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Ozone gas injection for osteoarthritis patients.

Dien Vu11/24/2015

2 What was the study?1

Injecting ozone gas into the knee of osteoarthritis patients. 98 patients enrolled:

63 patients received 10 ml ozone injection. 35 patients received 10 ml air injection. 2 patients in ozone group dropped out.

Evaluate the level of pain, function, quality of life, timed up and go (TUG) test.

The result: No significant differences in the TUG test. Significant improvements in pain level, joint functions, overall

quality of life.

3 Where was the study conducted?1 The study was conducted by Dr. Trevisani

and de Jesus from Federal University of Sao Paulo-Paulista School of Medicine, Brazil.

Dr. Trevisani and her student went to American College of Rheumatology’s Annual International Meeting in San Francisco to present her study and finding.

4 Ozone2

A gas, made up of 3 oxygen atoms. In the atmosphere. Protects the Earth from ultraviolet (UV) radiations from

direct sunlight. Absorb UV-c, UV-b, and some UV-a. UV radiation can cause sunburn, skin cancer, eye damage.

5 Good and bad Ozone2

90% of good ozone stays in the stratosphere layer. Ozone hole means destruction in the stratospheric layer.

10% of bad ozone stay in the troposphere. Ozone formed by pollution.

6 Ozone toxicity3,4,5,6

U.S. Environmental Protection Agency: “Ozone alert” = > 125 ppb over 4 hours period.“Ozone warning” = > 300 ppb over 4 hours period.“Ozone emergency” = >350 ppb over 4 hours period.

9 ppm ozone + other air pollutants = pulmonary edema.15-20 ppm in 2 hours = lethal to small animals.50 ppm for 1 hour = probably fatal to humans.

Other toxics of ozone gas when inhaled. Throat or lung irritation and inflammation. Asthma exacerbation, shortness of breath, chest tightness and pain. Damage rubber and plastics. Toxic to plants (tiny irregular spots, dark spots, bronzing/reddening leaves).

7 Ozone gas preparation3

Ozone is unstable and very reactive. Ozone is an oxidizing agent. The preparation is difficult and hazardous. How to make ozone?

Same concept with how Ozone is formed in polluted air.

Mix O2 and NO2 with exposure to bright light.

8 Ozone misuses6

Indoor ozone generator Manufactures: “activated oxygen,” “trivalent oxygen,”

”mountain-fresh air,” “energized oxygen,” etc. Ozone concentration in room > 0.3 ppm.

“Ozone warning” level. Ozone misuses:

Purify polluted air. Kill bacteria, virus, mold. Remove smoke and dust. Remove odor.

Regulation indoor ozone generators: No clear authority from any agency.

9 Osteoarthritis7,8

“Osteo-” = bone.“Arthritis” = inflammation of the joints. One of the most common form of arthritis. Degenerative cartilages, “wear-and-tear”. Symptoms: joints stiffness, cracking, grinding that cause

inflammation and pain. Affects over 50 millions Americans, and 80% > 50 years old. Affects joints in hands, spine, hips, knee.

10 What causes osteoarthritis?7 Cause is unknown.

Risk factors:

11 Traditional treatments for osteoarthritis9

There is no cure, only symptom controls. Surgery. Some treatments options that may delay surgery:

Painkillers: Tylenol, NSAID, opioid. Topical analgesic: capsaicin, Bengay, Salonpas Injection: hyaluronic acid. Supplements: glucosamine, chondroitin, SAM-e, ginger, turmeric.

Non-pharm: Alternating Heat and Cold pack. Acupuncture. Eating healthy. Rest the joints. Physical therapy. Exercise, weight loss. Avoid further injuries.

12 How does ozone help osteoarthritis patients?10,11

Mechanism unknown. Proposed mechanisms of ozone gas in musculoskeletal

disorders: Increase oxygenation to tissues. Stimulation of the anti-nociceptive system:

Analgesic. Anti-inflammatory effects. Balance free radicals.

Other benefits: Stimulating immune response. Disinfect bacteria, viruses, fungi, yeast, and protozoa.

13 Prolozone12,13,14

Prolozone = Prolotherapy + Ozone. Prolotherapy is a complementary treatment by injecting an irritant

solution into areas around ligaments every 2 weeks. Thought to increase growth of connective tissues. Result in tighten up the joint, stopping muscle spasms to stabilize the

joint, thus reduced pain. Mixtures included proteins, anti-inflammatory

medications/homeopathic, vitamins, minerals, mixture of ozone/oxygen.

Permanently cure untreatable pain for 75% patients. How does it work?

Improving oxygen delivery to damaged connective tissue. Regenerate damaged tissue. Allow tissue to heal and restore to full function.

There are no contraindications.

14 Prolozone Before and After12

15 Osteoarthritis prevention15

Modifiable risk factors: Protect an injured joint/prevent joint injury (sport, work). Exercising – Stretching and warm up. Eat a healthy diet. Excess body mass – placing stress on joints. Avoid repetitive motions.

Non-modifiable risk factors: Gender (higher risk in women). Age (increases with age). Race. Genetic.

Other possible factors: Estrogen deficiency. High bone density. C-reactive protein.

16 Future directions11 Ozone has been studied in many countries. Ozone has been gaining more attention in the U.S. Other sites besides the knee: knuckles, hands, hips, spines, etc. Weight the benefit versus risk. Develop standard for ozone gas synthesis and environmental control. Ozone therapy for other diseases:

Ozonized water for dental medicine. Infected wound. Circulatory disorder. Geriatric conditions. Macular degeneration. Viral diseases. Arthritis. Cancer. SARS. AIDS.

17 Reference1. Ozone Gas Injections May Do The Trick For Knee Osteoarthritis. American College of Rheumatology.

http://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/711/Ozone-Gas-Injections-may-do-the-Trick-for-Knee-Osteoarthritis. Accessed 11/23/2015.

2. What Is Ozone? National Aeronautics and Space Administration: Goddard Space Flight Center. http://ozonewatch.gsfc.nasa.gov/facts/SH.html. Last updated: 9/25/2013. Accessed 11/23/2015.

3. Shakhashiri, BZ. Ozone. http://scifun.chem.wisc.edu/chemweek/ozone/ozone.html. Accessed 11/23/20154. Ozone: Immediately Dangerous to Life or Health Concentrations. Centers for Disease Control and Prevention.

http://www.cdc.gov/niosh/idlh/10028156.html. Accessed 11/23/2015.5. Effects of Ozone Air Pollution on Plants. United States Department of Agriculture. www.ars.usda.gov/Main/docs.htm?

docid=12462. Accessed 11/23/2015. 6. Ozone Generators What You Need To Know. Connectict Department of Public Health.

http://www.ct.gov/dph/lib/dph/environmental_health/eoha/pdf/Ozone_Generator_Fact_Sheet.pdf. Last updated 5/2007. Accessed 11/23/2015.

7. Ehrlich SD. Osteoarthritis. University of Maryland Medical Center. http://umm.edu/health/medical/altmed/condition/osteoarthritis. Last updated 1/21/0214. Accessed 11/23/2015.

8. Yaneff J. Move over Aleve: Gas Injections May relieve Osteoarthritis Knee Pain. Doctor Health Press. http://www.doctorshealthpress.com/health-news/move-over-aleve-gas-injections-may-relieve-osteoarthritis-knee-pain. Accessed 11/23/2015.

9. Ringdahl E, Pandit S. Treatment of Knee Osteoarthritis. Am Fam Physician. 2011 Jun 1;83(11):1287-1292. 10. Hashemi, M, Jalili P, Mennati S, et al. The Effects of Prolotherapy With Hypertonic Dextrose Versus Prolozone (Intraarticular

Ozone) in Patients With Knee Osteoarthritis. Anesth Pain Med. 2015 Oct; 5(5); e27585.11. Elvis AM, Ekta JS. Ozone Therapy: A Clinical Review. J Nat Sci Biol Med. 2011 Jan-Jun; 2(1):66-70.12. Shallenberger F. Prolozone – Regenerating Joints and Eliminating Pain. Journal of Prolotherapy. 2011;3(2):630-638.13. Prolozone. Utah Valley Health Clinic. http://www.utahvalleyhealthclinic.com/services/prolozone/. Accessed 11/23/2015. 14. Prolotherapy. Beth Israel Deaconess Medical Center. http://www.bidmc.org/YourHealth/HolisticHealth/AlternativeTherapies.aspx?

ChunkID=21357. Last updated 9/2014. Accessed 11/23/2015. 15. Osteoarthritis. Centers For Disease Control and Prevention. http://www.cdc.gov/arthritis/basics/osteoarthritis.htm. Last updated

10/28/2015. Accessed 11/23/2015.

18 Question?

Thank you!