Platelet rich plasma injection grafts for musculoskeletal injuries: a review

In Europe and the United States, there is an increasing prevalence of the use of autologous blood products to facilitate healing in a variety of applications. Recently, we have learned more about specific growth factors, which play a crucial role in the healing process. With that knowledge there is abundant enthusiasm in the application of concentrated platelets, which release a supra-maximal quantity of these growth factors to stimulate recovery in non-healing injuries. For 20 years, the application of autologous PRP has been safely used and documented in many fields including; orthopedics, sports medicine, dentistry, ENT, neurosurgery, ophthalmology, urology, wound healing, cosmetic, cardiothoracic, and maxillofacial surgery. This article introduces the reader to PRP therapy and reviews the current literature on this emerging treatment modality. In summary, PRP provides a promising alternative to surgery by promoting safe and natural healing. However, there are few controlled trials, and mostly anecdotal or case reports. Additionally the sample sizes are frequently small, limiting the generalization of the findings. Recently, there is emerging literature on the beneficial effects of PRP for chronic non-healing tendon injuries including lateral epicondylitis and plantar fasciitis and cartilage degeneration (Mishra and Pavelko, The American Journal of Sports Medicine 10(10):1–5, 2006; Barrett and Erredge, Podiatry Today 17:37–42, 2004). However, as clinical use increases, more controlled studies are needed to further understand this treatment

Integrated climate-chemical indicators of diffuse pollution from land to water

Management of agricultural diffuse pollution to water remains a challenge and is influenced by the complex interactions of rainfall-runoff pathways, soil and nutrient management, agricultural landscape heterogeneity and biogeochemical cycling in receiving water bodies. Amplified cycles of weather can also influence nutrient loss to water although they are less considered in policy reviews. Here, we present the development of climate-chemical indicators of diffuse pollution in highly monitored catchments in Western Europe. Specifically, we investigated the influences and relationships between weather processes amplified by the North Atlantic Oscillation during a sharp upward trend (20102016) and the patterns of diffuse nitrate and phosphorus pollution in rivers. On an annual scale, we found correlations between local catchment-scale nutrient concentrations in rivers and the influence of larger, oceanic-scale climate patterns defined by the intensity of the North Atlantic Oscillation. These influences were catchment-specific showing positive, negative or no correlation according to a typology. Upward trends in these decadal oscillations may override positive benefits of local management in some years or indicate greater benefits in other years. Developing integrated climate-chemical indicators into catchment monitoring indicators will provide a new and important contribution to water quality management objectives

The Beast from the East: impact of an atypical cold weather event on hydrology and nutrient dynamics in two Irish catchments

peer-reviewedA historic lack of continuous stream nutrient monitoring at the catchment scale limits understanding of the effects of snowstorms. The most significant snowstorm since 1985, nicknamed “the Beast from the East”, occurred in February–March 2018. High-frequency stream outlet monitoring in two close but hydrologically and agriculturally contrasting catchments (<1,200 ha) captured phosphorus (total and reactive), total oxygenated nitrogen (TON), temperature and discharge dynamics during and after the event. The grassland catchment consists of poorly drained gley soils and exhibits overland flow pathways, while the arable catchment consists of well-drained brown earths and is dominated by subsurface pathways. Nitrate (NO3-N) concentrations were initially elevated (3.50 and 7.89 mg/L for poorly drained grassland and well-drained arable catchments, respectively) before becoming diluted by meltwater. Total reactive phosphorus (TRP) displayed a distal (anti-clockwise) concentration-discharge hysteresis in the poorly drained grassland catchment suggesting low mobilisation from the soil. Conversely, the well-drained arable catchment displayed proximal (clockwise) hysteresis, indicative of the mobilisation from stream and bank sediment. These relatively infrequent snow events behave similarly to heavy rainfall as regards nutrient losses, albeit subject to a time-lag induced by the speed of snowmelt and the soil moisture deficit (SMD) prior to snowfall. Antecedent land management is crucial to mitigate risk. The current absence of records and analyses of catchment response, particularly nutrient dynamics, to atypical cold weather events in Ireland limits understanding of their effects on water quality. The present study provides the first such baseline information from which land management strategies and the implications for attaining environmental targets can be explored

Student perceptions of the education environment in a Spanish medical podiatry school

Abstract Background The aim of this study was to explore students’ perceptions of the educational environment (EE) in a Spanish school of podiatry. Various aspects of EE were compared by academic year in the program. Methods This was a cross-sectional study using a questionnaire to collect perceptions using data from a 2015 survey. Podiatric medical students from Extremadura University participated in this study. EE was assessed with the Dundee Ready Education Environment Measure (DREEM) tool. The DREEM questionnaire covers five domains of student perceptions, including learning, teachers, academic self-perceptions, atmosphere, and social self-perceptions. Results Two hundred thirty-five students participated, resulting in a 90.73% response rate. Participants included similar numbers of students from different years in the program, and most were women. The global EE score was 2.58 out of 4, indicating that students’ perceptions were more positive than negative. Although some weaknesses were detected in this school, students viewed the EE positively in all five DREEM domains. Academic year in the program were generally not related to perceptions of EE. Conclusions Podiatric medical students declared, in general, that the EE was more positive than negative in our school, according to the DREEM questionnaire. However, although the results are on the whole good, some areas need to be revised to make improvements