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Purpose and Hypothesis: Although sex- and gender-specific analyses have been gaining more attention during the last years they have rarely been performed in orthopaedic literature. The primary purpose of this study was to investigate whether for injuries of the UCL the specific location of the rupture is influenced by sex. A secondary study question addressed the sex-independent effect of trauma intensity on the rupture site of the UCL., Methods: This study is a retrospective analysis of all patients with either a proximal or distal bony avulsion or with a mid-substance tear or ligament avulsion of the UCL treated surgically between 1992 and 2015 at two level-I trauma centres. Trauma mechanisms leading to the UCL injury were classified into the following categories: (1) blunt trauma (i.e., strains), (2) low-velocity injuries (e.g., fall from standing height, assaults), and (3) high-velocity injuries (e.g., sports injuries, motor vehicle accidents). After reviewing the surgical records, patients were divided into three groups, depending upon the ligament rupture site: (1) mid-substance tears, (2) proximal ligament or bony avulsions and (3) distal ligament or bony avulsions. Dependencies between the specific rupture site and the explanatory variables (sex, age, and trauma intensity) were evaluated using χ2 test and logistic regression analysis., Results: In total, 1582 patients (1094 males, 488 females) met the inclusion criteria. Mean age was 41 years (range: 9-90 years). Taking into account the effects of sex on trauma intensity (p<0.001) and of trauma intensity on rupture site (p<0.001), mid-substance tears occurred more frequently in women, whereas men were more prone to distal ligament or bony avulsions (p<0.001). In other words, sex and rupture site correlated due to the effects of sex on trauma intensity and of trauma intensity on rupture site, but taking into account those effects there still was a significant effect of sex on rupture site., Conclusions: The results of this study demonstrate that with regression analysis both sex and trauma intensity allow to predict rupture site in UCL injuries.

The remarkable feature of Schwann cells (SCs) to transform into a repair phenotype turned the spotlight on this powerful cell type. SCs provide the regenerative environment for axonal re-growth after peripheral nerve injury (PNI) and play a vital role in differentiation of neuroblastic tumors into a benign subtype of neuroblastoma, a tumor originating from neural crest-derived neuroblasts. Hence, understanding their mode-of-action is of utmost interest for new approaches in regenerative medicine, but also for neuroblastoma therapy. However, literature on human SCs is scarce and it is unknown to which extent human SC cultures reflect the SC repair phenotype developing after PNI in patients. We performed high-resolution proteome profiling and RNA-sequencing on highly enriched human SC and fibroblast cultures, control and ex vivo degenerated nerve explants to identify novel molecules and functional processes active in repair SCs. In fact, we found cultured SCs and degenerated nerves to share a similar repair SC-associated expression signature, including the upregulation of JUN, as well as two prominent functions, i.e., myelin debris clearance and antigen presentation via MHCII. In addition to myelin degradation, cultured SCs were capable of actively taking up cell-extrinsic components in functional phagocytosis and co-cultivation assays. Moreover, in cultured SCs and degenerated nerve tissue MHCII was upregulated at the cellular level along with high expression of chemoattractants and co-inhibitory rather than -stimulatory molecules. These results demonstrate human SC cultures to execute an inherent program of nerve repair and support two novel repair SC functions, debris clearance via phagocytosis-related mechanisms and type II immune-regulation. GLIA 2016;64:2133-2153., (© 2016 The Authors. Glia Published by Wiley Periodicals, Inc.)

Background: Paralleling the growth of bariatric surgery, the demand for post-bariatric body-contouring surgery is increasing and placing additional burdens on already strained health care systems. In Austria, medically necessary body contouring is covered by public health care. In a sample of 622 women, we assessed the proportion of patients that underwent post-bariatric surgery at least 2 years after gastric bypass., Methods: Former bariatric patients were asked whether they had undergone post-bariatric surgery or were planning to do so by structured telephone interviews. For patients who had undergone body contouring, the degree of satisfaction with the results was inquired. Costs for bariatric and post-bariatric procedures were assessed., Results: Of 622 patients, 93 (14.9 %) had undergone body contouring and 68 (10.9 %) considered a procedure, while 454 (73 %) definitely stated that they did not want plastic surgery. Cost coverage was declined in 7 patients (1.1 %). Plastic procedures (n = 101) included 65 abdominoplasties, 25 lower body lifts without thigh lifts, 7 brachioplasties, and 4 minor procedures. Forty-nine patients were very satisfied with the results, 28 were fairly satisfied, and 16 were not satisfied. Body contouring added about 6 % to the costs of surgical treatment for morbid obesity., Conclusions: Fewer patients than in other studies expressed a desire for post-bariatric surgery, 15 % actually proceeded to this step. The low demand was neither due to denied coverage nor to unfavourable results of plastic surgery. Additional costs for body contouring were less than expected.

Background: The demand for body sculpting procedures after massive weight loss (MWL) has grown, with medial thighplasty (MT) emerging as an effective option. This study examines the impact of MT on quality of life (QoL), particularly focusing on body image and self-perception in individuals who have undergone MWL. Methods: This retrospective, single-center study included 21 patients who had post-bariatric MWL and subsequently underwent MT. QoL, with a focus on body image and self-perception, and was assessed through a custom-designed questionnaire administered before and after surgery. Inclusion criteria were a BMI < 35 and a history of bariatric surgery. Results: Twenty-one patients (20 female, 1 male) were included, with an average age of 50.3 years. The median weight loss was 58.4 kg. Post-operatively, the Physical Component Score (PCS-12) showed significant improvement, while the Mental Component Score (MCS-12) did not show a notable change. However, self-acceptance, body contact, sexuality, and self-esteem all significantly improved post-surgery, whereas vitality did not. Conclusions: Consistent with previous studies, MT yields positive outcomes regarding physical well-being. This study further highlights the procedure's benefits for self-acceptance, body contact, sexuality, and self-esteem. Patients with expectations of improvements in vitality, or mental health concerns like depression or anxiety, should be carefully selected and may benefit from multidisciplinary care, including psychiatry or psychological support, to avoid dissatisfaction with post-surgical outcomes. [ABSTRACT FROM AUTHOR]

Ulna-shortening is a widely accepted procedure for the treatment of ulna-impaction syndrome. High rates of non-unions however necessitate improving the operation technique. The new device introduced in this study is a 7-hole plate in which two proximal holes are sliding-holes. By correct placement of two distal screws and two screws in the sliding-holes, rotational stability is guaranteed. The osteotomy is performed while the plate is loosely fixed to the ulna. After fixation of the two distal screws, the sliding-holes facilitate reposition with a good closure of the osteotomy gap. Excentric placement of two more screws and placement of a lag screw across the oblique osteotomy leads to further compression at the osteotomy site. Ulna-variance can be adjusted exactly. So far the plate has been implanted in 15 patients. Ulna-variance was reduced from + 2 to - 2.2 mm. The clinical results are comparable to those of ulna-shortenings in the literature. The sliding-hole plate allows an exact connection with good closure of the osteotomy without malrotation. With this simplified technique, the risk of non-union can be reduced.

Injured peripheral nerves regenerate their axons in contrast to those in the central nervous system. Yet, functional recovery after surgical repair is often disappointing. The basis for poor recovery is progressive deterioration with time and distance of the growth capacity of the neurons that lose their contact with targets (chronic axotomy) and the growth support of the chronically denervated Schwann cells (SC) in the distal nerve stumps. Nonetheless, chronically denervated atrophic muscle retains the capacity for reinnervation. Declining electrical activity of motoneurons accompanies the progressive fall in axotomized neuronal and denervated SC expression of regeneration-associated-genes and declining regenerative success. Reduced motoneuronal activity is due to the withdrawal of synaptic contacts from the soma. Exogenous neurotrophic factors that promote nerve regeneration can replace the endogenous factors whose expression declines with time. But the profuse axonal outgrowth they provoke and the difficulties in their delivery hinder their efficacy. Brief (1 h) low-frequency (20 Hz) electrical stimulation (ES) proximal to the injury site promotes the expression of endogenous growth factors and, in turn, dramatically accelerates axon outgrowth and target reinnervation. The latter ES effect has been demonstrated in both rats and humans. A conditioning ES of intact nerve days prior to nerve injury increases axonal outgrowth and regeneration rate. Thereby, this form of ES is amenable for nerve transfer surgeries and end-to-side neurorrhaphies. However, additional surgery for applying the required electrodes may be a hurdle. ES is applicable in all surgeries with excellent outcomes. [ABSTRACT FROM AUTHOR]

Upper extremity congenital anomalies in the newborn are second only to congenital heart anomalies. Some of the more commonly encountered upper extremity anomalies are trigger thumb, thumb hypoplasia, polydactyly, syndactyly, and amniotic band syndrome. While some conditions occur in isolation, others are known to commonly occur in association with syndromes. Familiarity with these conditions is important not only to provide adequate evaluation and workup of these patients but also to deliver appropriate surgical intervention and prepare parents with appropriate expectations. In this article, we outline the etiology, classification, surgical management, and outcomes of these five commonly encountered upper extremity congenital anomalies. [ABSTRACT FROM AUTHOR]

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Appropriate animal models, mimicking conditions of both health and disease, are needed to understand not only the biology and the physiology of neurons and other cells under normal conditions but also under stress conditions, like nerve injuries and neuropathy. In such conditions, understanding how genes and different factors are activated through the well-orchestrated programs in neurons and other related cells is crucial. Knowledge about key players associated with nerve regeneration intended for axonal outgrowth, migration of Schwann cells with respect to suitable substrates, invasion of macrophages, appropriate conditioning of extracellular matrix, activation of fibroblasts, formation of endothelial cells and blood vessels, and activation of other players in healthy and diabetic conditions is relevant. Appropriate physical and chemical attractions and repulsions are needed for an optimal and directed regeneration and are investigated in various nerve injury and repair/reconstruction models using healthy and diabetic rat models with relevant blood glucose levels. Understanding dynamic processes constantly occurring in neuropathies, like diabetic neuropathy, with concomitant degeneration and regeneration, requires advanced technology and bioinformatics for an integrated view of the behavior of different cell types based on genomics, transcriptomics, proteomics, and imaging at different visualization levels. Single-cell-transcriptional profile analysis of different cells may reveal any heterogeneity among key players in peripheral nerves in health and disease. [ABSTRACT FROM AUTHOR]

Macro- and histopathological examinations were performed on 200 Wistar rats of both sexes which had been intraperitoneally treated with either Brauns resorbable surgical glove powder or Bio-sorb surgical glove powder; control animals were injected with talcum powder. Talcum resulted in the well known foreign body granuloma along with adhesions. The amylaceous powders induced an initial inflammatory reaction with a subsequent non-reactive interval and thereafter solitary foreign body granulomas were formed. After terminating the experiment (12 weeks), no adhesions could be detected in animals treated with starch containing powder. A resorption of the powder was assumed in that the number of powder crystals was greatly reduced by the end of the experiment. The granulomas which developed after the 12th week were regarded as resorption granulomas. The development of adhesions was minimal with both types of amylaceous powder.

Background: Systematic reviewing is a time‐consuming and resource‐intensive process. Information specialists are maintaining study‐based registers to facilitate efficient conduct of systematic reviews. Classification of study‐level meta‐data ‐such as interventions –can result in much more accurate searches, saving time in the early steps of systematic reviewing. Objective: To classify all pharmacological interventions from all schizophrenia trials. Methods: We used Cochrane Schizophrenia's Study‐based Register as the source of trials, Emtree and MeSH for synonyms, AdisInsight and CT.gov for research drugs and WHO ATC for marketed drugs. Results: One third of tested interventions on patients with schizophrenia are pharmacological (816; belonging to 106 clinical classes) with antipsychotic drugs being the most researched (15.1%). Only 528 of these medications are listed in WHO ATC. Around one third of these drug interventions are seen only in research (236; from 21 pharmacological/biochemical classes). Within the pharmacological interventions, we identified 28 'qualifiers' including dose, route and timing of drug delivery. Conclusion: Identification and classification of pharmacological interventions from trials require use of many sources of information none of which are inclusive of all drugs. Limitations of each source are helpful to understand. Classification of non‐pharmacological interventions is now a priority for clinical and information scientists and professionals. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) often causes loss of sensory and motor function resulting in a significant reduction in quality of life for patients. Currently, no therapies are available that can repair spinal cord tissue. After the primary SCI, an acute inflammatory response induces further tissue damage in a process known as secondary injury. Targeting secondary injury to prevent additional tissue damage during the acute and subacute phases of SCI represents a promising strategy to improve patient outcomes. Here, we review clinical trials of neuroprotective therapeutics expected to mitigate secondary injury, focusing primarily on those in the last decade. The strategies discussed are broadly categorized as acute-phase procedural/surgical interventions, systemically delivered pharmacological agents, and cell-based therapies. In addition, we summarize the potential for combinatorial therapies and considerations. [ABSTRACT FROM AUTHOR]

After NEM treatment for 0, 3, 5, 6, 9, and 12 h, we counted the live cells at each time-point, and we selected 5 h for sampling the RNA-seq because the cell proliferation was significantly inhibited at 5 h in 10 µM NEM treated SW10 cells (Figure S1). Whole-Genome Expression Profiling of Dedifferentiated Schwann Cells We performed whole-genome expression profiling of DMSO-treated SW10 cells (control), as dedifferentiated Schwann cells and NEM-treated SW10 cells (H SB 2 sb S-pathway-inhibited Schwann cells), by RNA sequencing (RNA-seq) (Figure 1A). Next, because KEGG enrichment analysis identified ROS (Figure S3A), to test whether proteins involved in oxidative stress were regulated by NEM during ex vivo PND, we selected 19 oxidative stress proteins from the NEM/1DIV data overlapped with the QuickGO database [[16]] (Figure 4C). [Extracted from the article]

Cognitive impairments associated with schizophrenia (CIAS) represent a central element of the symptomatology of this severe mental disorder. CIAS substantially determine the disease prognosis and hardly, if at all, respond to treatment with currently available antipsychotics. Remarkably, all drugs presently approved for the treatment of schizophrenia are, to varying degrees, dopamine D2/D3 receptor blockers. In turn, rapidly growing evidence suggests the immense significance of systems other than the dopaminergic system in the genesis of CIAS. Accordingly, current efforts addressing the unmet needs of patients with schizophrenia are primarily based on interventions in other non-dopaminergic systems. In this review article, we provide a brief overview of the available evidence on the importance of specific systems in the development of CIAS. In addition, we describe the promising targets for the development of new drugs that have been used so far. In doing so, we present the most important candidates that have been investigated in the field of the specific systems in recent years and present a summary of the results available at the time of drafting this review (May 2022), as well as the currently ongoing studies. [ABSTRACT FROM AUTHOR]