Direct Anterior vs. Posterior Approach in Simultaneous Bilateral Total Hip Arthroplasty: A Meta-Analysis.

Simultaneous bilateral total hip arthroplasty (SimBTHA) offers benefits such as reduced hospital stay and costs for patients with bilateral hip disease. However, the optimal surgical approach remains uncertain. This study aimed to compare the perioperative outcomes of SimBTHA performed via the direct anterior approach (DAA) versus the posterior approach (PA).

Direct anterior vs other surgical approaches in patients with lumbar stiffness undergoing total hip arthroplasty: a systematic review and meta-analysis.

Introduction: The effectiveness of the direct anterior approach (DAA) compared to other surgical approaches for total hip arthroplasty (THA) in patients with lumbar spine stiffness remains unclear. This systematic review and meta-analysis aimed to compare clinical outcomes, including dislocation rates and other complications, between DAA and other surgical approaches for THA in patients with lumbar spine stiffness.

Materials And Methods: We conducted a systematic review and meta-analysis to compare the DAA with other surgical approaches (anterolateral, direct lateral, posterolateral and direct superior) in patients with lumbar spine stiffness undergoing THA.

Methylation assay in KMT2B-related dystonia: a novel diagnostic validation tool.

Background/objectives: KMT2B-related dystonia (DYT28, OMIM #617284) is a progressive neurological condition characterized by early onset movement disorders with autosomal dominant inheritance. In this study, we describe the use of a genome methylation episignature methodology to functionally validate two variants of uncertain significance (VUS) in the KMT2B gene.

Methods: Genome-wide methylation status was assessed using the EPIC methylation assay in peripheral blood samples from two subjects with early onset movement disorder and missense variants of uncertain significance in the KMT2B gene (p.

A qualitative exploration of the impact of the COVID-19 pandemic on gender-based violence against women living with HIV or tuberculosis in Timor Leste.

Violence against women or gender-based violence (GBV) is a significant public health issue facing women and girls in different settings. It is reported to have worsened globally during the COVID-19 pandemic. Despite the impact of the COVID-19 pandemic on increased violence against women in general, which has been reported in many settings globally, there is a paucity of evidence of its impact on violence against highly vulnerable women living with HIV or tuberculosis (TB).

Paradoxical Reaction in Intraocular Tuberculosis: Report of Three Cases.

Purpose: To present paradoxical reaction (PR) in three cases with ocular tuberculosis (OTB) treated with antitubercular therapy (ATT), highlighting diagnostic challenges and treatment strategies.

Methods: We retrospectively reviewed clinical records of three OTB patients presenting with paradoxical worsening after ATT initiation at two Brazilian university hospitals.

Results: The patients (2 males, 1 female) experienced worsening clinical presentation (increased inflammation, vision loss) within two to three weeks after initiating ATT.

Interventions of Brazil's more doctors program through continuing education for Primary Health Care.

Introduction: Brazil's More Doctors Program, in its training axis, aims to improve medical training for Primary Health Care through interventions related to the reality of the territory. The research presented here analyzed the interventions implemented by Brazil's More Doctors Program physicians, members of the Family Health Continuing Education Program, and the relationship with Primary Health Care programmatic actions.

Methodology: The research conducted made use of Text and Data Mining and content analysis.

Gerstmann-Sträussler-Scheinker Disease Presenting as Late-Onset Slowly Progressive Spinocerebellar Ataxia, and Comparative Case Series with Neuropathology.

Background: Genetic prion diseases, including Gerstmann-Sträussler-Scheinker disease (GSS), are extremely rare, fatal neurodegenerative disorders, often associated with progressive ataxia and cognitive/neuropsychiatric symptoms. GSS typically presents as a rapidly progressive cerebellar ataxia, associated with cognitive decline. Late-onset cases are rare.

Strengthening Health Research and Ethics Systems in Timor-Leste.

Introduction: Meaningful health research should lead to evidence-based decision-making that can be translated into policy and practice. Every country needs to have a well-functioning and resourced ethics review and clearance system to ensure health and medical research is conducted in line with ethical standards, preventing harm to research participants, and contributing to better health outcomes and national priorities. The purpose of this study is to describe the origins of the system for managing health research and ethics in Timor-Leste and how it has evolved over time; to identify the strengths and limitations of the current system; and to recommend areas for improvement.

Evaluation of massive education in prison health: a perspective of health care for the person deprived of freedom in Brazil.

Education, with an emphasis on prison health, has acted as a policy inducing changes in work processes, which the Brazilian National Health System (SUS) has used, and which is present in permanent health education, which promotes health care for people deprived of liberty. This article aims to present an analysis of the impacts of the strategy of massive education on prison health in Brazil from the perspective of health professionals and other actors operating in the Brazilian prison system. The data used in the study come from a questionnaire consisting of 37 questions applied nationwide between March and June 2022.

Melioidosis in Timor-Leste: First Case Description and Phylogenetic Analysis.

, the causative agent of melioidosis, has not yet been reported in Timor-Leste, a sovereign state northwest of Australia. In the context of improved access to diagnostic resources and expanding clinical networks in the Australasian region, we report the first 3 cases of culture-confirmed melioidosis in Timor-Leste. These cases describe a broad range of typical presentations, including sepsis, pneumonia, multifocal abscesses, and cutaneous infection.

Scoping Review on ADCY5-Related Movement Disorders.

Background: Adenylyl cyclase 5 (ADCY5)-related movement disorder (ADCY5-RMD) is a rare, childhood-onset disease resulting from pathogenic variants in the gene. The clinical features, diagnostic options, natural history, and treatments for this disease are poorly characterized and have never been established through a structured approach.

Objective: This scoping review attempts to summarize all available clinical literature on ADCY5-RMD.

Gut-microbiome-brain axis: the crosstalk between the vagus nerve, alpha-synuclein and the brain in Parkinson's disease.

This critical review of the literature shows that there is a close link between the microbiome, the gut, and the brain in Parkinson's disease. The vagus nerve, the main component of the parasympathetic nervous system, is involved in the regulation of immune response, digestion, heart rate, and control of mood. It can detect microbiota metabolites through its afferents, transferring this gut information to the central nervous system.

A framework for individualized splice-switching oligonucleotide therapy.

Splice-switching antisense oligonucleotides (ASOs) could be used to treat a subset of individuals with genetic diseases, but the systematic identification of such individuals remains a challenge. Here we performed whole-genome sequencing analyses to characterize genetic variation in 235 individuals (from 209 families) with ataxia-telangiectasia, a severely debilitating and life-threatening recessive genetic disorder, yielding a complete molecular diagnosis in almost all individuals. We developed a predictive taxonomy to assess the amenability of each individual to splice-switching ASO intervention; 9% and 6% of the individuals had variants that were 'probably' or 'possibly' amenable to ASO splice modulation, respectively.

Phenotypic, molecular, and functional characterization of COQ7-related primary CoQ deficiency: Hypomorphic variants and two distinct disease entities.

Primary coenzyme Q10 (CoQ) deficiency is a group of inborn errors of metabolism caused by defects in CoQ biosynthesis. Biallelic pathogenic variants in COQ7, encoding mitochondrial 5-demethoxyubiquinone hydroxylase, have been reported in nine patients from seven families. We identified five new patients with COQ7-related primary CoQ deficiency, performed clinical assessment of the patients, and studied the functional effects of current and previously reported COQ7 variants and potential treatment options.

Seroprevalence and prevention of hepatitis B, measles and rubella among healthcare workers in Dili, Timor-Leste.

Introduction: The World Health Organisation recommends that healthcare workers (HCWs) are immune to measles and rubella, and those at risk of exposure are offered the hepatitis B vaccine. No formal programme for occupational assessment and provision of vaccinations to HCWs currently exists in Timor-Leste.

Methods: A cross-sectional study was undertaken to determine the seroprevalence of hepatitis B, measles and rubella among HCWs in Dili, Timor-Leste.

Uncommon Foot Pain: A Rare Case of Sequential Migration of Cutaneous Pili Migrans.

Cutaneous pili migrans (CPM) is an uncommon condition in which a hair fragment penetrates the skin and produces a creeping lesion similarly of cutaneous larva migrans associated with local pain. There are few reports of CPM in the literature, and none visually describes the migration of the hair shaft in the epidermis associated with pain. Herein, we showed the first report describing a case of an sequential migration of CPM in an adult patient.

Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): study protocol for a population-representative cross-sectional serosurvey.

Introduction: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection.

Methods And Analysis: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age.

Dystonias: Clinical Recognition and the Role of Additional Diagnostic Testing.

Dystonia is the third most common movement disorder, characterized by abnormal, frequently twisting postures related to co-contraction of agonist and antagonist muscles. Diagnosis is challenging. We provide a comprehensive appraisal of the epidemiology and an approach to the phenomenology and classification of dystonia, based on the clinical characteristics and underlying etiology of dystonia syndromes.

Efficacy of aerobic exercise on the functioning and quality of life of children and adolescents with cerebral palsy: A systematic review and meta-analysis.

Aim: To investigate the efficacy of aerobic exercise on the functioning (participation, activities, and body functions and structures) and quality of life (QoL) of children and adolescents with cerebral palsy (CP).

Method: A systematic review with meta-analysis was performed. A comprehensive search of articles was performed using the electronic databases Embase, PubMed, PEDro, and CINAHL.

Pearls & Oy-sters: Paroxysmal Exercise-Induced Dyskinesias Due to Pyruvate Dehydrogenase Deficiency.

Paroxysmal exercise-induced movement disorders may be caused by energy metabolism disorders, such as Glut 1 deficiency, pyruvate dehydrogenase deficiency, or mitochondrial respiratory chain disorders. A 4-year-old boy with a history of febrile seizures presented with paroxysmal dystonia, triggered by exercise, or occurring at rest. Additional investigations demonstrated pallidal hyperintensities on brain MRI and low CSF glucose.