Tag: pubmed

Arch Orthop Trauma Surg. 2025 Apr 5;145(1):226. doi: 10.1007/s00402-025-05846-4.

ABSTRACT

INTRODUCTION: Crohn’s disease has been increasing in incidence globally and has several musculoskeletal manifestations including large joint arthritis. This study compares post-operative lengths of stay, healthcare costs, and complication rates between patients with and without Crohn’s Disease (CD) following Total Hip Arthroplasty (THA).

METHODS: Data were collected from the National Inpatient Sample Database Healthcare Cost and Utilization Project between the years 2016-2019. Patients with Crohn’s Disease (CD) and without Crohn’s Disease (NCD) undergoing THA were identified using International Classification of Diseases, 10th revision codes (ICD-10-CM/PCS). Length of stay, total cost, and medical and surgical complications were examined during this time period. SPSS (v 27.0 8, IBM Corp. Armonk, NY) was utilized to compare demographic and analytical statistics between CD and NCD patients undergoing THA.

RESULTS: 1,171 (0.32%) CD and 366,219 (99.68%) NCD patients undergoing THA were included. Compared to NCD patients, CD patients were more likely to be Caucasian (p < 0.05), younger (p < 0.001), non-obese (p = 0.022), non-emergently admitted (p = 0.04), and have longer lengths of stay (p < 0.001). Furthermore, CD patients had higher risks of acute renal failure (OR = 1.43, p = 0.025), acute blood loss anemia (OR = 1.431, p < 0.001), blood transfusion (OR = 1.73, p < 0.001), pneumonia (OR = 2.607, p = 0.005), deep vein thrombosis (OR = 2.81, p = 0.035), periprosthetic infection (OR = 1.57, p = 0.05), and length of stay greater than 2 days (OR = 1.293, p < 0.001). However, CD patients had lower risk of periprosthetic mechanical complication (OR = 0.218, p = 0.011).

CONCLUSION: This study demonstrates that CD patients undergoing THA are younger, have longer lengths of stay, and have greater rates of both local and systemic complications than NCD patients undergoing THA. As such, this study will aid in surgical candidate selection and proper operative planning for CD patients undergoing THA. Furthermore, future studies investigating the mechanisms behind these differences in post-operative outcomes can help to further advance orthopedic care for CD patients.

PMID:40186766 | DOI:10.1007/s00402-025-05846-4

Urolithiasis. 2025 Apr 5;53(1):66. doi: 10.1007/s00240-025-01736-x.

ABSTRACT

Uric acid calculi (UAC) account for about 10% of cases worldwide, although this varies among countries. The etiology of nephrolithiasis is multifactorial, involving both genetic and environmental factors. Kidney stones occur three times more frequently in individuals with a family history of the condition compared to those without such a history. Genetic factors also contribute to cases of UAC. Genes such as ZNF365, SLC2A9 and SLC22A12 may be associated with the development of uric acid stones. MicroRNAs (miRNAs) are small RNA molecules, that play a significant role in regulating gene expression. The aim of this study was to characterize the expression profile of miRNAs associated with the SLC2A9, SLC22A12 and ZNF365 genes in patients with uric lithiasis. Twenty-two patients with pure uric stones and 8 controls with no history of lithiasis were included, all of whom consented voluntarily. To analyze the gene expression levels of the microRNAs studied, total RNA was obtained using the miRVana^®miRNA kit, following the manufacturer’s guidelines. qPCR analyses were then carried out using specific probes for the selected microRNAs. When comparing clinical characteristics, patients with nephrolithiasis had significant hyperuricemia (p < 0.0001) and more acidic urine (p = 0.0012). Lower urinary citrate excretion was also observed in patients with nephrolithiasis (p = 0.0047). With regard to microRNA expression data, statistically significant under-expression was observed in patients with calculi of microRNAs 143-3p (p = 0.015), 4770 (p = 0.0194), 4750-3p (p = 0.037), 301b-5p (p = < 0.0001) and 9-5p (p = 0.0015). In addition, microRNAs 4770 and 4750-3p were underexpressed in individuals with multiple stones (p = 0.0197, p = 0.0023 respectively). In relation to miR-4750-3p, it was also overexpressed in cases with stones larger than 2 cm (p = 0.0557). With the results of our study, we can conclude that the microRNAs 143-3p, 4770, 4750-3p, 301b-5p and 9-5p may be associated with the development of uric lithiasis. In addition, under-expression of microRNAs 4770 and 4750-3p is associated with the occurrence of multiple stones, while over-expression of miR-4750-3p is related to the formation of stones larger than 2 cm.

PMID:40186757 | DOI:10.1007/s00240-025-01736-x

Support Care Cancer. 2025 Apr 5;33(4):357. doi: 10.1007/s00520-025-09388-8.

ABSTRACT

BACKGROUND: A cancer rehabilitation navigation (CRNav) program is an evidence-based care delivery model that uses a rehabilitation professional in the navigation role to support oncology care delivery, provide functional screening for early identification of impairment, and coordinate care delivery services to optimize early rehabilitation. There is limited research showing how a CRNav impacts healthcare utilization. The objective of this study was to assess utilization data for a CRNav Program and demonstrate how the program influences the effectiveness of cancer care delivery and patient and provider satisfaction.

METHODS: Data was collected from the electronic health record of the Brooks Rehabilitation/Halifax systems at a community cancer center to assess program and service utilization over 3.2 years using a retrospective design.

RESULTS: Over 3.2 years, the CRNav program received 1585 referrals and screened 1447 (91.3%) patients. Of the 1447 screenings performed, 73.6% were recommended to receive outpatient rehabilitation (n = 1065). Among patients screened, breast cancer was the most common cancer diagnosis (47%) followed by head and neck cancers (14%). There were 638 total rehabilitation visits identified for patients who were seen for services within the health system, with physical therapy encounters accounting for the greatest number (n = 462). The most common reasons for receiving physical therapy services included lymphedema (27%), pain (25%), and limited range of motion (12%). Patients reported high satisfaction (≥ 95.4%) in the areas of how well rehabilitation met expectations and overall satisfaction with the rehabilitation experience.

CONCLUSIONS: Using a CRNav in a community cancer center resulted in efficient care of patients with cancer, improved patient satisfaction and patient outcomes, and an enhanced clinician experience. This program provides a value-based approach to care supporting the quadruple aim and improving the identification and management of cancer-related functional morbidity.

PMID:40186756 | DOI:10.1007/s00520-025-09388-8

Clin Oral Investig. 2025 Apr 5;29(4):223. doi: 10.1007/s00784-025-06293-6.

ABSTRACT

OBJECTIVE: This study investigates the frequency and characteristics of obsessive-compulsive (OC) symptoms and Obsessive-Compulsive Personality Disorder (OCPD) in patients with Burning Mouth Syndrome (BMS).

BACKGROUND: Obsessive-Compulsive Disorder (OCD) is a chronic condition involving intrusive thoughts (obsessions) and repetitive behaviors (compulsions), while Obsessive-Compulsive Personality Disorder (OCPD) is a personality disorder characterized by specific traits such as perfectionism, rigidity and need for control. Both conditions frequently overlap, but their prevalence in patients with BMS has never been explored.

MATERIALS AND METHODS: A total of 151 BMS patients were assessed using the Obsessive-Compulsive Inventory-Revised (OCI-R), Compulsive Personality Assessment Scale (CPAS), Visual Analog Scale (VAS), Short-Form McGill Pain Questionnaire (SF-MPQ), Hamilton Anxiety and Depression scales (HAM-A, HAM-D), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Patients were grouped based on OCI and CPAS scores.

RESULTS: n = 123 (81.6%) of our sample were females, with a mean age of 63.19 ± 12.2 years. Clinically significant OC symptoms (OCI-R > 21) were observed in 41.7% of the sample, while 37% met OCPD criteria; both OC symptoms and OCPD were present in 24.5% of patients.

CONCLUSIONS: BMS patients show a high prevalence of OC symptoms and OCPD traits, which should be taken into account by clinicians and considered in the therapeutic approach, given that they could complicate symptom management.

CLINICAL RELEVANCE: By identifying these symptoms and traits through OCI-R and CPAS, clinicians may improve treatment strategies, in the perspective of a multidisciplinary tailored and personalized approach.

PMID:40186752 | DOI:10.1007/s00784-025-06293-6

Arch Orthop Trauma Surg. 2025 Apr 5;145(1):222. doi: 10.1007/s00402-025-05845-5.

ABSTRACT

OBJECTIVE: The aim of this study compare the effectiveness of the space between the popliteal artery and the posterior knee capsule (iPACK) and posterior capsule injection (PCI) in patients with primary end stage knee osteoarthritis treated with total knee arthroplasty (TKA).

METHODS: This was a double-blind, prospective, randomised trial. A total of 195 participants were randomly assigned to one of three groups: Group 1 with an adductor canal block (ACB) plus iPACK. Group 2 with ACB + PCI and a final control group with ACB only. All participants underwent primary total knee arthroplasty. Outcome measures comprised pain assessment using the Visual Analog Scale (VAS) and monitoring opioid analgesic consumption. VAS measurements were taken at the 1st, 6th, 12th, 24th, 48th, and 72nd hours, followed by the 10th day and the 12th week.

RESULTS: Age, sex, BMI and side of surgery were analyzed and no significant differences were found. Groups ACB + iPACK and ACB + PCI exhibited significantly lower VAS scores compared to the control group at 3, 6, and 12 h after surgery, with group ACB + iPACK showing the lowest VAS scores among all groups. No significant difference in VAS values between groups was detected after 24 h postoperatively and after that. Significant differences were observed between groups in opioid consumption. The values for the first hour, first day, second day, and total consumption exhibited statistically significant differences between the groups.

CONCLUSION: Our study has shown that PCI in combination with ACB is not inferior to the iPACK technique. It is our belief that these combination techniques can be used in accordance with the surgeon’s experience and preference. It is important to remember that PCI is quicker and easier to perform without using ultrasonography.

PMID:40186749 | DOI:10.1007/s00402-025-05845-5

MAGMA. 2025 Apr 5. doi: 10.1007/s10334-025-01226-6. Online ahead of print.

ABSTRACT

In quantitative susceptibility mapping (QSM), it is impossible to define an absolute reference for the reconstructed susceptibility values. Therefore, it has been suggested to use a relative reference, such as the mean susceptibility within an anatomical ROI. We investigated the theoretical basis of referencing, and what impact it may have on statistical ROI comparisons, particularly for clinical applications. We analysed a clinical epilepsy study and in-silico QSM reconstruction challenge data with various reference regions. The results are analysed as in a clinical study and resulting statistical variations are investigated from a theoretical point of view. We found that referencing has an impact on the significance of clinical findings. These effects may arise from a change in the precision of test statistics due to referencing. We also show potential biasing of results from referencing. Our findings suggest there may not be one “optimal” reference region, and care should always be taken with reference region selection depending on the specific pathology or cohort under investigation. Not explicitly referencing is less likely to lead to false positives than cherry picking a reference region to maximize statistically significant results. We encourage results to be published with their reference to facilitate future comparisons of datasets from different sources.

PMID:40186727 | DOI:10.1007/s10334-025-01226-6

Cogn Process. 2025 Apr 5. doi: 10.1007/s10339-025-01265-w. Online ahead of print.

ABSTRACT

Cognitive sex differences are shaped by hormone effects on brain development, organisation, structure, function, and ageing. In human speech and language, sex differences and hormone effects are typically studied in the form of performance-based differences (via measures of central tendency) with little attention given to underlying cognitive strategy. This study presents data from 126 healthy adults, aged 20-79 years, from three studies of letter based verbal fluency. Comparisons were conducted based on sex, menstrual cycle phase, and menopause stage to examine total words produced, plus switching and clustering strategy use. The investigation probed differences in performance, underlying cognitive strategies, and correlations between performance and strategy. For performance, there were no statistically significant sex or menopause group differences in total words, number of switches and cluster size. Menstrual cycle differences were significant for switches and cluster size, but not total words. However, there were large effect sizes for correlations between total word performance and strategy measures in some groups; these correlations formed patterns which differed as a function of sex, menstrual cycle phase, and menopausal stage. Words produced were highly correlated with switching in younger women at higher hormone menstrual cycle phases. Correlations between total words and both strategies were moderate and equivalent in older premenopausal and perimenopausal women. Postmenopausal women showed a pattern of higher correlation between total words and cluster size which was observed in younger women at the lower hormone cycle phase, and men. This study illustrates the impact of hormones and sex differences on strategy use in verbal fluency-underscoring the value of comparisons in strategy use between women at different reproductive life stages.

PMID:40186722 | DOI:10.1007/s10339-025-01265-w

Am J Speech Lang Pathol. 2025 Apr 4:1-37. doi: 10.1044/2025_AJSLP-24-00298. Online ahead of print.

ABSTRACT

PURPOSE: Although approximately 40% of school-based speech-language pathologists (SLPs) regularly serve Deaf and hard of hearing (DHH) students, at present, there are no agreed-upon standards specifying the minimum qualifications and best practices for working with this population, especially those who use signed language. The goal of the present study is to establish expert consensus on recommended clinical training and practice for SLPs working with signing DHH children.

METHOD: Experts in fields related to speech-language pathology and deaf education (N = 30, 16 DHH) participated in three rounds of a classical e-Delphi study. In Round 1, experts responded to open-ended questions about the role of SLPs working with DHH children who sign. In Rounds 2 and 3, experts rated their agreement with statements generated by fellow experts in Round 1.

RESULTS: A mixed-method design included qualitative content analysis (Round 1) and quantitative descriptive statistics (Rounds 2 and 3). Experts rated a total of 185 items in Round 2 and 186 items in Round 3. Consensus (at least 70% agreement) was met for 158 statements, with recommendations for SLPs’ knowledge, attitudes, and practices. Consensus was not achieved for 28 items, including the level of American Sign Language proficiency required for SLPs.

CONCLUSIONS: This study is the first to elicit input from a panel of experts seeking to establish professional standards for SLPs who work with signing DHH children. These findings contribute to the movement toward more inclusive and culturally responsive clinical practice and can inform educational standards and policy for SLPs. Future research is needed to determine whether practicing SLPs meet these recommended standards and how clinical training can support growth for standards that are not currently being met.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28665218.

PMID:40184609 | DOI:10.1044/2025_AJSLP-24-00298

J Am Acad Orthop Surg Glob Res Rev. 2025 Mar 25;9(4). doi: 10.5435/JAAOSGlobal-D-25-00032. eCollection 2025 Apr 1.

ABSTRACT

INTRODUCTION: Surgical treatment of metacarpophalangeal (MCP) joint hyperextension in the treatment of thumb basal joint arthritis can be categorized as motion preserving and arthrodesis. We compared minimum 2-year results between nonsurgical thumbs and thumbs undergoing ligament reconstruction with tendon interposition (LRTI) alone, thumb MCP arthrodesis, and volar plate capsulodesis as adjunct procedures to LRTI.

METHODS: Single surgeon patients with thumb MCP hyperextension >30° underwent arthrodesis or volar plate capsulodesis with LRTI. Thirty-one LRTI thumbs were compared with 22 LRTI with arthrodesis (LRTI + A), 21 LRTI with MCP capsulodesis (LRTI + C), and 65 nonsurgical controls. Patient-reported outcome measures were recorded with grip strength, tip pinch, lateral pinch, opposition, and pre-/postoperative hyperextension measured by one of the authors.

RESULTS: No difference was found in Michigan Hand Questionnaire scores (P = 0.13), QuickDASH values (P = 0.38), or visual analog scale results (P = 0.86). No difference was observed in grip strength (P = 0.97) or tip pinch (P = 0.66). Lateral pinch was decreased between LRTI and nonsurgical thumbs but not when compared with groups with adjunct MCP procedures (P = 0.0064). LRTI + A had the least opposition (P < 0.001). In the LRTI + C group, MCP hyperextension worsened in two patients (9%) and 14 of 22 (63%) had postoperative values equal or greater than 30°.

DISCUSSION AND CONCLUSION: Our LRTI + C cohort experienced persistent MCP hyperextension, with mean postoperative hyperextension of >30°. Despite the literature suggesting that this portends inferior outcomes, our LRTI + C cohort demonstrated near-equal outcomes when compared with the LRTI, LRTI + A, and control groups. We no longer perform capsulodesis for MCP hyperextension and offer arthrodesis for MCP arthrosis or hyperextension not actively correctable by the patient.

PMID:40184604 | DOI:10.5435/JAAOSGlobal-D-25-00032

Neurology. 2025 May 13;104(9):e213560. doi: 10.1212/WNL.0000000000213560. Epub 2025 Apr 4.

ABSTRACT

BACKGROUND AND OBJECTIVES: Poor long-term blood pressure (BP) control due to undertreatment of hypertension is not uncommon after intracerebral hemorrhage (ICH). It heightens the risk of ICH recurrence and subsequent stroke, which is the highest within the first year. Promptly achieving BP targets would significantly reduce these risks. To accomplish this, upfront triple antihypertensive medications could be prescribed soon after ICH because many ICH survivors require ≥3 antihypertensives. However, not all would suit this approach, particularly those with cerebral amyloid angiopathy (CAA), where elevated admission BP may be due to acute hypertensive response rather than underlying hypertension. In addition, overtreatment and excessive BP lowering would cause more side effects and have been associated with increased mortality in older patients. Hence, to facilitate individualized treatment, we aimed to develop a score (TRICH) to predict the need for ≥3 antihypertensives at 3 months after ICH.

METHODS: We developed the score using data from the University of Hong Kong prospective ICH registry (2011-2022) and validated it in 3 hospitals (2020-2022) locally. Consecutive patients with spontaneous ICH who survived >90 days and had follow-up BP 3 months after ICH were included. Predictors for needing ≥3 antihypertensive medications at 3 months were identified using multivariate logistic regression, and the score was created using the β-coefficients.

RESULTS: The TRICH score was developed from 462 patients (mean age 66.6 ± 14.3 years, 60% male) and validated in 203 patients (mean age 66.3 ± 14.6 years, 62% male). The 9-point score (age younger than 60 years = 1, male = 1, ischemic heart disease = 1, admission estimated glomerular filtration rate <60 mL/min/1.73 m² = 2, admission systolic BP 190-230 mm Hg = 2 while >230 mm Hg = 4) has a c-statistic (95% CI) of 0.79 (0.75-0.83) in the development cohort and 0.76 (0.69-0.82) in validation. A dichotomized score (≥3 points) predicted the need for ≥3 antihypertensives with 0.73 (95% CI 0.67-0.80) sensitivity and 0.76 (95% CI 0.70-0.81) specificity. The score performed better in patients with untreated/uncontrolled hypertension before ICH than in controlled patients (c-statistic [95% CI] 0.81 [0.77-0.86] vs 0.74 [0.69-0.80], p = 0.037) but showed no difference between patients with CAA and non-CAA patients.

DISCUSSION: The TRICH score identifies patients with ICH who need ≥3 antihypertensive medications 3 months after ICH with good discrimination ability. It may guide upfront triple antihypertensive prescription, but further research is warranted, particularly in non-Han Chinese populations.

PMID:40184593 | DOI:10.1212/WNL.0000000000213560