Efficacia del trattamento con concentrati piastrinici (P.R.P.) nelle lesioni condrali e tendinopatie

Purpose: Recent knowledge regarding tissue biology highlights a complex regulation of growth factors in reaction to tissue damage. Platelet Rich Plasma (P.R.P.), containing a natural pool of growth factors, can be obtained in a simple and minimally invasive way and be applied to the lesion site. The aim of this study is to explore this novel approach to treat cartilage degenerative lesions of the knee and tendon chronic lesions( patellar tendon, and achilles tendon). In this study we evaluated if the treatment with PRP injections can reduce pain and increase function in cases of patellar tendinosis (Jumper’s Knee), in chronic achilles tendinopathy and in patients with cartilage injuries of the knee. Materials and Methods: 40 patients with cartilage lesion of the knee, 28 male and 12 female with mean age 47 y. (min 18- max 52 years), were treated and prospectively evaluated at a minimum 6 months follow-up; in the same way, 12 patients with achilles tendon lesion (8 male and 4 female) with mean age 44,5 y. (min 32-max 58 years) and 10 patients with “Jumper’s Knee” (8 male and 2 female) with mean age 23,2 y. (min 18-max 37 years), were evaluated at 6 months follow up. The procedure involved 3 multiple injections , performed every two weeks. All patients were clinically evaluated at the end of the treatment and at 6 months follow up. IKDC, SF36, EQ-VAS, scores were used for clinical evaluation and patient satisfaction and functional status were also recorded. Results: Statistical analysis showed a significant improvement in the SF36 questionnaire in all parameters evaluated at the end of the therapy and 6 months follow-up in both group(tendinopathies and chondral lesions), and in the EQ VAS and IKDC score (paired T-test, p<0.0005) from basal evaluation to the end of the therapy, and a further improvement was present at 6 months follow-up. Whereas a higher improvement of the sport activity level was achieved in the “Jumper’s Knee” group. No complications related to the injections or severe adverse events were observed during the treatment and follow up period. Conclusion: PRP inhibits excess inflammation, apoptosis, and metalloproteinase activity. These interactive pathways may result in the restoration of tendon or cartilage, which can with stand loading with work or sports activity, thereby diminishing pain. PRP may also modulate the microvascular environment or alter efferent or afferent neural receptors. The clinical results are encouraging, indicating that PRP injections may have the potential to increase the tendon and cartilage healing capacity in cases with chronic tendinosis and chondropathy of the knee.

"Making Sense of Figures": Statistics, Computing and Information Technologies in Agriculture and Biology in Britain, 1920s-1960s

Throughout the twentieth century statistical methods have increasingly become part of experimental research. In particular, statistics has made quantification processes meaningful in the soft sciences, which had traditionally relied on activities such as collecting and describing diversity rather than timing variation. The thesis explores this change in relation to agriculture and biology, focusing on analysis of variance and experimental design, the statistical methods developed by the mathematician and geneticist Ronald Aylmer Fisher during the 1920s. The role that Fisher’s methods acquired as tools of scientific research, side by side with the laboratory equipment and the field practices adopted by research workers, is here investigated bottom-up, beginning with the computing instruments and the information technologies that were the tools of the trade for statisticians. Four case studies show under several perspectives the interaction of statistics, computing and information technologies, giving on the one hand an overview of the main tools – mechanical calculators, statistical tables, punched and index cards, standardised forms, digital computers – adopted in the period, and on the other pointing out how these tools complemented each other and were instrumental for the development and dissemination of analysis of variance and experimental design. The period considered is the half-century from the early 1920s to the late 1960s, the institutions investigated are Rothamsted Experimental Station and the Galton Laboratory, and the statisticians examined are Ronald Fisher and Frank Yates.