Femoroacetabular impingement syndrome (FAIS) is a risk factor for future hip osteoarthritis and is prevalent in both athletic and non-athletic populations. This bibliometric review aimed to understand the history of FAIS and provide detailed information for future FAIS research. The Clarivate Analytics Web of Science Core Collection was used to search and obtain all studies between 2020 and 2025 using bibliometrix (ver. 3.0.4) and R package software. Between 2020 and 2025, 1,486 articles were published on FAIS. There was an overall 41.3% downward trend in published research during this period. Furthermore, recent key terms include “physical impairments” and “muscle strength”. Institutions and surgical authors across North America, Europe, and Australia published the highest volume of research papers. Across keywords, femoroacetabular impingement and osteoarthritis had the strongest relationship. FAIS research continues to be led by surgical authors within surgical journals. While surgical key terms have been historically prevalent within the existing literature, research aligning with more conservative management has started to emerge. Despite an increase in physiotherapy researchers, inter-disciplinary collaboration remains limited and concentrated in western countries.

Background: s/Aims: Socioeconomic determinants of health are incompletely characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status influences initial treatment decisions and survival outcomes in patients with CCA, additionally performing multiple sub-analyses based on anatomic location of the primary tumor. Methods: Observational study using the 2018 submission of the Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 patients from 2004−2015 with a CCA were separated based on median household income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th percentile of MHI) groups. Seventy-three percent of patients had complete follow up data, and were included in survival analyses. Survival and treatment outcomes were calculated using R-studio. Results: When all cases of CCA were included, the high-income group was more likely than the low-income to receive surgery, chemotherapy, and local tumor destruction modalities. Initial treatment modality based on income differed significantly between tumor locations. Patients of lower income had higher overall and cancer-specific mortality at 2 and 5 years. Non-cancer mortality was similar between the groups. Survival differences identified in the overall cohort were maintained in the intrahepatic CCA subgroup. No differences between income groups were noted in cancer-specific or overall mortality for perihilar tumors, with variable differences in the distal cohort. Conclusions Lower income was associated with higher rates of cancer-specific mortality and lower rates of surgical resection in CCA. There were significant differences in treatment selection and outcomes between intrahepatic, perihilar, and distal tumors. Population-based strategies aimed at identifying possible etiologies for these disparities are paramount to improving patient outcomes.

Methods: The American College of Surgeons’ National Surgical Quality Improvement Program database was used to identify patients who underwent ACC. Prolonged LOS, non-home discharges, and major complications were assessed as the outcomes of interest. ML models were developed with the TabPFN algorithm and integrated into an open-access website to predict these outcomes. Results: The models for predicting prolonged LOS, non-home discharges, and major complications demonstrated mean areas under the receiver operating characteristic curve (AUROC) of 0.802, 0.816, and 0.702, respectively. These findings highlight the discriminatory capacities of the models: fair (AUROC >0.7) for differentiating patients with major complications from those without, and good (AUROC >0.8) for distinguishing between those with and without prolonged LOS and non-home discharges. According to the SHapley Additive Explanations analysis, single- versus multiple-level surgery, age, body mass index, preoperative hematocrit, and American Society of Anesthesiologists physical status repetitively emerged as the most important variables for each outcome. Conclusions This study has considerably enhanced the prediction of postoperative results after ACC surgery by implementing advanced ML techniques. A major contribution is the creation of an accessible web application, highlighting the practical value of the developed models. Our findings imply that ML can serve as an invaluable supplementary tool to stratify patient risk for this procedure and can predict diverse postoperative adverse outcomes.

Traditional surgical techniques for extradural lumbar schwannomas are associated with considerable morbidity, including spinal instability and injury to the viscera and lumbar plexus. Minimally invasive approaches decrease soft tissue damage, blood loss, and postoperative length of stay. For select extraforaminal schwannomas, a minimally invasive lateral transpsoas approach affords a direct surgical corridor. A 53-year-old obese female presented with 1 year of left iliopsoas weakness and L3 radiculopathy refractory to conservative management. Lumbar spine magnetic resonance imaging revealed a contrast-enhancing mass within the left psoas muscle consistent with an extraforaminal L3 schwannoma. The patient underwent minimally invasive oblique retroperitoneal surgical resection. Intraoperatively, the nerve root was splayed over the superior-lateral portion of the tumor limiting us to subtotal resection with nerve root preservation. The patient had improvement of pain and weakness that persisted at a 3-month follow-up. A minimally invasive lateral/oblique transpsoas approach provides a direct surgical approach for extraforaminal schwannoma. Patient body habitus and the nerve root relationship to the tumor may present limitations for the safe extent of resection.

Background: This study analyzed questions entered online by rotator cuff patients and determined types and quality of websites providing information at the top of queries. Methods: Three strings related to rotator cuff repair were explored in Google Search. The result pages were manually collected under the “People also ask” function for frequent questions and associated webpages. Questions were categorized using Rothwell’s classification with further topical subcategorization. Webpages were evaluated by Journal of American Medical Association (JAMA) benchmark criteria for source quality. Results: One hundred twenty “People also ask” questions were collected with their associated webpages. Based on the Rothwell classification of questions, queries were thematically organized into fact (41.7%), value (31.7%), and policy (26.7%) categories. The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/management (21.7%), and pain (18.3%). The average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most common suggested question for rotator cuff repair/surgery was, “Is rotator cuff surgery worth having?,” while the most common suggested question for rotator cuff repair pain was, “What happens if a rotator cuff is not repaired?” Conclusions The most common questions asked on Google pertaining to rotator cuff repair evaluate management options and relate to the timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding the questions that rotator cuff repair patients are asking online, surgeons can tailor preoperative education to common patient concerns and improve postoperative outcomes.Level of evidence: IV.

Purpose: Medical schools have faced various challenges in preparing their clinical students for the frontlines of a pandemic. This study investigated medical students’ satisfaction with their institutions during the coronavirus disease 2019 (COVID-19) pandemic with the intention of guiding educators in future public health crises. Methods: In this cross-sectional study surveying students in clinical rotations, the primary outcome was overall satisfaction regarding medical schools’ responses to the pandemic, and the four secondary outcomes were school communication, exposure to COVID-19, availability of personal protective equipment, and access to COVID-19 testing. Results: The survey was distributed to ten medical schools, of which 430 students responded for a response rate of 13.0%. While most students were satisfied (61.9%, n=266) with their schools’ response, more than one in five (21.9%, n=94) were dissatisfied. Among the four secondary outcomes, communication with students was most predictive of overall satisfaction. Conclusion In future crises, schools can best improve student satisfaction by prioritizing timely communication.

Periprosthetic joint infections are a major cause of morbidity and mortality following total joint arthroplasty. Two-stage arthroplasty, with the use of an antibiotic cement spacer, is an effective means of managing periperiprosthetic joint infections. There is a lack of data relating to the management, prognosis, and clinical outcomes associated with multiple peri-prosthetic joint infections. Here, we present a case report of a patient successfully treated for three synchronic peri-prosthetic joint infections of both knees and a single hip.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Hip ; Humans ; Joints ; Knee ; Mortality ; Prognosis

There is a spelling mistake of an author's name, and they want to change to Samir Pancholy from Sameer Pancholy.

BACKGROUND/AIMS: Several prognostic markers for heart failure (HF) have been determined but the importance of liver function tests (LFTs) remains unknown. The aim of this study was to determine the prognostic significance, if any, of abnormal LFTs in acute decompensated HF. METHODS: All adult patients (> 18 years of age) who were admitted to a community hospital with a diagnosis of acute decompensated HF during the period January 2008 to December 2009 were identified. Exclusion criteria included acute coronary syndrome, active hepatobiliary disease, renal failure (serum creatinine > or = 2 mg/dL), and malignancy. The primary end point was readmission secondary to acute exacerbation of HF. The Cox proportional hazard model was used for statistical analyses. RESULTS: Univariate analysis showed that serum total bilirubin (TB, p < 0.01), serum B-type natriuretic peptide (p < 0.05), ejection fraction (EF, p < 0.05), and heart rate (p < 0.05) were significant predictors of hospital readmission secondary to acute decompensated HF. Multivariate analysis showed that high serum TB (> 1.3 mg/dL) on admission was an independent predictor (p < 0.05) of hospital readmission secondary to HF. The 'at-risk' group-patients with serum TB > 1.3 mg/dL and/or EF < 35% on admission-had a readmission rate that was 87% +/- 20% (p < 0.05) higher than those with neither criterion. CONCLUSIONS: In patients with acute decompensated HF, elevated serum TB on admission with or without low EF (< 35%) predicts a worse prognosis and early future readmission, secondary to HF.
Aged ; Aged, 80 and over ; Bilirubin/*blood ; Biological Markers/blood ; Female ; Heart Failure/*blood/diagnosis ; Humans ; Kaplan-Meier Estimate ; Liver Function Tests ; Male ; Patient Readmission/statistics & numerical data ; Prognosis ; Retrospective Studies