Background. Common postoperative complications following surgery, particularly acute appendicitis surgery, include postoperative pain and vomiting, which can cause discomfort and delay recovery time. Methods. A randomized double‐blinded placebo‐controlled clinical trial was conducted with 80 cases of acute appendicitis of American Society of Anesthesiologists (ASA) physical status I or II and aged 18–60 y/o scheduled for appendectomy under general anesthesia. Patients were randomly divided into two equal groups: group A received 4 mg of ondansetron IV (2 ml) and group B received 2 ml of normal slain IV (placebo). Pain according to VAS, nausea and vomiting according to clinical symptoms, shivering and sedation according to the Bedside Shivering Assessment Scale (BSAS), and the Ramsay Sedation Scale (RSS) at 2, 6, 12, and 24 hours after surgery were evaluated and compared between the groups. Results. There was a significant decline in the severity of pain only at 2 hours after surgery between the ondansetron and control groups (5.3 ± 1.0 vs. 6.0 ± 1.0; p = 0.01), not showing a difference between the groups at 6, 12, and 24 hours after appendectomy. Postoperative nausea and vomiting at 2 (5% vs. 25%; p = 0.03) and 6 (7.5% vs. 27.5%; p = 0.04) hours after appendectomy in the ondansetron group. At different times, the ondansetron and control groups did not differ in terms of pethidine consumption or sedation. Conclusions. In conclusion, our study found that ondansetron was effective in reducing postoperative vomiting after acute appendicitis surgery. However, it did not show a clinically significant effect on postoperative pain. This trial is registered with IRCT20230722058883N1.

Background: Many patients who undergo shoulder arthroplasty (SA) have had at least 1 nonarthroplasty shoulder surgery before the surgery. There is conflicting evidence regarding the effects of previous shoulder surgery on the outcome of SA. A systematic review was conducted to compare functional outcomes and complications between SA patients with and without prior non-SA surgery on the ipsilateral shoulder. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched MEDLINE/PubMed, Embase, Scopus, and Web of Science comprehensively from inception to January 2023. Based on 9,279 records reviewed, 26 comparative studies were included in the meta-analysis consisting of 5,431 shoulders with prior nonarthroplasty procedures (cases) and 55,144 shoulders without previous surgery (controls). Variables such as functional scores, complications, and range of motion were compared between cases and controls using Review Manager Software. In addition, subgroup analysis was conducted based on prior surgery type (rotator cuff repair [RCR], open reduction and internal fixation [ORIF], soft tissue repairs, and not specified) and type of SA (hemiarthroplasty, anatomical total shoulder arthroplasty, and reverse total shoulder arthroplasty [RTSA]). The results were presented as odds ratios (ORs) or standardized mean differences (SMDs). Results: Except for a higher rate of periprosthetic joint infection (PJI) in patients who had undergone previous arthroscopic surgery (OR, 2.58; 95% confidence interval [CI], 1.66-4.01; p < 0.01), a higher rate of complications was only observed in patients with previous ORIF. These complications included aseptic loosening (OR, 3.43; 95% CI, 2.14-5.50; p < 0.01), shoulder dislocation (OR, 2.25; 95% CI, 1.05-4.84; p = 0.04), overall complication (OR, 3.95; 95% CI, 2.38-6.55; p < 0.01), and revision (OR, 2.52; 95% CI, 1.28-4.97; p = 0.01). Patients with a history of previous surgery demonstrated inferior functional outcomes in comparison with the control group, including American Shoulder and Elbow Surgeons (SMD, −0.39; 95% CI, −0.51 to −0.27; p < 0.01; I² = 36%), Constant–Murley score (SMD, −0.34; 95% CI, −0.44 to −0.24; p < 0.01; I² = 0%), abduction (SMD, −0.26; 95% CI, −0.45 to −0.08; p = 0.01; I² = 54%), and flexion (SMD, −0.33; 95% CI, −0.46 to −0.21; p < 0.01; I² = 40%). Subgroup analysis by previous type of surgery was not possible regarding functional outcomes. Conclusion: Patients who have had prior fracture surgery are at a higher risk of complications, reoperations, and revisions after SA than controls. The normal shoulder anatomy may be disrupted by prior surgery, which makes arthroplasty technically challenging, particularly when it comes to soft tissue balance. On the other hand, RCR before SA did not negatively affect clinical outcomes after RTSA and did not have a higher rate of overall complications (except PJI). Level of Evidence: Level III (Treatment Studies). See Instructions for Authors for a complete description of levels of evidence.

Machine perfusion technologies have redefined the landscape of organ preservation by enabling not just static cold storage, but graft optimization and assessment with the opportunity for additional therapeutic interventions. Preservation solutions, traditionally developed for static cold storage, are now being adapted for use in dynamic perfusion platforms. The optimal composition for machine perfusion remains unclear as we shift to creating biologically intelligent platforms tailored to mitigate ischemia–reperfusion injury. This review presents a mechanistic framework for understanding organ preservation through the lens of shared vulnerabilities, particularly: mitochondrial dysfunction, endothelial barrier breakdown, and the activation of inflammatory cascades. We discuss the evolution of classical preservation solutions, the rationale for redox-targeted and endothelial-stabilizing additives, and the promise of modular approaches adaptable to both static cold storage and machine perfusion. By integrating recent preclinical insights, systems biology, and emerging clinical trials, we outline the path toward unified, precision-preservation strategies capable of expanding the donor pool and improving transplant outcomes.

Purpose: The purpose of this study is to analyze the short anterior cruciate ligament return to sport after injury (ACL‐RSI) (Persian) version's cultural adaption and validity.Methods: To assess test–retest reliability, 102 participants were filled out the short ACL‐RSI(Per) scale 6 months or more after ACLR surgery. Internal consistency (Cronbach's alpha), test–retest reliability (intraclass correlation coefficients), construct validity (Pearson's r) and sensitivity (floor/ceiling effect) were determined. In addition, patient completed other relevant measures such as Lysholm scores, the hospital for special surgery ACL satisfaction survey (HSS ACL‐SS), the visual analogue scale (VAS) of pain and patient's satisfaction, the Tegner activity score (TAS), the single assessment numeric evaluation (SANE) and the Cincinnati Knee Rating System (CKRS).Results: The short ACL‐RSI(Per) scale showed high internal consistency (Cronbach's alpha = 0.91) and test–retest reliability (ICC = 0.923). Significant correlations between short ACL‐RSI(Per) and other scales supported validity. There was a statistically significant connection between the short ACL‐RSI(Per) and the following outcomes: HSS ACL‐SS (r = 0.698, p < 0.001), VAS pain (r = 0.356, p < 0.001), CKRS (r = 0.644, p < 0.001), TAS (r = 0414, p < 0.001), Lysholm score (r = 0.467, p < 0.001) and SANE score (r = 0.536; p < 0.001). In addition to a satisfactory ceiling impact (15%), a sizeable floor effect (16.7%) was also seen.Conclusion: The short ACL‐RSI(Per) scale is a reliable and valid tool for assessing psychological readiness for return to sport after ACL reconstruction in Persian.Level of Evidence: III.

Objective. The presence of infertility in couples not only results in heightened stress but also elevates the risk of developing psychological disorders, further exacerbating their situation. This study is designed to evaluate the relationship between semen analysis and depression, anxiety, and stress, as well as sexual function in infertile men. Method. This descriptive cross‐sectional study was carried out at Amir Al‐Momenin Hospital of Zabol between March 2019 and April 2020. The couples who were candidates for intracytoplasmic sperm injection according to male factors were recruited for the study. One hundered two men were asked to complete the depression, anxiety, and stress questionnaire (DASS‐42) and the International Index of Erectile Function questionnaire (IIEF‐15). The findings of the DASS and IIEF questionnaires were compared with the semen analysis test and reported. Results. The frequency of depression, anxiety, and moderate to very severe stress were found in 21 (20.6%), 40 (39.2%), and 23 (22.5%) cases, respectively. Surprisingly, 60 (59%) participants had erectile dysfunction. A significant correlation was found between mood disorders (depression, anxiety, and stress) and some components of the erectile function questionnaire, stress with erectile function (p = 0.045), depression with overall satisfaction (p = 0.011), and anxiety with intercourse satisfaction (p = 0.048) and overall satisfaction (p = 0.037). Also, there was a significant correlation between semen analysis parameters such as sperm motility with depression (p = 0.035) and anxiety (p = 0.037), normal sperm morphology with stress (p = 0.034), progressive sperm motility with orgasmic function (p = 0.006), and intercourse satisfaction (p = 0.014). Conclusion. The higher the mental health, the higher the erectile function. Improvement of mood disorders leads to improvement of semen parameters and increases the chances of pregnancy. Psychological support may be helpful so, in addition to medical treatment, these people should also receive supportive psychological treatment.