Search

Background Diabetic neuropathy is the most common complication of diabetes.We hypothesized that uncontrolled diabetes is associated with subclinical diabetic neuropathy that is influenced by duration of disease. Assessment of the prevalence and associated determining factors will be important for the prevention and treatment of neuropathy. Objective This aim of this study was to assess the frequency and determining factors of subclinical peripheral neuropathy in type 1 diabetic (T1DM) patients. Patients and methods The current hospital-based, case-control study was conducted at Zagazig University Hospitals. It included three age-matched and sex-matched groups. Each group comprised 30 participants: group A included diabetic patients with a duration of T1DM of 5 years or less; group B included patients with a duration of T1DM of more than 5 years; and the control group included normal healthy individuals. Clinical assessment was carried out to exclude symptoms and signs of neuropathy. Laboratory investigations including fasting and 2-h postprandial blood glucose level, glycosylated hemoglobin (HbA1c), lipid profile, liver function, kidney function, and nerve conduction studies were carried out for every participant. Results The frequency of subclinical neuropathy in group A and group B was 46.6 and 76.6%, respectively, and this difference was statistically significant (P=0.03). Univariate analysis revealed significantly higher levels of HbA1c, dyslipidemia, and nerve conduction parameters in group B compared with group A and the control group. Multivariate logistic regression analysis showed that duration of diabetes (P=0.02) and HbA1c (P=0.02) were the only independent factors associated with subclinical neuropathy. Conclusion The high frequency of subclinical neuropathy in diabetic patients highlights the importance of nerve conduction studies for the early detection of neuropathy in T1DM. [ABSTRACT FROM AUTHOR]

Background Available medications for the treatment of neuropathic pain, such as steroidal antiinflammatory drugs and NSAIDs, were shown to be of limited therapeutic benefit. Objectives This study aimed to evaluate the analgesic and anti-inflammatory effects of atorvastatin and pravastatin in acute and neuropathic pain in rats. Materials and methods Acute and neuropathic pains were induced in rat models by means of subplantar carrageenan injection and partial sciatic nerve ligation (PSNL), respectively. The anti-inflammatory effect of statins was assessed by the reduction in plantar edema (at 0, 1, 2, and 3 h) and prolongation of paw withdrawal reaction time in response to thermal stimulation (at 0, 0.5, 1, 2, 3, and 4 h) after carrageenan injection. Atorvastatin (2, 4, or 8 mg/kg) and pravastatin (4, 8, or 12 mg/kg) were administered intraperitoneally 30 min before carrageenan injection. The effect of statins on neuropathic pain was assessed by prolongation of paw withdrawal reaction time in response to thermal stimulation evaluated at 0, 3, 6, 9, 12, 15, and 18 days after PSNL. Atorvastatin (2, 4, or 8 mg/kg) and pravastatin (4, 8, or 12 mg/kg) were administered orally for 18 consecutive days after PSNL. In addition, the effect of atorvastatin and pravastatin on total cholesterol and tumor necrosis factor-α levels was also assessed. Results Both atorvastatin and pravastatin ameliorated carrageenan-induced rat paw edema and prolonged withdrawal time in response to thermal-induced pain. Both statins were also effective in ameliorating neuropathic pain induced by PSNL. These effects were independent of statin-induced hypolipidemic action but were concomitant with reduction of serum tumor necrosis factor-α levels. Conclusion Atorvastatin and pravastatin demonstrated effective therapeutic potentials to reduce acute and chronic pain together with the associated inflammation and hyperalgesia independent of their hypolipidemic effect. [ABSTRACT FROM AUTHOR]

Background: Low vitamin D levels had been shown to play a role in the pathogenesis of multiple sclerosis (MS). Currently, there is a paucity of information regarding the correlation between low levels of vitamin D and severity of MS in Egypt. Objective: This study aimed at detection of association between serum vitamin D concentrations and MS and its relation to the disease severity in Egypt. Methods: The present study was a case- control type, it included 25 patients with definitive multiple sclerosis on the basis of 'McDonald' criteria and 25 matched controls. All subjects were clinically evaluated including disease severity using EDSS. Serum levels of 25(OH) vitamin D were measured in the patients and controls. The patients were divided into three groups according to disease severity. Results: The mean level of vitamin D were significantly lower in patients group (19.92±8.94) as compared to control group (33.30±13.52). Inverse correlations were found between vitamin D levels and duration of illness (r=-0.746, P<0.001), Expanded Disability Status Scale (EDSS) (r=-0.755, P<0.001) and MRI lesion load (r=-0.611, P<0.01). Further analysis showed that there were statistical significant difference between the three groups regarding, duration of illness, mean score of EDSS, vitamin D level and MRI lesion load. Conclusion: Serum vitamin D levels were significantly decreased in MS patients compared to controls and were significantly correlated with MS severity and MRI lesion load. [ABSTRACT FROM AUTHOR]

Introduction: Revision Total Knee Arthroplasty (RTKA) is complex, and induced bone loss might endanger implant fixation and joint stability. Intramedullary stems improve fixation throughout stress redistribution. The current study aims to compare the performance of short tibial stems with long tibial stems, investigating their intermediate-term radiographic and survival outcomes in RTKA. The main hypothesis is that the two types of tibial stems would exhibit similar complication and revision rates in mid-term follow-up., Methods: Patients who underwent RTKA for all causes in a specialized arthroplasty center from 2010 to 2022 with minimum 2-year follow-up were included in this study. Patients receiving mega prosthesis or implants associated with sleeves or cones were excluded. The final groups consisted of 234 knees: 110 patients with short stems (SS) and 124 with long stems (LS). The mean age at surgery was 65.96 ± 8.73 years in SS and 67.07 ± 8.64 years in LS. The mean Body Mass Index (BMI) was 28.95 is SS and 30.88 in LS (p < 0.05). The average follow-up for SS group was 4.24 years and for LS 5.16 years (p < 0.05)., Results: Complications and re-revisions did not differ significantly between two groups (p > 0.05). Pathological radiolucency was present in 20.91% in SS group and 33.87% in LS group (p < 0.02). Time-to-re-revision was shorter in SS group and occurred at a mean of 3.1 years, while LS failed at a mean of 5.1 years (p < 0.001)., Conclusions: The SS and LS may be comparable in terms of complications and re-revision. SS significantly fails almost 2 years earlier than long stem (p < 0.001). Additionally, there is a higher tendency for re-revision due to loosening in patients who present pathological radiolucency in SS group. To obtain the benefits of short stem and improve the longevity of the construct; adjuvant zone II (metaphyseal) fixation might be the clue., (© The Authors, published by EDP Sciences, 2025.)

We retrospectively reviewed 56 fingers with a type 1 flexor digitorum profundus avulsion (jersey finger) injury. Nineteen fingers were treated with a four-strand pull-out suture technique that did not include the distal palmar plate, and 37 were treated with a six-strand pull-out suture technique that included the distal palmar plate. An early active mobilization regimen was used. At follow-up (mean 13 and 14 months, respectively), total active interphalangeal joint motion was significantly better in the six-strand/palmar plate group, as were the results assessed with the Strickland-Glogovac grading system and patient satisfaction according to the Stark criteria. No repair ruptures occurred in this group versus two ruptures in the four-strand/no-palmar-plate group. We consider that the better results can be attributed to a stronger repair, which facilitated early active mobilization. Level of evidence: III.

Background: The p53 pathway plays an important role in the regulation of apoptosis, osteoblast differentiation, skeletal development, and teratogenic sensitivity. The administration of cadmium chloride (CdCl(2)) on gestational day 9 in susceptible mouse strains causes postaxial forelimb ectrodactyly in a percentage of fetuses through unknown mechanisms. In this study, the hypothesis that the p53 gene dosage might affect the incidence or severity of CdCl(2)-induced forelimb ectrodactyly was examined., Methods: Heterozygous p53-null female mice, on the C57BL/6J background known to be sensitive to CdCl(2)-induced forelimb ectrodactyly, were mated with heterozygous males and then treated with a single intraperitoneal (ip) dose of CdCl(2) (4 mg x kg(-1)) at embryonic day (ED) 9. Embryos and fetuses, genotyped using DNA isolated from the yolk sacs, were collected at ED10 and examined for the pattern of cell death in the limb buds or collected at ED18 and examined for limb malformations., Results: In the wild type and heterozygous p53 embryonic limb buds, CdCl(2)-induced apoptosis involved mesenchymal cells as well as the apical ectodermal ridge (AER), whereas CdCl(2)-induced apoptosis was restricted mainly to the AER in the homozygous p53-null limb buds. No difference in the incidence or severity of forelimb ectrodactyly in the embryos of different p53 genotypes was observed., Conclusion: Despite the fact that CdCl(2) induced both p53-dependent (in the mesenchyme) and p53-independent (in the AER) cell death in the developing limb bud, CdCl(2)-induced ectrodactyly was independent of the p53 gene dosage at the studied time point., ((c) 2010 Wiley-Liss, Inc.)