Effect of the low-intensity pulsed ultrasound therapy on healing of Achilles tendinopathy in a rat model.

OBJECTIVE:  This study aimed to investigate the effect of the low-intensity pulsed ultrasound (LIPUS) on the healing of Achilles tendinopathy in a rat model induced by type 1 collagenase. METHODS:  The study was conducted on 144 Achilles tendons of 72 Wistar albino female rats with typical activity and weighing 300-350 g. The model of Achilles tendinopathy was created by injecting type 1 collagenase. According to the sampling time, 4 groups served as the control group, while 8 groups received treatment at varying periods. Low-intensity pulsed ultrasound therapy was initiated in 8 groups at 1, 7, and 15 days. Treatment was extended for 1 and 2 weeks. Achilles tendons were removed from the treatment and control groups on the 15th, 21st, 30th, and 45th days for biomechanical and pathologic examination. RESULTS:  Compared to the control groups, LIPUS treatment administered in the first days of the proliferation phase increased tensile strength by approximately 30%, modulus of elasticity by approximately 53%, fibrillar appearance by 53%, and inflammation by 53%-33% in a shorter time. It was also demonstrated that starting treatment in the first days of the proliferation phase resulted in comparable success even with 1-week treatment compared to 2-week treatment. CONCLUSION:  Low-intensity pulsed ultrasound therapy can provide positive results in managing Achilles tendinopathy in the rat model. Its capacity to shorten recuperation time has piqued the interest of conservative treatment approaches. As a result, more clinical research is required. Cite this article as: Kurtulmus T, Çelebi ME, Bektas E, Arican ÇD, Kucukyildirim BO, Demirkol M. Effect of the low-intensity pulsed ultrasound therapy on healing of Achilles tendinopathy in a rat model. Acta Orthop Traumatol Turc., 2024;58(2):102-109.

Investigation of the pressure value while performing biceps tenodesis for superior capsuler reconstruction.

BACKGROUND: To compare the histopathological results of biceps tenodesis (BT) performed with normal, low, and high pressures for superior capsule reconstruction (SCR) in rabbits with massive rotator cuff tears. MATERIALS AND METHODS: Thirty rabbits were divided into three groups. Rabbits 1-10 underwent SCR with BT at the same pressure (Group 1), value measured in the groove; 50% lower (Group 2); 50% higher (Group 3). After the 4-week follow-up, shoulder were en-bloc excised and histopathological evaluation was performed with modified Bonar's scale. Results were compared between the groups, statistically. RESULTS: Extracellular matrix were significantly lower in group 2 compared to the other groups (p < 0.05). Cellularity levels were significantly lower in group 2 compared to the other groups (p < 0.05). Group 2 had no difference between the sides (p > 0.05). Group 2 had lower vascularity levels compared to the other groups (p = 0.01). DICSUSSION: When the biceps tendon was in the bicipital groove and in a more mobile state with lower pressure exposure. BT performed with a tension that creates less pressure than the biceps in the groove is more successful in SCR.

Clinical Features and Follow-Up of Prurigo Pigmentosa: A Case Series.

Introduction Prurigo pigmentosa (PP) is an underrecognized disease in the Western population. Our aim is to describe the clinical features and follow-up outcomes of Caucasian patients diagnosed with PP. Methods This case series was conducted in the dermatology outpatient clinic of a tertiary hospital. Patients with confirmed PP from May 2020 to June 2021 were included in the study. Patient demographics, clinical features, potential triggers, treatment and follow-up data were recorded. Results A total of eight patients with female predominance were identified. The mean age of the patients was 24.5. The duration of symptoms ranged from four days to six months. All patients presented with pruritic, papular or papulovesicular lesions. Net-like hyperpigmentation was also present at the initial visit in two patients, in whom the duration of the symptoms was the longest. Lesions were most commonly located on the chest and back. Six of eight patients reported alteration of diet that potentially led to ketosis. Doxycycline 200 mg daily for two weeks led to a complete response in all six medically treated patients. Duration of follow-up ranged from 1-14 months (mean: 7.2 months). In five patients with a follow-up duration of more than three months, postinflammatory hyperpigmentation was resolved without any treatment. Only one patient had a recurrence. Conclusion PP does not seem to be a rare disease. Young women are most commonly affected, and ketosis stemming from decreased calorie intake may be the etiological factor in the majority of the patients. Dermatologists should be familiar with early signs of PP in order to minimize unnecessary therapies, recurrences and long-lasting hyperpigmentation.

The effects of COVID-19 pandemic on patients with acute appendicitis.

BACKGROUND: The effects of the COVID-19 infection on the world's health system began to be reported in a short time, with the spread of the infection all over the world and it gained a global acceptance as a pandemic. It was predicted that patients who require urgent surgical procedures may not be able to access appropriate treatment during this period and may suffer from this process. In this process, we planned to report the effects of the pandemic process to this patient group by evaluating patients with acute appendicitis, which is the most common cause of acute abdomen among general surgery emergencies. METHODS: In our study, we compared the patients who applied to the Training and Research Hospital we collaborated, whose clinics were compatible with acute appendicitis, between March 11, 2020, and May 21, 2020, with those applied within the same time period with the year before. We evaluated clinical and pathological findings of the patients and the treatment applied. RESULTS: In this study, there were 103 patients diagnosed with acute appendicitis before pandemic and 61 in pandemic period. We found that during the pandemic period, patients with acute appendicitis were admitted to the hospital less often, and in a later period, and more complicated clinical pictures were determined. Complicated appendicitis patients were higher in pandemic period compared with previous year (33.96% vs. 8.00% of patients, respectively; p<0.05). CONCLUSION: We emphasized that diseases that need to be treated urgently should not be left behind during the pandemic. Furthermore, we shared our clinical practice to ensure early discharge of patients with acute appendicitis during the pandemic process.