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Clin. Pract., Volume 15, Issue 2 (February 2025) – 15 articles

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11 pages, 583 KiB  
Article
The Development and Psychometric Validation of the Fainareti Screening Tool for Perinatal Mental Health in Greek Pregnant Women
by Maria Dagla, Irina Mrvoljak-Theodoropoulou, Vassilis Daglas, Evangelia Antoniou, Eleni Rigoutsou, Alexandros Papatrechas, Calliope Dagla, Eleni Tsolaridou and Despoina Karagianni
Clin. Pract. 2025, 15(2), 37; https://doi.org/10.3390/clinpract15020037 - 14 Feb 2025
Abstract
Background/Objectives: It would be helpful for primary healthcare professionals to have access to a brief, general screening tool allowing them to detect patients suffering from major mental illness. This also holds for organizations and institutions at which pregnant women ask for support [...] Read more.
Background/Objectives: It would be helpful for primary healthcare professionals to have access to a brief, general screening tool allowing them to detect patients suffering from major mental illness. This also holds for organizations and institutions at which pregnant women ask for support during the perinatal period. An evaluation of the psychometric properties, validity, and reliability of the Fainareti mental health screening tool was carried out in Greek women in this study. Methods: The study participants consisted of 518 women retrospectively followed from pregnancy to their first year postpartum as part of a health intervention at the Day Center for Women’s Mental Health Care (Perinatal Mental Health Disorders), operated by the non-profit organization Fainareti. Alongside the newly developed screening tool, this study utilized the Perinatal Anxiety Screening Scale (PASS), the Patient Health Questionnaire (PHQ-9), and the Edinburgh Postnatal Depression Scale (EPDS). Results: The assessment of the tool’s internal reliability included computing two separate internal consistency indices, with both indicating its significant level of reliability. The correlation analysis between the tool and the scales included in this study demonstrated the tool’s strong convergent validity, while factor analyses confirmed its satisfactory construct validity. Conclusions: Overall, these findings suggest that the one-factor Fainareti mental health screening tool is suitable for initial assessments of the mental health of Greek women. Full article
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15 pages, 1672 KiB  
Article
Left Atrial Strain Value Versus Tissue Doppler Echocardiography and the Left Atrium Volume Index in the Evaluation of Left Ventricular Diastolic Function in Patients with Chronic Kidney Disease
by Eman Elsheikh, Zainab Amjad, Samah I Abohamr, Muthana Al Sahlawi and Ibtsam Khairat
Clin. Pract. 2025, 15(2), 36; https://doi.org/10.3390/clinpract15020036 - 13 Feb 2025
Abstract
Background: In heart failure with preserved ejection fraction (HFpEF) and decreased ejection fraction (HFrEF), LA strain, an indicator of the filling and discharge of the left atrium (LA), was recently identified as a sign of diastolic dysfunction. Our objective was to examine the [...] Read more.
Background: In heart failure with preserved ejection fraction (HFpEF) and decreased ejection fraction (HFrEF), LA strain, an indicator of the filling and discharge of the left atrium (LA), was recently identified as a sign of diastolic dysfunction. Our objective was to examine the significance of left atrial (LA) strain relative to tissue Doppler echocardiography and the left atrial volume index (LAVI) in evaluating left ventricular (LV) diastolic performance in individuals with chronic kidney disease (CKD). Methods: A prospective cross-sectional study was conducted on 220 outpatients with CKD who fulfilled the inclusion criteria and were referred to the cardiology clinic at Tanta University for routine echocardiographic assessment during a period of 6 months (April to September 2024). Based on their estimated glomerular filtration rate (eGFR), patients were divided into five groups: GFR ranges from 90 to 120 mL/min/1.73 m2 in Group 1, 60 to 90 mL/min/1.73 m2 in Group 2, 30 to 60 mL/min/1.73 m2 in Group 3, 15 to 29 mL/min/1.73 m2 in Group 4, and less than 15 mL/min/1.73 m2 in Group 5. All participants were evaluated using echocardiographic measurements, such as the E/e ratio, left ventricular systolic and diastolic volumes, left atrial strain, left atrial volume index (LAVI), and ejection fraction (EF). Results: LA strain conduit and reservoir strain can significantly diagnose LV diastolic function in CKD patients (p < 0.001; AUC = 0.819 and 0.869, respectively) using cutoffs of ≤36 and ≥23, with 86% and 95.5% sensitivity, 65% and 60% specificity, 96.1% and 96% PPV, and 31.7% and 57.1%, NPV respectively. An AUC = 0.926 was observed with LAVI among grade 1 vs. grade 0 (0.9 is considered excellent in diagnosing patients with and without the disease). Other markers had AUC values of 0.5–0.6 among the grades of the diastolic function, suggesting no discrimination in diagnosing the disease. Conclusions: LA conduit strain and reservoir strain are independent markers that represent a superior and more sensitive approach than LAVI and tissue Doppler echocardiography for evaluating LV diastolic dysfunction in patients with CKD, even in the early stages. Full article
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11 pages, 403 KiB  
Article
Public Awareness of Ocular Chemical Injuries: A Cross-Sectional Study in Lithuania
by Justina Skruodyte, Martyna Sveikataite, Jurate Sveikatiene and Pranas Serpytis
Clin. Pract. 2025, 15(2), 35; https://doi.org/10.3390/clinpract15020035 - 13 Feb 2025
Abstract
Background: Ophthalmic emergencies are acute conditions that progress rapidly, posing a significant threat to a patient’s vision and requiring urgent intervention to prevent permanent visual impairment. This study aimed to assess the general awareness of ocular chemical burns and the adequacy of the [...] Read more.
Background: Ophthalmic emergencies are acute conditions that progress rapidly, posing a significant threat to a patient’s vision and requiring urgent intervention to prevent permanent visual impairment. This study aimed to assess the general awareness of ocular chemical burns and the adequacy of the immediate response measures while also seeking to improve the understanding of these injuries and contribute to promoting a healthier society. Methods: A comprehensive literature review was performed, and the most frequently reported questions were incorporated into the original survey. An anonymous questionnaire, available both online and in print, was developed to conduct a cross-sectional study to assess the general knowledge of the causes, symptoms, and appropriate first aid measures to be applied in cases of chemical ocular trauma. Results: Between April and May 2024, 175 individuals completed the questionnaire and were included in the study. More than half (54%) of the tested population demonstrated a poor level of knowledge about chemical ocular injuries, and only 30.9% of the respondents correctly indicated the need for imminent treatment. Twenty percent of the respondents could not identify whether alkalis or acids are more hazardous. Additionally, 5.7% of the respondents falsely considered consultation with an emergency department a priority before thorough irrigation. Most of the respondents (60.6%) incorrectly indicated that the appropriate first aid measures and treatment depend on the substance involved, and 68.1% of the respondents stated that treatment in the emergency department should be delayed, allowing for anamnesis collection and thorough examination. Conclusions: Ocular chemical injuries can substantially impact an individual’s quality of life. The present study found that the public knowledge concerning ocular chemical trauma, and the necessary immediate treatment is insufficient. Public education is vital, as delaying prompt and thorough irrigation at the chemical injury site may result in irreversible complications. Full article
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6 pages, 1258 KiB  
Case Report
A Case Study and Concise Literature Review: Adult Patient’s Initial Manifestation of Complicated Acute Otitis Media Presenting as Jugular Foramen Syndrome
by Sabri El-Saied, Oren Ziv, Aviad Sapir, Daniel Yafit and Daniel M. Kaplan
Clin. Pract. 2025, 15(2), 34; https://doi.org/10.3390/clinpract15020034 - 12 Feb 2025
Abstract
Background: Jugular foramen syndrome (JFS) is a rare condition characterized by the compression or impairment of one or more terminal cranial nerves passing through the jugular foramen. Although malignancies are the primary cause of JFS. Methods: In this report, we present the first [...] Read more.
Background: Jugular foramen syndrome (JFS) is a rare condition characterized by the compression or impairment of one or more terminal cranial nerves passing through the jugular foramen. Although malignancies are the primary cause of JFS. Methods: In this report, we present the first documented case of JFS caused by acute otitis media in an adult patient. Results: A 74-year-old woman presented with ear pain, hoarseness, dysphagia, dizziness, tinnitus, and hearing loss. A physical examination revealed a reddish-bulging tympanic membrane, left-sided hearing loss, right uvula deviation, and cranial nerve palsies affecting the ninth and tenth nerves. Imaging studies confirmed temporal bone inflammation, thrombosis of the sigmoid sinus extending into the internal jugular vein, and signs of thrombophlebitis of the jugular vein. The patient underwent a cortical mastoidectomy, sigmoid sinus decompression, and ventilation tube insertion, along with antibiotic, steroid, and anticoagulant therapy. Postoperatively, the patient’s condition improved significantly. Conclusions: This case highlights the importance of considering complicated acute otitis media in the differential diagnosis of neurological abnormalities associated with JFS. A thorough evaluation of the patient’s medical history and radiological imaging can assist in identifying the cause of the symptoms and guide appropriate surgical or conservative treatment. Further research is essential to gain more comprehensive insights into the pathophysiology and therapeutic interventions of JFS affecting the ears. Full article
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10 pages, 1329 KiB  
Review
Challenges of Constipation in People Suffering from Schizophrenia: A Narrative Review
by Takahiko Nagamine
Clin. Pract. 2025, 15(2), 33; https://doi.org/10.3390/clinpract15020033 - 11 Feb 2025
Abstract
Background/Objectives: Individuals diagnosed with schizophrenia are susceptible to constipation induced by antipsychotic medications. However, research investigating the prevalence of this adverse effect and its underlying mechanisms is limited. Methods: To address this knowledge gap, a narrative review was conducted on the [...] Read more.
Background/Objectives: Individuals diagnosed with schizophrenia are susceptible to constipation induced by antipsychotic medications. However, research investigating the prevalence of this adverse effect and its underlying mechanisms is limited. Methods: To address this knowledge gap, a narrative review was conducted on the subject of constipation in patients with schizophrenia. A comprehensive electronic search was conducted in the PubMed and J-Stage databases. Results: The prevalence of constipation in individuals with schizophrenia is high, ranging from 30% to 60%. The risk of constipation increases with high doses of antipsychotics and with the concomitant use of anticholinergics and mood stabilizers. The prevalence of constipation varies by sex, with women demonstrating a higher risk compared to men. Conclusions: Constipation is a prevalent complaint among individuals with schizophrenia, with women exhibiting a higher risk. The underlying pathophysiology of sex differences in constipation is attributed to variations in monoamines within the descending pain inhibitory pathway, which governs the neural circuitry associated with defecation. Constipation can lead to significant complications, underscoring the need for a multifaceted approach to treatment that considers the intestinal environment beyond the mere use of laxatives. Full article
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11 pages, 679 KiB  
Article
Dentures Used for Rehabilitation of Mastication After Loss of Teeth Maintain Proper Biomechanical Properties of Masseter Muscles—A Comparative Study
by Sebastian Szajkowski, Jarosław Pasek and Grzegorz Cieślar
Clin. Pract. 2025, 15(2), 32; https://doi.org/10.3390/clinpract15020032 - 10 Feb 2025
Abstract
Background: Various types of dentures are applied in the treatment of missing teeth. The research carried out so far has proven that both the absence of teeth and the replacement of missing teeth with dentures affect the functional condition of masseter muscles. [...] Read more.
Background: Various types of dentures are applied in the treatment of missing teeth. The research carried out so far has proven that both the absence of teeth and the replacement of missing teeth with dentures affect the functional condition of masseter muscles. The purpose is, thus, to find out how the tone, elasticity, and stiffness of masseter muscles change after prosthetic treatment. Material and methods: The material for the study consisted of 137 individuals, who were divided into group 1, with dentures (n = 87) and undergoing prosthetic treatment, and group 2, without dentures (n = 50) with teeth preserved, and not undergoing prosthetic treatment. Additionally, group 1 was divided into subgroups, in accordance with the type of prosthetic treatment applied: group 1a—removable complete dentures (n = 14), group 1b—removable partial dentures (n = 48), group 1c—fixed partial dentures (n = 22), group 1d—fixed complete dentures (n = 3). The biomechanical properties of masseter muscles, namely: tone, stiffness, and elasticity were assessed by means of myotonometry. The measurements were taken under muscle relaxation and under maximum muscle contraction. Results: The values of the parameters of tone, stiffness, and elasticity were higher in group 2, without dentures, in comparison with group 1, with dentures, yet they did not differ with statistical significance. The type of prosthesis used affected the results obtained. Masseter muscles demonstrated the best biomechanical parameters in the case of applying fixed partial dentures. Conclusions: Prosthetic replacement of missing teeth contributes to maintaining the good condition of masseter muscles, which has been confirmed by the results of myotonometric measurements taken. Full article
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10 pages, 1202 KiB  
Article
Clinical Features of Dermatomyositis Associated with Myositis-Specific Antibodies in Moroccan Patients
by Milouda Chihi, Leila Barakat, Fatima Zahra Benhayoun, Abire Allaoui, Samy Housbane, Mina Moudatir, Fouzia Hali, Ahmed Aziz Bousfiha and Jalila El Bakkouri
Clin. Pract. 2025, 15(2), 31; https://doi.org/10.3390/clinpract15020031 - 6 Feb 2025
Abstract
Background/Objectives: Dermatomyositis (DM) is a rare idiopathic inflammatory myopathy characterized by muscle weakness and typical cutaneous rash. Dermatomyositis-specific antibodies, such as anti-TIF1γ, anti-SAE, anti-Mi2, anti-MDA5, and anti-NXP2, have been associated with specific clinical phenotypes. Our study aimed to describe the clinical profile of [...] Read more.
Background/Objectives: Dermatomyositis (DM) is a rare idiopathic inflammatory myopathy characterized by muscle weakness and typical cutaneous rash. Dermatomyositis-specific antibodies, such as anti-TIF1γ, anti-SAE, anti-Mi2, anti-MDA5, and anti-NXP2, have been associated with specific clinical phenotypes. Our study aimed to describe the clinical profile of Moroccan patients with DM and clinical associations with myositis-specific antibodies. Methods: We recruited 54 adult patients with DM according to the Bohan and Peter criteria, admitted to the internal medicine and dermatology departments of the University Hospital Center Ibn Rochd of Casablanca from January 2020 to December 2023. Testing for myositis-specific autoantibodies (MSAs) was conducted using an Immunodot assay. Statistical analysis was performed using the Chi-square test. Results: Among our patients, 74% were female. The mean age of the patients at the time of diagnosis was 45.8 years (±12.95 years). The main clinical manifestations were a V-neck sign (70.4%), myalgia (70.4%), Gottron’s papules (68.5%), heliotrope rash (63%), arthritis/arthralgia (48.1%), proximal muscle weakness (68.5%), periungual erythema (46.3%), and dysphagia (59.3%). Of the 54 patients, 37 (68.5%) showed dermatomyositis-specific antibody positivity. The most frequently found autoantibody was anti-Mi2 (22.2%), followed by anti-TIF1γ (14.8%), anti-NXP2 (9.2%), anti-MDA5 (7.4%), and anti-SAE (7.4%). The association between clinical manifestations and MSAs showed that anti-TIF1γ antibodies were associated with the V-neck sign (p < 0.05), and the MSA-negative group was protected from periungual erythema (p < 0.05). No other significant association was found. Conclusions: This study shows the autoantibody profile of Moroccan patients with DM and the associations of MSAs with clinical manifestations. Full article
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16 pages, 397 KiB  
Article
Addressing Rotator Cuff-Related Shoulder Pain: Findings from a Greek Regional Observational Study Utilizing a Clinical Case Scenario
by Eleftherios Paraskevopoulos, Anna Christakou, Andrew Smythe, Eleni Kapreli, Maria Papandreou, Charalambos Papacharalambous, Kyriakos Pavlou and George M. Pamboris
Clin. Pract. 2025, 15(2), 30; https://doi.org/10.3390/clinpract15020030 - 31 Jan 2025
Abstract
Background: Rotator cuff-related shoulder pain (RCRSP) is a prevalent musculoskeletal issue, encompassing various shoulder conditions. While exercise typically forms the foundation of conservative treatment, there exists ongoing discourse regarding the effectiveness and role of passive treatments. International guidelines recommend initial conservative management, [...] Read more.
Background: Rotator cuff-related shoulder pain (RCRSP) is a prevalent musculoskeletal issue, encompassing various shoulder conditions. While exercise typically forms the foundation of conservative treatment, there exists ongoing discourse regarding the effectiveness and role of passive treatments. International guidelines recommend initial conservative management, with surgery considered only after failed conservative treatment. However, recent studies reveal discrepancies between recommended practices and actual clinical management. The aim of the study was to assess current practices in managing RCRSP among Greek physiotherapists, with a focus on understanding the alignment of these practices with international guidelines for conservative treatment. Methods: A cross-sectional survey was conducted among Greek physiotherapists to assess current practices in managing RCRSP. The survey, adapted from previous studies, collected demographic data and assessed clinical reasoning through a vignette-based approach. Responses were analyzed for alignment with guideline-recommended care. Results: Out of over 9000 contacted physiotherapists, 163 responded. A majority expressed a specific interest in shoulder pain (85%). Patient education (100%) and exercise (100%) were widely endorsed, with limited support for imaging (44%), injection (40%), and surgery (26%). Younger respondents were less inclined towards surgical referral (p = 0.001). Additionally, adjunctive interventions like mobilization (66%) and massage therapy (58%) were commonly employed alongside exercise and education. Treatment duration typically ranged from 6 to 8 weeks, with exercises reviewed weekly. Conclusions: The study highlights a consistent preference for conservative management among Greek physiotherapists, aligning with international guidelines. However, there are variations in practice, particularly regarding adjunctive interventions and exercise prescription parameters. Notably, there is a disparity between recommended and actual use of certain modalities. Full article
(This article belongs to the Special Issue Musculoskeletal Pain and Rehabilitation)
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16 pages, 268 KiB  
Article
Comparison of Patient Acceptance and Caregiver Satisfaction of Glass-Ionomer Cement vs. Silver Fluoride/Potassium Iodide Application to Manage Molar Incisor Hypomineralisation Hypersensitivity Immediately and After 12 Weeks
by Ramiar Karim, Walaa Ahmed, Mohamed Baider, Christian H. Splieth and Julian Schmoeckel
Clin. Pract. 2025, 15(2), 29; https://doi.org/10.3390/clinpract15020029 - 31 Jan 2025
Abstract
Aim: To compare caregiver satisfaction and children’s acceptance of silver fluoride/potassium iodide (AgF + KI) treatment (Riva Star Aqua®, SDI Limited, Victoria, Australia) and glass-ionomer cement (GIC) application (Ionostar Plus + Easy Glaze, VOCO, Germany) in reducing hypersensitivity in permanent molars [...] Read more.
Aim: To compare caregiver satisfaction and children’s acceptance of silver fluoride/potassium iodide (AgF + KI) treatment (Riva Star Aqua®, SDI Limited, Victoria, Australia) and glass-ionomer cement (GIC) application (Ionostar Plus + Easy Glaze, VOCO, Germany) in reducing hypersensitivity in permanent molars affected by molar incisor hypomineralisation (MIH) with the MIH treatment need index (MIH-TNI) 3 and 4 immediately after its application and after 12 weeks. Materials and Methods: This prospective, comparative, clinical study recruited schoolchildren with at least one hypersensitive MIH molar with a Schiff cold air sensitivity score (SCASS) of 2 and 3. Caregivers in both groups (AgF + KI and GIC + glaze) answered a questionnaire (5-Point Likert Scale) regarding the perception of the treatment immediately (15 min post application) and in the 12 weeks follow-up. Children’s behaviour during both applications was assessed using FBRS (Frankl Behaviour Rating Scale). Results: A total number of 47 children (n = 22 for AgF/KI and n = 25 for GIC) with a mean age of 8.6 ± 1.42 were recruited. A high proportion of the children in both arms (n = 40 out of 44; 90.1%) reported a reduction in hypersensitivity in the last 12 weeks. On average, children (n = 39; FBRS ≥ 3) in both groups showed positive behaviour, with a significantly more definitely positive behaviour in the GIC group (p < 0.05, independent student t-test). Caregiver satisfaction with both study procedures was high after immediate assessment (n = 19 out of 22, 86.4% for AgF/KI and n = 19 out of 25, 76.0% for GIC application) and in 12 weeks of follow-up (n = 17 out of 20, 85.0% for AgF/KI and n = 22 out of 24, 91.6% for GIC application). However, the taste AgF/KI is more frequently considered not acceptable for the child (n = 10; 45%) than smell (n = 2; 9%). Interestingly, there was a statistically significant difference in caregivers’ preference toward alternative desensitisation treatment (tooth restoration coverage, desensitisation paste, stainless steel crown and fluoride varnish) in both treatment groups (p < 0.05, Mann–Whitney U test). Conclusions: Both GIC and AgF/KI applications can be considered acceptable approaches to reduce hypersensitivity in permanent molars affected by MIH both immediately and in long-term follow-up for schoolchildren based on caregivers’ assessments. Full article
20 pages, 1059 KiB  
Review
Collagen Injections for Rotator Cuff Diseases: A Systematic Review
by Rocco Aicale, Eugenio Savarese, Rosita Mottola, Bruno Corrado, Felice Sirico, Raffaello Pellegrino, Danilo Donati, Roberto Tedeschi, Luca Ruosi and Domiziano Tarantino
Clin. Pract. 2025, 15(2), 28; https://doi.org/10.3390/clinpract15020028 - 28 Jan 2025
Abstract
Background: Because of its anatomy and function, the rotator cuff (RC) is vulnerable to considerable morbidity. The prevalence of RC diseases (RCDs) among the general population is 5–39%, reaching over 30% in patients older than 60. The aim of the present systematic review [...] Read more.
Background: Because of its anatomy and function, the rotator cuff (RC) is vulnerable to considerable morbidity. The prevalence of RC diseases (RCDs) among the general population is 5–39%, reaching over 30% in patients older than 60. The aim of the present systematic review is to investigate the effects of the use of collagen injections in the treatment of RCDs. Methods: A systematic search of scientific electronic databases (such as PubMed, Scopus and Web of Science) was performed up to November 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent authors conducted the search and assessed the articles. The inter-rater reliability for the quality assessment was measured using Cohen’s kappa coefficient, while the Modified Coleman Methodology Score (CMS) was applied to evaluate the methodological quality of the articles included in this systematic review. Results: A total of eight articles were included, with the overall quality of the included articles being evaluated as fair. Despite the use of different types of collagen and injection protocols, as well as the different scores applied, each included study showed clinically relevant improvements. However, given the high degree of heterogeneity of the included studies, we cannot draw conclusions regarding which type of collagen and injection protocol are best for RCD treatment. Discussion: Collagen administration for RCDs seems to be effective at reducing pain and improving function, as well as the tendon structure, especially in partial tears and RC tendinopathy. High-quality, prospective studies with long-term follow-up are necessary to validate the findings of the articles included in this systematic review. Full article
(This article belongs to the Special Issue Musculoskeletal Pain and Rehabilitation)
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15 pages, 1239 KiB  
Review
Etonogestrel Subdermal Implant in Adolescents: Everything We Should Know to Conduct Proper Counseling, a Narrative Review
by Alessandro Messina, Safae Elmotarajji, Eleonora Dalmasso, Costanza Valentini, Valentino Remorgida, Livio Leo, Alessandro Libretti and Bianca Masturzo
Clin. Pract. 2025, 15(2), 27; https://doi.org/10.3390/clinpract15020027 - 27 Jan 2025
Abstract
Background/Objectives: Comprehensive sexual education and access to contraceptives play a vital role in alleviating the economic, health, and social challenges associated with unplanned pregnancies in adolescents. According to the World Health Organization (WHO), adolescence refers to the transitional stage from childhood to [...] Read more.
Background/Objectives: Comprehensive sexual education and access to contraceptives play a vital role in alleviating the economic, health, and social challenges associated with unplanned pregnancies in adolescents. According to the World Health Organization (WHO), adolescence refers to the transitional stage from childhood to adulthood, encompassing individuals aged 10 to 19. This period is critical for reproductive decision making, making it essential to closely observe patterns of sexual activity and contraceptive use among young people. Despite advancements, many adolescents still encounter significant barriers to accessing and effectively utilizing contraceptive methods. Methods: A bibliographic search was performed across three major biomedical databases: PubMed, Embase, and CINAHL. The research question was developed utilizing the PIO (Population, Intervention, Outcome) framework to guide the investigation. Results: Long-acting reversible contraceptives (LARCs), including the etonogestrel (ENG) implant, have been recognized for their ability to significantly reduce maternal and neonatal mortality and morbidity as well as decrease the incidence of unsafe abortions. Conclusions: Access to adequate counseling and effective contraceptive services can profoundly impact young people’s lives, preventing unplanned pregnancies and promoting optimal sexual and reproductive health. Full article
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13 pages, 431 KiB  
Review
Readability of Informed Consent Forms for Medical and Surgical Clinical Procedures: A Systematic Review
by José Manuel García-Álvarez and Alfonso García-Sánchez
Clin. Pract. 2025, 15(2), 26; https://doi.org/10.3390/clinpract15020026 - 24 Jan 2025
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Abstract
Background/Objectives: The wording of informed consent forms for medical or surgical clinical procedures can be difficult to read and comprehend, making it difficult for patients to make decisions. The objective of this study was to analyze the readability of informed consent forms [...] Read more.
Background/Objectives: The wording of informed consent forms for medical or surgical clinical procedures can be difficult to read and comprehend, making it difficult for patients to make decisions. The objective of this study was to analyze the readability of informed consent forms for medical or surgical clinical procedures. Methods: A systematic review was performed according to the PRISMA statement using PubMed, Embase, and Google Scholar databases. Primary studies analyzing the readability of informed consent forms using mathematical formulas published in any country or language during the last 10 years were selected. The results were synthesized according to the degree of reading difficulty to allow for the comparison of the studies. Study selection was performed independently by the reviewers to avoid the risk of selection bias. Results: Of the 664 studies identified, 26 studies were selected that analyzed the legibility of 13,940 forms. Of these forms, 76.3% had poor readability. Of the six languages analyzed, only English, Spanish, and Turkish had adapted readability indexes. Flesch Reading Ease was the most widely used readability index, although it would be more reliable to use language-specific indices. Conclusions: Most of the analyzed informed consent forms had poor readability, which made them difficult for a large percentage of patients to read and comprehend. It is necessary to modify these forms to make them easier to read and comprehend, to adapt them to each specific language, and to carry out qualitative studies to find out the real legibility of each specific population. Full article
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13 pages, 911 KiB  
Article
C-Reactive Protein, International Normalized Ratio, and Fibrinogen in Diagnostic Scale of Complicated Acute Appendicitis
by Leticia Lorena Hernández-González, Said José Serrano-Guzmán, Jesús David Guzmán-Ortiz, Hermelo Esteban Pérez-Ceballos, José Luis Cano-Pérez, Víctor Cruz-Hernández, Héctor Ulises Bernardino-Hernández, Lucía Lourdes Martínez-Martínez and Sergio Roberto Aguilar-Ruiz
Clin. Pract. 2025, 15(2), 25; https://doi.org/10.3390/clinpract15020025 - 23 Jan 2025
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Abstract
Background/Objectives: Differentiating complicated acute appendicitis (CA) and uncomplicated acute appendicitis (UC) is essential to guide clinical management. While CA requires urgent surgical management, UC can be treated with antibiotic therapy in selected cases. However, accurate identification of CA remains a clinical challenge. This [...] Read more.
Background/Objectives: Differentiating complicated acute appendicitis (CA) and uncomplicated acute appendicitis (UC) is essential to guide clinical management. While CA requires urgent surgical management, UC can be treated with antibiotic therapy in selected cases. However, accurate identification of CA remains a clinical challenge. This study aimed to identify factors associated with CA and to develop a diagnostic severity scale. Methods: In this retrospective study, we included 132 adult patients (>16 years) with a confirmed postsurgical diagnosis of appendicitis, of whom 52 had CA and 80 had UA. Signs, symptoms, comorbidities, laboratory values, and ultrasonographic findings were evaluated to determine predictive factors and construct a diagnostic scale. Results: The factors most significantly associated with CA were elevated plasma concentrations of C-reactive protein (>7.150 mg/dL), fibrinogen (481.5 mg/dL), International Normalized Ratio (INR) (>1.150), and the presence of free fluid periappendicular. The combination of these factors within one scale showed an area under the curve (AUC) of 0.84, with a sensitivity of 78.75% and a specificity of 82.69%. Conclusions: Serum C-reactive protein concentration, fibrinogen, and INR can be employed individually or as part of a scale as important indicators in diagnosing CA. Full article
(This article belongs to the Special Issue Teaching Pathology Towards Clinics and Practice)
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12 pages, 475 KiB  
Article
Exploring the Health Literacy and Patient Activation Among Patients with Glaucoma: A Cross-Sectional Study
by Lοukia Tsichla, Evridiki Patelarou, Efstathios Detorakis, Miltiadis Tsilibaris, Athina Patelarou, Antonios Christodoulakis, Eleni Dokoutsidou and Konstantinos Giakoumidakis
Clin. Pract. 2025, 15(2), 24; https://doi.org/10.3390/clinpract15020024 - 23 Jan 2025
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Abstract
Background: Glaucoma is one of the leading causes of blindness that can be mitigated through early recognition and effective management. Specifically, early and effective self-management outside hospitals can slow disease progression and reduce its negative daily impact. This includes adherence to medication, high [...] Read more.
Background: Glaucoma is one of the leading causes of blindness that can be mitigated through early recognition and effective management. Specifically, early and effective self-management outside hospitals can slow disease progression and reduce its negative daily impact. This includes adherence to medication, high levels of health literacy (requires patients to be able to find, understand, and use relevant health information), early recognition of symptoms, regular visits to ophthalmologists, etc. However, there is a lack of empirical evidence regarding levels of adherence to medication and health literacy in glaucoma patients in Greece. This study aimed to assess health literacy and self-management activation levels in glaucoma patients and explore the relationship between these factors. Materials and Methods: A total of 312 glaucoma patients were recruited from outpatient ophthalmology clinics in Heraklion, Greece, between November 2023 and May 2024 through convenience sampling. The Greek versions of the Patient Activation Measure-13 (PAM-13) and the European Health Literacy Survey Questionnaire 16 (HLS-EU-16) evaluated self-management activation and health literacy, respectively. Results: Patients exhibited low self-management activation (level 1: disengaged and overwhelmed, =40.7, SD: ±29.9) and sufficient health literacy (=10.7, SD: ±3.7). No significant association was found between health literacy and self-management activation (p = 0.602). Conclusions: Glaucoma patients had low to moderate levels of self-management activation and health literacy, without a significant association between them. Therefore, multifaceted strategies are needed to enhance these patients’ activation and health literacy. Further research, using larger, multi-center samples, is needed to clarify the link between these variables. Full article
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9 pages, 243 KiB  
Article
Placenta Praevia with Abnormal Adhesion—A Retrospective Study
by Lucian Șerbănescu, Dragoș Brezeanu, Cătălin Nicolae Grasa, Sebastian Mirea, Paris Ionescu, Vadym Rotar, Traian-Virgiliu Surdu and Andreea Cristina Costea
Clin. Pract. 2025, 15(2), 23; https://doi.org/10.3390/clinpract15020023 - 23 Jan 2025
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Abstract
Background: Placenta accreta spectrum (PAS) refers to abnormal placental attachment, categorized into placenta accreta, increta, and percreta, with varying severity. The incidence of PAS has risen alongside the increasing rate of caesarean sections. PAS is a significant cause of maternal complications, including bleeding, [...] Read more.
Background: Placenta accreta spectrum (PAS) refers to abnormal placental attachment, categorized into placenta accreta, increta, and percreta, with varying severity. The incidence of PAS has risen alongside the increasing rate of caesarean sections. PAS is a significant cause of maternal complications, including bleeding, hysterectomies of necessity and intestinal or urinary surgical complications, and of foetal complications, preterm birth or foetal anaemia. Early diagnosis is crucial for its management and for improving its outcomes. Materials and Methods: This retrospective study, conducted at the County Emergency Clinical Hospital “Saint Andrew the Apostle”, Constanța, analysed cases of placenta praevia and PAS from 2018 to 2022. Data were collected from observation sheets and operative protocols, involving 13,841 patients. Placenta praevia and PAS were diagnosed using ultrasound and MRI and confirmed by histopathology. Results: Among the 13,841 deliveries, 25 cases of placenta praevia (0.82% incidence) and 17 cases of PAS (0.57% incidence) were identified. Ultrasound demonstrated 88% sensitivity, and MRI 94% sensitivity for PAS detection. Of the 17 PAS cases, 11 were diagnosed as placenta accreta, 3 were diagnosed as placenta increta, and 3 as placenta percreta, with all percreta cases involving bladder invasion. Hysterectomy was the standard surgical treatment. Discussion: The risk factors for PAS included previous caesarean sections (94.1% of PAS cases), smoking, and uterine fibroids. The study confirmed the importance of early imaging and the involvement of a multidisciplinary team in managing PAS, particularly in complex cases with bladder involvement. Caesarean section followed by hysterectomy was the preferred surgical approach. Conclusions: Smoking, uterine scars, and uterine fibroids are significant risk factors for placenta praevia with pathological adhesion. Ultrasound and MRI are highly accurate in diagnosing PAS, with histopathology providing definitive confirmation. Multidisciplinary care is essential in managing complex cases, ensuring optimal maternal and foetal outcomes. The surgical treatment involves caesarean section and hysterectomy, with additional interventions for bladder invasion in percreta cases. Full article
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