Search Results (139)

Background/Objectives: Chronic idiopathic constipation (CIC) is a common gastrointestinal disorder with a global prevalence of about 14%, common in women and elderly population. It often lacks effective treatment. This randomized clinical trial was aimed to evaluate the efficacy and tolerability of Hippophae rhamnoides L. (sea buckthorn) fruit extract in adults with CIC. Methods: A UHPLC-HRMS/MS analysis was performed on the hydroethanolic H. rhamnoides fruit extract to evaluate its composition. Ninety participants were randomly assigned to receive either 500 mg of H. rhamnoides extract or placebo delivered through a capsule daily for 28 days. The primary outcome was the change in weekly spontaneous complete bowel movements (SCBMs), while secondary outcomes included stool consistency (Bristol Stool Form Scale—BSFS), gastrointestinal symptoms, and quality of life (SF-12). Results: Metabolic profile of the extract tentatively identified 75 bioactive compounds, predominantly flavonoids, triterpenoids and phospholipids. H. rhamnoides fruit extract significantly improved SCBM frequency (from 1.5 to 2.6 per week; p < 0.001) and normalized stool consistency (mean BSFS score from 1.4 to 3.5; p < 0.001), compared to no change in the placebo group. Significant reductions in bloating, abdominal pain, and heaviness were observed, while flatulence showed no between-group significant difference. No adverse events or use of rescue treatments were reported. Quality-of-life scores remained largely unchanged, with a non-significant trend towards improved mental health in the treated group. Conclusions: These findings suggest that H. rhamnoides fruit extract is a safe and effective option for managing CIC, offering an alternative to other plant extracts with laxative effects. Full article

Background: The viscoelastic properties of muscle tissue are important factors affecting muscle performance; they play a significant role in maintaining spinal stability, as well as muscle contraction and function. Changes in these properties can result in pain, restricted movement, or poor posture. However, there is limited information in the literature regarding the viscoelastic properties of the paraspinal muscles, such as tone and stiffness, in individuals with chronic low back pain, which is one of the most common musculoskeletal disorders. The main aim of our study was to investigate the effects of reformer Pilates exercises on muscle viscoelastic properties in individuals with chronic low back pain for 4 weeks. In addition, our secondary aim was to examine the effects of Pilates-based exercises on body anthropometric values, pain intensity, functionality and kinesiophobia levels, sleep, and quality of life in individuals with chronic low back pain and to compare these parameters with a healthy group without low back pain. Methods: The study was carried out in a private clinic center and involved a total of 52 participants: 24 healthy subjects (control group) and 28 subjects with chronic low back pain (CLBP group). Pilates-based exercises were applied 2 days a week for 8 sessions for a total of 4 weeks. Muscle viscoelastic properties, body anthropometric values, pain intensity, functional status, kinesiophobia, sleep quality, and quality of life of all cases were evaluated. Muscle viscoelastic values were measured with a portable myotonometer, MyotonPro. Results: After 4 weeks of Pilates-based training, no significant improvements were observed in the parameters of muscle tone and stiffness in both groups (p > 0.05). It was found that pain intensity (p = 0.001), sleep quality (p = 0.004), quality of life (p = 0.019), and disability level (p = 0.003) improved after 4 weeks of Pilates-based training in subjects with chronic low back pain. In addition, there were significant differences in the parameters of the chest, waist, hip, and thigh circumferences after 4 weeks of Pilates-based training, except for the abdomen, in both groups (p < 0.05). Conclusions: A period of four weeks of Pilates exercises did not lead to significant changes in the muscle viscoelastic properties of the lumbar and abdominal muscles, although performing these exercises did result in regional thinning. The efficacy of Pilates exercises in reducing pain, disability, and kinesiophobia and in improving sleep and quality of life has been demonstrated in individuals suffering from chronic low back pain. Full article

Background/Objectives: Urinary incontinence (UI) is common among women practicing sports, particularly those involving heavy lifting or high-impact movements that increase intra-abdominal pressure. UI can negatively affect social life, self-confidence, and motivation to remain active. This study aimed to examine the associations of sociodemographic, training-related, obstetric, and surgical factors with UI in female weightlifters. Methods: This cross-sectional study included 84 French women who regularly practiced weightlifting. Participants completed a structured questionnaire collecting sociodemographic and gynecological information, as well as the Urinary Symptom Profile (USP). Data were analyzed using appropriate inferential statistical tests, including the Mann–Whitney U test, Student’s t-test, chi-square test, and Fisher’s exact test, as applicable. A 95% confidence level was adopted for all analyses. Results: Among participants (aged 15–49 years), 51 (60.7%) reported involuntary urine leakage, and 31 (36.9%) scored 1–3 on the USP stress incontinence subscale. Most participants were non-smokers (73.8%), with a median of 3.5 years of weightlifting experience, four weekly training sessions, and six–seven competitions per year. No significant associations were found between UI and sociodemographic factors, obstetric history, previous surgeries, or training characteristics. Maximal lifts in Clean & Jerk and Snatch exercises were also similar between participants with and without UI. Slight trends suggested a higher UI prevalence among women with vaginal deliveries, episiotomies, or vaginal lacerations. Regarding athletes with and without UI, no differences were found (p > 0.05) with respect to weightlifting belt use or the breathing phase during load lifting. Conclusions: UI is common among female weightlifters, but in this study, was not associated with sociodemographic factors or weightlifting practices. These findings indicate that UI prevalence cannot be explained by the variables studied and highlight the need for further research into other potential contributing factors. Full article

Heart Rate Variability (HRV) biofeedback could be considered as a tool to help athletes to optimize their performance. This study aimed to examine the effects of a one-week HRV biofeedback (HRV-BFB) program on physiological indices, sensorimotor functions, and kata performance in Eastern martial arts athletes. Forty high-level martial arts athletes (karate, wushu, taekwondo, kyokushinkai) aged 17–27 years were divided into two groups: a control group (n = 20) and a biofeedback group (BFB, n = 20). Athletes from both groups underwent assessment of sensorimotor functions and the technical quality of their kata routines. The primary outcome was the expert-rated kata performance score. All routines were video-recorded and independently rated by three certified judges. The BFB group completed a hybrid HRV-BFB program consisting of supervised resonance-frequency breathing sessions in the laboratory and one week of home-based practice. During supervised sessions, athletes performed slow abdominal-paced breathing (6 breaths/min). At home, they practiced the same breathing pattern twice daily for one week (5 min per session, smartphone-guided). Nonparametric tests were used because several variables deviated from normality, and the sample size per group was limited (n = 20). After completing the HRV-BFB training, movement oscillation frequency improved significantly, reflected by lower movement oscillation frequency (p = 0.0009, r = 0.79), faster choice reaction time at a tendency level (p = 0.0793, r = 0.39), and an increase in blood volume pulse (BVP) (p = 0.037, r = 0.48) in BFB group compared to control group. Following BFB training, the judges’ scores did not change in the control group, while a significant increase was observed in the BFB group (p = 0.038, r = 0.44), indicating a positive effect of BFB training on kata performance. Regular HRV-BFB training emphasizing slow-paced abdominal breathing may enhance autonomic regulation, fine motor control, and improve the technical execution of kata routines in athletes. Full article

Background: Prader–Willi syndrome (PWS) is a multisystemic complex imprinting disorder. Prenatal diagnosis of PWS is still a challenge with non-specific ultrasound markers and limitations for diagnosis with non-invasive screening methods. Prenatal suspicion and early postnatal diagnosis are essential for promoting healthy growth and development, preventing complications, and providing healthcare professionals and families with the necessary support and resources for effective management. Presentation: We report two PWS cases caused by maternal uniparental disomy, who presented with IUGR, characterized by reduced fetal abdominal circumference (AC) in the second and early third trimesters, reduced fetal movements, normal Doppler indices and oligohydramnios. They were diagnosed in the early neonatal period with no prenatal suspicion but with similar ultrasound markers of the developing pregnancies, analyzed retrospectively. Aim: This study aims to emphasize the need to raise awareness among specialists about genetic syndromes such as Prader–Willi syndrome, to improve the information provided to couples regarding the limitations of current prenatal screening methods, as well as to ensure that, in cases of prenatal suspicion, appropriate genetic testing can be initiated. A confirmed diagnosis would allow timely and adequate measures to be taken, given the complications of the postnatal period in these patients and their need for specialized care and management. Conclusions: The presence of the aforementioned prenatal characteristics may raise suspicion for PWS. In such cases, invasive diagnostic procedures and methylation testing may be indicated, enabling earlier diagnosis and timely management, which can ultimately improve the quality of life of affected individuals and their families. Full article

Background/Objectives: Ultrasonography (US) is a non-invasive and repeatable examination for evaluating chronic constipation. However, few studies have explored treatment decisions based on rectal US findings. To date, the efficacy and safety of elobixibat have not been evaluated using rectal US classification in patients with chronic constipation. This study aimed to evaluate the short-term efficacy and safety of elobixibat in patients with chronic constipation classified as “no fecal retention” by rectal US. Methods: We retrospectively analyzed 32 patients with chronic constipation who underwent rectal US and received elobixibat (10 mg/day) between May 2019 and December 2024. Rectal US findings classified patients into four groups: no fecal retention, fecal retention without hard stools, fecal retention with hard stools, and gas retention. The primary endpoint was the response rate of spontaneous bowel movements (SBMs) within 3 days after starting elobixibat in the “no fecal retention” group. Results: Among 18 patients in the “no fecal retention” group, 94.4% achieved SBMs within 3 days, indicating a favorable short-term response. Adverse events included abdominal distension and abdominal pain, each observed in one patient (3.1%). Conclusions: Elobixibat was effective and well tolerated in patients with chronic constipation classified by rectal US findings. Full article

Background/Objectives: This 7-day rat tracheocutaneous fistula study considered the not-studied issues of tracheocutaneous fistula course, wound healing, and fistula in the NO-system relations. Therefore, we focused on fistulas’ severe course, tracheocutaneous fistula → air leak → compensatory diaphragmatic/abdominal “heaving”, NO-system failed relations, and therapy resolution. Stable gastric pentadecapeptide BPC 157 was proposed. Methods: Tracheocutaneous fistula rats received daily medication (/kg), alone or combined, BPC 157 therapy (10 µg, 10 ng, in drinking water or intraperitoneally) along with a triple NO-agent approach (L-NAME 5 mg, L-arginine 100 mg, and L-NAME+L-arginine, intraperitoneally). Results: Tracheocutaneous fistulas occurred as specific and NO-system-related as follows: NO system: blockade (L-NAME-aggravation) over-activity (L-arginine-amelioration) or immobilization (L-NAME+L-arginine oppose each other’s effects). Controls presented severe clinical signs of respiratory distress, failed healing, skin and tracheal defects, a not-healed and open, macro/microscopically, and fistulous tract that was well-formed and wide, tracheal shrinking below the fistula, and clinically, open-mouth breathing, “heaving abdomen”, cyanosis (bluish snout, ears, extremities), abundant secretion through the fistula, and weight loss. Fistula tissue NO level decreased, and the malondialdehyde (MDA) level increased. The BPC 157 therapy (both application routes) resulted in rapid recovery. Healing of defects (skin and trachea) and fistula closure, macro/microscopically, corresponded with clinical findings, avoiding observable clinical signs of dyspnea, reducing weight loss, and avoiding any sign of “heaving abdomen”. BPC 157-treated rats displayed regular breathing movements without observable signs of respiratory distress. Finally, when combined, BPC 157 therapy upgrades L-arginine amelioration, abolishes L-NAME-induced worsening, and restores full healing after NO immobilization (L-NAME+L-arginine). BPC 157 counteracted increase in NO level and counteracted increase in MDA level. Conclusions: Thus, first, acting systemically, BPC 157 reverses tracheocutaneous fistula course in rats. It acts through the NO system. Full article

Background: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. They can cause immune-mediated colitis (IMC), a potentially severe adverse event. Current data on severe IMC (grade 3–4) are limited, particularly regarding clinical, endoscopic, and histological features. Methods: We conducted a multicenter, retrospective observational study promoted by GETECCU, including adults with solid tumors who developed grade 3–4 IMC requiring hospitalization and systemic therapy. Clinical symptoms, endoscopic findings (Mayo and UCEIS indices), and histological features were systematically collected and analyzed. Results: A total of 196 patients were included. Diarrhea was universal (median 8 bowel movements/day), with 76% reporting abdominal pain and 39% rectal bleeding. Endoscopy (n = 139) revealed vascular pattern loss (80%), mucosal lesions (69%), and Mayo scores ≥2 in 69%. Histopathology (n = 141) showed abnormalities in 85%, including cryptitis (50%), lymphocytic infiltration (48%), and crypt abscesses (37%). Notably, 72% of patients with normal endoscopy had histological inflammation. Endoscopic severity correlated with bleeding and impaired general condition but not with stool frequency or pain intensity. Histological and endoscopic severity were modestly associated. Conclusions: Severe IMC presents with heterogeneous clinical, endoscopic, and histological features, with limited correlation between these domains. Endoscopic findings were often ulcerative and inflammatory, yet histological abnormalities were frequently present even in endoscopically inactive disease. These findings highlight the importance of biopsy in all suspected IMC cases and underscore the need for validated multidimensional assessment tools for accurate diagnosis and management of severe IMC. Full article

Prehabilitation programs for abdominal pre-operative patients are increasingly recognized for improving surgical outcomes, reducing post-operative complications, and enhancing recovery. Internet of Things (IoT)-enabled human movement monitoring systems offer promising support in mixed-mode settings that combine clinical supervision with home-based independence. These systems enhance accessibility, reduce pressure on healthcare infrastructure, and address geographical isolation. However, current implementations often lack personalized movement analysis, adaptive intervention mechanisms, and real-time clinical integration, frequently requiring manual oversight and limiting functional outcomes. This review-based paper proposes a conceptual framework informed by the existing literature, integrating Digital Twin (DT) technology, and machine learning/Artificial Intelligence (ML/AI) to enhance IoT-based mixed-mode prehabilitation programs. The framework employs inertial sensors embedded in wearable devices and smartphones to continuously collect movement data during prehabilitation exercises for pre-operative patients. These data are processed at the edge or in the cloud. Advanced ML/AI algorithms classify activity types and intensities with high precision, overcoming limitations of traditional Fast Fourier Transform (FFT)-based recognition methods, such as frequency overlap and amplitude distortion. The Digital Twin continuously monitors IoT behavior and provides timely interventions to fine-tune personalized patient monitoring. It simulates patient-specific movement profiles and supports dynamic, automated adjustments based on real-time analysis. This facilitates adaptive interventions and fosters bidirectional communication between patients and clinicians, enabling dynamic and remote supervision. By combining IoT, Digital Twin, and ML/AI technologies, the proposed framework offers a novel, scalable approach to personalized pre-operative care, addressing current limitations and enhancing outcomes. Full article

Background and Clinical Significance: Effective postoperative pain management is crucial in patients undergoing extensive thoracoabdominal surgery, such as esophageal reconstruction, where both thoracic and abdominal incisions are involved. In such cases, a single epidural catheter may not provide sufficient analgesic coverage. Dual epidural analgesia (DEA) offers a potential solution, allowing segmental, targeted pain control while minimizing systemic opioid exposure. Case Presentation: A 64-year-old male underwent esophageal reconstruction using a combined thoracoabdominal approach. Two epidural catheters were placed at Th5/6 and Th11/12 levels. Intraoperatively, segmental bupivacaine boluses and multimodal non-opioid intravenous analgesia were administered. Postoperatively, continuous epidural bupivacaine infusion was maintained, supplemented with morphine boluses when the numeric rating scale (NRS) was ≥5. Mean NRS scores were 2 at rest and 5 on movement on postoperative day 1 (POD1); 1 and 4 on POD2; and 3 and 5 on POD3. Total epidural morphine consumption was 36 mg over 340 h, and the 24-h bupivacaine dose was 180 mg (2.77 mg/kg/24 h). No complications were observed. Conclusions: Dual epidural analgesia provided effective, opioid-sparing multimodal pain control in complex thoracoabdominal surgery. This case highlights DEA as a safe and feasible approach when single-catheter coverage is inadequate, supporting enhanced recovery and reduced opioid use after esophageal reconstruction. Full article

Background: Breathing rate is affected by physical stressors such as temperature or hypercapnia and by psychosocial stressors such as noise or overcrowding. In behavioral tests for tinnitus, rodents are often presented with trains of startle pulses. We postulated that using these pulses at successively higher sound levels would produce a cumulative increase in stress. Here, we demonstrate a novel means of assessing that increase in stress. Methods: By placing pairs of reflective markers on the abdomen and using a motion tracking system, we were able to remotely measure respiratory movements. A series of 20 startle pulses were presented in sequence at seven increasing sound levels, and changes in respiratory rate were tested with the Wilcoxon matched-pairs signed rank test and the Friedman Test. Results: Markers placed on 20 alert active mice showed evidence of sniffing behavior but no purely respiratory signal. By contrast, in all 18 guinea pigs, abdominal markers did track respiratory movements. The breathing rate in guinea pigs was similar to previous studies: (mean 104 ± 13; range 86–131 bpm). Presenting quiet startle pulses to guinea pigs caused a significant increase in breathing rate (by about 20%), even with pulses at 75–80 dB SPL. Increasing pulse sound levels in the range of 85–105 dB SPL did not reliably produce any further increase in breathing rate. Conclusions: We propose that tracking abdominal movement may allow measurement of psychosocial stress in the guinea pig. Once an animal is startled, increasing the pulse sound level did not produce any further increase in stress levels. Full article

Background: Ultrasound is a non-invasive imaging technique that provides real-time evaluation of anatomical structures. While versatile in examining various organs, it can be physically demanding for physicians due to the need for challenging positions, causing musculoskeletal pain and potentially work-related diseases over time. The study aimed to assess the ergonomics of abdominal and breast ultrasound, identify the most challenging anatomical area, determine which part of the examination causes the greatest strain, and evaluate the overall ergonomic impact of the entire procedure. Methods: This single-center study involved 4 radiologists and focused on breast and abdominal ultrasonography. Kinematic data were recorded using the Noraxon Ultium Motion inertial system to track body movements during the ultrasound procedures. Five critical segments were identified while examining the liver, right kidney, left kidney, right breast, and left breast. Ergonomic assessment was performed using the Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) methods, evaluating postural risks and physical strain during each segment and the whole procedure. Results: Both RULA and REBA assessments yielded median total scores of 6.0–7.0 and 6.0–7.5, respectively, reflecting consistently medium to high musculoskeletal loading. Examinations of the left breast and left kidney were associated with the most demanding postures. These elevated scores demonstrate that abdominal and breast ultrasonography imposes substantial ergonomic strain, potentially increasing the risk of work-related musculoskeletal disorders. Conclusions: The high ergonomic risk scores indicate an urgent need to modify scanning techniques and workstation design to reduce musculoskeletal strain in sonographers. Implementing ergonomic improvements is essential to prevent occupational injuries and promote long-term health. Full article

Due to its portability, non-invasiveness, and real-time capabilities, ultrasound imaging has been widely adopted for liver disease detection. However, conventional ultrasound examinations heavily rely on operator expertise, leading to high workload and inconsistent imaging quality. To address these challenges, we propose a Robotic Ultrasound Scanning System (RUSS) based on reinforcement learning to automate the localization of standard liver planes. It can help reduce physician burden while improving scanning efficiency and accuracy. The reinforcement learning agent employs a Deep Q-Network (DQN) integrated with LSTM to control probe movements within a discrete action space, utilizing the cross-sectional area of the abdominal aorta region as the criterion for standard plane determination. System performance was comprehensively evaluated against a target standard plane, achieving an average Peak Signal-to-Noise Ratio (PSNR) of 24.51 dB and a Structural Similarity Index (SSIM) of 0.70, indicating high fidelity in the acquired images. Furthermore, a mean Dice coefficient of 0.80 for the abdominal aorta segmentation confirmed high anatomical localization accuracy. These preliminary results demonstrate the potential of our method for achieving consistent and autonomous ultrasound scanning. Full article

Background and Objectives: Stroke and hemiplegia disrupts symmetrical activation of skeletal and abdominal muscles, impairing trunk control and functional movement. Although asymmetry is also present in healthy adults, its magnitude and patterns differ with neurological impairment. Understanding trunk muscle symmetry across functional tasks in healthy individuals and patients with stroke is essential for targeted rehabilitation strategies. Materials and Methods: A comparative cross-sectional study was conducted including healthy adults and patients with stroke. Muscle activation symmetry of the rectus abdominis, external oblique, internal oblique, and multifidus was analyzed across four trunk movements: flexion, extension, and lateral flexion to the dominant or non-dominant side. A two-way repeated measures ANOVA examined main and interaction effects of condition, muscle, and group. Results: Trunk muscle symmetry was significantly influenced by the movement conditions, and patterns of change differed between groups. While no consistent differences were observed across muscles, specific interactions revealed condition-dependent variations, particularly between abdominal and deep spinal muscles. Lateral flexion elicited the greatest asymmetry, with distinct response patterns in healthy individuals compared with patients with stroke. Conclusions: This study highlights the importance of addressing movement-specific demands in trunk rehabilitation. Rather than focusing on isolated muscles, interventions should consider the dynamic and condition-dependent nature of symmetry to optimize functional recovery in patients with stroke. Full article

Background/Objectives: Archery is a technical sport involving repetitive and asymmetrical movements that requires trunk stability to enable good performance of the upper extremities. Being an asymmetrical sport, imbalances between sides might appear in the abdominal and back muscles. To assess trunk muscle function and symmetry in young competitive archers. Methods: Analyzing pre-season screening evaluation tests from medical files. This included an ultrasound examination of back and abdominal muscles (transverse abdominus and internal oblique) during rest and contraction and trunk muscle clinical strength tests. Results: Data on 15 elite archery athletes (mean age 17.2 (±2.7) years) were included. No athletes reported low back pain. No differences were found between the dominant and non-dominant sides in all outcome measurements (absolute thickness and percentage difference). Internal oblique muscle thickness during rest and contraction for the dominant side was higher in males compared with females (p < 0.05). The back muscles were more symmetrical than the abdominal muscles. Conclusions: Despite the asymmetrical functional demands of sport archery, young athletes displayed trunk muscle symmetry, particularly in their back muscles. While some variability in abdominal muscle asymmetry was observed, these differences were not statistically significant. Full article