Complex subtrochanteric fracture represents a severe injury of the proximal femur, with a significant functional impact and complex postoperative rehabilitation requirements. This case report describes the clinical evolution of a 54-year-old female patient admitted following a skiing accident, in whom radiographic examination revealed a complex subtrochanteric fracture with traumatic detachment and displacement of the lesser trochanter by 30 mm relative to the femoral shaft, surgically treated by osteosynthesis with a locked intramedullary nail. Postoperatively, the patient presented with pain in the hip joint and a significant limitation of hip range of motion, resulting in impaired overall functional capacity. An individualized physiotherapy program was initiated, focusing on pain control, restoration of joint mobility, and recovery of muscle strength. Clinical evolution was assessed using functional scales, goniometric measurements, and muscle strength testing. Following the rehabilitation intervention, progressive improvement in hip joint mobility, increased range of motion, and enhanced muscle strength were observed, together with an improvement in the patient’s overall functional capacity. The results suggest the importance of a structured postoperative rehabilitation program in optimizing functional prognosis after complex subtrochanteric fractures.
Electric source imaging (ESI) is commonly reconstructed at selected time points of an interictal epileptiform discharge (IED), although the source may evolve during the discharge. We investigated whether temporal sampling alters the spatial relationship between the ESI maximum and a temporal encephalocele (TE). We performed a lesion-referenced secondary analysis of a previously reported TE cohort. Averaged IEDs were reconstructed independently with MUSIC and sLORETA. Source-to-TE distance at the main negative peak was compared with the earlier technically valid component, classified as onset, half-rise, or a preceding peak in polyphasic IEDs. The primary measure was paired change in source-to-TE distance (ΔD_TE = D_peak − D_earlier). Complete paired measurements were available in 15 trajectories for each inverse method. Median source-to-TE distance increased from 13 to 28 mm with MUSIC (median ΔD_TE +10 mm; Holm-adjusted p=0.0032) and from 15 to 26 mm with sLORETA (median ΔD_TE +5 mm; adjusted p=0.0032). The peak source was farther from the TE in 12/15 MUSIC and 13/15 sLORETA trajectories. Direction of change agreed between methods in 11/12 jointly evaluable patients. The lesion-source relationship was time-dependent within the IED, indicating that temporal sampling materially influences lesion-directed ESI interpretation.
Neuromuscular function and psychological well-being can be affected by spinal cord injury leading to paraplegia, including upper-body muscle activation, reaction time and self-concept. This study investigated the effects of 12 weeks Neurobic Exercise Program and Multicomponent Exercise Program on these outcomes in individuals with paraplegia. Forty-five participants were randomly assigned to three groups Neurobic Exercise Group (NEG; n = 15), Multicomponent Exercise Program Group (MEP; n = 15), and Control Group (CG; n = 15). Both exercise interventions were conducted for 12 weeks 5 days/week. Electromyographic activity of the anterior deltoid and trapezius, self-concept and auditory and visual reaction time were assessed pre- and post-intervention. The data were analyzed using descriptive statistics, paired and independent t-tests, analysis of covariance, and Scheffé post hoc comparisons. Significant improvements were observed in all measured outcomes in both exercise groups compared with the control group (p < 0.05). The MEP showed greater changes in EMG activity, self-concept and auditory and visual reaction time than the NEG. While both exercise modalities may provide neuromuscular and psychological benefits to individuals with paraplegia, differences in exercise content, particularly the incorporation of direct resistance exercise within the MEP, should be considered when interpreting between-program variations.
Amputation is the most feared outcome of peripheral arterial disease (PAD), yet the trajec-tory from revascularization to limb loss is rarely captured in single-center data. We ana-lysed a hospital registry to identify predictors of amputation, its impact on recovery-related outcomes, and, using same-patient readmission linkage, direct evidence of progression from a non-amputation admission to a later amputation. Retrospective cohort study of 646 consecutive admissions to a university-affiliated vascular surgery department (January 2022–July 2026). After excluding 52 aneurysm admissions, 594 admissions in 541 patients with occlusive arterial disease were analysed. Comorbidities and procedures were extracted from ICD-10 and procedure codes; amputations were classified as major or minor. Same-patient admissions were linked to build per-patient sequences. Predictors of amputation were assessed by univariable tests and multivariable logistic regression. Amputation occurred in 81/594 admissions (13.6%: 1.7% major, 11.1% minor, 0.8% reamputation). Fontaine stage IV tissue loss was the strongest correlate (25.0% vs 1.2–0% in stages II–III, OR=37.3, p<0.001). On multivariable analysis, diabetes (OR=3.39, 95% CI 1.92–5.98, p<0.001) and prior amputation (OR=2.51, 95% CI 1.35–4.69, p=0.004) independently predicted amputation; age, sex, residence and cardiovascular comorbidity did not. Amputation was associated with longer stay (median 19.1 vs 7.1 days, p<0.001) and more frequent ICU use (29.6% vs 13.6%, p<0.001). Among 45 readmit-ted patients without amputation at their first admission, 5 (11.1%) required one later (me-dian 70 days); all 5 were diabetic and had received endovascular therapy initially. Diabetes and prior amputation – not age or cardiovascular comorbidity – were the dominant predictors of limb loss, and amputation nearly tripled length of stay. A re-admission-linked signal identified diabetic patients progressing from endovascular re-vascularization to amputation within weeks to months, supporting structured post-procedural surveillance and multidisciplinary diabetic-foot pathways.
Static postural alignment can be quantified non-invasively using smartphone-based photogrammetric tools. This study examined changes in APECS-derived postural-alignment variables after a 12-week core-strengthening program delivered within university physical education. In this prospective pre-post study, 219 non-sport students from Transilvania University of Brașov were enrolled; 213 completed paired baseline and post-intervention APECS assessments. Participants attended one 50-minute session per week for 12 weeks. Static posture was assessed using Apecs-AI 4.2.1 under a standardized acquisition protocol. Paired analyses estimated baseline-to-post changes, Cohen's dz, 95% confidence intervals, and Holm-adjusted p values across 22 APECS outputs. Mean attendance was 11.05±0.95 sessions, and protocol fidelity was 91.4±4.9%. Significant reductions were observed in 10 of 22 APECS variables after multiplicity correction. The prespecified trunk/pelvic outcomes showed reductions: anterior trunk inclination decreased by 0.32° (95% CI, 0.24–0.40), posterior trunk inclination by 0.17° (0.10–0.24), and sagittal pelvic tilt by 1.00° (0.90–1.10). Eleven adverse events were recorded, all resolved, with no serious event. A once-weekly core-strengthening program was associated with measurable reductions in APECS-derived static postural-alignment deviations, most notably sagittal pelvic tilt; the clinical meaning of these changes remains uncertain, and controlled trials are needed to determine whether the changes are attributable to the intervention.
