Platelets-rich-plasma in management of non operative post cruciate ligament injury.

Posterior cruciate ligament (PCL) injury is a rare ligamentous knee injury which most commonly occurs due to direct trauma; it represents only 0.65% of knee injuries. On the basis of magnetic resonance imaging (MRI), PCL injury is divided into surgical and non-surgical. In the last few years we have witnessed an increasing interest in regenerative medicine. The use of innovative techniques allow the reduction of rehabilitation times in sports injuries. Platelet-Rich-Plasma (PRP) is a plasma-derived which stimulate the tissue repair. The objective of our work is to compare the rehabilitation times in PCL non-operative injuries treated with standard conservative treatment and PCL injuries treated with autologous PRP followed by rehabilitation program. We divided patients into two different groups: Group A formed by patients who underwent a standard conservative rehabilitation program and Group B which included patients treated by ultrasound guided PRP injection and following physiotherapy program. Both groups of patients resumed sports activities; however the rehabilitation times for patients which had undergone treatment with autologous PRP injection were reduced compared to patients who underwent a standard conservative treatment.

Influence of a Specific Aquatic Program on Social and Gross Motor Skills in Adolescents with Autism Spectrum Disorders: Three Case Reports.

Swimming pool activities revealed to be efficacious to train psychomotor skills and increase adaptive behaviors in children with Autism Spectrum Disorders (ASD). Therefore, the purpose of this study was to investigate the efficacy of a specific multi-systemic aquatic therapy (CI-MAT) on gross motor and social skills in three adolescents with Autism Spectrum Disorders (ASD). METHODS: three adolescents with ASD of which two boys (M1 with a chronological age of 10.3 years and a mental age of 4.7 years; M2 with a chronological age of 14.6 and a mental age inferior to 4 years) and one girl (chronological age of 14.0 and a mental age inferior to 4 years). The study was divided into three phases: baseline, 12-week CI-MAT program and Post-Test. Participants were administered a battery of tests incorporating anthropometric measurements, gross motor development test and a social skills questionnaire before and after a 12-week MAT-CI program. RESULTS: Subjects improved locomotors and object control skills following the CI-MAT program in a different way. Concerning social behaviors, the higher proportion of gains was observed in the sensitivity of other's presence and eye contact, for the contact domain, and in the comply turn for the relationship domain. CONCLUSIONS: The results of this study showed that the CI-MAT program was effective for the development of gross-motor skills and social behaviors in subjects with ASD. Moreover there is an urge to carry out a whole psychological assessment targeting both motor and adaptive development suitable to provide educational and vocational plans of exercises for people with ASD.

α-Lipoic acid and superoxide dismutase in the management of chronic neck pain: a prospective randomized study.

BACKGROUND AND OBJECTIVE: Since oxidative stress plays a pathogenetic role in chronic neck pain (CNP), we investigated whether a combination of α-lipoic acid (ALA) and superoxide dismutase (SOD) might improve pain control and the efficacy of physiotherapy ("multimodal therapy") in patients with CNP. SETTING: This study was conducted in the Rehabilitation Unit of the Department of Surgical and Oncological Sciences at the University Policlinic in Palermo, Italy. DESIGN AND PATIENTS: This was a prospective, randomized, open study in outpatients. INTERVENTION: Patients randomly received either physiotherapy alone (group 2; n = 45) or a combination of ALA 600 mg and SOD 140 IU daily in addition to physiotherapy (group 1; n = 51), for 60 days. Pain was assessed by a visual analogue scale (VAS) and a modified Neck Pain Questionnaire (mNPQ). Treatment compliance and safety were also evaluated. RESULTS: Both groups experienced a significant reduction in the VAS and mNPQ scores after 1 month; however, while no further improvement was observed in group 2 at 60 days, group 1 showed a further VAS reduction (p < 0.001). In addition, in the mNPQ at 60 days, more patients in group 1 than in group 2 reported that their neck pain was improved (p < 0.01), and they showed greater compliance with prescribed physiotherapy (p = 0.048). No drug reaction was observed. CONCLUSION: Use of ALA/SOD in combination with physiotherapy may be a useful approach to CNP, being antioxidants that act on nerve inflammation and disease progression. CLINICAL REHABILITATION IMPACT: These preliminary observations suggest that some interesting goals (better pain control and physical wellbeing) can be achieved by multimodal therapy in CNP patients.

Pulmonary langerhans cell histiocytosis (histiocytosis X) on bronchoalveolar lavage: a report of 2 cases.

BACKGROUND: Pulmonary Langerhans cell histiocytosis (PLCH) is an interstitial lung disease characterized by bilateral nodular and cystic lesions. Clinically it seems to be a reactive process related to cigarette smoking. CASES: In 2 cases of PLCH, cytologic and immunocytochemical evaluation of bronchoalveolar lavage (BAL) fluid was successfully used for the diagnosis of PLCH. Two heavy smokers complained of fever, cough and debilitation. Serologic and hematologic values were normal. In both cases radiography and computed tomography (CT) were similar, showing multiple bilateral nodular or cystic lesions in the middle and upper lung zones. Cytospins obtained from BAL were Papanicolaou and May-Grünwald-Giemsa stained; others were immunostained with cytokeratin cocktail, CD1a and S-100. Cytospins showed a monomorphous and dispersed cell population consisting ofmononucleated or binucleated and occasionally multinucleated histiocytes. Single cells showed wide, well-defined, acidophilic cytoplasm and oval or kidney-shaped, vesicular nuclei with irregular shapes, evident nucleoli and frequent grooves and indentations. Immunocytochemical staining showed diffuse cytoplasmic positivity for S-100 and CD1a and negativity for cytokeratin; only the few cylindrical cells present in the cytospins were positive for cytokeratin. In both cases the cytologic diagnosis of PLCH was confirmed by subsequent CT and clinical follow-up. CONCLUSION: Cytologic and immunocytochemical evaluation of BAL fluid permits a definitive diagnosis of PLCH. This cytologic diagnosis is clinically relevant because it permits surgical biopsy to be bypassed and allows waiting for a possible spontaneous or pharmacologic resolution.