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  1. Article ; Online: What's New in Musculoskeletal Basic Science.

    Gugala, Zbigniew

    The Journal of bone and joint surgery. American volume

    2023  Volume 105, Issue 23, Page(s) 1831–1836

    Language English
    Publishing date 2023-10-23
    Publishing country United States
    Document type Editorial
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.23.01003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: What's New in Musculoskeletal Basic Science.

    Gugala, Zbigniew

    The Journal of bone and joint surgery. American volume

    2022  Volume 104, Issue 23, Page(s) 2047–2052

    Language English
    Publishing date 2022-10-25
    Publishing country United States
    Document type Editorial
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.22.00947
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: On a quest to dethrone the long-reigning king: commentary on an article by Christopher W. DiGiovanni, MD, et al.: "Recombinant Human platelet-derived growth factor-BB and beta-tricalcium phosphate (rhPDGF-BB/β-TCP): an alternative to autogenous bone graft".

    Gugala, Zbigniew

    The Journal of bone and joint surgery. American volume

    2013  Volume 95, Issue 13, Page(s) e95

    MeSH term(s) Angiogenesis Inducing Agents/therapeutic use ; Ankle Joint/surgery ; Arthrodesis ; Biocompatible Materials/therapeutic use ; Calcium Phosphates/therapeutic use ; Female ; Humans ; Male ; Proto-Oncogene Proteins c-sis/therapeutic use
    Chemical Substances Angiogenesis Inducing Agents ; Biocompatible Materials ; Calcium Phosphates ; Proto-Oncogene Proteins c-sis ; beta-tricalcium phosphate ; becaplermin (1B56C968OA)
    Language English
    Publishing date 2013-07-03
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.M.00677
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Missed Visits Predict Recurrence in Idiopathic Clubfoot.

    Martinez, Armando S / Loyd, Grey / Bridges, Callie / Milad, Matthew / Pathare, Nihar / Doston, Luke / Gugala, Zbigniew / Hill, Jaclyn F

    Journal of pediatric orthopedics

    2024  

    Abstract: Background: Congenital talipes equinovarus, also known as "clubfoot," is a common congenital deformity. While reported relapse rates vary widely, relapse continues to be a common problem faced in the treatment of this condition. The objective of this ... ...

    Abstract Background: Congenital talipes equinovarus, also known as "clubfoot," is a common congenital deformity. While reported relapse rates vary widely, relapse continues to be a common problem faced in the treatment of this condition. The objective of this study is to assess relationships between demographic/socioeconomic factors, follow-up, and rates of relapse in our population of clubfoot patients.
    Methods: Retrospective chart review was conducted for patients undergoing treatment for idiopathic clubfoot from February 2012 to December 2022 at a tertiary children's hospital. Records were analyzed for follow-up adherence and recurrence in the Ponseti method, in addition to patient demographic and socioeconomic factors. Statistical analysis was performed to evaluate associations between recurrence, missed clinical visits, and demographic/socioeconomic factors of interest.
    Results: Ninety-five patients were included in the study [74.7% male (N=71) and 25.2% female (N=24)]. A total of 64.2% (N=61) of patients developed recurrence during their treatment. Recurrence rates differed significantly by reported bracing noncompliance >1 month (35/46 vs. 26/49, P=0.019), having missed 1 or more clinical visits (38/61 vs. 8/34, P < 0.001), Medicaid or equivalent insurance type (41/56 vs. 20/39, P=0.028), non-white race (47/66 vs. 14/29, P=0.032, higher Social Deprivation Index score (56.13 vs. 41.06, P=0.019). Significant variables were analyzed using a multivariate logistic regression analysis (MVLR). After MVLR, having 1 or more missed clinical visits (OR 4.462, 95% CI: 1.549-12.856) remained significantly associated with increased rates of recurrence. Primary language preference and distance to the hospital were not associated with recurrence.
    Conclusions: Higher SDI scores, non-white race, Medicaid insurance, and missed clinical follow-up visits were all associated with increased rates of recurrence for clubfoot patients. Using an MVLR model, missed clinical follow-up visits remained independently associated with increased recurrence rates.
    Level of evidence: Level 2-retrospective, prognostic study.
    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000002686
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Clinical Considerations for Return to Driving a Car following a Total Knee or Hip Arthroplasty: A Systematic Review.

    Na, Annalisa / Richburg, Kacy / Gugala, Zbigniew

    BioMed research international

    2020  Volume 2020, Page(s) 8921892

    Abstract: Aim: The purpose of this study is to systematically review patient characteristics and clinical determinants that may influence return to driving status and time frames following a primary TKA or THA and provide an update of the current literature.: ... ...

    Abstract Aim: The purpose of this study is to systematically review patient characteristics and clinical determinants that may influence return to driving status and time frames following a primary TKA or THA and provide an update of the current literature.
    Methods: This review was completed per the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Final electronic database searches were completed in October 2019 in Medline/PubMed, Medline/OVID, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library using preselected search terms. Manuscripts of prospective and nonrandomized studies that examined the return to driving a car after a primary knee or hip arthroplasty patients were included. The Methodological Index for Non-Randomized Studies was used to measure study quality. Two authors selected studies and assessed their qualities. All disagreements were resolved through discussion and, as needed, a third reviewer. Data on study title, author(s), country, year, study design, sample size, inclusion and exclusion criteria, age, BMI, gender, statistical analyses, driving measure, follow-up time, surgical approach, laterality, and postoperative management were extracted from each study.
    Results: A total of 23 studies were eligible, including 12 TKA studies (
    Conclusions: Study results were consistent with previous systematic reviews in that return to driving a car after a primary TKA or THA is highly variable, and most commonly occurs around 4 weeks, but can range between 2 and 8 weeks. While various patient and clinical factors can influence return to driving for a TKA or THA, the most common contributing facts were pain and laterality. The heterogeneous nature of the studies prevented a meta-analysis for determining contributions of return to driving following a primary TKA or THA. Regardless, this study updates previous systematic reviews and presents insight on patient and clinical factors beyond generalized timeframes for return to driving a car. This information and results from future studies are essential to guide clinical recommendations and patient and clinician expectations for return to driving a car after a primary TKA or THA.
    MeSH term(s) Arthroplasty, Replacement, Hip/methods ; Arthroplasty, Replacement, Knee/methods ; Automobile Driving ; Hip/physiology ; Hip/surgery ; Humans ; Knee Joint/physiology ; Knee Joint/surgery ; Prospective Studies ; Recovery of Function/physiology
    Language English
    Publishing date 2020-07-06
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 2698540-8
    ISSN 2314-6141 ; 2314-6133
    ISSN (online) 2314-6141
    ISSN 2314-6133
    DOI 10.1155/2020/8921892
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The Legal, Ethical, and Scientific Considerations for Returning Explanted Orthopaedic Hardware to the Patient.

    Black, Natalie R / Winslade, William J / Lindsey, Ronald W / Gugala, Zbigniew

    The Journal of bone and joint surgery. American volume

    2021  Volume 104, Issue 9, Page(s) e37

    Abstract: Abstract: Orthopaedic hardware explantation is a multifaceted topic with complex legal, ethical, and scientific aspects that require thorough exploration. Issues of device ownership, explant-induced disease propagation, and potential device resale pose ... ...

    Abstract Abstract: Orthopaedic hardware explantation is a multifaceted topic with complex legal, ethical, and scientific aspects that require thorough exploration. Issues of device ownership, explant-induced disease propagation, and potential device resale pose legal risks to providers and health-care institutions. Ethically, implant removal highlights the potential that performing procedures at the request of the patient will incentivize patient compliance and strengthen the patient-surgeon relationship. However, the return of explanted hardware to patients could hinder scientific study and innovation, ultimately limiting advancement in risk reduction and patient outcomes. Continued research into these topics remains paramount to ensure that clinicians and institutions deliver optimal patient care while abiding with legal and ethical imperatives. This article addresses the legal, ethical, and scientific issues that are pertinent to returning an explanted orthopaedic implant to the patient and the potential ramifications of such practice.
    MeSH term(s) Device Removal ; Humans ; Morals ; Orthopedic Equipment ; Orthopedics
    Language English
    Publishing date 2021-11-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.21.00318
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Acute and severe trabecular bone loss in a rat model of critical illness myopathy.

    Gugala, Zbigniew / Cacciani, Nicola / Klein, Gordon L / Larsson, Lars

    Journal of orthopaedic research : official publication of the Orthopaedic Research Society

    2021  Volume 40, Issue 6, Page(s) 1293–1300

    Abstract: Prolonged mechanical ventilation for critically ill patients with respiratory distress can result in severe muscle wasting with preferential loss of myosin. Systemic inflammation triggered by lung mechanical injury likely contributes to this myopathy, ... ...

    Abstract Prolonged mechanical ventilation for critically ill patients with respiratory distress can result in severe muscle wasting with preferential loss of myosin. Systemic inflammation triggered by lung mechanical injury likely contributes to this myopathy, although the exact mechanisms are unknown. In this study, we hypothesized that muscle wasting following mechanical ventilation is accompanied by bone loss. The objective was to determine the rate, nature, and extent of bone loss in the femora of rats ventilated up to 10 days and to relate the bone changes to muscle deterioration. We have developed a rat model of ventilator-induced muscle wasting and established its feasibility and clinical validity. This model involves pharmacologic paralysis, parenteral nutrition, and continuous mechanical ventilation. We assessed the hindlimb muscle and bone of rats ventilated for 0, 2, 5, 8, and 10 days. Routine histology, microCT, and biomechanical evaluations were performed. Hindlimb muscles developed changes consistent with myopathy, whereas the femurs demonstrated a progressive decline in trabecular bone volume, mineral density, and microarchitecture beginning Day 8 of mechanical ventilation. Biomechanical testing showed a reduction in flexural strength and stiffness on Day 10. The bone changes correlated with the loss of muscle mass and myosin. These results demonstrate that mechanical ventilation leads to progressive trabecular bone loss parallel to muscle deterioration. The results of our study suggest that mechanically ventilated patients may be at risk of compromised bone integrity and muscle weakness, predisposing to post-ventilator falls and fractures, thereby warranting interventions to prevent progressive bone and muscle decline.
    MeSH term(s) Animals ; Cancellous Bone ; Critical Illness ; Humans ; Muscular Atrophy ; Muscular Diseases/etiology ; Rats ; Respiration, Artificial/adverse effects
    Language English
    Publishing date 2021-08-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605542-4
    ISSN 1554-527X ; 0736-0266
    ISSN (online) 1554-527X
    ISSN 0736-0266
    DOI 10.1002/jor.25161
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Optimization and Characterization of a Bone Culture Model to Study Prostate Cancer Bone Metastasis.

    Wu, Yi-Hsuan / Gugala, Zbigniew / Barry, Megan M / Shen, Yichao / Dasgupta, Subhamoy / Wang, Hai

    Molecular cancer therapeutics

    2022  Volume 21, Issue 8, Page(s) 1360–1368

    Abstract: Nearly 90% of patients with advanced prostate cancer manifest bone metastases. Distinct from the osteolytic metastasis mostly observed in other cancer types, prostate cancer bone metastasis is typically more osteoblastic, which is relatively understudied ...

    Abstract Nearly 90% of patients with advanced prostate cancer manifest bone metastases. Distinct from the osteolytic metastasis mostly observed in other cancer types, prostate cancer bone metastasis is typically more osteoblastic, which is relatively understudied due to the lack of reliable and efficient models to resemble the indolent cellular growth and complexity of metastatic progression. In our previous studies, we developed bone-in-culture array (BICA) to primarily model the osteoblast-involved, pre-osteolytic stage of breast cancer bone metastasis. Given that the progression of prostate cancer bone metastasis is largely osteoblastic, it is reasonable to speculate that the original BICA model can be adjusted to investigate prostate cancer bone metastases. In this study, we refined BICA by reducing the surgical labor and improving its reproducibility and capacity. The optimized BICA can successfully recapitulate important features of prostate cancer bone metastasis such as the osteoblastic phenotype, indolent growth, cancer-niche interactions, and response to hormones. Our efforts address the long-standing need for reliable and efficient models to study prostate cancer bone metastasis.
    MeSH term(s) Bone Neoplasms/secondary ; Humans ; Male ; Osteoblasts ; Prostatic Neoplasms/pathology ; Reproducibility of Results
    Language English
    Publishing date 2022-06-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2063563-1
    ISSN 1538-8514 ; 1535-7163
    ISSN (online) 1538-8514
    ISSN 1535-7163
    DOI 10.1158/1535-7163.MCT-21-0684
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Clinical Characteristics of Patients with Type 2 Diabetes Mellitus Receiving a Primary Total Knee or Hip Arthroplasty.

    Na, Annalisa / Jansky, Laurie / Gugala, Zbigniew

    Journal of diabetes research

    2019  Volume 2019, Page(s) 9459206

    Abstract: Aim: The purpose of this study is to explore clinical characteristics of patients with T2DM receiving a primary knee (TKA) or hip (THA) arthroplasty to patients without T2DM receiving a TKA or THA and patients with T2DM with no history of osteoarthritis ...

    Abstract Aim: The purpose of this study is to explore clinical characteristics of patients with T2DM receiving a primary knee (TKA) or hip (THA) arthroplasty to patients without T2DM receiving a TKA or THA and patients with T2DM with no history of osteoarthritis (OA).
    Methods: The study included a retrospective database review of 500 consecutive primary TKA or THA identified with ICD-9 codes and 100 consecutive T2DM patients. Patients who received a TKA or THA were screened for inclusion and exclusion and divided into with or without T2DM groups. A comparison group of patients with T2DM only without arthroplasty was screened to exclude patients with a history of OA or arthroplasty. All groups were compared based on demographic and relevant comorbidity differences. OA characteristics, including OA and previous arthroplasty of the involved and contralateral joints, were compared between patients with and without T2DM receiving a TKA or THA. Finally, patients with T2DM with and without TKA or THA were compared for T2DM differences.
    Results: Study results found that among those receiving a primary arthroplasty, patients with T2DM were more likely to be obese and older and reported cardiovascular, urinary, dyslipidemia, and peripheral neuropathy than those with T2DM. Among the T2DM individuals, those receiving an arthroplasty surgery were older and obese and more likely to report peripheral neuropathy; however, those with T2DM with no OA were more likely to report atherosclerosis and cardiovascular disease. Within the arthroplasty subgroup of individuals with T2DM, those requiring antidiabetic medication were 4.5 times more likely to have contralateral OA or arthroplasty.
    Conclusions: The results of this study suggest that patients with T2DM requiring a primary arthroplasty are a unique subgroup that requires careful considerations as they are often older, have obesity, and specific comorbidities predisposing to worse postoperative outcomes than their non-T2DM arthroplasty counterparts. Therefore, clinical practice and future studies must consider strategies that would limit OA and arthroplasty management delays while accounting for comorbidities and patient characteristics.
    MeSH term(s) Age Distribution ; Aged ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Case-Control Studies ; Comorbidity ; Diabetes Mellitus, Type 2/epidemiology ; Diabetic Nephropathies/epidemiology ; Diabetic Neuropathies/epidemiology ; Dyslipidemias/epidemiology ; Female ; Humans ; Hypertension/epidemiology ; Male ; Middle Aged ; Obesity/epidemiology ; Osteoarthritis, Hip/epidemiology ; Osteoarthritis, Hip/surgery ; Osteoarthritis, Knee/epidemiology ; Osteoarthritis, Knee/surgery ; Peripheral Nervous System Diseases/epidemiology ; Renal Insufficiency, Chronic/epidemiology ; Retrospective Studies ; Texas/epidemiology
    Language English
    Publishing date 2019-11-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2711897-6
    ISSN 2314-6753 ; 2314-6753
    ISSN (online) 2314-6753
    ISSN 2314-6753
    DOI 10.1155/2019/9459206
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: A Population of M2 Macrophages Associated With Bone Formation.

    Olmsted-Davis, Elizabeth / Mejia, Julio / Salisbury, Elizabeth / Gugala, Zbigniew / Davis, Alan R

    Frontiers in immunology

    2021  Volume 12, Page(s) 686769

    Abstract: We previously identified transient brown adipocyte-like cells associated with heterotopic ossification (HO). These ancillary cells support new vessel synthesis essential to bone formation. Recent studies have shown that the M2 macrophage contributes to ... ...

    Abstract We previously identified transient brown adipocyte-like cells associated with heterotopic ossification (HO). These ancillary cells support new vessel synthesis essential to bone formation. Recent studies have shown that the M2 macrophage contributes to tissue regeneration in a similar way. To further define the phenotype of these brown adipocyte-like cells they were isolated and characterized by single-cell RNAseq (scRNAseq). Analysis of the transcriptome and the presence of surface markers specific for macrophages suggest that these cells are M2 macrophages. To validate these findings, clodronate liposomes were delivered to the tissues during HO, and the results showed both a significant reduction in these macrophages as well as bone formation. These cells were isolated and shown in culture to polarize towards either M1 or M2 similar to other macrophages. To confirm that these are M2 macrophages, mice received lipopolysacheride (LPS), which induces proinflammation and M1 macrophages. The results showed a significant decrease in this specific population and bone formation, suggesting an essential role for M2 macrophages in the production of bone. To determine if these macrophages are specific to HO, we isolated these cells using fluorescence-activated cell sorting (FACS) from a bone defect model and subjected them to scRNAseq. Surprisingly, the macrophage populations overlapped between the two groups (HO-derived
    MeSH term(s) Adipocytes, Brown/drug effects ; Adipocytes, Brown/metabolism ; Adipocytes, Brown/pathology ; Animals ; Cell Plasticity ; Cells, Cultured ; Clodronic Acid/pharmacology ; Disease Models, Animal ; Femoral Fractures/genetics ; Femoral Fractures/metabolism ; Femoral Fractures/pathology ; Femur/metabolism ; Femur/pathology ; Lipopolysaccharides/pharmacology ; Macrophages/drug effects ; Macrophages/metabolism ; Macrophages/pathology ; Mice, Transgenic ; Ossification, Heterotopic/genetics ; Ossification, Heterotopic/metabolism ; Ossification, Heterotopic/pathology ; Osteogenesis ; Phagocytosis ; Phenotype ; Receptors, Adrenergic, beta-3/metabolism ; Transcriptome
    Chemical Substances Adrb3 protein, mouse ; Lipopolysaccharides ; Receptors, Adrenergic, beta-3 ; Clodronic Acid (0813BZ6866)
    Language English
    Publishing date 2021-10-12
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2021.686769
    Database MEDical Literature Analysis and Retrieval System OnLINE

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