World Health Organization announced the novel coronavirus disease outbreak to be a global pandemic. The distribution of community outbreaks shows seasonal patterns along certain latitude, temperature, and humidity i.e. similar to the behavior of seasonal viral respiratory tract infections. COVID-19 displays significant spread in northern midlatitude countries with an average temperature of 5-11 °C and low humidity. Vitamin D deficiency has also been described as pandemic, especially in the Europe. Regardless of age, ethnicity, and latitude; recent data showed that 40% of the Europeans are vitamin D deficient (25(OH)D levels <50 nmol/L), and 13% are severely deficient (25(OH)D <30 nmol/L).A quadratic relationship was found between the prevalences of vitamin D deficiency in most commonly affected countries by COVID-19 and the latitudes. Vitamin D deficiency is more common in the subtropical and midlatitude countries than the tropical and high latitude countries. The most commonly affected countries with severe vitamin D deficiency are from the subtropical (Saudi Arabia; 46%, Qatar; 46%, Iran; 33.4%, Chile; 26.4%) and midlatitude (France; 27.3%, Portugal; 21.2% and Austria; 19.3%) regions. Severe vitamin D deficiency was found to be nearly 0% in some high latitude countries (e.g. Norway, Finland, Sweden, Denmark and Netherlands).Accordingly, we would like to call attention to the possible association between severe vitamin D deficiency and mortality pertaining to COVID-19. Given its rare side effects and relatively wide safety, prophylactic vitamin D supplementation and/or food fortification might reasonably serve as a very convenient adjuvant therapy for these two worldwide public health problems alike. Accepted manuscript supplementation for potential risk of hypercalcemia while taking high doses of vitamin D3. Needless to say; as vitamin D is synthesized mainly in the skin, sun (UV-B) exposure (15-20 min daily) inducing the light pink color of minimal erythema would be the natural way of production and activation of vitamin D by keratinocytes. 55 Accordingly, presenting this paper, we would like to call attention to the possible association between severe vitamin D deficiency and mortality pertaining to COVID-19. Given its rare side effects and relatively wide safety, prophylactic vitamin D supplementation and/or food fortification might reasonably serve as a very convenient and incomparable/invaluable adjuvant therapy for these two worldwide public health problems alike. al. Low serum vitamin D is not associated with an increase in mortality in oldest old subjects: the Octabaix three-year follow-up study. Gerontology. 2014; 60: 10-5. 13. Veronese N, Sergi G, De Rui M, et al. Serum 25-hydroxyvitamin D and incidence of diabetes in elderly people: the PRO.V.A. study. J Clin Endocrinol Metab. 2014; 99: 2351-8. 14. Aspell N, Laird E, Healy M, et al. The prevalence and determinants of vitamin D status in community-dwelling older adults: Results from the English Longitudinal Study of Ageing (ELSA). Nutrients. 2019; 11...

Sarcopenia is an important public health problem, characterized by age-related loss of muscle mass and muscle function. It is a precursor of physical frailty, mobility limitation, and premature death. Muscle loss is mainly due to the loss of type II muscle fibres, and progressive loss of motor neurones is thought to be the primary underlying factor. Anterior thigh muscles undergo atrophy earlier, and the loss of anterior thigh muscle function may therefore be an antecedent finding. The aim of this review is to provide an in-depth (and holistic) neuromusculoskeletal approach to sarcopenia. In addition, under the umbrella of the International Society of Physical and Rehabilitation Medicine (ISPRM), a novel diagnostic algorithm is proposed, developed with the consensus of experts in the special interest group on sarcopenia (ISarcoPRM). The advantages of this algorithm over the others are: special caution concerning disorders related to the renin-angiotensin system at the case finding stage; emphasis on anterior thigh muscle mass and function loss; incorporation of ultrasound for the first time to measure the anterior thigh muscle; and addition of a chair stand test as a power/performance test to assess anterior thigh muscle function. Refining and testing the algorithm remains a priority for future research. LAY ABSTRACT Sarcopenia is an important public health problem, characterized by age-related loss of muscle mass and muscle function. The diagnostic recommendations published to date have addressed total or appendicular muscle mass. However, under the umbrella of the International Society of Physical and Rehabilitation Medicine (ISPRM), experts in the special interest group on sarcopenia (ISarcoPRM) developed a new algorithm, based on regional measurements and functional evaluations of the anterior thigh muscle, which is the most commonly and initially affected condition in sarcopenia. Unlike other suggestions, diseases associated with the renin-angiotensin system are emphasized in this algorithm, and ultrasound has been used for measurement of anterior thigh muscle mass.

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Platelet‐rich plasma (PRP) treatment has a potential to become a part of nonsurgical approach in carpal tunnel syndrome (CTS) as a regenerative method. PRP therapies aim to enhance the self‐healing ability of human body, by exposing the injured tissue to a high concentration of autologous growth factors. Nerve tissues also seem to benefit from the regenerative effects of PRP concentrates. The aim of this study is to investigate the possible beneficial effects of PRP injection in CTS. A total of 40 hands of 30 patients were included (20 hands per group) with mild to moderate idiopathic CTS. Patients with mild to moderate CTS were placed into either control or PRP groups. Activity modification and night‐only wrist splints were suggested in both groups. Additionally, in PRP group, a single perineural PRP injection into the carpal tunnel was applied under ultrasound guidance. Sensibility tests, Boston carpal tunnel questionnaire (BCTQ), and electrophysiological and ultrasonographical findings were measured initially and after 4 weeks. Groups were similar regarding demographics. BCTQ scores and ultrasonographical values were improved in both groups. Delta analyses revealed that the difference of BCTQ scores improved better in PRP group. Electrophysiological values improved in PRP group. Our study demonstrated that a single, perineural PRP injection into carpal tunnel provided further improvements in CTS.

Ultrasonography is a useful imaging method in showing the rib fractures those overlooked on chest X-rays in minor blunt chest trauma, and no significant clinical feature exists as a predictor for these insidious fractures. However, bony rib fractures significantly occur in elderly patients and result in a longer duration of pain.