Platelet Rich Plasma (PRP) injections are indicated for the treatment of difficult, chronic Tendinitis around the hand, wrist, and upper arm, including Tennis Elbow (Lateral Epicondylitis) and Golfer’s Elbow (Medial Epicondylitis). These types of tissue have limited blood supplies so they heal slowly. In these instances, steroid injections are marginally effective or contra-indicated. What is Platelet Rich Plasma (PRP)? PRP is formulated by drawing a small amount (about 10 ml) of the patient’s own blood and spinning it in a centrifuge for five minutes. This separates the red and white blood cells, leaving a solution containing the concentrated platelets. This solution contains an average of two to five times the number of platelets and two to twenty-five times the amount of various growth factors as compared to the same amount of the patient’s whole blood. After injury the body rushes many types of cells, including platelets, to the damaged area. This solution, containing concentrated growth factors, initiates and accelerates wound healing. Studies that have been done on patients after PRP injections suggest a facilitated healing response resulting from introduction of a greater amount of growth factors into the damaged tissue. What is the treatment process? After the reduction process described above, the plasma containing platelets with growth factors is injected into the site of the injured tissue. The entire process takes less than twenty minutes, including drawing the patient’s blood, centrifuging it, and then injecting a plasma portion into the injured site. What happens afterward? The patient can expect some soreness for about forty eight hours following the injection. Mild analgesic medications, such as acetaminophen (Tylenol) with or without Codeine can be used to treat discomfort. Non-steroidal antiinflammatory medications are prohibited for one week afterward, as they interfere with the action of the PRP. A follow-up appointment after the injection will be made with Dr. Pruzansky. It is recommended that physical activity involving the affected limb be limited for twenty-four hours. A stretching program directed by Dr. Pruzansky and a Physical Therapist should be followed for two weeks. Four weeks post- injection, the patient may return to recreational activity and sports, as tolerated. Improvement over several months is anticipated as the tissue heals in response to the stimulus from the growth factors. Is it safe? No negative effects have been reported in any of the completed studies. This process uses the patient’s own blood, thereby eliminating any chance of rejection response and minimizes the possibility of infection. Does it work? The PRP injections have been used in several studies, as well as on Professional Athletes. Patients have reported an average of 60% pain reduction after two months and 80% improvement after six months time.
REFLECTION BiDil: Assessing a Race-Based Pharmaceutical ABSTRACT Isosorbide and hydralazine in a fi xed-dose combination (BiDil) has provoked controversy as the fi rst drug approved by the Food and Drug Administration marketed for a single racial-ethnic group, African Americans, in the treatment Life Sciences, Michigan State University, of congestive heart failure. Family physicians will