Platelet-Rich Plasma vs Prolotherapy in the Management Of Knee Osteoarthritis: Randomized Placebo-Controlled Trial

Objective: Osteoarthritis (OA) is an age-dependent disease caused by degenerative and healing processes in subchondral tissue of articular and bone cartilage, resulting in an alteration of its biomechanical properties that eventually causes pain, stiffness, and decreased articular function. The aim of this study is to compare the in vivo the efficacy of platelet-rich plasma (PRP) and prolotherapy with that of placebo in the treatment of knee osteoarthritis(OA). Materials and Methods: From January 2015 to September 2015, 100 consecutive patients who had a history of chronic (>3 months) pain or swelling radiographically documented grades I to III gonarthrosis (graded according to the Kellgren–Lawrence classification scale for tibiofemoral joint degeneration) were enrolled. The exclusion criteria included severe OA (grade IV according to the Kellgren–Lawrence classification (22)), received an intra-articular injeciton of hyalurinic acid agents within 6 months, previous lower extremity surgery, systemic disorders (diabetes, rheumatic diseases, severe cardiovascular diseases, haematological diseases, infections), presence of any concomitant knee lesion causing pain or swelling. In this randomized placebo-controlled clinical trial patients with knee osteoarthritis were randomly assigned into 3 groups: participants in Group 1 received prolotheraphy, participants in Group 2 received intra-articular injections of PRP and participants in Group 3 received saline injection. Demographic findings and Western Ontario and McMaster Universities arthritis index (WOMAC) were recorded before each injection and 3 and 6 months after the first injection. Results: Group 1 comprised 20 patients with a mean age 66,00±5,79, Group 2 comprised 18 patients with a mean age 64,16±6,36 and Group 3 comprised 20 patients with a mean age 62,00±6,46. Groups were similar in terms of age, gender and body mass index (p>0,05). Baseline total WOMAC scores and WOMAC subscales of the groups were also similar (p>0,05). Although total WOMAC scores and WOMAC subscales improved in Group 1 and Group 1 after treatment, none of these improvements reached statistical significance (p>0,05). Moreover, post-treatment total WOMAC scores and subscales of WOMAC were similar in all groups (p>0,05). Conclusion: Our findings does not support the use of PRP or prolotherapy as a first- or second-line treatment for knee OA

Duplication of the mandible in Klippel-Feil syndrome

The duplication of the mandible is an extremely rare case, which was first described by McLaughlin in 1948 as a case report of duplication of the mouth, the tongue and the mandible. Betty in 1956 and Davies in 1973 reported similar cases. The duplication of the mandible may be associated with the Klippel-Feil syndrome (KFS). A low hairline, short neck with cervical vertebral fusion and painless limitation of the head movement are the characteristic findings of this syndrome. The incidence of the syndrome varies from 1/30,000 to 1/40,000. Although autosomal recessive inheritance was suggested, no familial inheritance was found in some cases. A very rare case of mandibular duplication in association with KFS, whose duplicated mass was removed following distraction, has been reported. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved

Management of palatal fistulas and a simple surgical algorithm proposal

Objectives: Despite improved techniques in repair of cleft palate, failure of healing of palatal structures resulting in a palatal fistula is one of the major challenges in the practice of reconstructive surgery. The aim of this study is to evaluate treatment success and failure in patients with palatal fistulas following cleft palate repair. Patients and Methods: Totally 44 patients with a history of cleft palate who underwent surgery for palatal fistula were included in this study undertaken between January 1999 and August 2014. Fistulas were classified as anterior and posterior according to the repair technique and were repaired using one of the following techniques: buccal mucosal flap, tongue flap or mucoperiosteal flap. Results: Success rate for anterior fistulas was 71.42% with tongue flap and 76.92% with mucoperiosteal flap. Success rate for posterior fistulas was 84.62% with mucoperiosteal flap and 75% with buccal mucosal flap. Difference in success rates between the anterior and posterior fistulas was not statistically significant. Conclusion: Our study results suggest the use of mucoperiosteal flaps for both anterior and posterior fistulas smaller than 5mm as the first choice, guided by the principle of replacing absent tissue with similar tissue

Determination of Friction Coefficient at Journal Bearings by Experimental and by Means of Artificial Neural Networks Method

Knowing friction coefficient is important for determination of wear loss conditions at journal bearings. Tribological events that influence wear and its variations affect experimental results. In this study, friction coefficient at CuSn10 Bronze radial bearings has been determined by a new approach as experimental and artificial neural networks method. In experiments, effects of bearings have been examined at dry and lubricated conditions and at different loads and velocities

Evaluation of residual tumors and recurrence rates of malignant melanoma and non-melanoma skin cancer of head and neck region

Objective: In this study, we aimed to evaluate residual tumors and recurrence rates of malignant melanoma (MM) and a nonmelanoma skin cancer of (NMSC) head and neck region. Patients and Methods: Medical data of a total of 398 lesions of 323 patients who underwent surgical excision for a basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) were retrospectively analyzed. All patients were classified according to age, sex, location of the tumor, histopathological diagnosis, lesion diameter, excision diameter, surgical margin status, and residual lesions and recurrence rates. Results: There were 244 lesions (61.3%) in 189 males and 154 lesions (38.7%) in 134 females. The most common type of skin cancer was BCC in 268 lesions (67%), followed by SCC in 122 (31%), and MM in eight (2%), respectively. Recurrence was seen in 3% of the NMSC cases and in 25% of the MM cases. There was a statistically significant correlation between the histopathological diagnosis and recurrence rates. Compared to NMSC, MM cases had a higher risk for recurrence (p=0.029). Conclusion: Our study results suggest that recurrence is associated with the localization and type of the tumor, but not with the age or sex of the patient

Acute Liver Failure and Hepatic Encephalopathy After Cleft Palate Repair

Paracetamol is the most commonly used analgesic after cleft palate repair. It has rarely caused acute hepatic failure at therapeutic or supratherapeutic doses. Only one case of therapeutic paracetamol toxicity after cleft palate repair had been reported previously. Here, we present a similar patient who developed acute liver failure and hepatic encephalopathy after an uncomplicated cleft palate surgery. Lack of large prospective trials in young children due to ethical concerns increases the value of the case reports of acetaminophen toxicity at therapeutic doses. The dosing recommendations of paracetamol may need to be reconsidered after cleft palate surgery

Implant Stability Outcomes After Immediate and Delayed Revascularized Free Fibula Flaps: A Preliminary Comparative Study

Purpose: This pilot study investigated the retrospective outcomes of implants placed immediately or with a delayed protocol in revascularized free fibula flaps (FFF). Materials and Methods: Patients undergoing FFF between 2014 and 2017 were included in the study. Implants were inserted either immediately or 23.63 +/- 10.61 months after reconstructive surgery. Resonance frequency analyses were recorded at the time of implant placement (first control) and 4 months postoperatively while uncovering and screwing the gingiva formers (second control). The statistical significance level was set at P .05). Conclusion: High stability scores similar to alveolar bone could be achieved by both immediate and delayed implant placement. Bicortical implantation results in better implant stability