Thermal balneotherapy in Antsirabe-Madagascar: water analysis and its applications in an African context.

The Orthopaedic Rehabilitation Centre of Madagascar can be found in the city of Antsirabe. The health care facility is equipped with 2 thermal sources of bicarbonate water used for post-operative rehabilitation and for the ailment of chronic degenerative illnesses. The aim of this study, which derives from the cooperation between the School of Specialization in Thermal Therapy of the University of Parma and Antsirabe Orthopaedic Hospital, is to analyze the real properties of thermal waters utilized in this centre and to do an overview of its possible applications in this particular African context.

Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection.

BACKGROUND: Platelet-rich plasma is being used more frequently to promote healing of muscle injuries. The growth factors contained in platelet-rich plasma accelerate physiological healing processes and the use of these factors is simple and minimally invasive. The aim of this study was to demonstrate the efficacy of ultrasound-guided injection of platelet-rich plasma in muscle strains and the absence of side effects. MATERIALS AND METHODS: Fifty-three recreational athletes were enrolled in the study. The patients were recruited from the Emergency Room in the University Hospital at Parma according to a pre-defined protocol. Every patient was assessed by ultrasound imaging to evaluate the extent and degree of muscle injuries. Only grade II lesions were treated with three ultrasound-guided injections of autologous platelet-rich plasma every 7 days. Platelet concentrate was produced according to standard methods, with a 10% variability in platelet count. The platelet gel for clinical use was obtained by adding thrombin to the concentrates under standardised conditions. Outcomes assessed were: pain reduction, muscle function recovery and return to sports activity, ultrasound-imaging tissue healing, relapses, local infections, and any side effect during the treatment. RESULTS: In all cases muscle lesions healed fully on ultrasound-imaging, the pain disappeared, and muscle function recovery was documented with a return to sports activity. A single patient had a relapse 1 year after treatment. DISCUSSION: Platelet-rich plasma injected into the injury site is one of the most important factors rendering the treatment effective. To maximise its efficacy the preliminary ultrasound must be done accurately to localise the lesion and guide the needle into the corresponding lesion. According to the current results, which document full muscle recovery and no relapse except for one case, platelet-rich plasma ultrasound-guided injection represents a valid mini-invasive treatment for muscle injuries.

Treatment of wrist and hand fractures with natural magnets: preliminary report.

The Authors, after having defined the phenomenon and the biological characteristics of natural magnets, evaluate their ability in accelerating the formation of bone callus in hand and wrist fractures compared to treatment with immobilization in a plaster cast. Forty patients (4 females and 37 males) between 20 and 86 years of age were treated. A small natural magnet was inserted in each of the plaster casts (diameter: 2cm, height: 0.5cm) made of 4 blocks in Neodymium-Iron-Boron, capable of generating 4 magnetic poles (2 positive and 2 negative) of diagonal alternate polarity that produced a symmetric, quadruple static magnetic field. The created magnetic flow was wavelike, concentrated in one direction, and developed a force up to 12,500 gauss. From this study it has emerged that inserting a quadruple magnet in a plaster cast in hand and wrist fractures results in the formation of bone callus in an average time that is 35% inferior to the "standard" time. Accelerating the healing of the fracture is important since it reduces immobilization time for the joints involved, avoiding subsequent weakness and stiffness and allowing the patient to begin rehabilitative physiotherapy sooner, which permits a faster functional recovery.

Cryoultrasound therapy and tendonitis in athletes: a comparative evaluation versus laser CO2 and t.e.ca.r. therapy.

Aim of this study is to compare the different kinds of tendonitis in athletes using cryoultrasound therapy, lasertherapy CO2 and t.e.ca.r. therapy (transfert energetic capacitive and resistive). Forty five athletes were selected; they were all affected by severe insertional tendonitis of the Achilles tendon (15 of them), of the patellar tendon (15 of them) and of the epicondylar region (15 of them) during the last two months. They were divided into three groups. The first group underwent a treatment of 12 lasertherapy CO2 sessions, the second group 12 cryoultrasound therapy sessions and the last group 12 t.e.ca.r. therapy sessions. Each patient was registered by an independent observer according to the pain before (initial V.A.S.) and after treatment (final V.A.S.) using the analogic visual range from 0 (lack of pain) to 10 (unbearable pain) and the indicator of efficacy (difference between initial V.A.S. and final V.A.S./initial V.A.S.x 100). The obtained results were expressed as a difference between the two V.A.S. values and as a parameter of effectiveness (value ranging from 0 to 100) in order to correlate the initial condition of the patients with the performed physiotherapic treatment. The obtained V.A.S. score was submitted to statistic evaluation by analysis of variance through repeated measures, taking into consideration a value of p<0.05. Possible differences among the group of patients were shown by analysis of variance through one single way by comparison among groups. Every patient benefited from the treatment. Analyzing the initial and final V.A.S. values in the three groups, statistically significant variations emerged (p<0.05). A meaningful difference resulted among the different kinds of treatment; a marked difference was noticed between laser CO2 and cryoultrasound therapy (p<0.01). No statistically significant differences were observed between t.e.ca.r. and laser CO2 therapy or between t.e.ca.r. and cryoultrasound therapy. It must be admitted that the mean difference between initial and final V.A.S. is higher in the Cryoultrasound group (7.40), than in the Laser group (6.33) compared to t.e.ca.r. group (6.74). This result would explain a higher range of effectiveness in the Cryoultrasound group (85) compared to the laser CO2 (71.9 ) and t.e.ca.r. group (77.3). It can be asserted that cryoultrasound is a useful instrument for the physician working in the sports field. It offers advantages in comparison with laser CO2. It does not show significant differences with t.e.ca.r. therapy, although it shows a better mean range of effectiveness.