Advances in General Practice of Medicine

National orthopaedic registries compile databases regarding the procedures and outcomes. Registers while used in policy development, projecting future trends and resource allocation also provide a means to monitor patient care, implant performance, support evidence-based practices and a scale in which to assess quality improvement in orthopaedic surgery. These databases can also facilitate shared decision-making between patients and surgeons. Since international databases exist on joint prostheses that can be used to generate a comparative analysis between different countries. By standardizing data collection among countries, one can compare various geographical and demographic factors that may play a role in data variation. In this paper, data from the “Norwegian National Network for Arthroplasty and Hip Fracture” registry was collected, and statistical analysis performed to identify differences and trends in the Norwegian data. The focus of this paper is on knee arthroplasties and, more specifically, the reasons for primary arthroplasty, revision surgery, and reoperation surgery. We compared the Norwegian data with Sweden, Switzerland, England, and Australian registries, however, due to reporting inconsistencies, no comparison was generated. Thus, this paper adds an epexegesis to the Norwegian National Registry on reasons for revisions data and constitutes a part of course work in Experimental Orthopaedic Engineering (BME 7220).

This paper explores the dynamic changes in breast moisture content in relation to hormonal fluctuations throughout the menstrual cycle, emphasizing the role of estrogen and progesterone in influencing breast physiology. The menstrual cycle is divided into four phases—menstrual, follicular, ovulatory, and luteal—each of which elicits measurable variations in breast volume, density, and moisture due to hormone-driven tissue remodeling and fluid retention. Estrogen predominates in the follicular phase, promoting ductal proliferation and mild fluid accumulation, while the luteal phase is characterized by a significant rise in progesterone, resulting in marked stromal edema, increased glandular development, and heightened fluid retention. These hormonal changes are mediated through the renin-angiotensin-aldosterone system (RAAS) and vasopressin pathways, which contribute to systemic and localized water retention, especially within breast tissue. The paper synthesizes hormonal biochemistry, breast anatomy, and biomechanical modeling to examine how these cyclic changes impact breast density and volume, with clinical implications for breast tenderness, mammographic sensitivity, and cancer screening. Imaging data and statistical analyses reveal a consistent pattern of increased breast density and volume during the luteal phase. Understanding these cyclical changes enhances the ability to anticipate breast-related symptoms, improve diagnostic timing, and personalize care, particularly for women with dense breast tissue or hormone-sensitive conditions.

Background: Diffusion kurtosis imaging (DKI) has been found to be more precise than diffusion weighted imaging (DWI) for detecting irreversible infarction in acute ischemic stroke. This study aimed to evaluate whether fast DKI has distinctive advantages in detecting venous stroke caused by cerebral venous thrombosis (CVT).
Methods: All data from patients diagnosed with venous stroke due to CVT and qualified for mechanical recanalization treatment were collected. Fast DKI and DWI were obtained both before and after revascularization therapy, and lesions were measured. Lesion volumes on T₂ weighted imaging (T₂WI) were followed up at six months.
Results: A total of 11 patients were recruited. Compared to the contralateral brain, ADC values of the lesions in pre-operation increased significantly (1340.12±235.42 vs 919.75±128.98, P < 0.05), while MK decreased (0.59±0.11 vs 0.81±0.12, P < 0.05). And the same changing trend about ADC values (1258.94±185.08 vs 949.81±148.52, P < 0.05) and MK values (0.64±0.12 vs 0.83±0.12, P < 0.05) in post-operation. There was no significant difference in the volume of lesions between DKI and DWI during the same examination period (26.97 vs 29.28, P_pre > 0.05; 13.34 vs 13.14, P_post > 0.05). However, the lesion volume after revascularization was significantly reduced compared to the first DKI and DWI examinations (26.97 vs 13.34, P < 0.05), and the same as DWI (29.28 vs 13.14, P < 0.05). Volume of T2WI lesions after the 6th month diminished significantly compared with both DKI lesions and DWI lesions before treatment (7.25 vs 26.97, P < 0.05; 7.25 vs 31.19, P < 0.05). Fast DKI had a higher signal to noise ratio (SNR) than traditional DKI and DWI.
Conclusion: The MK of the venous stroke lesions decreased significantly in the subacute stage of CVT, suggesting reversible infarction. Fast DKI has more distinctive superiority in the evaluation of venous stroke. Fast DKI approach may hold great promise for patients in clinical setting because of a higher SNR than DWI. But the sample need to be further expanded because of only 11 patients recruited.

The gut bacterial microbiome (GBM) plays an emerging role in the pathophysiology of chronic diseases, including hypertension (HTN). Growing evidence suggests that gut dysbiosis, defined by an altered microbial composition and diversity, is involved in the onset and progression of HTN. Exploring the underlying mechanisms linking the GBM and HTN paves the way for novel targeted therapeutic strategies. This narrative review aims to synthesize current data on the interactions between the GBM and HTN, highlight the bidirectional nature of this relationship, and discuss the clinical implications of microbiome modulation in hypertension management. Gut dysbiosis leads to increased intestinal permeability, facilitating systemic translocation of lipopolysaccharides, which in turn activate inflammatory (TLR4, NF-κB) and sympathetic pathways, contributing to endothelial dysfunction and elevated blood pressure. Moreover, certain microbial metabolites, such as short-chain fatty acids (SCFAs), exhibit antihypertensive effects, whereas trimethylamine-N-oxide (TMAO) is associated with increased vascular stiffness and activation of the renin–angiotensin–aldosterone system. The relationship between the GBM and HTN is reciprocal: while dysbiosis can promote HTN, HTN itself may disrupt the gut microbial ecosystem. This bidirectional interaction suggests the existence of a pathological vicious cycle. Innovative strategies to modulate the GBM, including the use of probiotics, prebiotics, postbiotics, and specific dietary interventions such as the Dietary Approaches to Stop Hypertension diet, are currently under investigation. The emergence of pharmacological approaches targeting pathogenic microbial metabolites, such as TMAO, also represents a promising avenue toward precision medicine in hypertension.

Xanthogranulomatous orchitis is a chronic, non-neoplastic inflammation that is quite rare. In this paper, we discuss the case of a 79-year-old male patient who presented with bilateral scrotum swelling and dysuria that persisted for two weeks. Despite two weeks of anti-infection treatment, the patient's symptoms persisted, leading to a decision to perform transurethral prostate resection and bilateral orchiectomy after careful consideration. After the surgery, the postoperative pathology indicated that the patient had xanthogranulomatous orchitis on the left side and acute positive orchitis with hemorrhage on the right side. Fortunately, three months after the procedure, the patient experienced no negative events and was pleased with the postoperative results.