Ultrasound-Guided Autologous Platelet-Rich Plasma Injections Versus Focal Ultrasound-Guided Extracorporeal Shockwave Therapy for Plantar Fasciitis in Athletes and Nonathletes: A Retrospective Comparative Study With Minimum 2-Year Follow-Up.

Plantar fasciitis is often cause of heel pain, especially in sporting-related activities. Different conservative measures for the management of plantar fasciitis were compared in several researches. The purpose of this retrospective study was to evaluate and compare clinical outcomes of chronic plantar fasciitis treated with ultrasound-guided platelet-rich plasma (PRP) and focal ultrasound-guided extracorporeal shockwave therapy (ESW). Secondarily, results on subpopulation of athletes were recorded. Fifty-five patients treated for plantar fasciitis were included, 24 among them were competitive or recreational athletes. Treatment outcomes were assessed using Visual Analog Scale and Foot Function Index before and after treatment. Time to return to sport among patients practicing sporting activities was recorded. Before treatment, no differences were observed between groups in terms of age, gender, body mass index, and months of follow up. From baseline to final follow-up assessment, significant improvement was observed in all the outcomes measures. The subgroup analysis showed no differences between patients stratified for type of treatment and sport/nonsport practitioners. The overall failure rate was higher, although not significant, in patients who underwent ESW therapy and they required a higher number of orthopedic visits. Among sports practitioners the mean time to return to sport (months) was faster in PRP group than ESW group (p = .044). PRP and ESW represent both reliable solutions for plantar fasciitis leading to good results in terms of patients' satisfaction, pain, and clinical outcomes. However, after treatment with PRP injections less recurrences in overall population and faster return to sporting activities in sports practitioners were observed.

Efficacy of Autologous Platelet-Rich Plasma Injections for Grade 3 Symptomatic Degenerative Meniscal Lesions: A 1-Year Follow-up Prospective Study.

BACKGROUND: Platelet-rich plasma (PRP) injections have been proposed as a biologic option to provide symptomatic relief and delay surgery in patients with degenerative joint disease of osteoarthritis (OA). The efficacy of autologous PRP on symptomatic degenerative meniscal lesions (DMLs) has never been investigated. HYPOTHESIS: We hypothesized that patients with symptomatic DMLs without OA undergoing autologous PRP injections experience a significant clinical improvement at 12 months. STUDY DESIGN: Prospective case series. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 69 patients with symptomatic DMLs without radiographic evidence of knee OA (Kellgren-Lawrence radiographic grading scale 0-1) received 4 autologous PRP injections once a week. Patients were prospectively evaluated before the injection and then at 1, 3, 6, and 12 months. Evaluation was based on Lysholm knee scoring scale (primary outcome), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Tegner activity scale, and visual analogue scale scores. RESULTS: Patients treated with PRP injections demonstrated an improving knee function and symptoms over the duration of the study. A significant improvement from baseline to 12 months was observed in all the outcome measures, and no patients experienced failure or required surgery during the follow-up. Patients younger than 50 years reported lower subjective level of pain and higher Tegner activity scale at baseline and had significantly better Lysholm knee scoring scale (P = 0.03) and WOMAC (P = 0.03) scores at 6 months, as well as better range of motion at 3, 6, and 12 months (P < 0.001). Thirty-three (47.8%) patients were very satisfied, 26 (37.7%) satisfied, 8 (11.6%) partially satisfied, and 2 (2.9 %) not satisfied, with 62 (89.8%) patients willing to repeat the same treatment. No patient was lost to follow-up and no patient experienced adverse reaction, infection, failure, recurrence or underwent further surgery. CONCLUSION: PRP injections provide short-term benefits in symptomatic DMLs. Although promising results were evident at 12 months, this is a preliminary study and no definitive recommendation can be made based, for example, on longer follow-up. CLINICAL RELEVANCE: This research supports the use of autologous PRP injections for symptomatic DMLs.

Anthrozoology in Action: Performing Cognitive Training Paths in a Garden Shelter to Make Dogs More Suitable as Pets.

The overpopulation of shelters and the increase of homeless dogs have become serious problems in many countries. One contributor to the number of both sheltered and homeless dogs is the abandonment and relinquishment of pet dogs by their owners for different reasons - in many cases depending on dogs' undesirable or problematic behaviors. Luckily, the behavioral characteristics of a dog are, to some extent, modifiable parameters. The aim of this study was to train the dogs housed in a garden shelter in Italy to become suitable as pets by becoming familiar to different tools and situations that they could encounter in a domestic setting through a customized educational path based on social and environmental enrichment. Shelters can hardly afford the expenses for administering training to dogs. The problem could be overcome by engaging the best graduating students attending referenced training schools, whose mission is to train professionals with high theoretical and practical skills. Shelters' administrators should choose referenced schools only, that teach positive training methods respectful of animals and that support the human-animal bond.

Autologous US-guided PRP injection versus US-guided focal extracorporeal shock wave therapy for chronic lateral epicondylitis: A minimum of 2-year follow-up retrospective comparative study.

PURPOSE: To compare the efficacy of two independent groups of patients treated with ultrasound (US)-guided extracorporeal shock wave (ESW) therapy and with US-guided injection of platelet-rich plasma (PRP) for chronic lateral epicondylitis (LE) with a minimum of 2-year follow-up. METHODS: We retrospectively evaluated 63 patients treated for chronic LE (31 patients with autologous US-guided PRP injection and 32 patients with US-guided focal ESW therapy) from 2009 to 2014. All the patients were evaluated by means of Roles-Maudsley (RM) score, quick Disabilities of Arm, Shoulder, and Hand (QuickDASH) score, visual analogic scale (VAS) and patient-rated tennis elbow evaluation (PRTEE) to retrospectively assess the pain relief, level of activity, the self-reported function and subjective satisfaction at minimum of 2-year follow-up. RESULTS: Both US-guided autologous PRP injection and US-guided focal ESW administration proved effective in chronic LE with significant improvement in the QuickDASH, VAS, RM and PRTEE scores ( p < 0.0001). No adverse effects or complications were recorded in any groups. No differences were found in recurrence rate and final results of the QuickDASH, VAS, RM and PRTEE scores between the two groups ( p > 0.05). The mean time between treatment and symptom resolution was significantly shorter for the PRP treatment ( p = 0.0212); furthermore, the mean time to return to the normal activities was quicker for PRP group ( p = 0.0119). CONCLUSION: Both PRP injection and ESW therapy are feasible and safe options for the treatment of chronic LE with low risk of complications and with good long-term follow-up results. US-guided PRP injection has quick efficacy when compared with US-guided focal ESW therapy.

Validation of the Socially Acceptable Behaviour (SAB) test in a Central­Italy pet dog population.

Aggressiveness is reported to be the most important public health issue related to both owned and free­roaming dogs. Common approaches to assess canine aggressiveness are temperament tests. The main aim of this study was to evaluate whether one such test, the Socially Acceptable Behaviour (SAB) test, created to evaluate aggressive and fearful behaviour in dogs in the Netherlands, could be used reliably to assess dog aggression and fear in a population of owned dogs in Central Italy. Reactions to the test were recorded and compared to the owners' perception of their dog's aggressiveness using a validated questionnaire (C­BARQ). Dogs showing aggressive reactions during the test obtained significantly higher (more aggressive) scores on the C­BARQ subscales 'stranger­directed aggression' (SDA p<0.001), 'owner­directed aggression' (ODA p = 0.03), and 'familiar dog aggression' (FDA p = 0.006), than dogs who did not react aggressively. Logistic regression analysis revealed that 7 of the SAB­subtests were predictive of the SDA score. The findings indicated that aggression directed toward unfamiliar people can be reliably assessed using the SAB test for a population of Italian pet dogs.

Conservative Treatment of Ankle Osteoarthritis: Can Platelet-Rich Plasma Effectively Postpone Surgery?

Osteoarthritis is the most common and disabling of the orthopedic diseases. Currently, the conservative treatment of osteoarthritis is limited to symptomatic treatment, whose goal is to improve function and pain control. Ankle osteoarthritis is relatively uncommon, in contrast to osteoarthritis of the hip and knee, and the therapeutic options (both pharmacologic and surgical) are limited, with surgery providing poorer and less predictable results. The effectiveness of platelet-rich plasma injections for osteoarthritis is still controversial, especially so for ankle arthritis, owing to the lack of evidence in the present data. We retrospectively evaluated the mid- to long-term clinical results (mean follow-up of 17.7 months) for platelet-rich plasma injections in 20 patients (20 ankles) with ankle osteoarthritis. We evaluated the presence of pain using the visual analog scale, function using the Foot and Ankle Disability Index, and subjective satisfaction. The pre- and post-treatment scores, obtained from the clinical records and from telephone interviews during the follow-up period, were compared using the Student t test. We found a strong positive effect for 4 platelet-rich plasma injections (injected once a week) on pain (p = .0001) and function (p = .001), with 80% of patients very satisfied and satisfied, and only 2 patients (10%) required surgery because of early treatment failure. These results suggest that the use of platelet-rich plasma injection is a valid and safe alternative to postpone the need for surgery.

Radial shock wave therapy: effect on pain and motor performance in a paralympic athlete.

BACKGROUND: Recent studies demonstrated the usefulness of radial shock waves therapy (RSWT) in treating hypertonia in patients affected by cerebral palsy (CP), stroke, and dystonia. RSWT have never been used to treat spasticity in disabled athletes. CASE REPORT: An athlete affected by tetraparesis due to CP underwent three RSWT sessions in a week. We assessed muscular tone using the Modified Ashworth Scale (MAS), pain and fatigue experienced during athletic performance with Visual Analogic Scale (VAS) and Borg scale Category-Ratio anchored at number 10 (Borg CR10). We also performed an electrophysiological study recording the stretch reflex on the quadriceps femori muscle and assessing the soleus H-reflex to calculate post-activation depression (PAD). After 3 RSWT sessions, we found a reduction in all clinical parameters. Although MAS was unchanged, stretch reflex was significantly reduced and PAD increased, suggesting a role in contrasting non-reflex components of hypertonia. CLINICAL REHABILITATION IMPACT: The use of RSWT may improve the disabled athletes' performance.

Chronic Tendonopathy as a Unique Cause of Non Traumatic Triceps Tendon Rupture in a (Risk Factors Free) Bodybuilder: A Case Report.

INTRODUCTION: Distal triceps tendon rupture is an uncommon lesion rarely due to a non-traumatic mechanism. In these cases, the majority of patients show predisposing factors for tendon degeneration: underlying medical co-morbidities, previous systemic and locally injected corticosteroids and systemic anabolic steroids. A clear evidence for an etiopathogeneticroleforchronictendonopathy in triceps tendon rupture is sti 11 lacking. CASE REPORT: We report the case of a rare non-traumatic complete rupture of the triceps tendon, at the olecranon insertion, occurring in a healthy male middle-aged non-professional bodybuilder. He presented to our attention with a five days history of weakness, swelling and pain at the left elbow, started after a snapping sound during a single arm triceps extension exercise. He was a healthy sportsman, no smoker and no drinker. He had suffered, in the two months before, of mild bilateral exercise-related elbow discomfort, never limiting his sport and daily activities. The man was treated by an early surgical repair. Histological analysis was conducted on intraoperative samples. The treatment allowed complete remission and return to sport practice without functional deficit. CONCLUSION: An overload-related chronic tendonopathy was identified as the unique factor with causal role in the determinism of the above described lesion. This case highlights, for the first time in literature, that just a chronic tendonopathy, in absence of any other predisposing condition, can lead to a non-traumatic complete triceps tendon rupture.

Assessment of motor laterality in foals and young horses (Equus caballus) through an analysis of derailment at trot.

The conflicting results regarding the study of motor laterality in horses may indicate that there does not exist a proper method to assess the degree and the direction of motor bias in these animals. Unfortunately, even less is known about the development of laterality in horses, and to what extent early manipulations can still exert their effects in adulthood. We propose a new method that can be easily applied at a very early age thus avoiding testing adult horses eventually biased by human handling and/or training. Forty-six horses (29 nine-month-old foals and 17 two-year old horses) were handled since birth bilaterally and housed in groups in wide areas. At the time of the analysis, in order to minimize environmental and sensorial disturbances, each horse was tested in a round pen individually or as dyad mother-foal. The ability/inability to properly execute a circle at trot was then recorded, assuming the direction of derailment, i.e. the cutting of the circle, as an indicator of motor bias. From the results of the study it is arguable that motor laterality in horses is acquired over time: in fact foals tested while their mothers were being subjected to longeing showed a higher percentage of ambidextrous animals, while two-year-old horses appeared biased toward the right (p<0.05). Results are discussed in the light of the scientific knowledge about equine biomechanics, taking into account horses' locomotion that leads to the advancement of the body mass through the activation of a kinetic chain that originates from the hindquarters.

Traumatic myiasis by Wohlfahrtia magnifica in Italy.

Seven farms, two in Central Italy and five in Southern Italy, were visited for the presence of larvae-infested wounds. Ninety-six (3%) out of 3129 sheep examined had a traumatic myiasis with a very high percentage of infested animals found only in a farm (10.5%). Wounds were mainly localized on the vulva and prepuce. Infested animals were restless, anxious, and reluctant to graze. None of the 10 goats in one infested flock had wounds, whereas a shepherd dog from another flock presented a wound on the ear. All the larvae and adults reared from them in the laboratory were identified as Wohlfahrtia magnifica (Schiner, 1862) (Diptera, Sarcophagidae). The cases presented here are the first clinical cases of wohlfahrtiosis in sheep and dogs reported in Italy, and indicate that this myiasis is endemic in this country. A wider epidemiological investigation on the prevalence, incidence and seasonality of W. magnifica infestation of Italian W. magnifica population/s would be useful to understand its geographical provenience and the likely risk for its spreading throughout Italy and other non-endemic areas.

A management model applied in two 'no-kill' dog shelters in central Italy: use of population medicine for three consecutive years.

The principal tools currently used in Italy to limit stray dog populations are dog registration and identification, birth control and increasing public awareness. Since 1991, national legislation does not permit euthanasia of unwanted roaming dogs unless they have an incurable condition or are proven to be dangerous. Unattended dogs are placed in long-term shelters in questionable conditions where they often remain for most of their lives. Kennel management is one of the most critical aspects of animal welfare, particularly as the number of stray dogs is rising faster than the current rate of adoption. The Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise 'G. Caporale' (IZS A&M) manages two kennels in Teramo and uses standard management procedures that include regular behavioural and physical examinations. All results recorded in a computer database were analysed to identify production goals and improve welfare, in line with a population medicine model. Prevalence and incidence of different pathologies were recorded and analysed to improve veterinary management and organisation. No new dogs were admitted from 2005 onwards, thereby producing an ideal 'closed system' where the effects of rational management can be studied in the absence of unpredictable risks from introduced pathologies. Statistical evaluations revealed major differences between 2006 and 2007. The use of the 'population medicine' management system resulted in improved dog health and welfare, as indicated by the significant reduction in both the prevalence and incidence of major pathologies between 2006 and 2007. A significant improvement was also seen in the control of the incidence of leishmaniasis which reduced sharply during this period.