Are there any benefits for post-operative splinting after carpal tunnel release? A systematic review and meta-analysis.

BACKGROUND: There is a controversy on the effectiveness of post-operating splinting in patients with carpal tunnel release (CTR) surgery. This study aimed to systematically evaluate various outcomes regarding the effectiveness of post-operating splinting in CTR surgery. METHODS: Multiple databases, including PubMed, EMBASE, CINAHL, Web of Science, and Cochrane, were searched for terms related to carpal tunnel syndrome. A total of eight studies involving 596 patients were included in this meta-analysis. The quality of studies was evaluated, and their risk of bias was calculated using the methodological index for non-randomized studies (MINORS) and Cochrane's collaboration tool for assessing the risk of bias in randomized controlled trials. Data including the visual analogue scale (VAS), pinch strength, grip strength, two-point discrimination, symptom severity score (SSS), and functional status scale (FSS) were extracted. RESULTS: Our analysis showed no significant differences between the splinted and non-splinted groups based on the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. The calculated values of the standardized mean difference (SMD) or the weighted mean difference (WMD) and a 95% confidence interval (CI) for different variables were as follows: VAS [SMD = 0.004, 95% CI (-0.214, 0.222)], pinch strength [WMD = 1.061, 95% CI (-0.559, 2.681)], grip strength [SMD = 0.178, 95% CI (-0.014, 0.369)], SSS [WMD = 0.026, 95% CI (- 0.191, 0.242)], FSS [SMD = 0.089, 95% CI (-0.092, 0.269)], and the two-point discrimination [SMD = 0.557, 95% CI (-0.140, 1.253)]. CONCLUSIONS: Our findings revealed no statistically significant differences between the splinted and non-splinted groups in terms of the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. These results indicate that there is no substantial evidence supporting a significant advantage of post-operative splinting after CTR.

Mortality following proximal femoral fractures in elderly patients: a large retrospective cohort study of incidence and risk factors.

BACKGROUND: Global prevalence of osteoporosis and fragility fractures is increasing due to the aging population. Proximal femoral fractures are among the most common orthopedic conditions in elderly that significantly cause health deterioration and mortality. Here, we aimed to evaluate the mortality rates and risk factors, besides the functional outcomes after these injuries. METHODS: In a retrospective cohort study, all patients admitted with a femoral neck or intertrochanteric fracture between 2016 and the end of 2018 were enrolled in this study. Medical records were reviewed to include patients over 60 years of age who had a proximal femoral fracture and had a complete medical record and radiographs. Exclusion criteria included patients with pathological fractures, cancer under active treatment, follow-up loss, and patient access loss. Demographic and clinical features of patients alongside the details of fracture and patient management were recorded and analyzed. In-hospital and post-discharge mortalities due to included types of fractures at one and 12 months were the primary outcome. Modified Harris Hip Scores (mHHS) was the measure of functional outcome. RESULTS: A total of 788 patients including 412 females (52.3%) and 376 males (47.7%) with a mean age of 76.05 ± 10.01 years were included in this study. Among patients, 573 (72.7%) had an intertrochanteric fracture, while 215 (27.3%) had a femoral neck fracture, and 97.1% of all received surgical treatment. With a mean follow-up of 33.31 months, overall mortality rate was 33.1%, and 5.7% one-month and 20.2% 12-months rates. Analysis of 1-month mortality showed a significant mortality difference in patients operated after 48 h of fracture (p = 0.01) and in patients with American Society of Anesthesiologists (ASA) scores of 3-4 compared to ASA scores of 1-2 (p = 0.001). One-year mortality data showed that the mortality rate in femoral neck fractures was lower compared to other types of fracture. Surgical delay of > 48 h, ASA scores of 3-4, and treatment by proximal femoral plate were associated with shorter survival. The overall mean mHHS score was 53.80 ± 20.78. CONCLUSION: We found several risk factors of mortality, including age ≥ 80 years, a > 48-hour delay to surgery, and pre-operative ASA scores of 3-4 in patients with proximal femoral fracture. Furthermore, the use of a proximal femoral plate was a significant risk factor for mortality and lower mHHS scores.

Comparison of visfatin levels in patients with breast cancer and endometrial cancer with healthy individuals: A systematic review and meta-analysis.

Background and aims: Endometrial cancer (EC) and breast cancer (BC) are prevalent in women. Visfatin is an adipokine that, in addition to being involved in metabolism and inflammation, may also be interested in carcinogenesis. Visfatin measurement in cancer patients has shown that visfatin levels in cancer patients differed from those in healthy subjects. Various studies have shown that the level of visfatin is increased in people within EC and BC, and this difference has a significant relationship with prognosis. Methods: A comprehensive search of related articles from PubMed, Scopus, Web of Science, and the Google Scholar database was done by November 2021. Eligible articles measured visfatin levels in patients with breast cancer and EC. After selecting the eligible studies, the data were extracted and analyzed using the random effect method. Results: Given the effect size and the confidence interval obtained, the total level of visfatin in cancer patients was different from that in healthy individuals, and this difference was statistically significant. However, the difference in visfatin levels in patients with breast cancer was much more significant than in patients with EC compared to the control group. Conclusions: Due to the significant increase in visfatin levels in these patients, visfatin may be a potential prognostic factor in breast and ECs. Visfatin levels in cancer patients differed from those in healthy subjects, and this difference was also statistically significant (p-values = 0.00). Visfatin levels also differed between breast cancer patients and healthy individuals, which was statistically significant (p-values = 0.00). The difference in visfatin levels between patients with EC and healthy subjects was statistically significant (p-values = 0.047).

Marangoni spreading and contracting three-component droplets on completely wetting surfaces.

SignificanceThe shape and dynamics of small sessile droplets are dictated by capillary forces. For liquid mixtures, evaporation adds spatio-temporal modulation to these forces that can either enhance or inhibit droplet spreading, depending on the direction of the resulting Marangoni flow. This work experimentally and numerically demonstrates the coexistence of two antagonistic Marangoni flows in a ternary mixture. Played against each other, they can choreograph a boomerang-like wetting motion: Droplets initially rapidly spread, then contract into a compact cap shape. While such a behavior has been impossible in wetting scenarios of simple liquids, it enables spread-retract-remove surface processing with the addition of a single small liquid volume, demonstrated here in a surface-cleaning experiment.

The reliability of the Wagner Scale for evaluation the diabetic wounds: A literature review.

BACKGROUND AND AIMS: Classification of wound severity is important in medical care decisions specially in diabetic patients. The Wagner Scale provides a structure to determine the severity of a wound by examining its depth and extent. The adequate reliability of this instrument, like other instruments for measuring health status, is important. So, the aim of this review is to report evidence on the reliability of the Wagner scale. METHOD: A comprehensive search was performed in databases. Observational studies that assessed the reliability of the Wagner scale, with statistical measures, were included. Methodological quality of studies was evaluated with the COSMIN checklist. Finally, we report the reliability measurements, narratively. RESULTS: We assessed 7 studies. In all studies 1873 subjects participated. Methodological quality was good only in one study. In two studies used of weighted kappa (Inter Observer Reliability) that reliability was in median level in both studies. The relation between Wagner score and amputation were report in two studies that measured by X2trend and regression analysis. In four measurements, reported the correlation between Wagner with ulcer healing by X2trend, Log Rank, Kaplan-Meier, and inter quartile range. CONCLUSION: It can be confirmed that the reliability of the Wagner scale is appropriate and this tool is recommended to evaluate the severity of the wounds specially in diabetic patients. It should also be noted that the user of the scale must be trained. In future studies, it is recommended to use appropriate methodology and complete reports for the reliability of Wagner scale.

Thermal Marangoni Flow Impacts the Shape of Single Component Volatile Droplets on Thin, Completely Wetting Substrates.

Despite surface energies dictating complete wetting, it has been classically observed that volatile alkanes do not spread completely on glass substrates, and faster evaporation rates lead to higher contact angles. Here we investigate how substrate thickness influences this behavior. For sufficiently thin substrates, we find alkanes evaporate slower and display higher apparent contact angles, at odds with the typical explanations involving just evaporation, capillarity, and viscous dissipation. We derive the droplet temperature distribution and use it as part of a criteria to show that thermal Marangoni contraction plays a significant role in establishing droplet shape on thin substrates.

Surface coatings including fingerprint residues can significantly alter the size and shape of bloodstains.

When conducting a blood pattern analysis (BPA) the size, shape, distribution, and location of bloodstains found at a crime scene may be critical in forming a hypothesis as to what transpired during a bloody event. Prior studies have demonstrated that the size and shape of a bloodstain on a smooth surface are determined from impact dynamics and to a lesser degree by the target material itself. Yet, these studies have relied on clean surfaces, and it is unclear whether the presence of microscopic coatings and residues could significantly alter the size or shape of the dried stain. Here, in the present work, experiments are conducted to demonstrate that various coatings, such as the sebaceous residue from a latent fingerprint, can dramatically alter the size and shape of the stain from the moment of impact through the drying process. These experiments also highlight that a drop impacting a tilted superhydrophobic-coating glass substrate can cause the blood drop to completely recoil without leaving a stain. Relying on a combination of high-speed and time-lapse photography, the specific stages in the stain evolution responsible for the deviations from the current models are identified. At a relatively low impact velocity, the stain sizes on the coated glass surfaces were 35-72% smaller than on the clean glass surface. At a higher impact velocity, the stains on the coated surfaces were not only smaller, but also contained drop spatter around the primary stain that was not observable in the absence of the microscopic coatings. The reduction in bloodstain size did not appreciably change when a chemical was added to deactivate the anticoagulant and allow the blood to clot.

Trapping a Hot Drop on a Superhydrophobic Surface with Rapid Condensation or Microtexture Melting.

A water drop can bounce upon impacting a superhydrophobic surface. However, on certain superhydrophobic surfaces, a water drop will stick rather than bounce if it is sufficiently hot. Here, we aim to better understand the mechanisms that can lead to this bouncing-sticking transition. Specifically, we model two potential mechanisms in which a superhydrophobic surface could trap a sufficiently hot drop within milliseconds: melting of microtextured wax and condensation of the vapor within the superhydrophobic texture. We then test these mechanisms through systematic drop impact experiments in which we independently vary the substrate and drop temperatures on a waxy superhydrophobic Nasturtium leaf. We find that, whenever the surface or the drop is above a microtexture-melting temperature, the drop sticks. Below this temperature, a critical temperature threshold for bouncing can be predicted and controlled by considering the relative timescales between condensation growth and drop residence time. We envision that these results can provide insight into the design of a new class of superhydrophobic surfaces to act as a rapid thermal fuse to prevent drops that exceed a critical temperature from bouncing onto a thermally sensitive target.

Heat exchange between a bouncing drop and a superhydrophobic substrate.

The ability to enhance or limit heat transfer between a surface and impacting drops is important in applications ranging from industrial spray cooling to the thermal regulation of animals in cold rain. When these surfaces are micro/nanotextured and hydrophobic, or superhydrophobic, an impacting drop can spread and recoil over trapped air pockets so quickly that it can completely bounce off the surface. It is expected that this short contact time limits heat transfer; however, the amount of heat exchanged and precise role of various parameters, such as the drop size, are unknown. Here, we demonstrate that the amount of heat exchanged between a millimeter-sized water drop and a superhydrophobic surface will be orders of magnitude less when the drop bounces than when it sticks. Through a combination of experiments and theory, we show that the heat transfer process on superhydrophobic surfaces is independent of the trapped gas. Instead, we find that, for a given spreading factor, the small fraction of heat transferred is controlled by two dimensionless groupings of physical parameters: one that relates the thermal properties of the drop and bulk substrate and the other that characterizes the relative thermal, inertial, and capillary dynamics of the drop.

Macrotextured spoked surfaces reduce the residence time of a bouncing Leidenfrost drop.

Liquid drops can bounce when they impact non-wetting surfaces. Recently, studies have demonstrated that the time that the bouncing drop contacts a superhydrophobic surface can be reduced by incorporating ridged macrotextures on the surface. Yet the existing models aimed at explaining this phenomenon offer incompatible predictions of the contact time when a drop impacts multiple intersecting macrotextures, or spokes. Furthermore, it is unclear whether the effects of the macrotexture on the drop hydrodynamics extend to non-wetting surfaces in which direct contact is avoided by a thin vapor layer. Here we demonstrate that the phenomenon observed for macrotextured, superhydrophobic surfaces extends to macrotextured, wettable surfaces above the Leidenfrost temperature. We show that the number of droplets and overall residence time both depend on the number of intersecting spokes. Finally, we compare and contrast our results with mechanistic models to rationalize various elements of the phenomenon.