Journal of Clinical Medicine

Background: Coronary heart disease (CHD) remains the most prevalent pathology within the circulatory system. Among its chronic complications, ischemic mitral valve regurgitation (IMR) is observed in approximately 15% of patients with sustained myocardial ischemia. The presence of this complex valvular defect significantly increases both overall mortality and the incidence of adverse cardiovascular events. Notably, the presence of moderate to severe mitral regurgitation in patients undergoing surgical revascularization has been shown to double the risk of death. Despite the well-established etiology of IMR, data regarding the efficacy of surgical interventions and the determinants of postoperative outcomes remain inconclusive. Methods: The objective of the present study was to evaluate both early and long-term outcomes of surgical treatment of mitral regurgitation in patients undergoing coronary artery bypass grafting (CABG) due to ischemic heart disease. Particular attention was given to the influence of the severity of regurgitation, left ventricular ejection fraction (LVEF), and the dimensions of the left atrium (LA) and left ventricle (LV) on the postoperative prognosis. An additional aim was to identify preoperative risk factors associated with increased postoperative mortality and morbidity. A retrospective analysis was conducted on 421 patients diagnosed with ischemic mitral regurgitation who underwent concomitant mitral valve surgery and CABG. Exclusion criteria included emergent and urgent procedures as well as non-ischemic etiologies of mitral valve dysfunction. Results: The study cohort comprised 34.9% women and 65.1% men, with the mean age of 65.7 years (±7.57). A substantial proportion (76.7%) of patients were aged over 60 years. More than half (51.5%) presented with severe heart failure symptoms, classified as NYHA class III or IV, while over 70% were categorized as CCS class II or III. Among the surgical procedures performed, 344 patients underwent mitral valve repair, and 77 patients required mitral valve replacement. Additionally, 119 individuals underwent concomitant tricuspid valve repair. Short-term survival was significantly affected by the presence of hypertension, prior cerebrovascular events, and chronic kidney disease. In contrast, hypertension and chronic obstructive pulmonary disease were identified as significant predictors of adverse late-term outcomes. Conclusions: Interestingly, neither the preoperative severity of mitral regurgitation nor the echocardiographic measurements of LA and LV dimensions were found to significantly influence surgical outcomes. The perioperative risk, as assessed by the EuroSCORE II (average score: 10.0%), corresponded closely with observed mortality rates following mitral valve repair (9.9%) and replacement (10.4%). Notably, the need for concomitant tricuspid valve surgery was associated with an elevated mortality rate (12.4%). Furthermore, the preoperative echocardiographic evaluation of LA regurgitation severity, as well as LA and LV dimensions, did not exhibit a statistically significant impact on either early or long-term surgical outcomes. However, a reduced LVEF was correlated with increased long-term mortality. The presence of advanced clinical symptoms and the necessity for tricuspid valve repair were independently associated with a poorer late-term prognosis. Importantly, the annual mortality rate observed in the late-term follow-up of patients who underwent surgical treatment of ischemic mitral regurgitation was lower than rates reported in the literature for patients managed conservatively. The EuroSCORE II scale proved to be a reliable and precise tool in predicting surgical risk and outcomes in this patient population. Full article

Objective: To evaluate the role of nurses in self-management interventions for chronic inflammatory arthritis (CIA). Key areas of interest included the following: (1) providing education on self-injection techniques for biologic disease-modifying antirheumatic drugs (bDMARDs), (2) promoting healthy lifestyles, and (3) supporting mental health. Patients’ satisfaction with the care received was also examined. Methods: A cross-sectional study involving CIA patients, rheumatologists, and nurses was conducted. Participants assessed nurses’ competence in areas such as training for bDMARD self-injection, lifestyle guidance, and emotional support. Satisfaction scores and preferences in managing side effects were also analyzed. Results: The participants expressed high confidence in the nurses’ ability to support CIA self-management. The patients rated the nurses significantly higher than doctors in training for self-injection (p = 0.002) and offering guidance on nutrition and healthy habits (p = 0.002). Although it was not a statistically significant difference, the patients also showed stronger trust in the nurses’ ability to provide psychological and emotional support. Most patients (93.0%) would contact a rheumatologist in case of side effects; 35.5% would seek a nurse. The patients attended by both a doctor and nurse reported significantly higher satisfaction compared to those seen only by a rheumatologist (p < 0.001). Both the doctors and nurses acknowledged the importance of the nurse–patient relationship for effective care (p = 0.527). Conclusions: The findings highlight the critical role of nurses in patient education—particularly in training for self-injection and promoting a healthy lifestyle and mental well-being. Their involvement is strongly associated with higher patient satisfaction and contributes significantly to the overall effectiveness of care in CIA management. Full article

Objectives: This review aims to systematically evaluate the clinical outcomes of left ventricle-only fusion pacing (LV-only fCRTp) and identify evidence-based selection criteria that may optimize patient response and long-term therapeutic benefit. Background: Cardiac resynchronization therapy (CRT) is traditionally associated with biventricular pacing (BiVp). However, approximately 20–40% of patients seem to remain non-responders to this therapy. LV-only fCRTp offers a more physiological alternative by combining left ventricular epicardial pacing with the intrinsic ventricular activation wavefront. Beyond optimization strategies, the observed variability in response highlights the need for better patient selection in order to fully unlock its therapeutic potential. Methods: A systematic literature search was conducted in PubMed and Cochrane Library for original articles published up to April 2025, following PRISMA 2020 guidelines. The search focused on LV-only fCRTp performed either through standard RA/LV/RV biventricular devices or RA/LV dual-chamber systems. Results: Twenty-seven studies met the inclusion criteria. Among these, 17 studies obtained LV-only fCRTp using biventricular devices, and 10 were considered true LV-only fCRTp using RA/LV dual-chamber devices. Standard and specific selection criteria were used to qualify patients for LV-only fCRTp. Preserved atrioventricular conduction, ischemic cardiomyopathy, arrhythmic risk stratification, and the management of supraventricular arrhythmias were common overlapping parameters among studies with high variability, highlighting their potential role in response. RA/LV devices yielded consistent clinical benefits and low complication rates, particularly in nonischemic patients with stable AV conduction and low arrhythmic risk, while having a lower financial burden. Conclusions: Beyond guideline recommendations for CRT, this review identifies supplementary selection criteria that could further influence the effectiveness and stability of fusion pacing. Full article

Background: Surgical care in conflict regions like Tigray, Ethiopia, faces severe challenges due to limited resources, infrastructural deficiencies, and high trauma burden. From 2019 to 2023, a multidisciplinary team conducted five humanitarian missions focusing on orthoplastic reconstruction of extremity and mandibular injuries from high-energy gunshot trauma. Methods: A retrospective analysis was performed on 98 patients who underwent free or pedicled flap reconstruction. Data included demographics, flap type, technique, complications, follow-up, and early clinical outcomes score as well as mobility scores. Flaps were harvested using loupes anastomosis performed using microscopes, depending on availability. Results: Among 98 patients (25.5% female, 74.5% male), 69 free flaps and 38 pedicled flaps were performed. Free fibula flaps (n = 54) included 33 mandibular and 21 extremity reconstructions. Additional flaps included ALT, gracilis, and LD flaps. Pedicled flaps included 18 fibula and 20 ALT/LD flaps. Mean age was 35.5 years; mean operative time was 429.5 min, with mandibular fibula transfers being longest. Microsurgical techniques were used in 34% of cases. Median follow-up was 10 months. Microsurgical complications occurred in 18.4%, mainly in fibula transfers (25.9%). Non-microsurgical issues included wound infections (n = 15), graft loss (n = 3), and bleeding (n = 5). Flap loss occurred in 16.3% overall. Early clinical outcome results were good (30.6%), acceptable (28.6%), and moderate (24.5%). Conclusions: Orthoplastic reconstruction using both free and pedicled flaps is feasible in low-resource, conflict settings. Despite infrastructural challenges, functional outcomes were achievable, supporting the value of adaptable microsurgical strategies in humanitarian surgery. Full article

Background: Cardiac arrest remains a significant public health challenge with variable mortality trends across different demographics and regions, affecting healthcare planning and intervention strategies. We conducted this study to analyze cardiac arrest-related mortality trends from 1999 to 2023 and predict future trends up to 2035. Methods: This study analyzed data from 1999 to 2023, focusing on cardiac arrest as the primary cause of death (ICD-10: I46). Age-adjusted mortality rates (AAMRs) were standardized according to the 2000 U.S. Census. Joinpoint regression was utilized to calculate annual percentage change (APC), and an ARIMA model with Python 3.10 was used for mortality predictions. Results: A total of 365,608 cardiac arrest-related deaths were recorded in the USA from 1999 to 2023. There was a sharp decline in mortality rate until 2001 (APC: −10.35, p < 0.05), followed by a slowed decline until 2013 (APC: −2.91, p < 0.05), and then a gradual uptrend. Males exhibited a higher AAMR (5.8, 95% CI: 5.8–5.9) compared to females (4.2, 95% CI: 4.1–4.2). African Americans had the highest AAMR (8.9, 95% CI: 8.9–9), followed by Caucasians (4.8, 95% CI: 4.8–4.9) and American Indians (3.5, 95% CI: 3.3–3.7). The South region of the US had the highest AAMR, followed by the Northeast, Midwest, and West. Alabama exhibited the highest AAMR, followed by Nevada and Hawaii. Predictive analysis suggests a potential stable slow downtrend in mortality rates by 2035 (AAMR: 4.28, 95% CI: −1.8–10.4). Conclusions: The observed trends and future predictions underscore the importance of targeted public health interventions and healthcare planning to address cardiac arrest mortality. Full article

Background: Keratorefractive Lenticule Extraction (KLEx) is an emerging flap-free surgical technique for the correction of myopic astigmatism. However, postoperative astigmatic accuracy remains variable. This study aimed to identify clinical and surgical factors that influence the outcomes of astigmatic correction following KLEx. Methods: A total of 98 patients with myopic astigmatism underwent KLEx. Manifest refraction was evaluated at three months postoperatively. Astigmatic outcomes were assessed using Alpins vector analysis. Multivariate linear and logistic regression models were used to determine associations between preoperative and intraoperative variables—such as age, eye laterality, tear film quality, sphere-to-cylinder ratio, and preoperative cylinder—and astigmatic correction parameters, including residual cylinder, correction index, magnitude of error, and angle of error. Results: Older age was associated with larger residual cylinder and angle of error. Eye laterality and tear film quality significantly influenced correction accuracy. A higher sphere-to-cylinder ratio and preoperative cylinder were also predictive of astigmatic correction performance. Conclusions: The accuracy of astigmatic correction in KLEx is significantly influenced by multiple clinical and surgical factors. Awareness of these predictors may guide surgical planning and improve refractive outcomes. Full article

Background: Endometriosis is a complex, estrogen-dependent condition that can significantly impact women’s quality of life and fertility. Current diagnostic strategies remain invasive and often prolonged, demonstrating the need for reliable, non-invasive biomarkers. In this context, microRNAs (miRNAs), due to their stability in blood and regulatory roles in inflammation and cell proliferation, have emerged as promising candidates. Methods: This review systematically analyzes 17 studies published between 2010 and 2025 that investigated the diagnostic utility of circulating and tissue-based miRNAs in endometriosis. Results: A wide range of dysregulated miRNAs was identified, with miR-125b-5p, miR-451a, and miR-3613-5p showing the most consistent alterations across studies. However, diagnostic performance varied considerably—largely due to methodological heterogeneity. Key differences were observed in sample type (serum, plasma, endometrium), patient selection, and control group definition. The menstrual cycle phase and hormonal status were often not matched or reported, limiting reproducibility. Conclusions: Despite encouraging findings, the current evidence base is weakened by inconsistent protocols and limited validation. Standardized, multicenter research with well-characterized patient cohorts is essential to the establishment of clinically applicable miRNA-based diagnostics. If validated, miRNAs may offer a transformative, non-invasive approach for earlier detection and improved management of endometriosis. Full article

Background: A gluten-free diet (GFD) has been shown to be nutritionally inadequate for those with wheat-related disorders. However, the differences in findings and the absence of quantitative analysis limits the interpretation of previous reviews. Objectives: We conducted a systematic review and meta-analysis to identify the risk of micronutrient deficiencies in patients with celiac disease (CeD) and non-celiac gluten or wheat sensitivity (NCWS). Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Web of Science (Ovid) databases. The risk of bias was determined using the ROBINS-1, and the quality of evidence was assessed using the GRADE approach. Results We identified 7940 studies; 46 observational studies (11 cohort, 9 cross-sectional, and 26 case–control) were eligible for analysis. CeD patients had an increased risk of vitamin D and E deficiencies compared with the non-CeD controls. CeD on a GFD had a decreased risk of vitamin D, B12, E, calcium, and iron deficiencies compared with untreated CeD. NCWS had an increased risk of vitamin B12, folate, and iron deficiency compared to the controls. The overall quality of evidence was rated very low. Conclusions: The risk of various micronutrient deficiencies is increased in CeD but is decreased for some after a GFD. Adequately powered studies with a rigorous methodology are needed to inform the risk of nutrient deficiencies in patients with CeD and NCWS. Protocol registration: Prospero-CRD42022313508. Full article

Background/Objectives: Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may report abnormalities in voice and speech; however, no formal research has been conducted in this area. Methods: An online mixed-methods survey was completed by 685 people with ME/CFS. A total of 302 respondents completed the qualitative component (44.09%). Questions assessed disease experience with ME/CFS and post-exertional malaise without prompting on specific symptoms. Within the qualitative results, a search of the terms “speech, voice,” “words,” and “speak” was conducted. Results: Excluding neurocognitive associations, colloquial phrases, and “speech therapy,” there were 38 mentions of the terms in the context of voice or speech changes across 28 unique qualitative survey responses (9.27%). Conclusions: A notable portion of respondents reported voice or speech changes when responding to open-ended qualitative questions about their disease experience. More research is needed regarding the implications of voice and speech anomalies in ME/CFS pathology and disease monitoring. Full article

Objectives: The aim of this study was to validate the Polish version of the Somatosensory Amplification Scale (SSAS-PL) and examine its psychometric properties in clinical and non-clinical samples. Methods: The study included 1128 participants (711 healthy adults, 194 cardiac patients, 223 psychiatric patients). The analyses were categorized into exploratory and confirmatory phases. Exploratory analyses were conducted on a randomly selected sample that comprised 60% of the study participants (training sample) to estimate the reliability (Cronbach’s alpha) and factorial validity (EFA with varimax rotation). Confirmatory analyses were performed on an independent (test) sample that represented 40% of the total sample size to facilitate the cross-validation of the factor structure (CFA) and to assess the convergent and discriminant validities (using the HTMT method) in relation to health anxiety (SHAI) and psychopathological symptoms (KOFF-58). Additionally, measurement invariance was examined with respect to gender (female vs. male) and health status (healthy vs. clinical). Results: The SSAS-PL demonstrated good internal consistency (α = 0.75–0.78) after removing item 1. A one-factor structure showed the best fit and theoretical interpretability. The measurement invariance was supported across clinical groups. The SSAS-PL showed convergent validity with the measures of somatic symptoms, anxiety, and health anxiety. It demonstrated discriminant validity from other psychopathology measures. Conclusions: The SSAS-PL was a reliable and valid measure of somatosensory amplification in the Polish population. Its unidimensional structure aligned with most cross-cultural adaptations. The scale may be useful for assessing somatosensory amplification in both research and clinical settings in Poland. Further research on its utility in specific clinical populations is warranted. Full article

Background/Objectives: Low-density lipoprotein cholesterol (LDL-C) is a causal factor in the development of atherosclerosis and a predictor of cardiovascular disease. However, the association between LDL-C levels and cardiovascular outcomes in patients undergoing dialysis remains controversial, with current guidelines advising against initiating statin therapy in this population. This study investigated the relationship between LDL-C levels and cardiovascular outcomes in Korean adults undergoing dialysis, using nationwide data. Methods: A total of 21,692 patients with end-stage kidney disease undergoing dialysis between 2009 and 2017 were identified from the Korean National Health Insurance Service database. Statin non-users (primary cohort) and users (secondary cohort) comprised 15,414 and 6278 patients, respectively. LDL-C levels were categorized, and cardiovascular outcomes including composites of cardiovascular death, myocardial infarction, and ischemic stroke were analyzed. Results: Among statin non-users, LDL-C levels > 100 mg/dL were significantly associated with an increased risk of the composite outcome, in a dose-dependent manner, compared with LDL-C levels < 70 mg/dL. Specifically, participants with LDL-C levels ≥ 160 mg/dL demonstrated a 43% increased risk of the composite outcome and a 2.25-fold higher risk of myocardial infarction compared to those with LDL-C levels < 70 mg/dL. Among statin users, LDL-C levels > 130 mg/dL were associated with an increased risk of the composite outcome. Conclusions: This study highlights the significant association between elevated LDL-C levels and adverse cardiovascular outcomes in patients undergoing dialysis. These findings underscore the importance of close monitoring and proactive management of LDL-C levels in this high-risk population. Future research should focus on developing tailored lipid-lowering strategies to improve cardiovascular outcomes in these patients. Full article

Background/Objectives: Skin adnexal tumors (SATs) are rare neoplasms originating from sebaceous glands, hair follicles, and sweat glands, often presenting diagnostic challenges due to their histopathological diversity and clinical resemblance to other lesions. This epidemiological and clinicopathological study aimed to evaluate SATs diagnosed between January 2018 and October 2024 across two medical centers in Turkey. Methods: A total of 652 cases were analyzed based on demographic features, tumor size, anatomical localization, and histological subtypes per the 2018 WHO classification. The study also explored the predictors of malignancy, including tumor size and multifocality. Results: Among the cases, 98% were benign and 2% malignant. Sebaceous tumors were the most common (34.5%), followed by eccrine/apocrine (34.2%) and follicular tumors (31.3%). Benign tumors showed a slight female predominance (56.6%), while malignant tumors were more frequent in males (61.5%). The majority of tumors were located in the head and neck region (84.6%), and a tumor size >20 mm was significantly associated with malignancy. Conclusions: This study, one of the largest series from Turkey, highlights the importance of clinicopathological correlation in SATs. It contributes to the literature by identifying size-based cut-off values for malignancy prediction and by assessing interobserver agreement, multifocality, and tumor subtype distribution. Full article

Background/Objectives: In recent years, scientific literature has illustrated the growing interest in telerehabilitation after ACL reconstruction. The aim of this study is to compare the effectiveness of remotely supervised rehabilitation with traditional supervised rehabilitation after ACLR, focusing on objective postoperative functional assessment outcomes. Methods: A retrospective analysis of prospectively collected data was carried out, selecting patients that underwent arthroscopic ACLR by a single surgeon. Functional assessments of the patients were carried out at 1 and 2 weeks and 1, 2 and 3 months after surgery, including range of motion (ROM), maximal voluntary isometric contractions (MVICs) of extensor and flexor muscles, the sit-to-stand test and the countermovement jump. Intergroup statistics were carried out using a non-inferiority hypothesis. Results: A total of 251 patients were included in this study (supervised rehabilitation n = 165; remotely supervised rehabilitation n = 86). Functional assessment improved over time in both groups. The extension ROM deficit decreased to 0 difference 30 days after surgery. The median flexion ROM ILD at 60 days was significantly different among the groups, with a residual 10° ILD in the Group R compared with 0° ILD in group S (p = 0.01). All other assessments did not achieve statistical significance. Conclusions: The results support the integration of a digital rehabilitation tool in post-ACLR recovery programs. The results suggest that remotely supervised rehabilitation can be a viable alternative to traditional supervised rehabilitation for early-stage recovery. However, more research is needed to optimize protocols and to identify patients who may benefit most from this approach. Full article

Background/Objectives: Air embolism on contrast-enhanced computed tomography (CECT) scans may have significant consequences, particularly if a right-to-left shunt is present, as seen in hereditary hemorrhagic telangiectasia. We sought to evaluate the frequency of CECT-associated air emboli in a single tertiary care referral center. Methods: Consecutive non-enhanced and contrast-enhanced cardiac CT studies (NECCT and CECCT, respectively) were evaluated prospectively over a 6-month period. Following the University of Alberta’s Health Research Ethics Board approval (code: Pro00042313; date: 1 May 2014), two experts reviewed all studies independently to assess for the presence and location of air emboli. The control group consisted of only NECCTs. All patients, except for the control group in this study, had an IV cannula placed. When present, the number, volume, and location of air emboli were recorded. Results: In this study, 110 subjects underwent intravenous cannula placement and both NECCT and CECCT. Of these, 27 of the NECCT studies (24.5%) and 36 of the CECCT studies (32.7%) demonstrated intravascular air emboli. Of those with air emboli, the average volume of intravascular gas was 19.22 ± 25.35 µL in the NECCT studies, with most of the intravascular air (70.4%) seen in the right atrial appendage (RAA). The average volume of intravascular air was 14.81 ± 26.54 µL in the CECCT studies, with most of the intravascular air also located within the RAA (72.2%). The incidence of intravascular air was higher in the CECCT group (28.6% increase), with lower volumes of intravascular air. None of the subjects in the control group (n = 28), who underwent NECCT without intravenous cannulation, demonstrated air emboli. Conclusions: Air emboli were present in a significant proportion of subjects undergoing intravenous cannulation and subsequent CECT. The use of CECT should be carefully considered in high-risk populations. Full article

In 2023, the VAS international working group on Buerger’s Disease (BD) recommended two diagnostic criteria based on a prior Delphi study: “definitive” and “suspected”. The “definitive” criteria are history of smoking, typical angiography, and typical histopathological features. All three features are mandatory to confirm a “definitive” diagnosis of BD. The conundrum is—what features should be considered typical of BD angiography? According to this review, segmental occlusion of infrapopliteal arteries, corkscrew collaterals that appear to continue the occluded arterial segment (Martorell’s sign) or bypass the segmental occlusion, absence of atherosclerotic plaque or aneurysm could differentiate BD from ASO. Hence, for “typical” BD angiography, these manifestations should certainly be considered. However, data for differentiating angiography patterns of BD from the small- and medium-sized vasculitis including Behcet’s disease, scleroderma, hepatitis associated vasculitis, and anti-phospholipid syndrome are limited. Further studies for investigating the angiography pattern in BD patients in early and late presentation of BD, particularly in the patients with long-term follow up, are highly recommended. Full article

Background/Objectives: Frailty is a key determinant of outcomes in older adults with heart failure (HF). The free triiodothyronine/free thyroxine (FT₃/FT₄) ratio has emerged as a promising frailty biomarker that reflects metabolic and systemic resilience. This study investigates its association with frailty, nutrition, muscle strength, inflammation, and one-year mortality in very old patients with HF. Methods: In this longitudinal, single-center study, we enrolled 193 older outpatients (mean age, 86.5 ± 6.1 years; 56% women) recently discharged after acute HF. All patients underwent physical examination, blood testing, and comprehensive geriatric assessment, including handgrip strength (HGS). Participants were stratified by FT₃/FT₄ ratio (<1.7 vs. ≥1.7). Associations with the Clinical Frailty Scale (CFS) were examined using multivariable linear regression. Spearman’s correlations assessed relationships with inflammatory and nutritional biomarkers. Cox regression evaluated the association with all-cause mortality. Results: Patients with a low FT₃/FT₄ ratio (31.1%) exhibited greater frailty (CFS: median [IQR], 6 [2] vs. 4 [3]; p = 0.020), poorer nutritional status (Mini Nutritional Assessment: 10 [4] vs. 12 [3]; p = 0.008), and lower HGS (mean ± SD, 16.8 ± 3.7 kg vs. 20.3 ± 4.8 kg; p = 0.002). An inverse association was identified between the FT₃/FT₄ ratio and frailty (adjusted β = −0.09; p = 0.019). Individuals with low FT₃/FT₄ also showed elevated inflammatory markers and had more than double the one-year mortality rate compared to those with higher ratios [HR 2.32 (95% CI, 1.24–4.34; p = 0.007)]. Conclusions: In very old adults recently hospitalized for HF, a lower FT₃/FT₄ ratio was associated with frailty, malnutrition, inflammation, and increased mortality, supporting its potential role as a marker of biological vulnerability. Full article

Introduction: Urinary incontinence (UI) is associated with uncontrolled urine leakage and is treated as a serious disability that prevents the fulfillment of life roles and negatively affects quality of life. Many women do not have knowledge about the nature of UI and treatment options, and the embarrassing nature of the disease makes it difficult to seek specialist care. The aim of this study was to assess quality of life among women with UI and how it affects various areas of their daily functioning. Defining factors that modify the impact of UI on quality of life can provide prognostic information about functional limitations, which will facilitate the rapid implementation of preventive and therapeutic measures. Methods: This study included 158 women with UI. Patients were asked to complete a set of questionnaires, including the Questionnaire for Urinary Incontinence Diagnosis (QUID), Revised Urinary Incontinence Scale (RUIS), King’s Health Questionnaire (KHQ), Acceptance of Illness Scale (AIS), Inventory for Measuring Coping with Stress (Mini-COPY), and Set of Scales for Self-Assessment of the relationship with a partner. Results: Based on the analyses, it was determined that women with MUI experienced a lower quality of life, greater limitations in daily activities, and greater physical limitations compared to women with UUI and SUI. There was a correlation between the severity of UI, the duration of the disease, the level of acceptance of the disease, the education level of the subjects, and quality of life in all areas of functioning. Conclusions: Numerous functional limitations and reduced quality of life have been observed among patients with UI. As part of UI management in clinical practice, it seems reasonable to include measures aimed at identifying patients who are likely to experience more severe consequences of UI so that they can receive targeted care. Full article

Background: Pneumothorax (PTX) is the most common complication of CT-guided lung biopsies. New technical advances, namely the optimization of needle approach angles within an a priori defined “safe zone,” are intended to reduce this risk. This study evaluates whether PTX incidence and chest tube placement decreased significantly after these technical advances were implemented. Methods: We retrospectively analyzed 118 consecutive patients who had undergone CT-guided lung biopsy between 9 January 2020, and 4 April 2025. The study was divided into three periods of increasingly growing institutional procedural experience: Pre-Knowledge (January 2020–March 2022; n = 45), Partial Knowledge (April–December 2022; n = 18), and Full Knowledge (January 2023–April 2025; n = 55). PTX incidence and chest tube use were compared across periods using chi-square and Fisher’s exact tests, while Kaplan–Meier survival analysis was used to evaluate PTX-free survival over time. Results: Overall PTX incidence significantly declined from 71.1% in the Pre-Knowledge Period to 21.8% in the Full Knowledge Period (p < 0.000001). Rates of chest tube placements also decreased from 17.8% to 9.1%, although this difference was not statistically significant (p = 0.372). Kaplan–Meier analysis showed a statistically significant improvement in PTX-free survival over time (indicating improvement in the timing of complication onset; p = 0.0042). Procedural optimization was also fostered by a large median intrapulmonary needle length and consistent needle angulation within the safe zone. Conclusions: Formal implementation of needle angle optimization and procedural protocol standardization has effectively reduced the frequency and severity of PTX following CT-guided lung biopsies. These results highlight the benefit of continuous education and technique standardization in improving patient safety and clinical outcomes. Full article

Background/Objectives: Digital prosthodontics increasingly utilize both additive (3D printing) and subtractive Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), yet comprehensive comparisons remain limited. This scoping review evaluates their relative performance across prosthodontic applications. Methods: Systematic searches (PubMed, Scopus, Web of Science, Embase, 2015–2025) identified 28 studies (27 in vitro, 1 retrospective). Data were extracted on accuracy, efficiency, materials, and outcomes. Results: CAD/CAM milling demonstrated superior accuracy for fixed prostheses, with marginal gaps for milled zirconia (123.89 ± 56.89 µm), comparable to optimized 3D-printed interim crowns (123.87 ± 67.42 µm, p = 0.760). For removable prostheses, milled denture bases achieved a trueness of 65 ± 6 µm, while SLA-printed dentures post-processed at 40 °C for 30 min showed the lowest root mean square error (RMSE) (30 min/40 °C group). Three-dimensional printing excelled in material efficiency (<5% waste vs. milling > 30–40%) and complex geometries, such as hollow-pontic fixed dental prostheses (FDPs) (2.0 mm wall thickness reduced gaps by 33%). Build orientation (45° for crowns, 30–45° for veneers) and post-processing protocols significantly influenced accuracy. Milled resins exhibited superior color stability (ΔE00: 1.2 ± 0.3 vs. 3D-printed: 4.5 ± 1.1, p < 0.05), while 3D-printed Co-Cr frameworks (SLM) showed marginal fits of 8.4 ± 3.2 µm, surpassing milling (130.3 ± 13.8 µm). Digital workflows reduced chairside time by 29% (154.31 ± 13.19 min vs. 218.00 ± 20.75 min). All methods met clinical thresholds (<120 µm gaps). Conclusions: Milling remains preferred for high-precision fixed prostheses, while 3D printing offers advantages in material efficiency, complex designs, and removable applications. Critical gaps include long-term clinical data and standardized protocols. Future research should prioritize hybrid workflows, advanced materials, and AI-driven optimization to bridge technical and clinical gaps. Full article