Medicina
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Background and Objectives: Proximal tibiofibular joint detachment (PTFJD) is a fibular untethering procedure during lateral closing-wedge high tibial osteotomy (LCWHTO) for varus knee osteoarthritis. However, the PTFJD procedure is technically demanding, and confirmation of clear joint separation is not straightforward. The aim of this study was to compare the degree of completion and safety of PTFJD versus tibial-sided osteotomy (TSO); this latter procedure is our novel technique for fibular untethering during LCWHTO. ⋯ However, the osteotome was blocked posteriorly by the popliteus muscle in the TSO group cases, indicating protection of posterior neurovascular structures during the TSO procedure. Conclusions: TSO, a novel fibular untethering procedure for LCWHTO, resulted in clear separation of the fibula from the lateral tibial cortex, and protection of posterior neurovascular structures by the popliteus muscle during the procedure. We anticipate that our novel surgical technique will provide more clear-cut and safer fibular untethering for LCWHTO.
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Comparative Study
Comparison of Asymptomatic Brain Lesions Between Thalassemia Major and Sickle Cell Anemia Patients.
Background and Objectives: This study aimed to identify asymptomatic brain lesions in patients with β-thalassemia major (TM) and sickle cell anemia (SCA) and evaluate the correlation of these lesions with factors such as splenectomy, thrombocytosis, and blood transfusions. Materials and Methods: A total of 26 patients with thalassemia major and 23 patients with sickle cell anemia were included. Ischemic lesions were categorized as lacunar, small vessel, or multifocal. ⋯ Ferritin levels were significantly higher in the thalassemia major group (2018.92 ng/mL) than in the sickle cell anemia group (660.39 ng/mL) (p < 0.001). Conclusions: Although ischemic lesions were more frequently observed in patients with sickle cell anemia, the difference was not statistically significant. These findings emphasize the importance of ongoing surveillance and individualized management to mitigate cerebrovascular risks in both patient populations.
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Background and Objectives: Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated, fibroinflammatory, multiorgan disease with an obscure pathogenesis. Findings indicating excessive platelet activation have been reported in systemic sclerosis, which is another autoimmune, multisystemic fibrotic disorder. The immune-mediated, inflammatory, and fibrosing intersections of IgG4-RD and systemic sclerosis raised a question about platelets' role in IgG4-RD. ⋯ If the platelets' role is validated through further carefully designed research, the therapeutic potentials of selected conventional and/or novel antiplatelet agents remain to be evaluated in patients with IgG4-RD. Transcriptomics and/or proteomics research with platelets should take into account the relatively low amounts of platelet mRNA, miRNA, and protein. Secondary analysis of omics data sets has great potential to reveal new and valuable information.
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Review Case Reports
Congenital Bullous Syphilis: A Case Report from Italy and a Comprehensive Literature Review.
Background and Objectives: Congenital syphilis remains a significant global health concern, with severe morbidity and mortality if undiagnosed and untreated. Although many infants appear asymptomatic at birth, subtle clinical signs-including bullous lesions (congenital bullous syphilis, also known as pemphigus syphiliticus)-may facilitate early detection. Recognizing this rare manifestation is crucial for timely intervention, reducing serious outcomes. ⋯ Conclusions: Bullous syphilis, though rare, is an important early sign of congenital syphilis. Prompt recognition and diagnosis-enabled by diligent maternal screening, targeted neonatal testing, and careful clinical examination-are essential to initiate timely penicillin therapy and prevent severe complications or death. This review underscores the need for heightened clinical vigilance and adherence to established guidelines for syphilis screening and treatment during pregnancy, ultimately improving neonatal outcomes.
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Review
Short-Term and Long-Term Effects of Bariatric Surgery on Diabetic Retinopathy: A Systematic Review.
Background and Objectives: Diabetic retinopathy (DR) is a common diabetes complication and a leading cause of blindness. Although bariatric surgery (BS) is well studied for diabetes management, its effects on DR onset and progression, particularly long-term outcomes, remain underexplored. This review seeks to evaluate the short- and long-term retinal outcomes of BS in diabetic patients. ⋯ However, the long-term effects remain uncertain due to conflicting findings. Rapid glycemic changes after surgery may pose risks of DR progression. Large-scale, longitudinal studies are needed to clarify the role of BS in DR progression and regression.