搜索结果：legs

Calcium ion (Ca2+) acts as a second messenger involved in various adaptations by activating signaling pathways. The expression of Ca2+ regulators is modified by resistance training. Thus, Ca2+ signaling may be altered during a period of resistance training. In this study, male Sprague-Dawley rats underwent repeated resistance exercise via transcutaneous electromyostimulation, and the expression of Ca2+-related factors was examined 3&#x202f;h after the 1st, 5th, and 10th exercise sessions. Expression of sarcolipin (SLN) and regulator of calcineurin 1 (RCAN1) was significantly higher in exercised legs than control legs after the 5th (p&#x202f;<&#x202f;0.001) and 10th sessions (p&#x202f;<&#x202f;0.001). Calcineurin expression showed significant main effects of exercise (p&#x202f;=&#x202f;0.009) and session (p&#x202f;<&#x202f;0.001). A significant main effect of session was also observed for Ca2+/calmodulin-dependent protein kinase II (CaMKII) (p&#x202f;<&#x202f;0.001), CaMKII &#x3b1; (p&#x202f;<&#x202f;0.046), CaMKII &#x3b2; (p&#x202f;=&#x202f;0.002), and CaMKII &#x3b3; (p&#x202f;<&#x202f;0.001). In contrast, expression of sarcoplasmic reticulum Ca2+-ATPase (SERCA) did not change with repeated electromyostimulation. Pearson's correlation analysis showed a significant positive correlation between the expression of SLN and RCAN1 (r&#x202f;=&#x202f;0.630, p&#x202f;=&#x202f;0.005) and between SLN and CaMKII &#x3b3; (r&#x202f;=&#x202f;0.471, p&#x202f;=&#x202f;0.048), as well as a trend for a positive correlation between SLN and CaMKII (r&#x202f;=&#x202f;0.463, p&#x202f;=&#x202f;0.053). These results suggest that repeated sessions of electromyostimulation increase SLN expression, which may in turn contribute to enhanced Ca2+ signaling after exercise.

Visual cues play a central role in romantic attraction, yet individuals may not accurately recall what captured their attention. Drawing on dual-process models of cognition, this study examined the correspondence between measured gaze behavior and retrospective self-reported salience in women's romantic perception. Sixty-eight women viewed 10 romantic scenes portraying heterosexual couples while their eye movements were recorded. Five areas of interest (AOIs)-female face, male face, female body, male body, and background-were analyzed across key eye-tracking metrics: total dwell time, average fixation duration, fixation count, and first fixations. Participants then ranked these AOIs by perceived salience and reported up to three visual attraction cues (e.g., smile, hands, legs) per AOI. Women's sustained visual attention was preferentially directed toward same-sex targets. Faces served as attentional anchors, attracting both early attention and deeper processing, as reflected in longer fixation durations, whereas gender differences were more pronounced for bodies, with male bodies consistently receiving the least attention. Introspective access was metric-specific: Self-reports aligned most strongly with fixation duration, moderately with first fixation, weakly with total dwell time, and not with fixation count. At the cue level, early orienting showed only limited correspondence with the most salient self-reported cue, but stronger alignment when broader any-match criteria were applied. Self-reports prioritized expressive (e.g., smile, eyes) and grooming facial cues (e.g., hairstyle, beard), as well as sexually dimorphic and stylistic body-related cues (e.g., legs, breasts, outfit, and body shape for women; hands, outfit, shoulder width, and arm muscles for men). These findings indicate that romantic visual attention operates across distinct processing stages, with only partial overlap between what individuals look at and what they report. While sustained attention is partly accessible to introspection, early attentional processes remain largely automatic, highlighting limits in awareness during initial impression formation.

Chronic venous disease (CVD) is a prevalent condition that results from venous hypertension and leads to a variety of symptoms including leg pain, swelling, and venous ulcers. The condition significantly impacts quality of life (QoL) and imposes a burden on healthcare systems. Venoactive drugs (VADs) can manage CVD symptoms by improving venous tone, reducing inflammation, and enhancing microcirculation. In this review, six experts from Latin America provide a critical appraisal of the evidence supporting the use of VADs in CVD management. The review evaluates the efficacy of various VADs, including micronized purified flavonoid fraction (MPFF), rutosides, calcium dobesilate, sulodexide, horse chestnut seed extract, and red vine leaf extract. MPFF demonstrated robust efficacy in randomized controlled trials, significantly reducing symptoms such as pain, leg heaviness, and edema, and improving QoL. Other VADs, such as rutosides and calcium dobesilate, showed varying degrees of effectiveness, though the quality of supporting evidence remains inconsistent. This review also highlights variations in international guidelines - some recommending VADs more strongly than others, with MPFF emerging as the preferred option, supported by high-quality evidence. However, further research is necessary to clarify the role of other VADs and provide more definitive guidance on their use in clinical practice. PLAIN LANGUAGE SUMMARY: Chronic venous disease (CVD) is a condition that affects the veins in the legs, causing pain, swelling, and other symptoms like heaviness and cramping. It can also lead to more severe issues such as skin changes and ulcers. CVD is common and can greatly reduce a person's quality of life (QoL). It can also place a significant burden on healthcare systems. Venoactive drugs, or VADs, are medicines that help improve blood flow in the veins, reduce swelling, and ease inflammation. These drugs are used to alleviate CVD symptoms, especially when other conservative treatments, like compression stockings, are insufficient. This review describes the published evidence about different types of VADs and their effectiveness in CVD. Some drugs, like micronized purified flavonoid fraction (MPFF), have been shown to be particularly effective in reducing leg pain, swelling, and heaviness, as well as helping to improve the QoL of people with CVD. Other VADs, including rutosides, calcium dobesilate, and horse chestnut seed extract, have demonstrated clinical efficacy. Different medical guidelines for treating CVD from around the world recommend using VADs, though with some discrepancies on recommendation gradings. While MPFF is referred to in these guidelines as a leading option, further research is needed to better understand how different VADs can be used most effectively in treating CVD.

Using highly precise measurements, we found obstructive sleep apnea (OSA) was linked to poorer bone health at most sites. Higher oxygen saturation, rather than sleep efficiency, was beneficial. Total sleep duration was partially nonlinearly related to bone health. Patients with chronic sleep problems should be screened for low BMD. Previous studies have shown associations between sleep characteristics and bone health, but findings are inconsistent. This study investigated the relationships between objectively measured sleep characteristics and bone mineral density (BMD) as well as bone mineral content (BMC) using dual-energy X-ray absorptiometry (DXA) measurements at various skeletal sites. The analysis included data from 4690 participants aged 40-70&#xa0;years in the Human Phenotype Project (HPP) cohort. Associations between total sleep time, mean oxygen saturation (%), sleep efficiency, and obstructive sleep apnea (OSA) indices-respiratory disturbance index (RDI), apnea-hypopnea index (AHI), and oxygen desaturation index (ODI)-measured by a sleep apnea monitoring device, and BMD/BMC assessed by DXA imaging of various skeletal components were examined using multivariable linear regression models. All associations were tested for interactions with age. OSA indices (AHI, ODI, RDI) showed linear or non-linear inverse associations with BMD or BMC at most bone sites. The negative associations of AHI and ODI with spine outcomes were non-linear, with stronger effects at higher index ranges. Total sleep time was inversely associated with BMC of the legs, femoral neck, and femoral shaft, with consistent estimates for BMD. U-shaped associations were observed between total sleep time and BMC of both arms and spine L2. Oxygen saturation was positively associated with BMD and BMC of the total body, arms, head, and spine. Sleep efficiency showed no association with any outcomes. Age-stratified analyses revealed stronger estimates in younger participants. OSA appears to be associated with reduced BMD and BMC, even in individuals without other major health conditions. These findings highlight the need for increased clinical awareness, including BMD screening for OSA patients, and, on the other hand, the detection of sleep problems in patients with osteoporosis or reduced BMD and BMC.

In Africa, bewitchment is described as a moral framework that helps individuals and societies make sense out of disease and misfortune. Numerous African belief systems attribute difficult-to-treat health problems to bewitchment, rather than a conventional medical diagnosis, especially if biomedical doctors are unable to resolve the condition. This study examines one such illness, known as xifula, in rural Limpopo Province, South Africa. Using convenience sampling, 95 participants (&#x2265;18 years old) were interviewed to gauge their knowledge of the condition known as xifula. Data was analysed using NVivo software. Xifula is a cultural concept of distress related to bewitchment. The most common symptom of xifula is swelling of the legs or hands, followed by chronic headaches. Participants noted that xifula can start as a minor ailment, but then grows into a larger problem. After a long period without healing, however, xifula can begin to represent a significant threat to the individual's health. Nearly all participants noted that xifula cannot be treated by Western biomedical professionals and instead requires a traditional healer to treat the condition. This research highlights the importance of context-specific education about the diagnosis and treatment of common ailments, as beliefs about afflictions, their causes, and appropriate treatments suggest a need for tailored information. As biomedical and traditional healthcare currently exist as parallel, siloed structures of diagnosis and treatment in Africa, there should also be efforts to bridge the divide between the two. This study was funded by a grant from the John Templeton Foundation.

This study aimed to compare parameters influencing the rearing efficiency of geese that received either a full quality score or a reduced quality score on their first day of life. A sample of 480 birds was randomly selected from goslings assigned by hatchery staff to the full and reduced quality score categories, with 240 birds (120 males and 120 females) per group. Goslings were evaluated using several specific criteria: level of activity, navel area, presence of remaining yolk, development of legs, appearance of eyes and fluff, and status of the remaining membrane. Goslings in the full quality score group received the maximum total score of 100 points. Goslings in the reduced quality score group had lower scores, with abnormalities predominantly associated with the navel area (>90% of birds). Geese were assigned to six replicates of 80 birds each (40 birds with a full quality score and 40 birds with a reduced quality score) and reared in a semi-intensive production system until they reached 20 weeks of age. During the rearing period, body weight (BW) and mortality rate were monitored, and feed conversion ratio (FCR) was calculated. At 20 weeks of age, 72 geese (36 from each subgroup) were slaughtered and subjected to a comprehensive carcass analysis. The reduced quality score group exhibited a decelerated growth rate until approximately 5 weeks of age (P < 0.05). However, from 6 to 20 weeks of age, the BW of geese of both sexes in both experimental groups was comparable (P > 0.05). The reduced quality of goslings on the first day of life did not affect FCR or mortality over the entire rearing period. Female geese from the reduced quality score group had a higher proportion of leg muscles in BW and carcass weight (P = 0.002 and 0.016, respectively) and a lower proportion of intestines in BW (P = 0.038). The full and reduced quality score groups showed no significant differences in other carcass traits (P > 0.05). In conclusion, goslings classified by hatchery staff as second-grade quality, i.e., reduced health quality but not posing a direct threat to survival, can be successfully reared in a semi-intensive production system.

Sleep-wake regulation is controlled by circadian and homeostatic processes, with adenosine acting as a key molecular mediator of homeostatic sleep pressure. Extracellular adenosine accumulates during wakefulness as a result of neuronal energy metabolism, particularly in the basal forebrain, and declines during recovery sleep, thereby reflecting the physiological need for sleep. The sleep-promoting effects of adenosine are mediated primarily by two G protein-coupled receptor subtypes, the adenosine A1 receptor and the adenosine A2A receptor. The adenosine A1 receptor, coupled to inhibitory Gi/o proteins and widely expressed in the cortex, hippocampus, thalamus, and basal forebrain, suppresses wake-promoting neuronal activity and facilitates slow-wave activity during non-rapid eye movement sleep. In contrast, the adenosine A2A receptor, coupled to stimulatory Golf proteins and enriched in the striatum and nucleus accumbens, promotes sleep by activating neurons in the preoptic hypothalamus and engaging the indirect basal ganglia pathway. Despite these well-established roles, the contributions of dysregulation of the adenosine A1 receptor and the adenosine A2A receptor to specific sleep disorders remain incompletely understood. This review examines how signaling of the adenosine A1 receptor and the adenosine A2A receptor is altered in insomnia, obstructive sleep apnea, narcolepsy, and restless legs syndrome, and evaluates the therapeutic potential of receptor-selective strategies for adenosine receptor-targeted treatment.

The famous serum run of 1925 has focused upon Balto, Togo, and the Norwegian mushers Gunnar Kaasen and Leonard Seppala. The mushers who ran most of the legs were actually descended from Alaskan Natives, including George and Edgar Nollner and Charlie Evans. Thanks to the Fairbanks Library archivists who sent me the interview with Charlie Evans and Edgar Nollner. This short fiction won one of the inaugural McGovern Center Writing Awards.

Pancreatitis, panniculitis, and polyarthritis syndrome is a rare extrapancreatic triad associated with pancreatic disease and occasionally malignancy. We report a 51-year-old woman with prior hormone receptor-negative, human epidermal growth factor receptor 2-positive breast invasive ductal carcinoma (bilateral mastectomy, adjuvant trastuzumab/pertuzumab, radiation) who developed abrupt painful erythematous nodules of both legs and progressive polyarthralgia of the hands, knees, and ankles. Symptoms were initially treated as inflammatory rheumatic disease with systemic corticosteroids and disease-modifying therapy without benefit, leading to severe functional decline. Imaging later revealed a large hepatic mass; biopsy confirmed metastatic pancreatic acinar cell carcinoma, unifying the presentation as pancreatitis, panniculitis, and polyarthritis syndrome. Coordinated multidisciplinary care, oncology-directed chemotherapy, interventional pain management, and psychological support, improved pain control and mobility. This case adds to the limited pancreatitis, panniculitis, and polyarthritis literature and highlights that absent gastrointestinal symptoms can delay diagnosis; early recognition and collaborative management are essential in malignant pancreatitis, panniculitis, and polyarthritis presentations.

Nivolumab, a human IgG4 PD-1 immune checkpoint inhibitor antibody, blocks PD-1 and can restore anticancer immune responses by impairing T-cell suppression via the PD-1 pathway. Nivolumab is generally well-tolerated, with fewer treatment-related adverse events (AEs) than other systemic therapies. Here we report a case of nivolumab-induced folliculitis involving the lower limbs in a 35-year-old male. The patient had multiple follicular-based pustules over the bilateral legs with surrounding erythema. The patient was treated with topical steroids, which resulted in complete resolution.

This cross-sectional study examined whether exposure to long-term resistance and endurance training can counteract muscular weakness on a functional, neurological and structural level in adolescents with cerebral palsy (CP) compared to typically-developed peers (TD) in dependence of training status. Five trained (4 males; mean age: 19.8) and four untrained adolescents with CP (3 males; 20.2) were compared to nine age- and sex-matched TD trained (7 males; 19.8) and nine untrained peers (7 males; 20.3). Isometric and isokinetic measurements assessed strength in knee flexion and extension, voluntary activation (VA) was assessed using the twitch interpolation technique and ultrasound imaging of the quadriceps was performed to assess anatomical cross sectional area (ACSA) and architecture. Linear regression models revealed that CP trained had lower absolute isometric strength (dominant: -18% [-48; 11]; non-dominant: -35% [-58; -11]) than TD untrained while CP untrained showed between 29% and 33% lower strength than TD untrained. VA in CP trained (dominant: -13% [-23; -3]; non-dominant: -10% [-30; 11]) and CP untrained (dominant: -14% [-23; -4]; non-dominant: -8% [-29; 13]) showed similar deficits compared to TD untrained. CP trained showed higher ACSA than TD untrained in the dominant leg of the vastus lateralis muscle (+&#x2009;16% [-7; 38]), while the non-dominant side showed lower values (-18% [-45; 9]). Exposure to long-term resistance and endurance training is associated with a smaller gap in muscle strength and muscle volume in the dominant leg of adolescents with CP while neural drive does not seem to be affected through training exposure. It is discussed that training load might have been too low in the non-dominant leg of CP trained to induce relevant neuromuscular adaptations. ClinicalTrials.gov Identifier NCT05859360, date of registration May 16, 2023.

Age-related changes to BMD, morphometry, and microarchitecture do not occur uniformly across the population and the common skeletal phenotypes beyond BMD are not well defined. Additionally, the associations between bone and muscle are critical to understanding fall and fracture risk. We hypothesized that unsupervised clustering of High Resolution-peripheral Quantitative Computed Tomography (HR-pQCT) measures at the distal tibia (DT) and radius (DR), separately, would reveal unique skeletal phenotypes; and certain phenotypes would be associated with worse muscle function. In the Study of Muscle, Mobility and Aging (SOMMA; first annual follow-up visit), a cohort of community-dwelling older women and men (61% women; 87% White), HR-pQCT parameters acquired at the DT (N&#x2009;=&#x2009;321; 76.3&#x2009;&#xb1;&#x2009;4.6&#xa0;yr) and DR (N&#x2009;=&#x2009;295; 76.1&#x2009;&#xb1;&#x2009;4.5&#xa0;yr) were standardized within-sex then combined to form clusters. This resulted in 3 phenotypic clusters, (C1) high total BMD (Tt.BMD) and cortical area (Ct.Ar); (C2) medium Tt.BMD, Ct.Ar and low trabecular BMD (Tb.BMD); and (C3) low Tt.BMD, and Ct.Ar. DT C2 and C3 exhibited lower micro finite element analysis failure loads, with the cortical load fraction higher in C2 and lower in C3. C2 and C3 both had a similar proportion of osteoporotic and osteopenic/low bone density individuals, highlighting the novel granularity of HR-pQCT clusters vs. aBMD clinical cutoffs. In linear regression models for women, DT C3 was associated with lower leg power (p&#x2009;<&#x2009;.05). For men, DT C3 was associated with lower stair climb and leg power (p&#x2009;<&#x2009;.05). No significant difference was found in grip strength between DT clusters. For DR, no significant difference or association was found between muscle function and clusters for women and men. These findings suggest the concept of bone phenotypic-specific associations with lower but not upper extremity muscle function and have possible implications for the interaction between skeletal phenotypes and muscle function as potential contributory factors to fracture risk. Current measures of bone health do not capture the individual variation of combined measures of bone density, shape, structure. Also, how these bone characteristics relate to muscle function is unclear. In older women and men, three clusters were identified based on the bone characteristics. One cluster, with low bone density and thickness, was associated with lower leg power for women and men, and with lower stair climb power for men, vs. other clusters. Therefore, this cluster has poorer bone characteristics and lower muscle function. These findings could suggest targets for muscle function to improve fall and fracture risk.

Major amputation remains the default response to gas-forming soft tissue infection of the lower limb in diabetic patients across Sub-Saharan Africa, despite its devastating functional and economic consequences in settings with minimal prosthetic services. We report a prospective cohort study of 20 such patients who underwent primary decompressive fasciotomy at a tertiary centre in Dakar, Senegal. Overall limb salvage was achieved in 75% (15/20), and in-hospital mortality was zero. Among nine patients ultimately requiring amputation, the planned level was downstaged in 78%, including one patient initially assessed for hip disarticulation who underwent lower leg amputation. Preoperative vascular status was the decisive predictor: salvage reached 91% with good arterial perfusion versus 0% in mediacalcosis (M&#xf6;nckeberg's arteriosclerosis) (p&#x2009;<&#x2009;0.01). Therefore, decompressive fasciotomy, being a less invasive, inexpensive, and technically accessible procedure, should precede amputation in every diabetic patient with gas-forming lower limb infection and preserved arterial flow.

We report a leg ulcer infection caused by Vibrio metschnikovii in a patient with chronic venous leg ulcers in Montevideo, Uruguay. Shotgun MS/MS combined with long-read whole-genome sequencing confirmed species assignment to V. metschnikovii. In addition, we incorporate a mini-review of the previous reported cases in Latin America.

Mangled limb injuries, typically caused by high-energy trauma, present significant challenges in surgical decision-making, particularly when considering limb salvage versus primary amputation. While common mechanisms include vehicular or industrial accidents, unconventional etiologies are rarely documented. We report a unique case of a 43-year-old female who sustained a mangled left lower limb injury following a gearbox explosion in a Porsche Cayenne. The injury resulted in a near-complete amputation at the distal third of the leg, with extensive contamination by oily and metallic debris. Radiologic assessment confirmed complex fractures and vascular injury, with transection of the posterior tibial and peroneal arteries. Despite a high Mangled Extremity Severity Score (MESS) of 7 and initial surgical consensus favoring below-knee amputation, the patient and her family strongly advocated for limb preservation. The initial management involved damage control surgery with extensive debridement and external fixation. A multidisciplinary team provided staged reconstruction despite significant soft tissue loss and neurological deficits. The patient demonstrated favorable vascular recovery and maintained foot viability, ultimately preserving the limb. This case highlights an unusual mechanism of mangled limb trauma and underscores the critical role of shared decision-making in trauma care. It reinforces that, in carefully selected patients, limb salvage may be feasible even in scenarios traditionally warranting amputation.

Developmental dysplasia of the hip (DDH) remains a leading cause of early hip osteoarthritis and poses considerable technical challenges during total hip arthroplasty. Existing classification systems focus on the abnormal relationship between the femoral head and the acetabulum without emphasising the femoral morphological variations, which are equally significant in surgical planning. Dysplastic femora often demonstrate excessive neck anteversion, variable neck-shaft angles, reduced offset, and metaphyseal-diaphyseal mismatch with narrow intramedullary canals. These anatomical variations often compromise the abductor mechanism and alter hip biomechanics. Thorough preoperative planning is crucial and should include the evaluation of leg-length discrepancy, reconstruction of the hip centre of rotation, assessment of femoral version and canal morphology, implant selection, and consideration of femoral shortening osteotomy. Computed tomography-based planning can enhance preoperative planning in complex cases. Both cemented and cementless stems align with positive findings in DDH patients. Cemented stems enable reliable version control, decrease intraoperative fracture risk, and may be beneficial for patients with poor bone quality. In mild cases, most uncemented stems are suitable. More severe deformities necessitate specialised implant designs with conical fluted stems, which provide strong fixation and excellent long-term survivorship. Modular and custom-made options also achieve favourable outcomes in high-grade deformities. Femoral shortening osteotomies are often needed to restore biomechanics, correct abnormal version, and prevent nerve injury during reduction. The subtrochanteric osteotomy has been linked with excellent results in treating severe DDH. High-quality research is essential to deepen our understanding of proximal femur morphological abnormalities and to enhance surgical results.

Patients with prior venous thromboembolism (VTE) seem to recur more frequently at the same site as their prior VTE, but their symptoms at presentation of suspected recurrent VTE is unclear. The aim was to describe the patterns of presentation of suspected and confirmed recurrent VTE. This is a secondary analysis of the PREDICTORS study (ClinicalTrials.gov: NCT02297373), an international prospective multicenter observational cohort study. The primary outcomes were the location of symptoms and confirmed diagnosis of suspected recurrent VTE. In total, 708 patients were included. Patients with isolated deep venous thrombosis (DVT) as the most recent prior VTE presenting with suspected recurrent VTE had more frequently lower extremity symptoms only (249/343; 73%), rather than respiratory symptoms only (41/343; 12%), and confirmed recurrent VTE were mostly isolated proximal DVT (78/100; 78%). Patients with isolated pulmonary embolism as the most recent prior VTE presented more frequently with respiratory symptoms only (136/237; 56%), rather than lower extremity symptoms only (42/237; 18%), and confirmed recurrent VTE were more frequently isolated pulmonary embolism (38/62; 61%). Among patients with DVT as the most recent prior VTE, confirmed recurrent DVT were more frequently in the ipsilateral leg of the index event (ipsilateral 72/468 [15%], contralateral 31/468 [7%]; odds ratio 2.3 [95% CI, 1.5-3.6]). In addition to confirming that patients were more frequently diagnosed with recurrent VTE at the same site of their last VTE, our study reported on suspected recurrent VTE symptoms and showed that patients presented more frequently with symptoms related to the same site of their last VTE.

This study evaluated the effectiveness of silicone superabsorbent polymer (SAP) dressings in patients with venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs), with emphasis on wound area reduction (WAR) and improvement in wound bed characteristics over a six-week observation period. This prospective, single-arm study evaluated two silicone SAP dressings-RespoSorb Silicone Border (RSSB; also marketed as Zetuvit Plus Silicone Border) and RespoSorb Silicone (RSSil; also marketed as Zetuvit Plus Silicone) (both PAUL HARTMANN AG, Germany)-in patients with exuding VLUs or DFUs across eight clinical sites in Poland. The primary endpoint was relative WAR, measured using centralised digital planimetry, with &#x2265;20% WAR defined as clinically meaningful. Secondary endpoints included: complete re-epithelialisation; changes in granulation and slough tissue composition; exudate management; periwound skin condition; dressing wear time; and safety. A total of 80 patients took part in this study. Participants were predominantly male (62.5%) with a mean age of 67.1 years; 53 received RSSB and 27 received RSSil. At the final visit, &#x2265;20% WAR was achieved in 59/79 (74.7%) patients before cleansing/debridement and in 66/79 (83.5%) after cleansing/debridement (p<0.001 for superiority) (one baseline image for both before and after cleansing/debridement was missing and unavailable for planimetry assessment). The median relative WAR was 69.6% (interquartile range (IQR): 28.9-100%) following cleansing/debridement. The median granulation tissue coverage decreased by 75.2% (IQR: 24.3-100%) and slough coverage decreased by 98.6% (IQR: 46.7-100%) after cleansing/debridement, while median exudate volume reduced by 0.38ml (IQR: -0.1-1.75ml) from baseline (all p<0.001). Complete re-epithelialisation occurred in 21/80 (26.9%) patients. Median dressing wear time was four days (IQR: 3-6 days) over all six follow-up visits. In this study, the two silicone SAP dressings used demonstrated clinically meaningful improvement in wound outcomes in chronic VLUs and DFUs, with most patients achieving &#x2265;20% WAR alongside effective exudate management and improved wound bed quality.

Accurate characterization of femoral condylar kinematics and its association with collateral ligament behavior are essential for maintaining overall knee stability, particularly frontal plane stability after medial unicompartmental knee arthroplasty (UKA). Conventional reference flexion axes, such as the transepicondylar axis (TEA) and geometric center axis (GCA), provide only static representations of motion. The recently proposed iso-height axis (IHA) offers a dynamic reference, yet its clinical relevance under weight-bearing conditions after UKA remains unclear. 24 patients, 13 fixed-bearing (FB) and 11 mobile-bearing (MB) UKA, underwent dual fluoroscopic imaging (DFIS) during weight-bearing (single-leg lunge, sit-to-stand) and non-weight-bearing (open-chain leg raising) maneuvers. Femoral condyle kinematics were analyzed using TEA, GCA, and IHA, with statistical analysis comparing native and UKA knees. In FB UKA, A-P condylar translation was consistently the smallest with IHA (UKA: 0.78-1.69&#x2009;mm across tasks), compared with GCA (2.98-3.62&#x2009;mm) and TEA (2.99-6.03&#x2009;mm; mean across medial/lateral condyles). FB UKA demonstrated robust correlations between condylar kinematics and ligament changes across all three axes, with IHA uniquely capturing bilateral lateral collateral ligament (LCL) correlations during lunge (lateral: &#x3b2;&#x2009;=&#x2009;0.031,&#x3b2;*&#x2009;=&#x2009;0.43; medial: &#x3b2;&#x2009;=&#x2009;0.028, &#x3b2;*&#x2009;=&#x2009;0.39). MB UKA had reduced correlations, primarily limited to LCL-TEA during open-chain leg raising. Flexion-axis choice substantially affects the interpretation of femoral condylar kinematics after UKA. Weight-bearing assessment better reveals clinically relevant abnormalities, and IHA may provide a more physiologically meaningful reference than TEA or GCA.