Intern Emerg Med. 2025 Sep 27. doi: 10.1007/s11739-025-04114-y. Online ahead of print.
NO ABSTRACT
PMID:41015639 | DOI:10.1007/s11739-025-04114-y
Tag: nevin manimala
Musculoskelet Surg. 2025 Sep 27. doi: 10.1007/s12306-025-00926-5. Online ahead of print.
ABSTRACT
PURPOSE: To evaluate the radiographic and functional outcomes of scaphoid fractures and nonunions treated with volar locked plate fixation, with or without autologous bone grafting, and to explore whether graft use was associated with improved consolidation or function.
METHODS: This retrospective cohort study included 19 adult patients who underwent surgical treatment with volar anatomical plates for scaphoid fractures or nonunions. Radiographic union was assessed at 3, 6, and 12 months. Functional outcomes were measured using the QuickDASH score preoperatively and at 12 months postoperatively. Graft use was determined intraoperatively based on defect characteristics. Statistical analyses included non-parametric tests and multivariable models.
RESULTS: The mean patient age was 24.5 ± 5.4 years, and 94.7% were male. Scaphoid nonunion was present in 11 patients (57.9%), and autologous bone grafting was performed in 15 (78.9%). Radiographic consolidation was achieved in 94.7% of cases at 12 months. QuickDASH scores improved significantly (mean change: 20.6 points; p < 0.001). There were no significant differences in union or functional outcomes between grafted and non-grafted patients (p = 1.000 and p = 0.115, respectively). Interestingly, patients with nonunions demonstrated significantly better postoperative function than those with acute fractures (p = 0.034), although this did not exceed the minimal clinically important difference. Multivariable analysis failed to identify predictors of union or function, explaining only 37% of the variance.
CONCLUSION: Volar locked plate fixation provides high union rates and significant functional improvement in scaphoid fractures and nonunions. Bone grafting did not confer additional benefit, supporting selective rather than routine use. Further studies are warranted to clarify prognostic factors and optimize treatment strategies.
PMID:41015638 | DOI:10.1007/s12306-025-00926-5
J Therm Biol. 2025 Sep 23;133:104281. doi: 10.1016/j.jtherbio.2025.104281. Online ahead of print.
ABSTRACT
Knee osteoarthritis is a degenerative joint disease, causing pain and reduced mobility, especially in older adults. Current imaging methods like CT, MRI, and bone scintigraphy mainly reveal structural changes, but have limitations such as radiation exposure, high cost, and limited repeatability. In contrast, infrared thermal imaging is a non-invasive, radiation-free technique that detects temperature changes linked to joint inflammation. It offers real-time, repeatable results, making it useful for monitoring and guiding timely interventions. This cross-sectional study was conducted on 56 participants diagnosed with knee osteoarthritis to evaluate the role of infrared thermal imaging in assessment and immediate monitoring. Thermal imaging measurements were obtained from both affected and contralateral knees using standardized protocols. Clinical assessment included Kellgren-Lawrence grading, Western Ontario and McMaster Universities Osteoarthritis Index, and Visual Analogue Scale pain scores. Statistical analysis included receiver operating characteristic curve analysis, correlation analysis, and diagnostic performance metrics. Result showed that the mean temperature difference between affected and contralateral knees was 1.80 ± 0.64 °C (p < 0.001, Cohen’s d = 2.81). Thermal temperature differences showed significant correlation with Kellgren-Lawrence grade severity (r = 0.442, p < 0.001). Using an optimal cutoff of 1.16 °C, thermal imaging demonstrated 95 % sensitivity and 43 % specificity for detecting clinically significant osteoarthritis. The area under the receiver operating characteristic curve was 0.65. This research concluded that Infrared thermal imaging provides a non-invasive method for detecting knee osteoarthritis with high sensitivity. The technique shows promise as an adjunctive diagnostic tool, particularly for screening and monitoring disease progression.
PMID:41014663 | DOI:10.1016/j.jtherbio.2025.104281
Physiother Res Int. 2025 Oct;30(4):e70114. doi: 10.1002/pri.70114.
ABSTRACT
BACKGROUND AND PURPOSE: Assessment of physiotherapy undergraduate students in clinical placement is academically important and holds practical value. This study aimed to translate the Assessment of Physiotherapy Practice (APP) tool, which is widely used for this purpose, into Turkish and to verify the factor validity and examine the reliability of this version using a cross-sectional design on senior physiotherapy students.
METHODS: The APP and performance indicators were translated into Turkish in accordance with the recommended protocol. Exploratory and confirmatory factor analyses were conducted using scale data from 100 students. For reliability analyses, 10 clinical supervisors from a Turkish university assessed 63 students using the Turkish version of the Assessment of Physiotherapy Practice (APP-TR) tool. Supervisors performed the APP-TR assessment for each student at week 3 and at the end of the 6-week clinical placement, yielding a score for analysis.
RESULTS: In both assessments, the scale demonstrated high levels of internal consistency (Cronbach’s α = 0.961 for the first assessment, 0.959 for final assessment). Two factors were identified by exploratory factor analysis explaining 65.84% of the total variance and a two-factor model was confirmed to fit by confirmatory factor analysis. Test-retest reliability was assessed by ICC and was high for all subheadings and total score. For all items, the close agreement was at least 98.41% and the exact agreement was at least 88.89% in the percentile analysis between the two assessments.
DISCUSSION: The results of this study suggest that the APP-TR is a reliable and valid tool for evaluating final year physiotherapy students in a clinical placement in Turkey.
PMID:41014636 | DOI:10.1002/pri.70114
Probl Endokrinol (Mosk). 2025 Sep 14;71(4):77-82. doi: 10.14341/probl13545.
ABSTRACT
BACKGROUND: To optimize androgen replacement therapy for male hypogonadism to improve reproductive prospects.
AIM: To compare the effectiveness of restoring the quality of ejaculate in men receiving androgen replacement therapy (AZT) and patients receiving course combination therapy with testosterone and chorionic gonadotropin (AZT/HG).
MATERIALS AND METHODS: In observational prospective study was included 53 men observed at The National Medical Research Center for Endocrinology and AZT (n=19) or AZT/HG (n=34) more than 5 years, followed by stimulating gonadotropin therapy. The qualitative parameters of ejaculate were evaluated in all patients. The basic level of statistical significance was p<0,05.
RESULTS: The patient groups were comparable in age, BMI, duration of therapy used, type of testosterone preparation, as well as the etiology of hypogonadism. Sperm concentration in the AZT group there was a statistically significant negative dynamics, while in the ART/HG group, there were no statistically significant differences in the dynamics of sperm concentration. Statistically significant differences in the value of sperm concentration change were revealed. In both groups was observed statistically significant negative dynamics for sperm motility and morphology. There were no statistically significant differences in the value of changes motility and sperm morphology in both studied groups.
CONCLUSION: Course combination therapy with testosterone and chorionic gonadotropin is characterized by better results for sperm concentration restoration compared with androgenic replacement therapy. For the restoration of sperm motility and morphology both methods do not show satisfactory results.
PMID:41014618 | DOI:10.14341/probl13545
Probl Endokrinol (Mosk). 2025 Sep 14;71(4):57-70. doi: 10.14341/probl13574.
ABSTRACT
BACKGROUND: The main treatment for primary hyperparathyroidism (PHPT) is parathyroidectomy (PTE), conservative therapy, including bisphosphonates, can be used for preoperative correction of hypercalcemia, as well as to improve bone tissue condition among individuals for whom surgery should be postponed or cannot be performed due to high perioperative risks. The question of the effect of bisphosphonates on bone tissue after surgery remains open.
AIM: To study the effect of preoperative bisphosphonate therapy on BMD parameters assessed in DXA and 3D-DXA in patients with PHPT one year after radical PTE.
MATERIALS AND METHODS: The study was conducted on the basis of the Department of pathology of the parathyroid glands and disorders of mineral metabolism of “Endocrinology Research Center” state-funded research facility of the Ministry of Health of the Russian Federation. The study included 50 patients (2 men, 48 women), divided into two groups depending on the presence or absence of preoperative bisphosphonate (BF) therapy. The methods of DXA and 3D-DXA using 3D-Shaper Medical software were used to evaluate BMD and bone microarchitectonics. The statistical analysis was performed using the R language and the Statistica v.13 package.
RESULTS: At the time of the disease’s manifestation, both groups were comparable in terms of the main indicators of calcium phosphorus metabolism, with the exception of the level of beta-crosslapse, which was higher in the group without preoperative BPh therapy (p<0,001). There were also no differences in the parameters of DXA and 3D-DXA. After surgery, both groups showed a comparable increase in BMD based on the results of DXA in the main parts of the skeleton and 3D-DXA in the femur. Changes at the level of the statistical trend were obtained for the 3D-DXA parameters, the final absolute values of which were slightly higher in the second group, including the thickness of the cortical layer in the femur as a whole and in the neck. When comparing the results of DXA before and after PTE in patients receiving BPh, statistically significant differences in absolute BMD values were obtained only in the lumbar spine (p<0,001).According to 3D-DXA data, statistically significant differences were found only in the volume of mineral density of the trabecular bone of the femur as a whole (p=0,001).When analyzing up to – in the second group, statistically significant differences in absolute BMD values were observed in the lumbar region (p<0,001), in the hip as a whole (p<0,001) and in its neck (p=0,001).According to 3D-DXA data, statistically significant differences were found in three of the eight analyzed indicators, the volume of mineral density of the trabecular bone of the femur as a whole and in the neck (p<0,001 for both), as well as the volume of mineral density of the cortical bone in the neck, (p=0,001).
CONCLUSION: The 3D-DXA method allows us to evaluate not only BMD, but also its microarchitectonics, which is important for predicting the risk of fractures in patients with PHPT. Studies have shown that preoperative BPh therapy can negatively affect the recovery of BMD after PTE, especially in cortical bone tissue. Further studies are needed to confirm these data and clarify the effect of CF on the postoperative course of PHPT.
PMID:41014616 | DOI:10.14341/probl13574
Probl Endokrinol (Mosk). 2025 Sep 14;71(4):47-56. doi: 10.14341/probl13538.
ABSTRACT
BACKGROUND: Determination of body composition components – muscle and fat mass – is an important step in clinical and epidemiological studies. The most common methods for quantitative determination of body composition are indirect methods. However, the variety of methods and models of devices used makes direct comparison of data at both group and individual levels difficult.
AIM: The aim of the study is to analyze the consistency of estimates of absolute values of fat and lean body mass, as well as the proportion of body fat mass, obtained using bioimpedance analyzers ABC-02 «Medas» (STC Medas, Russia), 770InBody (InBody, Korea) and ultrasound scanner BodyMetrix BX2000 (IntelaMetrix, USA) in a group of men and women.
MATERIALS AND METHODS: An observational, single-center, cross-sectional, uncontrolled study was conducted. The main anthropometric characteristics (height and weight, waist circumference) were measured. Body composition was determined by bioimpedancemetry (BIA) using the octopolar scheme on the 770InBody device and the tetrapolar scheme on the ABC-02 Medass device and ultrasound scanning using the BodyMetrix BX2000 (BM) ultrasound scanner. The absolute (FM) and relative amount of body fat (PBF) and lean body mass were calculated.
RESULTS: A total of 48 people (38 women and 10 men) aged 24 to 74 years were examined. The anthropometric characteristics of the examined subjects were presented in a wide range. A strong correlation was found for all pairs of body composition components: the minimum value for the pair PBF ABC-BM was 0.853 [0.730, 0.913], the maximum was 0.988 [0.977, 0.993] for the pair FM ABC-InBody. Also, significant statistical differences (p<0.001) were found for all pairs of measurements, except for PBF determined by the BIA method. High agreement (CCC>0.95) of BIA estimates of the absolute amount of fat mass was shown, moderate agreement (CCC 0.9-0.95) is characteristic of the PBF determined by different BIA analyzers, and for all other pairs the agreement of measurements can be assessed as weak (CCC<0.90).
CONCLUSION: The best agreement at the group and individual levels was found for FM estimates by two different BIA analyzers (InBody and ABC).
PMID:41014615 | DOI:10.14341/probl13538
Probl Endokrinol (Mosk). 2025 Sep 14;71(4):9-15. doi: 10.14341/probl13487.
ABSTRACT
BACKGROUND: Currently, due to the lack of clear criteria for predicting the aggressive course of pituitary adenomas (APA), the search for diagnostic markers is highly relevant. Genetic markers, among others, may serve as such markers since their identification is possible at early stages of the pathological process.
OBJECTIVE: To study the prevalence of genotypic polymorphisms G634C of the VEGFA gene (locus rs2010963), C/T of the TP53_2 gene (locus rs17884159), C/T of the HIF1A gene (locus rs11549465), and G-197A of the IL-17A gene in a sample of patients with APA and their association with the development of various clinical variants of the aggressive course of the disease.
MATERIALS AND METHODS: The study included 100 patients with a clinically confirmed diagnosis of pituitary adenoma (main group) and 83 practically healthy individuals (control group). The polymorphism of the studied genes was analyzed using allele-specific polymerase chain reaction (PCR) with SNP-Express reagent kits in real-time mode (“Sintol”, Russia). The interpretation of the results was carried out using the “RotorGene” software of the PCR-RV device. The study also included general clinical, biochemical, and hormonal tests, as well as instrumental and neuroimaging methods, including magnetic resonance imaging (MRI) of the chiasmatic-sellar region and statistical analysis.
RESULTS: The study showed that the heterozygous mutation (G/C) of the G634C VEGFA polymorphism was recorded in 21 cases (26%), and the homozygous mutation with a complete replacement of guanine (G) by cysteine (C) at position 634 (C/C) was detected in 4 cases. In patients with invasive pituitary adenomas (PA), the heterozygous variant (G/C) was twice as frequent – 32.7% (n=17) compared to the control group – 15.7% (n=13). The homozygous genotype (C/C) was also more frequently observed in patients with invasive PA growth – 7.7% (n=4) compared to the control group.The heterozygous variant (C/T) of the HIF1A gene was significantly more common (p=0.02) in patients with invasive adenomas compared to the control group: 25% (n=13) and 9.8% (n=8), respectively. In non-invasive PAs, this genotype was observed three times less frequently. The study of TP53_2 polymorphism (locus rs17884159) showed that in patients with invasive PAs, the frequency of the heterozygous variant (C/T) was significantly higher – 15.4% (n=8) compared to the control group – 4.8% (n=4).
CONCLUSION: The conducted genetic analysis of polymorphisms in the VEGFA, HIF1A, TP53_2, and IL-17A genes revealed significant deviations, confirming their practical significance in the early diagnosis of aggressive pituitary adenomas.
PMID:41014611 | DOI:10.14341/probl13487
Global Spine J. 2025 Sep 27:21925682251384669. doi: 10.1177/21925682251384669. Online ahead of print.
ABSTRACT
Study DesignSingle-center retrospective comparative study.ObjectiveWhile vitamin D (VD) levels are known to correlate with outcomes in lumbar degenerative disease (LDD), it remains unclear whether LDD is related to elevated risk of VD deficiency. This study aimed to compare the prevalence and epidemiological characters of VD deficiency between surgical LDD patients and health screening (HS) populations.Methods7300 HS participants and 1147 surgical LDD patients were included. All participants accepted serum VD test. In both HS participants and LDD patients, the epidemiological characteristics and influence factors of VD deficiency were analyzed. Propensity score matching was used to create a matched healthy control group, and the prevalence of VD deficiency was further compared.Results66.9% of HS participants and 42.9% of LDD patients were with VD deficiency. Age, sex, BMI and season were influence factors of VD deficiency in both groups. As age grows, the VD levels increase in young age and decrease in older age after the peak. Female, high BMI and Winter/Spring season were risk factors of VD deficiency. Compared with matched control group, LDD group exhibited statistically higher median VD levels than controls [median (interquartile range), 21.6 (16.3, 27.9) vs 19.3 (15.0, 25.3), P < 0.001]. However, the prevalence of VD deficiency was not significantly different between the matched groups.ConclusionLDD does not appear to be associated with an elevated risk of VD deficiency. Compared with the HS cohort, surgical LDD patients exhibit similar epidemiological patterns of VD levels, including an unusual biphasic relationship with age.
PMID:41014591 | DOI:10.1177/21925682251384669
Global Spine J. 2025 Sep 27:21925682251383882. doi: 10.1177/21925682251383882. Online ahead of print.
ABSTRACT
Study DesignSystematic Review.IntroductionRandomized controlled trials (RCTs) on lumbar endoscopic decompression inform treatment decisions for disk disease, radiculopathy, and lumbar spinal stenosis. This study assessed the fragility of statistical outcomes in these RCTs.MethodsPubMed, Embase, and MEDLINE were queried for RCTs reporting dichotomous outcomes with at least 1 endoscopic decompression arm. The fragility index (FI) and reverse FI (rFI) represented the number of event reversals needed to change significance for significant and nonsignificant outcomes, respectively. The fragility quotient (FQ) was calculated by dividing FI by sample size. Subgroup analysis was performed by outcome type.Results37 RCTs met the inclusion criteria for analysis. A total of 160 outcomes were analyzed. The median FI was 4 (IQR: 3-5) and FQ 0.038 (IQR: 0.017-0.067). Significant outcomes (n = 23) had a median FI of 7 (IQR: 2-13), FQ 0.024 (IQR: 0.012-0.056); nonsignificant outcomes (n = 137) had FI 4 (IQR: 3-5), FQ 0.041 (IQR: 0.020-0.068). Revisions/reoperations were most robust (FI: 5, FQ: 0.037); microscopic outcomes most fragile (FI: 4, FQ: 0.022). Pain outcomes had FI 4 (FQ: 0.051); complications FI 4 (FQ: 0.038). In 47.5% of outcomes, patients lost to follow-up exceeded FI.ConclusionsFindings from RCTs on lumbar endoscopic decompression are vulnerable to small changes in outcome events. In nearly half of outcomes, patients lost to follow-up outnumbered the FI. Reporting FI and FQ with P-values may improve interpretation and reliability of trial results.
PMID:41014588 | DOI:10.1177/21925682251383882