Awake versus general anesthesia mapping in adult glioma resection: A systematic review of functional outcomes at ≥12 weeks post-operatively.

Influence of the correct placement of external ventricular drainage on puncture channel bleeding in patients with aneurysmal subarachnoid hemorrhage.

There are two established timepoints for microvascular bone reconstruction of the jaw in patients with oral squamous cell carcinoma (OSCC): 1. Primary reconstruction together with tumour resection and 2. Secondary reconstruction after successful adjuvant therapy. However, the decision between primary and secondary reconstruction remains controversial and is often made on a case-by-case basis. This study aimed to compare clinical outcomes of primary versus secondary osseous jaw reconstruction in patients with OSCC. The aim of this study was to retrospectively describe and compare clinically relevant oncological, functional, and perioperative outcomes of primary versus secondary microvascular osseous jaw reconstruction in patients with oral squamous cell carcinoma receiving adjuvant therapy. A retrospective cohort study was conducted including OSCC patients who underwent continuity resection of the jaw followed by microvascular reconstruction and adjuvant therapy between 01/2017 and 06/2024. Patients were retrospectively categorized into primary and secondary osseous reconstruction cohorts. Data on oncological, surgical, economical and functional outcomes were analyzed. A total of n = 191 patients were included (n = 133 primary, n = 58 secondary). The primary reconstruction group showed significantly lower time to dental rehabilitation (p < .001) and days of hospitalisation (p < .001), but no significant difference in local recurrence-free survival (p = .44) and transplant loss (p > .93) compared to the secondary group. None of the therapies can be considered superior in terms of oncological success. The results do not allow for a clear recommendation in favour of one therapy over the other.

Methamphetamine use as an independent risk factor for intracerebral hemorrhage in hypertensive patients: A case-control study.

Cachexia, a complex multifactorial syndrome characterized by loss of skeletal muscle mass, is common in cancer and impacts treatment response, quality of life (QoL) and survival. No effective therapy is currently available. This report summarizes findings from the literature on the relationship between cachexia and physical function, activities of daily living and health-related QoL in patients with solid tumours. We conducted a systematic literature review by searching Embase, MEDLINE and Cochrane Library publications from 2018-2023 for relevant studies. After screening and data extraction, a narrative synthesis was performed to identify QoL and functional outcomes in relation to cachexia. Forty publications representing 37 unique studies and 52 053 patients were identified, with 35 (94.6%) observational studies and two (5.4%) post hoc analyses of randomized trials ranging in sample size from 38 to approximately 17 000 patients. Mean/median patient age ranged from 45 to 79.6 years. Across the 40 publications, 11 different definitions of cachexia or body weight loss were used (with the most common, the Fearon etal. 2011 International Consensus criteria, used in 18 publications [45.0%]), revealing an overall lack of consensus on the most suitable diagnostic criteria for cachexia. Nineteen outcome types were reported, including physical function measures in 31 studies (77.5%), health-related QoL in 24 studies (60.0%), performance status in 16 studies (40.0%), pain and fatigue in 15 studies (37.5%) each, depression or anxiety in nine studies (22.5%) and activities of daily living in six studies (15.0%). Eleven outcome types were exclusively evaluated in univariate analysis; eight were evaluated in multivariate analysis. Many studies identified statistically significantly worse physical function, activities of daily living or health-related QoL in patients with cachexia or body weight loss compared with patients without these conditions. Of studies assessing physical function measures, 80.6% (25/31) identified a statistically significant association with cachexia or body weight loss in at least one outcome; for studies assessing health-related QoL, this was 91.7% (22/24); for performance status, 87.5% (14/16); for pain, 78.6% (11/14); for fatigue, 73.3% (11/15); for depression or anxiety, 55.6% (5/9); and for activities of daily living, 100% (6/6). This systematic literature review provides insights into functional outcomes and health-related QoL in predominantly real-world populations with cancer cachexia and can inform selection of cachexia clinical trial endpoints that reflect clinical benefits to patients. However, the wide range of methods, physical function metrics and patient-reported outcomes instruments used across studies support a call for standardization.

A systematic review of surgical treatment of reverse shoulder arthroplasty associated acromial and scapular spine stress fractures.

The purpose of this study was to compare functional outcomes of strength and endurance following 4 different treatment options for complete distal biceps tendon (DBT) ruptures: direct repair (DR), allograft reconstruction (AR), high-flexion angle repair (HFA), and non-operative management (NOP). A single-center retrospective chart review was performed on all patients with a DBT rupture. Sixty individuals at a minimum of 1-year postinjury participated in this study across the 4 groups: DR (n = 25), AR (n = 9), HFA (n = 11), and NOP (n = 15). Strength and endurance were measured on the injured and contralateral healthy arm using isokinetic dynamometry testing (Biodex Medical Systems, Inc) for forearm supination and elbow flexion. Patient-reported outcomes were collected through the Disabilities of the Arm, Shoulder, and Hand survey, and postsurgery satisfaction levels were collected through a proprietary survey. There were significant differences in the injury to operation time between surgical groups; DR participants had significantly shorter times (13.8 days) than the HFA (74.9 days, P < .001) and AR (208.9 days, P < .001) groups.Within-group comparisons revealed significant differences in flexion strength between arms for the DR (9.9 ± 18.7%; P = .003) and NOP groups (16.4 ± 19.6%; P = .012), with decreased strength in the injured arm. Significant differences were observed in total work output between arms for the DR, HFA, and NOP groups in supination (DR: 23.8 ± 30.9%, P < .001; HFA: 17.6 ± 24.8%, P = .020; NOP: 36.8 ± 31.7%, P = .001; respectively) and flexion (DR: 12.4 ± 15.6%, P < .001; HFA: 10.4 ± 18.4%, P = .036; NOP: 17.6 ± 30.1%, P = .045; respectively), with the injured arm performing less work.There were no significant between-group differences in any functional or patient-reported outcomes. While the HFA and DR participants had a significant decrease in work output for the injured arm, they still reported excellent patient-reported outcomes. The NOP group reported the highest mean Disabilities of the Arm, Shoulder, and Hand score (10.90); however, this did not exceed the threshold of the Minimal Clinically Important Difference (10.83). Surgical repairs generally preserve functional strength, particularly in supination. Anatomic suspensory fixation repairs (DR and HFA) and nonoperative management may lead to reduced endurance capacity in the injured arm. Despite functional differences between the healthy and injured arm, operative and nonoperative treatment for DBT rupture can yield satisfactory outcomes, highlighting the need for prospective randomized trials to determine the optimal treatment for DBT ruptures.

Etiology-specific predictors for short-term functional outcomes of OHCA: A Japanese Nationwide registry study.

Chlorogenic acid modulates configuration-dependent structural organization, lipid oxidation, and digestion in aqueous starch-unsaturated fatty acid systems.

Pectoralis major tendon repair outcomes: comparison of transosseous tunnel and cortical button fixation techniques.

Trans-tibial tension band wiring versus heavy suture fixation for type II periprosthetic patellar fractures after total knee arthroplasty: A comparative cohort study.

Efficacy and Safety of High Versus Low Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery a Systematic Review and Meta-analysis.

Mid-term to long-term survivorship and functional outcomes of the Meril Destiknee™ posterior-stabilized system in primary TKA.

Sphenoid wing meningiomas are characterized by bony hyperostosis and dural invasion. Surgical resection is often extensive, giving rise to complex orbital defects. Orbital reconstruction is associated with improved structural and functional outcomes. Patient-specific cranioplasty implants facilitate the accurate orbital volume reconstruction, with polyetheretherketone (PEEK) exhibiting advantageous material properties. This retrospective case series evaluates the clinical outcomes of immediate PEEK-implant reconstruction of complex orbital defects in patients undergoing sphenoid wing meningioma resection via a combined anterolateral approach between 2015 and 2024. Outcome measures include complications, re-operations, long-term implant retention and visual outcomes. A total of 25 patients underwent follow-up of 43.8 (31.4) months. Emergency re-operations were performed in 16.0 % of cases, including CSF leak repair (8.0%), extradural haematoma evacuation (4.0%) and orbital exploration (4.0%), all involving immediate implant reinsertion. No implant infection cases were reported. The exophthalmic index was reduced from 1.36 (0.27) to 1.06 (0.08) at 1year post-operatively (Z=4.5, p<0.01). Visual acuity was preserved in 88.0%. This study highlights the immediate PEEK-implant cranioplasty via the combined anterolateral approach as a valid reconstructive option for complex orbital defects in sphenoid wing meningioma patients. Prospective comparative studies are warranted to determine the ideal method of reconstruction in this challenging patient population.

Shotgun metagenomic profiling of the gut microbiota in Parkinson's disease dementia and dementia with Lewy bodies.

Initial external fixation after knee dislocation is associated with inferior outcomes following delayed multiligament reconstruction: a retrospective single-surgeon cohort study.

Redox responsive nanosystems for medicine: from reactive species mapping to precision treatment.

Structured mentorship enables novice surgeons to achieve acceptable outcomes in microsurgical aneurysm clipping: an argument for training the next generation.

From lifespan extension to hallmark-informed gerotherapeutic prioritization: A bibliometric-guided, strategy-oriented review of anti-aging drug research.

Reverse total shoulder arthroplasty (rTSA), once reserved for elderly low-demand patients, is increasingly used in younger adults despite concerns regarding complication rates and longevity. This systematic review and meta-analysis evaluate contemporary evidence on primary rTSA in patients aged ≤65 years. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, PubMed, Scopus, and CENTRAL databases were searched to October 2025. Studies reporting outcomes of primary rTSA in patients ≤65 years with ≥2 years of follow-up were included. Data on indications, functional outcomes, range of motion (ROM), patient-reported outcome measures (PROMs), complications, revisions, and implant survival were recorded and synthesized. Subgroup analyses based on patients' age and comparisons with older rTSA cohorts were also performed. Thirteen studies met our inclusion criteria. Cuff tear arthropathy (27.29%), massive cuff tears (23.39%), and glenohumeral osteoarthritis (22.34%) accounted for most indications. rTSA resulted in significant improvements in ROM and all major PROMs. The overall complication rate was 14.23%, and the revision rate was 2.92%, with instability and infection responsible for 64.2% of revisions. Mid- to long-term implant survival exceeded 85%. When compared with older patients, younger adults demonstrated equivalent ROM outcomes. Concerning PROMs younger patients demonstrated inferior American Shoulder and Elbow Surgeons (mean difference [MD] = -6.43, P = .01), visual analog scale (MD = 0.93, P < .01), Constant score (MD = -4.98, P < .01), University of California Los Angeles (MD = -2.07, P < .01), and Shoulder Pain and Disability Index (MD = 13.56, P < .01), whereas Simple Shoulder Test (MD = -0.7, P = .19) did not differ between the 2 groups. Moreover, younger patients presented a higher revision risk (risk ratio [RR] = 2.21, P < .01). Primary rTSA provides substantial and predictable improvements in pain and shoulder function among young adults, with acceptable early- to mid-term durability. Nevertheless, younger age remains associated with higher revision risk and modestly lower subjective outcomes, likely reflecting greater functional demands and post-operative expectations. These findings highlight the importance of nuanced surgical decision-making and patient counseling as rTSA use continues to expand in this demographic.