Medical sciences (Basel, Switzerland)最新文献

{"title":"Idiopathic Scoliosis Progression: Presenting Rib and Segmental Rib Index as Predictors-A Literature Review.","authors":"Theodoros B Grivas, Elias Vasiliadis, Konstantinos Soultanis, Marios Lykissas, Galateia Katzouraki, Nikolaos Sekouris, Dimitrios Lykouris, Christina Mazioti, Aristea Mamzeri, Despina Papagianni, Eleni Potamiti, Alexandros Kastrinis, Evangelos Theodosopoulos","doi":"10.3390/medsci13020062","DOIUrl":"10.3390/medsci13020062","url":null,"abstract":"<p><p>This report provides a concise selective representative overview of the predictor factors for progression in Idiopathic Scoliosis (IS). The Cobb angle method, rib hump deformity, imaging and advanced techniques for assessing skeletal maturity serve as key elements in evaluating prognostic factors for IS progression based on the patient's age at diagnosis-particularly in Infantile Idiopathic Scoliosis (IIS), Juvenile Idiopathic Scoliosis (JIS), and Adolescent Idiopathic Scoliosis (AIS). The commonly used approaches for determining skeletal maturity include the assessment of the iliac apophysis and scoliosis curve deterioration, the Sanders skeletal maturity staging system, the distal radius and ulna (DRU) classification for predicting growth spurts and curve progression in IS, as well as the ossification of vertebral epiphyseal rings, the humeral head, and the calcaneal apophysis. Prognostic factors influencing IS progression are further discussed in relation to the patient's age at onset-whether in infancy, childhood, or adolescence-as well as in both untreated and braced AIS patients. Additionally, the apical convex rib-vertebra angle in AIS is explored as an indicator of progression. Predictors for curve progression at skeletal maturity are outlined, along with various models for forecasting IS deterioration. Lastly, the Rib and Segmental Rib Index, a rib cage deformity parameter, is introduced as a predictor of scoliosis progression. In conclusion, this concise and selective overview of predictor factors for progression in IS highlights the current understanding of IS progression factors. It also introduces the Rib and Segmental Rib Index-a rib cage deformity parameter-as a predictor of IS progression.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Facial Melasma and Ocular Photoaging Diseases.","authors":"Lunla Udomwech, Chime Eden, Weeratian Tawanwongsri","doi":"10.3390/medsci13020061","DOIUrl":"10.3390/medsci13020061","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Facial melasma is a common, chronic, and relapsing hyperpigmentation disorder, affecting up to 40% of adult women in Southeast Asia. Although most cases are mild, the condition may have a considerable psychological impact. Ocular photoaging diseases are also common and have been increasingly recognized in aging populations exposed to chronic sunlight. Ultraviolet (UV) radiation is implicated in both melasma and ocular photoaging; however, their relationship remains unclear. <b>Methods:</b> This cross-sectional study investigated the association between facial melasma and UV-induced ocular conditions among 315 participants aged 30-80 years at Walailak University Hospital, Thailand. Facial melasma was diagnosed clinically and dermoscopically, with severity assessed using the modified Melasma Area Severity Index. Ophthalmological examinations evaluated UV-related ocular conditions, including pinguecula, pterygium, climatic droplet keratopathy, cataracts, and age-related macular degeneration. Logistic regression analyses were performed, adjusting for age, sex, and sun exposure. <b>Results:</b> Facial melasma was identified in 66.0% of participants (n = 208), and nuclear cataracts were significantly associated with melasma (adjusted odds ratio, 2.590; 95% confidence interval, 1.410-4.770; <i>p</i> = 0.002). Additionally, melasma severity correlated with nuclear cataract severity (ρ = 0.186, <i>p</i> = 0.001). Other ocular conditions were not significantly associated with melasma. <b>Conclusions:</b> These findings suggest a shared UV-related pathogenesis between facial melasma and nuclear cataracts. Sun protection measures, including regular sunscreen use, UV-blocking eyewear, and wide-brimmed hats, may help mitigate the risk of both conditions. Further multicenter studies are warranted to confirm these findings and explore the underlying mechanisms.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in LVAD Placements and Outcomes: A Nationwide Analysis Using the National Inpatient Sample and National Readmissions Database.","authors":"Vivek Joseph Varughese, Vignesh Krishnan Nagesh, Hadrian Hoang-Vu Tran, Nikita Wadhwani, Audrey Thu, Simcha Weissman, Adam Atoot","doi":"10.3390/medsci13020060","DOIUrl":"10.3390/medsci13020060","url":null,"abstract":"<p><strong>Background: </strong>Aim of the study is to analyze the trends and outcomes in Left Ventricular Assist Device (LVAD) placements between the years 2016 and 2022 using the National Inpatient Sample (NIS).</p><p><strong>Methods: </strong>Using the NIS for the years 2016-2022, we identified the total number of LVAD placements using the PCS 10 code 02HA0QZ. In-hospital outcomes and healthcare resource utilization burden were assessed. Stratification of outcomes with Extracorporeal Membrane Oxygenation (ECMO) support were performed for the years 2018-2022. Outcome analysis variance in admissions requiring ECMO support was performed using multivariate regression analysis. A two tailed <i>p</i>-value < 0.05 was used to determine statistical significance.</p><p><strong>Results: </strong>A general decreasing trend was observed in the total number of LVAD placements, with 852 total admissions requiring LVAD placements identified in 2016 compared to 665 in 2022. The admissions for LVAD placements requiring ECMO support had an increasing trend, with 2.21% of admissions needing ECMO support in 2018 compared to 12.18% in 2018. After multivariate regression analysis, the association between all-cause mortality during the hospital stay for LVAD placements and requirement of ECMO was found to be significant, with an odds ratio of 2.34 (1.83-4.42, <i>p</i>-value: 0.001).</p><p><strong>Conclusions: </strong>A general decreasing trend in LVAD placements was observed between 2016 and 2022. All-cause mortality and hospital charges during the admission had a stable trend over the years. The requirement of ECMO support had an increasing trend from 2018 to 2022. Requirement of ECMO support during the admissions for LVAD placements had a statistically significant association with all-cause mortality during the admission. A 11.50% readmission rate was observed in the 30 days following discharge, with heart failure being the major cause of readmission.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Nutritional Index Could Serve as a Reliable Prognostic Marker in Intensive Care Population.","authors":"Ibrahim Karagoz, Songul Peltek Ozer, Bahri Ozer, Gulali Aktas","doi":"10.3390/medsci13020059","DOIUrl":"10.3390/medsci13020059","url":null,"abstract":"<p><p><b>Background</b>: Morbidity and mortality rates in intensive care units (ICUs) reflect the severe health challenges faced by critically ill patients. Nutritional and immune status, as measured by the prognostic nutritional index (PNI), are increasingly recognized as important predictors of intensive care unit outcomes. <b>Objective</b>: We aimed to compare the prognostic nutritional index levels of survived and deceased subjects treated in intensive care units. <b>Methods</b>: This retrospective study examined the association between prognostic nutritional index and mortality among intensive care unit patients treated from June 2023 to June 2024. The prognostic nutritional index was calculated using serum albumin and lymphocyte levels, and patients were categorized into survived and deceased groups. Statistical analyses, including ROC and logistic regression, were used to evaluate prognostic nutritional index's predictive capacity. <b>Results</b>: We revealed that deceased patients had significantly lower prognostic nutritional index values, lower platelet counts, and higher C-reactive protein (CRP) and serum creatinine levels compared to survivors. The prognostic nutritional index was independently associated with mortality, with each unit increase decreasing mortality risk by 6%. <b>Conclusion</b>: These findings highlight the prognostic nutritional index's utility as a prognostic tool in intensive care unit settings, underscoring the need for nutritional assessments and targeted interventions to improve patient outcomes. Further research with larger cohorts is warranted to validate these findings and explore causative mechanisms.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Treatment Protocol Adherence and Variations in Paroxysmal Supraventricular Tachycardia in the Emergency Department: A Multi-Center Cohort Study.","authors":"Kevin Ku, Jack Healy, Christian A Lee, Maha Khan, Kevin D Chao, Saleh Hassan, Ching-Fang Tiffany Tzeng, Yu-Lin Hsieh, Andrew Shedd, Toral Bhakta, Dahlia Hassani, Eric H Chou","doi":"10.3390/medsci13020058","DOIUrl":"10.3390/medsci13020058","url":null,"abstract":"<p><p><b>Background</b>: Supraventricular tachycardia (SVT) is a common arrhythmia requiring prompt intervention in the emergency department (ED). Despite evidence-based guidelines recommending a stepwise approach, significant variability in clinical practice persists, particularly in adenosine dosing strategies. <b>Objective</b>: This study assessed adherence to SVT treatment protocols in the ED, focusing on the efficacy of an initial 6 mg versus 12 mg adenosine dose and the use of alternative pharmacologic agents. <b>Methods</b>: This multi-center, retrospective cohort study analyzed adult patients (≥18 years) diagnosed with stable SVT in urban EDs across North Texas between 1 January 2019, and 16 January 2022. Patients who spontaneously converted to normal sinus rhythm or presented with hemodynamically unstable SVT requiring immediate cardioversion were excluded. The primary outcome was the rate of successful conversion to sinus rhythm. Secondary outcomes included frequency of adenosine administration, deviations from 2020 AHA ACLS guidelines in SVT treatment, and risk factors associated with failure to convert to sinus rhythm following adenosine administration. <b>Results</b>: A total of 439 patients were included in the final analysis. Vagal maneuvers were attempted in 26% of cases, achieving a 31% success rate. Adenosine was used in 83% of pharmacologic interventions, with 57.5% receiving 6 mg and 42.5% receiving 12 mg as the initial dose. The 12 mg dose had a significantly higher conversion rate (54.2% vs. 40.6%, <i>p</i> = 0.03). Regression analysis identified key predictors of treatment success, including comorbidities, and baseline hemodynamics. Documentation inconsistencies, particularly regarding vagal maneuvers, were noted. <b>Conclusions</b>: In our cohort, an initial 12 mg adenosine dose was more effective than 6 mg for SVT conversion in the ED. Recognizing and addressing variations in guideline adherence can play a key role in improving patient care. Further prospective research is warranted to optimize dosing strategies and evaluate the impact of standardized protocols on clinical outcomes.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Placebo Effect in Chronic Thromboembolic Pulmonary Hypertension Trials: A Systematic Review and Meta-Analysis.","authors":"Daniel Caldeira, Daniel Inácio Cazeiro, Rui Plácido, Filipa Ferreira, Rita Calé, Fausto J Pinto","doi":"10.3390/medsci13020057","DOIUrl":"10.3390/medsci13020057","url":null,"abstract":"<p><p><b>Introduction:</b> Placebo-controlled studies are crucial in clinical trials, but the placebo effect can vary across conditions. We aimed to assess the placebo effect in chronic thromboembolic pulmonary hypertension (CTEPH) trials. <b>Methods:</b> We conducted a systematic review and included randomized placebo-controlled trials investigating CTEPH interventions. Primary outcomes were the pre-post changes in the 6 min walk test (6MWT) and quality of life in the placebo arms. Secondary outcomes included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), cardiac index, and NT-proBNP levels. Meta-analyses were performed using random-effects models. <b>Results:</b> Seven trials with 270 CTEPH patients in placebo arms were analyzed. The average 6MWT change was not significant (-1.31 m; 95%CI -12.49 to +9.79). Quality of life with EQ-5D was not significantly improved (-0.04; 95%CI -0.10 to +0.02). mPAP, PVR, cardiac index, and NT-proBNP also demonstrated non-significant changes with small magnitudes. <b>Conclusions:</b> The placebo effect in CTEPH trials was not statistically significant and had small magnitude but should not discourage the use of placebo-controlled trials where applicable and ethical.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Impact of Emotional Eating Among University Students: A Literature Review.","authors":"Olga Alexatou, Sousana K Papadopoulou, Maria Mentzelou, Georgia-Eirini Deligiannidou, Antonios Dakanalis, Constantinos Giaginis","doi":"10.3390/medsci13020056","DOIUrl":"10.3390/medsci13020056","url":null,"abstract":"<p><strong>Background/objectives: </strong>Emotional eating has been considered as a trend to consume energy concentrated and tasty foods in response to adverse emotions. Emotional eating may harmfully influence physical and mental health among university students, worsening their daily quality of life and their academic performance. The aim of the present study is to critically summarize and analyze the currently available clinical data concerning the impact of emotional eating among university students.</p><p><strong>Methods: </strong>Comprehensive exploration of the currently available scientific literature was performed in the most precise scientific databases, utilizing relevant and representative keywords.</p><p><strong>Results: </strong>More than a few interrelationships were found between emotional eating and body mass index, physical activity, depression, anxiety, stress, social media overuse, nutritional behaviors, and COVID-19 lockdown concerning university students.</p><p><strong>Conclusions: </strong>The currently available clinical studies support evidence that there are significant intercorrelations between emotional eating and several aspects of physical and mental health of university students. However, most of them have a cross-sectional design that cannot establish causality effects. In this respect, prospective surveys are strongly required to delineate the impact of emotional eating in the daily life of university students.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Potential Pitfall in the Interpretation of Microscope-Integrated Fluorescence Angiography: The Center-Periphery Effect.","authors":"Dieder Stolk, Paul Bloemen, Richard Martin van den Elzen, Martijn de Bruin, Caroline Driessen","doi":"10.3390/medsci13020054","DOIUrl":"10.3390/medsci13020054","url":null,"abstract":"<p><strong>Background/objectives: </strong>Indocyanine green fluorescence angiography (ICG-FA) enables the real-time visualization of tissue perfusion. However, objective research on microscope-integrated fluorescence angiography (FA) has not been conducted before. This study aims to evaluate the fluorescence light distribution in images formed by ICG-FA in two surgical microscopes using a phantom, and to provide recommendations for their application.</p><p><strong>Methods: </strong>An 11.8 by 6.8 cm ICG and Intralipid phantom was made to evaluate overall spatial fluorescence sensitivity in two surgical microscopes in multiple working distances (WDs) and magnification factors (MFs). The signal was quantified using a tailor-made software in Python 3.8.10.</p><p><strong>Results: </strong>A clear center-periphery effect was present in most settings in both microscopes, with the highest peripheral fluorescence signal loss in the lowest MF: 100% in the Tivato and 83% in the Pentero. Increasing the MF improved homogeneity, where the biggest difference was seen between the first and second MF. A 30 cm WD and 3.5× MF produced the most homogeneous images suitable for free-flap surgery. Manually opening the light beam diameter also reduced the center-periphery effect.</p><p><strong>Conclusions: </strong>Peripheral signal loss in microscope-integrated ICG-FA must be considered during clinical interpretation and for the quantification of tissue perfusion. In clinical practice during reconstructive free-flap surgery, a 30 cm WD, 3.5 MF, and manually opened light beam diameter should be applied to achieve the most homogeneous image.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Bowel Disease in the Post-STRIDE II Era: Epidemiology and Long-Term Clinical Outcomes from a Population-Based Study.","authors":"Fabio Ingravalle, Marco Valvano, Andrea Barbara, Dorian Bardhi, Giovanni Latella, Angelo Viscido, Mariachiara Campanale, Antonio Vinci, Carlo Viora, Giampiera Bulfone, Rocco Mazzotta, Massimo Maurici","doi":"10.3390/medsci13020055","DOIUrl":"10.3390/medsci13020055","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). The availability of an increasing number of new molecules approved for IBD treatment has increased our ability and aspirations to change the trajectory of the disease. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) II consensus (2018) is the current suggested strategy for IBD management, which recommends a treat-to-target approach. The primary objective of this study is to describe the clinical history of IBD in the post-STRIDE II era and to quantify the burden of IBD in terms of hospitalisation rate. The secondary objective is to estimate the 6-year risk of intestinal resection among IBD patients. <b>Methods:</b> A population-based time series analysis was conducted on administrative data; retrospective data from January 2011 to December 2021 were collected for the Local Health Authority \"Roma 1\" population (∼1.5 million residents). Hospitalisation and surgical events were prospectively recorded for patients newly diagnosed between January 2018 and February 2022 (n = 556), with follow-up throughout May 2024. A Kaplan-Mayer survivor analysis was performed to estimate the cumulative surgery risk. <b>Results:</b> In 2021, the IBD prevalence was 218.3 cases/100,000 people (77.2 CD, 141.1 UC). The incidence trend slowly increased during the last decade, up to 5.3 (CD) and 9.4 (UC) cases/100,000 ppl/year. The yearly hospitalisation rate remained stable, near 16.5%. The 6-year cumulative risk of surgery was 36% for CD and 20% for UC. <b>Conclusions:</b> The incidence of IBD has increased in the last few decades, with substantial stability in regard to the incidence of surgery and hospitalisations. Thus, the current IBD management approach has only had a small effect on changing the natural history of the disease.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Stress Shielding Prevention Using a Low Young's Modulus Ti-33.6Nb-4Sn Stem: A 7-Year Follow-Up Study.","authors":"Kazuyoshi Baba, Yu Mori, Hidetatsu Tanaka, Ryuichi Kanabuchi, Yasuaki Kuriyama, Hiroaki Kurishima, Kentaro Ito, Masayuki Kamimura, Daisuke Chiba, Toshimi Aizawa","doi":"10.3390/medsci13020051","DOIUrl":"10.3390/medsci13020051","url":null,"abstract":"<p><strong>Background: </strong>Stress shielding (SS) after total hip arthroplasty (THA) leads to proximal femoral bone loss and increases the risk of complications such as implant loosening and periprosthetic fracture. While various low-stiffness stems have been developed to prevent SS, they often compromise mechanical stability. A novel femoral stem composed of Ti-33.6Nb-4Sn (TNS) alloy offers a gradually decreasing Young's modulus from proximal to distal regions, potentially improving load distribution and reducing SS. This study aimed to evaluate the mid-term clinical and radiographic outcomes of the TNS stem, with a particular focus on its effectiveness in suppressing SS.</p><p><strong>Methods: </strong>A prospective clinical study was conducted involving 35 patients who underwent THA using the TNS stem, with a minimum follow-up of 7 years. Twenty-one patients with Ti6Al4V metaphyseal-filling stems served as controls. Clinical outcomes were assessed using Japanese Orthopaedic Association (JOA) scores, and radiographic SS was graded using Engh's classification and analyzed in Gruen zones. Inter-examiner reliability and statistical comparisons between groups were performed using appropriate tests.</p><p><strong>Results: </strong>The TNS group showed significantly higher preoperative JOA scores than the control group, but no significant difference in final scores. Both groups demonstrated significant improvement postoperatively. Third-degree SS occurred in the TNS group, although the overall SS grade distribution was significantly lower than in the control group (<i>p</i> = 0.03). SS frequency was significantly reduced in Gruen Zones 2, 3, and 6 in the TNS group.</p><p><strong>Conclusions: </strong>The TNS stem demonstrated a significant reduction in SS progression compared to conventional titanium stems over a 7-year period, with comparable clinical outcomes. However, the occurrence of third-degree SS indicates that material optimization alone may be insufficient, highlighting the need for further design improvements.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}