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11 pages, 220 KiB

Open AccessArticle

Exclusive Breastfeeding Rates Among Roma and Non-Roma Mothers in Greece: A Single-Center Cross-Sectional Study from “Tzaneio” General Hospital of Piraeus

by Artemisia Kokkinari, Evangelia Antoniou, Eirini Orovou, Maria Tzitiridou-Chatzopoulou, Maria Dagla and Georgios Iatrakis

Clin. Pract. 2024, 14(6), 2365-2375; https://doi.org/10.3390/clinpract14060185 - 4 Nov 2024

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Abstract

Background: Exclusive breastfeeding is vital for the optimal development of infants, yet the practice of using infant formula has become increasingly prevalent. While many studies globally investigate factors affecting breastfeeding, there is a scarcity of research focusing on marginalized groups, particularly the Roma [...] Read more.

Background: Exclusive breastfeeding is vital for the optimal development of infants, yet the practice of using infant formula has become increasingly prevalent. While many studies globally investigate factors affecting breastfeeding, there is a scarcity of research focusing on marginalized groups, particularly the Roma community. This study seeks to compare the breastfeeding rates of Roma and non-Roma mothers upon discharge from a maternity hospital in Greece. It also examines factors contributing to the decline in breastfeeding among Roma women, with particular emphasis on the role of midwifery support. The aim of this study is to promote the development of supportive policies and programs for breastfeeding among Roma mothers. Methods: A cross-sectional study was conducted from September 2019 to January 2022, involving 248 infants born at ≥37 weeks of gestation and their mothers, who were of Greek nationality. Both Roma and non-Roma participants received consistent, high-quality care from the same midwife researcher, who personally attended to them. All participants initiated breastfeeding immediately after their newborns’ births and practiced rooming-in by keeping their babies in the room with them during their hospital stay. Data were collected through questionnaires to determine the rates of exclusive breastfeeding among the two groups. Results: The study found that a smaller proportion of Roma mothers exclusively breastfed their infants compared to non-Roma mothers, despite receiving similar levels of support from healthcare professionals. Conclusions: The provision of midwifery support did not significantly enhance exclusive breastfeeding rates among Roma mothers. This suggests the need for more comprehensive and multi-faceted interventions. Further research is required to confirm these findings and to design effective programs aimed at increasing exclusive breastfeeding rates, thereby improving health outcomes for Roma children and mothers. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

15 pages, 2152 KiB

Open AccessArticle

Placebos in Healthcare: A Behavioral Study on How Treatment Responsiveness Affects Therapy Decisions in a Simulated Patient–Physician Interaction

by Alessandro Piedimonte, Valeria Volpino, Francesco Campaci, Francesca Borghesi, Giulia Guerra and Elisa Carlino

Clin. Pract. 2024, 14(5), 2151-2165; https://doi.org/10.3390/clinpract14050170 - 17 Oct 2024

Viewed by 1251

Abstract

Background and Purpose: Treatment choice during clinical practice is crucial to best help each patient. One of the physicians’ main goals is choosing a personalized effective treatment, but it also represents a challenging issue. Here, we explored different treatment choices in a simulated [...] Read more.

Background and Purpose: Treatment choice during clinical practice is crucial to best help each patient. One of the physicians’ main goals is choosing a personalized effective treatment, but it also represents a challenging issue. Here, we explored different treatment choices in a simulated patient–physician interaction. Materials and Methods: Medical students (n = 48) and young Practicing Physicians (n = 20) were recruited to behave as “physicians” while fellow researchers acted as “patients”. Participants were divided equally into a Belief Group, which received positive information about placebo efficacy, and a Non-Belief Group, which received negative information. Empathy traits and psychological variables were measured in both groups. During the task, participants were asked to choose between an active (TENS treatment) or a placebo treatment, to reduce patients’ pain. Patients never underwent the painful stimulation but acted as if they had, simulating high or low pain responses to the placebo treatment (placebo-responders/placebo non-responders) and low pain to the TENS treatment. Results: Behavioral results showed that the Belief Group gave significantly more placebo treatments when faced with a patient that simulated placebo responsiveness, while the Non-Belief group showed a mirrorlike behavior, administrating more believed TENS treatments when faced with a placebo non-responder. No differences were found between Medical Students and Practicing Physicians. Conclusions: This study constitutes a frame of reference for medical treatment decisions, indicating that physicians’ treatment choices are influenced by patients’ responsiveness to the treatments, as well as by their prior beliefs and empathy traits. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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10 pages, 221 KiB

Open AccessArticle

Urinary Incontinence and Quality of Life in Women of Central Jordan: A Cross-Sectional Study

by Rana Abu-Huwaij, Rolla Al-Shalabi, Enas Alkhader and Farah N. Almasri

Clin. Pract. 2024, 14(5), 1921-1930; https://doi.org/10.3390/clinpract14050152 - 20 Sep 2024

Viewed by 726

Abstract

Background: Considering the high prevalence of UI in the rural areas of Jordan and the limited clinical data on its occurrence in central Jordan, this study aims to investigate the prevalence, risk factors, and impact of urinary incontinence (UI) on the quality of [...] Read more.

Background: Considering the high prevalence of UI in the rural areas of Jordan and the limited clinical data on its occurrence in central Jordan, this study aims to investigate the prevalence, risk factors, and impact of urinary incontinence (UI) on the quality of life (QoL) of women in central Jordan. Method: This cross-sectional study was conducted from September to December 2022, using online the Incontinence Impact Questionnaire short form (IIQ-7) and Urogenital Distress Inventory short form (UDI-6). Participation was voluntary, and anonymous. Internal consistency was assessed using Cronbach’s α. Results: A total of 128 women participated in the study. More than half of the participants (54.33%, N = 69) experienced UI symptoms. Body mass index was the sole statistically significant factor linked to UI. Obese patients had the highest risk (OR 35, CI 95% 2.577–475.308, p < 0.05) compared to those with a healthy weight. Multivariate regression indicated significant associations of severe UI with smoking and vaginal births with a moderate impact of UI on QoL. Conclusions: The study’s findings emphasize the need for women’s health centers in the center of Jordan to develop comprehensive UI prevention and management programs to improve women’s health and well-being. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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12 pages, 1131 KiB

Open AccessArticle

Characteristics, Management, and Outcomes of Acute Life-Threatening Asthma in Adult Intensive Care

by Adam J. R. Watson, Thomas Roe, Oliver Arscott, Charlotte Thomas, James Ward, Ryan Beecham, David Browning, Kordo Saeed and Ahilanandan Dushianthan

Clin. Pract. 2024, 14(5), 1886-1897; https://doi.org/10.3390/clinpract14050149 - 12 Sep 2024

Viewed by 976

Abstract

Background: There is limited evidence regarding the management of acute life-threatening asthma in intensive care units (ICUs), and few guidelines have details on this. We aimed to describe the characteristics, management, and outcomes of adults with life-threatening asthma requiring ICU admission. Methods: In [...] Read more.

Background: There is limited evidence regarding the management of acute life-threatening asthma in intensive care units (ICUs), and few guidelines have details on this. We aimed to describe the characteristics, management, and outcomes of adults with life-threatening asthma requiring ICU admission. Methods: In this single-centre retrospective observational study, we included consecutive adults with acute asthma requiring ICU admission between 1 January 2016 and 31 December 2023. Our primary outcome was requirement for invasive mechanical ventilation (IMV). Results: We included 100 patients (median age 42.5 years, 67% female). The median pH, PaCO₂, and white cell count (WCC) on ICU admission were 7.37, 39 mmHg, and 13.6 × 109/L. There were 30 patients (30%) who required IMV, and the best predictors of IMV requirement were pH (AUC 0.772) and PaCO₂ (AUC 0.809). In univariate analysis, IMV requirement was associated with both increasing WCC (OR 1.14) and proven bacterial infection (OR 8.50). A variety of respiratory support strategies were utilised, with 38 patients (38%) receiving only non-invasive respiratory support. Conclusions: Our data highlight key characteristics which may be risk factors for acute asthma requiring ICU admission and suggest that pH, PaCO₂, and WCC are prognostic markers for disease severity. Our overall outcomes were good, with an IMV requirement of 30% and a 28-day mortality of 1%. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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10 pages, 526 KiB

Open AccessArticle

Individuals with Tinnitus Report More Positive Experiences following Internet-Based Cognitive Behavioral Therapy

by Vinaya Manchaiah, Eldré W. Beukes, Gerhard Andersson, Emily Bateman, De Wet Swanepoel, Kristin Uhler and Vinay

Clin. Pract. 2024, 14(4), 1615-1624; https://doi.org/10.3390/clinpract14040130 - 21 Aug 2024

Viewed by 975

Abstract

Background: This study aimed to examine whether individuals with chronic tinnitus report more positive experiences following internet-based cognitive behavioral therapy (CBT). Methods: A mixed-methods design was used, nested in clinical trials evaluating internet interventions for tinnitus. Participants (n = 164) completed online [...] Read more.

Background: This study aimed to examine whether individuals with chronic tinnitus report more positive experiences following internet-based cognitive behavioral therapy (CBT). Methods: A mixed-methods design was used, nested in clinical trials evaluating internet interventions for tinnitus. Participants (n = 164) completed online questionnaires (both structured and open-ended) providing demographic information as well as health variables (e.g., tinnitus distress, anxiety, depression, insomnia). An open-ended question listing positive effects or outcomes related to having tinnitus was also included. Responses to the open-ended questions were analyzed using qualitative content analysis. Results: Of the 164 eligible participants, 32.3% (n = 53) provided at least 1 positive experience both at pre- and post-intervention, with 9.1% (n = 19) providing positive experiences only at pre-intervention, 49 (29.9%) providing positive experiences only at post-intervention, and 28.7% (n = 47) of the participants did not provide any positive experiences on either measurement occasion. Significantly more positive experiences were reported following the intervention in the overall sample (p < 0.0001, paired sample t-test). In addition, participants who reported positive experiences in both pre- and post-intervention also reported more positive experiences following intervention (p = 0.008, paired sample t-test). Conclusions: Internet-based CBT can help individuals with tinnitus to think more positively by changing unhelpful thought patterns. Open-ended questions can supplement structured questionnaires to measure treatment outcomes. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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13 pages, 1231 KiB

Open AccessArticle

Global Trends in Kidney Stone Awareness: A Time Series Analysis from 2004–2023

by Noppawit Aiumtrakul, Charat Thongprayoon, Supawadee Suppadungsuk, Pajaree Krisanapan, Preyarat Pinthusopon, Michael A. Mao, Chinnawat Arayangkool, Kristine B. Vo, Chalothorn Wannaphut, Jing Miao and Wisit Cheungpasitporn

Clin. Pract. 2024, 14(3), 915-927; https://doi.org/10.3390/clinpract14030072 - 20 May 2024

Cited by 2 | Viewed by 2629

Abstract

Background: Despite the prevalence and incidence of kidney stones progressively increasing worldwide, public awareness of this condition remains unclear. Understanding trends of awareness can assist healthcare professionals and policymakers in planning and implementing targeted health interventions. This study investigated online search interest in [...] Read more.

Background: Despite the prevalence and incidence of kidney stones progressively increasing worldwide, public awareness of this condition remains unclear. Understanding trends of awareness can assist healthcare professionals and policymakers in planning and implementing targeted health interventions. This study investigated online search interest in “kidney stone” by analyzing Google Trends, focusing on stationarity of the trends and predicting future trends. Methods: We performed time series analysis on worldwide Google monthly search data from January 2004 to November 2023. The Augmented Dickey–Fuller (ADF) test was used to assess the stationarity of the data, with a p-value below 0.05 indicating stationarity. Time series forecasting was performed using the autoregressive integrated moving average to predict future trends. Results: The highest search interest for “kidney stone” (score 100) was in August 2022, while the lowest was in December 2007 (score 36). As of November 2023, search interest remained high, at 92. The ADF test was significant (p = 0.023), confirming data stationarity. The time series forecasting projected continued high public interest, likely reflecting ongoing concern and awareness. Notably, diverse regions such as Iran, the Philippines, Ecuador, the United States, and Nepal showed significant interest, suggesting widespread awareness of nephrolithiasis. Conclusion: This study highlighted that “kidney stone” is a consistently relevant health issue globally. The increase and stationarity of search trends, the forecasted sustained interest, and diverse regional interest emphasize the need for collaborative research and educational initiatives. This study’s analysis serves as a valuable tool for shaping future healthcare policies and research directions in addressing nephrolithiasis related health challenges. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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17 pages, 910 KiB

Open AccessArticle

The Correlation between Maternal and Neonatal Vit D (25(OH)D) Levels in Greece: A Cross-Sectional Study

by Artemisia Kokkinari, Maria Dagla, Evangelia Antoniou, Aikaterini Lykeridou, Giannoula Kyrkou, Kostas Bagianos and Georgios Iatrakis

Clin. Pract. 2024, 14(3), 749-764; https://doi.org/10.3390/clinpract14030060 - 26 Apr 2024

Viewed by 903

Abstract

Background: Few studies have correlated maternal and neonatal Vit D (25(OH)D) levels at birth in Greece. We investigated this potential association, taking into account the administration or not of low doses (400–800 IU) of prenatal Vit D supplements. Our study contributes evidence not [...] Read more.

Background: Few studies have correlated maternal and neonatal Vit D (25(OH)D) levels at birth in Greece. We investigated this potential association, taking into account the administration or not of low doses (400–800 IU) of prenatal Vit D supplements. Our study contributes evidence not only to the small amount of existing literature regarding the above correlation, but also to the topic of maternal and neonatal vitamin D deficiency (VDD) during pregnancy in Mediterranean countries, such as Greece. Methods: A cross-sectional study was conducted on 248 neonates and their mothers from September 2019 to January 2022. Blood samples of 25(OH)D were studied at the time of delivery. Frequency counts and percentages were registered, and logistic regression was used to investigate the independent factors associated with maternal Vit D status. The Chi-square test and the Pearson coefficient were used to demonstrate a possible association between maternal and neonatal 25(OH)D levels. Results: Our findings show a high prevalence of VDD in Greek women and their newborns at birth. This was observed not only in women who did not receive Vit D supplements, but also in all the study groups, especially in the autumn and winter months. We observed that mothers who received low doses (400–800 IU) of prenatal Vit D supplements increased both their own 25(OH)D concentrations and those of their newborns; however, the latter did not seem to be completely covered by the prenatal administration of Vit D because, although their 25(OH)D concentrations increased, they never reached sufficient 25(OH)D levels, unlike their mothers who reached sufficient concentrations. Conclusions: Overall, this study highlights the strong association between maternal and neonatal 25(OH)D concentrations at the end of gestation. However, neonates tended to show even lower 25(OH)D concentrations relative to maternal 25(OH)D concentrations. The same phenomenon was observed irrespective of the administration of Vit D supplements during pregnancy. Moreover, this is what was observed concerning the administration of formulations with 400–800 IU of Vit D, which the doctors in our clinic used in the present study. In any case, more clinical studies related to the administration of higher doses of Vit D supplementation to pregnant women would lead to more reliable conclusions. Without a doubt, the measurement of maternal vitamin D status during pregnancy provides opportunities for preventive and therapeutic interventions in the mother–infant pair. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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13 pages, 8122 KiB

Open AccessArticle

A Worldwide Bibliometric Analysis of Published Literature Assessing Fear of COVID-19

by Jesús Cebrino and Silvia Portero de la Cruz

Clin. Pract. 2024, 14(3), 672-684; https://doi.org/10.3390/clinpract14030054 - 23 Apr 2024

Cited by 1 | Viewed by 1083

Abstract

Many people experience intense fear of COVID-19. The purpose of this study was to provide a comprehensive visual overview of the published literature from 2020 to 2022 assessing fear of COVID-19. From 2020 to 2022, we employed the Scopus database to conduct a [...] Read more.

Many people experience intense fear of COVID-19. The purpose of this study was to provide a comprehensive visual overview of the published literature from 2020 to 2022 assessing fear of COVID-19. From 2020 to 2022, we employed the Scopus database to conduct a bibliometric analysis. We used the VOSviewer program to perform the author co-citation analysis, Mapchart to produce a worldwide map, and Wordart to make a word cloud image. From the 1769 records examined, 1654 (93.50%) were articles, with English being the most common language (96.31%). From 2020 to 2022, annual citations experienced significant growth (R² = 99.91%; p = 0.0195). The Institut National de la Santé et de la Recherche Médicale (INSERM, France) and China led in terms of publication output (n = 36; n = 255). M. D. Griffiths authored the highest number of articles (n = 21). The most active journal was the International Journal of Environmental Research and Public Health (n = 146), and the most prevalent keyword was “human/s” (11.51%). This bibliometric analysis evaluates the quality of the research on fear of the pandemic and the crisis management of COVID-19, which can provide managers and researchers with crucial insights for future decision making. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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Review

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11 pages, 271 KiB

Open AccessReview

Relationship Between Sleep Disturbances and Chronic Pain: A Narrative Review

by Sejal V. Jain, Geoffrey D. Panjeton and Yuri Chaves Martins

Clin. Pract. 2024, 14(6), 2650-2660; https://doi.org/10.3390/clinpract14060209 - 9 Dec 2024

Viewed by 503

Abstract

Sleep disturbances and chronic pain are prevalent and interrelated conditions that have significant impact on individuals’ quality of life. Understanding the intricate dynamics between sleep and pain is crucial for developing effective treatments that enhance the well-being of affected individuals and reduce the [...] Read more.

Sleep disturbances and chronic pain are prevalent and interrelated conditions that have significant impact on individuals’ quality of life. Understanding the intricate dynamics between sleep and pain is crucial for developing effective treatments that enhance the well-being of affected individuals and reduce the economic burden of these debilitating conditions. This narrative review examines the complex relationship between sleep disturbances and chronic pain. We describe the prevalence and types of sleep disturbances and sleep disorders in chronic pain patients. Posteriorly, we critically review the clinical and experimental evidence, investigating the relationship between sleep disturbances and chronic pain, aiming to clarify the impact of chronic pain on sleep and, conversely, the impact of sleep disturbances on pain perception. In conclusion, the literature largely agrees on the existence of a bidirectional relationship between chronic pain and sleep disturbances, though the strength of each direction in this association remains uncertain. Current evidence suggests that sleep impairment more strongly predicts pain than pain does sleep impairment. Additionally, addressing sleep disturbances in chronic pain patients is crucial, as poor sleep has been linked to higher levels of disability, depression, and pain-related catastrophizing. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

11 pages, 812 KiB

Open AccessReview

Key Considerations for Frail Patients Undergoing Hip Fracture Surgery

by Ana-Maria Dumitriu, Rǎzvan Ene and Liliana Mirea

Clin. Pract. 2024, 14(6), 2256-2266; https://doi.org/10.3390/clinpract14060177 - 23 Oct 2024

Viewed by 742

Abstract

Improving preoperative care for elderly patients with hip fractures is crucial for achieving the best outcomes. A multidisciplinary team that can improve overall care quality by addressing patient’s medical conditions, analgesia, timely surgery, and early postoperative mobilization is required. This narrative review provides [...] Read more.

Improving preoperative care for elderly patients with hip fractures is crucial for achieving the best outcomes. A multidisciplinary team that can improve overall care quality by addressing patient’s medical conditions, analgesia, timely surgery, and early postoperative mobilization is required. This narrative review provides insights regarding the extent of preoperative optimization needed for hip fracture surgery. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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17 pages, 4472 KiB

Open AccessReview

The Effect of Isotretinoin on Insulin Resistance and Serum Adiponectin Levels in Acne Vulgaris Patients: A Systematic Review and Meta-Analysis

by Eleni Paschalidou, Georgios Katsaras, Thomas Papoulakis, Evangelia Kalloniati, Dimitrios Kavvadas, Sofia Karachrysafi, Dorothea Kapoukranidou, Georgios Tagarakis and Theodora Papamitsou

Clin. Pract. 2024, 14(3), 1021-1037; https://doi.org/10.3390/clinpract14030081 - 31 May 2024

Viewed by 1411

Abstract

Background: Isotretinoin is the drug of choice for severe acne. We sought to examine the potential link between isotretinoin and insulin resistance. Methods: We conducted a systematic review and meta-analysis in accordance with the PRISMA statement. A comprehensive search of the PubMed/MEDLINE, SCOPUS, [...] Read more.

Background: Isotretinoin is the drug of choice for severe acne. We sought to examine the potential link between isotretinoin and insulin resistance. Methods: We conducted a systematic review and meta-analysis in accordance with the PRISMA statement. A comprehensive search of the PubMed/MEDLINE, SCOPUS, and Cochrane databases was performed until 12 January 2022 utilizing the PICO (Patient, Intervention, Comparison, Outcome) tool. Fifteen English-language studies focusing on isotretinoin-treated acne patients were included. Serum levels of insulin, glucose, and adiponectin were evaluated before and after treatment, and insulin sensitivity was assessed using the HOMA–IR. A meta-analysis was conducted using RevMan 5.4.1 software, and a quality assessment was undertaken using the ROBINS-I tool. Results: The meta-analysis unveiled a statistically significant rise in the post-treatment levels of adiponectin, an anti-inflammatory agent, which inhibits liver glucose production while enhancing insulin sensitivity (SMD = 0.86; 95% confidence interval (95% CI) = 0.48–1.25, p-value < 0.0001; I² = 58%). Our subgroup analysis based on study type yielded consistent findings. However, no statistically significant outcomes were observed for insulin, glucose levels, and the HOMA-IR. Conclusions: There is not a clear association between isotretinoin and insulin resistance, but it appears to enhance the serum levels of adiponectin, which participates in glucose metabolism. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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8 pages, 547 KiB

Open AccessReview

Concomitant Panniculectomy in Abdominal Wall Reconstruction: A Narrative Review Focusing on Obese Patients

by Salvatore Giordano, Andre’ Salval and Carlo Maria Oranges

Clin. Pract. 2024, 14(2), 653-660; https://doi.org/10.3390/clinpract14020052 - 22 Apr 2024

Viewed by 1491

Abstract

The global prevalence of obesity continues to rise, contributing to an increased frequency of abdominal wall reconstruction procedures, particularly ventral hernia repairs, in individuals with elevated body mass indexes. Undertaking these operations in obese patients poses inherent challenges. This review focuses on the [...] Read more.

The global prevalence of obesity continues to rise, contributing to an increased frequency of abdominal wall reconstruction procedures, particularly ventral hernia repairs, in individuals with elevated body mass indexes. Undertaking these operations in obese patients poses inherent challenges. This review focuses on the current literature in this area, with special attention to the impact of concomitant panniculectomy. Obese individuals undergoing abdominal wall reconstruction face elevated rates of wound healing complications and hernia recurrence. The inclusion of concurrent panniculectomy heightens the risk of surgical site occurrences but does not significantly influence hernia recurrence rates. While this combined approach can be executed in obese patients, caution is warranted, due to the higher risk of complications. Physicians should carefully balance and communicate the potential risks, especially regarding the increased likelihood of wound healing complications. Acknowledging these factors is crucial in shared decision making and ensuring optimal patient outcomes in the context of abdominal wall reconstruction and related procedures in the obese population. Full article

(This article belongs to the Special Issue 2024 Feature Papers in Clinics and Practice)

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