19043 research outputs found
Sort by
The Subjective Hip Value: A Retrospective Validation Study in Primary Total Hip Arthroplasty
No full textBackground: The hip dysfunction and osteoarthritis outcome score for joint replacement (HOOS JR) has been widely used to assess patient hip function. The subjective hip value (SHV) has become increasingly recognized as an efficient single-question survey for assessing hip joint function. This study aimed to determine the psychometric properties of the SHV in evaluating hip function in patients undergoing total hip arthroplasty (THA) in correlation with the traditional HOOS JR. Methods: This was a retrospective review of 1,157 distinct patients who underwent primary THA between January 2021 and December 2023. Scores for SHV and HOOS JR were collected preoperatively, as well as 3 months and 1 year postoperatively. Validity was determined using Pearson’s correlation tests between the SHV and HOOS JR. Results: Overall, the SHV was highly correlated with the HOOS JR at 3 months (R = 0.71, P \u3c 0.001) and 1 year postoperatively (R = 0.79, P \u3c 0.001). Additionally, changes in the SHV showed significant correlations with changes in the HOOS JR between the preoperative and postoperative periods. The SHV also had substantially fewer ceiling effects compared to the HOOS JR. Conclusions: The SHV is a valid and responsive single-item assessment for hip joint function following primary THA. Despite its limitations, its efficiency and ease of use make it a feasible option for routine clinical assessments, providing clinicians with valuable insights into patients\u27 recovery. Subsequently, the integration of the SHV into orthopedic practice holds promise for enhancing the management of postoperative care and improving patient outcomes
Eliminating Wound Tension in an Edematous Lower Extremity Defect Through Elastic Wrapping During Mohs Micrographic Surgery
No full textSCAR-Ed by Antibiotics: A Retrospective Cohort Study of Severe Cutaneous Adverse Reactions (SCAR) Relative Risk
No full textDespite a Multifactorial Etiology, Rates of Distal Junctional Kyphosis After Adult Cervical Deformity Corrective Surgery Can Be Dramatically Diminished by Optimizing Age Specific Radiographic Improvement
No full textStudy Design: Retrospective cohort study of a prospectively collected single-center database. Objective: Distal Junctional Kyphosis (DJK) is one of the most common complications in adult cervical deformity (ACD) correction. The utility of radiographic alignment alone in predicting and minimizing DJK occurrence warrants further study. To investigate the impact of post-operative radiographic alignment on development of DJK in ACD patients. Methods: ACD patients (≥18 yrs) with complete baseline (BL) and two-year (2Y) radiographic data were included. DJF was defined as DJK greater than 15° (Passias et al) or DJK with reop. Multivariable logistic regression (MVA) identified 3-month predictors of DJK. Conditional inference tree (CIT) machine learning analysis determined threshold cutoffs. Radiographic predictors were combined in a model to determine predictive value using area under the curve (AUC) methodology. “Match” refers to ideal age-adjusted alignment. Results: 140 cervical deformity patients met inclusion criteria (61.3 yrs, 67% F, BMI: 29 kg/m2, CCI: 0.96 ± 1.3). Surgically, 51.3% had osteotomies, 47.1% had a posterior approach, 34.5% combined approach, 18.5% anterior approach, with an average 7.6 ± 3.8 levels fused and EBL of 824 mL. Overall, 33 patients (23.6%) developed DJK, and 11 patients (9%) developed DJF. MVA controlling for age, and baseline deformity, followed by CIT found 3M cSVA \u3c3.7 cm (OR:.2, 95% CI:.06-.6), and TK T4-T12 \u3c50 (OR:.17, 95% CI:.05-.5, both P \u3c.05) were significant predictors of a lower likelihood of DJK. Receiver operator curve AUC using age, T1S match, TS-CL match, LL-TK match, cSVA \u3c3.7 cm, and T4-T12 \u3c50 predicted DJK with an AUC of.91 for DJK by 2Y, and.88 for DJF by 2Y. Conclusion: These findings suggest post-operative radiographic alignment is strongly associated with distal junctional kyphosis. When utilizing age-adjusted realignment in addition to newly developed thresholds, a suggested post-operative cSVA target of 3.7 cm and thoracic kyphosis less than 50, it is possible to substantially reduce the occurrence of distal junctional kyphosis and distal junctional failure
Adolescent vs. Young Adult Idiopathic Scoliosis Patients: How Different Are Their Two Year Postoperative Radiographic and Clinical Outcomes?
No full textPurpose: To compare the long-term outcomes among AIS (10–18 years) and young AdIS (YAdIS) (19–40 years) patients with minimum 2 year follow up. Methods: A retrospective review of AIS and YAdIS patients who underwent primary corrective surgery at a single center was conducted. Demographic, radiographic, operative data, patient reported outcome measures (PROMs), including the ODI and SRS-22r, and long-term complications were collected. A 1:1 propensity score matched (PSM) analysis was implemented to limit selection bias by controlling for gender, curve type, total instrumented levels (TIL), and main coronal cobb angle. Results: 95 patients (60 AIS, 35 YAdIS) were identified. Following PSM, 27 matched pairs were identified. AIS patients had greater LL (-55.6 ± 14.0 vs. -61.8 ± 11.7, p = 0.0486) at preop, less OR time (4.7 ± 1.2 h vs. 5.2 ± 1.5 h, p = 0.0468), intraoperative transfusion rates (70.4% vs. 96.3%, p = 0.0082), and postop Hb (9.0 ± 1.9 vs. 10.1 ± 1.4, p = 0.0280) and Hct (26.4 ± 5.4 vs. 29.7 ± 3.7, p = 0.0453). YAdIS patients had greater T2-T12 TK (42.7 ± 13.6 vs. 36.3 ± 11.0, p = 0.0412), T2-T5 TK (19.4 ± 9.4 vs. 13.3 ± 8.7, p = 0.0187), and TPA (12.4 ± 7.9 vs. 7.4 ± 8.9, p = 0.0200). There were no significant differences in baseline and 2 year follow up PROMs and in the rates of 2 year complications, including proximal/distal junctional kyphosis (PJK/DJK), pseudarthrosis, rod fracture, curve progression, and revision (p \u3e 0.05). Conclusion: Despite differences in operative characteristics, idiopathic scoliosis (IS) patients who underwent corrective surgery at a younger age had comparable PROMs and 2 year outcomes to older patients. Corrective fusion surgery is safe and effective in both adolescents and young adults and may avoid the higher complication rates seen in older adults
InTouch Week of November 24, 2025
No full textNYMC Marks 150 Year Academic Affiliation with NYC Health+Hospitals/Metropolitan with Celebration Symposium BioInc@NYMC Welcomes Dair Capture SOM Class of 2029 Comes Together for Friendsgiving Celebration NYMC and TU Hosted Webinar Series: “Ninety Minutes: The Medical Magazine of the Web” Third Volume of Medical Halachah Annual Links Halachah and Modern Medical Ethics Feature Your Artwork on the Chironian Back Cover TCDM Students Volunteer at Pop-Up Dental Clinic Free Ground Shipping on Merch In The Community: Students Lead Community Health Fair Offering Wide-Ranging Health Resources Student Spotlight: From Medical Student to Ironmanhttps://touroscholar.touro.edu/in_touch/1382/thumbnail.jp
Mechanisms of Placental Impairment and the Upregulation of Fetuin-B during Maternal Undernourishment
No full textProper nutrition is crucial during pregnancy to support fetal and placental development. Failure to meet these nutritional needs can result in adverse health outcomes for both mother and baby. Despite its high prevalence in underdeveloped countries, maternal undernourishment is a public health issue worldwide. There are several possible causes of maternal undernourishment, and these can occur alone or in combination, such as poor access to nutrition, hyperemesis gravidarum, and drug use. This condition can adversely affect placental development and function to the extent of placental insufficiency, perturbing the entire pregnancy. The placenta is responsible not only for hormonally and physically maintaining the pregnancy but also for providing nutrients to the fetus while removing harmful waste products. Fetuin-B, a hepatokine identified as a possible biomarker in other gestational pathologies, was significantly upregulated in maternally undernourished placentas. It is hypothesized that this upregulation of fetuin-B in combination with oxidative stress during maternal undernourishment could play a significant role in placental insufficiency, ranging from the function of the whole organ down to the trophoblast (extraembryonic stem cells forming the placenta) level. Several pharmaceutical interventions were utilized to identify pathway contribution and as possible therapeutics: Tempol for oxidative stress, MitoTEMPO for mitochondrial superoxide production, and TAK-242 for TLR4 involvement.
A previously established mouse model was utilized to examine the consequences of maternal undernourishment on the placenta. Pregnant dams were fed a reduced protein chow at a caloric deficit. In the past, this model consistently produced low-birth-weight offspring, supporting its effectiveness. At the whole organ level, placental vascularization (immunofluorescent staining), vascular reactivity (wire myography), and blood flow (laser- Doppler flowmetry) were measured. Placental explants and primary trophoblast cultures xi were probed for oxidative stress, proliferation, cell death, and cell differentiation (immunofluorescent staining). A commercial trophoblast cell line, HTR-8/SVneo, was utilized to examine the isolated effects of fetuin-B on trophoblast cells regarding oxidative stress, proliferation, cell death, TLR4 activation, and NF-kB expression. There was particular interest in mitochondrial function and how it is affected by maternal undernourishment and fetuin-B. Both primary and commercial trophoblasts treated with fetuin-B were compared in terms of mitochondrial superoxide production, antioxidant levels, metabolism, and electron transport chain complex activity.
Studies showed that maternal undernourishment, while upregulating oxidative stress and fetuin-B, perturbed placental development, reduced trophoblast pools, and impaired vascular function. Fetuin-B upregulation was exposed as a detrimental factor promoting excess oxidative stress in a positive feedback loop. It could account for many of the changes in the placenta during maternal undernourishment. Treatment with fetuin-B activates TLR4, increases NF-kB p65 expression, increases oxidative stress, and disrupts mitochondrial function. As revealed by the application of pharmaceutical agents, cellular oxidative stress, mitochondrial oxidative stress, and TLR4 activation contribute to these fetuin-B-linked outcomes.
Maternal undernourishment, through the increase in oxidative stress and upregulation of fetuin-B, impairs placental development and proper vascular function, negatively impacts trophoblasts that form the placenta, and promotes mitochondrial dysfunction. This study identified possible therapeutic agents that could serve as add-on treatments to a proper diet. The findings are widely applicable to placental insufficiency and shed light on the mechanisms involved in this condition that are commonly associated with obstetric pathologies
Vagal Sensory Neuron-Derived FGF3 Controls Insulin Secretion
No full textVagal nerve stimulation has emerged as a promising modality for treating a wide range of chronic conditions, including metabolic disorders. However, the cellular and molecular pathways driving these clinical benefits remain largely obscure. Here, we demonstrate that fibroblast growth factor 3 (Fgf3) mRNA is upregulated in the mouse vagal ganglia under acute metabolic stress. Systemic and vagal sensory overexpression of Fgf3 enhanced glucose-stimulated insulin secretion (GSIS), improved glucose excursion, and increased energy expenditure and physical activity. Fgf3-elicited insulinotropic and glucose-lowering responses were recapitulated when overexpression of Fgf3 was restricted to the pancreas-projecting vagal sensory neurons. Genetic ablation of Fgf3 in pancreatic vagal afferents exacerbated high-fat diet-induced glucose intolerance and blunted GSIS. Finally, electrostimulation of the vagal afferents enhanced GSIS and glucose clearance independently of efferent outputs. Collectively, we demonstrate a direct role for the vagal afferent signaling in GSIS and identify Fgf3 as a vagal sensory-derived metabolic factor that controls pancreatic β-cell activity