Search Results (836)

Transcatheter aortic valve implantation (TAVI) has transformed the management of severe aortic stenosis (AS), evolving from a therapy reserved for inoperable patients to a viable treatment across the spectrum of surgical risk. This success has stimulated innovation in transcatheter therapies for other valvular heart diseases, including aortic regurgitation (AR). In contrast to AS, AR is characterised by heterogeneous aetiologies, absence of annular calcification, larger and more elliptical annular dimensions, and concomitant aortopathy. These challenges have limited the efficacy and safety of conventional transcatheter aortic valves (TAVs), use of which in pure native AR is associated with high rates of valve embolisation, significant residual regurgitation, permanent pacemaker implantation, and mortality. The development of dedicated TAVs designed specifically for the treatment of AR has addressed many of these anatomical challenges. The JenaValve Trilogy and J-Valve systems incorporate leaflet-grasping mechanisms that enable secure anchoring independent of calcification, resulting in transformation of procedural and clinical outcomes. Recent prospective registry data, including the landmark ALIGN-AR trial, demonstrate high technical and procedural success rates, low residual regurgitation, acceptable safety profiles, and meaningful improvements in functional status and ventricular remodelling. These data have informed contemporary guideline updates, with the 2025 European Society of Cardiology (ESC)/European Association of Cardiothoracic Surgery (EACTS) Guidelines for the management of valvular heart disease issuing the first conditional recommendation for TAVI in selected patients with severe AR and the National Institute for Health and Care Excellence (NICE) recommending TAVI for native AR in patients for whom surgical AVR is not available or is high risk. This review summarises the clinical implications of AR, examines current guideline recommendations for management, and critically appraises the evidence supporting transcatheter treatment strategies. Full article

IgA nephropathy is the most common primary glomerulonephritis worldwide and a leading cause of chronic kidney disease and kidney failure, with geographic and ancestral variation and a course ranging from asymptomatic urinary abnormalities to progressive loss of kidney function. This narrative review links the multi-hit model to risk stratification, biomarkers, current management, and emerging therapies, and highlights implementation gaps. Risk assessment is longitudinal, prioritizing proteinuria and estimated glomerular filtration rate trajectories and integrating Oxford MEST-C, prediction tools, and biomarker and multi-omics approaches, while recognizing limitations in histologic reproducibility and model calibration. Current management is anchored in optimized supportive care aimed at sustained proteinuria reduction and kidney protection, including intensive blood pressure control with maximal tolerated renin–angiotensin system blockade, dietary sodium restriction and lifestyle measures, and sodium–glucose co-transporter 2 inhibitors for eligible patients. For selected higher-risk patients with persistent proteinuria despite optimized supportive care, immunomodulatory strategies are discussed, including systemic corticosteroids and targeted-release budesonide (Nefecon), emphasizing structured toxicity risk mitigation and cautioning against assuming interchangeability among alternative oral budesonide formulations. Emerging therapies are organized around mechanism-aligned targets across the BAFF/APRIL axis, complement pathways, and endothelin-based approaches, with growing interest in sequencing and combination regimens layered on supportive care. Key gaps include reliance on surrogate endpoints, limited long-term durability and safety data, and uneven evidence for special populations. Full article

Antimicrobial resistance (AMR) is an ever-growing threat to global healthcare. It is largely driven by delayed or inadequate pathogen identification and antimicrobial susceptibility testing in routine clinical workflows. By the time the clinician receives results to guide treatment from traditional culture-based diagnostics, several days may have elapsed, leading to the use and potential over-prescription of broad-spectrum antibiotics and the development of resistant pathogens. A rapid and clinically actionable diagnostic approach at the clinical point of care (POC) may help address this gap. This review examines current and emerging POC diagnostic technologies for AMR and outlines the fundamental principles and mechanistic classifications of POC diagnostic technologies. These include phenotypic, genotypic, immunological, and biosensor-based approaches. A critical overview of key technological platforms, including rapid phenotypic antimicrobial susceptibility testing (AST), microfluidics and isothermal nucleic acid amplification (e.g., LAMP and RPA), CRISPR-based diagnostics, nanomaterial-enhanced biosensors, and mobile-integrated systems is provided. The impact of POC diagnostics on antimicrobial stewardship, time to appropriate therapy, and patient outcomes in primary care settings, hospitals, intensive care units, and resource-limited settings is presented and discussed. In addition to clinical implementation challenges, this review considers the issues of analytical performance, workflow, regulatory pathways, cost, and implementation readiness. In addition, it outlines key trends regarding digital integration, surveillance, workforce training, and policy frameworks. Overall, the review outlines the role of POC diagnostics in enhancing antimicrobial response surveillance and the global fight against AMR. Among emerging platforms, rapid phenotypic AST, microfluidic and isothermal-based assays, CRISPR-based diagnostics, and integrated biosensor systems show the greatest potential for near-term clinical impact; however, widespread implementation remains constrained by challenges related to clinical validation, cost, workflow integration, and alignment with antimicrobial stewardship frameworks. Full article

Conventional diabetes therapy primarily targets HbA1c using a standardized, stepwise approach, often neglecting individual clinical and diagnostic phenotypes. In this second part of our discussion, we present an alternative strategy. After phenotyping the patient, we initiate a targeted pharmacological combination therapy tailored to the individual’s underlying pathophysiology, alongside lifestyle modifications. Sulfonylureas are completely avoided in this approach. Instead, medications are selected based on their alignment with the patient’s phenotype and absence of contraindications. Early insulin therapy, for example, is particularly effective in patients with β-cell-dysfunction-driven diabetes, whereas GLP-1-supported weight reduction and glitazone therapy are more suitable for insulin-resistance-driven diabetes. For monitoring and determining when temporary therapy intensification may be necessary, we rely on a combination of functional biomarkers (intact proinsulin, adiponectin, hsCRP, and leptin) and conventional clinical parameters (HbA1c, BMI, lipids, blood pressure). Using this personalized strategy, we have consistently achieved long-term glycemic control—often maintaining normal HbA1c levels for up to 15 years in our patients so far. Full article

Background/Objectives: Chronic and recurrent sialadenitis are inflammatory disorders of the major salivary glands often managed with repeated courses of systemic antibiotics, despite limited long-term efficacy and growing concerns regarding antimicrobial resistance. Minimally invasive intraductal therapies, including sialoendoscopy with irrigation, have emerged as effective alternatives aimed at addressing ductal obstruction and chronic inflammation while reducing antibiotic exposure. This study aimed to systematically review the available evidence on the effectiveness and safety of sialoendoscopy with intraductal irrigation in the management of chronic and recurrent sialadenitis, with particular attention to its potential antibiotic-sparing role. Methods: A literature review was conducted in accordance with PRISMA guidelines. Major scientific databases were searched to identify studies evaluating sialoendoscopy with intraductal irrigation in patients with chronic or recurrent sialadenitis. Study characteristics, patient populations, irrigation protocols, and clinical outcomes were extracted and qualitatively analyzed. Results: Sialoendoscopy with intraductal irrigation was associated with significant clinical improvement in more than two-thirds of patients, with complete or partial symptom resolution. The procedure demonstrated high technical feasibility and a favorable safety profile. Symptom control was maintained across most etiological subgroups. The need for prolonged or repeated systemic antibiotic treatment decreased following endoscopic intervention. Conclusions: Sialoendoscopy with intraductal irrigation may represent a promising and minimally invasive therapeutic option for chronic and recurrent sialadenitis and may contribute to improved antibiotic stewardship by reducing unnecessary systemic antibiotic use. These findings suggest that intraductal therapeutic strategies could be considered within evolving care pathways for chronic salivary gland disorders, aligning clinical management with broader public health efforts to combat antimicrobial resistance. Full article

Background: Post-cardiac arrest syndrome (PCAS) following out-of-hospital cardiac arrest (OHCA) is driven by global ischemia–reperfusion injury, endothelial dysfunction, and a dysregulated inflammatory response. This cascade frequently culminates in profound vasoplegia and multiorgan failure, even when guideline-directed post-resuscitation management is applied. Hemoadsorption using the CytoSorb device may attenuate hyperinflammation and vasoplegia by removing circulating inflammatory and injury-related mediators. Methods: This single-centre, retrospective cohort study compared adults with PCAS following OHCA who received hemoadsorption with propensity score-matched controls (1:1 matching; n = 50 per group). For patients treated with hemoadsorption, data were analyzed within predefined intervals covering the 24 h preceding therapy initiation (T1) and the 24 h following the completion of the hemoadsorption treatment period (T2). Controls were evaluated at time points aligned to those of their matched hemoadsorption counterparts. Hemodynamic, metabolic, respiratory, and organ injury markers were assessed. Results: Formal between-group comparisons of temporal change between T1 and T2 showed no statistically significant differences between hemoadsorption-treated patients and matched controls across key parameters, including VIS (Δ −18.7 vs. −7.7; p = 0.183) and lactate (Δ −1.8 vs. −1.25 mmol/L; p = 0.780), as well as markers of organ injury, pH, and oxygenation. In exploratory ANCOVA models, only base excess was associated with treatment group (p = 0.035). Survival to hospital discharge was comparable (48% vs. 40%; p = 0.423), with similar neurological outcomes. Within the hemoadsorption group, pre–post comparisons around hemoadsorption initiation (T1–T2) demonstrated marked improvements, including reduced vasoactive support (VIS 70.0 to 12.1; p = 0.039), substantial lactate clearance (4.1 to 1.1 mmol/L; p < 0.001), and declines in organ injury markers (AST, ALT, LDH, myoglobin), alongside more pronounced platelet reduction compared with controls (129 to 57 × 10³/µL vs. 189 to 123 × 10³/µL). However, adjusted analyses indicated that these changes were primarily driven by baseline shock severity rather than a treatment-specific effect. Conclusions: In this propensity score-matched cohort of PCAS patients after OHCA, hemoadsorption was associated with within-group physiological changes but showed no detectable advantage over matched controls, with similar survival. These findings are hypothesis-generating and warrant prospective studies with standardized timing and phenotype-guided patient selection. Full article

Objectives: To evaluate the association between European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) scores and treatment recommendations from European Society for Medical Oncology, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) in curative and metastatic breast cancer (BC), and to assess inter-guideline concordance. Methods: We conducted a comparative review of 47 systemic BC therapies with published ESMO-MCBS scores (accessed 30 June 2025). Guideline recommendations from ESMO, NCCN, and ASCO were extracted from the most recent versions and harmonized into ordinal tiers. Associations between MCBS scores and recommendation categories were evaluated using Fisher’s exact test and Spearman’s rank correlation in the palliative setting. Curative therapies were analyzed descriptively due to limited variability. Results: Among 38 palliative therapies, 40% achieved high clinical benefit (MCBS 4–5). A significant association was observed between MCBS scores and NCCN recommendations (p = 0.003; ρ = 0.48), with 62% of NCCN Category 1 therapies demonstrating high benefit versus 13% in other categories. No significant associations were observed with ASCO (p = 0.101; ρ = 0.18) or ESMO guideline recommendations (p = 0.073; ρ = 0.19). Inter-guideline concordance was strongest between ASCO and ESMO (p = 0.033; ρ = 0.48). In the curative setting (n = 9), most therapies received an MCBS grade A and top-tier guideline endorsement. Conclusions: Alignment between ESMO-MCBS and guideline recommendations is moderate and framework-dependent, strongest with NCCN in metastatic BC. Discordance primarily reflects differences between magnitude-of-benefit thresholds and evidence-certainty frameworks. ESMO-MCBS may serve as a complementary tool to enhance value-based clinical and policy decision-making. Full article

Background: Hormone receptor-positive (HR+), Human Epidermal growth factor Receptor 2 (HER2-negative) metastatic breast cancer (MBC) represents a substantial proportion of breast cancer cases in Saudi Arabia. Despite the established efficacy of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, particularly Palbociclib, in randomized control trials, real-world data from local institutions in Saudi Arabia remain limited. Objectives: This study aimed to evaluate progression-free survival (PFS), overall survival (OS), and toxicity profile among HR+, HER2-negative MBC female patients treated with Palbociclib at King Fahad Medical City (KFMC). Methods: A retrospective study was conducted on female patients with HR+/HER2-negative MBC treated with oral palbociclib combined with endocrine therapy (ET) at KFMC between January 2021 and September 2024. Data were collected from electronic health records. Descriptive statistics were conducted using mean for continuous variables and frequency for categorical variables. Survival analyses were conducted using Cox regression, log-rank tests and Kaplan–Meier analysis. Results: A total of 169 female patients with HR+/HER2− MBC were included. In the first-line setting, the median PFS was 20.14 months (95% CI: 14.65–30.49), compared with 11.3 months (95% CI: 7.98–not estimable) in the second-line setting. For OS, the median OS values were 53.1 months (95% CI: 41.2–not estimable) in the first-line group and 23.7 months (95% CI: 18.5–not estimable) in the second-line group. Significant predictors of shorter PFS included age, Body Mass Index (BMI), type of ET, cancer type, line of therapy, family history of cancer, and history of VTE. Visceral metastasis (HR = 3.087; p = 0.0229) and ECOG performance status of 4 (HR = 13.86; p = 0.0156) were associated with significantly shorter OS. The most common hematological adverse events (AEs) were neutropenia (45.6%), followed by anemia (5.9%), leukopenia (5.3%), and back pain (5.3%). Most toxicities were managed with dose reduction, holding treatment, or supportive care. Conclusions: Palbociclib demonstrated favorable survival outcomes and a manageable safety profile, with neutropenia being the most common AE. This study provides region-specific real-world evidence supporting the use of Palbociclib in HR+/HER2− MBC. These findings align with global trial data and highlight the importance of individualized treatment in clinical practice. Full article

Background/Objectives: To compare the efficacy of two aligner systems (Invisalign and Eon Aligner) across multiple linear and angular movements. Methods: A total sample of 80 patient cases (n = 40 in each group) was recruited retrospectively. Per case, 3 digital models were retrieved in the form of stereolithography (STL) files. Predicted and achieved tooth movements were measured using the 3Shape Clear Aligner Studio. Initial models were aligned on the predicted and achieved models to create superimposition. Differences in measurement between pre-treatment, predicted, and post-treatment scans were measured. Agreement between the two, Invisalign and Eon, was measured using the interclass correlation coefficient (ICC). Results: Both Invisalign (ICC = 0.82; 95% CI 0.66, 0.9) and Eon Aligner (ICC = 0.75; 95% CI 0.53, 0.87) have shown good agreement when calculating the average differences between the achieved and predicted interpremolar width values. Similar results were found for both intercanine width values (Invisalign: ICC = 0.96; 95% CI = 0.93, 0.98 vs. Eon Aligner: ICC = 0.98; 95% CI = 0.97, 0.99). In Eon cases, good to excellent agreement between the achieved and predicted models was observed for lateral (ICC = 0.89; 95% CI = 0.79, 0.94) and central (ICC = 0.93; 95% CI = 0.87, 0.96) mesiodistal rotations. Conversely, Invisalign displayed moderate strength of agreement for the lateral (ICC = 0.68; 95% CI = 0.40, 0.83) and central (ICC = 0.70; 95% CI = 0.44, 0.84) mesiodistal readings. While both aligners demonstrated some level of predictive capacity towards horizontal movements, they were unreliable in predicting vertical movements. Differences in magnitude of change between initial and achieved values between Eon and Invisalign were noted only for certain teeth in the case of horizontal and vertical movements. Conclusions: Both clear aligner therapy systems were able to achieve satisfactory outcomes in terms of inter-premolar and intercanine width changes. Eon Aligner, on the other hand, outperformed Invisalign in terms of rotational accuracy and horizontal movement precision. Notably, both systems demonstrated poor predictability for vertical movements and suffer from significant systemic bias requiring over-correction. Full article

Background/Objectives: Early-phase clinical trials (EPCTs) focus on safety and preliminary efficacy, often assessed by RECIST (Response Evaluation Criteria in Solid Tumours) tumour response. Health-related quality of life (HRQoL) is rarely evaluated in EPCTs and may not align with radiological outcomes. Methods: The PEARLER (Patient Experience in Early-Phase Cancer Clinical Trials) study evaluated the demographics, tumour response, HRQoL, and therapy type in two early-phase trial units in Australia between August 2023 and 2024. Patients completed the EORTC QLQ-C30 at baseline and follow-ups. The Global Health Status (GHS) score was selected as the primary HRQoL measure. Tumour response was assessed using RECIST 1.1. Spearman correlation and Kruskal–Wallis testing assessed the associations between RECIST, cross-sectional GHS change (ΔGHS; follow-up minus baseline), and therapy types. Multilevel models were used to evaluate longitudinal GHS values per RECIST category. Results: Of 122 patients recruited to the PEARLER study, 74 patients had paired RECIST and HRQoL data (complete response (CR) n = 0; partial response (PR) n = 15; stable disease (SD) n = 39; progressive disease (PD) n = 20). The median change in GHS was zero across RECIST groups, with broad individual variability. Notably, 18 of 54 patients (33.3%) with stable or responding disease experienced HRQoL decline. Meanwhile, 10 of 20 (50%) patients with PD experienced stable or improving HRQoL. The best RECIST response and ΔGHS showed a weak but statistically significant negative relationship (Spearman ρ = −0.28, p = 0.017), with the Kruskal–Wallis test demonstrating χ² = 6.20 (p = 0.045), indicating modest group differences driven by the deterioration in PD patients. The multilevel model demonstrated a lower GHS in patients with PD, with no statistically significant interaction of GHS change over time with the RECIST response (p = 0.226). Conclusions: HRQoL change is largely independent of radiologic tumour response and therapy type in EPCT participants. Patients experienced a HRQoL decline despite tumour response. Incorporating patient-reported outcomes alongside RECIST and safety outcomes is important to fully capture the impact of investigational therapies and guide patient-centred trial designs. Full article

Background: Orthodontic treatment is increasingly recognised as a complex, patient-centred intervention whose impact extends beyond occlusal correction to include physical comfort, psychosocial well-being, and self-perceived esthetics. Oral health-related quality of life (OHRQoL) has therefore become a key outcome for evaluating orthodontic care across all treatment stages. Aim: This narrative review of 140 studies synthesises current evidence on OHRQoL changes in orthodontic patients before treatment, during active therapy, and after treatment completion, with particular emphasis on temporal patterns and appliance-related differences. Methods: A comprehensive narrative review of 140 studies was conducted using PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar (search period: inception to December 2025). Studies assessing OHRQoL or patient-reported outcomes in orthodontic patients of any age were included. Only studies employing validated instruments, such as OHIP, CPQ, OIDP, and PIDAQ, were considered. Dual-reviewer agreement was assessed using Cohen’s kappa (κ = 0.82). Formal risk-of-bias assessment was conducted using ROBINS-I for non-randomised studies and the Cochrane Risk of Bias tool for RCTs. Sensitivity analyses were performed comparing high-quality studies (low risk of bias, n = 52) versus all included studies. Results: The reviewed evidence consistently demonstrates that malocclusion is associated with impaired baseline OHRQoL, particularly affecting psychosocial and esthetic domains. The early phase of orthodontic treatment is marked by a transient deterioration in OHRQoL due to pain, discomfort, speech disturbances, and functional limitations (87% of studies report pain peaks within 24–48 h; 79% report resolution by 4–7 days). These effects typically diminish as patients adapt to the appliance. Progressive improvement is observed during mid-treatment, while treatment completion is associated with substantial long-term gains in self-esteem, social functioning, and overall quality of life. Appliance type influences short-term outcomes, with clear aligners generally associated with better early OHRQoL than fixed and lingual systems (65–75% of studies favour aligners for early comfort; 78% favour lingual systems for esthetic satisfaction). Conclusions: Orthodontic treatment follows a dynamic, time-dependent OHRQoL trajectory characterised by short-term impairment and significant long-term psychosocial benefits. Systematic integration of validated OHRQoL measures into orthodontic care may enhance patient-centred decision-making and optimise clinical outcomes. Full article

Bloodstream infection (BSI) is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD), particularly those receiving hemodialysis. Delayed identification of pathogens and their resistance profiles can lead to inappropriate therapy and adverse outcomes. This review evaluates rapid molecular diagnostic approaches for detecting pathogens and resistance markers in BSI, with emphasis on their application in CKD. These technologies provide faster microbiological information by enabling direct or accelerated detection of pathogens and selected resistance determinants. Clinical studies indicate that their use supports prompt adjustment of antimicrobial therapy, especially when combined with antimicrobial stewardship and applied after blood culture positivity. In CKD, identification of the causative organism facilitates treatment selection aligned with renal function and helps reduce unnecessary exposure to nephrotoxic agents. However, diagnostic accuracy differs among platforms, and detection of resistance genes does not consistently reflect phenotypic susceptibility. Furthermore, most evidence is derived from mixed hospital populations rather than CKD-specific cohorts. These factors require careful interpretation within the clinical context. Rapid molecular diagnostics can enhance antimicrobial decision-making in BSI, but their effectiveness depends on integration with conventional microbiology and structured care pathways. Further research in CKD populations is required to clarify their impact on clinical outcomes and to support implementation in nephrology practice. Full article

Adolescents living with HIV (ALHIV) face ongoing challenges with treatment adherence and engagement in care, resulting in lower viral suppression rates compared to adults. Peer navigation has shown promise in supporting psychosocial well-being and adherence among adults, but evidence specific to adolescents in sub-Saharan Africa (SSA) remains limited. This qualitative evidence synthesis (QES) describes and assesses the quality of qualitative and mixed-methods studies on peer navigation and support interventions for ALHIV receiving antiretroviral therapy in SSA. Eligible studies, published in English between January 2015 and October 2025, were identified through a comprehensive search strategy in PubMed, Scopus, CINAHL, and APA PsycArticles. Data were extracted and analyzed thematically using Atlas.ti, and aligned with the Context–Intervention–Mechanism–Outcome (CIMO) framework. PNs in the studies were young people living with HIV who provided education, counselling and adherence support to their peers who were ALHIV. Effective programmes featured structured training, supportive supervision, and flexible delivery models adapted to adolescents’ preferences. Mechanisms of change included trust-building, emotional support, disclosure coaching and empowerment. Reported outcomes included improved adherence, clinic attendance and various psychosocial indicators. However, challenges such as stigma, role ambiguity, limited remuneration, and lack of policy guidance constrained the sustainability and scalability of PN programs. Overall, peer navigation interventions appear effective in strengthening adolescent HIV care when PNs are adequately trained, supervised and contextually adapted. The variation in how peer navigation and support interventions for ALHIV are delivered and designed, along with the lack of standardization of the interventions, may affect the generalizability of the findings and the rollout of PN programs across SSA. Full article

Background/Objectives: Amniotic-derived biologics have emerged as powerful modulators of tissue regeneration. This study evaluates the composition and characteristics of a human stem cell-conditioned media (hSCCM) that is a sterile, cell-free, amniotic-derived solution, and the presumed efficacy of hSCCM as an active ingredient in an enriched cosmetic lotion. Methods: Data from preclinical benchtop studies and an exploratory observational assessment were reviewed. First, an investigation of the active ingredient, hSCCM, was completed. Flow cytometry assays were completed for mesenchymal stem cell (MSC) characterization. Cellular proliferation assays were conducted to evaluate concentration response, shelf life, and temperature stability. ELISA and LC-MS/MS were used to specify and detail the proteomics of the hSCCM. Second, the hSCCM-enriched lotion’s cosmetic safety and efficacy were evaluated. Preliminary microbial, stability, and early-stage nonclinical retrospective user evaluation of the hSCCM-enriched lotion was conducted to help characterize the cosmetic and evaluate topical safety and efficacy. Results: Flow cytometry demonstrated alignment with ISCT (International Society for Cell and Gene Therapy) characterization for MSCs. Initial in vitro data demonstrated enhanced proliferative effects at hSCCM concentrations as low as 5% (p-value < 0.0001); no statistically significant trend in proliferative capability in aged samples (p-value = 0.79), and no significant effect on proliferative capability when exposed to acute temperature changes (p-values all above 0.05) were observed. Proteomic characterization showed an enriched amniotic-derived solution. Microbial testing of the enriched lotion demonstrated success with multiple unique preservative formulations. hSCCM-enriched lotion demonstrated stability across acute cold- and heat-stress representative scenarios. An exploratory retrospective observational analysis revealed promising trends. Conclusions: The hSCCM demonstrates topical efficacy across in vitro dermal and follicular assays via proliferative and regenerative mechanisms and protein enrichment. The enriched lotion showed success in early-stage microbial and stability testing and demonstrates positive trends in topical skin outcomes. These findings support their potential translational application in dermatologic and aesthetic usage, and broader integumentary contexts. Full article

Music therapy (MT) is increasingly being integrated into intensive care unit (ICU) settings to modulate pain, stress, and emotional dysregulation. Although clinically promising, objective biomarkers for quantifying its neurophysiological effects are still missing. In this context, the electroencephalogram (EEG) represents a valid tool to assess cortical dynamics associated with cognitive–affective engagement elicited by MT. Our study aims to evaluate the role of electroencephalography as an objective tool for monitoring cortical responses to MT in the ICU. EEGs acquired from nine burn patients undergoing MT in the ICU were considered. Signals were preprocessed to improve the signal-to-noise ratio. Then, six frequency bands (delta, theta, alpha, beta, gamma, and sensorimotor rhythm) were extracted to compute band powers and derive 37 involvement indexes, which were statistically compared across three experimental phases: before, during, and after MT. Results demonstrate that involvement indexes effectively capture neurophysiological shifts induced by MT. Significant differences were observed in 22 indexes when comparing During-MT and Post-MT phases, with 2 indexes being statistically different also when comparing During-MT and Pre-MT phases; 5 indexes differed statistically when comparing Pre-MT and Post-MT phases. These results suggest a transient cortical engagement elicited during MT in ICU settings. Our findings align with previous research reporting EEG (and certain EEG-derived involvement indexes) sensitivity to capture music-induced cognitive and emotional modulation. This confirms electroencephalography potential to objectively reflect MT effects and support its integration in multidisciplinary burn care; however, analysis on larger cohorts is necessary to validate EEG as a clinical tool in MT. Full article