bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Report: Correction of Extensive Osteochondral Defect with Structured Bone Graft Associated with Collagen Membrane Coating in Knee Due to Sequelae of Osteochondritis Dissecans
Authors: Silva RAB , Palhares GM 
Published: November 2024

Objectives Case report of the treatment of a 35-year-old woman with sequelae of an extensive osteochondral lesion in the Medial Femoral Condyle of the Right Knee. This report presents the clinical and radiological results after using the structured cancellous bone grafting technique from the Iliac bone with the aid of instruments for mosaicplasty associated with coverage with Collagen Membrane (Chondro-Gide®). Methods We removed the entire remaining osteochondral fragment down to the healthy cancellous bone and made perforations with the Mosaicplasty instrument designed to remove the recipient area to receive the cancellous bone plugs. We inserted the cancellous bone plugs into the defect of the Medial Femoral Condyle so that they filled the entire defect, remaining stable through the press-fit. After fixing and modeling the cancellous bone graft, the bone was covered with a collagen membrane (Chondro-Gide®). Results 12 months after surgery, the patient performed weight training without complaints, returned to all previous usual activities and had a range of motion of 0-120˚. 18 months post-operatively, the IKDC score went from 5 pre-operatively to 52 out of a possible 87 (59.8%). Magnetic Resonance Imaging was performed 12 months after surgery for follow-up evaluation and the images showed the filling of the bone defect and the formation of fibrous scar tissue. Conclusion The presented technique proved to be a satisfactory option available in our country for the treatment of extensive osteochondral lesions with significant involvement of the subchondral bone when allografting is impossible. The presented patient is in good clinical function after an 18-month follow-up, with no recurrence of the preoperative clinical condition.
Measurement of the posterior tibial slope with different methods – analysis by computed tomography in a sample from the brazilian population
Authors: Malpaga JMJ , Jorge PB , Oliveira DE , Horita MM , Salas VER , Morales GJS 
Published: November 2024

Objectives The posterior tibial slope (PTS) has been widely studied because of its relationship with tibial translation, knee stability and possible injuries related to the anterior cruciate ligament. But there is no consensus on the normal and pathological values for PTS and the best referral axes. Methods In this study, 96 people with non-orthopedic disorder were evaluated trough 3-D computed tomography (CT) scan. The TS of the medial and lateral tibial plateaus were measured using techniques adapted from previous protocols with three referral axes: the proximal tibial long axis, the anterior and posterior cortices. The CT scan were evaluated with two independent observers. Results The averages and standard deviations of medial PTS (MPTS) in the three methods were 10.4 ± 2,8, 8,3 ± 2,8 and 5,9 ± 2,8, separately. The results of lateral PTS (LPTS) were 9,9 ± 3,3, 7,8 ± 3,1 and 5,7 ± 3,1. There was no significant difference between the male and the female. All the referral axes had high interobserver reliability, with greater value (0.829) for posterior cortice axe for medial TS and anterior cortice for lateral TS (0.861). Conclusion The mean value for posterior tibial slope in a small Brazilian sample is similar to other ethnicity described in the literature. Tibial slope measurements have a high degree of variability between different measurement methods, but all referral axes had a high interobserver reliability.
Occurrence of patellofemoral osteoarthritis at medium and long terms in patients undergoing isolated reconstruction of the medial patellofemoral ligment with the medial third of the patellar tendon
Authors: Kupczik F , Gobbi RG , Schiavon MEG , Sbrissia B , Brunet MD , Camanho GL 
Published: November 2024

Objectives The purpose of this study was to analyze the presence of patellofemoral osteoarthritis (OA) in the medium and long term in patients undergoing reconstruction of the medial patellofemoral ligament (MPFL) with a medial strip of the patellar tendon to treat recurrent patellar instability. Methods Retrospective case series of 69 patients (86 knees) who underwent medial MPFL between 2004 and 2016, mean age 26.1 ± 8 years (15 to 45 years), were recorded at a mean follow-up of 72.2 ± 37.5 months (24 to 163 months). Parameters evaluated: age, sex, follow-up period, recurrence, pre-existing chondral lesion, trochlear dysplasia, patellar height, femoral tunnel positioning and patellofemoral OA (Iwano’s classification). Uni and multivariate analysis correlated the variables to patellofemoral OA. Results There was patellofemoral OA in only 16.3% (grade 1: 11.6%; grade 2: 3.5%; grade 3: 1.2%) of cases. Univariate analysis showed that only the follow-up period had an independent association with patellofemoral OA (p = 0.028) and multivariate analysis showed that only high-grade (B/C) of trochlear dysplasia had a significant correlation with the occurrence of patellofemoral OA (p = 0.004). There were no recurrences. Conclusion Isolated MPFL with a medial strip of the patellar tendon showed a low rate of patellofemoral OA in the medium and long-term follow-up. The presence of high-grade trochlear dysplasia did correlate to patellofemoral OA development.
Platelet-Rich Plasma, Bone Marrow Aspirate and Hyaluronic Acid Lead to Significant Improvement at 6 months Compared to Placebo: A Network Metanalysis of Injections for Knee Osteoarthritis
Authors: MAMERI ENZO SALVIATO , KHAN ZEESHAN , JAWAND HARKIRAT , CHAHLA JORGE 
Published: November 2024

Objectives To compare the efficacy of common intra-articular injections used in the treatment of knee osteoarthritis, including corticosteroid (CS), hyaluronic acid (HA), platelet-rich plasma (PRP), and bone marrow aspirate concentrate (BMAC), with a minimum follow-up of 6-months. Methods PubMed/MEDLINE, Scopus, and Cochrane databases were queried for level I to II randomized clinical trials with a minimum follow-up of 6 months that investigated the treatments of interest. Patient reported outcome scores for pain and function at baseline and at latest follow-up were extracted and the change in scores were converted to uniform 0-100 scales. An arm-based Bayesian network meta-analysis in a random-effects model was created to compare the treatment arms in terms of pain and function. Cumulative ranking of injection types based on pain and function effect differences was calculated using the SUCRA of interventions values. Results Forty-seven studies were included, most of which with overall low risk of bias (72.3%). HA and PRP both led to a significant improvement in pain compared to placebo. HA, PRP, and BMAC all led to a significant improvement in function scores when compared to placebo. Surface under the cumulative ranking curves (SUCRA) of the interventions revealed PRP, BMAC, and HA overall SUCRA scores of 91.61, 76.46, and 53.06 respectively. For the treatment of pain in patients with knee osteoarthritis, PRP ranked as the best intra-articular injection, followed by BMAC, then HA, then CS. For function improvement, PRP similarly ranked as the best injection, followed by BMAC, then HA. Conclusion Intra-articular PRP, BMAC and HA are all beneficious relative to placebo at 6 months for knee osteoarthritis. The results of the current study suggest PRP was the most efficacious intra-articular injection in terms of pain and function.
Revision knee arthroplasty with robotic assistance: Report of the first case in Brazil of conversion from partial arthroplasty to total knee arthroplasty
Authors: TEMPONI EDUARDO FROIS , DE CARVALHO JUNIOR LUCIO HONORIO , SOARES LUIZ FERNANDO MACHADO , GONCALVES MATHEUS BRAGA JACQUES , PIMENTA FREDERICO SILVA , JÚNIOR RICARDO CORRÊA FÁVERO 
Published: November 2024

Objectives To evaluate and describe the first case in Brazil of a patient undergoing revision surgical treatment with robotic assistance from partial arthroplasty to total knee arthroplasty. Methods Description of the follow-up and step-by-step techniques used to prepare and execute revision surgery with robotic assistance in a patient with limiting residual pain after unicompartmental knee arthroplasty. Results This report describes the case of a 61-year-old female patient. She had previously undergone Unicompartmental Knee Arthroplasty (UKA) in 2015 at another institution. After investigations to rule out infection or loosening of the UKA components and considering the persistence of symptoms, a conservative treatment approach, involving physiotherapy and infiltrations, was chosen, yielding no significant improvement. Faced with ongoing symptoms, the decision was made to perform a Total Knee Arthroplasty (TKA) with robotic assistance (rTKA). The choice of the Stryker Triathlon system was based on a preoperative computed tomography sent to the United States. The intervention took place on June 15, 2022. Following the Mako protocol, antennas and checkpoints were positioned, and anatomical points were marked under robotic navigation, including the area of the previous UKA. During the surgery, after removing the UKA components and resecting osteophytes, ligament balance was adjusted, achieving equalized gaps in extension and flexion. The patient had an accelerated rehabilitation protocol. She has been monitored for around 18 months with improvements in clinical and functional outcomes. Conclusion The use of robotic arm assistance in the revision from unsuccessful UKA to primary TKA is a novel technique that resulted in excellent operative outcomes in this case. Further studies are needed to better define implementation methods and create specific protocols.
Gait Kinetics in Medial Meniscus Posterior Root Tears: Investigating Protective Strategies and the Effects of Root Repair
Authors: Mameri ES , Gonzalez FF , Gustafson JA , Leporace G , Metsavaht L , Chala J 
Published: November 2024

Objectives To investigate changes in external moments in medial meniscus posterior root tear (MMPRT) patients, and the effect of medial meniscus posterior root repair (MMPRR) in restoring normal kinetics. Methods We present preliminary findings from six subjects with MMPRT, four with MMPRR, and three healthy age-matched control participants (CON). Participants walked on level ground at a self-selected gait speed. Data were collected using high-speed cameras and ground-embedded force plates. Peak knee moments for flexion-extension (KFM and KEM), abduction-adduction (KAbM, KAdM), and internal-external rotation (KERM, KIRM) were calculated using inverse dynamics during the stance phase of gait, and normalized to body mass and height. Group comparisons were conducted using the Kruskal-Wallis and Dunn test with Bonferroni correction. Results were considered statistically significant if p-values were less than 0.05. Results Both MMPRT and MMPRR groups exhibited significantly lower KFM relative to the CON group, suggesting a strategy to reduce quadriceps activation in both patient groups, which may persist after surgery. MMPRT patients showed significantly diminished KEM relative to both MMR and CON groups, indicating a strategy to reduce external knee forces following injury. MMPRR patients presented KEM that resembled the healthy control group, showing that repair surgery could potentially restore this gait variable. KAbM was statistically higher in the MMPRR and CON groups relative to MMPRT patients, which presented lower KAM than the other groups, suggesting a protective strategy to offload the medial compartment. KERM were significantly higher in the CON group compared to the MMT group, suggesting a protective strategy to avoid excessive external rotation by the MMT group. No significant differences were observed in KIRM across the three groups. Conclusion MMPRT leads to alterations in gait kinetics, compatible with a protective strategy to unload the knee and compensate for increased medial compartment contact pressures, which are partially restored following root repair.
Motion resistance in peripheral oxygen saturation monitoring using Biolight Analog SpO2 compared to Masimo SpO2: a non-inferiority study
Authors: Yang Ting , Liu Yong , Cai FengHua , Li Yong , Mudabbar Muhammad Saqib 
Published: November 2024

Abstract
Background
Pulse oximeters are vital for assessing blood oxygen levels but can produce inaccurate readings during patient motion, leading to false alarms and alarm fatigue. Analog SpO2 Technology, which uses analog waveforms to filter motion artifacts, may improve accuracy compared to digital sensors. However, the effectiveness of this technology in reducing false alarms in clinical settings remains unclear. This study assesses and compares the motion resistance of Analog SpO2 Technology of two devices in the market.

Methods
Thirty healthy adults underwent controlled experiments (Control, Linear Motion, Angular Motion) using two pulse oximeters. Linear Motion tested hand displacement impact, while Angular Motion involved rhythmic hand motions at 120 bpm and 160 bpm.

Results
Both devices performed similarly in Control, with no disruptions. In Linear Motion, mild disruptions occurred, but no significant differences in SpO2 readings or alarms. Angular Motion at 120 bpm showed stability with no alarms. At 160 bpm, Device B (Biolight Analog SpO2) had fewer technical alarms but more SpO2 alarms than Device A (Masimo Analog SpO2).

Conclusions
Analog SpO2 exhibited motion resistance under static, linear and continuous waving angular motion up to 120 bpm and 160 bpm, but alarms occurred at 160 bpm with continuous tapping angular motion. These findings signify non-inferiority of either device in clinical settings. Further studies should include patients with cardiovascular and/or respiratory diseases.

Trial Registration
The study was submitted to and approved by the Biolight Ethics Committee (S0723), and written informed consent from all participants was obtained.
Validation of IASLC 9th edition TNM classification for lung cancer: focus on N descriptor
Authors: Son Joung Woo , Lee Joonseok , Jeon Jae Hyun , Cho Sukki , Jung Woohyun , Shih Beatrice Chia-Hui , Kim Kwhanmien , Jheon Sanghoon 
Published: November 2024

Abstract
Background
We externally validated the proposed 9th edition of the TNM staging classification with our institution’s prospectively collected data and compared it to the 8th edition for overall survival (OS) and freedom from recurrence (FFR).

Methods
A retrospective analysis was conducted of 4029 cases of stage I-III non-small cell lung cancer that underwent surgical treatment from January 2004 to December 2020. Survival was compared using Kaplan-Meier curves and multivariable Cox regression analysis. The concordance index (C-index), Alkaike information criterion (AIC), and R2 were used to assess the discriminatory ability.

Results
In the 9th edition, the N2 category (n = 352) was subdivided into N2a (n = 256, 72.7%) and N2b (n = 96, 27.3%). The TNM stage changes were as follows: (1) IIB to IIA, 151 cases (26.0%); (2) IIIA to IIB, 52 cases (11.5%); (3) IIIB to IIIA, 57 cases (61.3%); (4) IIIA to IIIB, 56 cases (12.4%). The survival curves of the proposed 9th edition demonstrated similar patterns to those of the 8th edition, but with a greater discriminative ability for OS and FFR. Subdividing N2 into N2a and N2b refined prognosis prediction. The C-index, AIC, and R2 demonstrated improved values in the proposed 9th edition compared to the 8th edition.

Conclusions
The proposed 9th edition of the TNM staging classification for lung cancer showed favorable prognostic validity and better discrimination ability than the 8th edition.
Anacyclus pyrethrum enhances fertility in cadmium-intoxicated male rats by improving sperm functions
Authors: Mahmoud Aya A. , Shaaban Mennat Allah M. , Basal Wesam T. 
Published: November 2024

Abstract
Background
Environmental pollutants, particularly heavy metals, have been frequently connected to male infertility. Cadmium was previously shown to reduce male fertility by causing oxidative stress. Anacyclus pyrethrum is a well-known medicinal plant. Most of its parts, notably the roots, have excellent antioxidant and anti-inflammatory properties. The present study investigated the potential ability of Anacyclus pyrethrum to protect male rats against cadmium reproductive toxicity.

Methods
Twenty-eight adult Wistar male rats (8 weeks old) weighing (170-200g) were randomly divided into four groups (n = 7): group (1) the control, group (2) was orally administrated with Anacyclus pyrethrum extract (100mg/kg) for 56 consecutive days, group (3) received a single intraperitoneal (IP) injection of cadmium chloride (1mg/kg), and group (4) received a single IP dose of CdCl2 followed by 8 weeks of oral Anacyclus extract treatment.

Results
Cadmium Cd toxicity resulted in a significant decrease in the concentration of antioxidant enzymes (superoxide dismutase SOD and glutathione peroxidase GPx) in the semen coupled with a significant rise in malondialdehyde MDA level. Consequently, sperm analysis parameters were significantly affected showing decreased motility, viability, concentration and increased morphological aberrations. DNA fragmentation was also detected in the sperms of rats exposed to Cd using comet assay. Serum levels of testosterone T, follicle stimulating hormone FSH, and luteinizing hormone LH were significantly decreased. The mRNA expression levels of sex hormone receptors (FSHR, LHR and AR) in the testis of the Cd exposed rats were significantly decreased. Expression levels of Bax and Bcl2 genes in the sperms of Cd intoxicated rats were also affected shifting the Bax/Bcl2 ratio towards the induction of apoptosis. Co-treatment with the Anacyclus pyrethrum extract restored the oxidative enzymes activities and decreased the formation of lipid peroxidation byproduct, which in turn ameliorated the effect of Cd on sperm parameters, sperm DNA damage, circulating hormone levels, gene expression and apoptosis. These results indicate that Anacyclus pyrethrum could serve as a protective agent against cadmium-induced sperm toxicity.

Conclusion
Taken together, it can be concluded that the antioxidant activities of Anacyclus pyrethrum restored the semen quality and enhanced fertility in Cd-intoxicated male rats.
Resolution of acute inflammation induced by monosodium urate crystals (MSU) through neutrophil extracellular trap-MSU aggregate-mediated negative signaling
Authors: Lu Cheng-Hsun , Shen Chieh-Yu , Li Ko-Jen , Wu Cheng-Han , Chen Yu-Hsuan , Kuo Yu-Min , Hsieh Song-Chou , Yu Chia-Li 
Published: November 2024

Abstract
Background
Polymorphonuclear neutrophils (PMN) activation by monosodium urate crystals (MSU) is crucial to acute gouty arthritis and subsequent spontaneous remission within 7–10 days. Activated PMNs release neutrophil extracellular traps (NETs) that entrap MSU crystals, forming NET-MSU aggregates. Whether NET-MSU aggregates contribute to the resolution of acute inflammation remains to be elucidated. This study uses a cell-based approach to unveil their molecular bases.

Methods
All-trans retinoic acid-differentiated HL-60 cells (dHL-60) served as surrogate PMNs. NET release from MSU-activated dHL-60 was confirmed by detecting DNA, neutrophil elastase, and citrullinated histone 3, forming large NET-MSU aggregates. NET area was measured with Fiji software after SYTOX Green staining. Released pro-inflammatory cytokines IL-8 and TNF-α, and the anti-inflammatory cytokine IL-1RA in culture supernatants were quantified to calculate the estimate inflammation score (EIS). Cellular redox state was determined by a FRET-based sensor. Expression of intracellular positive (ERK1/2) and negative (SHP-1 and SHIP-1) cytokine signaling regulators was detected by western blot. qPCR detected mRNA expressions of CISH and SOCS1–SOCS7. Flow cytometry measured neutrophil N1 (CD54) and N2 (CD182) surface markers after staining with fluorescent-conjugated antibodies.

Results
Incubating dHL-60 with MSU for 4 h maximized NET-MSU aggregate formation and acute inflammation with an EIS of 11.6. Prolonging the incubation of dHL-60 + MSU to 22 h gradually raised the EIS to 19.40 without increasing NET area, due to reduced cellular redox capacity. Adding both new dHL-60 and new MSU crystals to the culture, mimicking the clinical scenario, increased NET area but conversely suppressed EIS to 1.53, indicating acute inflammation resolution. The resolution of acute inflammation following prolonged incubation was attributed to decreases in P-ERK and increases in P-SHP-1, SOCS2, SOCS3, and CISH gene expressions, which may suppress pro-inflammatory and enhance anti-inflammatory cytokine production. Moreover, the large NET-MSU aggregates facilitated N1 to N2 polarization, crucial for accelerating inflammation resolution.

Conclusion
We explored the potential molecular basis for the spontaneous resolution of MSU induced acute inflammation using a cell-based model in that huge NET-MSU aggregates frustrate the transformation of newly entering PMNs to the N2 phenotype, enhancing the production of the anti-inflammatory cytokine IL-1RA.
Acute pancreatitis after double cardiac valve replacement: a case report
Authors: El Amraoui Wafae , Ettaje Ayoub , Belcadi Oumaima , Chajai Salim , Elmourabit Yassine , Leghlimi Lalla Hasnaa , Marmad Lahcen , Tribak Mohamed , Lachhab Fadoua , Bensouda Adil , Moughil Said 
Published: November 2024

Abstract

Background
Acute pancreatitis following cardiac surgery is a rare complication. Early recognition of risk factors and vigilance toward initial symptoms can prevent significant morbidity and mortality. Bowel ischemia and the release of inflammatory mediators during cardiopulmonary bypass play key roles in the development of acute postoperative pancreatitis. Management is generally conservative, following the modified Atlanta 2012 criteria. This paper reviews the literature and emphasizes the importance of early investigation of abdominal pain after cardiac surgery.

Case presentation
We report a case of severe acute pancreatitis that developed after double valvular replacement, performed during a 3-h cardiopulmonary bypass in a patient who initially had endocarditis and underwent dialysis 3 times. Considering the risk factors, the patient was diagnosed early and managed conservatively, leading to a positive outcome.

Conclusions
Anesthesiologists must not disregard abdominal pain after cardiac surgery in the context of risk factors, as it may indicate gastrointestinal complications, including pancreatitis, which can be among the most dangerous complications if not treated promptly.