Natural Healing Research Articles

Fused Deposition Modeling 3D-Printed Scaffolds for Bone Tissue Engineering Applications: A Review.

The emergence of bone tissue engineering as a trend in regenerative medicine is forcing scientists to create highly functional materials and scaffold construction techniques. Bone tissue engineering uses 3D bio-printed scaffolds that allow and stimulate the attachment and proliferation of osteoinductive cells on their surfaces. Bone grafting is necessary to expedite the patient's condition because the natural healing process of bones is slow. Fused deposition modeling (FDM) is therefore suggested as a technique for the production process due to its simplicity, ability to create intricate components and movable forms, and low running costs. 3D-printed scaffolds can repair bone defects in vivo and in vitro. For 3D printing, variousmaterials including metals, polymers, and ceramics are often employed but polymeric biofilaments are promising candidates for replacing non-biodegradable materials due to their adaptabilityand environment friendliness. This review paper majorly focuses on the fused deposition modeling approach for the fabrication of 3D scaffolds. In addition, it also provides information on biofilaments used in FDM 3D printing, applications, and commercial aspects of scaffolds in bone tissue engineering.

Inhibitory Effect of Alternanthera Sessilis, Cucurbita Maxima and Aerva Lanata on Whewellite Urinary Crystals

Phosphate stones, such as struvite (magnesium ammonium phosphate hexahydrate), brushite (calcium hydrogen phosphate dihydrate), and oxalates like whewellite (calcium oxalate monohydrate) are different kinds of urinary stones. Such kidney stones can be treated with herbs for natural healing and side effects-free results. These urinary crystals are traditionally created in the lab using the gel growth process and a silica gel medium at a specified pH. The inhibitory effects can be analysed by using the extracts of herbal plants. In the present study, ethanol extracts of leaves of Alternanthera sessilis, seeds of Cucurbita maxima and flowers of Aerva lanata are investigated for their inhibitory activity against the whewellite urinary crystals. They are characterized using Fourier transform infrared spectrum and their crystalline nature is examined through powder X-ray diffraction. Asymmetric and symmetric stretching unit of C=O in oxalate appears at 1620 cm-1 and 1400, 1310 cm-1 respectively. The monoclinic crystal system with a space group of P21/n is confirmed from the powder X-ray diffraction studies. The results indicated that among the three ethanol extracts, leaves of Alternanthera sessilis, seeds of Cucurbita maxima and flowers of Aerva lanata- the flowers of Aerva lanata exhibited inhibition towards whewellite crystals. KEYWORDS Extract, flowers, herbs, oxalates, pH, seeds

Electrospun Biomimetic Periosteum Capable of Controlled Release of Multiple Agents for Programmed Promoting Bone Regeneration.

The effective repair of large bone defects remains a major challenge due to its limited self-healing capacity. Inspired by the structure and function of the natural periosteum, an electrospun biomimetic periosteum is constructed to programmatically promote bone regeneration using natural bone healing mechanisms. The biomimetic periosteum is composed of a bilayer with an asymmetric structure in which an aligned electrospun poly(ε-caprolactone)/gelatin/deferoxamine (PCL/GEL/DFO) layer mimics the outer fibrous layer of the periosteum, while a random coaxial electrospun PCL/GEL/aspirin (ASP) shell and PCL/silicon nanoparticles (SiNPs) core layer mimics the inner cambial layer. The bilayer controls the release of ASP, DFO, and SiNPs to precisely regulate the inflammatory, angiogenic, and osteogenic phases of bone repair. The random coaxial inner layer can effectively antioxidize, promoting cell recruitment, proliferation, differentiation, and mineralization, while the aligned outer layer can promote angiogenesis and prevent fibroblast infiltration. In particular, different stages of bone repair are modulated in a rat skull defect model to achieve faster and better bone regeneration. The proposed biomimetic periosteum is expected to be a promising candidate for bone defect healing.

Development of Biocompatible Digital Light Processing Resins for Additive Manufacturing Using Visible Light-Induced RAFT Polymerization.

Patients with bone diseases often experience increased bone fragility. When bone injuries exceed the body's natural healing capacity, they become significant obstacles. The global rise in the aging population and the escalating obesity pandemic are anticipated to lead to a notable increase in acute bone injuries in the coming years. Our research developed a novel DLP resin for 3D printing, utilizing poly(ethylene glycol diacrylate) (PEGDA) and various monomers through the PET-RAFT polymerization method. To enhance the performance of bone scaffolds, triply periodic minimal surfaces (TPMS) were incorporated into the printed structure, promoting porosity and pore interconnectivity without reducing the mechanical resistance of the printed piece. The gyroid TPMS structure was the one that showed the highest mechanical resistance (0.94 ± 0.117 and 1.66 ± 0.240 MPa) for both variants of resin composition. Additionally, bioactive particles were introduced to enhance the material's biocompatibility, showcasing the potential for incorporating active compounds for specific applications. The inclusion of bioceramic particles produces an increase of 13% in bioactivity signal for osteogenic differentiation (alkaline phosphatase essay) compared to that of control resins. Our findings highlight the substantial improvement in printing precision and resolution achieved by including the photoabsorber, Rose Bengal, in the synthesized resin. This enhancement allows for creating intricately detailed and accurately defined 3D-printed parts. Furthermore, the TPMS gyroid structure significantly enhances the material's mechanical resistance, while including bioactive compounds significantly boosts the polymeric resin's biocompatibility and bioactivity (osteogenic differentiation).

Prospects for integrating the Far East recreational potential into the medical rehabilitation system

In this article, we generalize the results a research study into natural healing resources in the Far East. The regions of the Russian Far East possess a significant and unique natural potential for comprehensive medical rehabilitation. The main therapeutic resources of the area, including its climate, mineral waters, and therapeutic muds, are characterized. Issues associated with the task of integrated use of natural and physical resources in effective spa treatment and comprehensive rehabilitation are discussed. The major action mechanisms of natural therapeutic factors widely used in spa treatment are outlined, and the possibilities of their integration with the system of medical rehabilitation are substantiated.

Effects of platelet‐rich fibrin on post‐extraction wound healing and wound pain: A meta‐analysis

AbstractWe conducted a meta‐analysis to assess the effect of platelet‐rich fibrin (PRF) on post‐extraction wound healing and pain, with a view to providing a reliable basis for the selection of treatment options in clinical practice. A computerised search of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for studies on the effect of PRF on post‐extraction wound healing and pain compared with natural healing (control group) was performed from the time of creation of the respective databases to July 2023. Literature screening, data extraction and quality assessment were done independently by two authors. Meta‐analysis was performed using RevMan 5.4 software. Fourteen studies with a total of 508 patients were finally included. Meta‐analysis showed that the use of PRF relieved patients' wound pain (standardised mean differences [SMDs]: −1.78, 95% confidence intervals [CIs]: −2.61 to −0.94, p < 0.001), promoted soft tissue healing of extraction wounds (SMD: 1.09, 95% CIs: 0.26–1.91, p = 0.010) and also reduced the incidence of alveolar osteitis (AO) in patients after tooth extraction (2.42% vs. 10.14%, odds ratio: 0.27, 95% CIs: 0.11–0.65, p = 0.004). Current clinical evidence suggests that the use of PRFs can reduce patients' postoperative wound pain, promote soft tissue healing of extraction wounds and reduce the incidence of postoperative AO compared with natural healing. However, due to limitations in the number and quality of studies, large‐scale randomised controlled trials are still needed to validate the results of this study in the future.

Interpositional bone graft with cortical and cancellous calvarial bone for addressing the bone gap after reduction malarplasty: a case report

Asians typically exhibit prominent zygomas; therefore, several attempts have been made to reduce these structures to achieve a softer appearance. The intraoral approach is preferred because of its shorter surgical duration and lower invasiveness; however, it is associated with serious complications, such as nonunion. In revisional surgery, the intraoral approach poses limitations in accessing the upper part of the zygoma and the lateral orbital rim area due to its restricted operative field. Therefore, we developed an intraoral interpositional bone graft technique that enabled almost complete reconstruction. A 40-year-old woman presented with persistent depression in the left infraorbital and cheek regions after two revision operations after reduction malarplasty. Based on computed tomography (CT) scan findings, reconstruction using bone grafts was planned. Calvarial bone was harvested and divided into cortical and cancellous parts. The cortical bone was sculpted into an L-shape and inserted into the gap between the maxilla and the lower zygoma body. The hard-to-reach lateral orbital rim area was filled with cancellous bone without fixation. Follow-up CT scans showed that the cortical bone grafts were well-maintained and stabilized with titanium plates, while the cancellous bone had undergone significant resorption and was replaced by new bone, indicative of successful natural healing.

A novel and efficient murine model for investigating tendon-to-bone healing

BackgroundTendon-to-bone healing is a critical challenge in sports medicine, with its cellular and molecular mechanisms yet to be explored. An efficient murine model could significantly advance our understanding of this process. However, most existing murine animal models face limitations, including a propensity for bleeding, restricted operational space, and a steep learning curve. Thus, the need for a novel and efficient murine animal model to investigate the cellular and molecular mechanisms of tendon-to-bone healing is becoming increasingly evident.MethodsIn our study, forty-four 9-week-old male C57/BL6 mice underwent transection and reattachment of the Achilles tendon insertion to investigate tendon-to-bone healing. At 2 and 4 weeks postoperatively, mice were killed for histological, Micro-CT, biomechanical, and real-time polymerase chain reaction tests.ResultsHistological staining revealed that the original tissue structure was disrupted and replaced by a fibrovascular scar. Although glycosaminoglycan deposition was present in the cartilage area, the native structure had been destroyed. Biomechanical tests showed that the failure force constituted approximately 44.2% and 77.5% of that in intact tissues, and the ultimate tensile strength increased from 2 to 4 weeks postoperatively. Micro-CT imaging demonstrated a gradual healing process in the bone tunnel from 2 to 4 weeks postoperatively. The expression levels of ACAN, SOX9, Collagen I, and MMPs were detected, with all genes being overexpressed compared to the control group and maintaining high levels at 2 and 4 weeks postoperatively.ConclusionsOur results demonstrate that the healing process in our model is aligned with the natural healing process, suggesting the potential for creating a new, efficient, and reproducible mouse animal model to investigate the cellular and molecular mechanisms of tendon-to-bone healing.Graphical abstract

3D Niche-Inspired Scaffolds as a Stem Cell Delivery System for the Regeneration of the Osteochondral Interface.

The regeneration of the osteochondral unit represents a challenge due to the distinct cartilage and bone phases. Current strategies focus on the development of multiphasic scaffolds that recapitulate features of this complex unit and promote the differentiation of implanted bone-marrow derived stem cells (BMSCs). In doing so, challenges remain from the loss of stemness during in vitro expansion of the cells and the low control over stem cell activity at the interface with scaffolds in vitro and in vivo. Here, this work scaffolds inspired by the bone marrow niche that can recapitulate the natural healing process after injury. The construct comprises an internal depot of quiescent BMSCs, mimicking the bone marrow cavity, and an electrospun (ESP) capsule that "activates" the cells to migrate into an outer "differentiation-inducing" 3D printed unit functionalized with TGF-β and BMP-2 peptides. In vitro, niche-inspired scaffolds retained a depot of nonproliferative cells capable of migrating and proliferating through the ESP capsule. Invasion of the 3D printed cavity results in location-specific cell differentiation, mineralization, secretion of alkaline phosphatase (ALP) and glycosaminoglycans (GAGs), and genetic upregulation of collagen II and collagen I. In vivo, niche-inspired scaffolds are biocompatible, promoted tissue formation in rat subcutaneous models, and regeneration of the osteochondral unit in rabbit models.

ANTIOXIDANT ACTIVITY OF Homotrigona fimbriata PROPOLIS EXTRACT

Antioxidant compounds have a role in protecting the body from free radicals, Propolis from Homotrigona fimbriata species is widely used as an alternative to natural healing in East Kalimantan. The secondary metabolite compounds in propolis contain many flavonoids and phenolic compounds. These compounds can be utilized to fight free radicals. The purpose of this study was to determine the antioxidant content of stingless bee (Homotrigona fimbriata) propolis extract. This was a quantitative study of the antioxidant potential of propolis extract. The benchmark antioxidant activity was measured based on its ability to counteract free radicals using the DPPH method. The results of this study showed the presence of secondary metabolites of alkaloids, flavonoids, tannins, and saponins as well as antioxidant activity of Homotrigona fimbriata propolis extract with a value of 95,8 ppm as strong category. This can be caused by differences in geographical location, and various resins found in the trees around the beehive will affect antioxidant activity. Keywords: Homotrigona fimbriata, antioxidant, stingless bee

Localized Electrochemical Repair (LER) of Conductive Materials

Circular economy models emphasize material repair, akin to nature's healing processes. However, while polymer healing has garnered attention, repairing metals and metal matrix composites (MMCs) remains less extensively studied. Herein, “localized electrochemical repair (LER)”, a process adept at efficiently mending conductive materials, is introduced. LER involves a nozzle with electrolyte near damage, creating a small electrochemical cell that guides controlled metal ion deposition. Notably, LER's energy efficiency, as low as 40 J mm−1, significantly outperforms other methods. This energy efficiency is one‐fifth of that required for conventional bath‐based electrohealing methods. Through the successful repair of a copper/alumina MMC that achieves ≈100% strength recovery, the effectiveness of LER is demonstrated and interface properties are assessed. LER aligns with circular economy ideals, offering precise, localized healing that is eco‐friendly and economically sound. It restores conductive materials while minimizing energy use and waste.

Morphofunctional Characteristics of Dorsal Root Ganglion Neurons in the Dynamics of Healing of a Purulent Wound

Abstract. between the morphological and functional state of spinal ganglia neurons and the dynamics of healing of a purulent wound in an experimental animal during its natural course and complex therapy with hydropulse sanitation (HIS) and the addition of platelet-rich blood plasma (PRP). Material and methods. In an experiment on 100 white outbred rats, a purulent wound on the lateral surface of the thigh was modeled by introducing a daily culture of Staphyllococcus aureus. Two groups were formed: natural healing and healing after therapy with hydropulse sanitation of the wound with an isotonic NaCl solution followed by the addition of platelet-enriched autoplasma. The material for the study was taken on the 1st, 3rd, 5th, 7th, 14th, and 21st days. The area of the wound and the dynamics of its healing were assessed using the planimetric method. For the study, lumbar spinal ganglia (SG) of segments LIII–LV. were taken. At the light-optical level, after staining with cresyl violet according to Nissl and azure B according to the S. Shea method, the area of nerve cells was measured, photometry of RNA content was carried out, and the number of satellite gliocytes was counted. The obtained data were processed using statistical analysis methods. Results. The healing process of a purulent skin wound ended with the formation of a scar on days 7–14 for both experimental groups. The use of GIS and PRP demonstrated better dynamics of defect closure - a reduction in wound area by 59.35±3.4% (p=0.018) in the period from 3 to 5 days, compared with 40.05±2.9% (p=0.009) with natural healing. The response of SG neurons during healing was characterized by pronounced polymorphism. The maximum number of cells with reactive changes during natural healing was observed on the 5th day of the experiment (17.2±3.2% for A-neurons and 36.7±4.3% for B-neurons). Complex therapy led to a decrease in the proportion of both reactively altered and destructive neurons. The cell area, RNA content, and the number of satellite glia increased on average by the 7th day of the experiment. Separate close correlations were identified between the dynamics of changes in the wound area and the studied quantitative characteristics. Conclusion. A purulent wound causes a complex of nonspecific reactions in the neurons of the SG. In the dynamics of wound healing, neurons with reactive changes more often demonstrated biphasic dynamics, more pronounced for B-type cells with a primary reaction on days 1–3 and a further transition to regenerative hypertrophy or destruction. Regenerative changes in SG neurons had a close correlation with the processes of regeneration of the wound defect.

Innovative approaches in regenerative endodontics

Background: Biomimicry or biomimetics refers to developing materials and techniques inspired by natural systems. In dentistry, this approach aims to replicate natural tooth structures and functions, addressing limitations of conventional materials and techniques. Regenerative endodontics, including cell homing and revascularization, represents significant advancements in this field, focusing on pulp-dentin regeneration and tooth vitality restoration. Aim: This review explores innovative biomimetic approaches in regenerative endodontics, including the latest techniques and their clinical implications. It aims to assess the effectiveness and future prospects of these methods in enhancing tooth repair and regeneration. Methods: The review synthesizes current literature on regenerative endodontic procedures, including cell homing, revascularization, scaffold implantation, and gene therapy. It examines experimental studies, clinical trials, and advancements in biomimetic materials and techniques, highlighting their applications and outcomes. Results: The review finds that regenerative endodontics has evolved from traditional apexification to advanced techniques such as cell homing and revascularization. Cell homing, which leverages the body’s natural healing processes without cell transplantation, shows promise in generating pulp-dentin tissue. Revascularization, involving the induction of a blood clot and stem cell recruitment, has demonstrated potential in restoring vitality to necrotic teeth.

A critical overview of challenging roles of medicinal plants in improvement of wound healing technology.

Chronic diseases often hinder the natural healing process, making wound infections a prevalent clinical concern. In severe cases, complications can arise, potentially leading to fatal outcomes. While allopathic treatments offer numerous options for wound repair and management, the enduring popularity of herbal medications may be attributed to their perceived minimal side effects. Hence, this review aims to investigate the potential of herbal remedies in efficiently treating wounds, presenting a promising alternative for consideration. A literature search was done including research, reviews, systematic literature review, meta-analysis, and clinical trials considered. Search engines such as Pubmed, Google Scholar, and Scopus were used while retrieving data. Keywords like Wound healing 'Wound healing and herbal combinations', 'Herbal wound dressing', Nanotechnology and Wound dressing were used. This review provides valuable insights into the role of natural products and technology-based formulations in the treatment of wound infections. It evaluates the use of herbal remedies as an effective approach. Various active principles from herbs, categorized as flavonoids, glycosides, saponins, and phenolic compounds, have shown effectiveness in promoting wound closure. A multitude of herbal remedies have demonstrated significant efficacy in wound management, offering an additional avenue for care. The review encompasses a total of 72 studies, involving 127 distinct herbs (excluding any common herbs shared between studies), primarily belonging to the families Asteraceae, Fabaceae, and Apiaceae. In research, rat models were predominantly utilized to assess wound healing activities. Furthermore, advancements in herbal-based formulations using nanotechnology-based wound dressing materials, such as nanofibers, nanoemulsions, nanofiber mats, polymeric fibers, and hydrogel-based microneedles, are underway. These innovations aim to enhance targeted drug delivery and expedite recovery. Several clinical-based experimental studies have already been documented, evaluating the efficacy of various natural products for wound care and management. This signifies a promising direction in the field of wound treatment. In recent years, scientists have increasingly utilized evidence-based medicine and advanced scientific techniques to validate the efficacy of herbal medicines and delve into the underlying mechanisms of their actions. However, there remains a critical need for further research to thoroughly understand how isolated chemicals extracted from herbs contribute to the healing process of intricate wounds, which may have life-threatening consequences. This ongoing research endeavor holds great promise in not only advancing our understanding but also in the development of innovative formulations that expedite the recovery process.

The Assessment of Volumetric Changes for Alveolar Ridge Preservation or Reconstruction by 3D Analysis at Posterior Extraction Sites with Severe Bone Defects Using DBBM-C Collagen Membrane and PRF: A Prospective and Randomized Clinical Trial.

Volumetric resorption of the alveolar ridge often occurs in both horizontal and vertical directions following tooth extraction. There is a specific lack of evidence for alveolar ridge reconstruction at molar and premolar sites with severe bone resorption. This randomized controlled trial used 3D and linear analyses to evaluate volumetric changes of the alveolar bone following alveolar ridge reconstruction (ARR) at molar and premolar sites with severe bone resorption as compared to unassisted socket healing before implant placement. A total of 31 patients (15 men, 16 women) with > 50% hard tissue loss in one or more socket walls were recruited and randomized into either a test group (postextraction ARR using deproteinized bovine bone mineral with 10% collagen [DBBM-C] and platelet-rich fibrin [PRF] with a resorbable collagen membrane) or a control group (natural healing after extraction). The clinical, linear, and volumetric implant-related and patient-reported outcomes were analyzed after 4 months of healing. Linear bone assessments revealed significantly greater ridge width gains in the test group (25% in the mesial, midfacial, and distal aspects) and less reduction of vertical bone ridge than in the control group (P < .05). Further, volumetric bone remodeling was significantly higher in the test group (35.1% ± 34.9% for ARR, 14.2% ± 12.8% for control; P < .05). Patient-reported discomfort and keratinized mucosal changes were comparable between groups. ARR with a combination of DBBM-C, PRF, and a resorbable membrane at posterior sites with a severe socket wall deficiency (> 50% bone loss) is a safe and more capable therapeutic method when compared to natural healing and unassisted sockets. Collectively, the present analyses demonstrate that ARR represents an efficient method to maintain and augment crestal bone at posterior extraction sites with severe bone defects when assessed after 4 months of healing.

Nature's Healing Touch: Exploring the Therapeutic Benefits of Ecotherapy and Ecopsychology in Cancer Supportive Care

Cancer care demands holistic strategies to address the intricate challenges faced by individuals during their journey. This narrative review explores the emerging field of ecotherapy and ecopsychology, encompassing nature-based interventions to enhance psychosocial well-being in the context of cancer. Ecotherapy, defined as the connection between nature and human well-being, offers a diverse range of modalities, including nature-based interventions, animal-assisted therapies, and virtual reality. Drawing from Vedic traditions, it highlights the human-cosmos analogy, emphasizing the interconnectedness between individuals and the nature. Theoretical frameworks such as the Biophilia Hypothesis, Attention Restoration Theory, Systems Theory, Place Attachment Theory and Stress Recovery Theory underpin ecotherapeutic practices. This review outlines the multifaceted benefits of ecotherapy, spanning stress reduction, emotional well-being, medical recovery, resilience building, social connectedness, and empowerment. Future directions underscore the need for individualized approaches, healthcare professional training, and collaborative efforts to unlock the full potential of ecotherapy in promoting psychosocial well-being throughout the cancer care continuum.

A Pilot Study on Sodhana of Puga (Areca catechu Linn.)

The “Ayurveda” science of life was one of the most valuable gifts our predecessors gave us. It is the natural healing system of India and has been passed down through countless generations without losing any of its unique lusters. Due to its efficiency, it is helping to improve human health in many incurable chronic and degenerative diseases. In Ayurveda treatises and Nighantus there is mention of many drugs, among them Puga (Areca catechu Linn) is one; it is mentioned in Vedas by the name Kramuka. In the karma paribhasha chapter, Sharangadhara cited Kramuka as an example of the vikasi guna, due to this it was considered to be Visha samana, after reviewing the various Nighantus, it was found that the vikasi guna, ojonashaka property was only visible in apakva- adrapuga. According to Nighantu Bhavaprakash, Puga should be boiled in "Choughar" to do Sodhana. The pharmacognostic characteristics, physicochemical, and preliminary phytochemical analyses of Asuddha and Suddha Puga were performed in the current study. The rasa of suddha Puga was found to be mild Madhura and Kasaya rasa, and it has a higher alcoholic extraction value than Asuddha Puga. The phytochemical evaluation shows a significant difference between Asuddha and suddha Puga

Chitosan a natural anti-inflammatory and wound healing agent: A brief update

Inflammation is a complex physiological response that serves as a critical component in the pathogenesis of various diseases. Over the years, chitosan, a natural polysaccharide sourced from chitin, has gained significant attention as a prospective anti-inflammatory agent. This brief review aims to summarize the existing knowledge about chitosan's anti-inflammatory effects and mechanisms. It discusses in vitro and in vivo studies on chitosan's impact on inflammatory markers, immune responses, and cellular signaling pathways. Additionally, it presents an overview of the different formulations and delivery systems of chitosan utilized in preclinical and clinical studies. The findings suggest that chitosan exhibits promising anti-inflammatory effects by modulating pro-inflammatory mediators, inhibiting inflammatory enzymes, and regulating immune cell functions. Moreover, the biocompatibility, biodegradability, and low toxicity of chitosan make it a promising candidate for therapeutic applications. However, additional investigation is necessary to clarify the exact mechanisms that explain its anti-inflammatory activity and enhance its therapeutic potential. Overall, this review highlights the chemistry, applications of chitosan in biomedical fields, and the utilization of chitosan as an anti-inflammatory agent in drug delivery systems, with a growing body of evidence supporting the potential of chitosan as a valuable anti-inflammatory agent, paving the way for future investigations and the development of novel therapeutic interventions.

TENDON BIOENGINEERING: CHALLENGES FOR CLINICAL APPLICATION

Tendons mainly consist of collagen in order to withstand high tensile forces. Compared to other, high turnover tissues, cellularity and vascularity in tendons are low. Thus, the natural healing process of tendons takes long and can be problematic. In case of injury to the enthesis, the special transition from tendon over cartilage to bone is replaced by a fibrous scar tissue, which remains an unsolved problem in rotator cuff repair.To improve tendon healing, many different approaches have been described using scaffolds, stem cells, cytokines, blood products, gene therapy and others. Despite promising in vitro and in vivo results, translation to patient care is challenging. In clinics however, tendon auto- or allografts remain still first choice to augment tendon healing if needed.Therefore, it is important to understand natural tendon properties and natural tendon healing first. Like in other tissues, senescence of tenocytes seems to play an important role for tendon degeneration which is interestingly not age depended. Our in vivo healing studies have shown improved and accelerated healing by adding collagen type I, which is now used in clinics, for example for augmentation of rotator cuff repair. Certain cytokines, cells and scaffolds may further improve tendon healing but are not yet used routinely, mainly due to missing clinical data, regulatory issues and costs.In conclusion, the correct diagnosis and correct first line treatment of tendon injuries are important to avoid the necessity to biologically augment tendon healing. However, strategies to improve and accelerate tendon healing are still desirable. New treatment opportunities may arise with further advances in tendon engineering in the future.

УПРАВЛІННЯ РОЗВИТКОМ КУРОРТІВ У СТРУКТУРІ ТЕРИТОРІАЛЬНИХ ГРОМАД

To study modern trends, including modern topics related to resorts, a review of literature and experience was conducted, which is traditionally carried out from the point of view of revealing various aspects of the functional activity of medical and health facilities and tourist trips to certain geographical regions for the purpose of health. The article reveals the conceptual position of the authors regarding the concept of a resort, reveals the main directions of the evolution of resort activity from the standpoint of changes in the demand for resort services and their offers. In the management of resorts within territorial communities, it is important to understand resource capabilities, specialization of resort facilities, scope of activity, benefits for the territorial community. In this regard, using the appropriate criteria for this study, the types of resorts were selected. The criterion-referenced approach to the grouping of resorts presented in the study convinces that, whatever the specialization of the resorts, their activity is carried out on the basis of using, first of all, natural healing and health-giving and created resources (material, technical and technological, energy, personnel support of the resort establishments themselves) of a certain of the territorial community and noted the objective fact that natural healing resources and territories with favorable conditions for healing are unevenly distributed in different countries of the world. The authors analyze the place and significance of the activities of resort establishments in the structure of the tourist destination, which in turn is a structural element in the economic complex of the territorial community. On the basis of such a structured approach, the levels of subjectivity and halos of realization of their interests in the territorial community, their commonality and contradictions are clearly highlighted. In order to justify management measures to solve modern problems and realize the possibilities of development of resorts in the structure and with the help of the territorial community, certain typical directions are highlighted.