Category: Nevin Manimala

Arch Orthop Trauma Surg. 2025 Aug 12;145(1):407. doi: 10.1007/s00402-025-06031-3.

ABSTRACT

INTRODUCTION: Accurate anatomical determination of the knee joint line is critically important for the success of both primary and revision total knee arthroplasty procedures. This study aimed to evaluate the reliability of anatomical landmarks for determining the knee joint line using plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI) in the Turkish population.

MATERIALS AND METHODS: This retrospective study included 186 patients. Anatomical reference points for the knee joint line were defined as the adductor tubercle, medial and lateral epicondyles, fibular head, tibial tuberosity, and inferior pole of the patella. Measurements obtained from all three imaging modalities were compared, and the relationships between femoral width (FW) and reference points were analyzed using correlation and linear regression analyses.

RESULTS: No statistically significant differences were found between the measurement results of the reference points across the imaging methods (lowest r = 0.91, p < 0.001). A strong correlation was observed between FW and the adductor tubercle joint line (ATJL) and medial epicondyle joint line (MEJL). Intraclass correlation coefficients (ICC) were greater than 0.90, indicating excellent reliability.

CONCLUSIONS: The adductor tubercle was identified as a reliable anatomical landmark for determining the knee joint line. Additionally, plain radiography, which offers advantages in terms of cost and reduced radiation exposure, may be a sufficient alternative for clinical applications. These findings can provide valuable contributions to surgical planning for accurate joint line determination. However, further studies are needed to validate these results in patients requiring surgical intervention.

PMID:40794293 | DOI:10.1007/s00402-025-06031-3

Support Care Cancer. 2025 Aug 12;33(9):781. doi: 10.1007/s00520-025-09798-8.

ABSTRACT

PURPOSE: A cancer diagnosis and treatment pose significant physical and psychological challenges. The study aimed to explore factors associated with distress over time in women diagnosed with breast cancer undergoing radiotherapy (RT) with access to a digital information tool, specifically examining if factors such as health literacy and self-efficacy had any influence on distress.

METHODS: In this pilot randomised controlled trial, women were assigned to an intervention group (n = 59) with access to a digital information tool or a control group (n = 52). Assessments were conducted at baseline, one week before RT (FU1), one week post- (FU2), and six months after treatment (FU3). Distress was measured at all time points, and associated factors were evaluated at baseline and six months.

RESULTS: In the intervention group, a statistically significant reduction in distress was observed over time (FU1, p = .009; FU2, p < .001; FU3, p < .001). The control group showed a significant reduction at FU3 (p = .009). Quade’s ANCOVA revealed no significant differences between the groups in distress prevalence (F = 3.460, p = .066). No significant changes in health literacy or self-efficacy were observed over time.

CONCLUSION: The results indicate no statistically significant effect on distress; however, there is a potential indication of a reduction in distress, suggesting that the digital information tool may offer some benefits. Further research is required to confirm this relationship.

PMID:40794292 | DOI:10.1007/s00520-025-09798-8

World J Urol. 2025 Aug 12;43(1):486. doi: 10.1007/s00345-025-05863-3.

ABSTRACT

OBJECTIVES: To compare the efficacy and safety of flexible and navigable suction sheath (FANS) versus non-flexible suctioning ureteral access sheath (S-UAS) in retrograde intrarenal surgery (RIRS) for renal stones, using a propensity score-matched retrospective cohort analysis.

MATERIALS AND METHODS: This retrospective cohort study included 256 patients undergoing RIRS for renal stones (1-4 cm) between December 2019 and March 2025 at The First People’s Hospital of Guangyuan. Patients were divided into two groups: 199 received FANS and 57 received S-UAS. Baseline characteristics were balanced using propensity score matching (PSM) with a caliper value of 0.1. Efficacy was assessed by stone-free rate, and safety was evaluated by postoperative complications, including fever and systemic inflammatory response syndrome (SIRS). Statistical analyses were performed using R v.3.6.1, with significance set at P < 0.05.

RESULTS: Before PSM, significant baseline differences existed in age, stone diameter, CT value, lower calyceal stone prevalence, and preoperative ureteral stent insertion. After PSM, 44 matched pairs showed no significant baseline differences (all standardized mean differences < 0.1). The FANS group had a significantly lower rate of failed stone clearance (9.1% vs. 34.1%, P = 0.010) post-PSM. No significant differences were observed in operative time (70.39 ± 43.73 vs. 62.50 ± 19.54 min, P = 0.278), hospital stay (7.75 ± 4.50 vs. 7.05 ± 2.17 days, P = 0.352), or SIRS (2.3% vs. 0%, P = 1.000). Postoperative fever was not significantly different post-PSM (0% vs. 6.8%, P = 0.240).

CONCLUSION: FANS is associated with a significantly higher stone-free rate compared to S-UAS in RIRS for renal stones, with comparable safety outcomes. These findings support the use of FANS to enhance stone clearance, though prospective, multi-center trials are needed to confirm these results.

PMID:40794291 | DOI:10.1007/s00345-025-05863-3

Eur J Orthop Surg Traumatol. 2025 Aug 12;35(1):347. doi: 10.1007/s00590-025-04458-3.

ABSTRACT

INTRODUCTION: Paediatric pelvic fractures are rare injuries. In such cases, the measurement of spinopelvic parameters is important in objectively evaluating pelvic asymmetry. This study investigated functional outcomes after the treatment of paediatric pelvic fractures.

MATERIALS AND METHODS: Patients aged 10-18 years who were admitted to our level 1 trauma centre were included in this retrospective study. Spinopelvic parameters were used to evaluate functional outcomes, and the changes of spinopelvic parameters in patients treated surgically and conservatively were compared. The Injury Severity Score (ISS) and Pelvic Abbreviated Injury Scale (AIS) score were calculated. Haemoglobin decreases in the first 24 h, and blood transfusion amounts were evaluated.

RESULTS: A total of 60 patients were treated during the study period, 28 (47%) surgically and 32 (53%) conservatively. No statistically significant differences in spinopelvic parameter measurements were observed between the groups (p > 0.05). There were also statistically significant differences between the groups in terms of haemoglobin decrease (p = 0.026) and transfusion amounts (p = 0.049) in the first 24 h; ISS and Pelvic AIS scores (p = 0.003), with values being higher in the surgery group.

CONCLUSIONS: This study aimed to evaluate the appropriate treatment of paediatric pelvic trauma and present quantitative data on functional outcomes for the first time in the literature. Surgery is the main treatment approach for displaced paediatric pelvic fractures to prevent deformity and complications. In this study, there was no statistically significant difference between the spinopelvic parameter measurements of patients who underwent surgical treatment and those who received conservative treatment (p > 0.05). This indicates that when unstable paediatric pelvic fractures are treated surgically, the outcomes are comparable to those achieved through conservative treatment. Studies with longer follow-up are needed to better demonstrate functional outcomes.

PMID:40794290 | DOI:10.1007/s00590-025-04458-3

J Am Chem Soc. 2025 Aug 12. doi: 10.1021/jacs.5c10754. Online ahead of print.

ABSTRACT

Array-based differential sensing is inspired by a mammal’s sense of taste and smell. The human sense of touch is also array-based; using mechanosensors in the skin that differentiate surfaces by their surface chemistry. Inspired by this, we aimed to develop a rationally biased and randomized oligomer sensor array which differentiates bulk solids by their surface chemistry. Column chromatography mimics this aspect of the sense of touch, as it is traditionally used to physically separate molecules in solution by the strength of their noncovalent interactions with the stationary phase. In this report, we differentiated column chromatography stationary phases (the analyte) by the retention time (the sensor’s analytical response) of a vast library of oligomers with statistically biased but random monomer compositions (the sensor array). The use of unsupervised principal component analysis (PCA) validated our sensor array design by differentiating five surfaces with tight replicate clustering and a high degree of cross-reactivity.

PMID:40794286 | DOI:10.1021/jacs.5c10754

Acta Anaesthesiol Scand. 2025 Sep;69(8):e70111. doi: 10.1111/aas.70111.

ABSTRACT

BACKGROUND: Concerns about the delayed diagnosis of acute compartment syndrome have led to recommendations favouring general anaesthesia over spinal anaesthesia in surgeries for diaphyseal tibia fractures. However, there is a lack of supporting clinical evidence. This study compared spinal anaesthesia and general anaesthesia in terms of compartment pressures, risk of acute compartment syndrome, and postoperative outcomes in tibia shaft fractures treated with intramedullary nailing.

METHODS: A randomized controlled study was carried out at a tertiary hospital from 2011 to 2021. Fifty patients with unilateral tibia shaft fractures were randomly assigned to receive either spinal or general anaesthesia. The primary outcome was compartment and delta pressures in the anterior tibial muscle compartment for 24 h after surgery. Secondary outcomes included near-infrared spectroscopy values, pain scores, and opioid consumption.

RESULTS: Delta pressures were higher in the spinal anaesthesia group (estimated average effect over 24 h: 6.4 mmHg [CI 0.2-12.6]; p = 0.042). However, absolute compartment pressures were comparable between groups (effect estimate: -0.9 mmHg [CI -6.7 to 5.0]; p = 0.77). No cases of acute compartment syndrome occurred in the spinal anaesthesia group, while three patients treated with general anaesthesia required fasciotomy. There was no statistical difference in compartment surface oxygenation measured with near-infrared spectroscopy, pain scores, or median total opioid consumption between the study groups during the 24-h postoperative follow-up.

CONCLUSION: Spinal anaesthesia was not associated with higher compartment pressures compared to general anaesthesia. These findings suggest that prevailing concerns and recommendations about spinal anaesthesia for tibia shaft fracture surgery may need reconsideration and challenge recommendations favouring general anaesthesia as the primary method.

EDITORIAL COMMENT: This study addresses whether or not spinal anaesthesia might affect acute compartment syndrome and outcomes in tibial shaft fractures. Despite small sample sizes, the findings suggest that spinal anaesthesia does not increase compartment pressures or delay diagnosis of acute compartment syndrome when patients are appropriately monitored. These results support spinal anaesthesia as a safe alternative in selected trauma patients in this context.

TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT01795287.

PMID:40792424 | DOI:10.1111/aas.70111

ESC Heart Fail. 2025 Aug 12. doi: 10.1002/ehf2.15391. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Heart failure (HF) is a multifactorial disease for which peak oxygen uptake (VO₂peak) may potentially be a prognostic marker of adverse clinical outcomes. This systematic review and meta-analysis aimed to assess published data on the prognostic impact of VO₂peak in HF.

METHODS: A literature search of observational studies was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until January 2025. A meta-analysis was conducted using the random-effects inverse-variance model through hazard ratios (HRs). Increased heterogeneity among studies was evaluated through meta-regressions and publication bias via Egger’s test.

RESULTS: Sixty-four studies were included in this systematic review and meta-analysis. Per 1 mL/kg/min increase in VO₂peak, all-cause mortality [HR: 0.86, 95% confidence interval (CI) 0.82-0.90, I² = 85%, P < 0.01] and incident ventricular assist device, transplant and all-cause mortality (HR: 0.84, 95% CI 0.79-0.89, I² = 33%, P < 0.01) were significantly reduced, but statistical significance of VO₂peak with cardiovascular mortality was not observed (HR: 0.92, 95% CI 0.82-1.02, I² = 0%, P = 0.12) using adjusted models. Variance among studies was detected based on age, sex, body mass index, left ventricular ejection fraction, atrial fibrillation, hypertension, chronic kidney disease, diabetes and treatment. A significant risk of publication bias was evident.

CONCLUSIONS: VO₂peak is a prognostic marker for multiple causes of mortality and hospitalization in patients with HF, which may promote further insights into patient risk stratification for adverse events and targeted management.

PMID:40792415 | DOI:10.1002/ehf2.15391

Healthc Q. 2025 May;28(1):85-92. doi: 10.12927/hcq.2025.27626.

ABSTRACT

Little is known about domiciliary hostels (known as residential care facilities [RCFs] in Hamilton, Ontario) for those needing affordable housing and minimal supports. Our multiple-methods study examined the characteristics and health needs of 36 RCF tenants across four RCFs. We found that 64.4% of participants were 50+ years old, 22.2% had ever been unhoused, 77.4% had comorbid physical and mental illness and 83.3% had been hospitalized. Financial resources, capacity for work and physical pain were key quality-of-life concerns. A whole-systems approach involving healthcare, social care and housing is needed to serve this marginalized and aging population.

PMID:40792411 | DOI:10.12927/hcq.2025.27626

Healthc Q. 2025 May;28(1):12-15. doi: 10.12927/hcq.2025.27637.

ABSTRACT

The health workforce is the lifeblood of the Canadian health system. Comprehensive data is essential to inform policy and resources allocation and to address care gaps. While data collection challenges exist, Canadian Institute for Health Information’s (CIHI’s) new health workforce data standards and the establishment of Health Workforce Canada strive to improve data quality. Using findings from The State of the Health Workforce in Canada, 2023 report, this article provides insights into Canada’s health workforce and underscores the value of enhancing Canada’s data collection and reporting. Strengthening health workforce data will drive improvements, fostering a healthier population and a sustainable health workforce.

PMID:40792400 | DOI:10.12927/hcq.2025.27637

Healthc Q. 2025 May;28(1):7-11. doi: 10.12927/hcq.2025.27638.

ABSTRACT

People living with dementia require care from a variety of health professionals and in different settings to optimize their quality of life. A phase-based approach to costing health system use supports our understanding of the longitudinal costs of care through disease progression at a population level. This report estimates five-year and phase-based net health system costs of dementia.

PMID:40792399 | DOI:10.12927/hcq.2025.27638