Objective: To evaluate the clinical efficacy and effectiveness of the use of cell therapy in the treatment of osteonecrosis of the hip in people with sickle cell disease (SCD) compared with hip arthroplasty. Methodology: Articles published from 2015 to 2019 in English, Portuguese, or Spanish were screened in the following databases: Cochrane, PubMed, Science Research, CAPES (Coordination for the Improvement of Higher Education Personnel), Virtual Health Library (VHL) and SciELO (Scientific Electronic Library Online). The following keywords were used: cell therapy, osteonecrosis, hip, sickle cell anemia and arthroplasty. People with sickle cell disease who developed osteonecrosis of the hip and underwent treatment using cell therapy or hip arthroplasty were selected as the sample. Results: After refining the searches and organizing the references, seven studies were selected that met the eligibility criteria. Discussion: We found that out of the seven studies evaluated, three presented autologous bone marrow cell implantation and four presented hip arthroplasty (THA) as an intervention procedure in osteonecrosis of the hip in people with SCD. In all studies in which THA was used, there was a higher prevalence of complications such as vaso-occlusive crises, pain, surgical wound infection and reintervention, among others. In most studies using cell therapy, pain was reduced or absent, there were no complications and reintervention was not necessary. All studies with cell therapy indicated a reduction in the progression of osteonecrosis of the hip. Conclusion:Considering the analyzed studies, it was found that autologous bone marrow cell implantation has gained prominence and great relevance in the treatment of osteonecrosis of the hip in people with sickle cell disease, presenting a better clinical outcome and greater efficacy and effectiveness compared with hip arthroplasty. Systematic review record: a study pre-registered in PROSPERO (https://www.crd.york.ac. uk/prospero/display_record.php?ID=CRD42020199505) under the number CDR42020199505, before data collection.

The objective of this work was to carry out a comparative clinical study of the cost between the Conventional Treatment and the Treatment with Platelet Rich Plasma (PRP) in patients with Pseudarthrosis in the Tibia. At human bone fractures, mainly at arising in accidents in traffic and others and your complications, represent one important condition what has jeopardized health and quality of life, in addition to crescents for the Unified Health System (SUS), so much in the treatment primary, how much of us care with their grievances. One there, the Pseudarthrosis, entity gives Orthopedics already quite known, it is one complication of fractures Where o bone no it presents features in consolidation and regeneration. This is mainly due to poor vascularization at the fracture site, inadequate or late treatment and follow-up of the fracture, or the presence of a gap between the bone fragments. Surgical treatment is the most common for Pseudoarthrosis and it may be necessary for the patient to have a vascularized bone graft in the affected region. Against in a scenery, in what if observe o increase in costs hospital at the treatment surgical of fractures, so as pension expenses at the costing in pensions and retirements, resulting in loss gives activity work and loss of Health and Quality of Life with great repercussion at economy of country, was performed a study with essay Clinical Cats Comparison of Treatment Surgical Conventional for Pseudarthrosis gives Tibia, with o use in new technologies like the injection in Plasma Rich in Platelets (PRP) at the focus gives referred lesion, in patients attended fur System single of Health (SUS). The results obtained demonstrate that treatment with Platelet Rich Plasma (PRP) is less expensive, less traumatic, effective and allows for a shorter hospital stay, in addition to improving the Quality of Life.

Objetivo: Apresentar uma revisão integrativa dos últimos 10 anos dos principais tipos de fraturas do membro superior tratadas em hospitais de nível terciário e suas implicações à saúde pública. Métodos: Utilizou-se as bases de dados: PubMed, Scientific Electronic Library Online (SCIELO), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e Biblioteca Virtual em Saúde (BVS) com os descritores: upper limb and fracture and Brazil. Considerou-se artigos publicados no Brasil entre 2009 e 2019 em inglês, espanhol ou português e que caracterizavam: população, etiologia, local da lesão, veículo, local do acidente e desfecho. Resultados: Foram encontrados 344 artigos, sendo 10 selecionados. O trauma de membro superior afeta principalmente adultos. Apresenta os acidentes de trânsito como principal etiologia, acometendo mão, punho e dedos. A motocicleta, as vias públicas e as internações são respetivamente, veículo, cenário e desfecho. Considerações finais: O trauma de membro superior é a 2° maior consequência dos acidentes de trânsito levando as fraturas ósseas e aumento do número de internações e gastos em saúde e previdenciários.

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