We studied the changes in serum C-reactive protein levels (CRP) and erythrocyte sedimentation rates (ESR) in patients with primary osteoarthritis, who underwent uncomplicated arthroplasty. Of the 28 patients studied, 12 had cementless total hip replacement (THR), and 16 underwent cemented total knee replacement (TKR) with a tourniquet. In both groups serum CRP levels increased rapidly after surgery, peaking on day 2 (THR 23.17 mg/dl, TKR 26.02 mg/dl), and dropping gradually to pre-operative values on day 21 in THR patients and at the end of the second month in TKR patients. ESR peaked on day 5 after operation (THR 100.5 mm/h, TKR 101.3 mm/h), dropping close to pre-operative values at the end of the third month in THR patients and at the end of the ninth month in TKR patients, although, even after a year, ESRs were slightly above their pre-operative values. Serum CRP levels changed more rapidly than ESRs and returned to normal more rapidly. CRP and ESR values tended to be higher in TKR than in THR patients.
Forty-eight rats were divided into four groups of 12. For 3 days, each group received the following vitamins in once-daily doses: group 1, vitamin E only; group 2, vitamin C only; group 3, vitamins E and C; and group 4, no treatment (control). The right tibia of each rat was fractured on day 4; the rats then received the same regimen three times a week (once-daily doses) until day 21. Fracture healing was evaluated radiologically by measuring the callus indices, and histologically by a 5-point grading scale. On days 14 and 21, the callus index values in group 2 were statistically higher than those in the other groups. Histological evaluation scores in group 2 were the highest overall, and group 3 scores were higher than those in groups 1 and 4. These findings indicate that vitamin C accelerates fracture healing, vitamin E does not exert a marked effect on this process, and vitamins E and C in combination do not have a synergistic impact on fracture healing.
Background Pain has been frequently described as a clinical feature of COVID‐19, and the main pain syndromes that have been associated with the acute phase of this disease so far are headache, myalgia, arthralgia, and neuropathic pain. Understanding the characteristics of pain symptoms is crucial for a better clinical approach. Methods Patients who were diagnosed as having COVID‐19 using reverse transcription‐polymerase chain reaction were included in the study. Patients were asked to complete a 51‐item questionnaire via a phone interview, which included questions on demographics, acute COVID‐19 symptoms, the presence of pain symptoms, and their characteristics in the acute phase of COVID‐19. Results A total of 222 out of 266 patients with COVID‐19 participated in the study, yielding a response rate of 83.5%. A total of 159 patients reported at least one kind of pain syndrome with a prevalence of 71.6%. Myalgia was reported in 110 (49.6%) patients, headache in 109 (49.1%), neuropathic pain symptoms in 55 (24.8%), and polyarthralgia in 30 (13.5%) patients. A total of 66 patients reported only one type of pain, 46 reported two types, 42 reported three types, and five patients reported all four types of pain. Logistic regression analysis showed that there were significant associations between these pain syndromes and a strong association was found between neuropathic pain and headache. Conclusion Pain is a frequently observed symptom of mild‐to‐moderate COVID‐19. There are significant relationships between pain syndromes in COVID‐19, which may be due to a sequence of common etiologic factors. Significance This study described the main pain syndromes associated acute phase of mild‐to‐moderate COVID‐19 and its associated features. Headaches and pain of neuropathic characteristics were prevalent in this sample.
To investigate the effect of a-tocopherol (vitamin E) on fracture healing in rabbits, two groups of 10 rabbits were either injected with a-tocopherol (treated) or untreated (controls). The right femurs of both groups were fractured, and the treated group were injected intramuscularly with 20 mg/kg a-tocopherol daily for 5 days starting on the day of fracture. After 21 days, histological sections of the fractured region were examined and scored. Fracture healing had progressed further in the a-tocopherol group than in the control group. A statistically significant difference between the histological grading of fracture healing in the two groups was found. This difference may result from an antioxidant (a-tocopherol) effect on free oxygen radicals in the fracture area. We conclude that a-tocopherol may affect fracture healing favourably and might be useful as a therapeutic agent in clinical fracture management.
In this study, the effect of free oxygen radicals on lipid peroxidation and the antioxidant role of alpha-tocopherol (vitamin E) in these reactions were investigated in haematoma fluid and venous blood samples in rabbits with femoral fracture. There were 21 male rabbits, divided into 3 groups. Conjugated dienes values (as optical density) were compared in venous blood of the rabbits in Group I taken preanaesthesia and after the onset of anaesthesia and the difference between these values proved to be insignificant (P > 0.05). A control group (Group 2) was given saline before fracture occurrence and the other group (Group 3) was injected with alpha-tocopherol 20 mg/kg intramuscularly. Venous blood samples and fracture haematoma fluids in both Group 2 and Group 3 were assayed biochemically. It was established that conjugated dienes values in fracture haematoma fluid in rabbits in the control group were higher than the values in the venous blood of the rabbits in the same group (P < 0.05). However, conjugated dienes values in the alpha-tocopherol injected group both in the haematoma fluid and in venous blood were reduced compared with those in the control group (P < 0.5). In view of the fact that ischaemia and reperfusion develop in fractured regions and that general body ischaemia develops following serious fractures of the extremities, we consider that prophylactic administration of antioxidants such as alpha-tocopherol may be beneficial in suppressing the destructive effects of free oxygen radicals in cells.
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