Joint Pathology Research Articles

Jaws of knowledge: an analysis of temporomandibular joint insights in dental training-a quasi-experiment study.

To access the knowledge of undergraduate and postgraduate students of the dental college on basic anatomy, physiology, clinical examination, and pathology of the temporomandibular joint (TMJ). A total of 610 undergraduate and postgraduate students of dental college, were included in this study. The questionnaire was pretested for validation and distributed online through Google forms. A pairwise comparison showed that the percentage of correct answers for interns significantly differed from that of IV Bachelor of Dental Surgery (P=0.050) and postgraduate students (P=0.048) (below average: up to 6 correct answers, good: 7-11 correct answers, excellent: 12 or more correct answers). TMJ diseases are common in daily life but frequently go undiagnosed and untreated due to a lack of clinical expertise. This demonstrates the necessity of providing instructions that give students in-depth knowledge and abilities for TMJ issues in clinical practice.

Platelet-Rich Plasma Injections in Chronic Lateral Ankle Instability: A Case Series.

The platelet-rich plasma (PRP) approach may be an effective treatment for joint and cartilage pathologies. However, the rationale for its effectiveness on joint instability is limited. This study aimed to assess the safety and effectiveness of PRP injections in patients with chronic lateral ankle instability (CLAI). This retrospective study was performed at a single-center outpatient clinic between January 2015 and February 2023 and included pre-intervention assessment and short-term follow-up. Patients were excluded if they had received previous surgical treatment or had constitutional hyperlaxity, systemic diseases, or grade II or III osteoarthritis. The clinical and functional evaluation consisted of the Karlsson score, the Cumberland Ankle Instability Tool (CAIT), Good's grading system, the patient's subjective satisfaction level, and the time required to return to exercise. The entire PRP therapy regime consisted of three PRP administrations at 7-day intervals and follow-up appointments. PRP was administered both intraarticularly and into talofibular ligaments. A total of 47 consecutive patients with CLAI were included, 11 were female (23.4%), with a mean age at intervention of 31.19 ± 9.74 years. A statistically significant improvement was found in the CAIT and Karlsson scores at 3 months (27.74 ± 1.68 and 96.45 ± 4.28, respectively) relative to the pre-intervention status (10.26 ± 4.33 and 42.26 ± 14.9, respectively, p < 0.000). The mean follow-up of patients with CLAI was 17.94 ± 3.25 weeks. This study represents successful short-term functional and clinical outcomes in patients with CLAI after PRP treatment, with no adverse effects. It demonstrates the feasibility of a randomized controlled trial to further assess this therapy.

Optimizing Acetabular Positioning: A Comprehensive Review of Contemporary Strategies in Total Hip Arthroplasty.

Total hip arthroplasty (THA) is a widely practiced surgical intervention to alleviate pain and reinstate functionality in individuals afflicted with hip joint pathology. The positioning of the acetabulum assumes paramount significance in determining the efficacy of THA, exerting profound influences on biomechanical dynamics, stability, and the durability of outcomes over time.This comprehensive review meticulously evaluates contemporary methodologies for optimizing acetabular positioning in THA, encompassing advanced technologies such as computer-assisted navigation systems, patient-specific instrumentation, robotic-assisted surgical approaches, image-based planning techniques, and intraoperative fluoroscopy.Crucially, key discoveries underscore the pivotal role of precise acetabular alignment in mitigating complications such as dislocation, component wear, and impingement. Moreover, the implications for clinical practice accentuate the imperative of continuous education and training to ensure effective deployment of sophisticated methodologies.Recommendations for furthering research and enhancing practice development underscore the necessity of scrutinizing long-term prognoses, assessing cost-effectiveness, and embracing technological innovations perpetually refining THA outcomes. Collaborative endeavors among researchers, practitioners, and industry stakeholders emerge as indispensable drivers of advancement in this domain, fostering an environment conducive to elevating the standard of care for individuals undergoing THA.

Pressure pain mapping of equine distal joints: feasibility and reliability.

Osteoarthritis is a prevalent degenerative joint disease initiating chronic pain and lameness in horses. While several objective gait analysis systems have been developed and validated to quantify lameness severity in horses, methods to evaluate whether peripheral sensitization contributes to the pain experienced are missing. To evaluate whether periarticular pressure pain mapping could be proposed as an auxiliary assessment tool in horses. Specific aims were to evaluate the feasibility and intra- and inter-rater reliability of pressure pain thresholds (PPT) determination at sites overlying the distal thoracic limb joints of clinically healthy horses. Prospective, randomized validation study. For feasibility assessment, PPT were measured with a hand-held digital algometer at six periarticular landmarks (2 sites per joint, 3 joints) bilaterally on the distal thoracic limb of 40 healthy horses (20 warmblood and 20 Freiberger). The joints tested were the metacarpophalangeal, on the latero-palmar and dorsal aspects (L-MCP and D-MCP), the proximal interphalangeal, on the dorsal and palmar aspect (D-PIP and P-PIP) and the distal interphalangeal, on the dorsal and lateral aspect (D-DIP and L-DIP). A feasibility score, ranging from 0 to 5, was attributed to each testing session. For intra- and inter-rater reliability assessment, L-MCP and D-MCP were selected to be tested again at 2 weeks intervals in 20 out of the 40 horses. Data were analyzed using a mixed-effect linear model to test differences in threshold per site and limb. Intra- and inter-rater correlation was calculated. Bland-Altman plots were performed to evaluate the variability of the measures. The procedure was considered feasible (score <2) in 95% of horses (95% CI 88%-100%). Overall, median [interquartile range (IQR)] PPT was 9.4 (7.5-11.3) N. No significant side differences were found. P-PIP and D-DIP recorded significantly lower PPT (p < 0.001 and p = 0.002, respectively) than L-MCP. Median (IQR) were 9.9 (7.3-12.4) N, 8.4 (6.1-10.5) N and 9.0 (7.4-10.6) N for L-MCP, P-PIP and D-DIP, respectively. The intra-rater agreement was 0.68 (95% CI 0.35-0.86) for L-MCP, and 0.50 (95% CI 0.08-0.76) for D-MCP. Inter-rater agreement was 0.85 (95% CI 0.66-0.94) for L-MCP and 0.81 (0.57, 0.92) for D-MCP. Evaluation of feasibility was performed only for distal thoracic limbs joints; no data are provided for hind limbs or proximal joints. Only warmblood and Freiberger horses were included. Intra- and inter-rater reliability assessments were performed exclusively on data collected at the MCP joint. Pressure pain mapping of distal thoracic limb joints was feasible in horses. Local sensitivity differed among sites and no side differences were noticed. Data collected from the MCP joint suggest highly variable, subject dependent intra-rater reliability, ranging from poor to good, and good to excellent inter-rater reliability. Further studies evaluating pathologic vs. healthy joints are needed before recommendations can be made about clinical usability and diagnostic validity.

Methodology for Robotic In Vitro Testing of the Knee.

The knee joint plays a pivotal role in mobility and stability during ambulatory and standing activities of daily living. Increased incidence of knee joint pathologies and resulting surgeries has led to a growing need to understand the kinematics and kinetics of the knee. In vivo, in silico, and in vitro testing domains provide researchers different avenues to explore the effects of surgical interactions on the knee. Recent hardware and software advancements have increased the flexibility of in vitro testing, opening further opportunities to answer clinical questions. This paper describes best practices for conducting in vitro knee biomechanical testing by providing guidelines for future research. Prior to beginning an in vitro knee study, the clinical question must be identified by the research and clinical teams to determine if in vitro testing is necessary to answer the question and serve as the gold standard for problem resolution. After determining the clinical question, a series of questions (What surgical or experimental conditions should be varied to answer the clinical question, What measurements are needed for each surgical or experimental condition, What loading conditions will generate the desired measurements, Do the loading conditions require muscle actuation) must be discussed to help dictate the type of hardware and software necessary to adequately answer the clinical question. Hardware (type of robot, load cell, actuators, fixtures, motion capture, ancillary sensors) and software (type of coordinate systems used for kinematics and kinetics, type of control) can then be acquired to create a testing system tailored to the desired testing conditions. Study design and verification steps should be decided upon prior to testing to maintain the accuracy of the collected data. Collected data should be reported with any supplementary metrics (RMS error, dynamic statistics) that help illuminate the reported results. An example study comparing two different ACL reconstruction techniques is provided to demonstrate the application of these guidelines. Adoption of these guidelines may allow for better interlaboratory result comparison to improve clinical outcomes.

Intervertebral disc degeneration instigates vertebral endplate remodeling and facet joint pathology in a large animal model

Intervertebral disc degeneration instigates vertebral endplate remodeling and facet joint pathology in a large animal model

Retraction: PKCδ null mutations in a mouse model of osteoarthritis alter osteoarthritic pain independently of joint pathology by augmenting NGF/TrkA-induced axonal outgrowth

Retraction: PKCδ null mutations in a mouse model of osteoarthritis alter osteoarthritic pain independently of joint pathology by augmenting NGF/TrkA-induced axonal outgrowth

ANALYSIS OF THE RESULTS OF PERCUTANEOUS VERTEBROPLASTY OF COMPRESSION FRACTURES OF BODIES OF CHEST AND LUMBAR VERTEBRAE ON THE BACKGROUND OF OSTEOPOROSIS

It is well known that the most frequent complication of osteoporosis is compression fractures of vertebral bodies. In addition to brittleness of the bones and mechanical stress, more and more evidence approving that compression fractures of vertebral bodies are related to many risk factors, such as aging, sex, concomitant morbidities of cardiovascular and cerebrovascular diseases and lifestyle (chronic smoking and alcohol consumption) are collected. Objective. Analyzing the condition of spines of the patients suffering from compression fractures of vertebral bodies on the background of osteoporosis after the performed Percutaneous vertebroplasty (PV). Methods. 553 patients who underwent hospital treatment at the spine pathology clinic of the Sytenko Institute of Spine and Joint Pathology (2005–2022) and underwent PV were examined. Results. The patients were divided into three groups depending on the number of damaged vertebrae. The 1st group included the patients with compression fractures of one vertebra (185 — 33.4 %); the 2nd group included the patients having 2 or 3 deformed vertebrae (216 — 39 %); and the 3rd group included the patients with 4–5 damaged vertebrae (152 — 27.4 %). Stages of compression of vertebral bodies during the X-ray morphometry was as follows before the surgery: I — 349 (24 %) vertebrae; II — 494 (34 %); III — 552 (38 %); and IV — 58 (4 %). We achieved the reduction of the level of compression of vertebral bodies as a result of PV in 20 % of cases (patients who noticed the manifestation of the pain syndrome within 2 weeks mostly suffered from these deformations). Conclusions. The results of analysis of PV of 553 patients with composite material and bone cement in the near and far future provide us an opportunity to state that this surgical treatment is an efficient and safe treatment method (despite the materials used). 40 (24 %) patients out of 165 patients of the group I, 52 (33 %) patients out of 157 patients of the group II and 54 (44 %) patients our of 133 patients of the group III were diagnosed with repeated compression fractures. Summarizing all the above, we should note that the more compression fractures the patient has, the higher the risk of further augmentation of other deformations of vertebral bodies is.

Postural balance in the comprehensive rehabilitation of adolescents with cleft lip and palate and maxillofacial anomalies: A literature review

BACKGROUND: Patients with cleft lip and palate experience significant jaw relationship disorders and pathological bite formation, leading to changes in the motor activity of chewing muscles and postural balance disturbances. Most studies on postural control are conducted on patients with skeletal dentofacial anomalies and deformities without cleft lip and palate. The state of postural balance in children with cleft lip and palate requiring long-term complex medical rehabilitation, including bone-reconstructive operations on the jaw bones, remains poorly understood.&#x0D; AIM: To analyze publications dedicated to the evaluation of postural balance in adolescents with cleft lip and palate combined with jaw relationship disorders and pathological bite formation.&#x0D; MATERIALS AND METHODS: The article includes an analysis and review of several studies that investigated the state of postural balance in adolescents with cleft lip and palate, particularly at the final stages of growth and formation of the musculoskeletal system. Scientific articles published in various medical journals, monographs, dissertations, and materials from scientific symposiums related to this topic were used in the literature review. PubMed, Medline, Scopus, Web of Science, and RSCI were searched without language restrictions. The search depth was 23 years, and 64 studies were selected.&#x0D; RESULTS: The article analyzes literature data related to theories of the mechanism of mutual influence between postural balance and the dentofacial apparatus (disorders and pathological bite formation). The state of postural balance is influenced by various factors, including the craniosacral system and anomalies of the cervical spine. Patients with cleft lip and palate, hemifacial microsomia, and other craniofacial dysostoses with growth disorders of jaw bones experience an imbalance in the entire “descending” chain, causing postural disturbances, increased plantar pressure, increased foot rigidity, and changes in photogrammetry indicators, which should be considered when developing an individual rehabilitation program for these patients. The treatment of these patients without considering postural balance disorders can lead to temporomandibular joint pathologies, unstable results of the conservative orthodontic treatment of bite pathologies, and bone-reconstructive operations on jaws.&#x0D; CONCLUSIONS: The study highlights the ways of adaptation of the musculoskeletal system in the presence of occlusal relationship disorders and emphasizes the need to evaluate this influence comprehensively for the treatment of these patients. The limitations of the presented studies should be emphasized: insufficient sample size, lack of control groups and prospective studies, limited types of examination, and lack of studies dedicated to more severe anomalies of craniofacial development.

Anthropometric measures of obesity in patients with knee joint pathology: Body surface area versus body mass index.

Obesity is quantified using body mass index. Body surface area may provide a superior and more anthropometric method of quantifying obesity in patients with musculoskeletal knee disease. This study compares the effect of weight, height, age and gender on body mass index and body surface area in a population with orthopaedic knee disease. An observational cohort study was conducted of patients presenting with musculoskeletal knee disease. Associations between body mass index, body surface area, age, gender, height, weight and operative versus non-operative management were analysed. A total of 151 patients were included. Body surface area was more strongly correlated to weight than body mass index (r = 0.98, p < 0.001 versus r = 0.84, p < 0.001). Body surface area also reflects height which body mass index under presents (r = 0.65, p < 0.001 versus r = -0.08, p = 0.35). Body mass index and body surface area were correlated with one another (r = 0.70, p < 0.001). Age was inversely correlated with body surface area (r = -0.20, p = 0.013) but not body mass index (r = 0.05, p = 0.585). Body mass index did not differ between males and females (30.1 versus 30.9, p = 0.37); however, BSA scores were significantly higher in males than females (2.11 versus 1.91, p < 0.001). Neither body surface area nor body mass index scores influenced operative versus non-operative treatment. Body surface area could be a useful alternative to body mass index when considering obesity in patients with musculoskeletal knee pathology. Body surface area better reflects the effects of height, weight, age and gender than body mass index.

Fibrocyte Phenotype of ENTPD1+CD55+ Cells and Its Association with Pain in Osteoarthritic Synovium.

Osteoarthritis (OA) is a prevalent degenerative joint disorder characterized by cartilage erosion, structural changes, and inflammation. Synovial fibroblasts play a crucial role in OA pathophysiology, with abnormal fibroblastic cells contributing significantly to joint pathology. Fibrocytes, expressing markers of both hematopoietic and stromal cells, are implicated in inflammation and fibrosis, yet their marker and role in OA remain unclear. ENTPD1, an ectonucleotidase involved in purinergic signaling and expressed in specific fibroblasts in fibrotic conditions, led us to speculate that ENTPD1 plays a role in OA pathology by being expressed in fibrocytes. This study aimed to investigate the phenotype of ENTPD1+CD55+ and ENTPD1-CD55+ synovial fibroblasts in OA patients. Proteomic analysis revealed a distinct molecular profile in ENTPD1+CD55+ cells, including the upregulation of fibrocyte markers and extracellular matrix-related proteins. Pathway analysis suggested shared mechanisms between OA and rheumatoid arthritis. Correlation analysis revealed an association between ENTPD1+CD55+ fibrocytes and resting pain in OA. These findings highlight the potential involvement of ENTPD1 in OA pain and suggest avenues for targeted therapeutic strategies. Further research is needed to elucidate the underlying molecular mechanisms and validate potential therapeutic targets.

Evaluation of ligament and meniscal injuries following knee trauma by MRI and its correlation with arthroscopy

Background: Magnetic resonance imaging (MRI) is a non-invasive, quick and convenient investigation for evaluation of ligament and meniscal pathologies of the knee joint. Although arthroscopy is an invasive procedure it is considered the gold standard for evaluating injuries to menisci and ligaments and can be used for both diagnostic and therapeutic purpose. The purpose of this study was to evaluate cruciate ligament and meniscal injuries following knee trauma by MRI and correlate the findings with arthroscopy. Materials and methods: This was a prospective study conducted at our institution including 61 patients with clinically suspected ligament and meniscal injury of knee. All the patients initially underwent MRI and subsequent arthroscopy. The location, type and grade of meniscal and ligament tears on MRI were recorded and later correlated with arthroscopic findings. Results: The right knee joint was involved in 65.6 % and the left knee in 34.4 % of cases. The anterior cruciate ligament was the most commonly injured structure. The sensitivity, specificity and accuracy of MRI in detecting anterior cruciate ligament injury were 100%, 71.4% and 96.72 % respectively, posterior cruciate ligament injury (100%, 100% and 100% respectively), medial meniscus injury (100%, 78.8% and 88.5% respectively) and lateral meniscus injury (100%, 90.5% and 93.44% respectively). Conclusion: MRI is highly sensitive and accurate in detection of cruciate ligament and meniscal tears. A good correlation was obtained between MRI and arthroscopic findings in this study. MRI used as a screening tool prior to arthroscopy helps in avoiding negative diagnostic arthroscopy. Keywords: anterior cruciate ligament; posterior cruciate ligament; medial meniscus; lateral meniscus; arthroscopy

Three-dimensional scapular orientation: a comparison of glenohumeral osteoarthritis and cuff tear arthropathy to the unaffected shoulder

BackgroundScapular orientation may play an important role in preoperative planning for shoulder arthroplasty; however, there is currently no defined method for producing standardized three-dimensional measurements. The purpose of this study is to develop a reproducible measurement system of scapular orientation and to evaluate differences between unaffected shoulders and those with diagnoses of primary glenohumeral osteoarthritis (GHOA) and rotator cuff tear arthropathy (CTA). MethodsPatients receiving computed tomography scans for preoperative shoulder arthroplasty planning were enrolled prospectively. Thin sliced axial images that included bilateral shoulders and the thorax were reformatted. The pathology of the bilateral glenohumeral joints was defined as GHOA, CTA, or unaffected. Scapular orientation was defined relative to the thorax using three-dimensional models to define the protraction, rotation, and tilt angles in the supine position. Univariate analysis was performed to compare demographics and scapular measurements between patients with GHOA, CTA, and unaffected shoulder pathology. Multivariate linear regression analysis was performed to identify independent predictors of scapular orientation. ResultsOne hundred fifty-eight shoulders, comprising 79 patients were included. Twenty-seven percent (n = 21/79) of patients had an unaffected contralateral shoulder. Shoulders with GHOA had significantly greater downward scapular rotation (-14 ± 7 degrees) than both unaffected shoulders (-8 ± 7 degrees; P < .001) and those with CTA (-7 ± 8 degrees; P < .001). Increased downward scapular rotation was predicted by a shoulder pathology of GHOA in multivariate analysis (beta -7.09; P < .001). The magnitude of side-to-side difference was greatest in scapular rotation for patients with GHOA compared to CTA, with no significant differences in tilt or protraction. ConclusionScapular rotation in the supine position varies by shoulder pathology, with greater downward rotation seen in patients with primary GHOA. These findings underscore the need for awareness of scapular orientation in addition to glenoid morphology when evaluating and planning shoulder arthroplasty cases.

Clinical Study of Analgesic and Anti-inflammatory Properties of Cannabis Derivatives in Patients with Temporomandibular Joint Pathology: Preliminary Study

We all know that the use of marijuana is a potent anti-inflammatory and analgesic and possible mechanisms of action and components that can help reduce the effects of pain in temporomandibular joint (TMJ) disorders. Our study aimed to analyze the anti-inflammatory and analgesic characteristics of cannabis derivatives in patients with temporomandibular pathology. Thirty-six patients were divided into three groups: one was treated with Cannabidiol (CBD) cream, the second was treated with CBD Vaper, and the third was treated with conventional anti-inflammatories such as Ibuprofen 600 mg. All patients underwent a dental computed tomography scan at the beginning and another at the end of treatment 28 days later. In addition to the study treatment of Cannabis and anti-inflammatories, all patients received physiotherapy treatment on day 0, day 14, day 21, and day 28 of the study. The study’s results allow us to evaluate that using the CBD cream with physiotherapy results in a favorable pain reduction of 59%, CBD Vaper with physiotherapy has reduced pain by 35%, and the combined use of ibuprofen medication with physiotherapy has reduced pain by 45%. Therefore, using CBD and physiotherapy allows a biological reduction of pain and inflammation at TMJ. The most significant reduction in analgesia and pain occurred with CBD cream, followed by ibuprofen, which had less effect than CBD Vaper. We can control the pain of the TMJ with the use of CBD and treatment with the physiotherapist that allows us to maintain the dose and time of use of CBD both in cream and in Vaper; this improves the quality of life and returns the patient to cognitive relieving stress and anxiety.

Statistical evaluation of the frequency of therapeutic and diagnostic devices used by prosthetic dentists for pathology of the temporomandibular joint

BACKGROUND: Occlusal splints are commonly used for treating myofascial and temporomandibular joint (TMJ) disorders. The success of their application depends on the knowledge of prosthetic dentists regarding TMJ disorders, device type used, splint manufacture method, treatment duration, and other factors.&#x0D; AIM: This study aimed to explore various approaches of prosthetic dentists to the diagnosis of myofascial disorders, bruxism, and TMG disorders and evaluate the methods of therapy used in clinical practice.&#x0D; MATERIALS AND METHODS: A survey and questionnaire was conducted among orthopedic dentists in the city of Voronezh working in private or state dental organizations, on the topic “Pathology of the temporomandibular joint and methods of therapy”. The question list consisting of 15 questions was developed for statistical evaluation of therapeutic and diagnostic constructions used by prosthetic dentists in their clinical practice in cases related to the pathology of the TMJ. During this study, specially designed questionnaires were filled out. Furthermore, the conversation with each participant was conducted for a direct analysis of orthopedic measures of TMJ disorders.&#x0D; To analyze the obtained values, the criterion χ2 or Pearson’s criterion of agreement, Fisher’s exact criterion, and Kramer’s V criterion were used. The confidence interval was set to 95%.&#x0D; RESULTS: Among the surveyed doctors, 78 (65.0%) had more than 15 years of experience, 27 (22.5%) had 5–15 years of experience, and 15 (12.5%) had less than 5 years of experience. When using a single-sample binomial criterion, the number of doctors working in different institutions significantly differed (p 0.001). Thus, majority of the surveyed doctors (n=102; 85%) worked in state-funded clinics and the remaining (n=18; 15%) in private clinics (p 0.001). Moreover, 25 respondents (20.8%) claimed that they do not use tires in their practice, whereas the remaining 95 (79.2%) do.&#x0D; CONCLUSIONS: The participation of prosthetic dentists in this study demonstrated their high interest in “Pathology of the temporomandibular joint and methods of therapy”. The results of the survey indicate a change in the level of dentists’ knowledge with increasing professional experience. The methods of therapy used by the study participants considerably differ and often do not comply with the basic recommendations of the Dental Association of Russia.

Abstract 4820: Comparison of Black and White patients in treatment for papillary thyroid cancer in an equal access health system

Abstract Introduction: In the U.S., Black patients with papillary thyroid cancer (PTC) are less likely to receive treatment than non-Hispanic White patients. Access to care and insurance status may be related to these disparities. We aimed to compare Black and White patients in receipt of cancer care for PTC in the equal access Military Health System. Materials and Methods: We used the MilCanEpi database to identify a cohort of men and women aged 18 or older who were diagnosed with PTC between January 1, 1998 and December 31, 2014. Patients were assessed for treatment by surgery (e.g., lobectomy, thyroidectomy), adjuvant radioactive iodine (RAI), or active surveillance. Treatment appropriate for risk status (low-risk or high-risk) was compared between non-Hispanic White and Black patients using multivariable logistic regression and expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CIs). Results: Among 3,511 patients with PTC, 65.0% White and 65.5% Black received surgical treatment (aOR 0.97, 95% CI 0.80-1.18 for Black vs. White). For patients with low-risk PTC, overall receipt of either surgery or active surveillance (aOR 0.86, 95% CI 0.67-1.10 for Black vs. White) was similar between races. For patients with high-risk PTC, overall receipt of surgery (aOR 1.19, 95% CI 0.71-2.01) or adjuvant RAI (aOR 1.44, 95% CI 0.60-3.44) was similar for Black compared to White patients. Conclusions: In an equal access health system, there were no overall racial differences in receipt of surgical treatment for PTC. Further, in analysis by risk status, there were no significant racial differences in receipt of active surveillance for low-risk PTC nor receipt of adjuvant RAI for high-risk PTC. This suggests the role of access to care in reducing racial disparities in treatment for PTC observed in the general U.S. population. Funding and Acknowledgement: The authors thank the Joint Pathology Center (JPC) for providing the DoD cancer registry data and the Defense Health Agency (DHA) for providing the MHS data repository (MDR) data. This project was supported by the Murtha Cancer Center Research Program (MCCRP) of the Department of Surgery, Uniformed Services University of the Health Sciences (USUHS) under the auspices of the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF, Inc.), grant numbers HHU0001-16-2-0014 and HU0001-18-2-0032 awarded to C.S. Disclaimer: The contents of this abstract are the sole responsibility of the authors and do not necessarily reflect the views, assertions, opinions, or policies of the Uniformed Services University of the Health Sciences, the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., the Department of Defense, or the Departments of the Army, Navy, or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. government. Citation Format: Yvonne L. Eaglehouse, Sarah Darmon, Craig D. Shriver, Kangmin Zhu. Comparison of Black and White patients in treatment for papillary thyroid cancer in an equal access health system [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4820.

BIOCHEMICAL PARAMETERS OF BLOOD OF LABORATORY ANIMALS IN CASE OF PROLONGED CONTACT WITH THE RESEARCH MATERIAL

The purpose of this study was to determine the biochemical parameters of blood of laboratory animals in prolonged contact with the experimental material&#x0D; Materials and methods. An experimental study was conducted in the laboratories and vivarium of the State Institution "Institute of Spine and Joint Pathology named after Prof. M.I. Sitenko" on 28 white laboratory rats aged 6 months with a body weight of 200 to 250 grams. The animals were randomly divided into two groups: a control group (14 rats) and an experimental group (14 rats), which were exposed to dental glass ionomer cement at a dose of 1.0 mg/kg. Toxic effects were evaluated for 1 month. The blood sampling procedure included tail vein dilation, disinfection, tail fixation, and blood collection. The study was conducted in special conditions with full feeding.&#x0D; Results. The study found no significant negative effects of prolonged use of dental glass ionomer cement (GIC) on kidney function. Analysis of diuresis, urea and creatinine levels in urine and blood serum showed no statistically significant differences between males and females. No sugar, ketones, or protein were detected in the animals' urine. Serum creatinine levels were (65.47±4.6) μmol/l in males and (63.38±7.1) μmol/l in females, while serum urea levels were (4.84±0.47) μmol/l in males and (4.67±0.42) μmol/l in females. Urinary urea levels were (374.35±20.7) mmol/l in males and (371.15±22.3) mmol/l in females.&#x0D; Conclusions. The obtained results of the study indicate statistically significant deviations in the studied indicators of the functional state of the kidneys both in males and females after prolonged use of dental glass-inomer cement based on polyacrylate carboxylate. The presence of sugar, ketones and protein was not detected in the urine of the animals. The analysis of serum creatinine levels showed no statistically significant differences between the conditions, and serum urea levels did not differ between them either. Thus, it can be concluded that the use of glass-inomer cement has no negative effect on the functional state of the kidneys in the studied animals.

The Cytological Energy Detection of Purulent Inflammation in Synovial Fluid Is Not All Black and White.

Neutrophils are frequently found in the cytological picture of synovial fluid in several joint pathologies, and a higher proportion of them can even wrongly indicate these cases as purulent inflammation. For reliable differentiation between purulent and non-purulent cases, we use the cytological energy analysis of the synovial fluid. Using this method, we examined 350 knee joint synovial fluid samples. Overall, we found that the percentage of neutrophils ranged between 20.0% and 50.0% in 44 (12.6%) cases and was above 50.0% in 231 (66.0%) cases. In the same group, only 85 (24.3%) highly anaerobic synovial fluid samples were evaluated as purulent inflammation, and another 17 (4.9%) cases were evaluated as very likely purulent inflammation. Further, we quantified the immediate risk of purulent inflammation using the "purulent score" (PS). Of the total of 350 samples, 103 (29.4%) cases were classified as having a very high risk of purulent inflammation (PS = 4), 53 (15.1%) cases were classified as having a significant risk of purulent inflammation (PS = 3), 17 (4.9%) cases were classified as having a moderate risk of purulent inflammation (PS = 2), and 75 (21.4%) cases were classified as having no immediate risk of purulent inflammation (PS = 1). Based on our results and analyses, the cytological energy analysis of synovial fluid is an effective method that can be used to detect and specify joint inflammation and the risk of septic arthritis development.

The effect of knee replacement on renal function in patients with hypertension and type 2 diabetes mellitus

Objective: to evaluate the effect of knee replacement on kidney function in patients with hypertension and type 2 diabetes mellitus. Materials and methods: at stage 1, 308 people suffering from hypertension (GB), stage III osteoarthritis of the knee joint (OA CS), type 2 diabetes mellitus (DM) were examined. GB occurred in 308 people, DM — in 66 people, and OA CS — in 216 people. Depending on the presence of OA CS, observation and comparison groups were identified. Within each group, subgroups are distinguished by the presence of SD: subgroup 1 (n=170) — OA CS +GB, subgroup 2 (n=46) — OA CS+GB+SD, subgroup 3 (n=72) — GB, subgroup 4 (n=20) — GB+SD. At stage 2, the dynamics of GFR after total knee arthroplasty (TEP CS) in subgroups 1 and 2 and against the background of AGT therapy in subgroups 3 and 4 were evaluated. Results: at the 1st stage, it was found that the proportion of people with GFR 60 ml/min/1.73 m2 was significantly higher in subgroup 1 (OA CS+GB) compared with subgroup 3 of patients with GB without joint pathology (40.6% vs. 12.5%, p0.01). The presence of DM in patients with GB significantly affected renal filtration function, which is reflected in an increase in serum creatinine levels in subgroup 4 (GB+DM) by 20.02% and a decrease in GFR by 15.35%.Against the background of the performed TEP in the group with GB, 64.06% had a stable GFR value or its increase, and in the subgroup of GB+ DM after TEP, 72.41% of patients had an increase or stable state of renal filtration capacity. At the same time, during the same follow-up period in the comparison group (in patients with GB without comorbid conditions), only 39.13% of cases had stable GFR values, and a decrease in GFR was recorded in 60.87%. At the same time, the dynamics of GFR values manifested itself in an increase of 11.19% in patients of subgroup 5 (TEP CS + GB) and by 12.47% in the group of the described knee joint intervention with a combination of GB and DM. In patients with controlled hypertension, GFR decreased by 6.6%. Conclusion: knee replacement in patients with hypertension and type 2 diabetes mellitus can slow down the rate of GFR reduction.

Role of the Gut Microbiota in Osteoarthritis, Rheumatoid Arthritis, and Spondylarthritis: An Update on the Gut-Joint Axis.

Dysregulation of the gut microbiota and their metabolites is involved in the pathogenic process of intestinal diseases, and several pieces of evidence within the current literature have also highlighted a possible connection between the gut microbiota and the unfolding of inflammatory pathologies of the joints. This dysregulation is defined as the "gut-joint axis" and is based on the joint-gut interaction. It is widely recognized that the microbiota of the gut produce a variety of compounds, including enzymes, short-chain fatty acids, and metabolites. As a consequence, these proinflammatory compounds that bacteria produce, such as that of lipopolysaccharide, move from the "leaky gut" to the bloodstream, thereby leading to systemic inflammation which then reaches the joints, with consequences such as osteoarthritis, rheumatoid arthritis, and spondylarthritis. In this state-of-the-art research, the authors describe the connections between gut dysbiosis and osteoarthritis, rheumatoid arthritis, and spondylarthritis. Moreover, the diagnostic tools, outcome measures, and treatment options are elucidated. There is accumulating proof suggesting that the microbiota of the gut play an important part not only in immune-mediated, metabolic, and neurological illnesses but also in inflammatory joints. According to the authors, future studies should concentrate on developing innovative microbiota-targeted treatments and their effects on joint pathology as well as on organizing screening protocols to predict the onset of inflammatory joint disease based on gut dysbiosis.