Clinics最新文献

{"title":"Power Doppler in hand joints predicts therapeutic failure in treatment-naive women with early rheumatoid arthritis: A prospective study","authors":"Karine Rodrigues da Luz ,&nbsp;Jamil Natour ,&nbsp;Marcelo de Medeiros Pinheiro ,&nbsp;Giovanna S. Petterle ,&nbsp;Marla Francisca dos Santos ,&nbsp;Artur da Rocha Correa Fernandes ,&nbsp;Rita Nely Vilar Furtado","doi":"10.1016/j.clinsp.2025.100593","DOIUrl":"10.1016/j.clinsp.2025.100593","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine whether ultrasound measurements of the hands could predict treatment failure in treatment-naive women with early rheumatoid arthritis.</div></div><div><h3>Method</h3><div>In a prospective case-control study, 48 women underwent blind assessments four times over 48-weeks, considering three failure stages: failure 1 (methotrexate), failure 2 (leflunomide), and failure 3 (adalimumab). Bilateral ultrasound exams evaluated wrist, 2nd, and 3rd Metacarpophalangeal Joints (MCPs), and Proximal Interphalangeal Joints (PIPs) for inflammatory indicators (synovial and tenosynovial proliferation using grayscale and Power Doppler [PD]) and joint damage (bone erosion and cartilage damage).</div></div><div><h3>Results</h3><div>The study involved 48 women, aged 47.7 ± 11.6 years, with an average disease duration of 7.5 ± 3.5 months. Of these, 41 (85.41 %) experienced failure 1, 25 (52 %) experienced failure 2, and 5 (10.5%) experienced failure 3. Predictors for failure 1 included PD/Q10 total score &gt; 2.5 (OR = 18.00), PD/SQ10 total score &gt; 5.0 (OR = 23.2), PD/Q MCP score &gt; 1.5 (OR = 14.58), and PD/SQ MCP score &gt; 3.0 (OR = 35). For failure 2, predictors encompassed PD/Q10 total score &gt; 4.5 (OR = 4.81), PD/SQ10 total score &gt; 9.5 (OR = 4.81), PD/Q MCP score &gt; 2.5 (OR = 4.92), PD/SQ MCP score &gt;5.0 (OR = 6.22), and PD/Q PIP score &gt; 1.5 (OR = 6.66). In relation to failure 3, a PD/Q wrist score &gt; 2.5 (AUC = 0.79; <em>p</em> = 0.035) was indicative.</div></div><div><h3>Conclusions</h3><div>Power Doppler proved to be a predictive indicator for treatment failure in early rheumatoid arthritis among treatment-naive women. It emerged as a predictor for both the initial and 2nd DMARD treatments, as well as the 1st immunobiological treatment, based on hand joint assessments.</div></div><div><h3>Trial registration</h3><div>Clinical trials.gov NCT04752748.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100593"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in immunomodulation for organ transplantation: The role of the Annexin A1/FPR axis","authors":"Rafael André da Silva ,&nbsp;João Vitor Ferreira de Lima ,&nbsp;Raquel Fink Lins e Silva de Macedo ,&nbsp;Monielle Sant'Ana ,&nbsp;Cristiane Damas Gil ,&nbsp;M. Natalia Vergara","doi":"10.1016/j.clinsp.2025.100626","DOIUrl":"10.1016/j.clinsp.2025.100626","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100626"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The supramolecular polymer-related signature predicts prognosis and indicates immune microenvironment infiltration in gastric cancer","authors":"Yan Liu,&nbsp;Hongyao Cui,&nbsp;Chuan Sun","doi":"10.1016/j.clinsp.2025.100641","DOIUrl":"10.1016/j.clinsp.2025.100641","url":null,"abstract":"<div><h3>Background</h3><div>Gastric Cancer (GC) remains a leading global cause of cancer mortality, underscoring the urgent need for advanced prognostic tools. This study aimed to construct and evaluate a prognostic risk signature based on Supramolecular Polymer-Related Genes (SPRGs) in gastric cancer.</div></div><div><h3>Methods</h3><div>The authors downloaded data from TCGA-STAD, GEO, and CCLE databases for patients with GC and validation cohorts. Through consensus clustering, Cox proportional hazards models, LASSO Cox regression, and nomogram development, the authors identified and constructed a GC Prognostic risk Index (SPI). Additionally, the authors conducted drug sensitivity analysis and immune landscape assessment. Functional evaluations were conducted through colony formation, transwell invasion, and wound healing assays.</div></div><div><h3>Results</h3><div>The authors identified that 182 SPRGs were significantly upregulated and 226 were downregulated in gastric cancer. Consensus clustering revealed two molecular subtypes, with cluster 1 having significantly lower overall survival compared to cluster 2. SPI effectively distinguished high-risk and low-risk patients across all cohorts. Furthermore, SPI was associated with tumor stage, lymph node metastasis, and tumor size, and could predict drug sensitivity in GC patients. Immune landscape analysis showed higher infiltration of naïve B cells, M2 macrophages, and activated NK cells in high-SPI patients. A nomogram model for GC prognosis using SPI and patient age was developed. KLC1 knockdown significantly suppressed GC cell proliferation, while markedly attenuating metastatic potential and invasion capacity.</div></div><div><h3>Conclusion</h3><div>This study constructed a prognostic risk signature based on SPRGs in gastric cancer, which is closely related to clinical pathological features, drug sensitivity, and immune landscape, providing new insights for personalized treatment.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100641"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of contrast-enhanced ultrasound combined with serum procalcitonin in tuberculous lymph nodes and metastatic lymph nodes","authors":"Lin Li ,&nbsp;Lan He ,&nbsp;Minchao Xiong ,&nbsp;Xiaoyan Wang","doi":"10.1016/j.clinsp.2024.100541","DOIUrl":"10.1016/j.clinsp.2024.100541","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the value of Contrast-Enhanced Ultrasound (CEUS) combined with Procalcitonin (PCT) in differentiating Tuberculous Lymph Nodes (TLN) from Metastatic Lymph Nodes (MLN).</div></div><div><h3>Methods</h3><div>This prospective cohort study included 207 consecutive patients diagnosed with CTL. Before confirming through pathology or laboratory tests, every patient received standard ultrasound, CEUS, and MRI examinations, with the imaging results analyzed afterward. Serum indicators were measured by Enzyme-Linked Immunosorbent Assay (ELISA). Predictive modeling was performed by multifactorial logistic regression. Evaluate the diagnostic and calibration performance of the predictive model by drawing Receiver Operating Characteristic (ROC) curves and calibration curves, and using Area Under the Curve (AUC) and Hosmer-Lemeshow (H-L) tests.</div></div><div><h3>Results</h3><div>The presence of lymph node lesions was confirmed by routine ultrasound and MRI in 207 patients, of which 102 (49.27 %) had a pathological or laboratory diagnosis of metastatic lymph nodes (MLN), and 50.8 % were tuberculous lymph nodes (TLN). According to imaging findings of CEUS, TLN was more commonly associated with enhanced concentric performance in the arterial phase (67.65 % vs. 40.95 %) and heterogeneous enhancement pattern in lymph nodes (70.59 % vs. 52.38 %). Peak Intensity (PI) of lesions was higher in patients with MLN. Increased age-enhanced concentric performance in the arterial phase, increased PI, and serum PCT greater than 5.39 ng/mL were independent risk factors for MLN. The prediction model of serum PCT combined with CEUS had a higher diagnostic value for MLN. The H-L test indicated a satisfactory model fit (all p &gt; 0.05), and the calibration curve closely approximates the ideal diagonal.</div></div><div><h3>Conclusion</h3><div>CEUS combined with serum PCT has better clinical application value in the differential diagnosis of TLN and MLN.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100541"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged high Myl9 levels are associated with the pathogenesis and respiratory symptom of post-acute COVID-19 syndrome: A 6-month follow-up study","authors":"Jun Sugihara ,&nbsp;Chiaki Iwamura ,&nbsp;Tomoya Tateishi ,&nbsp;Tadashi Hosoya ,&nbsp;Sho Shimada ,&nbsp;Kiyoshi Hirahara ,&nbsp;Shinsuke Yasuda ,&nbsp;Yasunari Miyazaki","doi":"10.1016/j.clinsp.2025.100584","DOIUrl":"10.1016/j.clinsp.2025.100584","url":null,"abstract":"<div><h3>Background</h3><div>Post-acute COVID-19 Syndrome (PACS) occurs in some COVID-19 patients long after acute infection and significantly affects patients’ health. However, the mechanism by which PACS develops is unknown. Myosin light chain 9 (Myl9), produced by activated platelets, plays a role in immune dysregulation and microthrombi formation during acute COVID-19. However, in the PACS phase, the association between Myl9 and residual symptoms remains unclear, and further investigation is needed.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, serum Myl9 concentrations were measured in 195 COVID-19 patients during hospitalization and at 3- and 6-month follow-up visits. Gaussian mixture modeling was used to identify groups on the basis of Myl9 levels. Relationships between Myl9 levels and residual symptoms were evaluated. Clinical characteristics influencing Myl9 levels were analyzed via logistic regression.</div></div><div><h3>Results</h3><div>A total of 304 serum samples from 195 patients were collected. Two distinct groups were identified in the Myl9 distribution with a cutoff of 386 ng/mL by Gaussian mixture modeling in this cohort. The high-Myl9 group presented significant residual respiratory symptoms at 6 months post-infection (<em>p</em> &lt; 0.05). Elevated Myl9 levels at 6 months were correlated with increased neutrophil counts (<em>p</em> &lt; 0.01) and respiratory comorbidities at diagnosis (<em>p</em> &lt; 0.05) according to univariate regression analysis. Multivariate regression analysis confirmed the relationship between the neutrophil count and high Myl9 levels.</div></div><div><h3>Conclusion</h3><div>Prolonged high Myl9 levels are associated with respiratory symptoms, suggesting the potential involvement of prolonged inflammation or endothelial damage in PACS.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100584"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing loss and small and large fibre neuropathy associated with the heterozygous variants c.20A>T in HBB and del-3.7 in HBA","authors":"Josef Finsterer ,&nbsp;Fulvio A. Scorza ,&nbsp;Carla A. Scorza ,&nbsp;Ana C. Fiorini","doi":"10.1016/j.clinsp.2025.100597","DOIUrl":"10.1016/j.clinsp.2025.100597","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100597"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab in gestational trophoblastic neoplasia: Systematic review and meta-analysis with sub-group analysis of potential prognostic factors","authors":"Marcio Barcellos ,&nbsp;Antonio Braga ,&nbsp;Matheus Machado Rech ,&nbsp;Solange Artimos de Oliveira ,&nbsp;Jose Mauro Madi ,&nbsp;Sue Yazaki Sun ,&nbsp;Jorge de Rezende-Filho ,&nbsp;Kevin M. Elias ,&nbsp;Neil S. Horowitz ,&nbsp;Ross S. Berkowitz","doi":"10.1016/j.clinsp.2025.100583","DOIUrl":"10.1016/j.clinsp.2025.100583","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the performance of pembrolizumab for the treatment of Gestational Trophoblastic Neoplasia (GTN).</div></div><div><h3>Methods</h3><div>The Medical Subject Headings related to immunotherapy/pembrolizumab and GTN were used alone or in combination to retrieve relevant articles. The authors searched in EMBASE, MEDLINE/PubMed, Elsevier's Scopus, and Web of Science until November/2024. The authors included any randomized controlled trials, cohort studies, case series, and case reports focusing on pembrolizumab treatment in GTN. Meta-analysis of proportions was carried out employing a random-effects model. The meta-analysis employed the inverse variance method, with the arcsine link function for the analysis of proportional data. All analyses were performed using Stata 18. For all analyses, a p-value &lt; 0.05 indicated statistical significance. This study was registered on PROSPERO (CRD42023493329).</div></div><div><h3>Results</h3><div>A total of 550 studies were identified after a literature search among which 15 original studies were included in the systematic review and in the meta-analysis. Pembrolizumab induced complete sustained remission in 71.59% (95% CI 53.27‒84.78%; I² = 0.00%, H² = 1.00, p = 0.90) of cases. The subgroups meta-analysis showed pembrolizumab had similar performance, regardless of age (&lt; 40 vs. ≥ 40-years-old, p = 0.38), GTN histopathology (Placental Site Trophoblastic Tumor [PSTT], Epithelioid Trophoblastic Tumor [ETT]/noninvasive mole/others versus invasive mole/choriocarcinoma, p = 0.48), time from diagnosis to the beginning of immunotherapy (&lt; 4 vs. ≥ 4-years, p = 0.84), pembrolizumab combined with chemotherapy (yes vs. no, p = 0.66).</div></div><div><h3>Conclusions</h3><div>Pembrolizumab seems an effective treatment for patients with high-risk GTN with chemoresistant or relapsed disease, including cases of PSTT/ETT, notwithstanding patient age, time to initiate immunotherapy and whether or not it was associated with chemotherapy.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100583"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding prognostic factors in SARS-CoV-2 complications among patients with hematological disorders","authors":"Fengbo Jin ,&nbsp;Wei Qian ,&nbsp;Yingying Chen ,&nbsp;Wanlu Tian ,&nbsp;Ling Ge ,&nbsp;Mingzhen Yang ,&nbsp;Leiming Xia","doi":"10.1016/j.clinsp.2025.100625","DOIUrl":"10.1016/j.clinsp.2025.100625","url":null,"abstract":"<div><div>Within the intricate tapestry of the global SARS-CoV-2 pandemic, this study delves into the intricate interplay of clinical data to elucidate prognostic factors associated with complications in patients concomitantly afflicted with hematological disorders and SARS-CoV-2. An exhaustive analysis of 71 individuals, spanning the period from November 2022 to March 2023, aims to unveil distinctive clinical characteristics and explicate the nuanced determinants steering the trajectory of the disease. The updated findings reveal a multi-faceted correlation, underscoring the complex interplay of clinical parameters. Among individuals with hematological disorders, anomalously elevated ferritin levels are closely associated with the development of SARS-CoV-2 pneumonia, while interferon-γ is intricately linked to the severity of SARS-CoV-2. Conversely, elevated ferritin levels, increased <span>D</span>-dimer and fibrin degradation products, along with significantly elevated iron levels, manifest a significant association with patient mortality. Intriguingly, those in patients in complete hematologic remission confront an augmented risk of developing SARS-CoV-2 pneumonia, while those abstaining from anti-tumor treatments exhibit mitigated case severity. This study unveils the intricate interplay of clinical factors impacting the prognosis of SARS-CoV-2 complications in individuals with hematological disorders. The cognizance of aberrant interferon-γ activation and nuanced associations with ferritin, iron levels, and coagulation markers contributes to a more holistic comprehension of the prognostic landscape.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100625"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of endoscopic submucosal dissection and transanal endoscopic surgery for the treatment of rectal neoplasia: A systematic review and meta-analysis","authors":"Igor Valdeir Gomes de Sousa,&nbsp;Alexandre Moraes Bestetti,&nbsp;Diego Paul Cadena-Aguirre,&nbsp;Angelo So Taa Kum,&nbsp;Paulo Ferreira Mega,&nbsp;Pedro Henrique Veras Ayres da Silva,&nbsp;Nelson Tomio Miyajima,&nbsp;Wanderley Marques Bernardo,&nbsp;Eduardo Guimarães Hourneaux de Moura","doi":"10.1016/j.clinsp.2025.100613","DOIUrl":"10.1016/j.clinsp.2025.100613","url":null,"abstract":"<div><h3>Background and aim</h3><div>Minimally invasive techniques offer alternatives to conventional surgery in the treatment of early-stage colorectal cancer, reducing morbidity. Transanal Endoscopic Microsurgery (TEM) and Transanal Minimally Invasive Surgery (TAMIS) are widely used, while Endoscopic Submucosal Dissection (ESD) is gaining attention for its ability to achieve complete resection with low recurrence rates. This study compares the efficacy and safety of ESD with Transanal Endoscopic Surgery (TES).</div></div><div><h3>Methods</h3><div>The authors performed a systematic review and meta-analysis of comparative studies involving patients with endoscopically resectable rectal lesions. Electronic searches were conducted in MEDLINE, EMBASE, Cochrane, and LILACS. Outcomes included recurrence rate, complete resection, en bloc resection, hospital stay, procedure time, and complication rate.</div></div><div><h3>Results</h3><div>The analysis included ten observational studies and one Randomized Controlled Trial (RCT) involving 1,094 patients. No significant differences were found in terms of recurrence rate, en bloc resection, R0 resection, and complications between techniques. The RCT showed a shorter procedure time in the TES (RD = 16.6; 95 % CI 8.88 to 24.32; p &lt; 0.0001), whereas observational studies found no significant difference. In addition, observational studies found a shorter hospital stay duration in the ESD (MD = -1.22; 95 % CI -2.11 to -0.33; I² = 82 %; p &lt; 0.007), while the RCT found no difference.</div></div><div><h3>Conclusion</h3><div>ESD and TES are safe and effective for the treatment of early-stage rectal tumors. Rates of local recurrence, block resection, R0 resection, complications, and procedure time were similar. However, the RCT showed a shorter procedure time with TES, while observational studies showed a shorter hospital stay with ESD.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100613"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic superior capsule reconstruction with dermal allograft and autologous long head of the biceps tendon for irreparable posterosuperior rotator cuff tears, a two-year clinical and radiological results","authors":"Joe Chih-Hao Chiu,&nbsp;Yu-Cheng Chen,&nbsp;Poyu Chen,&nbsp;Yi Lu,&nbsp;Cheng-Pang Yang,&nbsp;You-Hung Cheng,&nbsp;Alvin Chao-Yu Chen","doi":"10.1016/j.clinsp.2025.100628","DOIUrl":"10.1016/j.clinsp.2025.100628","url":null,"abstract":"<div><h3>Background</h3><div>A 2 mm-thick dermal allograft and autologous Long Head of the Biceps Tendon (LHBT) Superior Capsule Reconstruction (SCR) could provide improved clinical and radiographic outcomes for posterosuperior Massive Irreparable Rotator Cuff Tears (MIRCTs).</div></div><div><h3>Methods</h3><div>A retrospective study was conducted between April 2019 and October 2021. The LHBT was rerouted 5 mm posteriorly to the bicipital groove, and a 2 mm-thcick dermal allograft was used to cover the rerouted LHBT. Clinical assessment included Constant-Murley Shoulder score (CMS), American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), Visual Analog Scale (VAS) pain scores, and active ROM measurements. The radiological assessment included Acromiohumeral Distance (AHD), Superior Capsular Distance (SCD), muscle Fatty Infiltration (FI), and follow-up SCR integrity using ultrasound two years after surgery.</div></div><div><h3>Results</h3><div>25 patients (7 male, 18 female) were included with a mean age of 64.2 ± 6.9 years. Active ROM, AHD, and SCD did not change significantly after the surgery. Patients' VAS (8.3 ± 0.7 to 1.3 ± 0.6, <em>p</em> &lt; 0.001), SSV (22.4 ± 8.6 to 77.6 ± 12.7, <em>p</em> &lt; 0.001), CMS (36.2 ± 6.8 to 79.9 ± 8.4, <em>p</em> &lt; 0.001), and ASES (37.2 ± 10.0 to 80.5 ± 5.7, <em>p</em> &lt; 0.001) improved significantly at final follow-up. The ultrasound examination of all patients demonstrated a healed dermal allograft on the supraspinatus footprint. One patient (4 %) had a postoperative trauma causing irreparable subscapularis tear, leading to reverse total shoulder arthroplasty during revision surgery.</div></div><div><h3>Conclusions</h3><div>The combined SCR technique using a 2 mm dermal allograft and autologous LHBT for posterosuperior MIRCTs significantly improved the patient-reported outcomes.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100628"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}