Medicover

Background Hip fractures, particularly among the aging population, present a significant burden due to their association with morbidity, mortality, and long-term disability. Total hip arthroplasty (THA) is increasingly being adopted for fracture management in active patients, but implant performance data in real-world Indian settings remain sparse. This study assesses the early clinical efficacy, functional outcomes, and implant survivorship of the Latitud™ total hip replacement system (HRS) (Meril Healthcare Pvt. Ltd., Vapi, India), a novel prosthesis designed and manufactured in India, in patients undergoing THA for hip fractures. Methods This post hoc analysis derives from a prospective, multi-center, post-marketing surveillance study conducted across 11 tertiary care centers in India. A total of 44 adult patients presenting with various fracture patterns, including femoral neck, femoral head, intertrochanteric, sub-capital, and head-neck fractures, were evaluated following THA using the Latitud™ HRS. The primary objectives of the study were implant survivorship and adverse events over a two-year follow-up period, whereas the secondary objective of the study was to assess functional outcomes using the Harris hip score (HHS) and Oxford hip score (OHS) at six weeks, six months, one year, and two years postoperatively. Paired t-tests or Wilcoxon signed-rank tests were used for statistical comparisons, with p < 0.05 considered significant. Results A total of 44 patients were identified with the following fracture types: femoral neck (n = 18), femoral head (n = 8), head-neck (n = 2), and hip fractures (n = 12), with one case each of intertrochanteric, subcapital, intracapsular neck of femur (ICNF), and neck of femur fractures due to fall at home. Functional outcomes significantly improved, with the mean HHS increasing from 9.19 ± 9.52 preoperatively to 89.61 ± 3.57 (p < 0.0001), and the OHS from 4.89 ± 4.41 to 44.89 ± 3.77 (p < 0.0001). No serious adverse events were observed apart from the isolated revision case. At two years, implant survivorship was 97.7%, with a single revision due to polyethylene liner fracture. No other major complications, including infections, dislocations, or periprosthetic fractures, were reported. Conclusion The Latitud™ HRS demonstrated excellent short-term survivorship and marked functional improvement in patients with hip fractures, with minimal complications. These findings support its safety and effectiveness in the Indian clinical context and suggest its potential as a reliable implant for fracture-related THA. Further large-scale, long-term comparative studies are warranted to confirm these outcomes.

Many patients with atrial functional mitral regurgitation are not suitable candidates for surgery or transcatheter repair. For transcatheter mitral valve replacement, a common contraindication is the risk of left ventricular outflow tract obstruction, particularly in patients with atrial functional mitral regurgitation, who have characteristically small left ventricles. Herein, we examine the outcomes of transcatheter mitral valve replacement using the AltaValve system, which employs atrial fixation thus minimizing left ventricular outflow tract obstruction risk. Patients with severe, symptomatic mitral regurgitation who were treated in the AltaValve early feasibility study or on the basis of a compassionate use exemption. The definition of atrial functional mitral regurgitation required the presence of: (1) severe mitral regurgitation; (2) atrial fibrillation; (3) normal left ventricular size; (4) left ventricular ejection fraction ≥50%; and (5) absence of organic mitral disease. Procedural outcomes, 30-day survival, and echo findings are reported. Fourteen patients (71% women, mean age 77.9 years, Society of Thoracic Surgeons Predicted Risk of Mortality score 5.4%) were treated, including 11 via transseptal delivery and 3 via a transapical approach. Technical success and mitral regurgitation reduction from severe to none/trace were achieved in all cases. There were no cases of left ventricular outflow tract obstruction. All-cause mortality at 30 days was 14% (2/14). Class III/IV New York Heart Association status was reduced from 79% at baseline to 0% at 30 days. At 30 days, 11 of 12 surviving patients had an available echocardiogram; mitral regurgitation severity was trace/none in 90.9% (10/11) and mild in 9.1% (1/11). The AltaValve system shows promising early procedural and clinical results for the unique anatomy of patients with atrial functional mitral regurgitation. Long-term clinical studies to demonstrate the benefit of this system are warranted.

ContextDespite prolactin´s (PRL) role in stimulating hematopoiesis, anemia is commonly observed in men with macroprolactinomas. However, hematological changes in men with microprolactinomas and women with prolactinomas remain unexplored, and the impact of erythropoietic alterations on quality of life (QoL) is still unclear.ObjectiveTo explore sex-related changes in red blood cell (RBC) parameters and their potential impact on QoL at initial diagnosis of prolactinoma and after normalization of PRL under dopamine agonists.DesignRetrospective, monocentric study involving 205 patients with prolactinoma (127 women, 62%). The SF-36 QoL questionnaire was administered to 57 women and 34 men.ResultsIn women, no significant changes in RBC parameters were observed at diagnosis or after PRL normalization, regardless the adenoma size. Conversely, men with microprolactinoma showed a significant increase in hematocrit (HCT) and hemoglobin (Hb) levels after PRL normalization (median HCT 42.3 vs.44.0%; Hb 14.5 vs. 15.1 g/dL; both p < 0.005). Men with macroprolactinoma exhibited similar improvements (HCT 40.2 vs. 43.9%; Hb 14.0 vs. 15.1 g/dL; both p < 0.0001). In men, hypogonadism was observed in 73% of patients at baseline, and in 11% after PRL normalization. In male patients where SF-36 was administered at diagnosis and after PRL normalization, energy improvement was observed (median 50 vs. 60, p < 0.05). While changes in Hb and HCT were not significantly impacting the QoL of women and men, persistence of hypogonadism after PRL normalization, negatively impacted all the QoL scores of men.ConclusionPatients with prolactinoma show sex-dependent changes in RBC parameters. Unlike women, men exhibit decreased HCT and Hb levels irrespective of adenoma size. Of note, the failure to recover from hypogonadism significantly affected the QoL of men.

Skin cancers are the most common cancers and they are divided into two types: melanoma and non-melanoma skin cancers (NMSCs). Melanoma is the most lethal and aggressive type of skin cancer. The incidence of this type of cancer is increasing. Mortality from melanoma can be reduced by avoidance of exposure to ultraviolet radiation and regular skin examination. Materials and methods of research English-language scientific literature available in the PubMed and Google Scholar databases was reviewed using the following keywords: ”melanoma”; ”early-detection”; ”self-screening”; ”tanning”; ”sunscreen”; ”dermatoscopy”; ”mortality”; ”prevention”; ”risk-factors”; ”UV protection”; ”epidemiology”. Aim of the study The purpose of this narrative review is to present risk factors, prevention and the importance of early detection of melanoma. This review also shows that it is possible to increase people's awareness of skin self-examination and the importance of UV protection through the use of modern technology (text messaging). Conclusions There are many risk factors for melanoma. People's awareness of the risks of UV exposure from both sunbathing and tanning beds is increasing. More and more people are starting to protect themselves from the sun and regularly check their skin. This behavior reduces the risk of developing melanoma and increases the chances of detecting melanoma in its early stages.

Introduction Women who want to get pregnant soon often ask their doctors how to prepare best. During such a visit, doctors usually mention folic acid supplementation, a check-up with the dentist and gynaecologist or vaccinations. However, it is also worth pointing out the importance of lifestyle factors that affect fertility and fetal development. Modifying daily habits can improve fertility naturally and make getting pregnant faster. An increasing number of studies are being published on the importance of nutrition, physical activity, sleep, stress, stimulants and other factors on women's reproductive health. This article is a summary of the current state of knowledge in this area. Aim of the study The aim of this study is to review the literature and summarize current state of knowledge on the association between lifestyle factors and female reproductive function. Material and methods of research This literature review based on researches from PubMed platform. We searched articles describing connection between potentially modifiable lifestyle factors and women’s fertility. Search terms included keywords: „lifestyle”, „female fertility”, „obesity”, „sleep”, „nutrition”, „diet”, „stress”, „physical activity”, „smoking”, „alcohol”, „weight loss”, „reproductive health”.

Carriers of germline pathogenic variants (PVs) in succinate dehydrogenase genes (SDHx) are at risk of developing tumors, including paragangliomas, gastrointestinal stromal tumors, and renal cell carcinomas. Early tumor detection is paramount for improved clinical outcome. Blood-based biomarkers could aid in identifying individuals with PVs early and provide functional evidence in patients with variants of unknown significance. Blood plasma, urine, peripheral blood mononuclear cells, and erythrocytes from patients with and without SDHx PVs were investigated for central carbon metabolites. These were measured by liquid chromatography-tandem mass spectrometry and nuclear magnetic resonance spectroscopy and included among others, succinate, fumarate, α-ketoglutarate, and lactate. Plasma succinate to fumarate ratios effectively distinguished tumor-bearing and asymptomatic patients with and without SDHx PV with promising diagnostic performance (areas under the receiver operating characteristic curve 0.86-0.95), although higher levels were noted in individuals with SDHB PV. Metabolites in urine and in peripheral blood mononuclear cell extracts were largely similar between groups. Erythrocytes showed strong metabolic alterations in patients with SDHx PV compared to controls, with 8 of 13 low-molecular organic acids being significantly different (P < .05). The lactate-α-ketoglutarate-ratio of erythrocytes identified individuals with SDHx PV equally well as plasma, with a sensitivity and specificity of 92% (AUC 0.97). Blood biomarkers have been underutilized for identifying carriers of SDHx PV or to validate variants of unknown significance. Our findings advocate for further investigation into a combined approach involving plasma and erythrocytes for future diagnostic strategies.