Search Results (4,677)

Background/Objectives: Mycoplasma genitalium is an emerging cause of sexually transmitted infections (STIs) and is increasingly recognized for its association with cervicitis and pelvic inflammatory disease. However, prevalence data in specific Japanese subpopulations, particularly comparing pregnant and non-pregnant women, remains limited. This study aimed to determine the prevalence of M. genitalium and its co-infection rates with Chlamydia trachomatis and Neisseria gonorrhoeae among Japanese women. Methods: A cross-sectional study was conducted using vaginal swab specimens collected between April 2021 and November 2022 from patients visiting two clinics in Gifu, Japan. The study population comprised 2138 non-pregnant women presenting with urogenital symptoms or sexual contact history, and 236 pregnant women undergoing routine antenatal screening. Detection was performed using real-time polymerase chain reaction assays on the cobas^® 8800 system (Roche Diagnostics). Results: Among non-pregnant women, the overall prevalence was 3.8% (82/2138) for M. genitalium, 3.4% (72/2138) for C. trachomatis, and 0.4% (9/2138) for N. gonorrhoeae. Co-infection rates were low; M. genitalium and C. trachomatis co-infection was observed in 0.2% of cases. Among pregnant women, the prevalence was 3.8% (9/236) for both M. genitalium and C. trachomatis, and 0.4% (1/236) for N. gonorrhoeae. No statistically significant differences in prevalence were observed between pregnant and non-pregnant women for any pathogen. Conclusions: The prevalence of M. genitalium in this Japanese cohort was comparable to that of C. trachomatis in both pregnant and non-pregnant women, highlighting its significance as a major STI pathogen. These findings underscore the importance of including M. genitalium in routine STI screening panels for symptomatic women and antenatal care to prevent reproductive health complications. Given the high rates of antimicrobial resistance documented in Japanese M. genitalium strains, specific diagnostic testing is essential to enable targeted, resistance-guided therapy. Full article

Background/Objectives: Adult spinal deformity (ASD) correction is a complex surgery to restore spinal alignment and relieve patients’ symptoms. Modern techniques and technologies allow for aggressive surgical correction in tissue-friendly ways that preserve anatomy and may enable faster recovery. Robotic-assisted posterior spinal stabilization may be used as an adjunct to complex ASD reconstruction to facilitate a minimally invasive approach, reduce perioperative morbidity and physiological insult, and allow for the performance of procedures traditionally reserved for large academic centers to be effectively performed by qualified surgeons in optimized patients at smaller hospitals with fewer resources. The objective of this study is to assess realignment, perioperative complications, and patient-reported outcomes of complex, minimally invasive, robotic-assisted adult spinal deformity correction in a surgical specialty hospital. Methods: Demographic, surgical, and perioperative data were collected from the medical record. The Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for pain scores were collected preoperatively and at regular post-op visits. X-rays were captured preoperatively before hospital discharge and at follow-up visits. Results: Fifty consecutive deformity patients were corrected with a two-stage approach (anterior column reconstruction followed by posterior stabilization with robotic-assisted screw placement on the next day) at a 48-bed (eight operating rooms), surgeon-owned, subspecialty hospital. The average patient age was 70 years, and 64% were female. The average estimated blood loss (EBL) values for the first and second stages were 62 mL and 205 mL, respectively. The average operative time was 172 min during the first stage and 210 min for the second stage. Three interbody spacers (first stage) and 16 screws (second stage) were inserted on average in each procedure. The average length of stay (LOS) in the hospital was 5 days, and the average follow-up period was 10.6 months. No patients required a transfer to another facility with intensive care unit (ICU) capabilities, and none required a revision of hardware placement. There was an average reduction in the lumbar coronal scoliotic curve of 14.5° and an increase in lumbar lordosis of 14.8° at the latest follow-up (p < 0.01). The average mismatch between pelvic incidence and lumbar lordosis (PI-LL) preoperatively was 17.6°, which was reduced to 9.6° at the latest postoperative follow-up (p < 0.01). Mean ODI (%) and NRS scores were significantly improved by 33.8% (46.7 ± 13.3 to 30.9 ± 19.8; p < 0.01) and 55% (6.0 ± 2.2 to 2.7 ± 2.6; p < 0.01), respectively, at last follow-up. Conclusions: This study demonstrates the feasibility of performing complex, robotic-assisted ASD corrective surgery in a surgical specialty hospital, achieving significant correction of sagittal and coronal deformities, relieving patients’ symptoms, and offering efficiency and consistency to pedicle screw placement. This study demonstrates that a minimally invasive approach to complex deformity reconstruction reduces perioperative morbidity with decreased operative times, EBL, and LOS when compared to historic controls. This approach allows for the democratization of deformity care in that procedures typically reserved for large academic centers can be successfully accomplished at smaller institutions in optimized patients by qualified surgeons with appropriate perioperative support staff. Full article

Background/Objectives: To describe retinal imaging characteristics and the natural history of rhodopsin (RHO)-associated autosomal dominant retinitis pigmentosa (ADRP) by evaluating ellipsoid zone (EZ) width loss and measuring the degree of constriction of the area within and including the hyperautofluorescent ring. Methods: Eighteen patients with molecularly confirmed RHO variants were retrospectively evaluated. EZ width on spectral-domain optical coherence tomography (SD-OCT) and the area within and including the hyperfluorescent ring on fundus autofluorescence (FAF) were measured. The correlation between EZ width and hyperfluorescent ring area was assessed using a linear mixed-effects model. Results: Mean best corrected visual acuity (BCVA) (logMAR) was 0.21 at baseline and 0.29 at last visit over a mean follow-up of 5 years. Nine patients presented with sectoral RP, eight with typical RP, and one with unilateral RP. The mean EZ width constriction rate was −93.43 µm/year (SD = 130.58), and the area within and including the hyperautofluorescent ring decreased by −0.54 mm²/year (SD = 0.50). A strong positive association was observed between the EZ width and hyperfluorescent ring area at baseline (β = 151.7 ± 17.9, p < 0.001) and at the final visit (β = 185.7 ± 18.2, p < 0.001). Conclusions: In this study, patients with RHO-associated ADRP appeared to show a relatively slow rate of progression. Quantitative imaging markers, such as EZ width and the area within and including the hyperautofluorescent ring, may offer potentially reproducible measures of disease progression. These imaging biomarkers could be useful as outcome measures in future natural history studies and therapeutic trials, pending further validation. Full article

UV radiation causes health effects and repeated excessive sun exposure during childhood increases the risk of skin cancer in adulthood. The French region of Occitanie combines conditions conducive to sun exposure with a wide range of healthcare services. The study aims to describe temporal variations related to sun overexposure and patient characteristics, and evaluate the relevance of each data source. We conducted a retrospective analysis (2019–2022) on pharmacy sales, emergency care provided by SOS Médecins (SOSM), and emergency departments (EDs). More than 220,000 customers purchased products associated with sun overexposure, while 71 SOSM procedures and 417 ED visits were recorded. The activity is clearly seasonal, but remains five to ten times higher for pharmacies than for other sources. About 80% of ED patients were under 40 years of age, while 50% lived within 20 km of the consultation location. The impacts on healthcare systems vary, and each provides complementary insights into care related to sun overexposure. Increases in pharmacy sales are observed as early as spring, underscoring the need to strengthen prevention messaging from the start of the season. The study confirms the value of pharmacy sales data for assessing the impact of sun exposure, but ED or SOSM data enable real-time monitoring and patient characterization. Full article

Background: Patients undergoing dental treatment often experience psychological distress and social discomfort, yet longitudinal data on these changes are limited. Existing studies rely on cross-sectional designs or lengthy tools, reducing feasibility in routine practice. This study explored psychological and social trajectories during dental care, highlighting challenges and implications for patient wellbeing and care delivery. Methods: A prospective cohort study with repeated measures across three dental visits (V1–V3) was conducted. Participants completed a 21-item binary (yes/no) questionnaire assessing psychological (Q1–Q6) and social dimensions (Q7–Q14 at all visits; extended social domain Q7–Q21 at V2–V3). Composite scores were calculated, and longitudinal changes were analyzed using generalized estimating equations or mixed-effects models. Item-level trajectories were examined with multiple comparison adjustments. Results: Of 120 enrolled patients, 100 completed all visits. Psychological well-being consistently improved, while social outcomes showed more complex, domain-specific patterns. Item-level analyses revealed gains in appearance and satisfaction, whereas stigma, fear, and social integration remained relatively stable, underscoring the need to monitor multiple psychosocial dimensions. Conclusions: Psychosocial monitoring during dental care is feasible and potentially beneficial. The 21-item questionnaire was practical and well-accepted, with composite scores serving as simple indicators for tracking patient wellbeing and supporting a holistic, patient-centered approach. Further validation in larger and more diverse populations is needed. Full article

The current study aimed to examine whether Joint Commission International (JCI) accreditation is associated with higher patient satisfaction. A cross-sectional, questionnaire-based comparative study was conducted between April and July 2025 in outpatient departments of one JCI-accredited hospital (University Medical Center) and two nationally accredited public polyclinics in Astana, Kazakhstan. The questionnaire was designed to assess satisfaction across four domains: communication, staff responsiveness, hospital environment, and perceived quality of care. The patients attending the JCI-accredited hospital demonstrated significantly higher satisfaction across all domains compared to those of nationally accredited hospitals (p < 0.01). The largest difference was observed in staff responsiveness. In the multivariable regression analysis, the accreditation status emerged as the strongest independent predictor of overall patient satisfaction score (β = 0.42; 95% CI: 0.31–0.53; p < 0.001), even after adjusting for age, gender, education, employment status, and prior hospital visits. Education level and previous hospital experience were modest yet statistically significant predictors, whereas age, gender, and employment status were not significant in the adjusted analyses. JCI accreditation was associated with higher patient satisfaction scores in outpatient care settings, indicating a positive relationship between accreditation status and patient-centered outcomes. Full article

Background/Objectives: Objective, non-invasive biomarkers are needed to track anterior cruciate ligament (ACL) graft maturation and support individualized return-to-sport decisions. This study evaluated a single-session multiparametric quantitative MRI (qMRI) protocol for longitudinal assessment of ACL graft microstructural evolution and its association with patient-reported outcomes. Methods: Twenty-eight patients undergoing primary ACL reconstruction with hamstring autografts underwent multiparametric qMRI (T1, T2*, R2*, and PD mapping) at 1, 3, 6, and 12 months. The contralateral native ACL served as a within-subject control. IKDC, Lysholm, and VAS scores were recorded at each visit. Linear mixed-effects models were used to test longitudinal changes. Correlations of baseline-normalized changes between adjacent visits were used to evaluate imaging–clinical associations. Results: All qMRI parameters changed significantly over time (all p < 0.001). At 1 month, T1, PD, and T2* were lower and R2* higher than the contralateral native ACL (all p < 0.001). Thereafter, T1, PD, and T2* increased and R2* decreased, with most metrics approaching contralateral values by 3–6 months (all p < 0.05), and changes entered a plateau after 6 months (all p > 0.05). IKDC, Lysholm, and VAS improved over time (all p < 0.001), mainly before 6 months. Greater early T2* increases and R2* decreases (1–3 months) were associated with less pain relief and smaller Lysholm improvement (p < 0.05); no significant associations were observed from 6–12 months. Conclusions: Single-session multiparametric qMRI sensitively captures ACL graft maturation and highlights 3–6 months as a critical remodeling window, providing objective biomarkers to complement clinical assessment for individualized rehabilitation monitoring and return-to-sport timing. Full article

Background: Few studies have assessed the safety and efficacy of discharging emergency department patients with alcohol withdrawal after receiving parenteral phenobarbital. This study aimed to validate this practice and delineate the role of intramuscular phenobarbital for this indication. Methods: This single-center retrospective chart review included adult patients with non-severe alcohol withdrawal, as diagnosed by treating providers based on clinical judgment, who were managed in the emergency department’s low-acuity provider at triage zone, received parenteral phenobarbital, and were discharged within 12 h of arrival. The primary safety and efficacy endpoints were the percentages of patients who expired or re-presented to the emergency department for an alcohol-related diagnosis within seven days of the initial presentation, respectively. A subgroup analysis was performed to compare outcomes between those who only received intramuscular or intravenous phenobarbital. Results: Of the 192 patient encounters included, no deaths were reported. Twenty-one (10.9%) patients re-presented after the initial visit, received treatment, and were discharged home. One (0.52%) patient was admitted following re-presentation. The percentages of patients who re-presented in the intramuscular-only and intravenous-only groups were 8% and 13.5%, respectively (p = 0.25). The total and weight-based doses received were not significantly different between those who did and did not re-present in both the intramuscular-only and intravenous-only groups. The median length of stay in the intramuscular-only and intravenous-only groups was 3.97 h and 5.87 h, respectively (p < 0.001). Conclusions: Our findings suggest that patients presenting with non-severe alcohol withdrawal symptoms may be discharged from the emergency department following receipt of parenteral phenobarbital, without requiring additional outpatient alcohol withdrawal medications. Intramuscular phenobarbital appears to be a viable alternative route of administration and warrants further investigation. Full article

Background: Infertility is a growing global public health concern associated with reduced quality of life and increased anxiety and depressive symptoms across diverse populations. However, factors influencing mental health in women undergoing infertility treatment remain insufficiently understood. This study aimed to assess psychological distress and identify factors associated with anxiety and depression in women receiving infertility treatment. Methods: A cross-sectional study was conducted at a leading regional infertility referral center. Women with confirmed infertility were consecutively recruited during routine visits. Psychological distress was assessed using the validated Patient Health Questionnaire-4. Demographic, reproductive, and clinical data were collected from self-report and medical records. Associations of infertility duration and age with comorbidities and other demographic variables were evaluated using appropriate parametric and nonparametric tests, and correlations were examined using Spearman’s rank coefficient. Results: The mean age was 34.9 ± 5.9 years and the median duration of infertility was 3 years. Nearly half of participants had mild psychological distress (49.3%), while 16.7% and 2.7% had moderate and severe distress, respectively; 32% screened positive for anxiety and 17.3% for depression. Longer infertility duration was significantly associated with higher depressive symptom scores, whereas other demographic and clinical variables showed no significant associations. Conclusions: Psychological distress is highly prevalent among women with infertility, with depressive symptoms increasing with longer infertility duration. These findings highlight the need for routine psychological screening and integration of mental health support into infertility care in clinical practice and long-term treatment planning, emphasizing a comprehensive, patient-centered approach to reproductive medicine. Full article

Background/Objectives: Rapid and accurate electrocardiogram (ECG) interpretation is essential for timely recognition of ST-elevation myocardial infarction (STEMI) and initiation of reperfusion therapy in the emergency department (ED). We evaluated the diagnostic performance of a real-time artificial intelligence (AI) ECG interpretation system and its pragmatic impact when integrated into routine ED workflows. Methods: This prospective, single-center pragmatic observational study was conducted in a regional emergency medical center ED in Busan, Republic of Korea (1 January–31 December 2024). Consecutive adults (≥18 years) undergoing 12-lead ECG for cardiovascular-related symptoms were enrolled (N = 1524). A predefined alternating-day protocol allocated visits to physician-only interpretation days (physician-days, N = 763) or AI output disclosure days (AI-days, N = 761). Diagnostic performance for STEMI was assessed using paired ECG-level comparisons between physician-alone interpretation and AI output against a blinded expert-panel reference standard; clinical impact outcomes included reperfusion-related time metrics, hospital length of stay (LOS), and in-hospital mortality. Results: Against the expert reference standard, AI showed higher STEMI sensitivity than physician-alone interpretation (96.7% vs. 68.3%; McNemar p = 0.027), while specificity was lower (75.9% vs. 84.5%; p = 0.018). In pragmatic day-level comparisons, door-to-balloon time was shorter on AI-days (40.0 ± 19.81 vs. 47.34 ± 21.90 min; p = 0.001), and time to PCI was significantly reduced among patients with atypical presentations (42.3 ± 18.21 vs. 57.1 ± 20.11 min; p = 0.013). Among admitted patients, hospital LOS was shorter on AI-days (13 ± 9.21 vs. 17 ± 10.31 days; p = 0.010), whereas in-hospital mortality did not differ significantly between groups (17.0% vs. 16.77%; p = 0.191). Conclusions: Real-time AI-ECG integration in the ED was associated with improved STEMI detection sensitivity and shorter reperfusion-related time metrics, particularly in atypical presentations, and with reduced hospital LOS among admitted patients. Short-term mortality was comparable between groups. Further multicenter studies are warranted to confirm generalizability and to balance benefits against potential false-positive-related operational impacts. Full article

Background/Objectives: Given the growing prevalence of myopia worldwide, prevention and proactive management of at-risk children becomes increasingly important. This study sought to evaluate trends in myopia development in pediatric pre-myopic patients and determine how optometrists in Canada manage pre-myopia. Methods: In this retrospective chart review, records for children aged 6–10 years who had an eye exam between 2017 and 2021 were reviewed. Pre-myopic children were included if the presenting refraction at the first visit was between +0.75D and −0.25D (inclusive). Up to five unique patients were selected for each age (6, 7, 8, 9, and 10) and initial visit year (2017 to 2021) at each clinical site. Demographic information, refractive status and recommended interventions were recorded. Results: A total of 1740 pre-myopic patients were included across 15 practices in Ontario, of which 184 patients developed myopia (10.6%) during the years studied. Cohort year groups did not differ in baseline age (mean ± SD 8.39 ± 1.43 years) or baseline refractive error (+0.13 ± 0.27 DS). At initial encounters, most clinicians monitored without intervention (mean across cohort years 91.9%), with some recommending lifestyle changes (3.5%) and SV spectacles/CL (3.0%). This pattern remained stable over the years studied. Pre-myopic children developed myopia at a similar age over the study period (mean ± SE: 9.66 ± 0.16 years) and experienced a faster rate of loss of hyperopic reserve (loss of −0.26 ± 0.07 D/year in the 2017 cohort vs. −0.73 ± 0.18 D/year in the 2020 cohort and −0.71 ± 0.10 D/year in the 2021 cohort) regardless of patient age. Conclusions: Pre-myopic children in the 2020 and 2021 cohort years experienced an accelerated loss of hyperopic reserve compared to those in the 2017 cohort. Despite this, very few pre-myopic children were recommended lifestyle changes, which were known to be effective for delaying myopia onset. Since delaying myopia onset may be more impactful than subsequent myopia treatment, additional research should focus on effective interventions for the pre-myopic population. Full article

Background/Objectives: Machine learning (ML) models can predict hospital admission from emergency department (ED) triage data with areas under the receiver operating characteristic curve (AUC) exceeding 0.85. Whether incorporating the assigned provider’s identity—as a proxy for unmeasured practice variation—improves prediction has not been systematically studied. We aimed to compare 10 supervised ML classifiers for predicting hospital admission at ED triage, with and without provider identity, and to characterize model reasoning using SHapley Additive exPlanations (SHAP). Methods: We conducted a retrospective cohort study of 186,094 ED visits (2020–2023, training) and 58,151 visits (2024, temporal holdout test) at one academic tertiary-care ED. Ten classifiers spanning linear, distance-based, tree-based, ensemble, probabilistic, and neural network families were each trained in two conditions: baseline (23 triage features) and with provider identity appended. SHAP TreeExplainer was applied to the top-performing models (CatBoost and XGBoost). Results: The admission rate was 31.3% (training) and 31.7% (test). CatBoost achieved the highest baseline AUC of 0.8906 (0.8878–0.8933). Adding provider identity produced negligible AUC changes across all models (ΔAUC range: −0.0029 to +0.0015; all DeLong p > 0.05). SHAP analysis identified ESI level, respiratory rate, temperature, complaint category, and age as the dominant predictors, with clinically intuitive directionality. Conclusions: Provider identity does not meaningfully improve ML prediction of hospital admission beyond standard triage variables. The observed 28-percentage-point variation in provider admission rates is explained by patient case-mix differences than with independent practice pattern effects on prediction. SHAP provides transparent, clinically interpretable explanations suitable for bedside decision support. Full article

Background/Objectives: Patients with myeloproliferative neoplasms (MPNs) experience chronic inflammation, elevated cardiovascular risk, and substantial symptom burden. Dietary patterns with anti-inflammatory and cardioprotective effects may represent a modifiable strategy to address these overlapping risks, yet dietary intervention has not been systematically studied in MPN. We evaluated the feasibility, engagement, and preliminary clinical signals of a fully remote dietary counseling intervention in adults with MPN. Methods: In this single-center, randomized, open-label pilot study, 28 adults with polycythemia vera, essential thrombocythemia, or primary myelofibrosis were randomized 1:1 to Mediterranean (MED) or Dietary Approaches to Stop Hypertension (DASH) dietary counseling over 10 weeks. The protocol included a 2-week baseline run-in period, 10-week active intervention with four telehealth dietitian visits, and 4-week postintervention follow-up. Prespecified feasibility endpoints were the completion of dietitian visits, daily MPN Symptom Assessment Form Total Symptom Score (MPN-SAF TSS) surveys, Mediterranean Diet Adherence Screener (MEDAS) questionnaires, and Automated Self-Administered 24-Hour Dietary Recall (ASA24) assessments. Exploratory endpoints included the change in Healthy Eating Index 2015 (HEI-2015) and symptom burden. Results: Twenty-seven participants provided data and were analyzed (14 MED, 13 DASH). Dietitian visit attendance was 96% (MED) and 85% (DASH). Daily symptom survey completion averaged 93% (MED) and 58% (DASH). MEDAS completion was 81% (MED) and 51% (DASH); ASA24 completion was 55% (MED) and 38% (DASH). HEI-2015 increased from 55 to 63 in MED during active intervention. At week 12, 23% of MED and 13% of DASH participants achieved ≥50% TSS reduction. Symptom reductions were observed across multiple domains. Conclusions: A fully remote dietary intervention is feasible in adults with MPN, with strong engagement in the Mediterranean arm. These findings support adequately powered trials incorporating biomarker endpoints to evaluate dietary modification as a strategy for inflammation-driven symptoms and cardiovascular risk in MPN. Full article

Background: Pediatric respiratory infections represent a leading cause of emergency department (ED) visits and hospitalizations. Chest X-rays are frequently used in their diagnostic evaluation, despite guideline recommendations advocating restrictive imaging strategies, particularly in young children with uncomplicated disease. Excessive imaging raises concerns regarding cumulative radiation exposure and inefficient resource utilization. Objectives: To quantify potentially unnecessary chest radiography use in hospitalized pediatric patients with respiratory infections and to identify age-related and diagnostic patterns suitable for targeted imaging optimization interventions. Methods: We conducted a retrospective observational study analyzing pediatric patients presented to the ED of a tertiary county hospital in Romania over a period of 12 months. Data regarding respiratory diagnoses, hospitalization status, patient age, and chest radiography utilization were extracted from electronic medical records. Results: Among more than 26,000 pediatric emergency presentations, 4139 children required hospitalization, of whom 1212 were diagnosed with respiratory infections. A total of 3414 chest radiographs were performed, with the highest imaging burden observed in children aged 0–4 years. Repeated imaging was common in interstitial pneumonia, bronchiolitis, and bronchial hyperreactivity. A strong negative correlation was identified between patient age and imaging frequency (r = −0.70, p < 0.001). Conclusions: Thoracic radiographs are disproportionately used in young children with respiratory infections, particularly in conditions with limited imaging indications. These findings provide an essential baseline for the development of targeted quality improvement interventions aimed at reducing unnecessary pediatric imaging. Full article

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a bothersome condition characterized by pelvic pain and lower urinary tract symptoms (LUTS). Phytotherapy can be used to treat this challenging condition. The aim of this study was to investigate the role of an oral combination of bovine colostrum, Serenoa repens extract and other anti-inflammatory elements in the treatment of CP/CPPS patients. Methods: Our study was a prospective, observational, single-arm study that enrolled patients > 18 years with a history consistent with CP/CPPS, a Chronic Prostatitis Symptom Index (CPSI) pain domain score ≥ 5 and a Meares–Stamey microbiological test negative for bacterial infection. Pelvic or genital pain was measured via the Numeric Pain Rating Scale (NPRS) and validated questionnaires. All patients were treated with an oral combination of colostrum, Serenoa repens extract and other anti-inflammatory elements for 6 months. Follow-up visits were scheduled at 3 and 6 months. Pre- and post-treatment variables were compared by means of the Wilcoxon signed-rank nonparametric test. Results: We included 42 patients in our analysis. The median (Inter-Quartile Range, IQR) age was 42 (28–51) years. Compared with baseline, after 3 months we observed a significant reduction in pain: total CPSI score of 16 (12–21) vs. 22 (17–26), p < 0.001, −6 points (−27.3%); CPSI score of “pain” domain 7 (5–9) vs. 8 (7–11), p < 0.001, −1 point (−12.5%). Moreover, quality of life improved: CPSI “quality of life” domain 6 (4–9) vs. 8 (7–10), p < 0.001. After 6 months, a significant reduction in pain was maintained: total CPSI score 19 (10–23), p < 0.001, −3 points (−13.65%); and CPSI “pain” domain 7 (4–9), p < 0.001, −1 point (−12.5%). After 6 months, a mild reduction in urinary symptoms was also reported. During the observation period, five patients discontinued treatment, two of them because of gastrointestinal intolerance. Conclusions: The daily oral administration of bovine colostrum, Serenoa repens and other anti-inflammatory elements showed a potential in improving pain and other urinary symptoms and was generally well tolerated by patients affected by CP/CPPS. Full article