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Search Results (755)

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Keywords = VAS (visual analog scale) scale

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10 pages, 1375 KiB  
Review
Effects of Photobiomodulation Therapy (PBMT) in the Management of Postoperative Pain After Third Lower Molar Extraction: A Narrative Review
by Leopoldo Mauriello, Alessandro Cuozzo, Vitolante Pezzella, Vincenzo Iorio-Siciliano, Gaetano Isola, Gianrico Spagnuolo, Luca Ramaglia and Andrea Blasi
J. Clin. Med. 2025, 14(15), 5210; https://doi.org/10.3390/jcm14155210 - 23 Jul 2025
Abstract
Background: Third lower molar (TLM) extraction is one of the most common oral surgical procedures, often accompanied by postoperative pain and inflammation. In order to treat postoperative pain, different methods are used, mainly based on painkillers. PBMT may represent an adjunct to pain [...] Read more.
Background: Third lower molar (TLM) extraction is one of the most common oral surgical procedures, often accompanied by postoperative pain and inflammation. In order to treat postoperative pain, different methods are used, mainly based on painkillers. PBMT may represent an adjunct to pain management. Objective: This narrative review aims to evaluate the efficacy of PBMT in reducing postoperative pain following TLM extraction. Methods: A comprehensive search was conducted to identify studies examining the use of PBMT for postoperative pain relief after TLM extraction. Four randomized controlled trials (RCTs) met the inclusion criteria and were analyzed qualitatively. Results: Two studies showed statistically significant reductions in pain with PBMT. Kahraman et al. reported lower pain scores in the intraoral PBMT (p = 0.001), with up to a 3.2-point reduction on the Visual Analog Scale (VAS). De Paula et al. found improved pain control using a dual-wavelength (808 + 660 nm) versus a single wavelength protocol (p = 0.031). The remaining studies showed non-significant results toward pain reduction. Conclusions: PBMT shows encouraging results in managing postoperative pain after TLM extraction, specifically with intraoral and multi-wavelength protocols. However, further studies are necessary to confirm its clinical utility. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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11 pages, 342 KiB  
Article
A Comparison of Balance and Functional Outcomes After Robotically Assisted Versus Conventional Total Knee Arthroplasty in the Elderly: A Cross-Sectional Study
by Gökhan Bayrak, Hakan Zora, Taha Furkan Yağcı, Muhammet Erdi Gürbüz and Gökhan Cansabuncu
Healthcare 2025, 13(15), 1778; https://doi.org/10.3390/healthcare13151778 - 23 Jul 2025
Abstract
Background/Objectives: Total knee arthroplasty (TKA) is an effective surgical intervention for end stage knee osteoarthritis in elderly patients, with emerging robotically assisted techniques aiming to enhance surgical precision and patient outcomes. This study aimed to compare medium-term balance and functional outcomes between robotically [...] Read more.
Background/Objectives: Total knee arthroplasty (TKA) is an effective surgical intervention for end stage knee osteoarthritis in elderly patients, with emerging robotically assisted techniques aiming to enhance surgical precision and patient outcomes. This study aimed to compare medium-term balance and functional outcomes between robotically assisted and conventional manual TKA in community-dwelling elderly patients. Methods: This cross-sectional study included 50 elderly patients undergoing TKA, who were divided into robotically assisted (n = 25) and conventional manual (n = 25) groups. Demographic and clinical data, balance performance, and functional outcomes were compared at nearly 1.5 years postoperatively. Outcome measures included balance performance assessed by the Berg Balance Scale (BBS), pain via the Visual Analog Scale (VAS), knee function as measured by the Lysholm Knee Scoring Scale, quality of life using the Short Form-12 (SF-12), joint awareness as evaluated by the Forgotten Joint Score-12 (FJS-12), and surgical satisfaction. Results: The groups had similar demographic and clinical data regarding age, gender, follow-up duration, surgical time, and anesthesia type (p > 0.05). The robotically assisted group demonstrated better balance performance on the BBS (p = 0.043) and had a statistically shorter length of hospital stay (1.22 vs. 1.42 days; p = 0.005). However, no statistically significant differences were observed in VAS activity pain (p = 0.053), Lysholm Knee Scoring Scale (p = 0.117), SF-12 physical and mental scores (p = 0.174 and p = 0.879), FJS-12 (p = 0.760), and surgical satisfaction (p = 0.218). Conclusions: Robotically assisted TKA is associated with advantageous postoperative recovery, particularly in terms of balance performance, showing no clinical difference in other functional outcomes compared to the conventional manual technique. From a physical therapy perspective, these findings emphasize the importance of developing tailored and effective rehabilitation strategies in the medium term for functional recovery in the elderly population. Full article
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17 pages, 5672 KiB  
Article
The Effect of Dienogest on Deep Endometriosis Nodules Involving the Recto-Sigmoid Colon: A Prospective Longitudinal Long-Term Study
by Carlos Andrés Contreras, Ignacio Brunel, Mónica Restrepo, Claudia Patricia Franco, María Clara Soto, José Carlos Vilches, Rodrigo Orozco, Stefano Guerriero and Juan Luis Alcázar
J. Clin. Med. 2025, 14(14), 5164; https://doi.org/10.3390/jcm14145164 - 21 Jul 2025
Viewed by 198
Abstract
Objective: To assess the long-term effects of Dienogest on clinical complaints and nodule sizes in women affected by recto-sigmoid deep endometriosis (DE). Methods: This was a single-center longitudinal prospective observational study comprising a consecutive series of women affected by recto-sigmoid DE, who underwent [...] Read more.
Objective: To assess the long-term effects of Dienogest on clinical complaints and nodule sizes in women affected by recto-sigmoid deep endometriosis (DE). Methods: This was a single-center longitudinal prospective observational study comprising a consecutive series of women affected by recto-sigmoid DE, who underwent medical treatment with Dienogest (2 mg daily continuous). All women underwent clinical visits and transvaginal sonography (TVS) with bowel preparation prior to starting therapy and at 3–6-month intervals for at least 12 months. Clinical complaints such as dysmenorrhea, dyspareunia and dyschezia were assessed using a visual analog scale (VAS). The DE recto-sigmoid lesion was measured in the three orthogonal planes. The lesion’s volume was estimated using the prolate ellipsoid formula. The maximum diameter and lesion volume were used for analysis. Patients’ complaints and lesion sizes before starting the treatment and at final follow-up were compared. Results: From January 2017 to July 2020, 125 patients were consecutively recruited (mean age: 37 years, ranging from 20 to 50 years). The median follow-up period was 47.8 months (range: 12–74 months). We did not observe a significant correlation between the severity of the symptoms and the lesion size prior to starting therapy. Clinical complaints improved significantly during treatment (88% of women were symptomatic at initial visit, versus 53% at final follow-up, p < 0.001). The median lesion volume significantly decreased (median initial volume vs. final volume: 1.1 mL vs. 0.9 mL, p = 0.017). However, the median maximum lesion diameter did not change significantly (26.0 mm vs. 25.0 mm, p = 0.779). Conclusions: Long-term Dienogest therapy significantly relieves clinical symptoms related to recto-sigmoid DE. This is accompanied by a significant reduction in the lesion volume but not the maximum lesion diameter. Full article
(This article belongs to the Special Issue Challenges in Fertility Preservation)
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12 pages, 874 KiB  
Article
Open-Label Uncontrolled, Monocentric Study to Evaluate the Efficacy and Safety of the Electromagnetic Field and Negative Pressure in the Treatment of Cellulite
by Antonio Scarano, Antonio Calopresti, Salvatore Marafioti, Gianluca Nicolai and Erda Qorri
Life 2025, 15(7), 1148; https://doi.org/10.3390/life15071148 - 21 Jul 2025
Viewed by 184
Abstract
Cellulite is a widespread aesthetical dermatological condition affecting a significant proportion of postpubertal women, characterized by dimpled skin, primarily on the thighs, buttocks, and hips, which has an important psychological impact. Cellulite, also called lipodystrophy or oedematosclerotic panniculitis, causes an aesthetic change in [...] Read more.
Cellulite is a widespread aesthetical dermatological condition affecting a significant proportion of postpubertal women, characterized by dimpled skin, primarily on the thighs, buttocks, and hips, which has an important psychological impact. Cellulite, also called lipodystrophy or oedematosclerotic panniculitis, causes an aesthetic change in the skin that affects the epidermis, dermis, hypodermis and subcutaneous fat in different ways. The aim of the present prospective study research was to evaluate the efficacy of electromagnetic field and negative pressure in the treatment of cellulite. Methods: A total of 35 women with an average age of 40, ranging from 18 to 50 (mean 32.2 ± 7.48), with a body mass index between 18.5 and 26.9 (mean 22 ± 3.01), were enrolled in this study. The degree of cellulite of the patients was assessed clinically using the Cellulite Severity Scale (CSS) and Nürnberger–Müller classification. All patients received one session per week for a total 12 treatment sessions with Bi-one® LifeTouchTherapy medical device (Expo Italia Srl—Florence—Italy), which generates a combination of vacuum and electromagnetic fields (V-EMF). Total treatment time was approximately 20–30 min per patient. The GAIS score, Cellulite Severity Scale (CSS) and Nürnberger–Müller classification for cellulite was evaluated 1 month after the 12 treatments with LifeTouchTherapy. Results: A statistical difference was recorded in cellulite improvement by visual analog scale (VAS) and global aesthetic improvement scale (GAIS). Conclusions: The results of the present prospective clinical study show the efficacy and safety of Bi-one® LifeTouchTherapy in the treatment of cellulite. Electromagnetic fields combined with negative pressure therapy promote tissue regeneration and reduce fibrosis, which results in visible cosmetic improvements of cellulite. Full article
(This article belongs to the Collection Clinical Trials)
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12 pages, 2988 KiB  
Review
Effects of Photomodulation Therapy for Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis
by Yung-An Tsou, Nai-Jen Chang and Wen-Dien Chang
J. Funct. Morphol. Kinesiol. 2025, 10(3), 277; https://doi.org/10.3390/jfmk10030277 - 17 Jul 2025
Viewed by 297
Abstract
Objectives: This study aimed to evaluate the effects of photomodulation therapy (PMT) on delayed onset muscle soreness (DOMS). Methods: Controlled studies investigating PMT for DOMS were identified through systematic searches of PubMed and EMBASE databases. Selected articles were reviewed for the effects of [...] Read more.
Objectives: This study aimed to evaluate the effects of photomodulation therapy (PMT) on delayed onset muscle soreness (DOMS). Methods: Controlled studies investigating PMT for DOMS were identified through systematic searches of PubMed and EMBASE databases. Selected articles were reviewed for the effects of PMT, and the outcome data were extracted according to specific assessments and time points for meta-analysis. Results: A total of 14 studies met the inclusion criteria, all of which evaluated the effects of PMT following the induction of DOMS. The wavelength of PMT ranged from 660 to 950 nm and was applied to one to six points on the affected muscles. Four studies provided sufficient data for quantitative synthesis, comparing PMT with the placebo in terms of visual analog scale (VAS) scores and muscle strength at 24, 48, 72, and 96 h after the induction of DOMS. The results demonstrated a statistically significant reduction in VAS scores at 72 h (pooled SMD = −0.55) and 96 h (pooled SMD = −0.56), indicating a moderate effect. Muscle strength showed significant improvement at 24 h (pooled SMD = 0.97) and 48 h (pooled SMD = 0.99), reflecting a large effect size. Conclusions: These findings suggested that PMT may be an effective intervention for managing DOMS, with potential effects on reducing pain, enhancing muscle strength, and decreasing biochemical markers of muscle damage. Full article
(This article belongs to the Special Issue Muscle Stress and Damage in Sport and Exercise)
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13 pages, 974 KiB  
Article
G-Protein-Coupled Estrogen Receptor (GPER) in Inflammatory Myopathies
by Delia Righi, Diego Lopergolo, Nila Volpi, Daniela Franci, Paola Lorenzoni, Margherita Aglianò, Gianna Berti, Carlo Manco, Nicola De Stefano and Federica Ginanneschi
Neurol. Int. 2025, 17(7), 109; https://doi.org/10.3390/neurolint17070109 - 17 Jul 2025
Viewed by 109
Abstract
Background/Objectives: Given the multifaceted role of estrogen hormones in skeletal muscle pathophysiology and their well-established immunomodulatory properties, this study aimed to characterize the expression of the G-protein-coupled estrogen receptor (GPER) in patients with inflammatory myopathies (IM). Methods: Immunohistochemical analysis was performed [...] Read more.
Background/Objectives: Given the multifaceted role of estrogen hormones in skeletal muscle pathophysiology and their well-established immunomodulatory properties, this study aimed to characterize the expression of the G-protein-coupled estrogen receptor (GPER) in patients with inflammatory myopathies (IM). Methods: Immunohistochemical analysis was performed on muscle biopsies from 13 patients with IM, 11 with non-inflammatory myopathies (N.IM), and 5control subjects. Intergroup differences in GPER score were statistically evaluated. We performed an analysis based on the Visual Analog Scale (VAS). The scoring system evaluates overall pathology (VAS score) based on four distinct components: inflammation, vascular involvement, myopathic changes, and connective tissue alterations. Results: Immunolocalization analysis demonstrated that GPER is constitutively expressed in human skeletal muscle and is upregulated in IM. Enhanced expression included both sarcolemmal and intracellular membrane localization. Notably, GPER upregulation showed a positive correlation with the severity of tissue inflammation. The IM group had significantly higher VAS scores compared to both the N.IM and control groups. Conclusions: We provide the first histopathological characterization of GPER expression in human skeletal muscle. In IM, GPER upregulation may play a protective role by negatively modulating the release of inflammatory mediators, as suggested by experimental evidence from other models of inflammation. The emerging therapeutic development of GPER agonists may represent a promising avenue for the treatment of inflammatory myopathies. Full article
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18 pages, 953 KiB  
Article
Efficacy of Greater Occipital Nerve Blockade in Craniofacial Neuralgia and Facial Pain Syndromes: A Retrospective Chart Review with Prospectively Collected Follow-Up Data
by Turan Poyraz and Aynur Ozge
J. Clin. Med. 2025, 14(14), 5034; https://doi.org/10.3390/jcm14145034 - 16 Jul 2025
Viewed by 200
Abstract
Background/Objectives: Greater occipital nerve blockade (GONB) is a minimally invasive intervention used to treat primary headaches. However, the evidence regarding its role in craniofacial pain syndromes and its potential impact on analgesic use remains limited. Previous studies have reported that GONB is [...] Read more.
Background/Objectives: Greater occipital nerve blockade (GONB) is a minimally invasive intervention used to treat primary headaches. However, the evidence regarding its role in craniofacial pain syndromes and its potential impact on analgesic use remains limited. Previous studies have reported that GONB is an effective method in patients with cranial neuralgia, but its efficacy is limited in persistent idiopathic facial pain (PIFP). Methods: This study was a retrospective cohort trial examining the medical records of 26 patients who applied to our Headache Clinic due to facial pain and cranial neuralgia between April 2023 and April 2025. Of these patients, 12 were trigeminal neuralgia (46%), 6 were occipital neuralgia (23%), 4 were trigeminal neuropathic pain (15%), and 4 were PIFP (15%) patients. In our study, the landmark-based GONB technique was used to determine the greatest tenderness to palpation (TTP) area. A standard 2.5 mL mixture of 30 mg 2% lidocaine and 4 mg dexamethasone was injected bilaterally as a single dose into the nerve region of all patients. After GONB, all patients were routinely contacted by phone or addressed face to face once a week for the first month and monthly thereafter, and medical changes were recorded with a standard-case follow-up form file. The case follow-up form allowed regular monitoring of parameters, such as the Visual Analog Scale (VAS), self-assessment scales for patients’ clinical responses, sensitivity to triggers, possible side effects, duration of effect, and the number of analgesics used. Results: A positive response with at least 50% overall improvement compared to the patient’s baseline level was found in 22 of 26 patients. Response to treatment was observed in 10 patients in the trigeminal neuralgia group (83%), 3 patients in the trigeminal neuropathic pain (75%) and PIFP groups (75%), and all in the occipital neuralgia group (100%). There was no statistically significant difference in response rates between the diagnostic groups. A significant difference was found in terms of response rates according to gender (p = 0.022). Accordingly, while response was observed in all 15 female patients, response was observed in 7 of 11 male patients (64%). Pre-GONB VAS values of those responding to treatment were found to be higher. Patients with positive responses to GONB had a significantly higher median value of the VAS total score (5; 95% CI: 1.83–4.52) in comparison to those with negative responses (8.32; 95% CI: 8.17–12.12) (p < 0.001). Post-GONB Intensity (VAS) and Post-GONB sensitivity to triggers decreased significantly (p < 0.001, p < 0.001). In those who responded, the decrease in analgesic use after GONB compared to before was statistically significant in the first and second months (p < 0.001, p < 0.003, respectively). Although the decrease continued in the third month, this difference did not reach statistical significance (p = 0.551). Conclusions: GONB reduces the duration, frequency, and intensity of headaches, and the need for acute analgesic use in CN and PIFP patients. Full article
(This article belongs to the Special Issue Headache: Updates on the Assessment, Diagnosis and Treatment)
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11 pages, 1724 KiB  
Systematic Review
Comparison of Effectiveness Between Ultrasound-Guided and Blind Corticosteroid Injections in Plantar Fasciitis: A Systematic Review and Meta-Analysis
by Hoa Ngan Doan, Yoo Jin Choo and Min Cheol Chang
Life 2025, 15(7), 1107; https://doi.org/10.3390/life15071107 - 15 Jul 2025
Viewed by 219
Abstract
The effectiveness of ultrasound (US)-guided compared with blind corticosteroid injections for the treatment of plantar fasciitis (PF) remains uncertain. This meta-analysis aimed to evaluate the clinical benefits of US-guided over blind injections in patients with PF. A systematic search of PubMed, Embase, Web [...] Read more.
The effectiveness of ultrasound (US)-guided compared with blind corticosteroid injections for the treatment of plantar fasciitis (PF) remains uncertain. This meta-analysis aimed to evaluate the clinical benefits of US-guided over blind injections in patients with PF. A systematic search of PubMed, Embase, Web of Science, and Scopus was conducted, collecting articles published up to 20 April 2025. Randomized controlled trials comparing US-guided and blind corticosteroid injections for PF were included. The extracted outcome measures, i.e., visual analog scale (VAS), heel tenderness index (HTI), tenderness threshold (TT), and plantar fascia thickness, were assessed at short- (2–6 weeks) and long-term (≥12 weeks) follow-ups. Compared with the blind injection group, the US-guided group showed significantly greater improvement in TT at both short- and long-term follow-ups, as well as a greater reduction in plantar fascia thickness. However, no significant differences were found between the two groups in VAS and HTI scores. US-guided corticosteroid injections provide superior clinical benefits compared with blind injections in patients with PF, particularly in enhancing mechanical pain tolerance and reducing plantar fascia thickness. Nevertheless, these findings should be interpreted with caution due to the limited methodological quality of the included studies. Full article
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16 pages, 1446 KiB  
Systematic Review
Soft Palate and Pharyngeal Surgery for the Treatment of Snoring: A Systematic Review
by Giovanni Cammaroto, Giuseppe Caccamo, Tommaso Rodella, Diletta Angeletti, Francesca Boscolo Nata, Davide Topazio and Luca Cerritelli
J. Clin. Med. 2025, 14(14), 4964; https://doi.org/10.3390/jcm14144964 - 14 Jul 2025
Viewed by 344
Abstract
Background: Snoring is a common symptom within the spectrum of sleep-disordered breathing, often occurring independently or in association with obstructive sleep apnea syndrome (OSAS). Despite its prevalence, treatment strategies remain variable and lack standardization, particularly regarding surgical interventions. This review aims to [...] Read more.
Background: Snoring is a common symptom within the spectrum of sleep-disordered breathing, often occurring independently or in association with obstructive sleep apnea syndrome (OSAS). Despite its prevalence, treatment strategies remain variable and lack standardization, particularly regarding surgical interventions. This review aims to evaluate and summarize the outcomes of soft palate and pharyngeal surgeries for adult snoring based on recent literature. Methods: A systematic review was conducted using the PubMed database, identifying studies published between 2014 and 2024 that involved adult patients undergoing upper airway surgery for snoring. Inclusion criteria required pre- and postoperative snoring assessment using the Visual Analog Scale (VAS). Studies were categorized by surgical technique (anterior vs. lateral/circumferential), anesthesia type, presence of tonsillectomy, BMI, OSAS severity (based on AHI), and use of Drug-Induced Sleep Endoscopy (DISE). Descriptive analysis was performed on the changes in VAS scores. Results: A total of 43 studies involving 2713 patients were included, with 18 eligible for quantitative analysis (716 patients). Across all patients, mean VAS scores improved from 7.29 to 3.50 (ΔVAS 3.79). Both anterior and lateral/circumferential techniques yielded significant symptom reduction (ΔVAS 4.12 and 3.68, respectively). General anesthesia showed slightly better outcomes than local anesthesia. Notably, tonsillectomy was associated with greater symptom improvement (ΔVAS 5.17 vs. 4.49). Patients with lower BMI and milder OSAS showed higher baseline VAS but similar improvements. Limited objective measures and heterogeneity in surgical protocols were key limitations. Conclusions: Surgical interventions for snoring provide subjective symptom relief regardless of surgical approach or OSAS severity. Tonsillectomy may enhance outcomes. Future efforts should prioritize standardized, objective outcome measures and personalized treatment planning, potentially incorporating DISE and wearable acoustic technologies. Full article
(This article belongs to the Section Otolaryngology)
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14 pages, 1977 KiB  
Article
Midterm Outcomes of Medial Patellofemoral Ligament Reconstruction in Adolescent Athletes: Comparison Between Acute and Recurrent Patella Dislocation
by Georgios Kalinterakis, Christos K. Yiannakopoulos, Christos Koukos, Konstantinos Mastrantonakis and Efstathios Chronopoulos
J. Clin. Med. 2025, 14(14), 4881; https://doi.org/10.3390/jcm14144881 - 9 Jul 2025
Viewed by 310
Abstract
Background/Objectives: Patellar instability in adolescents is a significant cause of short- and long-term morbidity and disability. Traditionally, patients with first-time patellar dislocation are managed nonoperatively, although most studies are not focusing on the adolescent athletic population. The primary objective of the current [...] Read more.
Background/Objectives: Patellar instability in adolescents is a significant cause of short- and long-term morbidity and disability. Traditionally, patients with first-time patellar dislocation are managed nonoperatively, although most studies are not focusing on the adolescent athletic population. The primary objective of the current study was to compare patient-reported outcomes and complications in adolescent athletes who underwent surgery either after the first patellar dislocation or after the recurrence of the dislocation with a minimum postoperative follow-up of 48 months (48–75 months). Methods: A total of 39 adolescent athletes who underwent medial patellofemoral ligament (MPFL) reconstruction (Group A, after the first dislocation, and Group B, recurrent patella dislocation) were included in this study. In all the patients, the same MPFL reconstruction technique was applied using a semitendinosus autograft. The graft was fixed on the patella using a transverse tunnel and adjustable loop button fixation and, in the femur, using a tunnel and absorbable screw fixation. The tunnel was drilled obliquely to prevent penetration of the distal femoral physis. The preoperative and postoperative clinical and functional evaluations of the patients were conducted via the visual analog scale (VAS), the Lysholm Knee Scoring System, the Kujala Anterior Knee Pain Scale, and the Pediatric International Knee Documentation Committee (Pedi-IKDC), and the return to sports score was assessed via the Tegner Activity Scale (TAS). Results: At the latest follow-up, both groups demonstrated significant improvement in the Lysholm scores, with Group A achieving a mean of 92.57 ± 6.21 and Group B achieving a mean of 90.53 ± 8.21 (p = 0.062). Postoperatively, Group A achieved a mean Kujala score of 94.21 ± 9.23, whereas Group B reached 92.76 ± 12.39, with no statistically significant difference (p = 0.08). The Pedi-IKDC score improved postoperatively in both groups. In Group A, it increased from 67.98 ± 12.29 to 93.65 ± 4.1, and in Group B, from 56.21 ± 13.6 to 91.67 ± 6.21 (p = 0.067). The preoperative visual analog scale (VAS) score for pain was significantly lower in Group A (3.1 ± 1.13) than in Group B (4.2 ± 3.01, p < 0.01). At the latest follow-up, the VAS scores improved in both groups, with Group A reporting a mean score of 0.47 ± 1.01 and Group B 0.97 ± 1.32 (p = 0.083). The Tegner activity scores were similar between the groups preoperatively, with Group A at 7.72 ± 1.65 and Group B at 7.45 ± 2.09 (p = 0.076). Postoperatively, Group A had a mean score of 7.28 ± 2.15, whereas Group B had a mean score of 6.79 ± 3.70 (p = 0.065). The mean time to return to sports was significantly shorter in Group A (5.1 ± 1.3 months) than in Group B (7.6 ± 2.1 months) (p < 0.01). Overall, 84.61% of the patients returned to their previous activity level. Specifically, 95.2% (20/21) of patients in Group A achieved this outcome, whereas 72.22% (13/18) achieved it in Group B. Patient satisfaction was generally high, with 76% (16/21) of patients in Group A reporting being satisfied or very satisfied, compared with 77% (14/18) in Group B. Conclusions: MPFL reconstruction is a safe and effective procedure for both acute and recurrent patellar dislocation in adolescent athletes. While patients who underwent acute reconstruction returned to sport more quickly and showed higher absolute postoperative scores, the greatest overall improvement from preoperative to final follow-up was observed in those treated for recurrent instability. Both surgical approaches demonstrated high satisfaction rates and minimal complications, supporting MPFL reconstruction as a reliable option in both acute and recurrent cases. Full article
(This article belongs to the Special Issue Youth Sports Injuries: From Prevalence to Prevention)
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9 pages, 1212 KiB  
Article
20-Year Efficacy of Endoscopic Thoracic Sympathectomy for Primary Hyperhidrosis: A Cohort Study
by Anna Ureña, Leandro Grando, Lluisa Rodriguez-Gussinyer, Ivan Macía, Francisco Rivas, Nestor Iván Quiroga, Camilo Moreno, Xavier Michavilla and Ricard Ramos
J. Clin. Med. 2025, 14(14), 4831; https://doi.org/10.3390/jcm14144831 - 8 Jul 2025
Viewed by 320
Abstract
Background: Primary focal hyperhidrosis, characterized by excessive sweating primarily affecting the hands and axillae, can significantly impact quality of life. Bilateral thoracic sympathectomy is the gold standard treatment, providing permanent resolution of palmar hyperhidrosis. Most studies evaluating outcomes and patient satisfaction after sympathectomy [...] Read more.
Background: Primary focal hyperhidrosis, characterized by excessive sweating primarily affecting the hands and axillae, can significantly impact quality of life. Bilateral thoracic sympathectomy is the gold standard treatment, providing permanent resolution of palmar hyperhidrosis. Most studies evaluating outcomes and patient satisfaction after sympathectomy focus on short- to medium-term follow-up, typically up to 5 years. This study aimed to assess anxiety, satisfaction, and sweat redistribution 20 years after bilateral endoscopic thoracic sympathectomy. Methods: Between January 2002 and December 2003, 106 patients with primary hyperhidrosis underwent bilateral endoscopic thoracic sympathectomy targeting ganglia T2–T3 at our center. The patients were contacted via telephone in 2023 and asked to complete the same survey they had filled out preoperatively and 12 months postoperatively. The survey evaluated sweat redistribution, anxiety, hyperhidrosis-related symptoms, and satisfaction. Anxiety, satisfaction, and perceived sweating were rated using a 5-point visual analog scale (VAS) ranging from 0 (unsatisfied/no symptoms) to 4 (very satisfied/severe symptoms). Results: Of the 106 eligible patients, 24 (22.6%) completed the survey. Most reported persistent anhidrosis (palmar or palmar–axillary) 20 years post-surgery. The survey results remained consistent with those at the 1-year follow-up. Significant sweat redistribution to the abdomen and back was observed. Patient satisfaction remained high, with no significant differences between the 1-year and 20-year assessments. Anxiety significantly decreased compared to preoperative levels (p < 0.001). Conclusions: Bilateral endoscopic thoracic sympathectomy is an effective long-term treatment for reducing excessive sweating. Patient satisfaction remains high over time, despite the persistence of compensatory sweating. Full article
(This article belongs to the Special Issue Thoracic Surgery: Current Challenges and Future Perspectives)
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15 pages, 659 KiB  
Article
Sex Differences in Strength, Self-Estimation, and Pain Perception Based on Physical Activity After Rotator Cuff Repair
by Zebin Wen, Yonghwan Kim, Yongchul Choi and Moonyoung Choi
Healthcare 2025, 13(13), 1624; https://doi.org/10.3390/healthcare13131624 - 7 Jul 2025
Viewed by 302
Abstract
Background: The role of physical activity in early recovery following arthroscopic rotator cuff repair (ARCR) remains unclear, particularly regarding potential sex differences. This study examined the effects of physical activity on pain, self-estimation, and strength recovery after ARCR in middle-aged and older adults. [...] Read more.
Background: The role of physical activity in early recovery following arthroscopic rotator cuff repair (ARCR) remains unclear, particularly regarding potential sex differences. This study examined the effects of physical activity on pain, self-estimation, and strength recovery after ARCR in middle-aged and older adults. Methods: Patients who underwent ARCR were classified into high physical activity (HPA, n = 94) and low physical activity (LPA, n = 99) groups based on the International Physical Activity Questionnaire. The Visual Analog Scale (VAS) for pain and the American Shoulder and Elbow Surgeons (ASESs) score for self-estimation were assessed preoperatively and at 6, 12, and 24 weeks postoperatively. Isokinetic shoulder strength was measured at the same intervals except for the 6-week assessment. Results: All groups demonstrated significant improvements in pain reduction and self-estimation over time (p < 0.05). At 6 and 12 weeks, the HPA group showed significantly lower VAS scores and higher ASES scores than the LPA group (p < 0.05). Notably, at 12 weeks, men in the LPA group exhibited pain levels comparable to the HPA group, whereas women in the LPA group continued to report significantly higher pain levels (p < 0.05). Isokinetic strength assessment revealed greater flexion and external rotation strength in the HPA group at 12 weeks (p < 0.05), though no significant between-group differences were observed at 24 weeks. Conclusions: Higher physical activity levels were associated with better early pain relief and self-estimation after ARCR, particularly within the first 12 weeks. These findings suggest that structured physical activity may enhance postoperative outcomes, with potential sex-based differences in pain perception. Full article
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16 pages, 570 KiB  
Article
Comparison of Guided Exercise and Self-Paced Exercise After Lumbar Spine Surgery: A Randomized Controlled Trial
by Seong Son, Han Byeol Park, Kyeong Sik Kong, Byung Rhae Yoo, Woo Kyung Kim and Jae Ang Sim
Life 2025, 15(7), 1070; https://doi.org/10.3390/life15071070 - 4 Jul 2025
Viewed by 410
Abstract
Background: The efficacy of postoperative exercise rehabilitation after spine surgery is controversial, and a protocol for exercise treatment and detailed outcomes based on functional activity have not yet been established. This study aimed to determine the efficacy of exercise rehabilitation after lumbar spine [...] Read more.
Background: The efficacy of postoperative exercise rehabilitation after spine surgery is controversial, and a protocol for exercise treatment and detailed outcomes based on functional activity have not yet been established. This study aimed to determine the efficacy of exercise rehabilitation after lumbar spine surgery. Methods: A prospective, randomized controlled trial was conducted in 40 patients who underwent lumbar spine surgery (20 patients each in the exercise and control groups) for 12 weeks. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and EuroQol-5 Dimensions 5-Level version (EQ-5D-5L). Body proportions, including body mass index, total muscle mass, and body fat percentage were analyzed. Functional activity was evaluated based on the range of motion of the lumbar spine, strength and endurance of lumbar flexion/extension, flexibility, 6 min walking test, single-leg stance, coordination, and gait pattern analysis. Results: The exercise group showed significantly greater improvement in VAS for pain (66.67% versus 20.00%, p < 0.001) and EQ-5D-5L (45.56% versus 20.00, p = 0.039) compared to the control group. Serial assessment revealed significant improvement in strength of lumbar flexion/extension, 6 min walking test, single-leg stance, coordination, and gait patterns in the exercise group compared to the control group. In particular, the single-leg stance time for the affected leg improved more markedly in the exercise group (280.9% versus 48.7%, p < 0.001). Conclusion: Tailored postoperative exercise after lumbar spine surgery is effective in reducing pain and enhancing functional recovery, including strength and balance. Full article
(This article belongs to the Special Issue Innovative Perspectives in Physical Therapy and Health)
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12 pages, 3321 KiB  
Article
Comparing Single and Dual Plating in Displaced Scapular Body Fractures: A Retrospective Study of Clinical and Functional Outcomes
by Hsin-Hsin Lee, Hao-Chun Chuang, Wei-Chin Lin, Jou-Hua Wang, Ming-Hsien Hu, Pei-Yuan Lee, Hong-Lin Su and Chang-Han Chuang
J. Clin. Med. 2025, 14(13), 4740; https://doi.org/10.3390/jcm14134740 - 4 Jul 2025
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Abstract
Background: Scapular body fractures, when significantly displaced or malunited, can cause glenohumeral discomfort and functional disability. This study compares single- and dual-plating techniques in terms of pain, function, and active range of motion (aROM) in patients with scapular body fractures. Methods: Twenty-eight patients [...] Read more.
Background: Scapular body fractures, when significantly displaced or malunited, can cause glenohumeral discomfort and functional disability. This study compares single- and dual-plating techniques in terms of pain, function, and active range of motion (aROM) in patients with scapular body fractures. Methods: Twenty-eight patients with scapular fractures were retrospectively analyzed, with sixteen undergoing single plating treatment and twelve dual plating treatment. The mean age was 44.9 years, and the mean follow-up was 14 months for single plating and 13.8 months for dual plating. Outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) scores, the Visual Analog Scale (VAS) for pain, aROM measurements, and the time to return to work. Functional outcomes were assessed using two-way ANOVA with Šidák’s multiple comparisons test at 2 weeks, 4 weeks, 3 months, 6 months, and 1 year. The time to return to work was analyzed with survival analysis and a log-rank test. Results: The single plating group had higher DASH scores than the dual plating group at 2 weeks (44.88 ± 10.81 vs. 32.75 ± 6.05, p = 0.005), 4 weeks (28.50 ± 5.91 vs. 22.83 ± 4.24, p = 0.033), and 3 months (19.63 ± 2.45 vs. 16.00 ± 2.45, p = 0.004), indicating greater disability. VAS scores were also higher in the single plating group at 2 weeks (4.00 ± 1.21 vs. 2.33 ± 0.88, p = 0.002) and 4 weeks (2.50 ± 1.03 vs. 1.17 ± 0.94, p = 0.008), suggesting faster pain relief in the dual plating group. However, differences were no longer significant after 3 months. At 1 year, the dual plating group demonstrated better external rotation (73 ± 3° vs. 63 ± 5°, p = 0.032), with no significant differences in internal rotation, abduction, or forward flexion. Dual plating patients returned to work earlier (Hazard Ratio = 3.346, 95% CI: 1.208 to 9.269, p = 0.020). Conclusions: In the current cohort, dual plating for scapular fractures offers superior early pain relief and functional outcomes compared to single plating, along with better external rotation at 1 year and an earlier return to work. These findings suggest that dual plating may facilitate faster recovery and enhanced active range of motion in selected patients, a hypothesis that warrants further investigation through future randomized trials. Full article
(This article belongs to the Special Issue Trends and Prospects in Shoulder and Elbow Surgery)
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13 pages, 534 KiB  
Article
Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations
by Valentina Billone, Giuseppe Gullo, Eleonora Conti, Silvia Ganduscio, Sofia Burgio, Giovanni Baglio, Gaspare Cucinella, Lina De Paola and Susanna Marinelli
Medicina 2025, 61(7), 1216; https://doi.org/10.3390/medicina61071216 - 3 Jul 2025
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Abstract
Background and Objectives: We compared mini-laparoscopic and laparoscopic hysterectomy in terms of surgery duration, postoperative pain, conversion rate, blood loss, postoperative complications (Clavien-Dindo classification), and the length of hospital stay. Materials and Methods: Patients were recruited between 1 January 2017 and [...] Read more.
Background and Objectives: We compared mini-laparoscopic and laparoscopic hysterectomy in terms of surgery duration, postoperative pain, conversion rate, blood loss, postoperative complications (Clavien-Dindo classification), and the length of hospital stay. Materials and Methods: Patients were recruited between 1 January 2017 and 1 January 2024, at the Department of Gynecology, “Villa Sofia-Cervello” Hospital. Indications for hysterectomy included uterine myoma, endometriosis, endometrial hyperplasia, adenomyosis, high-grade cervical dysplasia, early-stage endometrial cancer, and microinvasive cervical cancer. Patients were divided according to treatment into conventional laparoscopic hysterectomy (LH) with all 5 mm ports or the needlescopic approach (minilaparoscopic hysterectomy [MLH]), using 3 mm instruments. Postoperative pain was assessed using the visual analog scale (VAS) at multiple time points (2, 6, 12, and 24 h post-surgery). Results: A total of 308 patients were enrolled, with 153 women in the LH group and 155 in the MLH group. The surgery duration was on average 105.5 min in LH and 98.8 min in MLH (p < 0.0001). The intraoperative blood loss averaged 195.1 mL in LH and 100.3 mL in MLH (p < 0.001). The average length of hospital stay was 4.0 days for women undergoing LH compared to 3.2 days for women undergoing MLH (p < 0.001). Conclusions: This retrospective study demonstrated that MLH is an effective and functional technique for treating various gynecological conditions, with advantages in terms of aesthetic outcomes and reduced perioperative pain and recovery times. The positive results, supported by key parameters such as surgical duration, blood loss, and complications, could serve as a foundation for future studies on larger populations and for improving clinical practices in gynecology. Full article
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