Category: Nevin Manimala

J Wrist Surg. 2024 Jul 25;14(5):454-460. doi: 10.1055/s-0044-1788706. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: Ulnar-positive variance is widely recognized as a risk factor for idiopathic ulnar impaction syndrome (UIS). However, not all patients with ulnar-positive variance progress to symptomatic UIS. Other factors, such as the shape of the lunate or the distal radioulnar joint (DRUJ), may also play a role. This study aims to elucidate the relationship between the shape of the lunate and the structure of the DRUJ and idiopathic UIS.

MATERIALS AND METHODS: A cohort of 40 cases diagnosed with idiopathic UIS (UIS group) and 87 control subjects with ulnar-positive variance but without symptoms were compared. Lunate shape was assessed by measuring the lunate type and radiolunate angle (RLA), whereas DRUJ morphology was evaluated using the sigmoid notch angle, DRUJ subluxation ratio, and DRUJ inclination. Independent t -tests were conducted to analyze differences in radiographic metrics between the two groups, and logistic regression analyses were used to examine risk factors for idiopathic UIS. Receiver operating characteristic curves were utilized to determine the cutoff values for statistically significant variables.

RESULTS: Significant differences were observed between the two groups in terms of RLA, DRUJ subluxation ratio, and DRUJ inclination ( p < 0.05). Logistic multiple regression analysis revealed a negative correlation between idiopathic UIS occurrence and both RLA (odds ratio [OR]: 0.92; 95% confidence interval [CI]: 0.87-0.96; p < 0.001) and the DRUJ subluxation ratio (OR: 0.01; 95% CI: 0-0.07; p = 0.002). Conversely, a positive correlation was found between UIS occurrence and DRUJ inclination (OR: 1.06; 95% CI: 1.01-1.12; p = 0.021).

CONCLUSION: In patients with ulnar-positive variance, the incidence of symptomatic UIS decreases when the lunate extends more relative to the radius and when the DRUJ subluxation ratio increases or DRUJ inclination decreases.

LEVEL OF EVIDENCE: Level III, case-control study.

PMID:40995544 | PMC:PMC12456978 | DOI:10.1055/s-0044-1788706

J Wrist Surg. 2024 Jul 5;14(5):429-435. doi: 10.1055/s-0044-1787748. eCollection 2025 Oct.

ABSTRACT

PURPOSE: Arthrodesis is a traditional surgical procedure for treating thumb carpometacarpal (CMC) osteoarthritis. Previous studies have investigated surgical outcomes, focusing on the fixation technique, bone union rate, and surgical complications but not on the postoperative alignment of the thumb CMC joints. Therefore, we aimed to investigate how thumb fixation alignment affects the surgical outcomes of thumb CMC arthrodesis.

MATERIALS AND METHODS: Twenty-six patients (28 thumbs) who achieved bone union after arthrodesis with more than 1-year follow-up were retrospectively analyzed. We measured the radial abduction and palmar abduction angles and change in thumb length (Δthumb length) on postoperative radiographs and the first metacarpal rotation angle on postoperative computed tomography. Moreover, we investigated the 1-year clinical outcomes, including the Disabilities of Arm, Shoulder, and Hand (DASH) score, Hand20 questionnaire score, visual analog scale (VAS) score for pain, Δgrip strength, Δpulp pinch, and Δkey pinch strength. The correlation between the postoperative alignment and clinical outcomes was also statistically analyzed.

RESULTS: The mean radial abduction, palmar abduction, first metacarpal rotation angles, and Δthumb length were 20.8 degrees, 34.4 degrees, 109.4 degrees, and -1.8 mm, respectively. Radial abduction and palmar abduction angles were positively and negatively correlated with Δgrip strength ( r = 0.37 and -0.37), respectively. The first metacarpal rotation angle was positively correlated with the DASH score ( r = 0.51), Hand20 score ( r = 0.48), and VAS score for pain ( r = 0.42). ΔThumb length had no correlation with clinical outcomes at 1-year follow-up.

CONCLUSION: Thumb fixation alignment has an impact on the surgical outcomes of thumb CMC arthrodesis. To obtain a successful outcome, it is important to add slight pronation and avoid excessively small radial abduction and excessively large palmar abduction.

PMID:40995540 | PMC:PMC12456986 | DOI:10.1055/s-0044-1787748

Int J Dent. 2025 Sep 16;2025:2797748. doi: 10.1155/ijod/2797748. eCollection 2025.

ABSTRACT

Purpose: This study aimed to evaluate and compare alveolar bone density and crestal bone loss (CBL) around immediately temporized implants (ITIs) and conventionally placed submerged implants (CIs) in the posterior mandible using radiovisiography (RVG). Methods: In this prospective, randomized, split-mouth clinical study, nine patients with bilateral posterior mandibular edentulism were enrolled. A bone-level implant was placed bilaterally in each patient. One side received an immediate temporized, while the contralateral side received a CI. Standardized RVGs were obtained at baseline, 3 months, and 6 months. Alveolar bone density and CBL were measured using ImageJ software. Data were analyzed using paired t-tests with significance set at p < 0.05. Results: No statistically significant differences in alveolar bone density or CBL were observed between the ITI and conventional groups at any follow-up interval. Mean alveolar bone densities were higher in the ITI group at all intervals (baseline: 136.22 ± 36.23, 3 months: 137.03 ± 34, 6 months: 136.28 ± 34.59) compared to the conventional group (baseline: 136.56 ± 24.26, 3 months: 126.53 ± 34.93, 6 months: 119.95 ± 43.35). At 3 months, the ITI group exhibited greater CBL (0.22 ± 0.63 mm) than the conventional group (0.15 ± 0.83 mm). However, at 6 months, the ITI implants exhibited less CBL (- 0.07 ± 0.47 mm) compared to the conventional implants (0.19 ± 0.78 mm). Conclusion: Immediate temporization under nonfunctional loading did not negatively affect peri-implant bone compared to conventional submerged healing. These results support its clinical use in appropriately selected cases.

PMID:40995532 | PMC:PMC12457067 | DOI:10.1155/ijod/2797748

Int J Dent. 2025 Sep 16;2025:8406448. doi: 10.1155/ijod/8406448. eCollection 2025.

ABSTRACT

Objective: The purpose of this in vitro study was to evaluate the microshear bond strength (µSBS) of resin-modified glass ionomer cement (RMGIC) to enamel and dentin, with and without the inclusion of zinc oxide nanoparticles (ZnO NPs) and mesoporous ZnO NPs. Materials and Methods: 140 extracted human third molars were used, categorized into two primary groups based on the substrate-enamel or dentin-and further divided into seven subgroups (n = 10). The groups consisted of RMGIC alone, and RMGIC enhanced with either 3%, 5%, or 7% of conventional ZnO NPs or mesoporous ZnO NPs. µSBS testing was performed, followed by statistical evaluation. Results: The type of substrate and the incorporation of NPs significantly affected bond strength (p < 0.001), with enamel showing superior µSBS compared to dentin (p < 0.001). The subgroup containing 5% mesoporous ZnO NPs demonstrated the highest bond strength overall (p < 0.001), while no significant variations were detected among the other groups (p > 0.05). Conclusion: Enhancing RMGIC with 5 wt.% mesoporous ZnO NPs markedly improved adhesion to both enamel and dentin. Increasing the (nanoparticle) NP concentration beyond 5% did not further enhance bonding performance. Enamel exhibited consistently better bonding than dentin in all subgroups. These results highlight the potential of 5% mesoporous ZnO NPs in improving the clinical efficacy of RMGIC.

PMID:40995531 | PMC:PMC12457048 | DOI:10.1155/ijod/8406448

Acta Ortop Bras. 2025 Sep 22;33(5):e290192. doi: 10.1590/1413-785220253305e290192. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the epidemiological profile and waiting time for osteosynthesis in patients admitted due to intertrochanteric fracture in a public hospital in the Federal District of Brazil.

METHODS: This observational, descriptive, and retrospective study involved patients over 18 years old with intertrochanteric fractures between June and December 2023. Demographic, clinical data, and information about waiting time for osteosynthesis were collected. Analyses were performed using descriptive statistics and logistic regression.

RESULTS: The majority of patients (61.4%) were female, with a mean age of 74 years. The average time between fracture and care was 3.4 days, and from fracture to osteosynthesis was 22.7 days. The mortality rate was 6.8%, with higher prevalence in elderly women with comorbidities.

CONCLUSIONS: The study demonstrates that a prolonged time between fracture and osteosynthesis is associated with worse clinical outcomes, particularly in elderly patients with comorbidities. Optimizing the waiting time for surgery is essential to reduce morbidity and mortality and improve patient recovery. Level of Evidence IV; Observational, Descriptive, and Retrospective Study.

PMID:40995507 | PMC:PMC12456894 | DOI:10.1590/1413-785220253305e290192

Acta Ortop Bras. 2025 Sep 22;33(5):e290072. doi: 10.1590/1413-785220253305e290072. eCollection 2025.

ABSTRACT

INTRODUCTION: Lower back disorders are prevalent and a significant reason for emergency care visits. In 2020, 619 million people experienced low back pain, expected to rise to 843 million by 2050. A common cause is the presence of a lumbosacral transitional vertebra (LSTV). Objectives: This study evaluates the prevalence of Bertolotti Syndrome in patients with low back pain in an emergency setting and assesses interobserver reliability of LSTV classifications.

METHODS: A retrospective analysis of 1023 lumbar spine radiographs from patients presenting with low back pain from 2018 to 2020 was conducted. After exclusions, 469 radiographs were analyzed. Two orthopedists classified LSTVs using Tini and Castellvi’s systems. Statistical analyses included the Kappa agreement index, two-proportion Z test, confidence interval for the mean, and p-value calculations.

RESULTS: The prevalence of Bertolotti Syndrome was 62.5% for observer A and 61.6% for observer B. Type I LSTV was the most common, with over 70% of cases, followed by type III at over 15%. The most frequent morphology was bilateral involvement of the transverse process, with more than 50% of cases exhibiting IB morphology according to both classifications.

CONCLUSION: This study found a high incidence of Bertolotti Syndrome (over 60%) in patients with low back pain seeking emergency care, suggesting that LSTV should be more frequently considered in differential diagnoses. Improved recognition of LSTV could lead to better management strategies for low back pain associated with this congenital anomaly. Level of Evidence III; Retrospective Cohort Study.

PMID:40995499 | PMC:PMC12456892 | DOI:10.1590/1413-785220253305e290072

Acta Ortop Bras. 2025 Sep 22;33(5):e287110. doi: 10.1590/1413-785220253305e287110. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate capsulolabral repair in athletes with traumatic anterior glenohumeral instability using magnetic resonance imaging (MRI) and correlate it with clinical and epidemiological data.

METHOD: A prospective therapeutic clinical study was conducted with 36 athletes undergoing surgical treatment. MRI was performed preoperatively and in the third month postoperatively. The morphology, height, angulation, integrity and density of the repaired capsulolabral tissue were evaluated. Linear and logistic regression models were applied.

RESULTS: A total of 36 athletes were evaluated (mean age 29.64 ± 9.08 years). For all numerical variables (morphology, integrity, angles and heights) the differences were statistically significant, except for the coronal angle and homogeneity. Longer time to surgery or multiple dislocations reduced the improvement in morphology. There were no new episodes of dislocation. In the 3-month radiological evaluation, the integrity of the labrum was present in 97% of the patients, however, all patients still had a heterogeneous labrum.

CONCLUSION: There are statistically significant differences between the morphology, height and angulation of the labrum between the pre- and postoperative periods of patients operated on for glenohumeral instability. Although the 3-month MRI showed integrity of the labrum in almost all athletes, this tissue still presented altered density even with satisfactory clinical results. Level of Evidence III; Prospective Study.

PMID:40995498 | PMC:PMC12456893 | DOI:10.1590/1413-785220253305e287110

BMC Sports Sci Med Rehabil. 2025 Sep 24;17(1):267. doi: 10.1186/s13102-025-01309-w.

ABSTRACT

BACKGROUND: Chronic ankle instability (CAI) is associated with impaired balance, proprioception, and limited dorsiflexion range of motion (ROM). Whole-body vibration (WBV) and blood flow restriction (BFR) may address these deficits. This study aimed to determine whether adding BFR to WBV would produce greater immediate improvements in these parameters compared to WBV alone.

METHODS: In this double-blind, randomized controlled trial, thirty-eight non-professional male athletes with CAI were randomly assigned to WBV (n = 19; age: 23.5 ± 4.7 years) or WBV + BFR group (n = 19; age: 24.1 ± 4.9 years). Both groups received a single session of WBV at 30 Hz and 2 mm amplitude; the WBV + BFR group additionally underwent BFR at 80% arterial occlusion pressure. Balance error scoring system (BESS), modified star excursion balance test (m-SEBT), ankle dorsiflexion proprioception, side hop test, dorsiflexion ROM, and perceived instability were measured before and after the intervention.

RESULTS: Statistical tests showed no significant changes in BESS scores (p > 0.05). The WBV + BFR group showed a significant improvement in anterior reach of the m-SEBT (p = 0.04), while the WBV-only group did not (p = 0.69). Statistical analysis indicated a significant reduction in dorsiflexion repositioning error in the WBV group (p = 0.004), with between-group differences favoring WBV. Perceived instability significantly improved in the combined group (p = 0.001). Both groups showed improved dorsiflexion ROM (p < 0.05), with no significant difference between them (p = 0.76).

CONCLUSION: Both WBV and WBV + BFR improved dorsiflexion ROM in athletes with CAI, but neither produced immediate gains in static or dynamic balance, except for anterior reach with the combined intervention. Adding one session of BFR to WBV appeared to impair proprioception and increase perceived instability. These methods may be better used as adjuncts in rehab, not standalone treatments. Clinically, they should be applied cautiously and not immediately before activities demanding high joint stability.

CLINICAL TRIAL REGISTRATION: Registered at IRCT (IRCT20230203057314N1; June 2, 2023).

PMID:40993815 | DOI:10.1186/s13102-025-01309-w

Infect Agent Cancer. 2025 Sep 24;20(1):64. doi: 10.1186/s13027-025-00694-8.

ABSTRACT

PURPOSE: To analyze outcomes and evaluate the survival benefits of metronomic chemotherapy (MC) with S-1 in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with residual EBV-DNA after induction chemotherapy (IC).

METHODS: We retrospectively included patients diagnosed with LANPC between October 2015 and August 2021. All patients were treated with IC and had residual EBV-DNA after IC. Chi-square test, Kaplan-Meier methods, and Cox proportional hazards model were used for statistical analyses.

RESULTS: A total of 103 patients were identified, including 20 (19.4%) who received MC using S-1 for one year. Among these patients, 40 experienced disease progression, including 12 with locoregional recurrence (30.0%), 24 with distant metastasis (60.0%), and 4 with both locoregional recurrence and distant metastasis (10.0%). The 5-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 81.3%, 70.7%, 52.8%, and 72.1%, respectively. Multivariate prognostic analysis showed that post-IC residual EBV-DNA levels were independent prognostic factors for DMFS and PFS. Patients with EBV-DNA levels > 90 copies/mL had worse DMFS (hazard ratio [HR] 4.978, 95% confidence interval [CI] 1.413-17.535, P = 0.012) and PFS (HR 3.679, 95% CI 1.592-8.499, P = 0.002). Additionally, receiving MC was an independent prognostic factor for PFS and OS. Patients who received MC had better PFS (HR 0.310, 95% CI 0.120-0.802, P = 0.016) and OS (HR 0.100, 95% CI 0.013-0.745, P = 0.025).

CONCLUSIONS: Our study highlights the poorer survival outcomes observed in LANPC patients with residual EBV-DNA levels following IC, as well as the potential survival advantages of MC in this subgroup.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40993812 | DOI:10.1186/s13027-025-00694-8

Addict Sci Clin Pract. 2025 Sep 24;20(1):75. doi: 10.1186/s13722-025-00603-9.

ABSTRACT

BACKGROUND: Hepatitis C infection (HCV) and opioid use disorder (OUD) are syndemic in the U.S., thus primary care providers (PCPs) who treat OUD by prescribing buprenorphine can play key roles to advance HCV elimination targets. We compared HCV screening and treatment among PCPs who do and do not prescribe buprenorphine in Washington (WA) State.

METHODS: This study utilized a cross-sectional survey of PCPs in WA State, designed to characterize HCV care delivery practices and experiences/attitudes toward HCV. In this study, the independent variable was self-reported buprenorphine prescribing, and the main outcomes were (1) guideline-concordant HCV screening and (2) directly providing treatment for HCV. We used descriptive statistics to describe respondent characteristics. We used logistic regression to assess the association between buprenorphine prescribing status and HCV screening and treatment outcomes.

RESULTS: Our sample included 73 PCPs, of whom 55% prescribe buprenorphine. We found that 25% of buprenorphine prescribers directly treated HCV. There was over a 2x greater relative odds that buprenorphine prescribers would correctly screen for HCV relative to non-prescribers (OR = 2.24; 95% CI: 0.67-8.18, p = .20) and a nearly 2.5x greater relative odds that they would treat HCV relative to non-prescribers (OR = 2.42; 0.72-9.61; p = .17), although both findings were not statistically significant.

CONCLUSION: In a sample of PCPs in WA state, buprenorphine prescribers compared to non-prescribers appear more likely to screen for and directly treat HCV, yet only a minority treat HCV. Interventions are needed to enhance HCV guideline-concordant care among these and all PCPs on the frontlines of caring for persons with OUD.

PMID:40993801 | DOI:10.1186/s13722-025-00603-9