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Background: Posterior malleolar fractures are commonly assessed using two-dimensional measurements and morphology-based classification systems. However, ankle fracture morphology is inherently three-dimensional, and the reproducibility of CT-based volumetric segmentation for malleolar fracture fragments has not been sufficiently established. Objectives: This study aimed to evaluate the relationship between lateral and posterior malleolar fragment volumes in homogeneous supination–external rotation (SER)-type trimalleolar ankle fractures and to assess the intraobserver and interobserver reproducibility of a manual CT-based three-dimensional volumetric segmentation workflow. Methods: This retrospective musculoskeletal imaging study included 71 patients with SER-type trimalleolar ankle fractures who underwent preoperative computed tomography (CT). Posterior and lateral malleolar fracture fragments were segmented on thin-slice axial CT images using a standardized manual contour-based slice-by-slice workflow. Fragment volumes were calculated using dedicated volumetric imaging software. The association between lateral and posterior malleolar fragment volumes was assessed using Spearman correlation and multivariable linear regression analyses. Measurement reproducibility was evaluated using intraclass correlation coefficients for absolute agreement [ICC(A,1)] and Bland–Altman analyses. Results: The median lateral and posterior malleolar fragment volumes were 8.63 cm³ (interquartile range [IQR], 7.18–10.71) and 2.64 cm³ (IQR, 1.88–4.24), respectively. A weak but statistically significant positive correlation was observed between lateral and posterior malleolar fragment volumes (Spearman rho = 0.313, p = 0.008). In multivariable linear regression analysis, lateral malleolar fragment volume remained independently associated with posterior malleolar fragment volume after adjustment for age, sex, and body mass index (B = 0.316, standardized β = 0.39, p = 0.002). Intraobserver and interobserver reproducibility were excellent for all volumetric measurements, with ICC(A,1) values ranging from 0.996 to 0.999. Bland–Altman analyses demonstrated low mean bias and narrow limits of agreement across all comparisons. Geometric agreement was also excellent, with Dice similarity coefficient values ranging from 0.93 to 0.96 across intraobserver and interobserver segmentation comparisons.

Fibromyalgia Syndrome (FMS) is a complex disease characterized by widespread pain, fatigue, emotional disturbances, and autonomic dysfunction. Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) has emerged as a potential noninvasive approach to modulate FMS-related symptoms. To compare the effects of left and bilateral taVNS on pain, mood, functionality, and autonomic nervous system (ANS) activity in individuals with FMS. Forty female individuals with FMS were assigned to either a left (n = 20) or a bilateral (n = 20) taVNS group. Both received 11 sessions of taVNS targeting the tragus and concha regions (30 minutes each, 25 Hz, 300 µs) over nonconsecutive days, excluding weekends and menstrual periods. Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Fibromyalgia Impact Questionnaire (FIQ) were assessed. ANS activity was evaluated via heart rate variability (HRV). After 11 sessions of taVNS, a 2-week follow-up was performed. No significant differences were observed between groups except for FIQ and BAI on day 28 (p = .002-0.008). Both groups showed significant within-group improvements in VAS (r = 0.87-0.94; p < .001), BDI (r = 0.46-0.71; p < .001), FIQ (r = 0.95-0.99; p < .001), and BAI (r = 0.69-0.94; p < .001) scores. Parasympathetic Nervous System (PNS) (p = .365-0.776) and Sympathetic Nervous System (SNS) (p = .598-0.880) indices, which are the subparameters of HRV, showed no significant between-group differences, with small effect sizes (r < 0.15). Both stimulation protocols effectively reduced pain and improved mood and functionality in fibromyalgia, indicating a safe, noninvasive adjunctive treatment option. (Identifier: NCT06871306).

Amaç: Biz bu çalışmada akut ve kronik kemik çekiç cerrahi tedavisinin sonuçlarını karşılaştırmayı amaçladık. Yöntem: Toplam 33 kemik parça içeren 17 akut (grup 1) ve 16 kronik (grup 2) çekiç parmak hastası dahil edildi. Akut olgular grup 1, kronik olgular grup 2 olarak isimlendirildi. Yaş, cinsiyet, başvuru şekli, travma tipi gibi klinik veriler, hangi parmağın yaralandığı, başvuru zamanı, ayrılan kemik parçası miktarı, cerrahi öncesi ve sonrası ekstansiyon kaybı açısı, cerrahi tedavi yöntemi ve Crawford sınıflamasına göre derecesi hasta dosyalarından retrospektif olarak kayıt edildi. Bulgular: Gruplar arasında yaş, cinsiyet, travma şekli, hangi parmak olduğu ayrılan kemik oranı, tedavi şekli, ilk ve son ekstansiyon açıları, deplasman ve crawford sınıflaması açısından istatistiksel anlamlı bir fark bulunmazken (p>0.05), başvuru süresi (7.0 [2.5-9.5] vs 60.0 [30.0-90.0], p<0.001). Sonuç: Bu çalışma doğru tedavi seçimi ile kronik kemik çekiç vakalarında cerrahi tedavi sonuçların akut vakalar kadar iyi olabileceğini göstermektedir. Sonuçlarımızı teyit etmek için daha fazla katılımcının olduğu prospekif çalışmalara ihtiyaç vardır.

Introduction Aseptic loosening is one of the most important complications of arthroplasty surgery. It is known that immune response against particles plays role in the pathogenesis of aseptic loosening. Polyethylene (PE) has an important place in these particles. There are limited in vivo studies examining aseptic loosening caused by PE residues. Objective The aim of the present study is to evaluate the aseptic loosening created by highly cross-linked PE (HXLPE) and vitamin E-added PE particles in an in vivo knee prosthesis model. Materials and methods Thirty-nine male Sprague-Dawley rats, which were randomized into three groups, were included in the study. After surgical exposure of knee joints of rats, femoral intramedullary canals were drilled and instilled with isolated saline solution and saline solution that contained standard PE or vitamin E-added PE particles according to their groups. Afterwards, a titanium implant was placed on the femoral articular surface of each animal. Rats received intraarticular injections weekly of the same solution, which was initially instilled into their femoral canal. The rats were sacrificed at the end of the third week and then underwent radiological and histopathological evaluations. Result In histopathological evaluation, periprosthetic membrane formation, inflammatory cell change, and cellular damage of cartilage and bone tissue around the implant were assessed. There was a statistically lesser amount of cellular damage and periprosthetic membrane formation in the vitamin-E/HXLPE group compared to the HXLPE group (p=0.04, p=0.001). No significant difference was found between the PE groups with respect to inflammatory cells (p=0.715). Conclusions HXLPE caused more significant osteolysis compared to VE-HXLPE. Antioxidants in PE could provide a reduction in osteolysis and aseptic loosening.

Background: Plantar fasciitis (PF) is the most common cause of heel pain. Previous work has shown promising results regarding platelet-rich plasma (PRP) injections for the treatment of PF. The aim of this study is to prospectively compare the efficacy of PRP and autologous blood injections in a randomized anonymized patient group to treat PF. Methods: PF patients who failed at least 6 weeks of noninvasive conservative treatment aged between 40 and 65 years were recruited to be in the study. Patients were randomly assigned into group A (PRP) or group B (autologous blood). Injections were performed under ultrasonographic guidance in a double-anonymized manner. The groups were compared according to preinjection and postinjection health-related quality of life (HRQoL) scores measured with Foot and Ankle Disability Index (FADI) and visual analog scale (VAS). Intragroup comparative analysis was also performed at different time points. Independent t tests and repeated measures analyses of variance were used for statistical analysis, with P <.05 set for statistical significance. Results: Group A (PRP) included 30 (19 female, 11 male) patients with mean age 52.2 ±6.3; group B (ABI) included 30 (20 female, 10 male) patients with mean age 52.7 ± 6.5. Both groups had similar body mass index ( P = .719). No injection-related complications were recorded. After treatment, both groups had improved FADI and VAS scores compared to the baseline. Although the mean HRQoL scores were higher in the PRP group, there was no significant difference between the 2 groups ( P _VAS = .589; P _FADI = .742). Conclusion: Participants with plantar fasciitis improved statistically significantly after either PRP or ABI injections compared with baseline HRQoL scores, with no significant differences seen between the groups. Level of Evidence: Level I, prospective randomized double-anonymized clinical comparative study.

Akademisyen Yayınevi yöneticileri, yaklaşık 30 yıllık yayın tecrübesini, kendi tüzel kişiliklerine aktararak uzun zamandan beri, ticarî faaliyetlerini sürdürmektedir. Anılan süre içinde, başta sağlık ve sosyal bilimler, kültürel ve sanatsal konular dahil 750 kitabı yayımlamanın gururu içindedir. Uluslararası yayınevi olmanın alt yapısını tamamlayan Akademisyen, Türkçe ve yabancı dillerde yayın yapmanın yanında, küresel bir marka yaratmanın peşindedir.