Pharmacological and non-pharmacological therapies for prevention and treatment of osteoporosis in Duchenne Muscular Dystrophy: A systematic review.

Background: Long term glucocorticoid treatment in Duchenne Muscular Dystrophy (DMD) is associated with a high incidence of fragility fractures. This systematic review aims to assess the current evidence for pharmacological and non-pharmacological treatment for osteoporosis in children and adults with DMD.

Methods: Three online databases (Embase, Medline, Cochrane Library) were searched for studies that evaluated interventions for treatment or prevention of osteoporosis in DMD.

Comparative analysis of solvent-based and solvent-free (melting) methods for fabricating 3D-printed polycaprolactone-hydroxyapatite composite bone scaffolds: physicochemical/mechanical analyses and cytocompatibility.

Purpose: The study conducts a comparative analysis between two prominent methods for fabricating composites for bone scaffolds-the (solid) solvent method and the solvent-free (melting) method. While previous research has explored these methods individually, this study provides a direct comparison of their outcomes in terms of physicochemical properties, cytocompatibility, and mechanical strength. We also analyse their workflow and scalability potentials.

Palovarotene in fibrodysplasia ossificans progressiva: review and perspective.

Introduction: Palovarotene is a retinoic acid receptor gamma agonist that was studied in phase-2 and phase-3 clinical trials for the inhibition of new heterotopic ossification (HO) in fibrodysplasia ossificans progressiva (FOP). Despite numerous setbacks and regulatory delays, palovarotene is now the first approved FOP treatment in the U.S.

Imaging features and management of tuberculomas: a review of cases and literature.

Aims: To describe the imaging features of patients presenting with soft tissue masses and a provisional diagnosis of soft tissue tumours, for whom biopsy confirmed the presence of necrotising granulomata consistent with tuberculoma.

Material And Methods: A review of the histopathology database for patients who had a diagnosis of necrotising granulomata in nonspinal sites. Patients with bone and joint-based pathology were excluded.

Clinical practice recommendations for the diagnosis and management of X-linked hypophosphataemia.

X-linked hypophosphataemia (XLH) is a rare metabolic bone disorder caused by pathogenic variants in the PHEX gene, which is predominantly expressed in osteoblasts, osteocytes and odontoblasts. XLH is characterized by increased synthesis of the bone-derived phosphaturic hormone fibroblast growth factor 23 (FGF23), which results in renal phosphate wasting with consecutive hypophosphataemia, rickets, osteomalacia, disproportionate short stature, oral manifestations, pseudofractures, craniosynostosis, enthesopathies and osteoarthritis. Patients with XLH should be provided with multidisciplinary care organized by a metabolic bone expert.

Ongoing chromothripsis underpins osteosarcoma genome complexity and clonal evolution.

Osteosarcoma is the most common primary cancer of the bone, with a peak incidence in children and young adults. Using multi-region whole-genome sequencing, we find that chromothripsis is an ongoing mutational process, occurring subclonally in 74% of osteosarcomas. Chromothripsis generates highly unstable derivative chromosomes, the ongoing evolution of which drives the acquisition of oncogenic mutations, clonal diversification, and intra-tumor heterogeneity across diverse sarcomas and carcinomas.

Higher hospital volume reduces early failure rates in single-stage revision TKR for infection: An analysis of the United Kingdom National Joint Registry and National Administrative Databases.

Purpose: Revision knee replacement (RevKR) for infection is rare but increasing. It is hypothesised that higher hospital volume reduces adverse outcomes. The aim was to estimate the association of surgical unit volume with outcomes following first, single-stage RevKR for infection.

Advancement of 3D biofabrication in repairing and regeneration of cartilage defects.

Three-dimensional (3D) bioprinting, an additive manufacturing technology, fabricates biomimetic tissues that possess natural structure and function. It involves precise deposition of bioinks, including cells, and bioactive factors, on basis of computer-aided 3D models. Articular cartilage injurie, a common orthopedic issue.

Psychiatric poetics: mental healthcare and Giovanni Stanghellini's 'Logics of Discovery'.

The importance of art and humanities in mental health is widely recognised, and consumption and creation of poetry, prose, drama and the plastic arts are now considered to be relevant knowledge-generating and therapeutic activities. However, literary and art criticism remain at the margins. By contrast, in his two 'Logics of Discovery' papers, psychiatrist, psychopathologist and psychotherapist Giovanni Stanghellini brings to bear on clinical discovery and the healing alliance cultural historian Aby Warburg's approach to images (specifically, his ) and philosopher Giorgio Agamben's analysis of the linguistic phenomenon of parataxis in Friedrich Hölderlin's poetry.

Musculoskeletal Computed Tomography: How to Add Value When Reporting Adult Lower Limb Trauma.

Computed tomography plays an ever-increasing role in the management of fractures and dislocations due to its capability in efficiently providing multiplanar reformats and 3-dimensional volume rendered images. It can reveal findings that are occult on plain radiography and therefore allow for more accurate decision making with regard to fracture classification and management. Clinical radiologists play a critical role in facilitating the processing of imaging to provide adequate image reformats in the desired planes, producing 3 dimensional images but most crucially identifying pertinent findings, which will contribute between the selection of nonoperative and operative management and potentially influence surgical technique.

Current and future perspectives on pregnancy and lactation-associated osteoporosis.

Normal pregnancy and lactation have a marked physiological impact on maternal bone metabolism. This impact is usually temporary and reversible, but some women sustain fragility fractures whilst pregnant or lactating, termed pregnancy and lactation-associated osteoporosis (PLO). These fractures have severe negative consequences on their quality of life, at what is a crucial stage in a mother's life.

A deep learning framework deploying segment anything to detect pan-cancer mitotic figures from haematoxylin and eosin-stained slides.

Mitotic activity is an important feature for grading several cancer types. However, counting mitotic figures (cells in division) is a time-consuming and laborious task prone to inter-observer variation. Inaccurate recognition of MFs can lead to incorrect grading and hence potential suboptimal treatment.

In Vitro Assessment of the Extended 21-Day Microbial Barrier Provided by the Exofin Fusion Surgical Incision Closure System.

Tissue adhesives are increasingly being used as alternatives to traditional sutures and staples in surgical incision closure applications. Exofin Fusion, a novel cyanoacrylate-based adhesive with a mesh, has been developed to enhance surgical incision closure. This study investigates the microbial barrier effectiveness of Exofin Fusion.

Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty.

Aims: Arthroplasty has been shown to generate the most waste among all orthopaedic subspecialties, and it is estimated that hip and knee arthroplasty generate in excess of three million kg of waste annually in the UK. Infectious waste generates up to ten times more CO2 compared with recycled waste, and previous studies have shown that over 90% of waste in the infectious stream is misallocated. We assessed the effect of real-time waste segregation by an unscrubbed team member on waste generation in knee and hip arthroplasty cases, and compared this with a simple educational intervention during the 'team brief' at the start of the operating list across two sites.

Nanograin-enhanced surface-layer strengthening of 3D printed intervertebral cage induced by sandblasting.

3D-printed customized titanium alloy (Ti6Al4V, TC4) as load-bearing prostheses and implants, such as intervertebral cages, have been widely used in clinical practice. Native biological inertia and inadequate bone in-growth of porous titanium alloy scaffolds hampered their clinical application efficiency and then extended the healing period. To improve the osseointegration capacity of 3D-printed intervertebral cages, sandblasting was selected to execute their surface treatment.

Mechanical behaviour of additive manufactured PEEK/HA porous structure for orthopaedic implants: Materials, structures and manufacturing processes.

Polyether-ether-ketone (PEEK) composites represent one of the most promising approaches to overcoming the weak osseointegration associated with the bioinertness of PEEK, making them highly suitable for clinical translation. Implants with porous structures fabricated by additive manufacturing offer the potential for long-term stability by promoting bone ingrowth. However, despite the importance of porous design, there is still no consensus on the optimal approach for PEEK-based composites.

A wireless buckle transducer for measurement of human forearm tendon tension: operational principles and finite element study.

Introduction: Conventional methods for evaluating the management of spasticity, a complex neuromuscular disorder, typically fail to directly measure the muscle forces and loads applied through tendons, which is crucial for accurate diagnostics and treatment. To bridge this gap, we developed a novel modular buckle transducer (BT) designed to measure tendon forces . This device adjusts to accommodate tendon sizes ranging from 3 mm to 5 mm, maintaining accuracy within this range and avoiding the need for identical tendon calibration.

Incidence of Avascular Necrosis of the Femoral Head Post Hip Reduction Surgery in Children With Cerebral Palsy.

Avascular necrosis (AVN) of the femoral head confers a risk of morbidity amongst cerebral palsy (CP) patients. Meanwhile, the proportion who develop AVN post hip reduction surgery is unclear, and the risk factors are not established. To estimate the incidence and risk factors for AVN post hip reduction surgery in CP patients, we reviewed and analysed literature from Medline, Embase, and Web of Science repositories between January 1, 1990, and August 31, 2024.

Evaluating the Compliance to 24-Hour Venous Thromboembolism Risk Re-assessment Following Orthopaedic Surgery at a Tertiary Center: A Closed-Loop Clinical Audit.

Introduction Venous thromboembolism (VTE) is a preventable cause of patient morbidity and mortality among hospitalised patients. VTE events have a high incidence among orthopaedic patients, who routinely receive chemical thromboprophylaxis in the form of heparin, warfarin, antiplatelet agents or direct oral anticoagulants. These can be associated with adverse events, most commonly bleeding or heparin-induced thrombocytopenia.

Enhancements in artificial intelligence for medical examinations: A leap from ChatGPT 3.5 to ChatGPT 4.0 in the FRCS trauma & orthopaedics examination.

Introduction: ChatGPT is a sophisticated AI model capable of generating human-like text based on the input it receives. ChatGPT 3.5 showed an inability to pass the FRCS (Tr&Orth) examination due to a lack of higher-order judgement in previous studies.