The pathogenesis and management of heatstroke and heatstroke-induced lung injury.

In the past two decades, record-breaking heat waves have caused an increasing number of heat-related deaths, including heatstroke, globally. Heatstroke is a life-threatening systemic condition characterized by a core body temperature >40°C and the subsequent development of multiple organ dysfunction syndrome. Lung injury is a well-documented complication of heatstroke and is usually the secondary cause of patient death.

Identifying Predictors of Extended Intensive Care Unit Stay Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: An Analysis of 101 ACS NSQIP Pediatric Participating Centers.

Background: While prolonged operative time and increased levels fused have been shown to increase the risk of prolonged intensive care unit (ICU) length-of-stay (LOS), studies are limited in guiding decision-making regarding the need for intensive care postoperatively. This is especially the case among the cohort of adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF); associations between comorbidities and ICU LOS are not well-delineated.

Methods: AIS patients who underwent PSF from January 1st, 2016 to December 1st, 2016 at 101 participating centers were identified using the American College of Surgeons (ACS) National Surgical Quality Im-provement Project (NSQIP) Pediatric database.

Standardized Multimodal Pain Protocol Minimizes Inpatient Opioid Administration in Pediatric Orthopedic Surgery Population.

Background: Optimal management of post-operative pain is a critical component of orthopedic surgical care. There is a heightened awareness of narcotic prescribing habits given the current "opioid epidemic." The lack of standardized protocols has led to increased errors, delayed access to prescribed medications, and excessive narcotic prescribing.

Efficacy and safety of various regional nerve blocks for postoperative analgesia in paediatric patients undergoing developmental dysplasia of the hip surgery: a protocol for systematic review and network meta-analysis.

Introduction: Alleviating postoperative pain from developmental dysplasia of the hip (DDH) surgery is beneficial for paediatric patients. The most commonly used anaesthetic approach currently is general anaesthesia combined with regional nerve blocks. Existing research primarily focuses on studies comparing regional nerve blocks with placebo controls, or studies comparing two different regional nerve blocking techniques.

Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient.

Introduction: This report describes the use of a combination of a retrograde femoral nail and distal femur locking plate for the treatment of an open intra-articular distal femur fracture in a 99-year-old female. The purpose of this report is to highlight that nail-plate fixation constructs can be performed percutaneously and expeditiously even in extremely old patients; therefore, patient age should not be a limiting factor in choosing this construct to allow for immediate weight-bearing.

Case Report: The patient was a 99-year-old female who presented to the emergency room after a fall.

Self-assembled water soluble and bone-targeting phosphorylated quercetin ameliorates postmenopausal osteoporosis in ovariectomy mice.

Natural compounds have shown promising application prospects in preventing or treating various diseases, including osteoporosis on account of their abundant sources, low price, multi-targeting and multiple biological effects. As a bioactive natural product, quercetin (Que) has previously demonstrated to ameliorate osteoporosis (OP), however, its poor bioavailability resulting from low water solubility, poor stability and lack of bone-targeting largely restricted its efficacy and clinical applications. Inspired by the bone-targeting capability of phosphate compounds, we reported a one-step procedure for synthesis of phosphorylated Que (p-Que) by direct phosphorylating phenol groups of Que for the first time.

Ultrasound Diagnosis of Hamstring Muscle Complex Injuries Focus on Originate Tendon Structure-Male University Rugby Players.

With the remarkable advances in diagnostic ultrasound equipment, there is a growing need for ultrasound diagnosis of muscle and soft tissue injuries in sports injuries. Among these, hamstring strains are often difficult to treat and require early and accurate diagnosis. Injuries to the proximal part of the hamstring often take a long time to heal.

Radical Resection of a Radial Ewing Sarcoma and Ulnar Centralization in a 10-Month-Old Girl: A Case Report.

Case: We outline the management of a 10-month-old girl with an Ewing sarcoma involving the entire radius. The patient was treated with neoadjuvant chemotherapy resulting in almost a complete response. A limb-sparing procedure was performed consisting of a radical resection of the entire radius and centralization of the carpus to the ulna.

Ultrafast enzyme-responsive hydrogel for real-time assessment and treatment optimization in infected wounds.

Monitoring wound infection and providing appropriate treatment are crucial for achieving favorable outcomes. However, the time-consuming nature of laboratory culture tests may delay timely intervention. To tackle this challenge, a simple yet effective HDG hydrogel, composed of hydrogen peroxide (H₂O₂), dopamine, and GelMA polymer, is developed for the ultrafast detection and treatment of Staphylococcus aureus (SA) infections.

Perseverance of Optimal Realignment is Associated With Improved Cost-utility in Adult Cervical Deformity Surgery.

Background: Early-term complications may not predict long-term success after adult cervical deformity (ACD) correction.

Objective: Evaluate whether optimal realignment results in similar rates of perioperative complications but achieves longer-term cost-utility.

Study Design: Retrospective cohort study.

hnRNPU-mediated pathogenic alternative splicing drives gastric cancer progression.

Background: Alternative splicing (AS) is a process that facilitates the differential inclusion of exonic sequences from precursor messenger RNAs, significantly enhancing the diversity of the transcriptome and proteome. In cancer, pathogenic AS events are closely related to cancer progression. This study aims to investigate the role and regulatory mechanisms of AS in gastric cancer (GC).

Elbow rotation affects the accuracy of rotational formulas: validation of a modified method.

Background: Supracondylar humerus fractures (SCHFs) are the most common elbow fractures in children and are typically treated with closed reduction and Kirschner pin fixation. However, varying degrees of residual rotational displacement may remain after closed reduction. Several methods exist to assess rotational displacement, but none account for the effect of elbow rotation on the results.

MRI grading using the neuropathy score-reporting and data system with electrodiagnostic correlation in radial neuropathy around the elbow: a 13-year retrospective review.

Objective: To evaluate the Neuropathy Score-Reporting and Data System (NS-RADS) MRI grading system in conjunction with electrodiagnostic (EDx) testing for radial neuropathy at the elbow.

Materials And Methods: Patients presenting between 2010 and 2023 with suspected radial neuropathy who underwent both EDx testing in the form of electromyography and nerve conduction studies and MRI within a 12-month period were evaluated. Three blinded radiologists used the NS-RADS grading system to evaluate nerve entrapment (E grades), muscle denervation (M grades) proximally within the supinator/extensor carpi radialis brevis (ECRB), and more distally within the forearm extensor muscles.

Fibrous scaffolds loaded with BMSC-derived apoptotic vesicles promote wound healing by inducing macrophage polarization.

Macrophages play a key role in wound healing. Dysfunction of their M0 polarization to M2 leads to disorders of the wound immune microenvironment and chronic inflammation, which affects wound healing. Regulating the polarization of M0 macrophages to M2 macrophages is an effective strategy for treating wound healing.

Addition of PROMIS Pain Instruments to PROMIS Upper Extremity Physical Function Improves the Responsiveness of PROMIS scores compared to Legacy scores in patients undergoing Total Shoulder Arthroplasty: A Prospective Study.

Introduction: Patient Reported Outcome Measurement Information Systems (PROMIS) is increasingly being utilized across the United States as a patient reported outcome evaluation tool for a wide variety of musculoskeletal conditions. However, PROMIS Upper Extremity physical function (P-UE) has demonstrated limited responsiveness in the early postoperative period after total shoulder arthroplasty (TSA). The aim of this study is to determine if addition of PROMIS Pain Interference (P-Interference) or Pain Intensity (P-Intensity) scores improve the ability to detect postoperative changes in the one-year postoperative period following TSA.

Chrysoeriol: a natural RANKL inhibitor targeting osteoclastogenesis and ROS regulation for osteoporosis therapy.

Chrysoeriol (CHE) is a naturally occurring compound with established anti-inflammatory and anti-tumor effects. This study examines its potential role in regulating osteoclast differentiation and activity, both of which are crucial for bone remodeling. Computational docking revealed high binding affinity between CHE and RANKL, specifically at the Lys-181 residue of RANKL, suggesting potential inhibitory interactions on osteoclastogenesis.

Prevalence of metal implants among US adults aged 40 years and older.

Metal implants are commonly used in clinical practice. However, little is known regarding the prevalence of metal implants. Therefore, this study aimed to evaluate the prevalence of metal implants in the United States (US) among individuals aged ≥ 40 years.

How i do it: full-endoscopic transsacral approach for the treatment of extraforaminal L5/S1 disc herniation.

Background: For L5/S1 extraforaminal disc herniation, how to efficiently expose the herniated nucleus pulposus and reduce facet joint damage remain to be explored.

Methods: Lumbar discectomy was performed using a full-endoscopic transsacral approach, in which sacral ala and extraforaminal ligament were partially resected to expose the L5/S1 intervertebral disc. Methylene blue was used for disc staining, and the herniated nucleus pulposus was excised through the annular tear.

Giant periscapular lipoma unmasked by post-bariatric surgery weight loss: a case report.

Giant lipomas, rare benign tumours composed of mature adipose tissue, represent only 1% of all lipomas, typically exceeding 10 cm in diameter or weighing over 1000 g. These tumours can cause nerve compression, discomfort, or functional impairment, necessitating surgical excision. We report a 52-year-old male with a giant intramuscular lipoma in the periscapular region, initially identified following significant weight loss after bariatric surgery.

Cephalomedullary Nails for Isolated Subtrochanteric Femur Fractures: Age-Related Variations in Fracture Pattern and Perioperative Factors Do Not Affect Clinical and Radiographic Outcomes.

Introduction: There is scarce data in literature on the demographics, treatment, and outcomes of subtrochanteric femur fracture patients. This study evaluated the effect of age on injury details, perioperative and hospital parameters, and outcomes following subtrochanteric fracture fixation.

Methods: An IRB-approved review of a consecutive series of subtrochanteric femoral fractures was performed.

Unemployment and mental health: a global study of unemployment's influence on diverse mental disorders.

Introduction: Globally, one in five individuals faces unemployment, which substantially increases their risk of developing mental disorders. Understanding the relationship between unemployment and specific mental health outcomes is crucial for formulating effective policy interventions.

Methods: This study examines the relationship between unemployment and mental disorders across 201 countries from 1970 to 2020.

Image-Guided Musculoskeletal Interventional Radiology in the Personalised Management of Musculoskeletal Tumours.

Musculoskeletal image-guided interventional radiology plays a key role in diagnosing and treating a range of conditions. Recent advances have yielded a wide variety of procedures that can be applied selectively and enable the personalisation of patient care. This review aims to outline the indications, applications, and techniques of subspecialist musculoskeletal oncology interventional procedures that were used at our tertiary referral centre with a focus on how these may be used to personalise patient management.

Anatomy and Pathologies of the Spinous Process.

The spinous processes act as a lever for attachments of muscles and ligaments. Spinal imaging is commonly performed as a diagnostic test for pain and radiculopathy. A myriad of incidental or unexpected findings, both potentially asymptomatic and symptomatic, may be encountered during the interpretation of these images, which commonly comprise radiographs, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI).

Correction of L5 Tilt in 2-Row Vertebral Body Tethering Versus Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Study Design: Single-center retrospective cohort study.

Objective: To compare the correction of fractional curve and L5 tilt in 2RVBT versus PSF with LIV in the lumbar spine.

Summary Of Background Data: Vertebral body tethering, an AIS fusion-alternative, avoids rigid constructs, allowing for lower instrumented vertebra (LIV) selection.