Sodium Hyaluronate In Patients Research Articles

6 - Bladder instillations of Adelmidrol+ Sodium Hyaluronate in patients with symptomatic actinic cystitis: Efficacy of the treatment

6 - Bladder instillations of Adelmidrol+ Sodium Hyaluronate in patients with symptomatic actinic cystitis: Efficacy of the treatment

Effectiveness and safety of an ultrasound-guided injection of platelet-rich plasma versus sodium hyaluronate in patients with knee osteoarthritis

Purpose: To examine the effectiveness and safety of ultrasound-guided platelet-rich plasma (PRP) injection versus sodium hyaluronate injection in patients with knee osteoarthritis (KOA).Methods: The clinical data of 92 patients treated at the West China Hospital Sichuan University-Ziyang Hospital between May 2020 and December 2021 were retrospectively analyzed. Patients were allocated to PRP group (ultrasound-guided PRP injection) and a hyaluronic acid (HA) group (sodium hyaluronate injection) with each group containing 46 patients. Before and after treatment, the two groups were compared in terms of visual analog scale (VAS) score, Lysholm score, levels of serum inflammatory factors, insulin-like growth factor (IGF)-1, fibroblast growth factor (FGF)-2 and WOMAC score.Results: After treatment, PRP group exhibited significantly lower pain scores and higher function scores than HA group. Furthermore, PRP group exhibited lower levels of inflammation markers, higher levels of growth factors as well as better treatment efficiency and incidence of adverse reactions when compared with HA group (p < 0.05).Conclusion: Ultrasound-guided PRP therapy ameliorates pains and joint functions in KOA patients. The therapeutic effect may be associated with the regulation of cartilage performance and alleviation of inflammatory state. Therefore, PRP injection therapy combined with ultrasound guidance might also have clinical potential for other applications.

Pilot Study to Evaluate the Efficacy of Polynucleotide Sodium Compared to Sodium Hyaluronate and Crosslinked Sodium Hyaluronate in Patients with Knee Osteoarthritis.

Degenerative arthritis of the knee joint has become a major social problem worldwide due to population aging. There are several treatment options for knee osteoarthritis, and the intraarticular injection of sodium hyaluronate is commonly selected by many clinicians as a nonsurgical treatment. However, the efficacy of the treatment is controversial. In this pilot study, we aimed to compare polynucleotide sodium (Conjuran®) with sodium hyaluronate (Hyruan Plus®) and 1,4-butanediol diglycidyl ether-crosslinked sodium hyaluronate (Synovian®) in terms of analgesic efficacy after intraarticular injection in patients with knee osteoarthritis. One of the three intraarticular agents was selected according to what agents were available for outpatients when each patient was enrolled in the study. The 15 enrolled patients were subdivided into 3 groups of 5 patients each. Three injections were performed under ultrasound guidance at a 1-week intervals over a total of 3 weeks. The visual analog scale (VAS) score, the Korean version of the Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), the EuroQol five-dimension scale (EQ-5D) score, and the Korean version of the painDETECT Questionnaire (K-PDQ) score were evaluated before injection and at 1, 2, and 6 weeks after the start of the treatment protocol. The primary endpoint was the change in weight-bearing pain at 4 weeks after the last injection. Secondary endpoints included pain at rest and during walking and the K-WOMAC, EQ-5D, and K-PDQ scores. Weight-bearing pain decreased significantly more from pretreatment to 6 weeks after the start of the treatment protocol in the polynucleotide sodium-treated patients than in the patients who were treated with other agents (p = 0.006, one-way ANOVA). There were no significant between-group differences in the other secondary endpoints. No adverse events occurred. In conclusion, polynucleotide sodium could effectively reduce weight-bearing pain in the patients with knee osteoarthritis compared to standard hyaluronic acid viscosupplementation.

Experience of using a combination mucoactive drug during chemotherapy in patients with MDR/XDR tuberculosis

The objective: to evaluate the effectiveness of the medication containing a 7% NaCl solution and 0.1% sodium hyaluronate in patients with destructive pulmonary tuberculosis and multiple/extensive drug resistance (MDR/XDR) and inflammatory changes in the tracheobronchial tree. Subjects and methods. A prospective randomized controlled study was carried out, which included 69 patients with destructive pulmonary tuberculosis and MDR/XDR and respiratory complaints and changes in the tracheobronchial tree detected by fibrobronchoscopy. All patients underwent a complete clinical and functional examination, and by analyzing the questionnaires, the mMRC dyspnea index was calculated, the CAT test was performed, and the response to treatment was assessed using the Likert scale. The patients were randomly divided into two groups. The main group included 30 patients; in addition to anti-tuberculosis therapy, through a nebulizer, they received inhalation with the solution containing 7% NaCl and 0.1% sodium hyaluronate, 5 ml 2 times a day for 10 consecutive days, 20 inhalations. The control group (39 people) received individual chemotherapy according to the resistance profile with standard mucolytic treatment. The examination was carried out before the course with the mucoactive drug (visit I), then at the end of the course – after 10 days (visit II) and after 30 days (visit III) from the moment of inclusion in the study. The significance of differences (p) was determined at p <0.05 using χ² Pearson, Fisher's exact test, Mann-Whitney test, and paired Wilcoxon test. Results. There was an increase in the effectiveness of treatment of patients in this category according to the following criteria: disappearance or decrease of respiratory symptoms (on the 10th day from the start of treatment), early regression of inflammatory changes in the tracheobronchial tree (on the 30th day from the start of treatment in 24 (73.4%) patients in the main group, in 10 (25.1%) patients in the comparison group (RR = 3.34; 95% CI 2.78-3.90)].

Results of the combined mucoactive drug application in the treatment of patients with MDR/XDR tuberculosis

Objective. To evaluate the efficacy of a drug containing 7% NaCl and 0.1% sodium hyaluronate in patients with destructive pulmonary tuberculosis with MDR / XDR MBT with inflammatory changes in the tracheobronchial tree. Materials and methods. A prospective randomized controlled trial was conducted, which included 69 patients with destructive pulmonary tuberculosis with MDR/XDR MBT and with respiratory complaints and changes in the tracheobronchial tree according to fibrobronchoscopy. All patients underwent a dynamic examination. Questionnaires were processed, and dyspnea index calculated in accordance with mMRC, CAT, FBS; the response to treatment was analyzed using the Likert scale. Patients were randomized into two arms that received individualized antituberculosis treatment according to the sensitivity of the pathogen. Nebulizer inhalations with 7% NaCl solution and 0.1% sodium hyaluronate 5 ml 2 times a day for 10 consecutive days (20 procedures in total for each patient) were additionally prescribed to 30 subjects in the main study arm. In control group, 39 subjects received standard mycolytic treatment. Subjects underwent a dynamic examination: results were evaluated before the course of the mucoactive drug (Ist visit), then at the end of the course, after 10 days (IInd visit) and after 30 days (IIIrd visit) from the moment of inclusion into the study. The significance of differences (p) was determined at p <0.05. Results. The authors registered an increase in the efficacy of treatment in this category of patients according to the following criteria: disappearance or decrease of respiratory symptoms (on the 10th day from the start of treatment), early relief of inflammatory changes in the tracheobronchial tree (on the 30th day from the start of treatment in 24 (73.4%) subjects in the main group, and 10 (25.1%) in the control group (RR = 3.34; 95% CI 2.78-3.90).

A comparative study of combining intra-articular injection of platelet-rich plasma or sodium hyaluronate with isotonic muscle strength training in treating knee osteoarthritis

Objective To compare the efficacy of intra-articular injection of autologous platelet-rich plasma (PRP) with that of sodium hyaluronate for patients with knee osteoarthritis (KOA). Methods Fifty KOA patients were randomly divided into a PRP group (n=25) and a sodium hyaluronate group (n=25). Those in the PRP group were injected intra-articularly with 5 ml of autologous PRP every 2 weeks for 6 consecutive weeks, while the sodium hyaluronate group was given intra-articular injections of 2 ml of sodium hyaluronate once a week for 6 weeks. Both groups performed isokinetic strength training three times a week for 6 weeks. Before as well as 6 weeks, 3 months, 6 months and 12 months after the treatment, both groups were followed and evaluated using the Western Ontario and McMaster University osteoarthritis index (WOMAC). A Biodex System 4 isometric muscle strength testing system was used to evaluate the knees′ peak torque (PT) in flexion and extension, total power (TW), and average power (AP). Results Before the treatment there were no significant differences in pain, stiffness or average WOMAC score between the two groups. Afterward significant improvement was observed in the pain, stiffness and WOMAC scores of both groups. Compared with the sodium hyaluronate group, significantly greater decreases in the average WOMAC pain score were observed in the PRP group after the different intervals. That was also true of the average stiffness scores and the overall average WOMAC scores after 6 and 12 months. The flexor and extensor PT, TW and AP at the angular velocities of 60°/s and 90°/s also improved significantly in both groups after 6 weeks and 12 months, with the improvement of the PRP group significantly greater than that in the control group at the same time points. Conclusion Intra-articular injection of either autologous PRP or sodium hyaluronate can effectively alleviate the clinical symptoms of KOA when combined with isokinetic strength training. However, PRP is the more effective. Its use is worthy of clinical application and promotion. Key words: Knees; Osteoarthritis; Plasma; sodium hyaluronate; Isokinetic strength

Cytofunctional changes in nasal ciliated cells in patients treated with hyaluronate after nasal surgery.

Hyaluronic acid (HA) plays a significant role in tissue repair of mucosal surfaces and, consequently, in surgical injury remodelling of nasal mucosa. To assess the effect of high-molecular-weight HA administered by aerosol on the morphofunctional recovery of ciliated cells damaged by surgical trauma. A single-blind, prospective, randomized trial was carried out with 94 patients who were randomly assigned, after endoscopic turbinoplasty, either to treatment with nasal saline solution irrigation (control group, n = 47) or to treatment with nasal douches based on high concentration (9 mg) and high-molecular-weight sodium hyaluronate (active treatment group, n = 47). All the patients were evaluated by using nasal fiberendoscopy, mucociliary transport time, nasal cytologic test, and a visual analog scale in terms of symptoms before and at 2 and 4 weeks after surgery. Visual analog scale values were significantly lower in the active treatment (AT) group at week 2 regarding each individual symptom. Mucociliary transport time was significantly reduced in patients in the AT group but only 1 month after surgery. Both the percentage of cellular impairments and the number of cells with hyperchromatic supranuclear stria showed significant improvements in the AT group in all postsurgery evaluations (p < 0.05). Intranasal use of sodium hyaluronate in patients who underwent functional nasal surgery improved both mucociliary clearance and nasal mucosa regeneration due to a faster recovery of the impaired ciliated cells.

A double blind randomized active-controlled clinical trial on the intra-articular use of Md-Knee versus sodium hyaluronate in patients with knee osteoarthritis ("Joint").

BackgroundTo evaluate the clinical outcomes of a group of patients affected by knee osteoarthritis (OA) treated with MD-Knee (Guna S.p.a., Milan, Italy) versus a group of patients treated with sodium hyaluronate.MethodThis non-inferiority prospective randomized controlled trial involved 60 patients affected by knee OA, grade 2–3 of Kellgren-Lawrence scale. The MD-Knee Group, Group A (n = 29) was administered five intra-articular injections at 1 week interval; the sodium hyaluronate Group, Group B (n = 31), was administered five doses of intra-articular injection of sodium hyaluronate at 1 week interval. All patients were prospectively evaluated before and at 3 and 6 months after the treatment by the Lequesne Knee Index (LKI) as primary endpoint and the Visual Analogue Scale (VAS), Pain Killer consumption and SF-36 questionnaires as secondary endpoints.ResultsAt the 3- and 6 month follow-up, LKI and VAS improved significantly in both groups compared to baseline and no statistically significant differences were observed between Group A and Group B. There was no statistically significant difference in the SF36 questionnaire score and pain killer consumption between two groups at any time point.ConclusionsThis study shows that both preparations exert similar clinical effects as assessed through multiple outcome measures. MD-Knee is effective on knee OA symptoms over 6 months after a 5-weekly injection course, and it is equally effective as the reference sodium hyaluronate.Trial registrationTrial registration number: ISRCTN93862496. Registration date: January 18th, 2016

Clinical Effects and Safety of 3% Diquafosol Ophthalmic Solution for Patients With Dry Eye After Cataract Surgery: A Randomized Controlled Trial

To compare the efficacies and safety profiles of 3% diquafosol and 0.1% sodium hyaluronate in patients with dry eye after cataract surgery. Randomized controlled trial. setting: Soonchunhyang University Hospital, Seoul, South Korea. In all, 130 eyes of 86 dry eye patients who had undergone cataract surgery between January 2014 and January 2015 were enrolled and randomly divided into a diquafosol group and a sodium hyaluronate group. The diquafosol group used diquafosol 6 times a day and the hyaluronate group used sodium hyaluronate 6 times a day after cataract surgery. Evaluations of efficacy were conducted based on an Ocular Surface Disease Index questionnaire, tear breakup time (TBUT), Schirmer I test, corneal fluorescein and conjunctival lissamine green staining scores, serial measurement of ocular higher-order aberrations (HOAs), corneal HOAs, and uncorrected distance visual acuity test. Safety evaluations were based on anterior chamber inflammation and discontinuation of the eye drops. Objective signs and subjective symptoms were aggravated at 1 week postoperatively and began to recover significantly 4 weeks after surgery. The diquafosol group showed significantly superior TBUT (P < .001), corneal fluorescein (P = .045), and conjunctival staining (P = .001) compared to the sodium hyaluronate group throughout the study period. TBUT (P < .001) and the change in HOAs (P = .018) recovered significantly more quickly in the diquafosol group. The safety evaluations showed no intergroup differences. Eye drops of 3% diquafosol may be an effective and safe treatment for the management of cataract surgery-induced dry eye aggravation in patients with preexisting dry eye.

Experiencia clínica y urodinámica con ácido hialurónico intravesical en el síndrome de vejiga dolorosa asociado a cistitis intersticial

Introduction few studies have been carried out on therapeutic options in patients with painful bladder syndrome associated with interstitial cystitis. The aim is to verify the safety and effectiveness of treatment with sodium hyaluronate through intravesical instillation in patients with painful bladder syndrome. Materials and methods a series of 18 female patients is presented, with a mean age of 51 years and prior diagnosis of painful bladder syndrome, who were treated by means of the weekly infusion of an intravesical solution of 40 mg of sodium hyaluronate in sterile solution, over a period of eight weeks. The patients were examined clinically and urodynamically prior to their inclusion in the study and eight months after the instillations had concluded. Results there was a statistically significant improvement in the urodynamic parameters and in the symptoms measured quantitatively by means of the questionnaire “Pelvic Pain and Urgency/Frequency” between the baseline situation and after the vesical instillation of sodium hyaluronate in patients with painful bladder syndrome. There was no toxicity arising from the treatment, given that no adverse effects were recorded in relation to it. Conclusion the clinical use of intravesical hyaluronic acid in patients with painful bladder syndrome possibly associated with interstitial cystitis has been demonstrated. The clinical improvement is also associated both with increased bladder capacity and improved bladder sensitivity. Tolerance was excellent. Clinical tests that more profoundly evaluate the therapeutic potential of this drug in this type of patients are required.

Clinical and urodynamic experience with intravesical hyaluronic acid in painful bladder syndrome associated with interstitial cystitis

IntroductionFew studies have been carried out on therapeutic options in patients with painful bladder syndrome associated with interstitial cystitis. The aim is to verify the safety and effectiveness of treatment with sodium hyaluronate through intravesical instillation in patients with painful bladder syndrome. Materials and methodsA series of 18 female patients is presented, with a mean age of 51 years and prior diagnosis of painful bladder syndrome, who were treated by means of the weekly infusion of an intravesical solution of 40 mg of sodium hyaluronate in sterile solution, over a period of eight weeks. The patients were examined clinically and urodynamically prior to their inclusion in the study and eight months after the instillations had concluded. ResultsThere was a statistically significant improvement in the urodynamic parameters and in the symptoms measured quantitatively by means of the questionnaire “Pelvic Pain and Urgency/Frequency” between the baseline situation and after the vesical instillation of sodium hyaluronate in patients with painful bladder syndrome. There was no toxicity arising from the treatment, given that no adverse effects were recorded in relation to it. ConclusionThe clinical use of intravesical hyaluronic acid in patients with painful bladder syndrome possibly associated with interstitial cystitis has been demonstrated. The clinical improvement is also associated with an increase in the bladder's capacity and sensitivity. Tolerance was excellent. Clinical tests that more profoundly evaluate the therapeutic potential of this drug in this type of patients are required.

Prognostic indicators of the outcome of arthrocentesis with and without sodium hyaluronate injection for the treatment of disc displacement without reduction: a magnetic resonance imaging study

This study analysed the prognostic factors for successful arthrocentesis with and without sodium hyaluronate (SH) injection for the treatment of temporomandibular joint (TMJ) disc displacement without reduction (DDwoR) using clinical and radiological results. 29 TMJs in 25 patients with DDwoR were included. Patients were treated with arthrocentesis or arthrocentesis followed by intra-articular (i.a.) injection of SH. Treatment was evaluated for postoperative range of maximum mouth opening and the degree of postoperative pain on a VAS. Prognostic factors analysed were age, sex, duration of locking, trauma history, previous TMJ treatment, depression, bruxism, malocclusion and missing teeth. Degenerative changes were evaluated as probable prognostic factors. After treatment, 24 joints (83%) fulfilled the criteria for success. Duration of locking and present preoperative degenerative changes were the most significant factors for treatment outcome. The results suggest it is sufficient to use only arthrocentesis in patients without preoperative degenerative changes and arthrocentesis with SH in patients with degenerative changes on their preoperative MRIs, but because there were some significant differences between the two groups preventing the authors from comparing them statistically, they cannot come to that conclusion. To clarify the use of SH in such cases, standardized study groups are necessary for future studies.

A Randomized Controlled Trial of Superior and Inferior Temporomandibular Joint Space Injection With Hyaluronic Acid in Treatment of Anterior Disc Displacement Without Reduction

To compare the outcome of inferior and superior joint space injection of sodium hyaluronate in patients with disc displacement without reduction of the temporomandibular joint (TMJ). One hundred twenty patients with disc displacement without reduction of TMJ were randomized into 2 experimental groups. One group of patients received superior joint space injections of sodium hyaluronate and the other group was treated with inferior joint space injections. Patient's TMJ status and clinical symptoms were evaluated at the 3 and 6 month follow-up appointments. The clinical parameters recorded were maximal mouth opening (MMO), pain intensity on a visual analog scale (VAS), and modified Helkimo's clinical dysfunction index and analyzed with ANCOVA. Fifty of the superior and 54 of the inferior joint space injection therapy group returned for the 3 and 6 month evaluations; 86.67% of the patients were retained in the follow-up. MMO, VAS, and Helkimo's index of both groups improved at the 3 and 6 month follow-ups. The results of MMO changes and TMJ function were almost the same in both groups at 3 month follow-up. However, there was a significant reduction in TMJ pain in the inferior joint injection group at 3 month follow-up compared with the superior joint injection group (P< .001). There were also significant differences between the inferior joint injection group and superior joint injection group in MMO (P< .005), VAS (P< .001), and Helkimo's index (P< .001) at 6 month follow-up. This study showed that inferior joint space injection with sodium hyaluronate is a valid method of treating disc displacement without reduction of TMJ and a long-term study will be needed to assess the effect of inferior joint injection on the morphologic changes of the TMJ.

Poster 231: Comparison of Sono-Guided Intraarticular Injection of Triamcinolone and Sodium Hyaluronate in Patients With Adhesive Capsulitis of the Shoulder

Objective: To compare the effects of sono-guided intraarticular injection of triamcinolone and sodium hyaluronate in patients with adhesive capsulitis of the shoulder. Design: Randomized clinical trial. Setting: Physical medicine and rehabiliation department of Sanggye Paik Hospital. Participants: 38 patients with adhesive capsuitis of the shoulder were selected as study subjects. Interventions: Patients with adhesive capsuitis of the shoulder were selected as study subjects and assigned randomly into 2 groups, group A and B.

Comparative Study of Inferior Joint Space and Superior Joint Space Injection of Sodium Hyaluronate in Patients With Anterior Disc Displacement Without Reduction of the Temporomandibular Joint

In the past decade, there has been an explosion in the use of psychotropic medicines for both psychiatric and non-psychiatric conditions. Many new agents have been developed with multiple applications across a wide range of human conditions. We will review all classes of psychiatric medicines, including sub-classes, mechanisms of action, disease state indication and purported other uses. We will examine how these medicines may affect the Oral and Maxillofacial surgeon in terms of how psychotropic agents may contribute to oral disease, the potential for drug interactions with anesthetic agents and pain medications, and in terms of what the surgeon may expect from patients with conditions that require these treatments.

Comparative Study of Inferior Versus Superior Joint Space Injection of Sodium Hyaluronate in Patients With Anterior Disc Displacement Without Reduction of the Temporomandibular Joint: A Randomized Controlled Trial

Comparative Study of Inferior Versus Superior Joint Space Injection of Sodium Hyaluronate in Patients With Anterior Disc Displacement Without Reduction of the Temporomandibular Joint: A Randomized Controlled Trial

Intraarticular Hyaluronic Acid versus Glucocorticoid Injections for Nonradicular Pain in the Lumbar Spine

To investigate the efficacy and safety of intraarticular sodium hyaluronate (SH) compared with intraarticular glucocorticoids (triamcinolone acetonide; TA) in the treatment of chronic nonradicular lumbar pain. Sixty patients were included in this randomized, controlled, blind-observer clinical study and randomly assigned to two groups to receive 10 mg SH or 10 mg TA per facet joint. The facet joints on both sides at levels S1-L5, L5-L4, and L4-L3 were treated once per week under computed tomographic guidance. The study visits were timed to permit assessment of the immediate effect as well as possible carryover effects at 3 and 6 months after completion of treatment. Changes in pain were assessed with a visual analog scale (VAS) and changes in function and quality of life were assessed by the Roland Morris Questionnaire (RMQ), the Oswestry Disability Questionnaire (ODQ), the Low Back Outcome Score (LBOS), and the Short Form 36 (SF-36) questionnaire. Patients reported lasting pain relief, better function, and improved quality of life with both treatments. Mann-Whitney analyses of the patient questionnaires (RMQ, ODQ, and LBOS) very consistently showed that SH is not inferior to TA. In addition, the efficacy of SH was largely comparable with that of TA on the VAS and SF-36. No adverse effects were reported after administration of the test products. The intraarticular treatment of facet joints (levels S1-L5, L5-L4, and L4-L3) with SH in patients with chronic nonradicular pain in the lumbar spine resulted in a marked reduction in pain with improved function and better quality of life, which was at least equal to the effect of a course of TA injections. SH-treated patients showed greater benefits in the long term. Intraarticular SH is a very promising new option for the treatment of patients with chronic nonradicular lumbar symptoms.

The potassium sensitivity test: a predictor of treatment response in interstitial cystitis

To determine whether the potassium sensitivity test (PST) can be used to predict the response to treatment with intravesical sodium hyaluronate in patients with interstitial cystitis. Thirty-eight patients diagnosed with interstitial cystitis were recruited; each had a PST, carried out in a double-blind fashion, followed by six weekly doses of intravesical sodium hyaluronate. The patients were assessed before and after treatment using a self-administered interstitial cystitis symptom index (CSI) and problem index (PI). The clinical response was defined as none (<25% improvement in clinical symptoms), mild (>25%), moderate (50-75%) and excellent (>75%). The PST was positive in 23 and negative or indeterminate in 13 patients; two patients withdrew from the study. Overall 20 of 36 (55%) patients reported an improvement after six doses of intravesical sodium hyaluronate, but 17 (74%) with a positive PST improved, compared to only five (22%) with a negative test (P = 0.03). There was an improvement in the CSI after treatment in both groups, but a significant improvement in the PI only in patients with a positive PST (P = 0.01). The magnitude of change for the CSI and PI was significantly greater in the positive than in the negative group (CSI, P = 0.043; PI, P < 0.001). There were no major complications. Three patients complained of pain after the test, and two with a positive and one with a negative PST developed a urinary tract infection. Although the role of the PST in the diagnosis of interstitial cystitis requires further clarification, the test helps to predict the response to treatment with glycosaminoglycan-substitution therapy.

Efficacy and safety of 0.18% sodium hyaluronate in patients with moderate dry eye syndrome and superficial keratitis

Sodium hyaluronate (SH) is used in patients with dry eye. We evaluated the efficacy and safety of SH and carboxymethylcellulose (CMC) in the treatment of dry eye syndrome with superficial keratitis. A total of 22 patients with moderate dry eye and superficial keratitis were enrolled in a prospective, randomised, masked-observer, parallel-group, single-centre study. Patients were randomly assigned to a 0.18% SH or 1% CMC solution for a 2-month period. In addition to the commonly assessed parameters in patients with dry eye (among others symptoms and corneal staining with fluorescein), flow cytometry analysis of CD44, HLA DR expressions in impression cytology was investigated as a potential efficacy parameter. Both treatments improved the symptoms and ocular surface and were well tolerated. SH significantly (p<0.05) decreased CD44 values compared with CMC. Comfort was significantly (P<0.05) better in the SH group than that in the CMC group throughout the study. Recovery in keratitis (type, extent and depth) and symptoms were faster in the SH group than in the CMC group. Blurred vision was reported by patients in the CMC group only. SH was well tolerated and tended to show a faster efficacy than did the CMC-based formulation in patients with moderate dry eye and superficial keratitis. SH could therefore advantageously be prescribed from the early stages of dry eye disease. This study also showed that flow cytometry in impression cytology specimens is a reliable tool for exploring the ocular surface at the epithelial level and that CD44, in addition to HLA DR, could be an interesting endpoint for future trials in dry eye syndrome with products based on SH.

Poster 195 evaluation of fluoroscopic and arthrographically guided intra-articular injection of sodium hyaluronate in patients with osteoarthritis of the knee: A preliminary report. Ramon Castellanos, MD (Int Pain Inst, Coral Gables, FL); Tania Castellanos, RN, CNOR, e-mail: morro94@bellsouth.net

Poster 195 evaluation of fluoroscopic and arthrographically guided intra-articular injection of sodium hyaluronate in patients with osteoarthritis of the knee: A preliminary report. Ramon Castellanos, MD (Int Pain Inst, Coral Gables, FL); Tania Castellanos, RN, CNOR, e-mail: morro94@bellsouth.net