcinolone acetonide significantly reduced ulcer size and shortened healing time compared with several alternative treatments, it demonstrated no significant advantage in pain reduction or healing time over the placebo. The results of this work should be interpreted with caution because of the limited number of placebo-controlled trials and the moderate-to-high risk of bias in the included studies. Registration We registered our review protocol in PROSPERO under the ID CRD42024573362.