Tag: pubmed

OBJECTIVE: To investigate the effect of preoperative lower-limb muscle strength on perioperative blood loss, postoperative pain, and functional recovery in patients undergoing total knee arthroplasty (TKA).

METHODS: A retrospective analysis was conducted on the clinical data of 380 patients who underwent TKA and met the selection criteria between February 2023 and December 2024. Based on the gender-specific median of standardized preoperative lower-limb extensor isokinetic muscle strength (IMS), the patients were divided into a low-extensor strength group and a high-extensor strength group, with 190 cases in each group. The following data of the two groups were collected and compared, including age, gender, body mass index, comorbidities, surgical side, length of hospital stay, Kellgren-Lawrence grade, perioperative parameters [including hematocrit (Hct) and hemoglobin (Hb) levels within 1 week preoperatively and 2-3 days postoperatively, with the calculation of Hct loss and Hb loss (the difference between the pre- and post-operative measurements), and whether intraoperative allogeneic blood transfusion was performed], preoperative knee flexion and extension IMS, 5-time sit-to-stand (5-STS) test within 2 weeks preoperatively, as well as visual analogue scale (VAS) score for pain and active range of motion (AROM) within 2 weeks preoperatively and 1 day postoperatively. Pearson correlation analysis was used to analyze the correlation between preoperative lower-limb extensor IMS and TBL. Through multiple linear regression analysis, the effect of IMS on TBL was further explored after adjusting for confounding factors such as age, body mass index, hypertension, diabetes mellitus, coronary atherosclerotic heart disease, and chronic obstructive pulmonary disease.

RESULTS: There was no significant difference between the two groups in age, gender, body mass index, surgical side, Kellgren-Lawrence grade, comorbidities, length of hospital stay, preoperative Hct and Hb levels, intraoperative allogeneic blood transfusion rate, and changes in VAS scores ( P>0.05). The high-extensor strength group was superior to the low-extensor strength group in preoperative VAS scores, AROM, 5-STS, as well as postoperative Hct and Hb loss, and the changes of AROM and TBL were less than those in the low-extensor strength group, with all differences being significant ( P<0.05). Pearson correlation analysis showed a negative correlation between preoperative lower-limb extensor IMS and TBL ( r=-0.460, P=0.043). Multiple linear regression analysis showed that after adjustment, a lower TBL was associated with a higher preoperative lower-limb extensor IMS. Specifically, for every 1 N·m increase in preoperative lower-limb extensor IMS, TBL decreased by 9.973 mL. TBL was not significantly affected by other factors such as age, body mass index, and comorbidities.

CONCLUSION: Higher preoperative lower-limb muscle strength is associated with reduced intraoperative blood loss during TKA and improved postoperative pain relief and functional recovery. These findings highlight the critical role of preoperative muscle strength management, providing scientific evidence for designing standardized postoperative rehabilitation protocols and offering guidance for optimizing surgical timing to maximize recovery outcomes.

PMID:41981424 | DOI:10.7507/1002-1892.202512049

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Efficacy and safety of emergency administration of tranexamic acid in elderly patients with intertrochanteric femoral fractures

Post author By Nevin Manimala
Post date April 15, 2026

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2026 Apr 15;40(4):526-532. doi: 10.7507/1002-1892.202511095.

ABSTRACT

OBJECTIVE: To investigate the efficacy and safety of emergency administration of tranexamic acid (TXA) in reducing perioperative blood loss and blood transfusion rate in elderly patients with intertrochanteric femoral fractures.

METHODS: A retrospective analysis was conducted on the clinical data of 102 elderly patients with intertrochanteric femoral fractures who were admitted between October 2023 and May 2025 and met the selection criteria. Patients were divided into two groups based on whether TXA was administered in the emergency department: the TXA group (patients received a single intravenous infusion of 1 g TXA immediately upon emergency admission, n=50) and the control group (no TXA was used in the emergency department, n=52). There was no significant difference in baseline data between the two groups ( P>0.05), including age, gender, body mass index, American Society of Anesthesiologists (ASA) classification, AO/Orthopaedic Trauma Association (AO/OTA) fracture classification, underlying comorbidities, prothrombin time, activated partial thromboplastin time, fibrin degradation products, D-dimer, bone mineral density T-score, time from injury to admission, time from admission to surgery, hemoglobin (HB), and hematocrit (HCT) levels at emergency admission. The following parameters were collected and analyzed statistically: changes in HB and HCT on the day before surgery (compared with values at emergency admission); hidden blood loss (HBL) on the day before surgery; total blood loss (TBL) on postoperative day 1, day 3, and during the entire perioperative period; in-hospital blood transfusion rate; and incidence of complications such as thrombosis.

RESULTS: There was no significant difference in operation time between the two groups ( P>0.05). All patients were followed up 3-12 months (mean, 6.6 months). On the day before surgery, the decreases in HB and HCT in the TXA group were significantly lower than those in the control group ( P<0.05). The HBL on the day before surgery and perioperative TBL in the TXA group were significantly lower than those in the control group ( P<0.05), whereas there was no significant difference in TBL on postoperative day 1 or day 3 between the two groups ( P>0.05). The in-hospital blood transfusion rate in the TXA group (34.0%) was significantly lower than that in the control group (55.8%, P<0.05). During hospitalization and follow-up, no complication such as deep vein thrombosis of the lower extremities, pulmonary embolism, surgical site infection, or allergic reactions occurred in either group. Intermuscular venous thrombosis occurred in 4 patients (8.0%) in the TXA group and 5 patients (9.6%) in the control group, with no significant difference in incidence between the two groups ( P>0.05).

CONCLUSION: Elderly patients with intertrochanteric femoral fractures experience significant blood loss due to initial trauma. Emergency administration of TXA can reduce trauma-induced preoperative HBL, perioperative TBL, and in-hospital blood transfusion rate without increasing the incidence of thromboembolic events, thus proving safe and effective.

PMID:41981423 | DOI:10.7507/1002-1892.202511095

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Nevin Manimala Statistics

Elarekibep, an inhaled anti-IL-4 receptor alpha Anticalin, in moderate-to-severe asthma: a randomized, placebo-controlled phase 2a study (APATURA)

Post author By Nevin Manimala
Post date April 15, 2026

Respir Res. 2026 Apr 14. doi: 10.1186/s12931-026-03613-6. Online ahead of print.

NO ABSTRACT

PMID:41981420 | DOI:10.1186/s12931-026-03613-6

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Nevin Manimala Statistics

Clinical Performance of Bioglass-Enriched Resin Modified Glass Ionomer in Sealing Moderate Carious Lesions: An 18-Month Split-Mouth Clinical Trial

Post author By Nevin Manimala
Post date April 15, 2026

Int J Dent Hyg. 2026 Apr 14. doi: 10.1111/idh.70058. Online ahead of print.

ABSTRACT

Dental materials with the potential for caries progression prevention have been an attractive alternative to minimally invasive treatments.

OBJECTIVES: This randomized controlled split-mouth clinical trial aimed to assess, after 18 months, the retention, restoration quality, and caries progression or arrestment of active moderate carious lesions (International Caries Detection and Assessment System [ICDAS] 3-4) sealed with resin-modified glass ionomer cement (RMGIC) and 45S5 bioglass-enriched RMGIC (RMGIC/45S5).

METHODOLOGY: A total of 52 molars with occlusal caries (ICDAS 3-4) were selected. For this split-mouth clinical trial, the permanent molars without mechanical preparation were randomly sealed with RMGIC or RMGIC/45S5. After 18 months, the restorations were compared with the initial treatment (baseline) regarding retention, quality of the remaining material (anatomical shape, marginal adaptation, surface texture, and marginal discoloration), and clinical/radiographic caries progression. The Wilcoxon and Fisher’s exact tests were used for data evaluation.

RESULTS: After 18 months, no statistically significant differences were found in the retention and material quality of teeth treated with RMGIC or RMGIC/45S5 (p > 0.05). The clinical and radiographic evaluations showed no statistical difference between the materials when considering caries arrestment and progression (p > 0.05).

CONCLUSIONS: The addition of 45S5 bioglass to RMGIC did not change the retention, restoration quality, and caries progression or arrestment levels after 18 months of follow-up.

PMID:41981418 | DOI:10.1111/idh.70058

Tags nevin manimala, pubmed, statistics