Journal Description
Clinics and Practice
Clinics and Practice
is an international, scientific, peer-reviewed, open access journal on clinical medicine, published bimonthly online by MDPI (from Volume 11, Issue 1 - 2021).
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), PubMed, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Medicine, General and Internal) / CiteScore - Q2 (General Medicine)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 23.7 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Impact Factor:
1.7 (2023);
5-Year Impact Factor:
1.6 (2023)
Latest Articles
Augmented Reality in Dentistry: Enhancing Precision in Clinical Procedures—A Systematic Review
Clin. Pract. 2024, 14(6), 2267-2283; https://doi.org/10.3390/clinpract14060178 - 28 Oct 2024
Abstract
Background: Augmented reality (AR) enhances sensory perception by adding extra information, improving anatomical localization and simplifying treatment views. In dentistry, digital planning on bidimensional screens lacks real-time feedback, leading to potential errors. However, it is not clear if AR can improve the clinical
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Background: Augmented reality (AR) enhances sensory perception by adding extra information, improving anatomical localization and simplifying treatment views. In dentistry, digital planning on bidimensional screens lacks real-time feedback, leading to potential errors. However, it is not clear if AR can improve the clinical treatment precision. The aim of this research is to evaluate if the use of AR-based instruments could improve dental procedure precision. Methods: This review covered studies from January 2018 to June 2023, focusing on AR in dentistry. The PICO question was “Does AR increase the precision of dental interventions compared to non-AR techniques?”. The systematic review was carried out on electronic databases, including Ovid MEDLINE, PubMed, and the Web of Science, with the following inclusion criteria: studies comparing the variation in the precision of interventions carried out with AR instruments and non-AR techniques. Results: Thirteen studies were included. Conclusions: The results of this systematic review demonstrate that AR enhances the precision of various dental procedures. The authors advise clinicians to use AR-based tools in order to improve the precision of their therapies.
Full article
(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)
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Open AccessReview
Key Considerations for Frail Patients Undergoing Hip Fracture Surgery
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Ana-Maria Dumitriu, Rǎzvan Ene and Liliana Mirea
Clin. Pract. 2024, 14(6), 2256-2266; https://doi.org/10.3390/clinpract14060177 - 23 Oct 2024
Abstract
Improving preoperative care for elderly patients with hip fractures is crucial for achieving the best outcomes. A multidisciplinary team that can improve overall care quality by addressing patient’s medical conditions, analgesia, timely surgery, and early postoperative mobilization is required. This narrative review provides
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Improving preoperative care for elderly patients with hip fractures is crucial for achieving the best outcomes. A multidisciplinary team that can improve overall care quality by addressing patient’s medical conditions, analgesia, timely surgery, and early postoperative mobilization is required. This narrative review provides insights regarding the extent of preoperative optimization needed for hip fracture surgery.
Full article
(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)
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A Study of the Factors Impeding Proper Dietary Habits: An Investigation Using the Japanese Comprehensive Survey of Living Conditions
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Akira Komatsuzaki, Sachie Ono, Kanako Mitomi, Kiyoka Arashi, Yukika Enoki, Kanako Seino, Naru Komatsuzaki and Yuuko Ikeda
Clin. Pract. 2024, 14(6), 2245-2255; https://doi.org/10.3390/clinpract14060176 - 23 Oct 2024
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(1) Background: Diet is significant for nutritional intake and serves as an essential element for improving quality of life (QOL). Poor dietary management skills increase the risk of onset or progression of lifestyle-related diseases, and, in particular, are a factor in reduced QOL
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(1) Background: Diet is significant for nutritional intake and serves as an essential element for improving quality of life (QOL). Poor dietary management skills increase the risk of onset or progression of lifestyle-related diseases, and, in particular, are a factor in reduced QOL during old age. This study aimed to clarify the physical and social background factors impeding dietary self-management. (2) Methods: The study participants were 3814 men (age range, 30–69 years) extracted from anonymous data comprising 15,294 persons provided from the Japanese national statistics database. The participants were classified into two groups (Concerned vs. Unconcerned) according to whether they were concerned about their diet. Adjusted odds ratios (ORs) for diet-conscious behaviors were then obtained by means of binomial logistic regression analysis performed following univariate analysis. (3) Results: The Concerned and Unconcerned groups comprised 2548 (66.8%) and 1266 subjects (33.2%), respectively. The diet-conscious behavior with the highest response rate was eating regularly (46.7%). The most frequent items in the Unconcerned group were the subjective symptom “irritable” (48.9%), high stress (46.3%), working more than 56 h/week (43.8%), and smoking (41.9%). The only item with a large significant OR in the binomial logistic regression analysis was smoking (OR: 2.2). (4) Conclusions: These results suggest that a smoking habit and stress are factors that impede diet management behaviors.
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Open AccessCase Report
Three-Leaf-Clover Thyroid and Minimally Invasive Trans-Cervical Synchronous Thyroidectomy and Ectopic Mediastinal Thyroid Tissue Removal: Does the Age of the Patient Count amid a Multifaceted Strategy?
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Claudiu Nistor, Mihai-Lucian Ciobica, Oana-Claudia Sima, Anca-Pati Cucu, Mihai Costachescu, Adrian Ciuche, Lucian-George Eftimie, Dana Terzea and Mara Carsote
Clin. Pract. 2024, 14(6), 2228-2244; https://doi.org/10.3390/clinpract14060175 - 22 Oct 2024
Abstract
Background: Ectopic organ-associated conditions belong to the larger panel of developmental ailments, and among this challenging medical and surgical chapter, ectopic endocrine glands-related picture is mostly focused on the presence of the ectopic parathyroid and thyroid. Ectopic thyroid tissue within mediastinum (ETTM) stands
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Background: Ectopic organ-associated conditions belong to the larger panel of developmental ailments, and among this challenging medical and surgical chapter, ectopic endocrine glands-related picture is mostly focused on the presence of the ectopic parathyroid and thyroid. Ectopic thyroid tissue within mediastinum (ETTM) stands for a less common ETT site; while, globally, less than 1% of the mediastinum masses are ETTM. Objective: We aim to introduce a rare case of ETTM in a senior lady to whom one-time synchronous thyroidectomy with ETT removal was successfully performed via a minimally invasive modern procedure upon cervicotomy and intra-operatory use of the Cooper thymectomy retractor. Results: The panel of pros and cons with respect to providing endocrine thoracic surgery for ETTM resection in a 73-year-old subject is discussed amid a PubMed search of original English-language original reports from January 2000 until 15 August 2024 in order to identify similar distinct cases (individuals of 70 years or older who underwent surgery for ETTM). Conclusions: 1. We propose the term “three-leaf-clover thyroid” to capture the imaging essence of having an enlargement of both (eutopic) thyroid lobes and ETTM. 2. The modern surgical approach under these circumstances provided a rapid patient recovery with a low rate of complications and a minimum hospital stay. Hence, the procedure may be expanded to older patients after a careful consideration of their co-morbidities and of the need to releasing connected complaints (e.g., a 7-month history of intermittent dyspneea was found in this case with post-operatory remission). 3. The management remains a matter of individualised decision, and age may not be a limiting factor. 4. At the present time, this case adds to the very limited number of similar published cases in the mentioned age group that we could identify (seven patients, aged between 72 and 84; male-to-female ratio of 5 to 2; the rate of malignant ETTM was 3/7); of these cases, not all were reported to have a trans-cervical approach, and none reported the use of the Cooper thymectomy retractor to help the overall surgical procedure. This innovative surgical procedure offers the advantage of avoiding a sternotomy incision which has clear functional and aesthetic implications, while the video-assisted approach allows optimal visualization of the mediastinal anatomy and safe vascular sealing under visual control, without the risk of a major hemorrhage.
Full article
(This article belongs to the Special Issue Management of Thyroid Diseases: Current Strategies and Future Directions)
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The Effect of Isometric Exercise Position on the Effectiveness of Isolated Work of the Thigh Flexor Muscles Based on the Results of the sEMG Study
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Joanna Zyznawska, Grzegorz Frankowski, Ewa Wodka-Natkaniec and Joanna Skoczek
Clin. Pract. 2024, 14(6), 2217-2227; https://doi.org/10.3390/clinpract14060174 - 22 Oct 2024
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Backgroud: The main function of the hamstring muscles is to bend the knee joint and support the function of the hip extensors. Their frequent injuries are the result of overload related to, among others, dynamic running or jumping, and inadequate preparation for athletics
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Backgroud: The main function of the hamstring muscles is to bend the knee joint and support the function of the hip extensors. Their frequent injuries are the result of overload related to, among others, dynamic running or jumping, and inadequate preparation for athletics activities. The asymmetry of the work of individual flexor muscle groups is clearly marked in the case of valgus or varus of the knee joint, i.e., in different positions of the lower limb. The aim of the study was to determine the position and form of a rehabilitation exercise in which an isolated group of muscles flexing the knee joint will show the greatest bioelectrical activity. Methods: The study involved 25 students of the Jagiellonian University Medical College. The students were aged 20–26. The average age was 22.9 (±1.4). The study participants included 17 women with an average age of 23.0 (±1.1) and 8 men with an average age of 22.6 (±1.9). Women constituted 68% and men 32% of all respondents. All participants agreed to participate in the study. Surface electromyography measurements in both lower limbs provided an initial number of 50 cases. The activity of the knee flexor muscles during isometric contraction with resistance was measured in correlation with three foot and lower leg settings: internal rotation, neutral position, and external rotation. The bioelectrical activity of the semitendinosus muscle is significantly higher (p < 0.01) in the internal rotation position than in the neutral position of the lower leg, while the bioelectrical activity of the biceps femoris muscle is inversely higher (p < 0.01) in the external rotation position than in the neutral position. Results: The results are significant for both average and maximum values of muscle stimulation. During isometric contraction with resistance, the semitendinosus muscle shows the greatest bioelectrical activity in the internal rotation position of the lower leg and foot, and the biceps femoris muscle in the external rotation position of the lower leg and foot. Conclusions: The above information has important implicational applications when improving isolated groups of hamstrings. In the future, this may contribute to more effective rehabilitation of patients with injuries of the muscles described in the article.
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Effect of a Physical Exercise Intervention on Physical Function Parameters and Blood Analytical Changes in Lung Cancer Survivors: A Feasibility Study
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Teresa Soria-Comes, María Climent-Gregori, Inmaculada Maestu-Maiques, Ignacio Inchaurraga-Álvarez, Ferrán Cuenca-Martínez, Omar Cauli and Francisco M. Martínez-Arnau
Clin. Pract. 2024, 14(5), 2202-2216; https://doi.org/10.3390/clinpract14050173 - 18 Oct 2024
Abstract
Background: Lung cancer carries a high burden of systemic symptoms, including in survivors, leading to a reduced quality of life (QoL). We assessed whether a 12-week multicomponent supervised exercise programme, including muscular strength and aerobic training, was beneficial in patients who had undergone
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Background: Lung cancer carries a high burden of systemic symptoms, including in survivors, leading to a reduced quality of life (QoL). We assessed whether a 12-week multicomponent supervised exercise programme, including muscular strength and aerobic training, was beneficial in patients who had undergone surgery for early non-small cell lung cancer (NSCLC) in terms of physical performance, QoL, and metabolic and nutritional analytical parameters. Methods: Physical performance was measured by gait speed, handgrip strength, 30 s sit-to-stand (30s-STS) test repetitions, distance covered in the 6 min walk test (6MWT), and the Short Physical Performance Battery (SPPB) score. QoL was assessed with the EORTC-QLQ-C30 questionnaire. Blood glucose, cholesterol, triglycerides, total proteins, albumin, pre-albumin, creatinine, c-reactive protein, insulin-growth factor 1 (IGF-1), and the haemoglobin and hematocrit percentages were measured before and after the intervention in order to observe any beneficial effects related to metabolic markers. Results: After the intervention, the mean scores for the 6MWT (p < 0.001), STS (p < 0.001), 6MWT (p < 0.01), and SPPB (p < 0.01) had significantly improved. However, handgrip strength and nutritional analytical were unchanged. The EORTC-QLQ-C30 functions and symptoms significantly improved after the intervention (p < 0.05 and p < 0.01, respectively). A significant decrease in cholesterol, triglycerides, and IGF-1 and a significant increase in pre-albumin in blood was also observed post-intervention (p < 0.05). Conclusions: This supervised, community-based 12-week multicomponent was feasible (adherence rate 70.35%) and provided benefits not only to physical performance but also to the quality of life of patients with NSCLC.
Full article
(This article belongs to the Special Issue Musculoskeletal Pain and Rehabilitation)
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Novel Challenges and Opportunities for Anesthesia and Perioperative Care in Microvascular Flap Surgery: A Narrative Review
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Aleksi Matias Ojuva, Rihards Peteris Rocans, Janis Zarins, Evita Bine, Insana Mahauri, Simona Donina, Biruta Mamaja and Indulis Vanags
Clin. Pract. 2024, 14(5), 2187-2201; https://doi.org/10.3390/clinpract14050172 - 18 Oct 2024
Abstract
Complex microvascular techniques and in-depth knowledge of blood rheology and microanastomosis function are required for success in microvascular flap surgery. Substantial progress has been achieved in preventing complications, but the rate of flap loss is still significant and can have significant adverse effects
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Complex microvascular techniques and in-depth knowledge of blood rheology and microanastomosis function are required for success in microvascular flap surgery. Substantial progress has been achieved in preventing complications, but the rate of flap loss is still significant and can have significant adverse effects on the patient. Flap thrombosis, flap hematoma, and flap loss are the most frequent and severe major surgical complications. Advances in understanding the pathophysiology of different flap complications, the use of preoperative risk assessment and new treatment concepts could improve the perioperative care of microvascular flap surgery patients. Our aim was to outline novel avenues for best practice and provide an outlook for further research of anesthesia and perioperative care concepts in microvascular flap surgery.
Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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The Connection Between Depression and Ischemic Heart Disease: Analyzing Demographic Characteristics, Risk Factors, Symptoms, and Treatment Approaches to Identify Their Relationship
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Laura Ioana Bondar, Brigitte Osser, Gyongyi Osser, Mariana Adelina Mariș, Ligia Elisaveta Piroș, Robert Almășan, Csongor Toth, Caius Calin Miuta, Gabriel Roberto Marconi, Ana-Liana Bouroș-Tataru, Victor Măduța, Dana Tăședan and Mircea Ioachim Popescu
Clin. Pract. 2024, 14(5), 2166-2186; https://doi.org/10.3390/clinpract14050171 - 17 Oct 2024
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Background: This study investigates the association between depression and ischemic heart disease (IHD), conditions that often coexist and complicate patient management. Understanding the impact of demographic factors, risk factors, symptoms, and medical approaches in these patients is essential to develop effective clinical strategies.
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Background: This study investigates the association between depression and ischemic heart disease (IHD), conditions that often coexist and complicate patient management. Understanding the impact of demographic factors, risk factors, symptoms, and medical approaches in these patients is essential to develop effective clinical strategies. Objectives: The aim of this study is to investigate how demographic characteristics, risk factors, symptoms, and treatment methods differ between patients with depression alone and those with both depression and IHD. It seeks to identify how these factors influence patient outcomes, providing insights to improve management and treatment approaches for this complex patient group. Materials and Methods: This cross-sectional study included a sample of 332 patients diagnosed with depression, with a specific subgroup consisting of individuals who also had comorbid IHD. Statistical analyses were performed to compare the patients with depression, focusing on those with IHD. Data on demographic characteristics (e.g., gender, environment, social status), risk factors (e.g., hypertension, diabetes), symptom severity, and treatments (e.g., antidepressants, antipsychotics, anxiolytics, hypnotics) were analyzed. The study also evaluated the frequency of cardiac examinations and emergency hospitalizations. Results: Significant demographic differences were found between the two groups. Patients with both depression and IHD had higher rates of hypertension and diabetes mellitus and experienced more severe depressive symptoms, including reduced mood, energy, and activity levels. The treatment patterns were similar in terms of antidepressant use, but the IHD group had a higher use of antipsychotics, anxiolytics, and hypnotics. Additionally, these patients required more cardiac examinations and emergency hospitalizations. Conclusions: Comorbidity between depression and IHD presents complex clinical challenges, and it is crucial to implement an integrated management approach that addresses both mental and physical health. This study highlights the need for comprehensive therapeutic strategies to improve the quality of life and outcomes for patients with these coexisting conditions.
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Placebos in Healthcare: A Behavioral Study on How Treatment Responsiveness Affects Therapy Decisions in a Simulated Patient–Physician Interaction
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Alessandro Piedimonte, Valeria Volpino, Francesco Campaci, Francesca Borghesi, Giulia Guerra and Elisa Carlino
Clin. Pract. 2024, 14(5), 2151-2165; https://doi.org/10.3390/clinpract14050170 - 17 Oct 2024
Abstract
Background and Purpose: Treatment choice during clinical practice is crucial to best help each patient. One of the physicians’ main goals is choosing a personalized effective treatment, but it also represents a challenging issue. Here, we explored different treatment choices in a simulated
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Background and Purpose: Treatment choice during clinical practice is crucial to best help each patient. One of the physicians’ main goals is choosing a personalized effective treatment, but it also represents a challenging issue. Here, we explored different treatment choices in a simulated patient–physician interaction. Materials and Methods: Medical students (n = 48) and young Practicing Physicians (n = 20) were recruited to behave as “physicians” while fellow researchers acted as “patients”. Participants were divided equally into a Belief Group, which received positive information about placebo efficacy, and a Non-Belief Group, which received negative information. Empathy traits and psychological variables were measured in both groups. During the task, participants were asked to choose between an active (TENS treatment) or a placebo treatment, to reduce patients’ pain. Patients never underwent the painful stimulation but acted as if they had, simulating high or low pain responses to the placebo treatment (placebo-responders/placebo non-responders) and low pain to the TENS treatment. Results: Behavioral results showed that the Belief Group gave significantly more placebo treatments when faced with a patient that simulated placebo responsiveness, while the Non-Belief group showed a mirrorlike behavior, administrating more believed TENS treatments when faced with a placebo non-responder. No differences were found between Medical Students and Practicing Physicians. Conclusions: This study constitutes a frame of reference for medical treatment decisions, indicating that physicians’ treatment choices are influenced by patients’ responsiveness to the treatments, as well as by their prior beliefs and empathy traits.
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(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)
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Effect of Treatment of Neuropathic and Ischemic Diabetic Foot Ulcers with the Use of Local Ozone Therapy Procedures—An Observational Single Center Study
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Jarosław Pasek, Sebastian Szajkowski and Grzegorz Cieślar
Clin. Pract. 2024, 14(5), 2139-2150; https://doi.org/10.3390/clinpract14050169 - 16 Oct 2024
Abstract
Background: Diabetes ranks high among worldwide global health problems, and diabetic foot ulcer syndrome (DFU) is considered as one of its most serious complications. The purpose of this study was to evaluate the impact of local ozone therapy procedures on the wound healing
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Background: Diabetes ranks high among worldwide global health problems, and diabetic foot ulcer syndrome (DFU) is considered as one of its most serious complications. The purpose of this study was to evaluate the impact of local ozone therapy procedures on the wound healing process in patients with two DFU types: neuropathic and ischemic. Material and Methods: In the retrospective study reported here, the treatment outcomes of 90 patients were analyzed: 44 males (48.8%) and 46 females (51.2%), in the age range between 38 and 87 years of age, with neuropathic (group 1) and ischemic (group 2) diabetic foot ulcers treated by means of local ozone therapy. The assessment of therapeutic effects in both groups of patients included an analysis of the rate of ulcer healing using planimetry and an analysis of the intensity of pain associated with ulcers performed using the VAS scale. Results: After the application of ozone therapy procedures, a statistically significant decrease in the surface area of the ulcers was obtained in both groups of patients, respectively: in group 1 from 7 (6–7.5) cm2 to 3 (2–3.5) cm2 and in group 2 from 7.5 (6.5–8) cm2 to 5 (4.5–5.5) cm2 (p < 0.001), with a complete healing of ulcers not observed in any patients from groups 1 and 2. After treatment, the surface area of the assessed ulcers was smaller in the neuropathic group. The intensity of pain experienced after treatment also decreased with statistical significance in both groups (p < 0.001). Conclusions: Short-term local ozone therapy was effective in promoting wound healing and alleviating pain in patients with DFUs of both neuropathic and ischemic etiology. The effectiveness of therapy in the neuropathic type of DFUs was significantly higher than in the ischemic type, in which patients had a higher incidence of risk factors and more advanced lesions, characterized by a larger initial ulcer area and greater intensity of pain.
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The Romanian Translation and Cultural Adaptation of the Early Arthritis for Psoriatic Patients (EARP) Questionnaire, Psoriasis Epidemiology Screening Tool (PEST), and Toronto Psoriatic Arthritis Screen 2 (ToPAS 2)
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Emilia-Daniela Păsăran, Daniela Opriș-Belinski, Florian Berghea, Olguța Anca Orzan, Corina Oancea, Violeta-Claudia Bojincă, Mihai Bojincă, Denise-Ani Mardale, Ioana Cristina Saulescu and Andra-Rodica Bălănescu
Clin. Pract. 2024, 14(5), 2125-2138; https://doi.org/10.3390/clinpract14050168 - 16 Oct 2024
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Background/Objectives: Psoriasis is a chronic inflammatory condition mediated by the immune system with various manifestations. The increased prevalence of subclinical joint involvement has led to the development of early diagnostic methods for psoriatic arthritis, including several instruments that have been validated and used
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Background/Objectives: Psoriasis is a chronic inflammatory condition mediated by the immune system with various manifestations. The increased prevalence of subclinical joint involvement has led to the development of early diagnostic methods for psoriatic arthritis, including several instruments that have been validated and used in clinical practice. The aim of this study was to perform the Romanian translation, cultural adaptation, and validation of three assessment tools: the Early Arthritis for Psoriatic Patients (EARP) Questionnaire, Psoriasis Epidemiology Screening Tool (PEST), and Toronto Psoriatic Arthritis Screen 2 (TOPAS 2), which are designed to evaluate early-stage arthritis in patients with psoriasis. Methods: All the activities were carried out in accordance with the internationally recognized methodology recommended by the International Society for Pharmacoeconomics and Outcome Research (ISPOR), the recommendations of the World Health Organization (WHO) regarding the translation process and the validation of instruments, and data from the international literature. These three questionnaires were administered to 29 patients with psoriasis diagnosed by biopsy. A descriptive study was conducted and the data were analyzed with appropriate statistical tests using the PSPP program. A reliability test was assessed using Cronbach’s alpha coefficient. Results: The obtained values were significant for the first two questionnaires, with a value of 0.89 for the EARP and 0.63 for the PEST, but the value was not as significant for ToPAS2, at 0.40. Conclusions: This pilot study revealed that the Romanian and original versions of the three questionnaires are similar.
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Sleep Awareness of Japanese Outpatients: A Survey at a Psychiatry Department of a University Hospital
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Junya Soga, Kentaro Kawabe, Fumie Horiuchi, Yuta Yoshino, Yuki Ozaki, Kiwamu Nakachi, Rie Hosokawa, Saori Inoue, Yu Matsumoto, Maya Okazawa, Jun-ichi Iga and Shu-Ichi Ueno
Clin. Pract. 2024, 14(5), 2116-2124; https://doi.org/10.3390/clinpract14050167 - 15 Oct 2024
Abstract
Background: Insomnia is common in patients with psychiatric disorders. However, patients’ awareness of sleep has seldom been examined in detail. In this study, we investigated sleep awareness in outpatients at the psychiatry department of a university hospital. Methods: The participants (n =
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Background: Insomnia is common in patients with psychiatric disorders. However, patients’ awareness of sleep has seldom been examined in detail. In this study, we investigated sleep awareness in outpatients at the psychiatry department of a university hospital. Methods: The participants (n = 241) were recruited at the psychiatry department of Ehime University Hospital between 11 October and 5 November 2021. The following questionnaires were used: Clinical Global Impression Scale of Severity (CGI-S), Global Assessment of Functioning (GAF), General Health Questionnaire (GHQ-30), Athens Insomnia Scale (AIS), and Epworth Sleepiness Scale (ESS). Psychiatric disorders were diagnosed by certified psychiatrists using the International Statistical Classification of Diseases and Related Health Problems 10. Participants with an AIS score of ≥6 were allocated to the insomnia group for statistical analysis. A logistic regression analysis was conducted to identify which items of sleep hygiene the patients with insomnia practiced using the Sleep Guidelines for Health Promotion. Results: Of 241 participants, 133 (55.2%) were allocated to the insomnia group. The mean scores for the CGI were significantly higher and the GAF scores were significantly lower in the insomnia group than in the healthy sleep group (p < 0.01). Of the 12 sleep guidelines proposed by the Japanese Government, “Do not go to bed until you are sleepful, do not delay getting up”, was the item that maximally influenced insomnia. Conclusions: The insomnia group had worse scores on various medical assessment scales compared to the healthy sleep group. Based on a survey of outpatients at the psychiatry department of the university hospital, appropriate stimulus control techniques may help clinicians to treat outpatients with insomnia.
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Knowledge and Awareness of Cancer Genome Profiling Tests among Japanese Patients with Cancer
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Yuko Kawasaki, Tamotsu Sudo, Kazuo Tamura, Saki Hinoshita, Kayoko Hasuoka, Satoko Miyawaki, Nao Matsutani, Akira Hirasawa and Atsuko Uchinuno
Clin. Pract. 2024, 14(5), 2105-2115; https://doi.org/10.3390/clinpract14050166 - 12 Oct 2024
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(1) Background: The number of patients with cancer undergoing cancer genome profiling is increasing; however, it remains unclear how accurately they understand the details of the tests and treatments. This study aimed to clarify the awareness of cancer genome profiling tests among patients
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(1) Background: The number of patients with cancer undergoing cancer genome profiling is increasing; however, it remains unclear how accurately they understand the details of the tests and treatments. This study aimed to clarify the awareness of cancer genome profiling tests among patients with cancer who visited cancer genome medical clinics. (2) Methods: A questionnaire survey was conducted on awareness, anxiety, sources of information, and psychological states concerning cancer genome profiling tests. (3) Results: In total, 265 patients with cancer (117 men, 142 women, 6 no response, average age of 58.29 ± 11.9 years) were included in the study, of which 218 (82.3%) were aware of the term “cancer genomic medicine” and 90 (34.0%) were aware of its details. Thus, only a few respondents understood that cancer genome profiling tests facilitate the discovery of secondary findings and of genes associated with hereditary tumors. Regarding their psychological state when visiting the cancer genome clinic, the respondents were anxious about standard treatment and prognosis limits. (4) Conclusions: From the viewpoint of advance care planning, we suggest that medical professionals build a support system that links palliative care and cancer treatment and coordinates genetic counseling at an early stage.
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Open AccessArticle
Chronic Pain in Spanish Physiotherapy Practice: Treatment Challenges and Opportunities in Diverse Healthcare Settings—A Qualitative Study
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Ángeles Díaz-Fernández, Esteban Obrero-Gaitán, Irene Cortés-Pérez, Ana Raquel Ortega-Martínez, María Catalina Osuna-Pérez, Noelia Zagalaz-Anula, María del Rocío Ibancos-Losada and Rafael Lomas-Vega
Clin. Pract. 2024, 14(5), 2089-2104; https://doi.org/10.3390/clinpract14050165 - 10 Oct 2024
Abstract
Background/Objectives: Physiotherapists face significant challenges in managing chronic pain; a complex condition best addressed through a biopsychosocial (BPS) approach. Although substantial evidence exists globally, research specific to Spain remains limited. This study explores the experiences and challenges Spanish physiotherapists encounter in integrating BPS
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Background/Objectives: Physiotherapists face significant challenges in managing chronic pain; a complex condition best addressed through a biopsychosocial (BPS) approach. Although substantial evidence exists globally, research specific to Spain remains limited. This study explores the experiences and challenges Spanish physiotherapists encounter in integrating BPS elements across public and private healthcare settings. Methods: Semi-structured interviews with 12 experienced physiotherapists were conducted, using a qualitative approach with purposive sampling and reflexive thematic analysis. The analysis, grounded in a constructivist/interpretivist framework, allowed themes to emerge naturally from the data, supported by relevant quotes. Results: Three primary themes were identified: (1) challenges in implementing the BPS approach, including patient resistance and limited training; (2) facilitators for adopting the BPS model, such as multidisciplinary support and positive patient outcomes; and (3) emotional and psychological aspects of the physiotherapists. The findings highlight the complexities of chronic pain management in physiotherapy, emphasizing the need for enhanced psychological training, integrated multidisciplinary care, early diagnosis, and effective family involvement. These insights are critical for improving both patient care and physiotherapist well-being. Conclusions: This study provides valuable guidance for future strategies, focusing on educational enhancements, multidisciplinary collaboration, healthcare policy reform, and emotional support for physiotherapists within the Spanish healthcare context.
Full article
(This article belongs to the Special Issue Musculoskeletal Pain and Rehabilitation)
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Open AccessCase Report
The Role of Porcelain Veneers in the Aesthetic Restoration of Discolored Endodontically Treated Teeth
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Panagiotis Galiatsatos and Aristidis Galiatsatos
Clin. Pract. 2024, 14(5), 2080-2088; https://doi.org/10.3390/clinpract14050164 - 9 Oct 2024
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Background: The discoloration of endodontically treated anterior teeth poses a significant aesthetic concern for many individuals, impacting their confidence and self-image. Porcelain veneers have emerged as a popular solution for the aesthetic restoration of such teeth. This paper explores the role of porcelain
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Background: The discoloration of endodontically treated anterior teeth poses a significant aesthetic concern for many individuals, impacting their confidence and self-image. Porcelain veneers have emerged as a popular solution for the aesthetic restoration of such teeth. This paper explores the role of porcelain veneers in addressing tooth discoloration, examining their efficacy, durability, and aesthetic outcomes via a clinical case. Case description: In this clinical case, an aesthetic restoration of a discolored central incisor was performed using a ceramic veneer. Due to the high degree of discoloration, an internal bleaching of the tooth was carried out prior to the final restoration. Various factors influencing the selection of porcelain veneers as a treatment modality, including shade matching, preparation techniques, and adhesive bonding, are discussed. Conclusions: The advancements in materials and techniques have enhanced the versatility and aesthetic appeal of porcelain veneers, making them a valuable option for achieving natural-looking and durable aesthetic restorations in individuals with discolored endodontically treated anterior teeth.
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Open AccessArticle
The First Comprehensive Evaluation of Immuno-Inflammatory Markers for Prognosis in Esophageal Cancer Patients: A South Asian Perspective
by
Sajida Qureshi, Waqas Ahmad Abbasi, Hira Abdul Jalil, Saba Mughal and Muhammad Saeed Quraishy
Clin. Pract. 2024, 14(5), 2071-2079; https://doi.org/10.3390/clinpract14050163 - 6 Oct 2024
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Background: Esophageal cancer (EC) remains a significant health challenge in South Asia, with poor prognosis despite advancements in diagnostics and treatment. Identifying and validating prognostic factors is essential for improving patient outcomes. Methods: A prospective study was conducted with 146 biopsy-confirmed EC patients
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Background: Esophageal cancer (EC) remains a significant health challenge in South Asia, with poor prognosis despite advancements in diagnostics and treatment. Identifying and validating prognostic factors is essential for improving patient outcomes. Methods: A prospective study was conducted with 146 biopsy-confirmed EC patients at the Dr. Ruth K.M. Pfau Civil Hospital, Karachi, Pakistan. Clinical and laboratory data were collected and analyzed using descriptive statistics, receiver operating characteristic (ROC) analysis, and the Chi-square test. Survival outcomes were assessed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazard models for univariate and multivariate regression analyses, with statistical significance set at p ≤ 0.05. Results: Bivariate analysis showed significant associations of the neutrophil lymphocyte ratio (NLR) (p = 0.017), C-reactive protein to albumin ratio (CAR) (p = 0.033), red cell distribution width to platelet ratio (RPR) (p = 0.020), and systemic immune-Inflammation index (SII) (p = 0.009) with patient survival. Univariate analysis identified tumor length >10 cm (p = 0.016), T4 stage (p = 0.015), metastasis (p < 0.001), surgery not performed (p < 0.001), and SII (p = 0.022) as significant factors for survival, with higher SII linked to poorer overall survival (p = 0.020). Interestingly, in the multivariate model, only metastasis (p < 0.001) and surgery not performed (p = 0.011) remained significant. Conclusions: Immuno-inflammatory markers may be less pertinent prognostic factors for EC in the South Asian population.
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Open AccessArticle
A Single-Centre Analysis of Surgical Techniques for Myelomeningocele Closure: Methods, Outcomes, and Complications
by
Alina Roxana Cehan, Dorin Constantin Dorobanțu, Corina Ionela Tamas, Vlad Dimitrie Cehan, Flaviu Tamas and Adrian Balasa
Clin. Pract. 2024, 14(5), 2056-2070; https://doi.org/10.3390/clinpract14050162 - 29 Sep 2024
Abstract
(1) Background: Neural tube defects are a prevalent cause of congenital malformations, myelomeningocele (MMC) being the most severe form. This study evaluates the clinical outcome and postoperative-associated complications following MMC surgical closures, focusing on the following three techniques: direct suture (DS); VY advancement
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(1) Background: Neural tube defects are a prevalent cause of congenital malformations, myelomeningocele (MMC) being the most severe form. This study evaluates the clinical outcome and postoperative-associated complications following MMC surgical closures, focusing on the following three techniques: direct suture (DS); VY advancement flap (VYF); and Limberg flap (LF). (2) Methods: A retrospective observational study was conducted from March 2015 to February 2023, and the inclusion criteria were newborns who underwent lumbosacral MMC within 24 h of birth. (3) Results: Out of 20 cases, 45% underwent DS closure; 25% underwent VY-F closure; 15% underwent LF closure, and 15% (n = 3) underwent combined flap closure. A significant statistical correlation was observed between intracranial hypertension (IH), the need for external ventricular drainage (EVD), and DS closure type. In the DS group, 60% of patients required EVD (p = 0.041), and 90% had IH (p = 0.027). CSF fistula was present in 40% of LF cases and 30% of DS cases, while wound dehiscence was observed in 60% of LF cases and 30% of DS cases. (4) Conclusions: Our study demonstrated that DS was linked to higher rates of complications. The VY-F is the safest method for closing MMC defects.
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(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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Balance, Gait, Functionality and Fall Occurrence in Adults and Older Adults with Type 2 Diabetes Mellitus and Associated Peripheral Neuropathy
by
Natália Maria Bezerra Tavares, Jonathânya Marques Silva, Mayra Darlene Morato da Silva, Letícia Danielly Tenório Silva, Jackson Nascimento de Souza, Lucas Ithamar, Maria Cristina Falcão Raposo and Renato S. Melo
Clin. Pract. 2024, 14(5), 2044-2055; https://doi.org/10.3390/clinpract14050161 - 28 Sep 2024
Abstract
Background: Body balance is regulated by sensory information from the vestibular, visual and somatosensory systems, and changes in one or more of these sensory systems can trigger balance disorders. Individuals with type 2 Diabetes Mellitus (DM2) often present peripheral neuropathy, a condition that
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Background: Body balance is regulated by sensory information from the vestibular, visual and somatosensory systems, and changes in one or more of these sensory systems can trigger balance disorders. Individuals with type 2 Diabetes Mellitus (DM2) often present peripheral neuropathy, a condition that alters foot sensory information and can negatively influence balance and gait performance of these subjects. Objective: To evaluate and compare balance, gait, functionality and the occurrence of falls between individuals with and without a clinical diagnosis of DM2 with associated peripheral neuropathy. Methods: Cross-sectional study, which evaluated seventy individuals, thirty-five with and thirty-five without a clinical diagnosis of DM2, of both sexes and age range between 50 and 85 years, who were recruited from Basic Health Units of Serra Talhada, Pernambuco state, Brazil. The volunteers’ balance was analyzed using the Berg Balance Scale, gait-related functional tasks were measured using the Dynamic Gait Index, functional mobility was assessed using the Timed Up and Go test and functionality was assessed using the Katz Index. The occurrence of falls was recorded by the volunteers’ self-report. Results: Individuals with DM2 demonstrated the worst performance in balance (p = 0.000) and in gait-related functional tasks (p = 0.000), slower functional mobility (p = 0.000) and worse functionality (p = 0.016) compared to the group without DM2, demonstrating significant differences for all analyzed outcomes. A greater occurrence of falls was observed in individuals with DM2, compared to those without the disease (p = 0.019). Conclusion: Individuals with DM2 demonstrated worse performance on balance, gait-related functional tasks, slower functional mobility and worse functionality compared to those without the disease. Individuals with DM2 had the highest occurrence of falls in this study.
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Open AccessCase Report
Twisted Troubles: A Rare Case of Intestinal Obstruction Due to Endometriosis and a Review of the Literature
by
Ionut Eduard Iordache, Luana Alexandrescu, Alina Doina Nicoara, Razvan Popescu, Nicoleta Leopa, Gabriela Baltatescu, Andreea Nelson Twakor, Ionut Tiberiu Tofolean and Liliana Steriu
Clin. Pract. 2024, 14(5), 2027-2043; https://doi.org/10.3390/clinpract14050160 - 27 Sep 2024
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Background and Objectives: Intestinal endometriosis is an exceptionally rare cause of intestinal obstruction. This case report and literature review aim to highlight the clinical presentation, diagnostic challenges, and surgical management of this condition. Materials and methods: We report the case of a 50-year-old
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Background and Objectives: Intestinal endometriosis is an exceptionally rare cause of intestinal obstruction. This case report and literature review aim to highlight the clinical presentation, diagnostic challenges, and surgical management of this condition. Materials and methods: We report the case of a 50-year-old female patient who presented diffuse abdominal pain, nausea, vomiting, a distended abdomen, and an absence of intestinal transit for gas and faeces. Initial symptoms included flatulence and constipation, which gradually worsened for two months prior to the patient’s hospital admission, leading to acute intestinal obstruction. Diagnostic investigations, including blood tests, ultrasound (USG), X-ray, and a contrast-enhanced computer tomography (CT) scan, revealed significant small bowel dilatation and an ileal volvulus. The patient underwent urgent hydro-electrolytic and metabolic rebalancing followed by a median laparotomy surgical procedure. Intraoperative findings included a distended small intestine and an obstructive ileal volvulus, and required an 8 cm segmental enterectomy and terminal ileostomy. Results: Postoperative recovery was slow but favourable, with a gradual digestive tolerance. Histopathological examination of the resected ileum revealed intestinal endometriosis characterized by a fibro-conjunctive reaction and nonspecific chronic active inflammation. Five months later, the patient underwent a successful reversal of the ileostomy with a mechanical lateral anastomosis of the cecum and ileum, resulting in a favourable postoperative course. Conclusions: This case underscores the importance of considering intestinal endometriosis in women presenting with unexplained gastrointestinal symptoms and highlights the need for timely surgical intervention and careful postoperative management. Further research is required to better understand the pathophysiology and optimal treatment strategies for intestinal endometriosis.
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Open AccessCase Report
Aesthetical and Functional Rehabilitation for an Ankylosed Maxillary Canine—A Case Report
by
Tatiana Roman, Maxime Delarue, Matthieu Esquenet, Frédéric Rafflenbeul, Catherine Petit, Naji Kharouf and Olivier Etienne
Clin. Pract. 2024, 14(5), 2013-2026; https://doi.org/10.3390/clinpract14050159 - 27 Sep 2024
Abstract
Background: As the functional and aesthetical importance of the canine cannot be overstated, the management of a missing canine is challenging. This case report describes the treatment of an infra-occluded ankylosed maxillary canine in a patient with previously failed orthodontic treatment. Case description:
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Background: As the functional and aesthetical importance of the canine cannot be overstated, the management of a missing canine is challenging. This case report describes the treatment of an infra-occluded ankylosed maxillary canine in a patient with previously failed orthodontic treatment. Case description: A 20-year-old patient sought a second opinion for orthodontic treatment failure. The patient presented with an impacted, ankylosed, and severely infra-occluded right maxillary canine, as well as an iatrogenic clockwise cant of the maxillary occlusal plane and several root resorptions. The treatment corrected the cant of the occlusal plane while avoiding further root resorption, partially extracted the upper right canine, improved the quality and quantity of the soft tissue in the newly edentulous area, and provided a prosthetic rehabilitation using a lithium disilicate ceramic resin-bonded cantilever bridge. Conclusions: The use of a cantilevered bridge resulted in an aesthetically pleasing and minimally invasive rehabilitation. This technique is reversible, does not affect pulp vitality, and is a viable solution for rehabilitating the smiles of young patients. Clinical significance: The smile rehabilitation for an ankylosed maxillary canine, especially in the case of a previously failed orthodontic treatment, is an important clinical challenge. A minimally invasive long-term restoration with a cantilever bridge is a viable solution. Functional and aesthetically pleasant results can be achieved with a multidisciplinary approach.
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(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)
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