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Submission: On March 07 via manual from NZ — Scanned from NZ
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<option value="sustainability"> Sustainability </option>
<option value="suschem"> Sustainable Chemistry </option>
<option value="symmetry"> Symmetry </option>
<option value="synbio"> SynBio </option>
<option value="systems"> Systems </option>
<option value="targets"> Targets </option>
<option value="taxonomy"> Taxonomy </option>
<option value="technologies"> Technologies </option>
<option value="telecom"> Telecom </option>
<option value="textiles"> Textiles </option>
<option value="thalassrep"> Thalassemia Reports </option>
<option value="thermo"> Thermo </option>
<option value="tomography"> Tomography </option>
<option value="tourismhosp"> Tourism and Hospitality </option>
<option value="toxics"> Toxics </option>
<option value="toxins"> Toxins </option>
<option value="transplantology"> Transplantology </option>
<option value="traumacare"> Trauma Care </option>
<option value="higheredu"> Trends in Higher Education </option>
<option value="tropicalmed"> Tropical Medicine and Infectious Disease (TropicalMed) </option>
<option value="universe"> Universe </option>
<option value="urbansci"> Urban Science </option>
<option value="uro"> Uro </option>
<option value="vaccines"> Vaccines </option>
<option value="vehicles"> Vehicles </option>
<option value="venereology"> Venereology </option>
<option value="vetsci"> Veterinary Sciences </option>
<option value="vibration"> Vibration </option>
<option value="virtualworlds"> Virtual Worlds </option>
<option value="viruses"> Viruses </option>
<option value="vision"> Vision </option>
<option value="waste"> Waste </option>
<option value="water"> Water </option>
<option value="wind"> Wind </option>
<option value="women"> Women </option>
<option value="world"> World </option>
<option value="wevj"> World Electric Vehicle Journal (WEVJ) </option>
<option value="youth"> Youth </option>
<option value="zoonoticdis"> Zoonotic Diseases </option>
</select>
<div class="chosen-container chosen-container-single" title="" id="journal_chosen" style="width: 100%;"><a class="chosen-single">
<span>
Journal of Clinical Medicine (JCM)
</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off" tabindex="3">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
<div class="large-2 medium-2 small-6 columns ">
<div class="">
<div class="search-input-label" style="display: none;">Article Type</div>
</div>
<select id="article_type" tabindex="-1" name="article_type" class="chosen-select" style="display: none;">
<option value="">All Article Types</option>
<option value="research-article">Article</option>
<option value="review-article">Review</option>
<option value="rapid-communication">Communication</option>
<option value="editorial">Editorial</option>
<option value="abstract">Abstract</option>
<option value="book-review">Book Review</option>
<option value="brief-report">Brief Report</option>
<option value="case-report">Case Report</option>
<option value="article-commentary">Comment</option>
<option value="commentary">Commentary</option>
<option value="concept-paper">Concept Paper</option>
<option value="conference-report">Conference Report</option>
<option value="correction">Correction</option>
<option value="creative">Creative</option>
<option value="data-descriptor">Data Descriptor</option>
<option value="discussion">Discussion</option>
<option value="Entry">Entry</option>
<option value="essay">Essay</option>
<option value="expression-of-concern">Expression of Concern</option>
<option value="extended-abstract">Extended Abstract</option>
<option value="guidelines">Guidelines</option>
<option value="hypothesis">Hypothesis</option>
<option value="interesting-image">Interesting Images</option>
<option value="letter">Letter</option>
<option value="books-received">New Book Received</option>
<option value="obituary">Obituary</option>
<option value="opinion">Opinion</option>
<option value="perspective">Perspective</option>
<option value="proceedings">Proceeding Paper</option>
<option value="project-report">Project Report</option>
<option value="protocol">Protocol</option>
<option value="registered-report">Registered Report</option>
<option value="reply">Reply</option>
<option value="retraction">Retraction</option>
<option value="note">Short Note</option>
<option value="study-protocol">Study Protocol</option>
<option value="systematic_review">Systematic Review</option>
<option value="technical-note">Technical Note</option>
<option value="tutorial">Tutorial</option>
<option value="viewpoint">Viewpoint</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="article_type_chosen" style="width: 100%;"><a class="chosen-single">
<span>All Article Types</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off" tabindex="4">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
<div class="large-1 medium-1 small-6 end columns small-push-6 medium-reset-order large-reset-order js-search-collapsed-button-container">
<div class="search-input-label" style="display: none;"> </div>
<input type="submit" id="search" value="Search" class="button button--dark button--full-width searchButton1 US_SearchButton" tabindex="12">
</div>
<div class="large-1 medium-1 small-6 end columns large-text-left small-only-text-center small-pull-6 medium-reset-order large-reset-order js-search-collapsed-link-container">
<div class="search-input-label" style="display: none;"> </div>
<a class="main-search-clear search-container__link" href="#" onclick="openAdvanced(''); return false;">Advanced<span class="show-for-small-only"> Search</span></a>
</div>
</div>
</div>
<div class="search-container__advanced" style="margin-top: 0; padding-top: 0px; background-color: inherit; color: inherit;">
<div class="row">
<div class="large-2 medium-2 columns show-for-medium-up"> </div>
<div class="large-2 medium-2 small-6 columns ">
<div class="">
<div class="search-input-label" style="display: none;">Section</div>
</div>
<select id="section" tabindex="-1" name="section" class="chosen-select" style="display: none;">
<option value="">All Sections</option>
<option value="486">Anesthesiology</option>
<option value="1630">Brain Injury</option>
<option value="487">Cardiology</option>
<option value="1662">Cardiovascular Medicine</option>
<option value="2420">Clinical Guidelines</option>
<option value="2121">Clinical Laboratory Medicine</option>
<option value="497">Clinical Neurology</option>
<option value="2471">Clinical Pediatrics</option>
<option value="2287">Clinical Rehabilitation</option>
<option value="2468">Clinical Research Methods</option>
<option value="600">Dentistry, Oral Surgery and Oral Medicine</option>
<option value="489">Dermatology</option>
<option value="874">Emergency Medicine</option>
<option value="490">Endocrinology & Metabolism</option>
<option value="506">Epidemiology & Public Health</option>
<option value="491">Gastroenterology & Hepatopancreatobiliary Medicine</option>
<option value="2286">General Surgery</option>
<option value="492">Hematology</option>
<option value="493">Immunology</option>
<option value="494">Infectious Diseases</option>
<option value="1649">Intensive Care</option>
<option value="873">Mental Health</option>
<option value="496">Nephrology & Urology</option>
<option value="498">Nuclear Medicine & Radiology</option>
<option value="499">Obstetrics & Gynecology</option>
<option value="500">Oncology</option>
<option value="501">Ophthalmology</option>
<option value="502">Orthopedics</option>
<option value="503">Otolaryngology</option>
<option value="505">Pharmacology</option>
<option value="1734">Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine</option>
<option value="507">Pulmonology</option>
<option value="1636">Reproductive Medicine & Andrology</option>
<option value="1631">Sports Medicine</option>
<option value="508">Vascular Medicine</option>
<option value="0">General</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="section_chosen" style="width: 100%;"><a class="chosen-single">
<span>All Sections</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off" tabindex="5">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
<div class="large-2 medium-2 small-6 columns ">
<div class="">
<div class="search-input-label" style="display: none;">Special Issue</div>
</div>
<select id="special_issue" tabindex="-1" name="special_issue" class="chosen-select" style="display: none;">
<option value="">All Special Issues</option>
<option value="194905">Advancements in Cornea Transplantation</option>
<option value="33012">Advances and Challenges in Pharmacogenomics</option>
<option value="28562">Advances in Eating Disorders</option>
<option value="147271">Advances in Longevity Medicine</option>
<option value="185549">Advances in the Early Diagnosis and Management of Renal Diseases</option>
<option value="179075">Cardiovascular Autonomic Function: From Bench to Bedside</option>
<option value="56943">Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: Diagnosis and Treatment</option>
<option value="175566">Chronicity, Multimorbidity, and Medication Appropriateness</option>
<option value="153204">Diabetes Prevention and Intervention</option>
<option value="33478">Diagnosis and Management of Addiction and Other Mental Disorders (Dual Disorders)</option>
<option value="28168">Diagnosis and Treatment of Personality Disorder</option>
<option value="142937">Editorial Board Members’ Collection Series: Transplantation Surgery</option>
<option value="178105">Evidence-Based Relationship Factors in the Diagnosis & Treatment of Mood and Psychotic Disorders</option>
<option value="154730">Impact of Emerging Pandemic on Global Diseases and Human Well-Being</option>
<option value="187137">Infectious Diseases: Emerging Diagnostic Methods, Updated Treatment Protocols and New Antimicrobial Agents</option>
<option value="20195">Innovative Technology Based Interventions for Psychological Treatment of Common Mental Disorders</option>
<option value="124775">Multidisciplinary Approach to Diagnosing and Treatment of Temporomandibular Disorders—Patient Care Challenges</option>
<option value="29564">Natural Environment, Mood and Anxiety Disorders, and Suicidal Behavior</option>
<option value="48676">New Developments in the Field of Myeloid Neoplasms</option>
<option value="65309">New Genetic Insights into Parkinson's Disease</option>
<option value="147874">Oral Health in Children and Adolescents Undergoing Orthodontic Treatment—Current Issues and Future Challenges</option>
<option value="187637">Osteoarticular Infections: New Challenges and Current Concepts in Antibiotic Therapy</option>
<option value="195186">Pathophysiology of Hypertension and Related Diseases</option>
<option value="36273">Perio-Inflammation in Auto-Antibodies and T-Cell Mediated Oro-Pharyngeal Mucositis</option>
<option value="163864">Reproductive Endocrinology and Infertility</option>
<option value="32287">Translating Immunology into Therapeutic Concepts for Inflammatory Bowel Disease</option>
<option value="34983">Updates in Anxiety Disorders</option>
<option value="19753">Virtual Reality in the Assessment, Understanding and Treatment of Mental Health Disorders</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="special_issue_chosen" style="width: 100%;"><a class="chosen-single">
<span>All Special Issues</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off" tabindex="6">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
<div class="large-1 medium-1 small-6 end columns ">
<div class="search-input-label" style="display: none;">Volume</div>
<input type="text" id="volume" tabindex="7" name="volume" placeholder="..." value="">
</div>
<div class="large-1 medium-1 small-6 end columns ">
<div class="search-input-label" style="display: none;">Issue</div>
<input type="text" id="issue" tabindex="8" name="issue" placeholder="..." value="">
</div>
<div class="large-1 medium-1 small-6 end columns ">
<div class="search-input-label" style="display: none;">Number</div>
<input type="text" id="number" tabindex="9" name="number" placeholder="..." value="">
</div>
<div class="large-1 medium-1 small-6 end columns ">
<div class="search-input-label" style="display: none;">Page</div>
<input type="text" id="page" tabindex="10" name="page" placeholder="..." value="">
</div>
<div class="large-1 medium-1 small-6 columns small-push-6 medium-reset order large-reset-order medium-reset-order js-search-expanded-button-container"></div>
<div class="large-1 medium-1 small-6 columns large-text-left small-only-text-center small-pull-6 medium-reset-order large-reset-order js-search-expanded-link-container"></div>
</div>
</div>
</form><form id="advanced-search" class="large-12 medium-12 columns">
<div class="search-container__advanced">
<div id="advanced-search-template" class="row advanced-search-row">
<div class="large-2 medium-2 small-12 columns show-for-medium-up"> </div>
<div class="large-2 medium-2 small-3 columns connector-div">
<div class="search-input-label"><span class="show-for-medium-up">Logical Operator</span><span class="show-for-small">Operator</span></div>
<select class="connector">
<option value="and">AND</option>
<option value="or">OR</option>
</select>
</div>
<div class="large-3 medium-3 small-6 columns search-text-div">
<div class="search-input-label">Search Text</div>
<input type="text" class="search-text" placeholder="Search text">
</div>
<div class="large-2 medium-2 small-6 large-offset-0 medium-offset-0 small-offset-3 columns search-field-div">
<div class="search-input-label">Search Type</div>
<select class="search-field">
<option value="all">All fields</option>
<option value="title">Title</option>
<option value="abstract">Abstract</option>
<option value="keywords">Keywords</option>
<option value="authors">Authors</option>
<option value="affiliations">Affiliations</option>
<option value="doi">Doi</option>
<option value="full_text">Full Text</option>
<option value="references">References</option>
</select>
</div>
<div class="large-1 medium-1 small-3 columns">
<div class="search-input-label"> </div>
<div class="search-action-div">
<div class="search-plus">
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<div class="search-input-label"> </div>
<input class="advanced-search-button button button--dark search-submit" type="submit" value="Search">
</div>
<div class="large-1 medium-1 small-6 end columns show-for-medium-up"></div>
</div>
</div>
</form>POST /journal/jcm
<form method="post" action="/journal/jcm" id="qckvi" onsubmit="return !$('#journal-browser-go').hasClass('button--grey');">
<div style="margin-bottom: 10px;" class="UI_JournalBrowser_Volume">
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<div class="chosen-container chosen-container-single" title="" id="journal_browser_volume_chosen" style="width: 100%;"><a class="chosen-single">
<span>volume</span>
<div><b></b></div>
</a>
<div class="chosen-drop UI_JournalBrowser_Volume_Options">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off">
</div>
<ul class="chosen-results"></ul>
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<div style="margin-bottom: 10px;" class="UI_JournalBrowser_Issue">
<select id="journal-browser-issue" name="issue" style="width: 100%; margin-bottom: 0px; display: none;" class="chosen-select">
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<option value="1" class="volume-13" style="display: none;"> 1 </option>
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<li class=""><label for="ms-opt-206" style="padding-left: 23px;"><input type="checkbox" value="ijerph" title="International Journal of Environmental Research and Public Health" id="ms-opt-206">International Journal of Environmental Research
and Public Health</label></li>
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and Power</label></li>
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</li>
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Medicine</label></li>
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<li class=""><label for="ms-opt-243" style="padding-left: 23px;"><input type="checkbox" value="jsan" title="Journal of Sensor and Actuator Networks" id="ms-opt-243">Journal of Sensor and Actuator Networks</label></li>
<li class=""><label for="ms-opt-244" style="padding-left: 23px;"><input type="checkbox" value="jtaer" title="Journal of Theoretical and Applied Electronic Commerce Research" id="ms-opt-244">Journal of Theoretical and Applied Electronic
Commerce Research</label></li>
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<li class=""><label for="ms-opt-246" style="padding-left: 23px;"><input type="checkbox" value="jox" title="Journal of Xenobiotics" id="ms-opt-246">Journal of Xenobiotics</label></li>
<li class=""><label for="ms-opt-247" style="padding-left: 23px;"><input type="checkbox" value="jzbg" title="Journal of Zoological and Botanical Gardens" id="ms-opt-247">Journal of Zoological and Botanical Gardens</label></li>
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<li class=""><label for="ms-opt-250" style="padding-left: 23px;"><input type="checkbox" value="kinasesphosphatases" title="Kinases and Phosphatases" id="ms-opt-250">Kinases and Phosphatases</label></li>
<li class=""><label for="ms-opt-251" style="padding-left: 23px;"><input type="checkbox" value="knowledge" title="Knowledge" id="ms-opt-251">Knowledge</label></li>
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<li class=""><label for="ms-opt-254" style="padding-left: 23px;"><input type="checkbox" value="languages" title="Languages" id="ms-opt-254">Languages</label></li>
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<li class=""><label for="ms-opt-257" style="padding-left: 23px;"><input type="checkbox" value="limnolrev" title="Limnological Review" id="ms-opt-257">Limnological Review</label></li>
<li class=""><label for="ms-opt-258" style="padding-left: 23px;"><input type="checkbox" value="lipidology" title="Lipidology" id="ms-opt-258">Lipidology</label></li>
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<li class=""><label for="ms-opt-265" style="padding-left: 23px;"><input type="checkbox" value="lymphatics" title="Lymphatics" id="ms-opt-265">Lymphatics</label></li>
<li class=""><label for="ms-opt-266" style="padding-left: 23px;"><input type="checkbox" value="make" title="Machine Learning and Knowledge Extraction" id="ms-opt-266">Machine Learning and Knowledge Extraction</label></li>
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<li class=""><label for="ms-opt-317" style="padding-left: 23px;"><input type="checkbox" value="oral" title="Oral" id="ms-opt-317">Oral</label></li>
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<li class=""><label for="ms-opt-324" style="padding-left: 23px;"><input type="checkbox" value="pathogens" title="Pathogens" id="ms-opt-324">Pathogens</label></li>
<li class=""><label for="ms-opt-325" style="padding-left: 23px;"><input type="checkbox" value="pathophysiology" title="Pathophysiology" id="ms-opt-325">Pathophysiology</label></li>
<li class=""><label for="ms-opt-326" style="padding-left: 23px;"><input type="checkbox" value="pediatrrep" title="Pediatric Reports" id="ms-opt-326">Pediatric Reports</label></li>
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<li class=""><label for="ms-opt-328" style="padding-left: 23px;"><input type="checkbox" value="pharmaceutics" title="Pharmaceutics" id="ms-opt-328">Pharmaceutics</label></li>
<li class=""><label for="ms-opt-329" style="padding-left: 23px;"><input type="checkbox" value="pharmacoepidemiology" title="Pharmacoepidemiology" id="ms-opt-329">Pharmacoepidemiology</label></li>
<li class=""><label for="ms-opt-330" style="padding-left: 23px;"><input type="checkbox" value="pharmacy" title="Pharmacy" id="ms-opt-330">Pharmacy</label></li>
<li class=""><label for="ms-opt-331" style="padding-left: 23px;"><input type="checkbox" value="philosophies" title="Philosophies" id="ms-opt-331">Philosophies</label></li>
<li class=""><label for="ms-opt-332" style="padding-left: 23px;"><input type="checkbox" value="photochem" title="Photochem" id="ms-opt-332">Photochem</label></li>
<li class=""><label for="ms-opt-333" style="padding-left: 23px;"><input type="checkbox" value="photonics" title="Photonics" id="ms-opt-333">Photonics</label></li>
<li class=""><label for="ms-opt-334" style="padding-left: 23px;"><input type="checkbox" value="phycology" title="Phycology" id="ms-opt-334">Phycology</label></li>
<li class=""><label for="ms-opt-335" style="padding-left: 23px;"><input type="checkbox" value="physchem" title="Physchem" id="ms-opt-335">Physchem</label></li>
<li class=""><label for="ms-opt-336" style="padding-left: 23px;"><input type="checkbox" value="psf" title="Physical Sciences Forum" id="ms-opt-336">Physical Sciences Forum</label></li>
<li class=""><label for="ms-opt-337" style="padding-left: 23px;"><input type="checkbox" value="physics" title="Physics" id="ms-opt-337">Physics</label></li>
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<li class=""><label for="ms-opt-339" style="padding-left: 23px;"><input type="checkbox" value="plants" title="Plants" id="ms-opt-339">Plants</label></li>
<li class=""><label for="ms-opt-340" style="padding-left: 23px;"><input type="checkbox" value="plasma" title="Plasma" id="ms-opt-340">Plasma</label></li>
<li class=""><label for="ms-opt-341" style="padding-left: 23px;"><input type="checkbox" value="platforms" title="Platforms" id="ms-opt-341">Platforms</label></li>
<li class=""><label for="ms-opt-342" style="padding-left: 23px;"><input type="checkbox" value="pollutants" title="Pollutants" id="ms-opt-342">Pollutants</label></li>
<li class=""><label for="ms-opt-343" style="padding-left: 23px;"><input type="checkbox" value="polymers" title="Polymers" id="ms-opt-343">Polymers</label></li>
<li class=""><label for="ms-opt-344" style="padding-left: 23px;"><input type="checkbox" value="polysaccharides" title="Polysaccharides" id="ms-opt-344">Polysaccharides</label></li>
<li class=""><label for="ms-opt-345" style="padding-left: 23px;"><input type="checkbox" value="poultry" title="Poultry" id="ms-opt-345">Poultry</label></li>
<li class=""><label for="ms-opt-346" style="padding-left: 23px;"><input type="checkbox" value="powders" title="Powders" id="ms-opt-346">Powders</label></li>
<li class=""><label for="ms-opt-347" style="padding-left: 23px;"><input type="checkbox" value="proceedings" title="Proceedings" id="ms-opt-347">Proceedings</label></li>
<li class=""><label for="ms-opt-348" style="padding-left: 23px;"><input type="checkbox" value="processes" title="Processes" id="ms-opt-348">Processes</label></li>
<li class=""><label for="ms-opt-349" style="padding-left: 23px;"><input type="checkbox" value="prosthesis" title="Prosthesis" id="ms-opt-349">Prosthesis</label></li>
<li class=""><label for="ms-opt-350" style="padding-left: 23px;"><input type="checkbox" value="proteomes" title="Proteomes" id="ms-opt-350">Proteomes</label></li>
<li class=""><label for="ms-opt-351" style="padding-left: 23px;"><input type="checkbox" value="psych" title="Psych" id="ms-opt-351">Psych</label></li>
<li class=""><label for="ms-opt-352" style="padding-left: 23px;"><input type="checkbox" value="psychiatryint" title="Psychiatry International" id="ms-opt-352">Psychiatry International</label></li>
<li class=""><label for="ms-opt-353" style="padding-left: 23px;"><input type="checkbox" value="psychoactives" title="Psychoactives" id="ms-opt-353">Psychoactives</label></li>
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<li class=""><label for="ms-opt-358" style="padding-left: 23px;"><input type="checkbox" value="radiation" title="Radiation" id="ms-opt-358">Radiation</label></li>
<li class=""><label for="ms-opt-359" style="padding-left: 23px;"><input type="checkbox" value="reactions" title="Reactions" id="ms-opt-359">Reactions</label></li>
<li class=""><label for="ms-opt-360" style="padding-left: 23px;"><input type="checkbox" value="realestate" title="Real Estate" id="ms-opt-360">Real Estate</label></li>
<li class=""><label for="ms-opt-361" style="padding-left: 23px;"><input type="checkbox" value="receptors" title="Receptors" id="ms-opt-361">Receptors</label></li>
<li class=""><label for="ms-opt-362" style="padding-left: 23px;"><input type="checkbox" value="recycling" title="Recycling" id="ms-opt-362">Recycling</label></li>
<li class=""><label for="ms-opt-363" style="padding-left: 23px;"><input type="checkbox" value="religions" title="Religions" id="ms-opt-363">Religions</label></li>
<li class=""><label for="ms-opt-364" style="padding-left: 23px;"><input type="checkbox" value="remotesensing" title="Remote Sensing" id="ms-opt-364">Remote Sensing</label></li>
<li class=""><label for="ms-opt-365" style="padding-left: 23px;"><input type="checkbox" value="reports" title="Reports" id="ms-opt-365">Reports</label></li>
<li class=""><label for="ms-opt-366" style="padding-left: 23px;"><input type="checkbox" value="reprodmed" title="Reproductive Medicine" id="ms-opt-366">Reproductive Medicine</label></li>
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<li class=""><label for="ms-opt-369" style="padding-left: 23px;"><input type="checkbox" value="risks" title="Risks" id="ms-opt-369">Risks</label></li>
<li class=""><label for="ms-opt-370" style="padding-left: 23px;"><input type="checkbox" value="robotics" title="Robotics" id="ms-opt-370">Robotics</label></li>
<li class=""><label for="ms-opt-371" style="padding-left: 23px;"><input type="checkbox" value="ruminants" title="Ruminants" id="ms-opt-371">Ruminants</label></li>
<li class=""><label for="ms-opt-372" style="padding-left: 23px;"><input type="checkbox" value="safety" title="Safety" id="ms-opt-372">Safety</label></li>
<li class=""><label for="ms-opt-373" style="padding-left: 23px;"><input type="checkbox" value="sci" title="Sci" id="ms-opt-373">Sci</label></li>
<li class=""><label for="ms-opt-374" style="padding-left: 23px;"><input type="checkbox" value="scipharm" title="Scientia Pharmaceutica" id="ms-opt-374">Scientia Pharmaceutica</label></li>
<li class=""><label for="ms-opt-375" style="padding-left: 23px;"><input type="checkbox" value="sclerosis" title="Sclerosis" id="ms-opt-375">Sclerosis</label></li>
<li class=""><label for="ms-opt-376" style="padding-left: 23px;"><input type="checkbox" value="seeds" title="Seeds" id="ms-opt-376">Seeds</label></li>
<li class=""><label for="ms-opt-377" style="padding-left: 23px;"><input type="checkbox" value="sensors" title="Sensors" id="ms-opt-377">Sensors</label></li>
<li class=""><label for="ms-opt-378" style="padding-left: 23px;"><input type="checkbox" value="separations" title="Separations" id="ms-opt-378">Separations</label></li>
<li class=""><label for="ms-opt-379" style="padding-left: 23px;"><input type="checkbox" value="sexes" title="Sexes" id="ms-opt-379">Sexes</label></li>
<li class=""><label for="ms-opt-380" style="padding-left: 23px;"><input type="checkbox" value="signals" title="Signals" id="ms-opt-380">Signals</label></li>
<li class=""><label for="ms-opt-381" style="padding-left: 23px;"><input type="checkbox" value="sinusitis" title="Sinusitis" id="ms-opt-381">Sinusitis</label></li>
<li class=""><label for="ms-opt-382" style="padding-left: 23px;"><input type="checkbox" value="smartcities" title="Smart Cities" id="ms-opt-382">Smart Cities</label></li>
<li class=""><label for="ms-opt-383" style="padding-left: 23px;"><input type="checkbox" value="socsci" title="Social Sciences" id="ms-opt-383">Social Sciences</label></li>
<li class=""><label for="ms-opt-384" style="padding-left: 23px;"><input type="checkbox" value="siuj" title="Société Internationale d’Urologie Journal" id="ms-opt-384">Société Internationale d’Urologie Journal</label></li>
<li class=""><label for="ms-opt-385" style="padding-left: 23px;"><input type="checkbox" value="societies" title="Societies" id="ms-opt-385">Societies</label></li>
<li class=""><label for="ms-opt-386" style="padding-left: 23px;"><input type="checkbox" value="software" title="Software" id="ms-opt-386">Software</label></li>
<li class=""><label for="ms-opt-387" style="padding-left: 23px;"><input type="checkbox" value="soilsystems" title="Soil Systems" id="ms-opt-387">Soil Systems</label></li>
<li class=""><label for="ms-opt-388" style="padding-left: 23px;"><input type="checkbox" value="solar" title="Solar" id="ms-opt-388">Solar</label></li>
<li class=""><label for="ms-opt-389" style="padding-left: 23px;"><input type="checkbox" value="solids" title="Solids" id="ms-opt-389">Solids</label></li>
<li class=""><label for="ms-opt-390" style="padding-left: 23px;"><input type="checkbox" value="spectroscj" title="Spectroscopy Journal" id="ms-opt-390">Spectroscopy Journal</label></li>
<li class=""><label for="ms-opt-391" style="padding-left: 23px;"><input type="checkbox" value="sports" title="Sports" id="ms-opt-391">Sports</label></li>
<li class=""><label for="ms-opt-392" style="padding-left: 23px;"><input type="checkbox" value="standards" title="Standards" id="ms-opt-392">Standards</label></li>
<li class=""><label for="ms-opt-393" style="padding-left: 23px;"><input type="checkbox" value="stats" title="Stats" id="ms-opt-393">Stats</label></li>
<li class=""><label for="ms-opt-394" style="padding-left: 23px;"><input type="checkbox" value="stresses" title="Stresses" id="ms-opt-394">Stresses</label></li>
<li class=""><label for="ms-opt-395" style="padding-left: 23px;"><input type="checkbox" value="surfaces" title="Surfaces" id="ms-opt-395">Surfaces</label></li>
<li class=""><label for="ms-opt-396" style="padding-left: 23px;"><input type="checkbox" value="surgeries" title="Surgeries" id="ms-opt-396">Surgeries</label></li>
<li class=""><label for="ms-opt-397" style="padding-left: 23px;"><input type="checkbox" value="std" title="Surgical Techniques Development" id="ms-opt-397">Surgical Techniques Development</label></li>
<li class=""><label for="ms-opt-398" style="padding-left: 23px;"><input type="checkbox" value="sustainability" title="Sustainability" id="ms-opt-398">Sustainability</label></li>
<li class=""><label for="ms-opt-399" style="padding-left: 23px;"><input type="checkbox" value="suschem" title="Sustainable Chemistry" id="ms-opt-399">Sustainable Chemistry</label></li>
<li class=""><label for="ms-opt-400" style="padding-left: 23px;"><input type="checkbox" value="symmetry" title="Symmetry" id="ms-opt-400">Symmetry</label></li>
<li class=""><label for="ms-opt-401" style="padding-left: 23px;"><input type="checkbox" value="synbio" title="SynBio" id="ms-opt-401">SynBio</label></li>
<li class=""><label for="ms-opt-402" style="padding-left: 23px;"><input type="checkbox" value="systems" title="Systems" id="ms-opt-402">Systems</label></li>
<li class=""><label for="ms-opt-403" style="padding-left: 23px;"><input type="checkbox" value="targets" title="Targets" id="ms-opt-403">Targets</label></li>
<li class=""><label for="ms-opt-404" style="padding-left: 23px;"><input type="checkbox" value="taxonomy" title="Taxonomy" id="ms-opt-404">Taxonomy</label></li>
<li class=""><label for="ms-opt-405" style="padding-left: 23px;"><input type="checkbox" value="technologies" title="Technologies" id="ms-opt-405">Technologies</label></li>
<li class=""><label for="ms-opt-406" style="padding-left: 23px;"><input type="checkbox" value="telecom" title="Telecom" id="ms-opt-406">Telecom</label></li>
<li class=""><label for="ms-opt-407" style="padding-left: 23px;"><input type="checkbox" value="textiles" title="Textiles" id="ms-opt-407">Textiles</label></li>
<li class=""><label for="ms-opt-408" style="padding-left: 23px;"><input type="checkbox" value="thalassrep" title="Thalassemia Reports" id="ms-opt-408">Thalassemia Reports</label></li>
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subject Imprint Information get_app Journal Flyer Open Access ISSN:
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LATEST ARTICLES
17 pages, 1587 KiB
Open AccessArticle
Intraoperative Ketorolac and Outcomes after Ovarian Cancer Surgery
by
Mathieu Luyckx
,
Céline Verougstraete
,
Mathieu Jouret
,
Kiswendsida Sawadogo
,
Marc Waterkeyn
,
Frédéric Grandjean
,
Jean-Paul Van Gossum
,
Nathanael Dubois
,
Vincent Malvaux
,
Lucie Verreth
,
Pascale Grandjean
,
Pascale Jadoul
,
Charlotte Maillard
,
Amandine Gerday
,
Audrey Dieu
,
Patrice Forget
,
Jean-François Baurain
and
Jean-Luc Squifflet
J. Clin. Med. 2024, 13(6), 1546; https://doi.org/10.3390/jcm13061546 - 07 Mar
2024
Abstract
Introduction: Surgery is the cornerstone of ovarian cancer treatment. However,
surgery and perioperative inflammation have been described as potentially
pro-metastagenic. In various animal models and other human cancers,
intraoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs)
appears to have a positive impact on [...] Read more.
Introduction: Surgery is the cornerstone of ovarian cancer treatment. However,
surgery and perioperative inflammation have been described as potentially
pro-metastagenic. In various animal models and other human cancers,
intraoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs)
appears to have a positive impact on patient outcomes. Materials and methods: In
this unicentric retrospective study, we provide an exploratory analysis of the
safety and potential benefit of intraoperative administration of ketorolac on
the outcome of patients undergoing surgery for ovarian cancer. The study
population included all patients who were given a diagnosis of ovarian,
fallopian tube or peritoneal cancer by the multidisciplinary oncology committee
(MOC) of the Cliniques universitaires Saint-Luc between 2015 and 2020. Results:
We included 166 patients in our analyses, with a median follow-up of 21.8
months. Both progression-free survival and overall survival were superior in
patients who received an intraoperative injection of ketorolac (34.4 months of
progression-free survival in the ketorolac group versus 21.5 months in the
non-ketorolac group (p = 0.002), and median overall survival was not reached in
either group but there was significantly higher survival in the ketorolac group
(p = 0.004)). We also performed subgroup analyses to minimise bias due to
imbalance between groups on factors that could influence patient survival, and
the group of patients receiving ketorolac systematically showed a better
outcome. Uni- and multivariate analyses confirmed that administration of
ketorolac intraoperatively was associated with better progression-free survival
(HR = 0.47 on univariate analysis and 0.43 on multivariate analysis, p = 0.003
and 0.023, respectively). In terms of complications, there were no differences
between the two groups, either intraoperatively or postoperatively. Conclusion:
Our study has shown a favourable association between the use of ketorolac during
surgery and the postoperative progression of ovarian cancer in a group of 166
patients, without any rise in intra- or postoperative complications. These
encouraging results point to the need for a prospective study to confirm the
benefit of intraoperative administration of ketorolac in ovarian cancer surgery.
Full article
(This article belongs to the Special Issue State of the Art: Surgery for
Gynecologic Oncology)
14 pages, 1243 KiB
Open AccessArticle
Can Robotic Gait Training with End Effectors Improve Lower-Limb Functions in
Patients Affected by Multiple Sclerosis? Results from a Retrospective
Case–Control Study
by
Mirjam Bonanno
,
Maria Grazia Maggio
,
Laura Ciatto
,
Rosaria De Luca
,
Angelo Quartarone
,
Angela Alibrandi
and
Rocco Salvatore Calabrò
J. Clin. Med. 2024, 13(6), 1545; https://doi.org/10.3390/jcm13061545 - 07 Mar
2024
Abstract
Background: Multiple sclerosis (MS) is characterized as a neurodegenerative
condition possibly triggered by autoimmune mechanisms, impacting the entire
central nervous system. In this context, neurorehabilitation plays a crucial
role in every phase of the disease, aiming to restore and preserve motor
functions in [...] Read more.
Background: Multiple sclerosis (MS) is characterized as a neurodegenerative
condition possibly triggered by autoimmune mechanisms, impacting the entire
central nervous system. In this context, neurorehabilitation plays a crucial
role in every phase of the disease, aiming to restore and preserve motor
functions in MS patients. In particular, robotic gait training (RGT) allows
intensive, repetitive, and task-oriented training, which is pivotal in boosting
neuroplastic processes. Thus, the primary aim of our study is to evaluate the
effectiveness of innovative robotic gait training, using the G-EO system, on
gait, functional abilities, and quality of life (QoL) in patients affected by
MS. Secondly, we evaluated the effect of the robotic rehabilitation on
lower-limb motor functioning, balance, sensation, and joint functioning.
Methods: The study involved twenty MS patients, divided into two groups with
comparable medical characteristics and rehabilitation training duration. The
experimental group (EG) underwent robotic gait training with the G-EO system (n.
10), while the control group (CG) received traditional rehabilitation training
(n. 10). Results: Both groups exhibited improvements in disability level
(Functional Independence Measure), 10 m walking distance (10MWT), gait, and
balance performance (Functional Ambulation Classification, Tinetti Scale).
However, the EG demonstrated a more significant improvement. The G-EO system
notably reduced spasticity in the lower limbs (Modified Ashworth Scale)
exclusively in the EG. Discussion: This study suggests that the G-EO system
could be a valuable tool for enhancing gait functions, including lower-limb
movements, functional abilities, and QoL in individuals with MS. Full article
(This article belongs to the Special Issue Rehabilitation and Management of
Multiple Sclerosis)
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Supplementary material:
Supplementary File 1 (ZIP, 490 KiB)
14 pages, 291 KiB
Open AccessArticle
Performance of Primary Care Physicians in the Management of Glycemia, Lipids,
and Blood Pressure among People with Type 2 Diabetes: A Cross-Sectional Study
by
Bogdan Vlacho
,
Berta Fernandez-Camins
,
Albert Canudas-Ventura
,
Andrés Rodríguez
,
Àngels Mollo
,
Francesc Xavier Cos Claramunt
,
Maria Antentas
,
Dídac Mauricio
and
Josep Franch-Nadal
J. Clin. Med. 2024, 13(6), 1544; https://doi.org/10.3390/jcm13061544 - 07 Mar
2024
Abstract
Background: Our study aimed to evaluate the performance of primary healthcare
physicians (PCPs) in managing glycemia, lipids, and blood pressure in people
with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. Methods: We included
3267 PCPs with 367,132 T2DM subjects in a cross-sectional [...] Read more.
Background: Our study aimed to evaluate the performance of primary healthcare
physicians (PCPs) in managing glycemia, lipids, and blood pressure in people
with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. Methods: We included
3267 PCPs with 367,132 T2DM subjects in a cross-sectional analysis of the SIDIAP
(Sistema d’Informació per al Desenvolupament de la Investigació en Atenció
Primària) database for the year 2017. Results: 63.1% of PCPs were female, with
an average practice size of 1512 subjects. T2DM individuals had a mean (standard
deviation) age of 70 (±12.2) years old, a mean body mass index (BMI) of 30.2
(±5.21) kg/m2, and a median diabetes duration of 8.8 years. Overall, 42.6% of
subjects achieved target glycemic control (glycated hemoglobin < 7%). Notably,
59.2% maintained blood pressure < 140/90 mmHg during the 12-month study period.
The multivariable analysis identified positive associations between glycemic
control and female PCPs, practice sizes (1000–1500 people), a higher proportion
of patients aged ≥ 65 years, and rural practices. Combined glycemic, lipid, and
blood pressure target attainment was associated with medium-sized practices and
those with a higher proportion of patients aged ≥ 65 years. Conclusions:
Practice size, patient age distribution, and rurality are factors associated
with the performance of PCPs in the control of glycemia, lipids, and blood
pressure in T2DM subjects in primary health care centers in our region. Full
article
(This article belongs to the Special Issue Clinical Research on Diabetes and Its
Complications)
attachment
Supplementary material:
Supplementary File 1 (ZIP, 236 KiB)
15 pages, 2475 KiB
Open AccessArticle
Tackling Post-COVID-19 Rehabilitation Challenges: A Pilot Clinical Trial
Investigating the Role of Robotic-Assisted Hand Rehabilitation
by
Ana Cisnal
,
Gonzalo Alonso-Linaje
,
Juan Carlos Fraile
,
Javier Pérez-Turiel
,
Pablo Álvarez
and
Socorro Martinez
J. Clin. Med. 2024, 13(6), 1543; https://doi.org/10.3390/jcm13061543 - 07 Mar
2024
Abstract
Background: Prolonged hospitalization in severe COVID-19 cases can lead to
substantial muscle loss and functional deterioration. While rehabilitation is
essential, conventional approaches face capacity challenges. Therefore,
evaluating the effectiveness of robotic-assisted rehabilitation for patients
with post-COVID-19 fatigue syndrome to enhance both motor function [...] Read
more.
Background: Prolonged hospitalization in severe COVID-19 cases can lead to
substantial muscle loss and functional deterioration. While rehabilitation is
essential, conventional approaches face capacity challenges. Therefore,
evaluating the effectiveness of robotic-assisted rehabilitation for patients
with post-COVID-19 fatigue syndrome to enhance both motor function and overall
recovery holds paramount significance. Our objective is to assess the
effectiveness of rehabilitation in post-COVID-19 patients with upper extremity
impairment through the utilization of a hand exoskeleton-based robotic system.
Methods: A total of 13 participants experiencing acute or limited functional or
strength impairment in an upper extremity due to COVID-19 were enrolled in the
study. A structured intervention consisted of 45 min therapy sessions, conducted
four times per week over a six-week period, utilizing a hand exoskeleton. The
research employed standardized health assessments, motion analysis, and
semi-structured interviews for pre-intervention and follow-up evaluations.
Paired sample t-tests were employed to statistically analyze the outcomes.
Results: The outcomes showed a reduction in overall dependence levels across
participants, positive changes in various quality of life-related measurements,
and an average increase of 60.4 ± 25.7% and 28.7 ± 11.2% for passive and active
flexion, respectively. Conclusions: Our data suggest that hand exoskeleton-based
robotic systems hold promise to optimize the rehabilitation outcomes following
severe COVID-19. Trial registration: ID NCT06137716 at ClinicalTrials.gov. Full
article
(This article belongs to the Special Issue Novel Insights into
COVID-19-Associated Complications and Sequelae)
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15 pages, 258 KiB
Open AccessArticle
Association of Malnutrition with Surgical and Hospital Outcomes after Spine
Surgery for Spinal Metastases: A National Surgical Quality Improvement Program
Study of 1613 Patients
by
Aladine A. Elsamadicy
,
John Havlik
,
Benjamin C. Reeves
,
Josiah J. Z. Sherman
,
Samuel Craft
,
Paul Serrato
,
Sumaiya Sayeed
,
Andrew B. Koo
,
Syed I. Khalid
,
Sheng-Fu Larry Lo
,
John H. Shin
,
Ehud Mendel
and
Daniel M. Sciubba
J. Clin. Med. 2024, 13(6), 1542; https://doi.org/10.3390/jcm13061542 - 07 Mar
2024
Abstract
Background: Malnutrition is a common condition that may exacerbate many medical
and surgical pathologies. However, few have studied the impact of malnutrition
on surgical outcomes for patients undergoing surgery for metastatic disease of
the spine. This study aims to evaluate the impact of [...] Read more.
Background: Malnutrition is a common condition that may exacerbate many medical
and surgical pathologies. However, few have studied the impact of malnutrition
on surgical outcomes for patients undergoing surgery for metastatic disease of
the spine. This study aims to evaluate the impact of malnutrition on
perioperative complications and healthcare resource utilization following
surgical treatment of spinal metastases. Methods: We conducted a retrospective
cohort study using the 2011–2019 American College of Surgeons National Surgical
Quality Improvement Program database. Adult patients with spinal metastases who
underwent laminectomy, corpectomy, or posterior fusion for extradural spinal
metastases were identified using the CPT, ICD-9-CM, and ICD-10-CM codes. The
study population was divided into two cohorts: Nourished (preoperative serum
albumin values ≥ 3.5 g/dL) and Malnourished (preoperative serum albumin values <
3.5 g/dL). We assessed patient demographics, comorbidities, intraoperative
variables, postoperative adverse events (AEs), hospital LOS, discharge
disposition, readmission, and reoperation. Multivariate logistic regression
analyses were performed to identify the factors associated with a prolonged
length of stay (LOS), AEs, non-routine discharge (NRD), and unplanned
readmission. Results: Of the 1613 patients identified, 26.0% were Malnourished.
Compared to Nourished patients, Malnourished patients were significantly more
likely to be African American and have a lower BMI, but the age and sex were
similar between the cohorts. The baseline comorbidity burden was significantly
higher in the Malnourished cohort compared to the Nourished cohort. Compared to
Nourished patients, Malnourished patients experienced significantly higher rates
of one or more AEs (Nourished: 19.8% vs. Malnourished: 27.6%, p = 0.004) and
serious AEs (Nourished: 15.2% vs. Malnourished: 22.6%, p < 0.001). Upon
multivariate regression analysis, malnutrition was found to be an independent
and associated with an extended LOS [aRR: 3.49, CI (1.97, 5.02), p < 0.001], NRD
[saturated aOR: 1.76, CI (1.34, 2.32), p < 0.001], and unplanned readmission
[saturated aOR: 1.42, CI (1.04, 1.95), p = 0.028]. Conclusions: Our study
suggests that malnutrition increases the risk of postoperative complication,
prolonged hospitalizations, non-routine discharges, and unplanned hospital
readmissions. Further studies are necessary to identify the protocols that pre-
and postoperatively optimize malnourished patients undergoing spinal surgery for
metastatic spinal disease. Full article
(This article belongs to the Section Clinical Neurology)
14 pages, 972 KiB
Open AccessArticle
Fasting Plasma Ketone Bodies Are Associated with NT-proBNP: A Potential
Mechanism to Provide Fuel for the Failing Heart
by
Constantin L. Palm
,
Irina Shalaurova
,
Margery A. Connelly
,
Stephan J. L. Bakker
,
Berend Daan Westenbrink
and
Robin P. F. Dullaart
J. Clin. Med. 2024, 13(6), 1541; https://doi.org/10.3390/jcm13061541 - 07 Mar
2024
Abstract
Background: Heart failure (HF) features a shift in metabolism towards enhanced
utilization of ketone bodies. While elevations in plasma natriuretic peptides
represent a biochemical hallmark of HF, natriuretic peptides may promote
lipolysis, thereby contributing to fatty acid availability for ketogenesis.
Methods: We cross-sectionally [...] Read more.
Background: Heart failure (HF) features a shift in metabolism towards enhanced
utilization of ketone bodies. While elevations in plasma natriuretic peptides
represent a biochemical hallmark of HF, natriuretic peptides may promote
lipolysis, thereby contributing to fatty acid availability for ketogenesis.
Methods: We cross-sectionally tested to what extent fasting plasma total ketone
bodies (measured using nuclear magnetic resonance spectroscopy) are associated
with N-terminal pro-BNP (NT-proBNP; electrochemiluminescent sandwich
immunoassay) in individuals with and without HF. Results: Among 6217
participants from the Prevention of REnal and Vascular ENd-stage Disease
(PREVEND) study, 203 were identified with HF. NT-proBNP was four-fold and total
ketone bodies were 25% higher in HF participants (each p < 0.001). In both
participants with and without HF, total ketone body levels correlated with
NT-proBNP (r = 0.116 and 0.185, respectively; p < 0.001). In multivariable
linear regression analysis adjusted for relevant covariates, total ketone bodies
remained associated with NT-proBNP in the whole cohort (std β = 0.08, p <
0.001), without a difference in participants with and without HF (p interaction:
0.52). Conclusion: This general population-based study reveals an independent
association of fasting total body ketone bodies with plasma NT-proBNP. Our
findings suggest that a metabolic defense mechanism could be operative,
providing the myocardium with ketone bodies to meet its energy demands. Full
article
(This article belongs to the Section Cardiology)
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19 pages, 663 KiB
Open AccessReview
Δ9-Tetrahydrocannabinol (THC): A Critical Overview of Recent Clinical Trials and
Suggested Guidelines for Future Research
by
Peter Pressman
,
A. Wallace Hayes
,
Julia Hoeng
,
Diogo A. R. S. Latino
,
Anatoly Mazurov
,
Walter K. Schlage
and
Azhar Rana
J. Clin. Med. 2024, 13(6), 1540; https://doi.org/10.3390/jcm13061540 - 07 Mar
2024
Abstract
In this overview, we seek to appraise recent experimental and observational
studies investigating THC and its potential role as adjunctive therapy in
various medical illnesses. Recent clinical trials are suggestive of the diverse
pharmacologic potentials for THC but suffer from small sample sizes, [...] Read
more.
In this overview, we seek to appraise recent experimental and observational
studies investigating THC and its potential role as adjunctive therapy in
various medical illnesses. Recent clinical trials are suggestive of the diverse
pharmacologic potentials for THC but suffer from small sample sizes, short study
duration, failure to address tolerance, little dose variation, ill-defined
outcome measures, and failure to identify and/or evaluate confounds, all of
which may constitute significant threats to the validity of most trials.
However, the existing work underscores the potential therapeutic value of THC
and, at the same time, calls attention to the critical need for better-designed
protocols to fully explore and demonstrate safety and efficacy. In the most
general sense, the present brief review illuminates some intriguing findings
about THC, along with the basic threats to the validity of the research that
supports those findings. The intent is to highlight existing generic weaknesses
in the existing randomized controlled trial literature and, most importantly,
provide guidance for improved clinical research. Full article
(This article belongs to the Section Pharmacology)
attachment
Supplementary material:
Supplementary File 1 (ZIP, 409 KiB)
16 pages, 1608 KiB
Open AccessArticle
Association between Ustekinumab Trough Levels, Serum IL-22, and Oncostatin M
Levels and Clinical and Biochemical Outcomes in Patients with Crohn’s Disease
by
Luisa Bertin
,
Brigida Barberio
,
Alessandro Gubbiotti
,
Lorenzo Bertani
,
Francesco Costa
,
Linda Ceccarelli
,
Pierfrancesco Visaggi
,
Giorgia Bodini
,
Andrea Pasta
,
Renato Sablich
,
Maria Teresa Urbano
,
Antonio Ferronato
,
Andrea Buda
,
Manuela De Bona
,
Giulio Del Corso
,
Alessandro Massano
,
Imerio Angriman
,
Marco Scarpa
,
Fabiana Zingone
and
Edoardo Vincenzo Savarino
J. Clin. Med. 2024, 13(6), 1539; https://doi.org/10.3390/jcm13061539 - 07 Mar
2024
Abstract
Background: Ustekinumab (UST) has demonstrated effectiveness in treating
patients with Crohn’s disease. Monitoring treatment response can improve disease
management and reduce healthcare costs. We investigated whether UST trough
levels (TLs), serum IL22, and oncostatin M (OSM) levels could be early
indicators of non-response [...] Read more.
Background: Ustekinumab (UST) has demonstrated effectiveness in treating
patients with Crohn’s disease. Monitoring treatment response can improve disease
management and reduce healthcare costs. We investigated whether UST trough
levels (TLs), serum IL22, and oncostatin M (OSM) levels could be early
indicators of non-response by analysing their correlation with clinical and
biochemical outcomes in CD. Methods: Patients with CD initiating UST treatment
from October 2018 to September 2020 were enrolled at six Italian centres for
inflammatory bowel disease (IBD). Clinical and biochemical data were collected
at four time points: baseline, second subcutaneous (SC) dose, fourth SC dose,
and 52 weeks. TLs were measured during maintenance, at the second SC dose, and
at the fourth SC dose. IL-22 and OSM serum levels were assessed at baseline and
the second SC dose. We analysed whether TLs, IL22 levels, and OSM serum levels
were associated with clinical response, clinical remission, biochemical
remission, and endoscopic remission using the appropriate statistical tests.
Results: Out of eighty-four initially enrolled patients, five were lost to
follow-up, and eleven discontinued the drug before 52 weeks. At the 52-week time
point, 47% achieved biochemical remission based on faecal calprotectin levels,
and 61.8% achieved clinical remission. TLs at the second SC dose significantly
correlated with biochemical remission at the same time point (p = 0.011).
However, TLs did not correlate with clinical remission. Baseline OSM levels did
not correlate with biochemical or clinical remission or response. IL22 levels
notably decreased during UST therapy (p = 0.000), but its values did not
correlate with biochemical or clinical remission. Conclusions: UST is an
effective therapy for patients with CD. TLs measured at the second SC dose
significantly correlated with biochemical remission, emphasising their potential
role in treatment monitoring. Levels of OSM and IL-22, despite a significant
decrease in the latter during therapy, did not exhibit correlations with
clinical or biochemical outcomes in our study. Further studies are needed to
confirm these findings. Full article
(This article belongs to the Special Issue Targeted Treatment in Inflammatory
Bowel Diseases (IBD))
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Graphical abstract
15 pages, 1555 KiB
Open AccessArticle
Vitamin A Positively Correlates with Secretory Immunoglobulin A: A
Cross-Sectional Study in Omicron COVID-19 Outpatients
by
Francisco Javier Turrubiates-Hernández
,
Samuel García-Arellano
,
Laura Elena Herrera-Jiménez
,
Guillermo González-Estevez
,
Fabiola Márquez-Sandoval
,
Diana Lourdes Padilla-Bórquez
,
Hazael Ramiro Ceja-Gálvez
,
Natali Vega-Magaña
,
Ferdinando Nicoletti
,
Guillermina Muñoz-Ríos
and
José Francisco Muñoz-Valle
J. Clin. Med. 2024, 13(6), 1538; https://doi.org/10.3390/jcm13061538 - 07 Mar
2024
Abstract
Background: Respiratory tract infections remain among the leading causes of
mortality worldwide. The COVID-19 pandemic has highlighted the importance of
mucosal immunity in defending against infectious agents. Vitamin A is known to
influence the production of secretory immunoglobulin A (SIgA) predominantly in
the [...] Read more.
Background: Respiratory tract infections remain among the leading causes of
mortality worldwide. The COVID-19 pandemic has highlighted the importance of
mucosal immunity in defending against infectious agents. Vitamin A is known to
influence the production of secretory immunoglobulin A (SIgA) predominantly in
the gut, where it is a critical component of the first line of defense on
mucosal surfaces. Methods: This cross-sectional study, conducted 14 days
post-positive COVID-19 diagnosis, aimed to determine the relationship between
the nutritional status of vitamin A and SIgA levels in COVID-19 outpatients.
Serum and saliva samples were collected. Vitamin A nutritional status was
determined based on the assessment of dietary intake and the analysis of
retinol-binding protein 4 (RBP4). SIgA levels were analyzed from salivary
samples. In addition, serum antibodies were analyzed. Results: Dietary vitamin A
intake and RBP4 levels positively correlated with SIgA. Patients with higher
vitamin A intake showed higher SIgA/IgG1 and SIgA/IgG3 ratios, while those with
higher RBP4 levels showed higher SIgA/IgM, SIgA/IgG1, and SIgA/IgG2 ratios.
Conclusions: These findings underscore a significant correlation between vitamin
A nutritional status and SIgA levels in COVID-19 outpatients, which may suggest
the potential importance of maintaining optimal vitamin A levels for the
prevention of viral infections. Full article
(This article belongs to the Section Infectious Diseases)
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19 pages, 1658 KiB
Open AccessSystematic Review
The Physical and Psychosocial Impact of Fatigue among Patients with Sjogren’s
Syndrome: A Systematic Review
by
Denise-Ani Mardale
,
Daniela Opriș-Belinski
,
Violeta Bojincă
,
Mihai Bojincă
,
Diana Mazilu
,
Emilia Păsăran
,
Cristina Nițăa
,
Laura Groșeanu
,
Florian Berghea
and
Andra-Rodica Bălănescu
J. Clin. Med. 2024, 13(6), 1537; https://doi.org/10.3390/jcm13061537 - 07 Mar
2024
Abstract
Background: Primary Sjögren’s syndrome (pSS) is a complex autoimmune disorder
characterized by organ-specific symptoms in the salivary and lacrimal glands, as
well as systemic manifestations. Fatigue, a prominent aspect, significantly
influences the overall quality of life for individuals with pSS. Methods: This
review [...] Read more.
Background: Primary Sjögren’s syndrome (pSS) is a complex autoimmune disorder
characterized by organ-specific symptoms in the salivary and lacrimal glands, as
well as systemic manifestations. Fatigue, a prominent aspect, significantly
influences the overall quality of life for individuals with pSS. Methods: This
review seeks to evaluate the impact of fatigue by exploring its consequences,
potential causes, and effects on physical and psychological well-being, while
also investigating its management strategies. Following the “Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines, our
systematic literature review involved a five-step algorithm. Initially
identifying 78 articles in reputable international medical databases, we applied
eligibility criteria and removed duplicates, resulting in 19 articles for
qualitative synthesis. Results: This review delves into the predictive factors
for heightened fatigue in pSS, encompassing rheumatoid factor levels,
erythrocyte sedimentation rate, and immunoglobulin G levels. Sleep disturbances,
specifically nighttime pain and nocturia, emerged as determinants of persistent
daytime fatigue. Cognitive impairment in pSS involves deteriorations in global
memory, executive functioning, and attentional resources. Furthermore,
functional limitations in pSS impact patients’ quality of life. Conclusions: The
significance of fatigue in pSS, its consequences, and profound influence on the
quality of life necessitate further research for a more comprehensive
understanding of this complex issue. Full article
(This article belongs to the Special Issue Immune-Mediated Rheumatic Diseases)
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14 pages, 2804 KiB
Open AccessArticle
The Clinical Utility of Lower Extremity Dual-Energy CT Angiography in the
Detection of Bone Marrow Edema in Diabetic Patients with Peripheral Artery
Disease
by
Chiara Floridi
,
Laura Maria Cacioppa
,
Tommaso Valeri
,
Nicolo Rossini
,
Marzia Rosati
,
Vincenzo Vento
,
Alessandro Felicioli
,
Marco Macchini
,
Roberto Candelari
,
Marina Carotti
and
Andrea Giovagnoni
J. Clin. Med. 2024, 13(6), 1536; https://doi.org/10.3390/jcm13061536 - 07 Mar
2024
Abstract
(1) Background: Type 2 diabetes is a major cause of incidences and the
progression of peripheral artery disease (PAD). Bone marrow edema (BME) is an
important finding suggestive of underlying bone inflammation in non-traumatic
diabetic patients with PAD. Our aim was to [...] Read more.
(1) Background: Type 2 diabetes is a major cause of incidences and the
progression of peripheral artery disease (PAD). Bone marrow edema (BME) is an
important finding suggestive of underlying bone inflammation in non-traumatic
diabetic patients with PAD. Our aim was to evaluate the presence, severity, and
clinical implications of BME detected by virtual non-calcium application (VNCa)
of dual-energy CT angiography (DE-CTA). (2) Methods: A consecutive series of 76
diabetic patients (55 men; mean age 71.6 ± 11.2 yrs) submitted to lower limb
DE-CTA for PAD evaluation and revascularization planning, which were
retrospectively analyzed. VNCa images were independently and blindly revised for
the presence, location, and severity of BME by two radiologists with 10 years of
experience. BME and non-BME groups were evaluated in terms of PAD clinical
severity and 6-month secondary major amputation rate. (3) Results: BME was
present in 17 (22%) cases, while 59 (78%) patients were non-BME. The BME group
showed a significantly higher incidence of major amputation (p < 0.001) and a
significantly higher number of patients with advanced clinical stages of PAD
compared to the non-BME group (p = 0.024). (4) Conclusions: Lower limb DE-CTA
with VNCa application is a useful tool in the detection of BME in diabetic
patients with PAD, simultaneously enabling the evaluation of the severity and
location of the arterial disease for revascularization planning. BME presence
could be a marker of clinically severe PAD and a possible risk factor for
revascularization failure. Full article
(This article belongs to the Special Issue Dual-Energy and Spectral CT in
Clinical Practice)
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11 pages, 453 KiB
Open AccessArticle
Impact of a Semi-Rigid Knee Orthotic Intervention on Pain, Physical Activity,
and Functional Capacity in Patients with Medial Knee Osteoarthritis
by
Bernd J. Stetter
,
Janis Fiedler
,
Michèle Arndt
,
Thorsten Stein
and
Stefan Sell
J. Clin. Med. 2024, 13(6), 1535; https://doi.org/10.3390/jcm13061535 - 07 Mar
2024
Abstract
Background: The effectiveness of knee orthoses as part of conservative treatment
for patients with medial knee osteoarthritis has not been fully explored. The
purpose of this study was to evaluate the effects of a novel semi-rigid knee
orthosis on pain, physical activity, [...] Read more.
Background: The effectiveness of knee orthoses as part of conservative treatment
for patients with medial knee osteoarthritis has not been fully explored. The
purpose of this study was to evaluate the effects of a novel semi-rigid knee
orthosis on pain, physical activity, and functional capacity. Methods: Pain
levels, physical activity, and functional capacity were assessed in 24
participants experiencing symptomatic medial knee osteoarthritis one week before
(i.e., pretest) initiating a six-week orthosis intervention and again during the
final week of the intervention (i.e., post-test). Results: Night pain, pain
during walking, pain during stair climbing, and pain during sitting consistently
decreased by 41% to 48% while wearing the knee orthosis. Device-based measured
physical activity showed a 20.2-min increase in vigorous physical activity
during the post-test, while light and moderate physical activity did not show
significant changes. After six weeks of orthosis application, there was a 5%
increased distance for the six-minute walk test, and participants reported fewer
limitations both in everyday and athletic activities, as well as an enhanced
quality of life. Conclusions: These findings highlight the potential
effectiveness of a semi-rigid knee orthosis to enhancing functional capacity and
quality of life. More extensive and longer clinical trials are needed to improve
confidence in these findings and understand their impact on disease progression.
Full article
(This article belongs to the Special Issue Latest Advances in Clinical Diagnosis
and Treatment of Hip and Knee Osteoarthritis)
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13 pages, 6110 KiB
Open AccessArticle
Sustained Disease Control in DME Patients upon Treatment Cessation with
Brolucizumab
by
Justus G. Garweg
and
Sonja Steinhauer
J. Clin. Med. 2024, 13(6), 1534; https://doi.org/10.3390/jcm13061534 - 07 Mar
2024
Abstract
Background: Treatment cessation due to a dry retina has not been systematically
addressed in diabetic macular edema (DME). In three out of four patients
receiving 6 mg of brolucizumab in the KITE study, treatment was terminated after
the study ended. Methods: The KITE [...] Read more.
Background: Treatment cessation due to a dry retina has not been systematically
addressed in diabetic macular edema (DME). In three out of four patients
receiving 6 mg of brolucizumab in the KITE study, treatment was terminated after
the study ended. Methods: The KITE study was a double-masked, multicenter,
active-controlled, randomized trial (NCT 03481660) in DME patients. Per
protocol, patients received five loading injections of Brolucizumab at 6-week
intervals, with the option to adjust to 8 weeks in case of disease activity or
to extend in the second year to a maximum of 16 weeks in the absence of retinal
fluid. Results: After two years, one patient required eight weekly injections,
while three patients reached a maximal treatment interval of 16 weeks. The
severity of diabetic retinopathy improved in all patients with no dye leakage
according to fluorescein angiography (FA) and no retinal fluid according to OCT
in three patients. Treatment was paused in these three patients for >36 months,
while the fourth patient required continuous treatment at 5-week intervals after
switching to other licensed anti-VEGF agents. Conclusions: The adoption of
treatment according to individual needs, including considering treatment
cessation, may contribute to improved treatment adherence in many patients and
be more frequently possible than expected. Full article
(This article belongs to the Section Ophthalmology)
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11 pages, 547 KiB
Open AccessArticle
Exploring the Links between Physical Activity, Emotional Regulation, and Mental
Well-Being in Jordanian University Students
by
Mohammad Al-Wardat
,
Chiara Salimei
,
Hassan Alrabbaie
,
Mohammad Etoom
,
Malak Khashroom
,
Chantelle Clarke
,
Khader A. Almhdawi
and
Talitha Best
J. Clin. Med. 2024, 13(6), 1533; https://doi.org/10.3390/jcm13061533 - 07 Mar
2024
Abstract
Background: University students face multiple stressors that negatively impact
their mental well-being. Effective emotional regulation and physical activity
are crucial for mood management and overall health. This study explored the
connection between physical activity, emotional regulation, and mental health
symptoms (depression, anxiety, and [...] Read more.
Background: University students face multiple stressors that negatively impact
their mental well-being. Effective emotional regulation and physical activity
are crucial for mood management and overall health. This study explored the
connection between physical activity, emotional regulation, and mental health
symptoms (depression, anxiety, and stress) in Jordanian university students.
Methods: A cross-sectional online survey involved 416 students (146 male and 270
female) from Jordanian universities. The survey covered demographics, physical
activity (International Physical Activity Questionnaire), emotional regulation
strategies (Emotion Regulation Questionnaire), and mental health symptoms
(Depression Anxiety Stress Scales). Pearson’s correlations examined
relationships, and ANOVA compared differences in ‘low’, ‘medium’, and ‘high’
physical activity groups. Results: Greater use of expressive suppression was
correlated with increased anxiety symptom severity (p = 0.029). Although
physical activity levels were not significantly related to emotional regulation,
the ‘high’ physical activity group reported lower depression (p < 0.001) and
anxiety symptom severity (p < 0.001) than the ‘low’ and ‘medium’ groups.
Conclusions: Increased physical activity and emotional expression suppression
are independently associated with improved mental well-being in Jordanian
university students. This study underscores the importance of integrating
physical activity and emotional expression strategies to support student
well-being. Full article
(This article belongs to the Section Mental Health)
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13 pages, 929 KiB
Open AccessArticle
Detailed One-Year Follow-Up in Left Bundle Branch Area Pacing: Echocardiography,
Natriuretic Peptide, Electrical Parameters and Complications
by
Maciej Fularz
and
Przemysław Mitkowski
J. Clin. Med. 2024, 13(6), 1532; https://doi.org/10.3390/jcm13061532 - 07 Mar
2024
Abstract
Background: LBBAP is a promising method of cardiac pacing. Data on some
follow-up details are still limited. We aimed to evaluate LBBAP over a one-year
follow-up period. Methods: The studied population consisted of 110 patients who
underwent LBBAP device implantation (93 [...] Read more.
Background: LBBAP is a promising method of cardiac pacing. Data on some
follow-up details are still limited. We aimed to evaluate LBBAP over a one-year
follow-up period. Methods: The studied population consisted of 110 patients who
underwent LBBAP device implantation (93 for bradycardia indications, 17 for
CRT). Echocardiography and NT-proBNP measurement were performed before the
procedure and after one year. Electrical parameters, complications and some
other conditions that required attention were noted during the observation
period. Results: In total, 89 patients completed the one-year follow-up.
NT-proBNP and echocardiographic parameters (LVEF, left ventricular end-diastolic
dimension, left atrium dimension) improved after the one-year follow-up,
especially in the patients with CRT indications, but also in the bradycardia
patients. The independent predictors of a positive heart function response were
higher baseline NT-proBNP and the presence of either RBBB or LBBB. The
electrical parameters were satisfactory but a slight raise in the pacing
threshold was observed at subsequent control visits. Major complications
occurred in 4.5% of patients in the acute phase and in 4.4% during the follow-up
(the most common was dislodgement of the non-LBBAP lead). One patient is
presumed to have developed pacing-induced cardiomyopathy. The most frequent mild
complications were intraprocedural RBBB (9.1%) and conversion to deep septal
pacing during the follow-up period (5.5%). In addition, 4.4% of the patients
required individual programming of the pacing output to maintain the optimal
type of capture. Conclusions: The impact of LBBAP device implantation on cardiac
function parameters is positive in a wide range of indications, especially in
patients with RBBB or LBBB. The prevalence of complications is relatively high
but major complications are rarely associated with LBBAP issues. Full article
(This article belongs to the Special Issue Advances in Cardiac Electrophysiology
and Pacing: Part II)
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Graphical abstract
Graphical abstract
26 pages, 1847 KiB
Open AccessSystematic Review
Economic Cost of Rehabilitation with Robotic and Virtual Reality Systems in
People with Neurological Disorders: A Systematic Review
by
Roberto Cano-de-la-Cuerda
,
Aitor Blázquez-Fernández
,
Selena Marcos-Antón
,
Patricia Sánchez-Herrera-Baeza
,
Pilar Fernández-González
,
Susana Collado-Vázquez
,
Carmen Jiménez-Antona
and
Sofía Laguarta-Val
J. Clin. Med. 2024, 13(6), 1531; https://doi.org/10.3390/jcm13061531 - 07 Mar
2024
Abstract
Background: The prevalence of neurological disorders is increasing worldwide. In
recent decades, the conventional rehabilitation for people with neurological
disorders has been often reinforced with the use of technological devices
(robots and virtual reality). The aim of this systematic review was to [...]
Read more.
Background: The prevalence of neurological disorders is increasing worldwide. In
recent decades, the conventional rehabilitation for people with neurological
disorders has been often reinforced with the use of technological devices
(robots and virtual reality). The aim of this systematic review was to identify
the evidence on the economic cost of rehabilitation with robotic and virtual
reality devices for people with neurological disorders through a review of the
scientific publications over the last 15 years. Methods: A systematic review was
conducted on partial economic evaluations (cost description, cost analysis,
description of costs and results) and complete (cost minimization,
cost-effectiveness, cost utility and cost benefit) studies. The Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines
were followed. The main data sources used were PubMed, Scopus and Web of Science
(WOS). Studies published in English over the last 15 years were considered for
inclusion in this review, regardless of the type of neurological disorder. The
critical appraisal instrument from the Joanna Briggs Institute for economic
evaluation and the Consolidated Health Economic Evaluation Reporting Standards
(CHEERS) were used to analyse the methodological quality of all the included
papers. Results: A total of 15 studies were included in this review. Ten papers
were focused on robotics and five on virtual reality. Most of the studies were
focused on people who experienced a stroke. The robotic device most frequently
used in the papers included was InMotion® (Bionik Co., Watertown, MA, USA), and
for those focused on virtual reality, all papers included used semi-immersive
virtual reality systems, with commercial video game consoles (Nintendo Wii®
(Nintendo Co., Ltd., Kyoto, Japan) and Kinect® (Microsoft Inc., Redmond, WA,
USA)) being used the most. The included studies mainly presented cost
minimization outcomes and a general description of costs per intervention, and
there were disparities in terms of population, setting, device, protocol and the
economic cost outcomes evaluated. Overall, the methodological quality of the
included studies was of a moderate level. Conclusions: There is controversy
about using robotics in people with neurological disorders in a rehabilitation
context in terms of cost minimization, cost-effectiveness, cost utility and cost
benefits. Semi-immersive virtual reality devices could involve savings (mainly
derived from the low prices of the systems analysed and transportation services
if they are applied through telerehabilitation programmes) compared to in-clinic
interventions. Full article
(This article belongs to the Section Clinical Rehabilitation)
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Open AccessReview
Bedside Laparoscopy in the Critically Ill: A Review of the Literature
by
Alessandro Palladino
,
Carlo Vallicelli
,
Daniele Perrina
,
Girolamo Convertini
,
Federico Coccolini
,
Luca Ansaloni
,
Massimo Sartelli
and
Fausto Catena
J. Clin. Med. 2024, 13(6), 1530; https://doi.org/10.3390/jcm13061530 - 07 Mar
2024
Abstract
Critically ill patients treated in the intensive care unit (ICU) can present
with many abdominal conditions that need a prompt diagnosis and timely treatment
because of their general frailty. Clinical evaluation and diagnostic tools like
ultrasound or CT scans are not reliable or [...] Read more.
Critically ill patients treated in the intensive care unit (ICU) can present
with many abdominal conditions that need a prompt diagnosis and timely treatment
because of their general frailty. Clinical evaluation and diagnostic tools like
ultrasound or CT scans are not reliable or feasible in these patients. Bedside
laparoscopy (BSL) is a minimally invasive procedure that allows surgeons to
assess the abdominal cavity directly in the ICU, thus avoiding unnecessary
exploratory laparotomy or incidents related to intra-hospital transfer. We
conducted a review of the literature to summarize the state-of-the-art of BSL.
The Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and
Scopus databases were utilized to identify all relevant publications.
Indications, contraindications, technical aspects, and outcomes are discussed.
The procedure is safe, feasible, and effective. When other diagnostic tools fail
to diagnose or exclude an intra-abdominal condition in ICU patients, BSL should
be preferred over exploratory laparotomy. Full article
(This article belongs to the Special Issue Minimally Invasive Emergency Surgery)
21 pages, 9977 KiB
Open AccessArticle
Radiological Outcomes of Magnetically Controlled Growing Rods for the Treatment
of Children with Various Etiologies of Early-Onset Scoliosis—A Multicenter Study
by
Pawel Grabala
,
Munish C. Gupta
,
Daniel E. Pereira
,
Michal Latalski
,
Anna Danielewicz
,
Pawel Glowka
and
Michal Grabala
J. Clin. Med. 2024, 13(6), 1529; https://doi.org/10.3390/jcm13061529 - 07 Mar
2024
Abstract
Background: The management of spinal deformities diagnosed before the age of 10
is critical due to the child’s development, skeletal system, and growth
mechanism. Magnetically controlled growing rods (MCGRs) are a surgical treatment
option for the growing spine. The aim of this study [...] Read more.
Background: The management of spinal deformities diagnosed before the age of 10
is critical due to the child’s development, skeletal system, and growth
mechanism. Magnetically controlled growing rods (MCGRs) are a surgical treatment
option for the growing spine. The aim of this study was to analyze the
radiological findings of patients treated with MCGRs for early-onset scoliosis
(EOS) of various etiologies. We hypothesized that the MCGRs could provide
acceptable long-term radiographic results, such as an increase in the T1–T12 and
T1–S1 height and significant overall deformity correction. Methods: We
retrospectively reviewed 161 EOS patients with a combined total of 302 MCGRs
inserted at five institutions between 2016 and 2022 with a mean follow-up of at
least two years. The Cobb angle of the major curve (MC), thoracic kyphosis (TK),
lumbar lordosis (LL), and T1–T12 and T1–S1 height measurements were assessed
before, after, and during the follow-up. Results: Among the 90 female and 71
male patients, there were 51 neurological, 42 syndromic, 58 idiopathic, and ten
congenital scoliosis etiologies. Of the patients, 73 were aged under six years
old. The mean follow-up time was 32.8 months. The mean age at placement of the
MCGRs was 7 years and that at the last follow-up after fusion surgery was 14.5
years. The mean MC before the initial surgery was 86.2°; following rod
implantation, it was 46.9°, and at the last follow-up visit, it was 45.8°. The
mean correction rate among the etiology subgroups was from 43% to 50% at
follow-up. The mean TK was noted as 47.2° before MCGR implantation, 47.1° after
MCGR placement, and 44.5° at the last follow-up visit. The mean T1–T12 height
increased by 5.95 mm per year, with a mean T1–S1 height of 10.1 mm per year.
Conclusions: MCGR treatment allowed for an average correction of the curvature
by 50% during the period of lengthening, while controlling any deformity and
growth of the spine, with a significant increase in the T1–T12 and T1–S1 values
during the observation period. MCGR treatment in EOS carries a risk of
complications. While congenital and syndromic EOS often have short and less
flexible curves in those groups of patients, single rods can be as effective and
safe. Definitive fusion results in the mean final coronal correction between the
start of MCGR treatment and after undergoing PSF of approximately 70%. The mean
T1–T12 spinal height increased by 75 mm, while the T1–S1 spinal height gained a
mean of 97 mm. Full article
(This article belongs to the Special Issue Spinal Disorders: Current Treatment
and Future Opportunities: Part II)
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Open AccessArticle
The Influence of Successful Treatment of Stress Urinary Incontinence and Pelvic
Organ Prolapse on Depression, Anxiety, and Insomnia—A Prospective Intervention
Impact Assessment Study
by
Urszula Kalata
,
Michał Jarkiewicz
,
Andrzej Pomian
,
Aneta Janina Zwierzchowska
,
Edyta Horosz
,
Wojciech Majkusiak
,
Beata Rutkowska
and
Ewa Monika Barcz
J. Clin. Med. 2024, 13(6), 1528; https://doi.org/10.3390/jcm13061528 - 07 Mar
2024
Abstract
Introduction: The association between pelvic floor disorders (PFDs) and
psychiatric conditions is an area of emerging interest. The causal direction of
this relationship, however, remains ambiguous; it is unclear whether PFDs
directly contribute to the deterioration of mental health or if pre-existing
[...] Read more.
Introduction: The association between pelvic floor disorders (PFDs) and
psychiatric conditions is an area of emerging interest. The causal direction of
this relationship, however, remains ambiguous; it is unclear whether PFDs
directly contribute to the deterioration of mental health or if pre-existing
psychiatric conditions such as depression exacerbate the symptoms of PFDs. This
study aimed to evaluate the effects of successful surgical treatment for stress
urinary incontinence (SUI) and pelvic organ prolapse (POP) on symptoms of
depression, anxiety, and insomnia. Materials and Methods: This investigation
focused on patients who underwent successful surgical interventions for SUI and
POP. Both subjective and objective symptoms of PFDs, along with psychiatric
status, were assessed before and after the surgical procedures. Results: This
study found that successful surgical treatment of SUI and POP led to a
significant reduction in anxiety scores. Additionally, in patients with SUI,
successful treatment was objectively associated with a decrease in the severity
of insomnia. Alleviation of symptoms associated with the lower urinary tract,
prolapse, and colorectal–anal region following POP surgery was correlated with
improvements in depression and anxiety but not insomnia. Subjectively assessed
improvements in SUI subjective symptoms were linked to reductions in the
severity of depression, anxiety, and insomnia in patients who underwent
anti-incontinence surgery. Conclusions: These findings suggest a potential
cause-and-effect relationship between PFDs and certain psychiatric disorders,
highlighting the importance of successful treatment of PFDs in mitigating
symptoms of depression, anxiety, and insomnia. Full article
(This article belongs to the Special Issue Prevention and Treatment for Pelvic
and Relative Diseases)
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Open AccessReview
The Functional Implications of Transanal Irrigation: Insights from
Pathophysiology and Clinical Studies of Neurogenic Bowel Dysfunction
by
Gianna Rodriguez
,
Steven Kirshblum
,
Mai Thao
,
Mackenzie McArthur
and
Michael Camilleri
J. Clin. Med. 2024, 13(6), 1527; https://doi.org/10.3390/jcm13061527 - 07 Mar
2024
Abstract
Defecation function is negatively impacted in patients with neurogenic bowel
dysfunction (NBD), who require effective bowel care for stool evacuation. NBD
comprises fecal incontinence and/or constipation, which can reduce the quality
of life and dignity. Transanal irrigation (TAI) is recommended by several
clinical [...] Read more.
Defecation function is negatively impacted in patients with neurogenic bowel
dysfunction (NBD), who require effective bowel care for stool evacuation. NBD
comprises fecal incontinence and/or constipation, which can reduce the quality
of life and dignity. Transanal irrigation (TAI) is recommended by several
clinical guidelines as the second-line treatment after conservative treatment
and before surgical options are considered. As the only class in the second-line
treatment with an established safety and efficacy profile, the mechanism of
action of TAI has not fully been elucidated when administered through a rectal
catheter with a balloon. This review examines the current understanding
regarding the mechanism of action of TAI, with a focus on the pathophysiology of
neurogenic bowel and irregular defecation. By understanding the functional
implications of TAI, clinicians may be better able to integrate this modality
into bowel care programs, especially for patients with NBD who have significant
constipation due to delayed colonic motility and impaired stool emptying with
loss of voluntary control of defecation, and those who are unresponsive to
conservative treatment, including enemas. Full article
(This article belongs to the Special Issue Gastrointestinal Motility Disorders)
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HIGHLY ACCESSED ARTICLES
Article
Long-COVID Prevalence and Its Association with Health Outcomes in the
Post-Vaccine and Antiviral-Availability Era
by Ramida Jangnin et al.
J. Clin. Med. 2024, 13(5), 1208; https://doi.org/10.3390/jcm13051208
Published: 21 February 2024
Review
Are Surgeons Going to Be Left Holding the Bag? Incisional Hernia Repair and
Intra-Peritoneal Non-Absorbable Mesh Implant Complications
by Andrew W. Kirkpatrick et al.
J. Clin. Med. 2024, 13(4), 1005; https://doi.org/10.3390/jcm13041005
Published: 9 February 2024
Review
Recent Advances and Future Directions in Syncope Management: A Comprehensive
Narrative Review
by Anna Maria Martone et al.
J. Clin. Med. 2024, 13(3), 727; https://doi.org/10.3390/jcm13030727
Published: 26 January 2024
Review
Albuminuria, Forgotten No More: Underlining the Emerging Role in CardioRenal
Crosstalk
by Gregorio Romero-González et al.
J. Clin. Med. 2024, 13(3), 777; https://doi.org/10.3390/jcm13030777
Published: 29 January 2024
Review
Role of Female Sex Hormones in ADPKD Progression and a Personalized Approach to
Contraception and Hormonal Therapy
by Micaela Petrone et al.
J. Clin. Med. 2024, 13(5), 1257; https://doi.org/10.3390/jcm13051257
Published: 22 February 2024
Review
Critical Care Management of Severe Asthma Exacerbations
by Shameek Gayen et al.
J. Clin. Med. 2024, 13(3), 859; https://doi.org/10.3390/jcm13030859
Published: 1 February 2024
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