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Clinical neuroimaging studies indicate that both acute and chronic heavy alcohol drinking increase cerebral acetate uptake and lower brain glucose metabolism (147, 148), with the cerebellum showing the greatest shift toward acetate use (reviewed in (149))

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This can result in: Reduced pain Enhanced joint stability Improved range of motion Quicker return to normal activity Ideal Candidates for Prolotherapy Prolotherapy is most effective in Type I to Type III AC separations , especially when: Pain persists beyond 4-6 weeks of conservative care There is evidence of ligament laxity or instability The patient prefers a non-surgical option The patient is physically active and motivated for recovery The Prolotherapy Treatment Protocol for AC Separation Pre-Treatment Evaluation Prior to treatment, a comprehensive musculoskeletal exam is conducted to assess: Joint instability Tenderness and ligament integrity Shoulder biomechanics Imaging (X-ray or ultrasound) to classify injury severity Injection Technique Patient Positioning: Seated or supine with shoulder exposed Site Preparation: Skin cleaned with antiseptic