Journal Description
Medicina
Medicina
is an international, peer-reviewed, open access journal that covers all problems related to medicine. The journal is owned by the Lithuanian University of Health Sciences (LUHS) and is published monthly online by MDPI. Partner Societies are the Lithuanian Medical Association, Vilnius University, Rīga Stradiņš University, the University of Latvia, and the University of Tartu.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, and other databases.
- Journal Rank: CiteScore - Q1 (General Medicine)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.6 days after submission; acceptance to publication is undertaken in 2.5 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.6 (2022);
5-Year Impact Factor:
2.9 (2022)
Latest Articles
Neurological Examination via Telemedicine: An Updated Review Focusing on Movement Disorders
Medicina 2024, 60(6), 958; https://doi.org/10.3390/medicina60060958 (registering DOI) - 9 Jun 2024
Abstract
Patients with movement disorders such as Parkinson’s disease (PD) living in remote and underserved areas often have limited access to specialized healthcare, while the feasibility and reliability of the video-based examination remains unclear. The aim of this narrative review is to examine which
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Patients with movement disorders such as Parkinson’s disease (PD) living in remote and underserved areas often have limited access to specialized healthcare, while the feasibility and reliability of the video-based examination remains unclear. The aim of this narrative review is to examine which parts of remote neurological assessment are feasible and reliable in movement disorders. Clinical studies have demonstrated that most parts of the video-based neurological examination are feasible, even in the absence of a third party, including stance and gait—if an assistive device is not required—bradykinesia, tremor, dystonia, some ocular mobility parts, coordination, and gross muscle power and sensation assessment. Technical issues (video quality, internet connection, camera placement) might affect bradykinesia and tremor evaluation, especially in mild cases, possibly due to their rhythmic nature. Rigidity, postural instability and deep tendon reflexes cannot be remotely performed unless a trained healthcare professional is present. A modified version of incomplete Unified Parkinson’s Disease Rating Scale (UPDRS)-III and a related equation lacking rigidity and pull testing items can reliably predict total UPDRS-III. UPDRS-II, -IV, Timed “Up and Go”, and non-motor and quality of life scales can be administered remotely, while the remote Movement Disorder Society (MDS)-UPDRS-III requires further investigation. In conclusion, most parts of neurological examination can be performed virtually in PD, except for rigidity and postural instability, while technical issues might affect the assessment of mild bradykinesia and tremor. The combined use of wearable devices may at least partially compensate for these challenges in the future.
Full article
(This article belongs to the Section Neurology)
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Open AccessArticle
Large Language Models for Intraoperative Decision Support in Plastic Surgery: A Comparison between ChatGPT-4 and Gemini
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Cesar A. Gomez-Cabello, Sahar Borna, Sophia M. Pressman, Syed Ali Haider and Antonio J. Forte
Medicina 2024, 60(6), 957; https://doi.org/10.3390/medicina60060957 (registering DOI) - 8 Jun 2024
Abstract
Background and Objectives: Large language models (LLMs) are emerging as valuable tools in plastic surgery, potentially reducing surgeons’ cognitive loads and improving patients’ outcomes. This study aimed to assess and compare the current state of the two most common and readily available LLMs,
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Background and Objectives: Large language models (LLMs) are emerging as valuable tools in plastic surgery, potentially reducing surgeons’ cognitive loads and improving patients’ outcomes. This study aimed to assess and compare the current state of the two most common and readily available LLMs, Open AI’s ChatGPT-4 and Google’s Gemini Pro (1.0 Pro), in providing intraoperative decision support in plastic and reconstructive surgery procedures. Materials and Methods: We presented each LLM with 32 independent intraoperative scenarios spanning 5 procedures. We utilized a 5-point and a 3-point Likert scale for medical accuracy and relevance, respectively. We determined the readability of the responses using the Flesch–Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) score. Additionally, we measured the models’ response time. We compared the performance using the Mann–Whitney U test and Student’s t-test. Results: ChatGPT-4 significantly outperformed Gemini in providing accurate (3.59 ± 0.84 vs. 3.13 ± 0.83, p-value = 0.022) and relevant (2.28 ± 0.77 vs. 1.88 ± 0.83, p-value = 0.032) responses. Alternatively, Gemini provided more concise and readable responses, with an average FKGL (12.80 ± 1.56) significantly lower than ChatGPT-4′s (15.00 ± 1.89) (p < 0.0001). However, there was no difference in the FRE scores (p = 0.174). Moreover, Gemini’s average response time was significantly faster (8.15 ± 1.42 s) than ChatGPT’-4′s (13.70 ± 2.87 s) (p < 0.0001). Conclusions: Although ChatGPT-4 provided more accurate and relevant responses, both models demonstrated potential as intraoperative tools. Nevertheless, their performance inconsistency across the different procedures underscores the need for further training and optimization to ensure their reliability as intraoperative decision-support tools.
Full article
(This article belongs to the Special Issue Hot Topics and Innovations in Reconstructive and Cosmetic Surgery/Aesthetic Medicine)
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Open AccessArticle
Anti-COVID-19 Vaccination Alters the Menstrual Cycle and Dose Accumulation Enhances the Effect
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Hospital Español de Pachuca Research Group, Roque D. Licona-Meníndez and Alberto N. Peón
Medicina 2024, 60(6), 956; https://doi.org/10.3390/medicina60060956 (registering DOI) - 8 Jun 2024
Abstract
Background and Objectives: New investigations have detected an enhanced probability for women to develop menstrual cycle alterations after anti-COVID-19 vaccination. Moreover, given that the protective immunity provided by anti-COVID-19 vaccination appears to wane quickly, booster vaccination has been recommended. Nonetheless, whether adverse
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Background and Objectives: New investigations have detected an enhanced probability for women to develop menstrual cycle alterations after anti-COVID-19 vaccination. Moreover, given that the protective immunity provided by anti-COVID-19 vaccination appears to wane quickly, booster vaccination has been recommended. Nonetheless, whether adverse events arise from such repeated immunization has not been studied. Materials and Methods: We studied the incidence of menstrual cycle alterations, the quantity of menstrual cycle alterations per subject, and of altered menstrual cycles in nonpregnant women of fertile age after anti-COVID-19 vaccination in a cohort of vaccinated female subjects by the means of a standardized questionary that was applied via telephone calls each month. Subjects that received up to four doses were studied for 6 months after each dose. We calculated the odds ratio for enhanced incidence, as well as quadratic functions for the tendencies. A sensitivity analysis excluding subjects taking hormonal birth control and those with polycystic ovary syndrome was performed. Results: Anti-COVID-19 vaccination enhanced the probability to develop menstrual cycle alterations (OR 1.52, CI at 95% 1.2–1.8, p < 0.0001) and, interestingly, such a tendency was enhanced when subjects received more doses (R2 = 0.91). Furthermore, the same trends repeated for the quantity of alterations per subject, and of altered cycles. Such an effect was further demonstrated to be independent upon the vaccine brand being applied, the birth control status, and the diagnosis of polycystic ovary syndrome. Conclusions: Vaccination is the most cost-effective measure for primary prevention and is considered to be safe. Nonetheless, in this article, we show data that suggest that repeated vaccination of adult female subjects may lead to an enhanced incidence of menstrual cycle–related adverse events, quantity of alterations per subject, and altered cycles. We therefore think that the development of new vaccine formulations that produce longer-lasting immunity is of paramount importance to reduce the potential for dose accumulation–dependent enhanced risk.
Full article
(This article belongs to the Special Issue Public Health in the Post-pandemic Era)
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Open AccessArticle
Validation of the Korean Version of the Clinical Frailty Scale-Adjusted Korean Triage and Acuity Scale for Older Patients in the Emergency Department
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Ho Sub Chung, Yunhyung Choi, Ji Yeon Lim, Keon Kim, Sung Jin Bae, Yoon Hee Choi and Dong Hoon Lee
Medicina 2024, 60(6), 955; https://doi.org/10.3390/medicina60060955 (registering DOI) - 8 Jun 2024
Abstract
Background and Objectives: The Clinical Frailty Scale (CFS), used to screen for prehospital frailty in patients aged >65 years, is simple, time-efficient, and has been validated in emergency departments (EDs). In this study, we analyzed whether the Korean Triage and Acuity Scale
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Background and Objectives: The Clinical Frailty Scale (CFS), used to screen for prehospital frailty in patients aged >65 years, is simple, time-efficient, and has been validated in emergency departments (EDs). In this study, we analyzed whether the Korean Triage and Acuity Scale (KTAS) classification by level in older patients determined to have frailty based on the Korean version of the CFS increases the triage performance of the current KTAS. Materials and Methods: The primary outcome was 30-day in-hospital mortality, and secondary outcomes were hospital and intensive care unit (ICU) admissions. This study retrospectively analyzed prospectively collected data from three ED centers. Patients with a CFS score ranging from five (mildly frail) to nine (terminally ill) were categorized into the frailty group. We upgraded the KTAS classification of the frailty group by one level of urgency and defined this as the CFS-KTAS. Results: The cutoff values for predicting admission were three and two for the KTAS and CFS-KTAS, respectively. A significant difference was observed in the area under the receiver operating characteristic (AUROC) curve between the KTAS and CFS-KTAS. To predict ICU admission, the cutoff score was two for both scales. A significant difference was observed in the AUROC curve between the KTAS and CFS-KTAS. For predicting in-hospital mortality, the cutoff score was two for both scales. A significant difference was observed in the AUROC curve between the KTAS and CFS-KTAS. Conclusions: This study showed that the CFS-adjusted KTAS has a more useful prognostic value than the KTAS alone for predicting hospital outcomes in older patients.
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(This article belongs to the Section Emergency Medicine)
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Open AccessReview
IgE-Mediated Allergy and Asymptomatic Sensitization to Cannabis Allergens—Review of Current Knowledge and Presentation of Six Cases
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Jakub Wąsik, Aleksandra Likońska and Marcin Kurowski
Medicina 2024, 60(6), 954; https://doi.org/10.3390/medicina60060954 (registering DOI) - 8 Jun 2024
Abstract
Cannabis allergy is a relatively new phenomenon described in the 1970s. Its increased frequency has been observed over the last years due to the increasing therapeutic and recreational use of cannabis-based products. Sensitization possibly leading to allergy symptoms can occur not only through
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Cannabis allergy is a relatively new phenomenon described in the 1970s. Its increased frequency has been observed over the last years due to the increasing therapeutic and recreational use of cannabis-based products. Sensitization possibly leading to allergy symptoms can occur not only through the smoking of cannabis, but also through ingestion, the inhalation of pollen, or direct contact. The severity of symptoms varies from benign pruritus to anaphylaxis. There is scant information available to support clinicians throughout the entire therapeutic process, starting from diagnosis and ending in treatment. In this review, we present six cases of patients in whom molecular in vitro testing revealed sensitization to cannabis extract and/or cannabis-derived nsLTP molecules (Can s 3). Based on these cases, we raise important questions regarding this topic. The article discusses current proposals and highlights the importance of further research not only on cannabis allergy but also on asymptomatic sensitization to cannabis allergens, which may be ascertained in some percentage of the population.
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(This article belongs to the Section Hematology and Immunology)
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Open AccessCase Report
Two Different Tumors and Lung Aspergilloma: An Uncommon Etiopathogenic Association
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Vlad Alexandru Ionescu, Gina Gheorghe, Cosmin Adrian, Alexandru Bebliuc, Cezar Pavelescu, Valentin Enache, Florentina Gheorghe, Nicolae Bacalbasa and Camelia Cristina Diaconu
Medicina 2024, 60(6), 953; https://doi.org/10.3390/medicina60060953 - 7 Jun 2024
Abstract
Several cases reported in the literature have confirmed the link between pulmonary aspergillosis and various malignant diseases. Furthermore, it has been observed that the correlation between carcinoid tumor and lung adenocarcinoma is quite uncommon. The etiopathogenic mechanisms underlying these correlations remain poorly defined.
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Several cases reported in the literature have confirmed the link between pulmonary aspergillosis and various malignant diseases. Furthermore, it has been observed that the correlation between carcinoid tumor and lung adenocarcinoma is quite uncommon. The etiopathogenic mechanisms underlying these correlations remain poorly defined. We present the case of a patient with three of these diseases: a lung adenocarcinoma with a lepidic pattern, a typical carcinoid, and pulmonary aspergillosis. An additional noteworthy aspect of this case pertains to the timely detection of both lung malignancies. Thus, the necessity for further investigation to ascertain the pathogenic connection among the three diseases is underscored. The ultimate objective is to enhance the prognosis of individuals diagnosed with lung cancer, which is a prevailing malignant disease on a global scale.
Full article
(This article belongs to the Special Issue Early Lung Cancer: Diagnosis and Treatment)
Open AccessArticle
Analysis of the Effect of Exams on Perceived Stress and Temporomandibular Joint Status in Physiotherapy Students: A Pilot Study
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Marta Macarena Paz-Cortés, Andrea Martín-Vacas, Pedro Antonio Mendoza, Manuel Rozalén and Miguel Ángel Alvaredo
Medicina 2024, 60(6), 952; https://doi.org/10.3390/medicina60060952 - 7 Jun 2024
Abstract
Background and Objectives: Temporomandibular disorders or dysfunction (TMDs) encompass a range of complex conditions that impact the temporomandibular joint (TMJ), chewing muscles, teeth, and/or their supporting tissues. Stress is one of the most associated factors studied as a TMD predictor. The aim
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Background and Objectives: Temporomandibular disorders or dysfunction (TMDs) encompass a range of complex conditions that impact the temporomandibular joint (TMJ), chewing muscles, teeth, and/or their supporting tissues. Stress is one of the most associated factors studied as a TMD predictor. The aim is to figure out the influence of stress on TMJ status and salivary cortisol in university students during and before exams. Materials and Methods: The study was non-experimental, employing a longitudinal, analytical, observational cohort design. The study population consisted of students enrolled in the physiotherapy degree program at the Alfonso X El Sabio University (Madrid, Spain). Data were collected during two distinct academic periods: the first period was characterized by low academic stress and no exams, and the second period coincided with the high academic stress of final course exams. The collected results included sociodemographic data, assessment of TMJ status (Fonseca Index), evaluation of muscle evaluation (masseter, upper trapezius, and sternocleidomastoid) using a MOXY Monitor (muscle oxygenation) and Neurotrac® (surface EMG, sEMG), assessment of perceived stress (PSS-14), and measurement of salivary cortisol (enzyme immunoassay with Elisa). The statistical analysis was conducted with a confidence level of 95% (p ≤ 0.05) and asymptotic or bilateral significance. Results: 70 students were analyzed during two different measurement periods. According to the Fonseca Index, initially, 37.14% of the analyzed students showed mild TMDs, 17.14% moderate TMDs, and 45.72% showed no TMDs. In general terms, stress increased with age and is related to female sex, maximum mouth opening decreased with age, oxygen saturation decreased with age and academic stress, and myoglobin concentration was related to age. Furthermore, muscle contraction decreased during higher academic stress and increased with age. For women, age was a risk factor for suffering from TMDs, and stress worsened the transition from having TMDs to having no TMDs in both sexes. Conclusions: Academic stress influences TMJ status and muscle outcomes such as oxygen saturation, myoglobin concentration, and muscle contraction, although more research is needed.
Full article
(This article belongs to the Special Issue Boundaries between Oral and General Health)
Open AccessArticle
Combining Endocrine Therapy with Trastuzumab Emtansine Improves Progression-Free Survival and Overall Survival in HER2-Positive, Hormone Receptor-Positive Metastatic Breast Cancer
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Oğuzcan Kınıkoğlu, Hatice Odabas, Yunus Emre Altıntaş, Anıl Yıldız, Burçin Çakan, Goncagül Akdağ, Sedat Yıldırım, Hamit Bal, Tuğba Kaya, Salih Tünbekici, Deniz Işık, Tuğba Başoğlu, Mahmut Emre Yıldırım and Nedim Turan
Medicina 2024, 60(6), 951; https://doi.org/10.3390/medicina60060951 - 7 Jun 2024
Abstract
Background and Objectives: Patients with human epidermal growth factor receptor 2 (HER2) -positive, hormone receptor-positive (HR-positive) metastatic breast cancer (MBC) usually undergo trastuzumab emtansine (T-DM1) therapy in subsequent lines. Combining endocrine therapy (ET) with T-DM1 can improve treatment outcomes in this subtype. Therefore,
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Background and Objectives: Patients with human epidermal growth factor receptor 2 (HER2) -positive, hormone receptor-positive (HR-positive) metastatic breast cancer (MBC) usually undergo trastuzumab emtansine (T-DM1) therapy in subsequent lines. Combining endocrine therapy (ET) with T-DM1 can improve treatment outcomes in this subtype. Therefore, this study aimed to investigate the benefits of using T-DM1 with ET in HER2-positive and HR-positive MBC. This study was the first to investigate the benefits of combining ET with T-DM1. Material and Methods: This study analyzed the medical records of patients with HER2-positive and HR-positive MBC who were treated with T-DM1 from June 2010 to December 2021. The patients were divided into groups based on whether they received concomitant ET with T-DM1. The primary endpoint was to determine the progression-free survival (PFS), while the secondary endpoints were overall survival (OS), objective response rate, and safety of the treatment. Results: Our analysis examined 88 patients, of whom 32 (36.4%) were treated with T-DM1 in combination with ET. The combination therapy showed a significant improvement in median PFS (15.4 vs. 6.4 months; p = 0.00004) and median OS (35.0 vs. 23.1 months; p = 0.026) compared to T-DM1 alone. The ORR was also higher in the combination group (65.6% vs. 29.3%; p = 0.026). Patients treated with pertuzumab priorly had reduced median PFS on T-DM1 compared to those who were not treated with pertuzumab (11.7 vs. 5.4 months, respectively; p < 0.01). T-DM1 demonstrated better median PFS in HER2 3+ patients compared to HER2 2+ patients, with an amplification ratio of >2.0 (10.8 vs 5.8 months, respectively; p = 0.049). The safety profiles were consistent with previous T-DM1 studies. Conclusions: The combination of T-DM1 with ET can significantly improve PFS and OS in patients with HER2-positive and HR-positive MBC. Our study suggests that prior pertuzumab treatment plus trastuzumab treatment might decrease T-DM1 efficacy.
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(This article belongs to the Section Oncology)
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Open AccessReview
Pleomorphic Liposarcoma Unraveled: Investigating Histopathological and Immunohistochemical Markers for Tailored Diagnosis and Therapeutic Innovations
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Ana-Maria Ciongariu, Dana-Antonia Țăpoi, Adrian-Vasile Dumitru, Adrian Bejenariu, Andrei Marin and Mariana Costache
Medicina 2024, 60(6), 950; https://doi.org/10.3390/medicina60060950 - 7 Jun 2024
Abstract
Liposarcomas are some of the most challenging soft tissue tumors and are subclassified into multiple subtypes with special histologic and molecular features. The peculiarities of each histopathological subtype influence the clinical behavior, management, and treatment of these neoplasms. For instance, well-differentiated liposarcomas are
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Liposarcomas are some of the most challenging soft tissue tumors and are subclassified into multiple subtypes with special histologic and molecular features. The peculiarities of each histopathological subtype influence the clinical behavior, management, and treatment of these neoplasms. For instance, well-differentiated liposarcomas are common soft tissue malignancies and usually display a favorable outcome. On the other hand, pleomorphic liposarcoma is the rarest, yet the most aggressive subtype of liposarcoma. This histopathological diagnosis may be challenging due to the scarce available data and because pleomorphic liposarcomas can mimic other pleomorphic sarcomas or other neoplasms of dissimilar differentiation. Nevertheless, the correct diagnosis of pleomorphic liposarcoma is of utmost importance as such patients are prone to develop local recurrences and metastases. Treatment usually consists of surgical excision along with radiotherapy and follow-up of the patients. Therefore, this review aims to assess the complex clinical, histological, and immunohistochemical features of liposarcomas in order to establish how these characteristics influence the management and prognosis of the patients, emphasizing the particularities of pleomorphic liposarcoma.
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(This article belongs to the Section Oncology)
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Open AccessArticle
Comparison of Navigated and Frame-Based Stereotactic Biopsy—A Single-Center Cohort Study
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Maciej Laskowski, Piotr Paździora, Bartłomiej Błaszczyk, Małgorzata Gola, Marcin Ciekalski, Agnieszka Koperczak, Setlak Marcin, Mikołaj Zimny, Anna Zioła-Paździora, Maciej Wojtacha and Adam Rudnik
Medicina 2024, 60(6), 949; https://doi.org/10.3390/medicina60060949 - 7 Jun 2024
Abstract
Background and Objectives: As brain lesions present complex diagnostic challenges, accurate tissue sampling via biopsy is critical for effective treatment planning. Traditional frame-based stereotactic biopsy has been complemented by navigated biopsy techniques, leveraging advancements in imaging and navigation technology. This study aims
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Background and Objectives: As brain lesions present complex diagnostic challenges, accurate tissue sampling via biopsy is critical for effective treatment planning. Traditional frame-based stereotactic biopsy has been complemented by navigated biopsy techniques, leveraging advancements in imaging and navigation technology. This study aims to compare the navigated and frame-based stereotactic biopsy methods in a clinical setting, evaluating their efficacy, safety, and diagnostic outcomes to determine the optimal approach for precise brain lesion targeting. Materials and Methods: retrospective analysis was conducted on patients who underwent brain biopsies between January 2017 and August 2023 at an academic medical center. Data on patient demographics, clinical characteristics, biopsy technique (navigated vs. frame-based), and outcomes including accuracy, complications, and hospital stay duration were analyzed. Results: The cohort comprised 112 patients, with no significant age or gender differences between groups. Symptoms leading to biopsy were predominantly diminished muscle strength (42.0%), cognitive issues (28.6%), and aphasia (24.1%). Tumors were most common in the deep hemisphere (24.1%). The median hospital stay was 5 days, with a rehospitalization rate of 27.7%. Complications occurred in 4.47% of patients, showing no significant difference between biopsy methods. However, navigated biopsies resulted in fewer samples (p < 0.001) but with comparable diagnostic accuracy as frame-based biopsies. Conclusions: Navigated and frame-based stereotactic biopsies are both effective and safe, with comparable accuracy and complication rates. The choice of technique should consider lesion specifics, surgeon preference, and technological availability. The findings highlight the importance of advanced neurosurgical techniques in enhancing patient care and outcomes.
Full article
(This article belongs to the Section Neurology)
Open AccessArticle
Immunomodulatory Treatment Impact on IVF Outcomes in KIR AA Genotype: Personalized Fertility Insights
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Luana Seles, Ioana Alexandra Zaha, Mihai Luncan, Alin Bodog, Liliana Sachelarie, Mircea Sandor, Iulia Codruta Macovei, Erika Bimbo-Szuhai and Anca Huniadi
Medicina 2024, 60(6), 948; https://doi.org/10.3390/medicina60060948 - 6 Jun 2024
Abstract
Background and Objectives: Recurrent implantation failure (RIF) affects 10% of couples undergoing in vitro fertilization (IVF), spurring exploration into tailored treatments to enhance implantation rates. Maternal immune tolerance towards embryos, particularly killer-cell immunoglobulin-like receptors (KIRs) on natural killer (NK) cells, is a
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Background and Objectives: Recurrent implantation failure (RIF) affects 10% of couples undergoing in vitro fertilization (IVF), spurring exploration into tailored treatments to enhance implantation rates. Maternal immune tolerance towards embryos, particularly killer-cell immunoglobulin-like receptors (KIRs) on natural killer (NK) cells, is a focal point in RIF research. Materials and Methods: This retrospective cohort study, conducted at fertility clinic in Oradea, Romania, involved 65 infertile couples undergoing IVF treatment between January 2022 and December 2023. Couples were divided into two groups: KIR AA (Group A) and KIR Bx (Group B). Results: Factors such as age, type of infertility, oocytes retrieved, embryos produced, pregnancy rates in Group A without and with immunomodulatory treatment were documented. Group A, receiving immunomodulatory treatment, achieved a pregnancy rate of 47.8%, significantly higher than the 23.73% rate without treatment (p = 0.008). Group B had a higher mean patient age than Group A. However, miscarriage rates did not significantly differ between Group A with treatment and Group B (p = 0.2457), suggesting comparable outcomes with immunomodulation. Conclusions: The impact of immunological factors on recurrent implantation failure is being more and more emphasized and warrants the attention of specialists in human reproduction. Uterine natural killers and their function though KIR receptors deserve particular attention as immunomodulatory treatment may improve pregnancy rates in patients with KIR AA haplotype.
Full article
(This article belongs to the Special Issue Current Challenges and Future Prospects in Human Reproduction and Infertility)
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Open AccessCommunication
Evaluating the Impact of Oleocanthal and Oleacein on Skin Aging: Results of a Randomized Clinical Study
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Steven P. Nisticò, M. E. Greco, S. Amato, L. Bennardo, E. Zappia, E. Pignataro and G. Pellacani
Medicina 2024, 60(6), 947; https://doi.org/10.3390/medicina60060947 - 6 Jun 2024
Abstract
The prevalence of skin aging and the request for effective treatments have driven dermatological research towards natural solutions. This study investigates the anti-aging efficacy of two bioactive natural polyphenols, Oleocanthal and Oleacein, in a skincare formulation. A single-blind, randomized clinical trial involved 70
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The prevalence of skin aging and the request for effective treatments have driven dermatological research towards natural solutions. This study investigates the anti-aging efficacy of two bioactive natural polyphenols, Oleocanthal and Oleacein, in a skincare formulation. A single-blind, randomized clinical trial involved 70 participants, using a comprehensive exclusion criterion to ensure participant safety and study integrity. Participants applied the Oleocanthal and Oleacein 1% serum formulation twice daily for 30 days. The efficacy was objectively assessed using the VISIA® Skin Analysis System at baseline, after 15 days, and after 30 days. Results indicated significant wrinkle reduction in most groups. For women aged 45–79 years, the mean change was −33.91% (95% CI: −46.75% to −21.07%). For men aged 20–44 years, it was −51.93% (95% CI: −76.54% to −27.33%), and for men aged 45–79 years, it was −46.56% (95% CI: −58.32% to −34.81%). For women aged 20–44 years, the change was −25.68% (95% CI: −63.91% to 12.54%), not statistically significant. These findings highlight the potential of EVOO-derived polyphenols in anti-aging skincare, particularly for older adults. This research paves the way for further exploration into natural compounds in dermatology, particularly for aging skin management.
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(This article belongs to the Section Dermatology)
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Open AccessArticle
The Effects of Longer Use of Teriparatide on Clinical and Radiographic Outcomes after Spinal Fusion in Geriatric Patients
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Young-Hoon Kim, Kee-Yong Ha, Hyun W. Bae, Hyung-Youl Park, Young-Il Ko, Myung-Sup Ko and Sang-Il Kim
Medicina 2024, 60(6), 946; https://doi.org/10.3390/medicina60060946 - 6 Jun 2024
Abstract
Background: Teriparatide is an anabolic agent for osteoporosis and is believed to improve the bone healing process. Previous studies showed that teriparatide could enhance not only fracture healing but also spine fusion. It has been reported that use of teriparatide could promote
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Background: Teriparatide is an anabolic agent for osteoporosis and is believed to improve the bone healing process. Previous studies showed that teriparatide could enhance not only fracture healing but also spine fusion. It has been reported that use of teriparatide could promote the spine fusion process and decrease mechanical complications. However, there was no consensus regarding optimal treatment duration. The purpose of this study was to compare surgical outcomes between short-duration and long-duration teriparatide treatment after lumbar fusion surgery in elderly patients. Materials and Methods: All consecutive patients older than 60 years who underwent 1-level lumbar fusion surgery for degenerative diseases between January 2015 and December 2019 were retrospectively reviewed. Based on the duration of teriparatide treatment (daily subcutaneous injection of 20 µg teriparatide), patients were subdivided into two groups: a short-duration (SD) group (<6 months) and a long-duration (LD) group (≥6 months). Mechanical complications, such as screw loosening, cage subsidence, and adjacent vertebral fractures, were investigated. Postoperative 1-year union rate was also evaluated on computed tomography. Clinical outcomes were recorded using visual analog scale (VAS) and Oswestry Disability Index (ODI). Between-group differences for these radiographic and clinical outcomes were analyzed. Results: Ninety-one patients were reviewed in this study, including sixty patients in the SD group and thirty-one patients in the LD group. Their mean age was 72.3 ± 6.2 years, and 79 patients were female. Mean T-score was −3.3 ± 0.8. Cage subsidence (6.7% vs. 3.2%), screw loosening (28.3% vs. 35.5%), and adjacent vertebral fracture (6.7% vs. 9.7%) were not significantly different between the SD and LD groups. Union rate at 1-year postoperative was 65.0% in the SD group and 87.1% in the LD group (p = 0.028). Both groups showed improvement in VAS and ODI after surgery. However, the differences of VAS from preoperative to 6 months and 1 year postoperative were significantly higher in the LD group. Conclusions: Longer teriparatide treatment after lumbar fusion surgery resulted in a higher union rate at 1-year postoperative than the shorter treatment. Also, it could be more beneficial for clinical outcomes.
Full article
(This article belongs to the Special Issue Recent Updates in Geriatric Spine Surgery)
Open AccessReview
The Complement System as a Therapeutic Target in Retinal Disease
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Joshua Ong, Arman Zarnegar, Amrish Selvam, Matthew Driban and Jay Chhablani
Medicina 2024, 60(6), 945; https://doi.org/10.3390/medicina60060945 - 5 Jun 2024
Abstract
The complement cascade is a vital system in the human body’s defense against pathogens. During the natural aging process, it has been observed that this system is imperative for ensuring the integrity and homeostasis of the retina. While this system is critical for
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The complement cascade is a vital system in the human body’s defense against pathogens. During the natural aging process, it has been observed that this system is imperative for ensuring the integrity and homeostasis of the retina. While this system is critical for proper host defense and retinal integrity, it has also been found that dysregulation of this system may lead to certain retinal pathologies, including geographic atrophy and diabetic retinopathy. Targeting components of the complement system for retinal diseases has been an area of interest, and in vivo, ex vivo, and clinical trials have been conducted in this area. Following clinical trials, medications targeting the complement system for retinal disease have also become available. In this manuscript, we discuss the pathophysiology of complement dysfunction in the retina and specific pathologies. We then describe the results of cellular, animal, and clinical studies targeting the complement system for retinal diseases. We then provide an overview of complement inhibitors that have been approved by the Food and Drug Administration (FDA) for geographic atrophy. The complement system in retinal diseases continues to serve as an emerging therapeutic target, and further research in this field will provide additional insights into the mechanisms and considerations for treatment of retinal pathologies.
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(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation and Novel Treatments)
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Open AccessArticle
Persistence of COVID-19 Symptoms and Quality of Life at Three and Twelve Months after Hospital Discharge
by
Lizeth Guadalupe Gutiérrez-Canales, Carolina Muñoz-Corona, Isaac Barrera-Chávez, Carlos Viloria-Álvarez, Alejandro E. Macías, Liz Jovanna Martínez-Navarro, Jose A. Alvarez, David Alejandro Scavo-Montes and Eduardo Guaní-Guerra
Medicina 2024, 60(6), 944; https://doi.org/10.3390/medicina60060944 - 5 Jun 2024
Abstract
Background and Objectives: Medical and public recognition of “long-COVID or post-COVID syndrome”, as well as its impact on the quality of life (QoL), is required to better address the disease burden. Objectives: We aimed to describe the persistence of COVID-19 symptoms and QoL
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Background and Objectives: Medical and public recognition of “long-COVID or post-COVID syndrome”, as well as its impact on the quality of life (QoL), is required to better address the disease burden. Objectives: We aimed to describe the persistence of COVID-19 symptoms and QoL among patients at three and twelve months after their discharge from the hospital. Materials and Methods: We conducted an observational, prospective, and longitudinal analytic study from September 2021 to April 2022. To measure QoL, we used a validated version of the 36-item Short-Form Health Survey (SF-36). Results: We included 68 patients in the study. A total of 54 (79.4%) patients reported at least one persistent symptom at three months vs. 52 (76.4%) at twelve months (p = 0.804). Some persistent symptoms (myalgia, alopecia, and cough) decreased significantly at twelve months (50% vs. 30.9%, 29.4% vs. 13.2%, and 23.5% vs. 7.4%; respectively, p = 0.007); in contrast, other persistent symptoms (sleep–wake and memory disorders) were more frequent (5.9% vs. 32.4% and 4.4% vs. 20.6%; respectively, p = ≤0.001). Regarding QoL, a statistically significant improvement was observed in some scores over time, p = ≤0.037. At twelve months, dyspnea, myalgia, and depression were risk factors associated with a poor physical component summary (PCS), p = ≤0.027, whereas anxiety, depression, and fatigue were associated with a poor mental component summary (MCS), p = ≤0.015. Conclusion: As the proportion of persistent symptoms at twelve months is high, we suggest that patients must continue under long-term follow up to reclassify, diagnose, and treat new onset symptoms/diseases.
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(This article belongs to the Section Infectious Disease)
Open AccessReview
Effect of Treating Periodontal Disease in Pregnant Women to Reduce the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review
by
Heber Isac Arbildo-Vega, Tania Padilla-Cáceres, Luz Caballero-Apaza, Fredy Hugo Cruzado-Oliva, Vilma Mamani-Cori, Sheyla Cervantes-Alagón, Hernán Vásquez-Rodrigo, Franz Tito Coronel-Zubiate, Rubén Aguirre-Ipenza, Joan Manuel Meza-Málaga, Sara Antonieta Luján-Valencia, Tania Belú Castillo-Cornock and Katherine Serquen-Olano
Medicina 2024, 60(6), 943; https://doi.org/10.3390/medicina60060943 - 4 Jun 2024
Abstract
Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search
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Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR–2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.
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(This article belongs to the Special Issue Medicine and Dentistry: New Methods and Clinical Approaches)
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Significance of Duodenal Prolactin Receptor Modulation by Calcium and Vitamin D in Sulpiride-Induced Hyperprolactinemia
by
Danijela Branislav Radojkovic, Milica Pesic, Milan Radojkovic, Marija Vukelic Nikolic, Tatjana Jevtovic Stoimenov, Sasa Radenkovic, Vojislav Ciric, Dijana Basic and Tatjana Radjenovic Petkovic
Medicina 2024, 60(6), 942; https://doi.org/10.3390/medicina60060942 - 4 Jun 2024
Abstract
Background and Objectives: Hyperprolactinemia, as a potential side-effect of some antipsychotic medications, is associated with decreased bone density and an increased risk of fractures. This study investigates whether calcium and vitamin D supplementation affects prolactin receptor (Prlr) gene expression in the duodenum,
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Background and Objectives: Hyperprolactinemia, as a potential side-effect of some antipsychotic medications, is associated with decreased bone density and an increased risk of fractures. This study investigates whether calcium and vitamin D supplementation affects prolactin receptor (Prlr) gene expression in the duodenum, vertebrae, and kidneys of female rats with sulpiride-induced hyperprolactinemia. Materials and Methods: Twenty-one-week-old female Wistar rats were assigned to three groups: Group S consisted of ten rats who received sulpiride injections (10 mg/kg) twice daily for 6 weeks; Group D (10 rats) received daily supplementation of 50 mg calcium and 500 IU vitamin D along with sulpiride for the last 3 weeks; and Group C consisting of seven age-matched nulliparous rats serving as a control group. Real-time PCR was used to assess Prlr gene expression in the duodenum, vertebrae, and kidneys. Results: In Group S, Prlr gene expression was notably decreased in the duodenum (p < 0.01) but elevated in the vertebrae and kidneys compared to Group C. Conversely, Group D exhibited significantly increased Prlr expression in the duodenum (p < 0.01) alongside elevated expression in the vertebrae and kidneys. Conclusions: In sulpiride-induced hyperprolactinemia, decreased Prlr gene expression in the duodenum may lead to reduced intestinal calcium absorption. Consequently, prolactin may draw calcium from the skeletal system to maintain calcium balance, facilitated by increased Prlr gene expression in the vertebrae. However, vitamin D supplementation in sulpiride-induced hyperprolactinemia notably enhances Prlr gene expression in the duodenum, potentially ameliorating intestinal calcium absorption and mitigating adverse effects on bone health.
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(This article belongs to the Section Endocrinology)
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Impact of Anxious and/or Depressive Reactive State on the Effectiveness of Rehabilitation of Patients with Multiple Sclerosis
by
Tatjana Bućma, Igor Sladojević, Lena Topić Arambašić, Natalija Jeremić and Bosa Tomić
Medicina 2024, 60(6), 941; https://doi.org/10.3390/medicina60060941 - 4 Jun 2024
Abstract
Background and Objectives: Rehabilitation is a part of the comprehensive treatment of multiple sclerosis (MS). If present, psychological reactive states limit the results of the rehabilitation. The objectives were to determine the impact of psychological reactive states in these patients on the
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Background and Objectives: Rehabilitation is a part of the comprehensive treatment of multiple sclerosis (MS). If present, psychological reactive states limit the results of the rehabilitation. The objectives were to determine the impact of psychological reactive states in these patients on the functionality obtained by rehabilitation and QoL, and to determine the connection between the objective and subjective evaluation. Materials and Methods: Based on the Hospital anxiety and depression scale, the patients were divided into a group with anxious and/or depressive reactive state and a group without the reactive state. The values of functional scores—the Berg Balance Scale (BBS) and the Expanded Disability Status Scale (EDSS), as well as the parameters of the QoL-Physical health Component Score (PCS) and the Mental health Component Score (MCS)—were determined at the beginning and at the end of the rehabilitation. Results: There was a statistically significant difference between the BBS, EDSS, PCS, and MCS groups at the beginning and the end of the rehabilitation in both groups. A statistically significant difference at the beginning and the end of the rehabilitation between the groups was found only in PCS and MCS. A highly statistically significant correlation between EDSS and PCS, and EDSS and MCS, was found only in the group without the reactive state. Conclusions: Although rehabilitation leads to an objective improvement of functionality in patients with MS, the presence of the anxious and/or depressive reactive state limits the results of rehabilitation and leads to discrepancies in the aforementioned objective assessment and the patient’s subjective experience through the evaluation of their QoL.
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(This article belongs to the Section Neurology)
Open AccessArticle
Overweight, Obesity, and Associated Risk Factors among Students at the Faculty of Medicine, Jazan University
by
Sameer Alqassimi, Erwa Elmakki, Areej Siddiq Areeshi, Amani Baker Mohammed Aburasain, Aisha Hassan Majrabi, Enas Mohammed Ali Masmali, Eman Adel Ibrahim Refaei, Raghad Abdu Ali Mobaraki, Reem Mohammed A. Qahtani, Omar Oraibi, Majid Darraj, Mohammed Ali Madkhali and Mostafa Mohrag
Medicina 2024, 60(6), 940; https://doi.org/10.3390/medicina60060940 - 4 Jun 2024
Abstract
Background and Objectives: This study aimed to determine the prevalence of overweight, obesity, and the associated risk factors among medical students at Jazan University in Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among 228 medical students from their second to sixth
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Background and Objectives: This study aimed to determine the prevalence of overweight, obesity, and the associated risk factors among medical students at Jazan University in Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among 228 medical students from their second to sixth academic years at the Faculty of Medicine, Jazan University. A self-administered questionnaire was used to collect data regarding sociodemographic characteristics, physical activity, dietary habits, comorbidities, medication use, family history, and lifestyle factors. Anthropometric measurements including height, weight, and waist circumference were recorded. Chi-square test and binary logistic regression were used to identify the risk factors associated with obesity. Results: The prevalence of overweight and obesity among the participants was 13.3% and 15%, respectively. Hence, the combined prevalence of overweight and obesity is 28.3%. The mean weight was 63.39 ± 18.93 kg, and the mean height was 163.48 ± 9.78 cm. On the other hand, 17.3% of participants were underweight, whereas 54.4% had normal BMI. Most of the participants (61%) did not engage in regular exercise. A high proportion consumed fruits (82.9%) and vegetables (58.8%) 3 or fewer days per week, and 84.2% consumed 3 or fewer meals per day. Fast-food consumption more than 3 days per week was reported by 42.1% of participants. Obesity was not significantly associated with sociodemographic factors, physical activity, dietary habits, comorbidities, medication use, or family histories. However, those with a monthly family income of SAR 15,000–24,999 had significantly lower odds of obesity than those in the lowest income group (OR 0.230, p = 0.045). Conclusions: The prevalence of overweight and obesity among medical students at Jazan University is high. Although no significant associations were found between obesity and most risk factors, this study highlights the need for interventions that promote healthy lifestyles among medical students. Further research is needed to identify effective strategies for preventing and managing obesity in this population.
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(This article belongs to the Section Epidemiology & Public Health)
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Nationwide Big Data Analysis of Statin Use and Intracerebral Hemorrhage Risk in Acute Ischemic Stroke Patients in Taiwan
by
William Winardi, Sin-Hua Moi, Thomas Winardi, Yu-Wen Cheng, Po-Yuan Chen and Cheng-Kai Lin
Medicina 2024, 60(6), 939; https://doi.org/10.3390/medicina60060939 - 4 Jun 2024
Abstract
Background and Objectives: Although statins are recommended for secondary prevention of acute ischemic stroke, some population-based studies and clinical evidence suggest that they might be used with an increased risk of intracranial hemorrhage. In this nested case–control study, we used Taiwan’s nationwide
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Background and Objectives: Although statins are recommended for secondary prevention of acute ischemic stroke, some population-based studies and clinical evidence suggest that they might be used with an increased risk of intracranial hemorrhage. In this nested case–control study, we used Taiwan’s nationwide universal health insurance database to investigate the possible association between statin therapy prescribed to acute ischemic stroke patients and their risk of subsequent intracerebral hemorrhage and all-cause mortality in Taiwan. Materials and Methods: All data were retrospectively obtained from Taiwan’s National Health Insurance Research Database. Acute ischemic stroke patients were divided into a cohort receiving statin pharmacotherapy and a control cohort not receiving statin pharmacotherapy. A 1:1 matching for age, gender, and index day, and propensity score matching was conducted, producing 39,366 cases and 39,366 controls. The primary outcomes were long-term subsequent intracerebral hemorrhage and all-cause mortality. The competing risk between subsequent intracerebral hemorrhage and all-cause mortality was estimated using the Fine and Gray regression hazards model. Results: Patients receiving statin pharmacotherapy after an acute ischemic stroke had a significantly lower risk of subsequent intracerebral hemorrhage (p < 0.0001) and lower all-cause mortality rates (p < 0.0001). Low, moderate, and high dosages of statin were associated with significantly decreased risks for subsequent intracerebral hemorrhage (adjusted sHRs 0.82, 0.74, 0.53) and all-cause mortality (adjusted sHRs 0.75, 0.74, 0.74), respectively. Conclusions: Statin pharmacotherapy was found to safely and effectively reduce the risk of subsequent intracerebral hemorrhage and all-cause mortality in acute ischemic stroke patients in Taiwan.
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(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies)
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