Exercise Induced Muscle Damage May Be Improved by a Single Dose of Intra-Muscular Platlet Rich Plasma- A Pilot Study

Platelet-rich plasma (PRP) is being increasingly used in the modern medicine as a material stimulating, regenerating and accelerating tissue healing, including muscle injuries in sports. The aim of the present study was to determine the effect of PRP on strength recovery in exercise induced muscle damage (EIMD). A baseline value was established in six healthy male volunteers during maximal voluntary strength isometric contractions (MVC) of the elbow flexors in both arms. This was followed by MVC performance (80% IRM) concentric-eccentric exercise of both elbow flexors until point of exhaustion, and 24 h later the subjects were injected with PRP in the non-dominant arm (PRP-arm). Maximal isometric strength and muscle soreness was compared before and at 24, 48, 72 and 96 h after delayed onset muscle soreness (DOMS) between the arms. The results indicate that the muscle soreness was significantly decreased in PRP administered arm when compared to control-arm, however, the levels for isometric flexors peak torque (PT) and average strength (AS) significantly declined in the bout arm post exercise induced muscle damage. Administration of PRP had no effect on the muscle strength parameters, however, flexor PT values were higher in PRP administered arm compared to the control arm, but this was only achieved on the second day of post-exercise induced muscle damage

Which Implant Is Better for Treating Reverse Obliquity Fractures of the Proximal Femur: A Standard or Long Nail?

WOS: 000322879800010PubMed ID: 23564362Reverse obliquity fractures of the proximal femur have biomechanical characteristics distinct from other intertrochanteric fractures and high implant failure rate when treated with sliding hip screws. Intramedullary hip nailing for these fractures reportedly has less potential for cut-out of the lag screw because of their loadbearing capacity when compared with extramedullary implants. However, it is unclear whether nail length influences healing. We compared standard and long types of intramedullary hip nails in terms of (1) reoperation (fixation failure), (2) 1-year mortality rate, (3) function and mobility, and (4) union rate. We conducted a pilot prospective randomized controlled trial comparing standard versus long (a parts per thousand yen 34 cm) intramedullary hip nails for reverse obliquity fractures of the proximal femur from January 2009 to December 2009. There were 15 patients with standard nails and 18 with long nails. Mean age was 79 years (range, 67-95 years). We determined 1-year mortality rates, reoperation rates, Parker-Palmer mobility and Harris hip scores, and radiographic findings (fracture union, blade cut-out, tip-apex distance, implant failure). Minimum followup was 12 months (mean, 14 months; range, 12-20 months). We found no difference in reoperation rates between groups. Two patients (both from the long-nail group) underwent revision surgery because of implant failure in one and deep infection in the other. There was no difference between the standard- and long-nail groups in mortality rate (17% versus 18%), Parker-Palmer mobility score (five versus six), Harris hip score (74 versus 79), union rate (100% in both groups), blade cut-out (zero versus one), and tip-apex distance (22 versus 24 mm). Our preliminary data suggest reverse obliquity fractures of the trochanteric region of the femur can be treated with either standard or long intramedullary nails

Absolute compartment pressure versus differential pressure for the diagnosis of compartment syndrome in tibial fractures

We studied 39 patients with 42 diaphyseal tibial fractures in whom we suspected a high risk for the development of a compartment syndrome. We measured the anterior absolute compartment pressure (ACP) every 12 h for 72 h and also recorded the differential pressure (ΔP=diastolic blood pressure−ACP). Fasciotomy of the extremity was only performed when the differential pressure was less than 30 mmHg for more than 30 min. The highest values of the ACP were recorded between 24 h and 36 h after admission. Three fractures had a differential pressure less than 30 mmHg and all were treated by fasciotomy. In three fractures the ACP was equal to or higher than 50 mmHg, of which two had a differential pressure less than 30 mmHg. The patients were followed up for a mean of 36 months (29–45). All fractures healed, and none of our patients showed any sequelae of compartment syndrome at their last review

Clinical and molecular evaluation of MEFV gene variants in the Turkish population: a study by the National Genetics Consortium

Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with recurrent fever, abdominal pain, serositis, articular manifestations, erysipelas-like erythema, and renal complications as its main features. Caused by the mutations in the MEditerranean FeVer (MEFV) gene, it mainly affects people of Mediterranean descent with a higher incidence in the Turkish, Jewish, Arabic, and Armenian populations. As our understanding of FMF improves, it becomes clearer that we are facing with a more complex picture of FMF with respect to its pathogenesis, penetrance, variant type (gain-of-function vs. loss-of-function), and inheritance. In this study, MEFV gene analysis results and clinical findings of 27,504 patients from 35 universities and institutions in Turkey and Northern Cyprus are combined in an effort to provide a better insight into the genotype-phenotype correlation and how a specific variant contributes to certain clinical findings in FMF patients. Our results may help better understand this complex disease and how the genotype may sometimes contribute to phenotype. Unlike many studies in the literature, our study investigated a broader symptomatic spectrum and the relationship between the genotype and phenotype data. In this sense, we aimed to guide all clinicians and academicians who work in this field to better establish a comprehensive data set for the patients. One of the biggest messages of our study is that lack of uniformity in some clinical and demographic data of participants may become an obstacle in approaching FMF patients and understanding this complex disease