Purpose To compare the clinical and laboratory outcomes of intra-articular injections of culture-expanded bone-derived mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) to intra-articular corticosteroid injections for the treatment of knee osteoarthritis (OA). Methods Forty-seven patients with radiographic and symptomatic knee OA were randomized into three groups for intraarticular injections: autologous bone marrow-derived culture-expanded MSCs (n = 16); autologous bone marrow-derived culture-expanded MSCs + PRP (n = 14); and corticosteroid (n = 17). The outcomes were assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) and range of motion (ROM) at baseline, 1, 2, 3, 6, 9 and 12 months and intra-articular cytokines analysis at baseline, 6 and 12 months postoperatively. Results The three groups showed significant improvement in most KOOS domains and global score at 1st month and all domains and global score at 12-month follow-up (p < 0.05). At the 1st month, only the MSCs group showed significant differences in KOOS symptoms domain (p = 0.003). The MSCs and MSCs + PRP groups showed the highest percentage of improvement in most KOOS domains and global score compared to the corticosteroid group. All three groups showed a significant reduction in intra-articular levels of human interleukin-10 cytokine, from baseline to 12 months (p < 0.05). Conclusion An intra-articular injection of bone marrow-derived culture-expanded MSCs with or without the addiction of PRP is effective in improving the function and decreasing symptoms caused by knee OA at 12-month follow-up. Level of evidence II.

Prospective cohort study, Level II.

Results: Of the 401 cases sent to cytogenetic study, it was possible to obtain information about the chromosomal complement in 333 cases, of which 72.7% showed normal karyotype, and 27.3% abnormal karyotype. Aneuploidies represented 92.3% of the identified chromosomopathies, with trisomies being the most frequent, related with an advanced maternal age and an early gestational age. There was no agreement between the results of the cytogenetic and the anatomopathologic analysis. Discussion/Conclusion: The prevalence of chromosomal abnormalities, during the first trimester, is similar between sporadic and recurrent miscarriages. With increased maternal age, trisomies, the most frequent type of aneuploidy, are more likely to occur, with a mean increment in probability of 7.4% per year. A significant karyotype-pathological correlation was not established. Maternal contamination is the main obstacle to the accurate determination of the prevalence of chromosomal abnormalities. The molecular cytogenetic techniques already available can overcome the limitations of the conventional technique. Keywords: Abortion, Spontaneous/genetics; Chromosome Aberrations; Chromosome Disorders; Infertility, Female/genetics; Portugal. INtRODUÇÃOO abortamento espontâneo é um problema frequente durante a gravidez, estimando-se que afete cerca de 25 a 50% das mulheres que tentam engravidar, apesar de apenas 15% dos casos serem clinicamente reconhecidos. 1,2Sabe-se que a maioria dos abortamentos ocorre nas primeiras semanas de gestação, especialmente até às 14 semanas.1 Embora grande parte dos abortamentos seja esporádico, 1-3% dos casais sofre abortamento recorrente, definido como a perda consecutiva de três ou mais gravidezes, com um ainda maior impacto psicossocial. 1,3,4Várias patologias têm sido atribuídas como causa de abortamento esporádico, representando as anomalias cromossómicas no produto de conceção cerca de 50-60% dos casos. 2,5,6 A maioria destas anomalias são numéricas (95%), sendo as trissomias as mais prevalentes (60%), mais comummente a trissomia 16, seguidas das poliploidias e da monossomia X.1,2 No que diz respeito ao abortamento recorrente, a literatura não é tão consensual quanto à frequência das anomalias cromossómicas, existindo autores que afirmam que ocorrem com frequência semelhante à de abortamento esporádico 7-10 e outros que defendem uma menor frequência.

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