The effect of sclerotherapy and prolotherapy on chronic painful Achilles tendinopathy-a systematic review including meta-analysis.

Chronic painful Achilles tendinopathy (AT) is a common disorder among athletes. Sclerotherapy (ST) and prolotherapy (PT) are two promising options among the numerous other conservative therapies. As their efficacy and potential adverse effects (AE) are still unclear, we systematically searched, analyzed, and synthesized the available literature on ST and PT for treating AT. Electronic databases, Google Scholar and articles' reference lists were searched according to PRISMA guidelines. Eligibility criteria were set up according to the PICOS-scheme including human and animal studies. Three authors independently reviewed the results and evaluated methodological quality (Coleman Methodology Score and Cochrane Risk of Bias Assessment). The initial search yielded 1104 entries. After screening, 18 articles were available for qualitative synthesis, six of which were subjected to meta-analysis. The mean Coleman Score of the 13 human studies was 50. Four RCTs were ranked as having a low risk of selection bias. Three of those reported a statistically significant drop in the visual analog scale (VAS) score, one a significant increase in the VISA-A Score. 12 of 13 human studies reported positive results in achieving pain relief and patient satisfaction, whereas only one study's finding differed. Meta-analysis revealed an unambiguous result in favor of the intervention (weighted mean difference D=-4.67 cm, 95% CI -5.56 to -3.76 cm [P<.001]). Only one serious AE and two minor AEs were reported in the entire literature. This systematic review suggests that ST and PT may be effective treatment options for AT and that they can be considered safe. Long-term studies and RCTs are still needed to support their recommendation.

Neutron dose rate at the SwissFEL injector test facility: first measurements.

At the Paul Scherrer Institute, the new SwissFEL Free Electron Laser facility is currently in the design phase. It is foreseen to accelerate electrons up to a maximum energy of 7 GeV with a pulsed time structure. An injector test facility is operated at a maximum energy of 300 MeV and serves as the principal test and demonstration plant for the SwissFEL project. Secondary radiation is created in unavoidable interactions of the primary beam with beamline components. The resulting ambient dose-equivalent rate due to neutrons was measured along the beamline with different commercially available survey instruments. The present study compares the readings of these neutron detectors (one of them is specifically designed for measurements in pulsed fields). The experiments were carried out in both, a normal and a diagnostic mode of operation of the injector.