Search Results (89)

The Apuseni-Banat-Timok-Srednogorie Metallogenic Belt is one of the most important polymetallic metallogenic belts in the western segment of the Tethys, where numerous porphyry-type, skarn-type, and epithermal deposits are developed. However, scholars have noted a lack of systematic chronological and geochemical studies of andesites within this belt. Furthermore, the metallodynamic mechanisms controlling mineralization—such as oceanic plate exhumation and plate tearing—remain controversial. To complement the available research, this study focuses on andesites from the Čukaru Peki area in Serbia and integrates zircon U-Pb dating, molybdenite Re-Os isotopic analysis, and whole-rock geochemical analysis. The results reveal that plagioclase andesitic breccia and fine-grained plagioclase amphibole andesite were emplaced during the Late Cretaceous. Consistently, the molybdenite isochron age (81.46 ± 0.60 Ma, MSWD = 1.30) constrains the mineralization event to the same period. Both rock types exhibit geochemical signatures typical of island arc volcanic rocks, characterized by high SiO₂ contents and low Al₂O₃, MgO, and TiO₂ contents, as well as pronounced fractionation between light and heavy rare earth elements (LREEs and HREEs). The magma source is the mantle wedge metasomatized by fluid-rich melts derived from the dehydration of the subducted oceanic crust. Additionally, the primary magma produced by partial melting of this metasomatized mantle wedge assimilated and was contaminated by continental crustal material predating the Vardar Ocean’s closure during its ascent. Our findings suggest that the regional andesites are products of the exhumation of the Vardar Ocean. This study aims to provide a theoretical foundation for mineral exploration in the Timok ore cluster and, simultaneously, support the identification of ore prospecting targets in andesite alteration zones. Full article

Background and Objectives: Corneal ulcers in patients with lagophthalmos due to facial nerve palsy pose a significant therapeutic challenge. Topical insulin has emerged as a promising adjuvant therapy for enhancing corneal re-epithelialization. The aim of this study is to evaluate the efficacy of insulin drops compared with lipid-based artificial tears, and to compare the corneal healing rate in achieving complete epithelialization within 30 days in diabetic patients. Materials and Methods: This retrospective case–control study included 32 patients with facial nerve palsy and lagophthalmos who developed an exposed corneal ulcer, of whom 20 received topical insulin and 12 received lipid-based artificial tears. The primary outcome was complete epithelialization at day 30. Additional variables included age, sex, and baseline defect characteristics. Results: By day 30, complete epithelialization was achieved in 18 of 20 patients (90%) in the insulin group compared with 5 of 12 (41.7%) in the control group. Binary logistic regression analysis confirmed significantly higher odds of healing with insulin treatment (OR = 10.8; 95% CI 1.8–63.9). No systemic adverse events or signs of hypoglycemia were observed. Conclusions: Topical insulin significantly accelerates corneal epithelialization in patients with facial nerve palsy and exposed ulcers, offering safe and effective adjuvant therapy for a high-risk population. Despite promising results, the study’s limitations—including small sample size, single-center design, and retrospective nature—highlight the need for larger, multicenter prospective studies to confirm efficacy, optimize dosing, and further evaluate long-term safety. Full article

Chronic type B aortic dissection (cTBAD) is a challenging condition frequently complicated by persistent false lumen (FL) perfusion, leading to aneurysmal degeneration. Despite significant advances in thoracic endovascular aortic repair (TEVAR), long-term management remains challenging because of continuous FL backflow from distal re-entry tears and progressive aortic dilatation. We present the first documented case of FL exclusion using a custom-made false lumen occlusion device (FLOD). A 77-year-old male who had undergone TEVAR in 2017 underwent computed tomography angiography (CTA) in 2025, with the results revealing aneurysmal degeneration of the descending thoracic aorta (maximum diameter 58.5 mm) and two distal re-entry tears with substantial FL perfusion. Following multidisciplinary evaluation, the patient underwent endovascular reintervention with proximal stent graft extension and the deployment of a custom FLOD into the FL via femoral access. Completion angiography confirmed proper FL exclusion with preservation of visceral artery patency. Transesophageal echocardiography demonstrated rapid FL thrombosis. The patient was discharged on postoperative day 5 in good condition without complications. This case highlights that combining endograft extension with a dedicated FLOD is a safe and effective strategy for selected patients with complex cTBAD anatomy. Full article

Induction motors are a common component of electromechanical equipment in mining operations, yet they are susceptible to failures resulting from frequent start–stops, overloading, wear and tear, and component failure. It is evident that such failures can result in severe ramifications, encompassing industrial accidents and economic losses. The present paper proposes a detailed study of engine fault diagnosis technology. It has been demonstrated that prevailing intelligent engine diagnosis algorithms exhibit a limited diagnostic efficacy under variable operating conditions, and the reliability of diagnostic outcomes based on individual signals is questionable. The present paper puts forward the proposition of an investigation into a fault diagnosis algorithm for induction motors. This investigation utilized a range of analytical methods, including signal analysis, deep learning, transfer learning, and information fusion. Currently, the methods employed for fault diagnosis based on traditional machine learning are reliant on the selection of statistical features by those with expertise in the field, resulting in outcomes that are significantly influenced by human factors. This paper is the first to integrate a multi-branch ResNet strategy combining three-phase and single-phase currents. A range of three-phase current input strategies were developed, and a deep learning-based motor fault diagnosis model with adaptive feature extraction was established. This enables the deep residual network to extract fault depth features from the motor current signal more effectively. The experimental findings demonstrate that deep learning possesses the capacity to automatically extract depth features, thereby exceeding the capabilities of conventional machine learning algorithms with regard to the accuracy of motor fault diagnosis. Full article

Arthroscopic Superior Capsular Reconstruction has emerged as a promising surgical intervention for irreparable massive rotator cuff tears, aiming to restore glenohumeral joint stability and improve patient outcomes. A critical determinant of ASCR success is the selection of an appropriate graft material. This review explores the spectrum of grafts utilized in ASCR, including autografts, allografts, xenografts, and synthetic materials. The primary focus is on how the inherent biological properties of these grafts—such as cellularity, vascularity, immunogenicity, and extracellular matrix composition—profoundly influence the processes of graft healing, integration into host tissues, and ultimately, the rates of re-tearing. Autografts, particularly fascia lata, often demonstrate superior biological incorporation due to their viable cells and non-immunogenic nature, leading to high healing rates. Allografts, while offering advantages like reduced donor site morbidity, present biological challenges related to decellularization processes and slower remodeling, resulting in more variable healing outcomes. Xenografts face significant immunological hurdles, often leading to rejection and poor integration. Synthetic grafts provide an off-the-shelf option but interact with host tissue primarily as a scaffold, without true biological integration. Understanding the nuanced biological characteristics of each graft type is paramount for surgeons aiming to optimize healing environments and minimize re-tear rates, thereby enhancing the long-term efficacy of ASCR. Full article

Background: The incidence of chemical ocular trauma after accidentally instilling the “wrong” eyedrops is still frequent, but cases resulting from stamper ink refills are rare. Case Presentation: A 73-year-old man presented to our emergency department with a history of inadvertently instilling stamper ink refill into both eyes (BEs) instead of artificial tears. Immediate irrigation and evaluation were performed. The initial visual acuity (VA) was 0.4 in the right eye (RE) and 0.8 in the left eye (LE). Slit lamp examination showed edema palpebra with periocular blue staining in BEs, chemotic conjunctiva with a much darker color in the RE than the LE, and epithelial defects with a positive fluorescein test in BEs. A diagnosis of bilateral corneal abrasion and chemotic conjunctiva was established. Ten hours after the emergency visit, RE VA decreased to 0.2, and corneal edema was found during the follow-up examination. Medications including levofloxacin antibiotic, sodium hyaluronate, sodium chloride, combined polymyxin sulfate–neomycin sulfate and dexamethasone eyedrops, mefenamic acid, and ascorbic acid tablets were prescribed. The RE corneal edema still occurred, and the endothelial cell count was 1952 and 987 cells/mm² in the RE and LE at the one-week follow-up. After three weeks, corneal edema had fully resolved, and the VA was 0.4 and 0.8 in the RE and LE, respectively. Conclusions: This case report adds to the spectrum of the continuing problem of chemical ocular trauma after mistakenly instilling the eyedrops. Promoting and changing to different packages for non-ophthalmic products in plastic bottles mimicking eyedroppers is essential to minimize these injuries. Full article

Objectives: To examine the rate of meniscal re-tear in patients with concomitant ACL reconstruction, with specific focus on surgical factors and patient demographic factors. Methods: A retrospective chart review was performed on all patients who underwent meniscal repair with concomitant ACL reconstruction at our institution over a seven-year period. Demographic and case variables were assessed, including sex, age, height, weight, BMI, medial versus lateral repairs, ACL graft type, ACL reconstruction technique, meniscus repair technique, and post-operative weight bearing status. Failure of repair was defined as need for repeat surgery on the same meniscus. Results: There were 191 patients included in the study; of those 118 did not need further surgery on the meniscus at a minimum of 2 years post operation while 73 did have a re-operation on the same meniscus (rate of failure 38.2%). There were significant differences between re-operation and non-re-operation groups based on ACL graft type (54% failure for allograft vs. 30/23% failure for both autograft cohorts) and meniscal repair side (46% re-tear rate for medial meniscus vs. 17% for lateral meniscus). The pediatric (under 18 years old) cohort included 57 patients; 28 patients required additional meniscal surgery and 29 did not (rate of re-operation 49%). Conclusions: The overall failure rate of meniscus repair was nearly 40%. Risk factors for re-tear of the meniscus were repair of the medial meniscus and allograft usage for ACL reconstruction. The rate of re-tear in patients under 18 was nearly 50%, which is higher than in the adult population. Full article

Background: Optimal timing for surgery following acute rotator cuff tears remains unclear. This study examines how the timing of arthroscopic rotator cuff repair (RCR) affects retear rates and functional outcomes. Methods: This PROSPERO-registered review (CRD42024528249) followed PRISMA guidelines and included randomized trials, and cohort, studies on adults with imaging-confirmed full-thickness rotator cuff tears. Studies lacking timing data or key outcomes were excluded. Risk of bias was assessed using ROBINS-I. Meta-analysis of retear rates was performed comparing surgical timing. Qualitative analysis was conducted classifying results as early-beneficial, delayed-detrimental, or neutral. Results: Our review included 13 studies and 871 patients with an average age of 57.9. Meta-analysis of eight studies comparing retear rates between early and delayed RCR demonstrated a significant benefit associated with early intervention risk ratio 0.60 (95% CI: 0.38–0.96). Functional outcomes also favored early intervention with four studies demonstrating significantly greater postoperative functional improvements in the early intervention group. Conclusions: Early arthroscopic RCR decreased the rate of retear and improved functional outcomes. No study found early intervention to be detrimental or delayed intervention to be superior. These findings support consideration of early repair when clinically appropriate. Future studies should determine more finite timing guidelines. Full article

Background: The purpose of this study was to evaluate Achilles tendon ruptures (ATR) in NHL players and the effects on return to play and player performance metrics. The incidence, mechanism of injury, management strategy, return to play (RTP), and post-injury were assessed from official online sports databases. Methods: A retrospective review of NHL players who sustained a partial or complete tear of the Achilles tendon from 2008 to 2024 was performed. Data were collected from NHL injury databases and media reports, and included player demographics, injury mechanism, treatment, and post-injury performance metrics. A Wilcoxon signed rank test was used to compare pre-injury and post-injury performance metrics, with significance set at p < 0.05. Results: Here, 15 NHL players with a mean age of 27.8 years were identified, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. Overall, 73.3% of ATRs were non-contact in nature, with 60.0% of ATRs occurring during off-season training. Fourteen players were managed with non-operative treatment, with no re-ruptures reported. The RTP rate was 93.3%, with players missing a mean number of 45.7 games. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury. Conclusions: This study found that Achilles tendon ruptures are an uncommon injury in NHL players, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. A high RTP rate of 93.3% was observed in this cohort. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury, highlighting the potential devastating sequelae of ATRs in elite NHL athletes. Full article

Background and Objectives: Pediatric Sjögren’s syndrome is a rare autoimmune disease with a heterogeneous clinical expression and limited pediatric-specific diagnostic criteria. Ocular involvement often represents an early manifestation, yet it may go unrecognized in children due to poor symptom reporting and the underuse of objective diagnostic tools. This retrospective study evaluated six pediatric patients with Sjögren’s syndrome, integrating systemic and ocular findings with a focus on early immunological and clinical markers. Materials and Methods: All patients underwent ophthalmological assessments, including tear break-up time, Schirmer’s test, and slit-lamp examination. Results: Tear break-up time values consistently indicated tear film instability (mean RE 7.4 ± 2.5 s; LE 7.7 ± 2.3 s), while Schirmer’s test showed greater variability. Slit-lamp examination revealed inhomogeneous tear films in all patients and blepharitis in 66.7%, consistent with Meibomian gland dysfunction. Systemic features included arthralgia, Raynaud’s phenomenon, fatigue, and frequent seropositivity for ANA and anti-SSA/Ro antibodies. Minor salivary gland biopsy confirmed lymphoepithelial sialadenitis in all cases. Conclusions: These findings highlight the importance of combining laboratory and clinical markers with ophthalmological parameters to support an early diagnosis of Sjögren’s syndrome in pediatric patients. Integrating TBUT and slit-lamp evaluation with serological and histopathological data may enhance diagnostic accuracy and guide timely, targeted intervention to prevent long-term complications. Full article

Background: Arthroscopic rotator cuff repair faces high retear risks in multi-tendon injuries due to insufficient biological healing; leukocyte-rich PRP may enhance tendon–bone integration through inflammatory modulation and growth factor release. Methods: Four databases including PubMed, Embase, Cochrane Library, and Web of Science were searched until March 2025. Literature screening, quality evaluation, and data extraction were performed according to inclusion and exclusion criteria. GRADE was used to grade the strength of the evidence and the results. Results: The main finding of this study was that leukocyte-rich platelet-rich plasma combined with arthroscopic surgery for rotator cuff injuries can improve the Constant Score (MD = 1.13, 95% CI: 0.19, 2.07, p = 0.02, I² = 47%), American Shoulder and Elbow Surgeons score (MD = 6.02, 95% CI: 4.67, 7.36, p < 0.01, I² = 0%), and University of California, Los Angeles score (MD = 1.20, 95% CI: 0.34, 2.06, p < 0.01, I² = 0%) of patients with rotator cuff tear after treatment, and reduce the postoperative Visual Analog Scale score (MD = −0.62, 95% CI: −1.16, −0.08, p = 0.02, I² = 83%) of patients. However, there were no statistical differences regarding the Simple Shoulder Test (MD = 0.08, 95% CI: −0.23, 0.39, p = 0.61, I² = 5%). Conclusions: Based on current evidence, the use of LR-PRP in arthroscopic rotator cuff repair could lessen postoperative pain and improve postoperative functional scores in individuals with rotator cuff injuries. Full article

Background: The isolated rectus femoris tendon (RT) is a less commonly used autograft for anterior cruciate ligament (ACL) reconstruction. Graft selection is a critical part of ACL reconstruction, especially in revision surgery. Hypothesis: This study compares patient-reported outcome measurements (PROMs) between revision ACL reconstruction with an RT autograft and a hamstring tendon (HT) autograft. We hypothesized that the RT autograft will yield comparable functional results and high patient satisfaction. Study Design: This was a cohort study; the level of evidence is III. Methods: Fifty-five patients (RT n = 28; HT n = 27) who underwent revision ACL reconstruction were included in this study, with a mean follow-up time of 40.3 months (range, 16.4–64.8) for RT and 61.2 months (range, 34.6–86.3) for HT. Apart from the harvesting technique, the surgical technique was the same for both groups. Clinical and intraoperative data were collected for our postoperative registry. In addition, funcinal outcome was measured using the International Knee Documentation Committee score (IKDC), the Lysholm score, Tegner activity scale, and numeric rating scale (NRS). The type and frequency of postoperative complications were documented. Results: At the final follow-up, no significant differences were observed between the RT and HT groups in the IKDC (mean ± SD: 74.7 ± 10.9 vs. 74.9 ± 12.9), Lysholm score (90.9 ± 15.0 vs. 89.0 ± 14.6), or Tegner activity scale (median [IQR]: 5 [4–6] vs. 5 [4–6]). The mean femoral tunnel diameter was 9.0 mm (range, 7.5–10 mm) for the RT and 8.2 mm (range 7.0–9.5 mm) for the HT. The use of the RT reduced the need for a two-stage procedure by 50% compared to HT (n = 5 vs. n = 10), although this difference was not statistically significant (p = 0.11). Stability measured by the Lachman test improved significantly in both groups from the pre- to postoperative period. Retear of the ACL graft was observed in two patients in both groups (7.1% RT and 7.4% HT). Conclusions: The RT and HT autografts achieved similar outcomes in PROMs for revision ACL reconstruction. Good tendon quality with parallel fibers and adjustable thickness characterize the RT. A tendency for a reduced rate of two-stage surgery with RT was noticed. Clinical Relevance: The incidence of revision ACL reconstruction is rising. Surgeons should be aware of all the available graft options. The isolated RT expands the range of autografts available for ACL reconstruction. Full article

Discoid medial meniscus (DMM) is a rare congenital anomaly, with bilateral cases being even more uncommon. Due to its rarity, comprehensive data on its prevalence, clinical presentation, and optimal management strategies are limited. This study aimed to evaluate the prevalence, clinical characteristics, and treatment outcomes of symptomatic DMM in a pediatric population. A retrospective review was conducted on patients under 18 years of age diagnosed with symptomatic DMM. Data were extracted using ICD-10 codes Q68.6 and M23.16 and were supplemented by free-text searches. The inclusion criteria encompassed a confirmed DMM diagnosis, availability of MRI and radiographic imaging, complete clinical documentation, and a minimum of six months of postoperative follow-up. Demographic data, clinical presentations, imaging findings, surgical interventions, and outcomes were analyzed. Three patients (five knees) met the inclusion criteria. All presented with symptomatic DMM requiring surgical intervention. Arthroscopic saucerization combined with meniscal repair was performed in all cases. Postoperative follow-up revealed that two of the patients achieved excellent outcomes, while one required three reoperations due to retearing but remained symptom-free at one year post-revision. Radiographic assessments did not reveal characteristic changes typically associated with DMM. Symptomatic DMM, though rare, may be encountered more frequently than previously reported, especially when focusing on symptomatic cases. Arthroscopic saucerization with concurrent meniscal repair appears to be an effective treatment modality, yielding favorable mid-term outcomes. Given the limited number of cases and the variability in their presentations, further research with larger cohorts is essential to establish standardized management protocols and to better understand the long-term prognosis of patients with this rare condition. Full article

Background and Objectives: Shoulder pain, mainly involving rotator cuff tears, is a common type of musculoskeletal pain that significantly impairs quality of life. Arthroscopic rotator cuff repair has become the gold standard for treating symptomatic, full-thickness rotator cuff tears. Double-row repair techniques are widely used because of their superior fixation and healing results. However, fewer implants may reduce treatment costs and raise questions about the impact on clinical outcomes and re-tear rates. This study compares the functional outcomes and re-tear rates of two transosseous-like double-row repair techniques: one anchor and one push lock (Group 1), and two anchors and two push locks (Group 2). Materials and Methods: A prospective, randomized, single-blind study was conducted on 53 patients undergoing arthroscopic repair for crescent-shaped rotator cuff tears (3–5 cm). Before surgery and 24 months after surgery, patients were evaluated for shoulder function using Constant–Murley scores and shoulder abduction angles. MRI was used to assess re-tear rates. Results: Both groups showed significant postoperative improvement in Constant scores (Group 1: 84.1; Group 2: 84.0; p > 0.05). Re-tear rates were slightly higher in Group 1 (23.1%) than in Group 2 (18.5%), but this was not statistically significant (p > 0.05). Shoulder abduction angles improved similarly between groups, with no significant difference in outcome. Despite higher costs and longer operative times, the two-anchor technique provided more stable fixation, but its functional outcomes were comparable to the single-anchor method. Conclusions: Using fewer implants in a double-row repair provides comparable functional outcomes and re-tear rates, and offers surgeons a cost-effective alternative, especially at the beginning of their learning curve. However, the two-anchor technique may be more beneficial in cases requiring improved mechanical stability. These findings provide valuable information to balance cost and effectiveness in rotator cuff repair. Full article

Injuries to the soleus muscle are often unrecognized, which increases the risk of complete tearing. Consequently, it results in the need for a long break in sports. This is mainly because the soleus muscle is complex, and the clinical signs of injury are difficult to capture, which can mimic Achilles tendinopathy and tennis player’s calves. This muscle has a complex connective tissue structure with three intramuscular tendons, which makes it challenging to interpret pathological muscle conditions. Injuries to the soleus muscle can be acute or chronic and are usually considered to be a minor discomfort by both the patient and the sports medicine physician, leading to a relatively quick return to sports activity with a high risk of re-injury. This narrative literature review aims to explore the diagnostic challenges and treatment failures associated with soleus muscle injuries, highlighting the critical lack of standardized protocols and a comprehensive understanding of the nuances of these injuries, which requires the collection of qualitative data from clinical case studies, quantitative data from imaging studies and rehabilitation outcomes, and expert opinion to formulate evidence-based guidelines to improve patient management. Calf muscle pain symptoms should not be ignored because the injury may become chronic, and the lack of treatment adequate to the actual cause of the pain increases the risk of the injury deepening, including complete rupture. High-resolution ultrasonography and magnetic resonance imaging are recommended methods for differentially diagnosing soleus muscle injury in conjunction with physical examination to make a precise and reliable diagnosis. A soleus muscle injury case report and a comprehensive proposal for conservative treatment supplement our literature review. Full article