Tag: pubmed

J Orthop. 2025 May 27;68:163-170. doi: 10.1016/j.jor.2025.05.055. eCollection 2025 Oct.

ABSTRACT

PURPOSE: Traditional bone-plug allografts in reconstruction of anterior cruciate ligament (ACL) tears require shaping of the bone plug by surgeons, yielding inconsistent results, greater costs, and increased operative time. We compare the load-to-failure between pre-shaped and surgeon-shaped Achilles allografts with calcaneal bone blocks to assess their use in ACL reconstruction.

METHODS: Six pre-shaped Achilles allograft tendons with calcaneus bone grafts were compared to 6 surgeon-shaped allografts. Calcaneal grafts were inserted into artificial saw bone while the opposite ends were fixed to a linear-torsion dynamic test machine for cyclic and load-to-failure testing. Loading began with a preconditioning phase, followed by uniaxial cycles. Failure load was and mechanism of failure for each graft was identified.

RESULTS: Of the 6 pre-shaped bone grafts, 3 (50 %) experienced a failure at the sawbone/screw interface, 2 (33 %) experienced a bone graft fracture, and 1 (17 %) a tendon avulsion during cycling. Of the 6 surgeon-shaped bone grafts, 3 (50 %) experienced failure at the sawbone screw interface, and 3 (50 %) experienced a bone block fracture. No significant differences in biomechanical properties measured during load-to-failure testing or failure modes were detected between the two graft types.

CONCLUSION: Pre-shaped grafts exhibited a trend towards higher load and displacement at failure, although this was not statistically significant. These findings, along with potential cost and time savings, warrant further study on their impact on surgical efficiency and outcomes.

PMID:40530321 | PMC:PMC12167822 | DOI:10.1016/j.jor.2025.05.055

Arthroplast Today. 2025 Jun 4;33:101722. doi: 10.1016/j.artd.2025.101722. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Total hip arthroplasty (THA) has emerged as a valuable strategy for managing hip tuberculosis (TB) osteoarthritis, but the optimal of 1-stage and 2-stage THA in patients with hip TB of varying severity levels surgical approach remains debated. The purpose of this study was to investigate whether there were differences in the effect of different surgical protocols on hip TB treatment.

METHODS: A retrospective cohort study was conducted on 43 patients who underwent THA for hip TB at our institution between 2010 and 2020. Twenty-three patients received a 1-stage THA, while 20 underwent a 2-stage procedure. Infection control, functional status, complications and the blood loss and transfusion volume were evaluated mean 4-year follow-up.

RESULTS: Both surgical approaches demonstrated favorable outcomes. No significant differences were observed between the 1-stage and 2-stage groups in terms of infection control (P = .35), functional improvement as measured by the Harris Hip Score (P = .42), or complication rates (P = .61). The mean Harris Hip Score improved significantly in both groups from baseline (P < .01 for both), with a slightly higher score at 1 year in the 1-stage group (P = .04). The differences in both blood loss and transfusion volume were statistically significant (P < .01 and P = .01, respectively).

CONCLUSIONS: For patients with mild disease, 1-stage THA may be an appropriate choice, while 2-stage THA is recommended for severe cases. Within their respective indications, both approaches demonstrate good outcomes in terms of infection control and functional restoration.

PMID:40530300 | PMC:PMC12172307 | DOI:10.1016/j.artd.2025.101722

Front Plant Sci. 2025 Jun 3;16:1560603. doi: 10.3389/fpls.2025.1560603. eCollection 2025.

ABSTRACT

INTRODUCTION: Phlomoides rotata, an important Tibetan medicinal plant, has garnered significant attention due to its remarkable medicinal value and ecological functions. However, overharvesting and climate change have progressively reduced its distribution range, threatening its survival.

METHODS: This study employed an optimized MaxEnt model, integrating field survey data and multiple environmental variables, to predict and analyze the potential suitable distribution of P. rotata in Tibet.

RESULTS: The model achieved high predictive accuracy, with Ture skill statistic (TSS) = 0.87 and Cohen’s Kappa Coefficient (Kappa) = 0.81. Under current climatic conditions, the suitable habitat area of P. rotata is 33.31×10⁴ km², primarily distributed in alpine meadows and sparse shrublands in regions such as Lhasa, Nyingchi, Qamdo, Shannan, and eastern Nagqu. Analysis of key environmental factors revealed that land cover type (30.7%), temperature seasonality (19.9%), and vegetation type (10.2%) are the most significant drivers influencing the distribution of P. rotata. Under future climate change scenarios, the distribution of suitable habitats exhibits notable dynamic trends. In the low-emission scenario (SSP126), the suitable habitat area shows an overall expansion. In contrast, under medium- and high-emission scenarios (SSP245 and SSP585), the suitable habitat area gradually shrinks. The distribution centers consistently migrate northwestward, with the longest migration distance observed under SSP585 (89.55 km).

DISCUSSION: This study identifies the critical driving factors for the distribution of P. rotata and elucidates its response patterns to climate change. These findings provide a theoretical foundation for the resource management, ecological conservation, and sustainable utilization of Tibetan medicinal plants while offering valuable references for the study of other alpine plants.

PMID:40530282 | PMC:PMC12170608 | DOI:10.3389/fpls.2025.1560603

Front Plant Sci. 2025 Jun 3;16:1566514. doi: 10.3389/fpls.2025.1566514. eCollection 2025.

ABSTRACT

INTRODUCTION: Magnaporthiopsis maydis, the causal agent of late wilt disease (LWD), poses a significant threat to maize production by reducing grain yield and quality. Identifying and developing resistant genotypes adapted to different environments is essential for sustainable crop improvement.

METHODS: Fifteen maize genotypes were evaluated for their response to LWD across three growing seasons at two experimental locations-Gemmeiza and Sids. Disease incidence, agronomic performance, anatomical features, and antioxidant enzyme activities were assessed. Gene expression analysis of PR1 and PR4 was conducted using RT-qPCR. Genotype × environment interaction (GEI) was analyzed using combined ANOVA and the additive main effects and multiplicative interaction (AMMI) model.

RESULTS: Significant differences were observed among genotypes, environments, and their interactions (GEI) for disease incidence and yield-related traits (p < 0.05). AMMI analysis confirmed substantial GEI effects on DI% and hundred kernel weight. Genotypes TWC1100, SC30K9, and SC2031 consistently showed the lowest disease incidence and the highest resistance rating index (RRI > 8.3) across both locations, while the susceptible check Boushy recorded the highest DI% and lowest RRI. TWC1100 and SC30K9 also achieved the highest kernel weights at Gemmeiza (42.8 g and 41.5 g, respectively). Stability analysis using AMMI stability value (ASV) identified TWC1100, SC30K9, TWC324, and SC130 as the most stable genotypes. Biochemical analysis revealed that resistant genotypes exhibited higher peroxidase activity and lower electrolyte leakage. Anatomical examination showed superior root structure in resistant genotypes, particularly SC2031. Molecular analysis confirmed the upregulation of PR1 and PR4 genes post-infection, with TWC1100 showing robust expression, while Boushy exhibited minimal gene activation.

DISCUSSION: The integration of agronomic, anatomical, biochemical, and molecular analyses revealed promising maize genotypes with enhanced resistance to late wilt disease (LWD) and stable performance across diverse environments. These findings highlight the potential of these genotypes as valuable candidates for inclusion in breeding programs targeting improved disease resistance and yield stability under varying environmental conditions.

PMID:40530266 | PMC:PMC12170576 | DOI:10.3389/fpls.2025.1566514

J Multidiscip Healthc. 2025 Jun 12;18:3391-3401. doi: 10.2147/JMDH.S515576. eCollection 2025.

ABSTRACT

OBJECTIVE: The study investigated to examine the clinical outcomes of hemiarthroplasties using posterior femoral trochanter osteotomy for the treatment of femoral neck fractures in patients at the sequelae stage of cerebrovascular disease.

METHODS: A retrospective analysis was conducted on the data of 53 patients who had been admitted to the Department of Orthopedics at Yan’an University Affiliated Hospital between May 2020 and May 2023. These patients had been diagnosed with femoral neck fractures and concurrent muscle weakness at the sequelae stage of cerebrovascular disease. The patients were divided into two groups: the osteotomy group (20 cases), which underwent hemiarthroplasties via an L osteotomy of the posterior femoral trochanter, and the conventional group (33 cases), which received hemiarthroplasties through the posterolateral approach of the greater trochanter. The two groups were compared on various parameters, including incision length, operation duration, intraoperative blood loss, postoperative drainage, blood transfusion rates, length of hospitalization, early mobilization post-surgery, hip joint function scores at follow-up visits (3 and 12 months), and the rate of postoperative dislocation of the femoral head.

RESULTS: No significant differences were observed between the two groups regarding incision length (P=0.06), operation duration (P=0.284), intraoperative blood loss (P=0.925), Blood transfusion rate (P=0.489), postoperative drainage (P=0.831) and length of hospital stay (P=0.341). However, the early mobilization time following surgery was shorter in the osteotomy group compared to the conventional group (P<0.001). Additionally, the Harris hip joint function scores for the osteotomy group were significantly higher than those for the conventional group at both the 3- and 12-month postoperative assessments (P=0.003, P=0.004, respectively). The dislocation rate of the femoral head in the osteotomy group was lower than that in the conventional group with no statistical significance difference (P=0.521).

CONCLUSION: The use of hemiarthroplasties via posterior femoral trochanter osteotomy demonstrates favorable clinical outcomes in the treatment of femoral neck fractures.

PMID:40530244 | PMC:PMC12170355 | DOI:10.2147/JMDH.S515576

Clin Interv Aging. 2025 Jun 12;20:825-836. doi: 10.2147/CIA.S519546. eCollection 2025.

ABSTRACT

INTRODUCTION: Cardiovascular diseases (CVD) represents a leading cause of morbidity and mortality worldwide, including China. Accurate prediction of CVD risk and implementation of preventive measures are critical. This study aimed to develop a short-term risk prediction model for CVD events among individuals aged ≥60 years in Shanghai, China.

METHODS: Stratified random sampling recruited elderly individuals. Retrospective data (2016-2022) were analyzed using Lasso-Cox regression, followed by a multivariable Cox regression model. The risk scoring was visualized through a nomogram, and the model performance was assessed using calibration plots and receiver operating characteristic curves.

RESULTS: A total of 9,636 individuals aged ≥60 years were included. The Lasso-Cox regression analysis showed male gender (HR=1.482), older age (HR=1.035), higher body mass index (HR=1.015), lower high-density lipoprotein cholesterol (HR=0.992), higher systolic blood pressure (HR=1.009), lower diastolic blood pressure (HR=0.982), higher fasting plasma glucose (HR=1.068), hypertension (HR=1.904), diabetes (HR=1.128), and lipid-lowering medication (HR=1.384) were related to higher CVD risk. The C-index in the training and validation data was 0.642 and 0.623, respectively. Calibration plots indicated good agreement between predicted and actual probabilities.

CONCLUSION: This short-term predictive model for CVD events among the elderly population exhibits good accuracy but moderate discriminative ability. More studies are warranted to investigate predictors (gender, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, hypertension, and lipid-lowering medication) of CVD incidence for the development of preventive measures.

PMID:40530237 | PMC:PMC12170357 | DOI:10.2147/CIA.S519546

Cureus. 2025 May 18;17(5):e84334. doi: 10.7759/cureus.84334. eCollection 2025 May.

ABSTRACT

Introduction Acetabular and pelvic fractures account for roughly 3% of all skeletal injuries and typically result from high-energy trauma. Surgical fixation is often required to restore pelvic stability and joint congruency. These procedures are technically demanding due to complex pelvic anatomy and limited access. Reconstruction plates are commonly used for their versatility in compression, tension, buttress, and antiglide functions. The Stryker Pelvic PRO Next Generation plating system (Stryker, Portage, MI) offers implants for anterior and posterior fixation, designed to accommodate complex bony morphology. This study evaluates clinical and radiographic outcomes in patients treated with this implant system. We hypothesized that its use would yield rates of bone consolidation, nonunion, and adverse events comparable to the current literature. Methods With institutional review board approval, a retrospective review was conducted at a level I trauma center for patients treated with the Stryker PRO system between January and October 2024. Cases were identified using Current Procedural Terminology codes 27226, 27227, and 27228. Demographics, injury characteristics, surgical details, and outcomes were collected. Radiographic bone consolidation was defined as the presence of bridging callus in three out of four cortices with no visible fracture line or the disappearance of fracture lines, while clinical consolidation was defined as the patient achieving full weight-bearing status without pain. Delayed union was defined as the absence of radiographic healing by three months post-operatively, while nonunion was defined as persistent fracture at six months requiring surgical intervention or documented pain with visible fracture line. Descriptive statistics were performed using IBM SPSS Version 29.0.2.0. Results The study included 20 patients (mean age 44.6, 70% male) with pelvic or acetabular fractures. Most injuries resulted from motor vehicle accidents (70%), with common fracture types including AO 62.A1/62.B1 and posterior wall fractures. Radiographic and clinical consolidation were achieved in 80% of cases each, with 95% overall union. Seven adverse events occurred in five (25%) patients, including infection, heterotopic ossification, osteolysis, and avascular necrosis; 16.6% required reoperation. A total of 28 plates were used, most commonly spring plates (50%); 70% of patients required additional fixation. Conclusion The Stryker PRO implant system demonstrated rates of bone consolidation, nonunion, and adverse events comparable to the current literature.

PMID:40530233 | PMC:PMC12173097 | DOI:10.7759/cureus.84334

Cureus. 2025 May 17;17(5):e84266. doi: 10.7759/cureus.84266. eCollection 2025 May.

ABSTRACT

Background Osteoarthritis of the knee is a prevalent chronic condition, often necessitating total knee arthroplasty (TKA) when conservative treatments fail. Single-stage and double-stage bilateral TKA procedures are both widely performed, and the optimal approach in terms of perioperative complications and functional outcomes remains debated. This study aims to compare single-stage and double-stage bilateral TKA concerning postoperative recovery, complications, and hospitalization parameters. Methods A retrospective study was conducted at R. L. Jalappa Hospital, Tamaka, Kolar, from August 2023 to July 2024, including 38 patients with Kellgren-Lawrence grade 3 or 4 primary osteoarthritis undergoing bilateral TKA. Patients were divided into two cohorts: Group A (n = 19) underwent single-stage TKA, and Group B (n = 19) underwent double-stage TKA (≤12 months apart). Outcomes assessed included pain (Visual Analogue Scale (VAS)), functional recovery (Oxford Knee Score (OKS), Knee Society Score (KSS)), perioperative complications, transfusion rates, and hospitalization duration. Statistical analyses compared both groups. Results The mean age of participants was comparable (65.74 ± 8.13 years in Group A vs. 65.58 ± 10.01 years in Group B). Both groups exhibited similar preoperative VAS (8.53 ± 1.17 vs. 8.47 ± 0.96), OKS (20.32 ± 3.20 vs. 19.74 ± 3.21), and KSS (50.58 ± 5.09 vs. 50.11 ± 5.5). The single-stage group had a significantly shorter hospital stay (6.21 ± 0.85 days vs. 7.74 ± 1.28 days, p = 0.001). Functional scores at six months showed higher OKS in Group A (50.00 ± 3.23) than Group B (47.95 ± 2.697, p = 0.040), while KSS scores were similar. Perioperative complications included deep vein thrombosis (DVT) in three (7.8%) patients, bleeding in one (2.6%) patient, pulmonary embolism (PE) in one (2.6%) patient, wound healing issues in two (5.3%) patients, and urinary complications in two (5.3%) patients, with no significant difference between groups. Conclusion Single-stage bilateral TKA is associated with shortened hospital stay and improved functional outcomes at six months compared to the double-stage approach, without significant differences in perioperative complications. These findings suggest that single-stage TKA may be a preferable option in carefully selected patients.

PMID:40530232 | PMC:PMC12170246 | DOI:10.7759/cureus.84266

World J Surg. 2025 Jun 17. doi: 10.1002/wjs.12649. Online ahead of print.

ABSTRACT

IMPORTANCE: Obesity is a significant factor that increases complication rates in patients undergoing abdominal wall reconstruction (AWR). This has led to caution about performing elective AWR in patients with higher body mass index (BMI). In light of this, our study aims to synthesize the current information on AWR outcomes in patients stratified according to the obesity classification, providing evidence-based insights into the impact of BMI on AWR outcomes.

OBJECTIVE: To compare the clinical outcomes in patients of different BMI groups undergoing AWR.

DATA SOURCES: A systematic literature search of two databases (PubMed and Cochrane CENTRAL) from January 1st, 1966, until July 31, 2024, identified five relevant studies.

STUDY SELECTION: Included in our analysis were original studies that assessed clinical outcomes in patients with a BMI < 35 kg/m² compared to those with a BMI ≥ 35 kg/m² undergoing elective AWR. Studies with a patient population of less than 18 years or oncologic patient population were excluded.

DATA EXTRACTION AND SYNTHESIS: This systematic review and meta-analysis are reported as per the PRISMA statement. As recommended by the Cochrane Collaboration, the Newcastle-Ottawa scale was used to evaluate methodological quality. The Mantel-Haenszel random-effects method was used to calculate the pooled odds ratios (ORs) with their 95% confidence intervals (CIs).

MAIN OUTCOME: The primary outcomes were hernia recurrence, readmission, reoperation, and surgical site infection (SSI).

RESULTS: Out of 4769 classifiable patients that underwent AWR, the majority were obese- CDC Class 1, 2 (2401; 50%) or morbidly obese-Class 3 (1054; 22%). Patients with a BMI < 35 kg/m² compared to a BMI ≥ 35 kg/m² were associated with significantly decreased odds of readmission (OR 0.52, 95% CI 0.38-0.70, I² = 0%, and p < 0.0001), reoperation (OR 0.72, 95% CI 0.55-0.93, I² = 17%, and p = 0.01), and developing SSI (OR 0.62, 95% CI 0.48-0.81, I² = 35%, and p = 0.0005), whereas hernia recurrence (OR 1.03, 95% CI 0.35-3.00, I² = 88%, and p = 0.96) was statistically insignificant.

CONCLUSION AND RELEVANCE: A patient’s BMI should not be the sole determinant when planning elective AWR, as increasing BMI does not impact hernia recurrence rates. However, obese patients should be counseled on the higher risk of developing infections, requiring reoperation, and necessitating readmission due to their weight.

PMID:40528287 | DOI:10.1002/wjs.12649

Ann Med. 2025 Dec;57(1):2514943. doi: 10.1080/07853890.2025.2514943. Epub 2025 Jun 17.

ABSTRACT

OBJECTIVE: This study aims to analyze the clinical characteristics, treatment outcomes, and risk factors associated with respiratory support in infants hospitalized with pertussis.

PATIENTS AND METHODS: We retrospectively analyzed the clinical data of 0-1-year-old pertussis patients admitted to Baoding Hospital of Beijing Children’s Hospital affiliated with Capital Medical University from January 2022 to May 2024. SPSS27.0 statistical software was used to analyze the differences in data among different groups of children with pertussis and to summarize their clinical characteristics. A multiple logistic regression model was used to analyze the clinical risk factors of the respiratory support group.

RESULTS: We enrolled 233 hospitalized children with pertussis. Children requiring respiratory support had lower vaccination rates and higher incidences of cyanosis, wheezing, and RSV infection. Logistic regression identified age, cyanosis after coughing, and IVIG use as independent predictors of respiratory support. Age was an independent protective factor: older children were less likely to require respiratory support (OR = 0.151). Compared with children aged ≥3 months, children aged <3 months had a higher history of contact with cough patients, with symptoms such as cyanosis after coughing, white blood cell counts (WBCs) ≥20 × 10⁹/L, lymphocyte percentage ≥60%, and increased RSV infection incidence. Rates of respiratory support, bronchoscopy treatment, IVIG, tracheal intubation, and exchange transfusion treatment increased (all p < 0.05).

CONCLUSIONS: Younger pertussis patients have more severe clinical manifestations, with significantly increased WBCs, and they are more likely to be infected with other viruses. Age is an independent protective factor, and the younger the patient, the more likely they are to require respiratory support. These findings highlight the need for early recognition and targeted interventions, particularly in younger infants with severe symptoms.

PMID:40528283 | DOI:10.1080/07853890.2025.2514943