Treatment of lateral epicondylitis with platelet rich plasma or corticosteroid injection: A Short term Comparative study

BACKGROUND: Lateral epicondylitis is the commonest chronic disabling painful condition of the elbow. Elbow pain and tenderness with resisted wrist extension are common manifestations in lateral epicondylitis. Recent studies have suggested platelet rich plasma (PRP) to be a safe and effective therapy for tennis elbow. PURPOSE: To compare the effectiveness of single dose injection of autologus platelet rich plasma with corticosteroid injection in treatment of lateral epicondylitis and to measure the outcome in a short term follow up study. STUDY DESIGN: Randomized controlled trial METHODS: A total of 40 patients with lateral epicondylitis were treated at Coimbatore Medical Hospital, April 2014 to June 2014 over 3 months. All patients had minimum three months of symptoms. Randomization and allocation to the trial group were carried out by a lot method. The platelet rich plasma (PRP) was prepared from venous whole blood. After receiving a local anesthetic, all patients had single dose injection of autologus platelet rich plasma with corticosteroid injection in their extensor tendons at elbow. Patients received either an autologous platelet rich plasma injection or a corticosteroid injection through a peppering needling technique. The primary analysis included visual analog scale (VAS) pain scores and Disabilities of the Arm, Shoulder and Hand (DASH) outcome scores RESULTS: The PRP group was more often successfully treated than the corticosteroid group. When baseline VAS and DASH scores were compared with the scores at 12 weeks follow up, both groups showed improvement across time (intention-to-treat principle). However, the VAS and DASH scores of the corticosteroid group have not shown improvement, while those of the PRP group showed improvement at the end of 12 weeks (as treated principle). There were no complications related to the use of PRP. CONCLUSION: Treatment of patients with lateral epicondylitis with PRP reduces pain and increases function significantly, exceeding the effect of corticosteroid injection at the end of 12 weeks follow up. Future decisions for application of PRP for lateral epicondylitis should be confirmed by more number of patients and further follow up and should take into account possible costs and harms as well as benefits

On Nori's Fundamental Group Scheme

We determine the quotient category which is the representation category of the kernel of the homomorphism from Nori's fundamental group scheme to its \'etale and local parts. Pierre Deligne pointed out an error in the first version of this article. We profoundly thank him, in particular for sending us his enlightning example reproduced in Remark 2.4 2).Comment: 29 page

Seasonal and Temperature-Associated Increases in Gram-Negative Bacterial Bloodstream Infections among Hospitalized Patients

BACKGROUND: Knowledge of seasonal trends in hospital-associated infection incidence may improve surveillance and help guide the design and evaluation of infection prevention interventions. We estimated seasonal variation in the frequencies of inpatient bloodstream infections (BSIs) caused by common bacterial pathogens and examined associations of monthly BSI frequencies with ambient outdoor temperature, precipitation, and humidity levels. METHODS: A database containing blood cultures from 132 U.S. hospitals collected between January 1999 and September 2006 was assembled. The database included monthly counts of inpatient blood cultures positive for several clinically important Gram-negative bacteria (Acinetobacter spp, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa) and Gram-positive bacteria (Enterococcus spp and Staphylococcus aureus). Monthly mean temperature, total precipitation, and mean relative humidity in the postal ZIP codes of participating hospitals were obtained from national meteorological databases. RESULTS: A total of 211,697 inpatient BSIs were reported during 9,423 hospital-months. Adjusting for long-term trends, BSIs caused by each gram-negative organism examined were more frequent in summer months compared with winter months, with increases ranging from 12.2% for E. coli (95% CI 9.2-15.4) to 51.8% for Acinetobacter (95% CI 41.1-63.2). Summer season was associated with 8.7% fewer Enterococcus BSIs (95% CI 11.0-5.8) and no significant change in S. aureus BSI frequency relative to winter. Independent of season, monthly humidity, monthly precipitation, and long-term trends, each 5.6°C (10°F) rise in mean monthly temperature corresponded to increases in gram-negative bacterial BSI frequencies ranging between 3.5% for E. coli (95% CI 2.1-4.9) to 10.8% for Acinetobacter (95% CI 6.9-14.7). The same rise in mean monthly temperature corresponded to an increase of 2.2% in S. aureus BSI frequency (95% CI 1.3-3.2) but no significant change in Enterococcus BSI frequency. CONCLUSIONS: Summer season and higher mean monthly outdoor temperature are associated with substantially increased frequency of BSIs, particularly among clinically important gram-negative bacteria

New Methods in Tissue Engineering: Improved Models for Viral Infection

New insights in the study of virus and host biology in the context of viral infection are made possible by the development of model systems that faithfully recapitulate the in vivo viral life cycle. Standard tissue culture models lack critical emergent properties driven by cellular organization and in vivo–like function, whereas animal models suffer from limited susceptibility to relevant human viruses and make it difficult to perform detailed molecular manipulation and analysis. Tissue engineering techniques may enable virologists to create infection models that combine the facile manipulation and readouts of tissue culture with the virus-relevant complexity of animal models. Here, we review the state of the art in tissue engineering and describe how tissue engineering techniques may alleviate some common shortcomings of existing models of viral infection, with a particular emphasis on hepatotropic viruses. We then discuss possible future applications of tissue engineering to virology, including current challenges and potential solutions.Hertz Foundation (Fellowship)National Science Foundation (U.S.). Graduate Research FellowshipNational Institute of Diabetes and Digestive and Kidney Diseases (U.S.) (Grant DK085713)Skolkovo Institute of Science and Technology (Grant 022423-003

Organization and Running of the First Comprehensive Hereditary Cancer Clinic in India

Hereditary cancers are thought to account for around 5% of cancers, particularly breast/ovarian and colorectal cancers. In India there is a paucity of data on hereditary cancers and the mutations in some of the common genes linked to hereditary cancers, such as BRCA1, BRCA2, hMSH2 and hMLH1. The country's first comprehensive hereditary cancer clinic was established in February 2002. The article describes the organization and running of the Clinic. It also discusses some of the social issues relevant to the given population in running the Hereditary Cancer Clinic

Steinberg modules and Donkin pairs

We prove that in positive characteristic a module with good filtration for a group of type E6 restricts to a module with good filtration for a subgroup of type F4. (Recall that a filtration of a module for a semisimple algebraic group is called good if its layers are dual Weyl modules.) Our result confirms a conjecture of Brundan for one more case. The method relies on the canonical Frobenius splittings of Mathieu. Next we settle the remaining cases, in characteristic not 2, with a computer-aided variation on the old method of Donkin.Comment: 16 pages; proof of Brundan's conjecture adde

Uveitis Associated with Monogenic Autoinflammatory Syndromes in Children

Monogenic autoinflammatory syndromes (MAISs), are caused by pathogenic genetic variants in the innate immune system, leading to dysregulation and aberrant inflammasome activation spontaneously or with minimal triggering. The diagnosis and treatment of MAISs can be intricate, relying on an increased recognition of potential differential diagnoses. This review examines the clinical features of MAIS, with a special focus on uveitis. It also evaluates treatment options and assesses the effects of activating molecular and cytokine pathways