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12 pages, 521 KiB  
Article
Examination of the Relationship Between Pain Intensity, Pain Perceptions, and Kinesiophobia in Patients with Non-Specific Chronic Musculoskeletal Pain
by Sofia Sgourda, Maria Loulla, Eirini Zisiopoulou, Krystalia Katsiou, Sofia Nikolaidi, Ioannis Kyrosis and Anna Christakou
Muscles 2025, 4(3), 27; https://doi.org/10.3390/muscles4030027 - 4 Aug 2025
Abstract
Chronic musculoskeletal pain negatively affects patients’ quality of life, and pain perceptions may significantly influence rehabilitation outcomes. This study investigated the relationships among pain intensity, pain perceptions, and kinesiophobia in individuals with chronic musculoskeletal pain. No previous studies have examined these variables in [...] Read more.
Chronic musculoskeletal pain negatively affects patients’ quality of life, and pain perceptions may significantly influence rehabilitation outcomes. This study investigated the relationships among pain intensity, pain perceptions, and kinesiophobia in individuals with chronic musculoskeletal pain. No previous studies have examined these variables in combination. A cross-sectional observational study was conducted with 37 participants with non-specific chronic musculoskeletal pain for at least 6 months, affecting the neck (n = 8), lower back (n = 18), upper limbs (n = 5), lower limbs (n = 5), or shoulder (n = 1). The following validated tools were used: (a) Pain Beliefs and Perceptions Inventory (PBPI), (b) the Tampa Scale for Kinesiophobia (TSK), and (c) the Short-Form McGill Pain Questionnaire (SF-MPQ). Spearman r correlation analyses were performed. Total kinesiophobia scores were positively correlated with (a) total pain intensity (McGill score) (r = 0.37, p = 0.022), (b) present pain intensity (PPI) (r = 0.52, p = 0.001), (c) pain duration (r = 0.51, p = 0.001), (d) the “mystery” factor of pain perception (r = 0.41, p = 0.013), and (e) the Visual Analogue Scale (VAS) (r = 0.42, p = 0.009). The total pain perception scores were positively associated with the “fear of injury” factor of kinesiophobia (r = 0.36, p = 0.028). The McGill pain scores were strongly correlated with both PPI (r = 0.63, p = 0.001) and VAS (r = 0.51, p = 0.001). There is a significant relationship between pain perception and kinesiophobia levels in patients with chronic musculoskeletal pain. Limitations of the study include a small and heterogeneous sample regarding pain localization. Further research is required using larger, more homogeneous populations to confirm the present findings. Full article
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14 pages, 2221 KiB  
Article
Dynamic vs. Rigid: Transforming the Treatment Landscape for Multisegmental Lumbar Degeneration
by Caner Gunerbuyuk, Mehmet Yigit Akgun, Nazenin Durmus, Ege Anil Ucar, Helin Ilkay Orak, Tunc Oktenoglu, Ozkan Ates, Turgut Akgul and Ali fahir Ozer
J. Clin. Med. 2025, 14(15), 5472; https://doi.org/10.3390/jcm14155472 (registering DOI) - 4 Aug 2025
Abstract
Background: Multisegmental lumbar degenerative disease (ms-LDD) is a common condition in older adults, often requiring surgical intervention. While rigid stabilization remains the gold standard, it is associated with complications such as adjacent segment disease (ASD), higher blood loss, and longer recovery times. The [...] Read more.
Background: Multisegmental lumbar degenerative disease (ms-LDD) is a common condition in older adults, often requiring surgical intervention. While rigid stabilization remains the gold standard, it is associated with complications such as adjacent segment disease (ASD), higher blood loss, and longer recovery times. The Dynesys dynamic stabilization system offers an alternative by preserving motion while stabilizing the spine. However, data comparing Dynesys with fusion in multisegmental cases are limited. Objective: This study evaluates the clinical and radiographic outcomes of Dynesys dynamic stabilization versus rigid stabilization in the treatment of ms-LDD. Methods: A retrospective analysis was conducted on 53 patients (mean age: 62.25 ± 15.37 years) who underwent either Dynesys dynamic stabilization (n = 27) or PLIF (n = 26) for ms-LDD involving at least seven motion segments. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), while radiological parameters such as lumbar lordosis (LL), sagittal vertical axis (SVA), and spinopelvic parameters (pelvic incidence, pelvic tilt and, sacral slope) were analyzed. A two-stage surgical approach was employed in the Dynesys group to enhance osseointegration, particularly in elderly osteoporotic patients. Results: Both groups showed significant improvements in VAS and ODI scores postoperatively (p < 0.001), with no significant differences between them. However, the Dynesys group demonstrated superior sagittal alignment correction, with a significant increase in LL (p < 0.002) and a significant decrease in SVA (p < 0.0015), whereas changes in the rigid stabilization group were not statistically significant. Additionally, the Dynesys group had fewer complications, including a lower incidence of ASD (0 vs. 6 cases). The two-stage technique facilitated improved screw osseointegration and reduced surgical risks in osteoporotic patients. Conclusions: Dynesys dynamic stabilization is an effective alternative to rigid stabilization in ms-LDD, offering comparable pain relief and functional improvement while preserving motion and reducing ASD risk. The two-stage approach enhances long-term stability, making it particularly suitable for elderly or osteoporotic patients. Further long-term studies are needed to confirm these findings. Full article
(This article belongs to the Special Issue Orthopedic Surgery: Latest Advances and Perspectives)
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23 pages, 2059 KiB  
Systematic Review
Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis
by Yuntong Zhang, Yunfei Gui, Roger Adams, Joshua Farragher, Catherine Itsiopoulos, Keegan Bow, Ming Cai and Jia Han
Nutrients 2025, 17(15), 2547; https://doi.org/10.3390/nu17152547 - 3 Aug 2025
Abstract
Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that can greatly affect quality of life in middle-aged and elderly individuals. Nutritional supplements are increasingly used for KOA due to their low risk, but direct comparative evidence on their efficacy and [...] Read more.
Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that can greatly affect quality of life in middle-aged and elderly individuals. Nutritional supplements are increasingly used for KOA due to their low risk, but direct comparative evidence on their efficacy and safety remains scarce. This study aimed to systematically compare the effectiveness and safety of seven common nutritional supplements for KOA. Methods: A systematic review and network meta-analysis were conducted following PRISMA guidelines. Embase, PubMed, and the Cochrane Library were searched through December 2024 for randomized controlled trials (RCTs) evaluating use of eggshell membrane, vitamin D, Boswellia, curcumin, ginger, krill oil, or collagen, versus placebo, in adults with KOA. Primary outcomes included changes in scores for WOMAC pain, stiffness and function, and pain visual analog scale (VAS). Adverse events were also assessed. Bayesian network meta-analyses estimated ranking probabilities for each intervention. Results: In total, 39 RCTs (42 studies; 4599 patients) were included. Compared with placebo, Boswellia showed significant improvements in WOMAC pain (mean difference [MD] = 10.58, 95% CI: 6.45 to 14.78, p < 0.05), stiffness (MD = 9.47, 95% CI: 6.39 254 to 12.74, p < 0.05), function (MD = 14.00, 95% CI: 7.74 to 20.21, p < 0.05), and VAS pain (MD = 17.26, 95% CI: 8.06 to 26.52, p < 0.05). Curcumin, collagen, ginger, and krill oil also demonstrated benefits in some outcomes. No supplement was associated with increased adverse events compared to placebo. Bayesian rankings indicated Boswellia had the highest probability of being most effective for pain and stiffness, with krill oil and curcumin showing potential for function improvement. Conclusions: Nutritional supplements, particularly Boswellia, appear to be effective and well-tolerated for improving KOA symptoms and function. These results suggest that certain supplements may be useful as part of non-pharmacological KOA management. However, further large-scale, well-designed randomized controlled trials (RCTs) are needed to confirm these findings, particularly those that include more standardized dosages and formulations, as well as to evaluate their long-term efficacy. Full article
(This article belongs to the Section Nutrition Methodology & Assessment)
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10 pages, 969 KiB  
Article
Effect of Repetitive Peripheral Magnetic Stimulation in Patients with Neck Myofascial Pain: A Randomized Sham-Controlled Crossover Trial
by Thapanun Mahisanun and Jittima Saengsuwan
J. Clin. Med. 2025, 14(15), 5410; https://doi.org/10.3390/jcm14155410 (registering DOI) - 1 Aug 2025
Viewed by 224
Abstract
Background/Objectives: Neck pain caused by myofascial pain syndrome (MPS) is a highly prevalent musculoskeletal condition. Repetitive peripheral magnetic stimulation (rPMS) is a promising treatment option; however, its therapeutic effect and optimal treatment frequency remain unclear. This study aimed to investigate the therapeutic [...] Read more.
Background/Objectives: Neck pain caused by myofascial pain syndrome (MPS) is a highly prevalent musculoskeletal condition. Repetitive peripheral magnetic stimulation (rPMS) is a promising treatment option; however, its therapeutic effect and optimal treatment frequency remain unclear. This study aimed to investigate the therapeutic effect and duration of effect of rPMS in patients with MPS of the neck. Methods: In this randomized, sham-controlled, crossover trial, 27 patients with neck MPS and baseline visual analog scale (VAS) scores ≥ 40 were enrolled. The mean age was 43.8 ± 9.1 years, and 63% were female. Participants were randomly assigned to receive either an initial rPMS treatment (a 10 min session delivering 3900 pulses at 5–10 Hz) or sham stimulation. After 7 days, groups crossed over. Pain intensity (VAS), disability (Neck Disability Index; NDI), and analgesic use were recorded daily for seven consecutive days. A linear mixed-effects model was used for analysis. Results: At baseline, the VAS and NDI scores were 61.8 ± 10.5 and 26.0 ± 6.3, respectively. rPMS produced a significantly greater reduction in both VAS and NDI scores, with the greatest differences observed on Day 4: the differences were −24.1 points in VAS and −8.5 points in NDI compared to the sham group. There was no significant difference in analgesic use between the two groups. Conclusions: A single rPMS session provides short-term improvement in pain and disability in neck MPS. Based on the observed therapeutic window, more frequent sessions (e.g., twice weekly) may provide sustained benefit and should be explored in future studies. Full article
(This article belongs to the Section Clinical Rehabilitation)
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14 pages, 872 KiB  
Article
Beyond Pain Management: Skin-to-Skin Contact as a Humanization Strategy in Cesarean Delivery: A Randomized Controlled Trial
by José Miguel Pérez-Jiménez, Rocío de-Diego-Cordero, Álvaro Borrallo-Riego, Manuel Luque-Oliveros, Domingo de-Pedro-Jimenez, Manuel Coheña-Jimenez, Patricia Bonilla Sierra and María Dolores Guerra-Martín
Healthcare 2025, 13(15), 1866; https://doi.org/10.3390/healthcare13151866 - 30 Jul 2025
Viewed by 184
Abstract
Background: Postoperative pain management after a cesarean section remains a significant challenge, as inadequate control can delay maternal recovery and hinder early bonding and breastfeeding. While multimodal analgesia is the standard approach, non–pharmacological strategies like immediate skin–to–skin contact (SSC) are often underused despite [...] Read more.
Background: Postoperative pain management after a cesarean section remains a significant challenge, as inadequate control can delay maternal recovery and hinder early bonding and breastfeeding. While multimodal analgesia is the standard approach, non–pharmacological strategies like immediate skin–to–skin contact (SSC) are often underused despite their potential benefits in reducing pain, improving uterine contractions, and increasing maternal satisfaction. Objective: To evaluate the effects of immediate SSC on postoperative pain perception, uterine contraction quality, and maternal satisfaction, and to explore ways to incorporate SSC into routine post–cesarean care to promote recovery and humanized care. Method: A randomized clinical trial was conducted with 80 women undergoing elective cesarean sections, divided into two groups: SSC (40 women) and control (40 women). Postoperative pain was measured using the Visual Analog Scale (VAS) at various intervals, while uterine contraction quality and maternal satisfaction were assessed through clinical observation and a Likert scale, respectively. Results: We found that women in the SSC group experienced significantly lower pain scores (VAS2 and VAS3, p < 0.001), stronger infraumbilical uterine contractions (92.5%, p < 0.001), and higher satisfaction levels (average 9.98 vs. 6.50, p < 0.001). An inverse correlation was observed between pain intensity and satisfaction, indicating that SSC enhances both physiological and psychological recovery. Conclusions: Immediate SSC after cesarean is an effective, humanizing intervention that reduces pain, supports uterine contractions, and boosts maternal satisfaction. These findings advocate for integrating SSC into standard postoperative care, aligning with ethical principles of beneficence and autonomy. Further research with larger samples is necessary to confirm these benefits and facilitate widespread adoption in maternity protocols. Full article
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11 pages, 4175 KiB  
Article
Comparison of Hybrid Dynamic Stabilization with TLIF Versus Dynamic Stabilization Alone in Degenerative Lumbar Instability
by Uzay Erdogan, Gurkan Berikol, Ibrahim Taha Albas, Mehmet Yigit Akgun, Tunc Oktenoglu, Ozkan Ates and Ali Fahir Ozer
Diagnostics 2025, 15(15), 1887; https://doi.org/10.3390/diagnostics15151887 - 28 Jul 2025
Viewed by 188
Abstract
Objective: This study aimed to compare the clinical and radiological outcomes of dynamic rod stabilization with and without transforaminal lumbar interbody fusion (TLIF) in patients undergoing surgery for degenerative lumbar instability. Specifically, we evaluated the prognostic value of hybrid systems in reducing [...] Read more.
Objective: This study aimed to compare the clinical and radiological outcomes of dynamic rod stabilization with and without transforaminal lumbar interbody fusion (TLIF) in patients undergoing surgery for degenerative lumbar instability. Specifically, we evaluated the prognostic value of hybrid systems in reducing adjacent segment disease (ASD), enhancing fusion rates, and improving functional outcomes. Methods: A retrospective analysis was conducted on 62 patients treated between 2019 and 2022. Group 1 (n = 34) underwent dynamic rod stabilization alone, while Group 2 (n = 28) received dynamic stabilization combined with TLIF. Radiological assessments included disk height index (DHI) and fusion rates. Clinical outcomes were measured using the Visual Analog Scale (VAS) for back and leg pain at baseline, 12, and 24 months. Statistical analysis was performed using Jamovi® software (version 2.4.1). Results: The hybrid group (dynamic + TLIF) demonstrated significantly higher anterior fusion rates (p < 0.001) and greater improvement in VAS scores for back (p = 0.005) and leg pain (p < 0.001) at 12 months. Although operative time was longer (p = 0.002), there was no significant difference in hospital stay (p = 0.635). No significant differences were observed in ASD development (p = 0.11) or pseudoarthrosis (p = 0.396). The hybrid group maintained better lumbar lordosis and higher adjacent segment DHI. Conclusions: Hybrid dynamic stabilization combined with TLIF provides superior clinical outcomes and fusion rates compared to dynamic stabilization alone, without significantly increasing the risk of ASD. These findings support the use of hybrid constructs as a balanced strategy for treating degenerative lumbar instability. Full article
(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging—3rd Edition)
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16 pages, 2166 KiB  
Case Report
Tailored Rehabilitation Program and Dynamic Ultrasonography After Surgical Repair of Bilateral Simultaneous Quadriceps Tendon Rupture in a Patient Affected by Gout: A Case Report
by Emanuela Elena Mihai, Matei Teodorescu, Sergiu Iordache, Catalin Cirstoiu and Mihai Berteanu
Healthcare 2025, 13(15), 1830; https://doi.org/10.3390/healthcare13151830 - 26 Jul 2025
Viewed by 419
Abstract
Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term [...] Read more.
Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term gout who presented a bilateral simultaneous quadriceps tendon rupture (BSQTR). We showcase the clinical presentation, the surgical intervention, rehabilitation program, dynamic sonographic monitoring, and home-based rehabilitation techniques of this injury, which aimed to improve activities of daily living (ADL) and quality of life (QoL). The patient was included in a 9-week post-surgical rehabilitation program and a home-based rehabilitation program with subsequent pain management and gait reacquisition. The outcome measures included right and left knee active range of motion (AROM), pain intensity measured on Visual Analogue Scale (VAS), functioning measured through ADL score, and gait assessment on Functional Ambulation Categories (FAC). All endpoints were measured at different time points, scoring significant improvement at discharge compared to baseline (e.g., AROM increased from 0 degrees to 95 degrees, while VAS decreased from 7 to 1, ADL score increased from 6 to 10, and FAC increased from 1 to 5). Moreover, some of these outcomes continued to improve after discharge, and the effects of home-based rehabilitation program and a single hip joint manipulation were assessed at 6-month follow-up. Musculoskeletal ultrasound findings showed mature tendon structure, consistent dynamic glide, and no scarring. Full article
(This article belongs to the Special Issue Joint Manipulation for Rehabilitation of Musculoskeletal Disorders)
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8 pages, 248 KiB  
Article
The Association Between Female Breast Size, Backache, and Quality of Life in Young Women: A Cross-Sectional Study
by Raphael Lotan, Natali Marmor, Sharon Weiss, Mojahed Sakhnini and Oded Hershkovich
Medicina 2025, 61(8), 1353; https://doi.org/10.3390/medicina61081353 - 26 Jul 2025
Viewed by 238
Abstract
Background and Objectives: The association between female breast size and spinal back pain is widely suggested in clinical practice but remains insufficiently quantified in general, non-surgical populations in the scientific literature. Larger breasts may increase biomechanical strain on the spine, contributing to [...] Read more.
Background and Objectives: The association between female breast size and spinal back pain is widely suggested in clinical practice but remains insufficiently quantified in general, non-surgical populations in the scientific literature. Larger breasts may increase biomechanical strain on the spine, contributing to musculoskeletal pain and reduced quality of life. This study aimed to evaluate the association between breast size and back pain in a general orthopedic population of young women. Materials and Methods: A cross-sectional study was conducted among 200 women aged 18–36 who attended orthopedic clinics for non-spinal complaints. Data were collected via structured telephone questionnaires, including demographics, self-reported breast size (cup and band), pain characteristics, and SF-12 quality of life scores. Binary logistic regression, ANOVA, and chi-square analyses assessed associations between breast size, pain presence, severity, and functional outcomes. Results: Back pain prevalence increased with breast size: only 4.9% of B cup participants reported backache, compared to 85% of DD/E cup participants. VAS scores rose from 0.3 ± 1.6 (B cup) to 6.0 ± 2.9 (DD/E cup). Each 1 cm increase in band length raised the odds of back pain by 19.8% (OR = 1.198, p < 0.001), while large cup size was associated with up to 12-fold increased odds of pain. Larger breast size was also significantly associated with work limitations and social impairment. Conclusions: Breast size was strongly associated with the presence and severity of back pain, particularly in the thoracic and cervical regions. Clinicians should consider breast size in the assessment of backache, and reduction mammaplasty may have therapeutic value beyond aesthetics. Full article
12 pages, 578 KiB  
Article
The Role of Allografts in Revision ACL Reconstruction
by Antonio Maestro, Carmen Toyos, Nicolás Rodríguez, Iván Pipa, Lucía Lanuza, Filipe Machado, César Castaño and Santiago Maestro
Medicina 2025, 61(8), 1350; https://doi.org/10.3390/medicina61081350 - 25 Jul 2025
Viewed by 173
Abstract
Background and Objectives: Although the use of allografts in revision anterior cruciate ligament reconstruction is associated with theoretical advantages, it has historically led to poorer clinical results and lower survival rates. However, the heterogeneity of the available literature makes it difficult to [...] Read more.
Background and Objectives: Although the use of allografts in revision anterior cruciate ligament reconstruction is associated with theoretical advantages, it has historically led to poorer clinical results and lower survival rates. However, the heterogeneity of the available literature makes it difficult to elucidate the effectiveness of allographs, as most of the studies published do not make any reference to some of the key aspects related to the processing of the allograft employed. The present study analyzed the clinical results and the survival of allografts in patients undergoing revision anterior cruciate ligament reconstruction with a well-characterized, single type of allograft. Materials and Methods: This was a retrospective observational study analyzing a series of patients undergoing revision anterior cruciate ligament reconstruction with an Achilles tendon allograft with a bone block (FlexiGraft, LifeNet Health), subjected to low-dose irradiation at dry ice temperatures. Preoperative and follow-up clinical variables (IKDC, pain, hop test, and YBT scores) were recorded. Survival was analyzed using the Kaplan–Meier methodology. Results: A total of 39 patients (34 male, 5 female) were included in the study. The mean patient age was 37.3 years and mean postoperative follow-up was 78.7 months. Forty-one percent of patients were competitive athletes, and all of the patients in the sample exhibited preoperative instability. The mean allograft thickness was 9.2 mm. During surgery, 51.3% of patients required meniscus repair and 20.5% had to be treated for chondral defects. At the last follow-up visit, 92.3% of the subjects presented with IKDC grade A and 7.7% with IKDC grade B. The mean subjective IKDC score was 0.79 and mean pain intensity was 1.15 according to the VAS scale. Limb symmetry, as measured by the various hop tests and the Y balance test, were within the safety range, with 74.4% of patients succeeding in returning to their previous level of sport. Ten-year survival was estimated at 97.4%. Conclusions: Allografts obtained and processed following the current regulations governing patient selection and graft harvesting, which are additionally processed without recourse to chemical procedures and sterilized at less than 2 MRad in dry ice conditions, represent an effective and safe alternative in revision anterior cruciate ligament reconstruction. Full article
(This article belongs to the Special Issue Anterior Cruciate Ligament (ACL) Injury)
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20 pages, 275 KiB  
Article
Role of Questionnaires in the Assessment of Severity and the Outcomes of Minimally Invasive Surgery for Snoring and Obstructive Sleep Apnea
by Natalia Olszewska, Ewa Olszewska and Cuneyt M. Alper
J. Clin. Med. 2025, 14(15), 5268; https://doi.org/10.3390/jcm14155268 - 25 Jul 2025
Viewed by 197
Abstract
Background/Objectives: Sleep questionnaires are used as screening tools to estimate the presence and severity of snoring and obstructive sleep apnea (OSA). The aim was to prospectively assess the diagnostic and prognostic accuracy of sleep questionnaires (Epworth Sleepiness Scale (ESS), Visual Analog Scale [...] Read more.
Background/Objectives: Sleep questionnaires are used as screening tools to estimate the presence and severity of snoring and obstructive sleep apnea (OSA). The aim was to prospectively assess the diagnostic and prognostic accuracy of sleep questionnaires (Epworth Sleepiness Scale (ESS), Visual Analog Scale for snoring loudness (VAS), Short Form Health Survey 36 (SF-36), STOP-Bang, and Pittsburgh Quality of Sleep (PSQI)) in subjects who underwent minimally invasive surgery for snoring and OSA. Methods: A total of 49 participants with primary snoring and/or OSA underwent minimally invasive surgery. Pre- and post-operative sleep study parameters and sleep questionnaire results were analyzed to assess the correlation between the subjective and objective parameters before and after surgery and changes with the surgery. Results: Pre-operative sleep study parameters demonstrated: an apnea–hypopnea index (AHI) of 16.71 ± 9.31, oxygen desaturation index (ODI) of 14.43 ± 9.31, and mean percentage of snoring time (ST) of 17.26 ± 14.5%, ESS of 9.04 ± 5.76, VAS of 8.18 ± 1.93, SF-36 of 42.12 ± 22.86, STOP-Bang of 3.65 ± 1.13, and PSQI of 6.61 ± 3.23. Post-operative sleep study parameters demonstrated an AHI of 10.39 ± 7.86, ODI of 10.17 ± 7.78, and ST of 12.55 ± 13.36%, ESS of 6.61 ± 4.55, VAS of 4.13 ± 2.87, SF-36 of 42.45 ± 24.70, STOP-Bang of 2.49 ± 1.42, and PSQI of 4.98 ± 2.13. Changes with surgery for sleep parameters demonstrated a decrease in AHI: 37.83%, ODI: 29.52%, ST: 27.3%, ESS: 26.86%, VAS: 49.50%, PSQI: 24.69%, and STOP-Bang: 31.84%. The score of SF-36 was not significant. Conclusions: Sleep questionnaires are an essential component of the workup for patients with snoring and OSA. There are differences in their ability to identify the presence and quantify the severity of snoring and OSA when compared to objective sleep parameters. Their sensitivity in assessing changes with treatment also varies. Full article
(This article belongs to the Special Issue Obstructive Sleep Apnea: Latest Advances and Prospects)
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
Viewed by 306
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
Viewed by 226
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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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 402
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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14 pages, 286 KiB  
Article
Comparative Efficacy and Safety of Two Different Formulations of Linear Hyaluronic Acid in Patients with Knee Osteoarthritis
by Vincenzo Rania, Cristina Vocca, Gianmarco Marcianò, Maria Cristina Caroleo, Lucia Muraca, Emanuele Toraldo, Francesca Greco, Caterina Palleria, Gian Pietro Emerenziani and Luca Gallelli
Pharmaceuticals 2025, 18(7), 1065; https://doi.org/10.3390/ph18071065 - 19 Jul 2025
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Abstract
Introduction: Knee osteoarthritis (OA) is defined by articular cartilage loss, increased discomfort, and functional restrictions. Changes in lifestyle, painkillers, intra-articular injections, and, as a last resort, surgery are all part of clinical therapy. In this setting, intra-articular injections of hyaluronic acid (HA) [...] Read more.
Introduction: Knee osteoarthritis (OA) is defined by articular cartilage loss, increased discomfort, and functional restrictions. Changes in lifestyle, painkillers, intra-articular injections, and, as a last resort, surgery are all part of clinical therapy. In this setting, intra-articular injections of hyaluronic acid (HA) represent a relevant and diffused therapeutic option. Materials and Methods: A prospective observational study was performed from October 2024 to May 2025 in 70 patients with knee OA. HA was administered in three intra-articular injections and was followed up at 3 and 6 months from the last injection. Knee Injury and Osteoarthritis Outcome Score (KOOS) was evaluated as primary outcome measure; Visual Analogue Scale (VAS), time up and go test, six-minute walking test, general health assessment with 36-Item Short Form Health Survey (SF-36), Zung’s Self-Rating Anxiety Scale (Zung SAS), and Zung’s Self-Rating Depression Scale (Zung SDS) as secondary outcome measures. Results: We observed a statistically significant improvement in clinical scores at 3 months in both HA formulations compared to the control group. No relevant side effects were described during the study. Conclusion: Hyalubrix 30 mg/2 mL and DIART 1.8%/2 mL are two safe and effective therapeutic options to manage knee OA, offering benefits in pain control, functionality and emotional wellness. Full article
(This article belongs to the Section Pharmacology)
18 pages, 644 KiB  
Article
Atrial Fibrillation Risk Scores as Potential Predictors of Significant Coronary Artery Disease in Chronic Coronary Syndrome: A Novel Diagnostic Approach
by Alexandru-Florinel Oancea, Paula Cristina Morariu, Maria Godun, Stefan Dorin Dobreanu, Miron Mihnea, Diana Gabriela Iosep, Ana Maria Buburuz, Ovidiu Mitu, Alexandru Burlacu, Diana-Elena Floria, Raluca Mitea, Andrei Vâță, Daniela Maria Tanase, Antoniu Octavian Petris, Irina-Iuliana Costache-Enache and Mariana Floria
Life 2025, 15(7), 1134; https://doi.org/10.3390/life15071134 - 18 Jul 2025
Viewed by 342
Abstract
Chronic coronary syndrome (CCS) and atrial fibrillation (AF) are prevalent cardiovascular conditions that share numerous risk factors and pathophysiological mechanisms. While clinical scores commonly used in AF—such as CHA2DS2VA (which includes congestive heart failure, hypertension, age ≥ 75, diabetes, [...] Read more.
Chronic coronary syndrome (CCS) and atrial fibrillation (AF) are prevalent cardiovascular conditions that share numerous risk factors and pathophysiological mechanisms. While clinical scores commonly used in AF—such as CHA2DS2VA (which includes congestive heart failure, hypertension, age ≥ 75, diabetes, stroke/TIA, vascular disease, and age 65–74), HAS-BLED (which incorporates hypertension, abnormal renal/liver function, stroke, bleeding history, labile INR, elderly age, and drug/alcohol use), and C2HEST (incorporating coronary artery disease, COPD, hypertension, elderly age ≥ 75, systolic heart failure, and thyroid disease)—are traditionally applied to rhythm or bleeding risk prediction, their value in estimating the angiographic severity of coronary artery disease (CAD) remains underexplored. We conducted a prospective, single-center study including 131 patients with suspected stable CAD referred for coronary angiography, stratified according to coronary angiographic findings into two groups: significant coronary stenosis (S-CCS) and non-significant coronary stenosis (N-CCS). At admission, AF-related scores (CHA2DS2, CHA2DS2VA, CHA2DS2VA-HSF, CHA2DS2VA-RAF, CHA2DS2VA-LAF, HAS-BLED, C2HEST, and HATCH) were calculated. CAD severity was subsequently assessed using the SYNTAX and Gensini scores. Statistical comparisons and Pearson correlation analyses were performed to evaluate the association between clinical risk scores and angiographic findings. Patients in the S-CCS group had significantly higher scores in CHA2DS2VA (4.09 ± 1.656 vs. 3.20 ± 1.338, p = 0.002), HAS-BLED (1.98 ± 0.760 vs. 1.36 ± 0.835, p < 0.001), CHA2DS2VA-HSF (6.00 ± 1.854 vs. 5.26 ± 1.712, p = 0.021), and C2HEST (3.49 ± 1.501 vs. 2.55 ± 1.279, p < 0.001). Multivariate logistic regression identified HAS-BLED and C2HEST as independent predictors of significant coronary lesions. A threshold value of HAS-BLED ≥ 1.5 and C2HEST ≥ 3.5 demonstrated moderate discriminative ability (AUC = 0.694 and 0.682, respectively), with acceptable sensitivity and specificity. These scores also demonstrated moderate to strong correlations with both Gensini and SYNTAX scores. AF-related clinical scores, especially HAS-BLED and C2HEST, may serve as practical and accessible tools for early CAD risk stratification in patients with suspected CCS. Their application in clinical practice may serve as supplementary triage tools to help prioritize patients for further diagnostic evaluation, but they are not intended to replace standard imaging or testing. Full article
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