Tag: pubmed

J Hand Surg Glob Online. 2025 May 22;7(4):100729. doi: 10.1016/j.jhsg.2025.02.019. eCollection 2025 Jul.

ABSTRACT

PURPOSE: The purpose of this study was to compare the safety and efficacy of the carpal tunnel release surgery in cadaveric specimens, using a newly developed surgical knife incorporating a guide, with and without ultrasound guidance.

METHODS: For this study, 100 fresh frozen human cadaveric hands, free from fractures or surgical antecedents, were used (mean age: 71.3 ± 15.8 years, 60 men and 40 women). The specimens were allocated into two groups of 50 to undergo carpal tunnel release with or without ultrasound guidance, using the knife and guide (KeriKnife, KeriMedical) by four experienced hand surgeons. Donor demographics and operated side were recorded. Following surgery, every surgeon reported the difficulty of cutting the ligament on a scale of 1 (easy) to 5 (difficult), whether the ligament was completely cut, and whether the intervention caused any injuries to the surrounding structures.

RESULTS: There were no differences between the groups in terms of age, sex, weight, or side. Following surgery, the surgeons rated the difficulty similarly between the groups. The ligament was incompletely cut in one (2%) specimen that underwent the surgery with ultrasound, whereas it was incomplete in two (4%) that underwent the surgery without ultrasound, although the difference was not statistically significant. Furthermore, there was one injury in the group without ultrasound.

CONCLUSIONS: The KeriKnife has shown its effectiveness for carpal tunnel release with or without ultrasound control. The only iatrogenic injury happened during the surgical release without ultrasound control.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

PMID:40497274 | PMC:PMC12150071 | DOI:10.1016/j.jhsg.2025.02.019

J Hand Surg Glob Online. 2025 May 21;7(4):100746. doi: 10.1016/j.jhsg.2025.100746. eCollection 2025 Jul.

ABSTRACT

PURPOSE: Glucagon-like peptide-1 receptor agonist (GLP-1RA) use continues to rise because of its efficacy in glycemic control and weight reduction. There are sparse data on the implications of GLP-1RA therapy on surgical outcomes. Given the higher prevalence of carpal tunnel syndrome in patients with diabetes mellitus, obesity, or both, this study evaluated the impact of perioperative GLP-1RA use on both short-term (90-day) and long-term (1-year) postoperative complications in patients undergoing carpal tunnel release (CTR).

METHODS: A retrospective cohort analysis was conducted with the TriNetX research database and identified all patients who underwent CTR at 95 health care organizations between 2004 and 2024. Two cohorts were stratified by perioperative GLP-1RA use and propensity score matched (1:1) to mitigate baseline differences in demographics, comorbidities, and procedural approach. Primary outcomes, including scarring, wound dehiscence, and infection, were evaluated over a 90-day postoperative period, whereas secondary outcomes, including subsequent CTR and median nerve (MN) injury, were assessed at the 1-year follow-up. Cohorts were compared using odds ratios (OR) with 95% confidence intervals (CI).

RESULTS: The query identified 303,360 patients who underwent CTR, including 13,439 on perioperative GLP-1RA therapy. After matching, homogeneous cohorts each consisted of 10,773 patients. At 90 days after surgery, the GLP-1RA cohort had significantly lower odds of wound dehiscence (OR, 0.691; 95% CI, 0.488-0.978) compared with patients not on GLP-1RA therapy. No significant differences were observed in rates of infection (superficial, deep, or unspecified), abscess incision and drainage, or scarring. At 1 year, GLP-1RA patients had lower odds of subsequent CTR (OR, 0.897; 95% CI, 0.839-0.959) and MN injury (OR, 0.399; 95% CI, 0.192-0.832).

CONCLUSIONS: Perioperative GLP-1RA use was associated with a small yet statistically significant reduction in the odds of wound dehiscence following CTR and did not increase the odds of any other 90-day postoperative complications. Additionally, GLP-1RA therapy demonstrated lower odds of subsequent CTR and MN injury at the 1-year follow-up. Prospective investigation is warranted to further clarify the impact of GLP-1RA therapy in patients undergoing CTR.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.

PMID:40497273 | PMC:PMC12148469 | DOI:10.1016/j.jhsg.2025.100746

J Hand Surg Glob Online. 2025 May 21;7(4):100721. doi: 10.1016/j.jhsg.2025.03.002. eCollection 2025 Jul.

ABSTRACT

PURPOSE: Carpal tunnel release (CTR) is commonly performed with the patient wide awake using local anesthetic (LA). Although most patients tolerate this type of procedure, there is a possibility of some discomfort or pain. We compared two LA infiltration techniques-subcutaneous infiltration alone (superficial) and subcutaneous infiltration with infiltration into the carpal tunnel (deep)-to determine which provides a better pain experience during CTR.

METHODS: Seventy-four participants (n = 80 cases) were recruited and randomized to either deep or superficial LA infiltration. Thirty-eight received deep LA and 42 superficial LA. Primary outcomes were presence and severity of pain and/or tingling during the LA infiltration and during the procedure. We also examined the severity of pain at 2, 8, and 24 hours after the procedure. Clinical outcomes were assessed with the Boston Carpal Tunnel Questionnaire score at baseline and at 3 months postprocedure. Statistical comparisons were performed using chi-square and analysis of variance tests.

RESULTS: The average age of participants was 63.04 ± 12.92 years (n = 40 females and n = 34 males). In the deep group, 21% experienced pain during LA infiltration compared to 9.5% in the superficial group, whereas 13.2% of the deep group and 11.0% of the superficial group experienced pain during the procedure. Both groups showed a significant improvement in clinical outcomes, measured by the Boston Carpal Tunnel Questionnaire.

CONCLUSIONS: In this randomized clinical trial comparing deep versus superficial LA infiltration techniques for CTR, we found that there was no statistically significant difference in the pain experienced during the administration of the LA or during the procedure. Given these findings, we recommend using superficial infiltration for CTR as it is technically easier and reduces the risk of potential median nerve injury.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic Ib.

PMID:40497269 | PMC:PMC12148473 | DOI:10.1016/j.jhsg.2025.03.002

J Hand Surg Glob Online. 2025 May 22;7(4):100737. doi: 10.1016/j.jhsg.2025.100737. eCollection 2025 Jul.

ABSTRACT

PURPOSE: Our aim was to compare the efficacy and safety of the available surgical interventions for trapeziometacarpal joint (TMCJ) arthritis.

METHODS: We conducted a systematic review and network meta-analysis of randomized studies comparing surgical interventions for TMCJ arthritis. Our primary outcome was patient-reported pain, and secondary outcomes were patient-reported functional disability, key pinch strength, and complications. Mean differences (MD) and standardized mean differences (SMD) were calculated for continuous outcomes and odds ratios (OR) for dichotomous outcomes, all with 95% confidence intervals.

RESULTS: Twenty-one randomized studies were included. In pairwise meta-analyses, when simple trapeziectomy was compared with trapeziectomy with ligament reconstruction and tendon interposition (LRTI), all pain, functional disability, and key pinch strength were similar (pain visual analogue scale, MD 0.22 points [-0.66 to 0.21]; functional disability, SMD 0.17 [-0.06 to 0.41]; key pinch strength, MD 0.07 kg [-0.22 to 036], P = .64). Compared with trapeziectomy (with or without LRTI), total joint arthroplasty provided similar short-term pain relief (MD 0.20 points [-0.10 to 0.50], moderate certainty of evidence), statistically greater improvement in short-term functional disability (disabilities of the arm, shoulder, and hand), and key pinch strength (function disabilities of the arm, shoulder, and hand, MD 5.24 points [0.72-9.75], low certainty of evidence; key pinch strength, MD 0.92 kg [0.63,-1.21], and moderate certainty of evidence]). Only the difference in key pinch strength exceeded clinical significance. In network meta-analyses, total joint arthroplasty ranked first for all short-term pain, function, and key pinch strength; however, its superiority over other treatments was only significant for key pinch strength. Short-term complications between simple trapeziectomy and trapeziectomy with LRTI, and between trapeziectomy and total joint arthroplasty were similar; however, longer-term data were not available.

CONCLUSIONS: Total joint arthroplasty appears to be at least as effective as trapeziectomy for pain relief and functional disability and may be superior for key pinch strength in the short-term. Until long-term efficacy, complication, and survivorship data arising from high-quality comparative studies become available, its widespread use cannot be recommended.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.

PMID:40497265 | PMC:PMC12150098 | DOI:10.1016/j.jhsg.2025.100737

Depress Anxiety. 2025 Jun 3;2025:5130737. doi: 10.1155/da/5130737. eCollection 2025.

ABSTRACT

Objectives: This study was conducted to investigate the personality traits, stress, anxiety, depression levels, fear of childbirth, and affecting factors in Turkish female university students. Materials and Methods: The study was planned as a descriptive and correlational type. The sample consisted of 500 female students who met the research criteria at the Faculty of Health Sciences and Faculty of Education of a university. The data were collected face-to-face using a personal information form, including socio-demographic and pregnancy-birth-related thoughts, the Childbirth Fear-Prior to Pregnancy (CFPP) scale, the Type D Personality Scale (negative affectivity and social inhibition subscales), and the Depression Anxiety Stress Scale-21 (DASS-21). Ethics committee approval and institutional permissions were obtained from the students to conduct the study. In the analysis of the data, the Kolmogorov-Smirnov test, descriptive methods Mann-Whitney U, and the Kruskal-Wallis test were used. Results: 52.8% of the students were from the Faculty of Health Sciences, 48.4% were nursing students, and 30.6% were in their first class of students. The mean CFPP score was 40.14 ± 11.35. The mean score was 12.01 ± 6.79 for negative affectivity, 9.58 ± 6.09 for social inhibition, 6.75 ± 4.05 for stress, 5.28 ± 4.09 for anxiety, and 5.58 ± 4.50 for depression. There was a low level of positive correlation between CFPP and social inhibition subscales (r = 0.113), negative affectivity (r = 0.282), stress (r = 0.241), anxiety (r = 0.231), and depression (r = 0.221 (p = 0.01). The predictor of students’ fear of childbirth prior to pregnancy was negative affectivity. Conclusions: Turkish university students’ fear of childbirth prior to pregnancy was associated with personality traits, depression, anxiety, and stress. It is recommended to identify the depression, anxiety, stress levels, personality traits, and fear of childbirth of female university students in the prepregnancy period, plan information and education, and conduct further research on the fear of childbirth.

PMID:40497255 | PMC:PMC12151619 | DOI:10.1155/da/5130737

Front Bioeng Biotechnol. 2025 May 27;13:1595935. doi: 10.3389/fbioe.2025.1595935. eCollection 2025.

ABSTRACT

PURPOSE: This study aimed to evaluate the effect of the degree of facet joint resection under the combined action of large-channel endoscopy and visualized trephines on lumbar biomechanics.

METHODS: The original CT data of a healthy male volunteer were selected. An L3-5 lumbar spine model, M0, was established via the three-dimensional finite element method. Different degrees of resection of the superior articular process of L4 were simulated via a visualized trephine during the operation, and six models were established (M1: tip resection; M2: resection of the ventral 1/3; M3: resection of the ventral 1/2; M4: resection of the ventral 2/3; M5: resection of the ventral 3/4; and M6: complete resection). Loads were applied to the model to simulate six motions of flexion, extension, left/right lateral bending, and left/right rotation. The stress distributions of the vertebral body, intervertebral disc and articular cartilage of the L3-4 segment and adjacent segments were observed.

RESULTS: Compared with M0, L4 vertebral stress was elevated in the M1 model, L4 vertebral stress was reduced in the M2 and M3 models, and L4 vertebral stress was significantly elevated in the M4, M5, and M6 models (P < 0.05). Compared with M0, the differences in the L3 vertebral body, L5 vertebral body, L3-4 disc, and L4-5disc stresses were not statistically significant (P > 0.05) in the M1, M2, and M3 models, whereas the stresses were significantly higher (P < 0.05) in the M4, M5, and M6 models. Compared with M0, the difference in L3-4 facet joints stress between the M1, M2 and M3 models was not statistically significant (P > 0.05), whereas the L3-4 facet joints stress between the M4, M5 and M6 models were significantly higher (P < 0.05), with a greater increase on the left facet joint.

CONCLUSION: When more than half of the superior articular process of L4 is resected under large-channel endoscopy, the stress on the vertebral body, intervertebral disc and articular cartilage of the L3-4 segment increases, which may cause iatrogenic instability but has no significant effect on the stress on the vertebral body or intervertebral disc of adjacent segments.

PMID:40497253 | PMC:PMC12149569 | DOI:10.3389/fbioe.2025.1595935

Front Bioeng Biotechnol. 2025 May 27;13:1597209. doi: 10.3389/fbioe.2025.1597209. eCollection 2025.

ABSTRACT

INTRODUCTION: The conventional (CDL) and sumo (SDL) deadlifts are two fundamental techniques used in competitive lifting and as effective exercises for strengthening the knee and hip muscles. This study aims to investigate their biomechanical differences through a comprehensive analysis of joint kinematics, joint kinetics, and muscle activation.

MATERIALS AND METHODS: Thirty experienced male lifters performed both CDL and SDL at 85% of their one repetition maximum (1-RM). Lower limb joint range of motion (ROM), internal joint moments, and muscle activation of key lower limb and spinal muscles were recorded and analyzed. Paired t-tests and Statistical parametric mapping (SPM) were used to compare parameters between lifting techniques (p < 0.025).

RESULTS: SDL showed greater ROM in the frontal and transverse planes, particularly at the hip and knee, whereas CDL involved greater hip flexion and ankle dorsiflexion. CDL generated higher hip extension moments, while SDL produced greater frontal and transverse plane joint moments at the hip and knee. Additionally, SDL induced a greater ankle inversion moment. In the transverse plane, ankle moments were higher in CDL during phase 1 and became greater in SDL in phase 2. Regarding EMG peak values, the biceps femoris exhibited greater activation in CDL across both phases. The tibialis anterior and the erector spinae thoracis demonstrated greater activation in CDL during phase 1 and phase 2, respectively. Conversely, the vastus lateralis exhibited higher peak activation in SDL, but only during phase 1.

CONCLUSION: CDL is more effective for targeting posterior chain, particularly the hip extensors, while SDL emphasizes anterior chain involvement and induces greater mediolateral stabilization demands. SDL may be particularly beneficial for knee reinforcement and increases frontal plane demands, supporting its relevance in rehabilitation contexts that require enhanced mediolateral stability. These findings highlight the importance of selecting the appropriate deadlift technique according to specific training or rehabilitation objectives.

PMID:40497251 | PMC:PMC12148905 | DOI:10.3389/fbioe.2025.1597209

JPRAS Open. 2025 Apr 15;45:42-54. doi: 10.1016/j.jpra.2025.04.006. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Liposuction is a surgical method for fat aspiration, which reduces the amount of subcutaneous fat. Adipose tissue is important in regulating insulin sensitivity; however excess tissue accumulation, especially in the form of intra-abdominal fat, is associated with an increased risk of developing metabolic syndrome. Clinical findings associated with metabolic syndrome include central obesity, dyslipidemia, insulin resistance, hypertension, and atherosclerotic disease. Nevertheless, the long-term metabolic impact of liposuction is unclear. We aimed to analyze the effects of liposuction on the lipid profile, arterial blood pressure, and glucose metabolism in healthy women.

PATIENTS AND METHODS: Twelve patients who underwent liposuction were included in the study. The blood pressures, arterial blood pressure, and lipid profiles were measured before surgery and approximately 1 year after surgery. In addition, insulin sensitivities were measured using oral glucose tolerance test.

RESULTS: In the long term, liposuction led to a slight reduction of body fat (p<0.05), but it did not affect the blood pressure or insulin sensitivity. Although the levels of total and low-density lipoprotein cholesterol were reduced, these decreases were not statistically significant.

DISCUSSION: The results of the study are consistent with some of the published data, which indicated a slight decrease in blood lipids.

CONCLUSION: Small-volume liposuction does not appear to induce significant metabolic changes. A larger cohort and longer follow-ups are needed to evaluate the effects on the lipid profile, blood pressure, and glucose metabolism of the patients being studied.

PMID:40497245 | PMC:PMC12148641 | DOI:10.1016/j.jpra.2025.04.006

Ther Clin Risk Manag. 2025 Jun 5;21:841-850. doi: 10.2147/TCRM.S517790. eCollection 2025.

ABSTRACT

BACKGROUND: Enhanced Recovery After Surgery (ERAS) principles have gained widespread recognition for optimizing recovery across various surgical specialties. Effective management of postoperative pain plays a pivotal role in facilitating early rehabilitation and enhancing patient outcomes, particularly in ankle fracture surgery. This study investigated the effectiveness of rehabilitation therapies rooted in ERAS protocols in alleviating postoperative wound pain and improving recovery for patients undergoing ankle fracture surgery.

METHODS: A total of 376 patients who underwent ankle fracture surgery between December 2022 and December 2023 were included in this retrospective analysis. Of these, 190 patients received ERAS-guided rehabilitation, while 186 underwent standard rehabilitation care. The ERAS program encompassed tailored interventions such as multimodal pain control, prompt mobilization, and personalized physical therapy regimens. Pain intensity was evaluated using the Visual Analog Scale (VAS) at 24 hours, 48 hours, and 7 days postoperatively. Additional metrics, including the duration of hospital stay, complication rates, and patient satisfaction, were also assessed.

RESULTS: Patients in the ERAS group experienced significantly lower VAS scores than the standard care group at 24 hours (4.2 ± 1.1 vs 5.6 ± 1.4, P<0.001), 48 hours (3.1 ± 0.9 vs 4.4 ± 1.2, P<0.001), and 7 days post-surgery (2.0 ± 0.7 vs 3.1 ± 0.9, P<0.001). Furthermore, those receiving ERAS care had a shorter average hospital stay (5.1 ± 1.6 days vs 6.7 ± 2.1 days, P<0.001) and reported higher levels of satisfaction (92.1% vs 78.4%, P<0.001). However, there were no statistically significant differences in overall complication rates between the two groups (3.7% vs 4.3%, P=0.712).

CONCLUSION: Rehabilitation therapies incorporating ERAS principles demonstrate substantial benefits in reducing postoperative wound pain and expediting recovery in ankle fracture surgery patients. These findings underscore the value of integrating ERAS-driven protocols into clinical practice to enhance patient experiences and postoperative outcomes.

PMID:40497243 | PMC:PMC12149278 | DOI:10.2147/TCRM.S517790

Patient Prefer Adherence. 2025 Jun 6;19:1693-1701. doi: 10.2147/PPA.S524213. eCollection 2025.

ABSTRACT

BACKGROUND: Patient contentment is an indicator of the quality of pharmacy services. Pharmacists can recognize and resolve drug-related issues, provide patients with the information they need, raise patient contentment, and improve the standard of patient care. Utilizing E-prescription (Wasfaty) is one of the key services in the healthcare system that achieves the aspiration of the Kingdom’s Vision 2030 by improving efficiency, accuracy, and convenience for patients and healthcare professionals. The present study seeks to evaluate the effect of the Wasfaty app on patients’ contentment in the Tabuk region and the factors associated with it.

METHODS: A cross-sectional study was conducted from January to March 2024 in Tabuk among patients using the Wasfaty app. Data was collected using a convenience sampling technique and a self-administered questionnaire. The analysis of the data was conducted using SPSS software version 27.0. Descriptive statistics (mean, percentage, standard deviation, p-value) illustrate the respondents and their characteristics. Mantel-Haenszel test was used to estimate the odds ratio. Significance was reached when p < 0.05.

RESULTS: A total of 422 beneficiaries participated in the study. The majority of respondents were female (55.2%) and the majority were under 50 years. Only 23.5% of the included population visit the community pharmacy for chronic diseases. A majority of the participants (68.7%) viewed Wasfaty services positively. Availability of the Wasfaty service, medication availability, detailed instructions by pharmacists, efficiency of the Wasfaty app, and service speed and waiting time were positively associated with their overall positive experience.

CONCLUSION: The results of our study demonstrated overall high contentment with Wasfaty app and its effectiveness in improving patient medication management. The factors associated with the patient’s contentment helps in promoting the quality of care provided to the patients.

PMID:40497235 | PMC:PMC12151085 | DOI:10.2147/PPA.S524213