Search Results (13,060)

Background/Objectives: Neurological disorders (ND) are a global health challenge, affecting millions and greatly reducing quality of life. Disorders such as Alzheimer’s disease, mild cognitive impairment (MCI), schizophrenia, and depression often share overlapping symptoms, complicating diagnosis and treatment. Early detection is crucial for timely intervention; however, traditional diagnostic methods rely on subjective assessments and costly imaging, which are not universally accessible. Addressing these challenges, this study investigates the classification of multiple ND using electroencephalography (EEG) signals. Methods: Various feature extraction methods were employed, and the Least Absolute Shrinkage and Selection Operator (Lasso) algorithm was utilized for effective feature selection. Two-class (disease–disease and healthy control–disease), three-class (healthy control and two ND, as well as three ND), and four-class (healthy control and three ND) classifications were conducted using different machine learning algorithms with the selected features. An EEG dataset comprising 40 Alzheimer’s patients, 43 healthy controls, 42 schizophrenia patients, 28 MCI patients, and 28 depression patients served as the experimental benchmark. Results: The Linear Discriminant Analysis (LDA) classifier achieved the highest accuracy, distinguishing between healthy controls and Alzheimer’s with 100% accuracy and demonstrating strong performance in other comparisons. Multi-class classification reached 84.67% accuracy for distinguishing depression, MCI, and schizophrenia, while four-class classification achieved 57.89%, highlighting the complexity of differentiating among multiple ND. The frequent selection of frontal lobe channels across ND indicates their critical role in classification. Conclusions: This study contributes to the literature by emphasizing disease-to-disease classification over the traditional control-versus-patient framework, highlighting the potential for more effective diagnostic tools in clinical settings. Full article

Autologous platelet-rich plasma (PRP) has emerged as a promising regenerative therapy in various medical fields, including the treatment of stress urinary incontinence (SUI) in women. PRP promotes regeneration by delivering a concentrated dose of platelets to damaged tissues, triggering healing mechanisms such as hemostasis, revascularization, and connective tissue regeneration through the release of growth factors. Despite evidence supporting the short- and medium-term benefits of PRP, its long-term efficacy remains unclear, largely due to the limited duration of follow-up in existing studies. Furthermore, the lack of standardized protocols for both preparation and administration of PRP poses a significant challenge to accurately assessing and comparing its sustained therapeutic outcomes. This literature review utilized comprehensive searches of PubMed and Google Scholar databases to analyze current evidence regarding PRP’s role in managing SUI in women. SUI, often resulting from weakened pubo-urethral ligament or intrinsic sphincter dysfunction due to childbirth, aging, or hormonal changes, significantly impacts quality of life. PRP offers a safe, minimally invasive, and cost-effective treatment option; however, further large-scale, well-designed studies are necessary to define optimal protocols and confirm long-term benefits. Advancing understanding of PRP therapy could substantially improve clinical management and patient quality of life in SUI. Full article

Background and Objectives: Transcatheter Aortic Valve Replacement (TAVR) has revolutionized the management of severe aortic stenosis (AS), offering a less invasive alternative to surgical replacement, which is particularly beneficial for elderly and high-risk populations. This narrative review aims to summarize current evidence regarding TAVR’s clinical outcomes, patient selection, the role of cardiac remodeling, and the impact of geriatric syndromes on procedural success. Materials and Methods: This review is based on a comprehensive analysis of the peer-reviewed literature indexed in major scientific databases. We included relevant studies addressing TAVR in older adults, focusing on cardiac biomarkers, imaging, patient stratification, and geriatric syndromes, such as frailty, delirium, and sarcopenia. Results: Evidence indicates that TAVR significantly improves survival and quality of life in elderly patients with severe AS. Advanced cardiac imaging and biomarkers contribute to improved risk stratification and post-procedural management. Geriatric syndromes are prevalent in this population and strongly influence clinical outcomes. Tailored prehabilitation and multidisciplinary approaches are increasingly recognized as critical components of TAVR care. Conclusions: TAVR is an effective and safe option for older adults with severe AS. Optimal outcomes depend not only on procedural expertise but also on recognizing and addressing the complex interplay between cardiac pathology and geriatric vulnerabilities. A holistic, patient-centered approach is essential to maximize the therapeutic benefits in this growing patient population. Full article

Alzheimer’s disease (AD) is the leading cause of dementia worldwide and is becoming one of the most morbid diseases of this century. Recently, ocular research in AD has gained significance, as the eye, due to its close relationship with the brain, can reflect the presence of neurological disorders. Several studies have reported alterations in various ocular structures in AD, ranging from tear fluid to the retina. These changes, particularly in the retina and the optic nerve, along with cerebral atrophy affecting visual brain areas, may lead to visual dysfunctions. This narrative review summarizes and critically examines current evidence on these impairments and explores their possible underlying mechanisms. A decrease in visual acuity, contrast sensitivity, and color vision has been observed, primarily associated with retinal ganglion cell loss or damage. Furthermore, alterations in the visual field, ocular motility, and visual perception have been recorded, mainly resulting from cortical changes. These optical parameters frequently correlate with patients’ cognitive status. In conclusion, these findings highlight the importance of developing strategies to preserve visual function in these patients, helping to prevent further deterioration in their quality of life, and emphasize the potential of visual function assessment as a tool for diagnosis or predicting AD progression. Full article

Background/Objectives: Age-related macular degeneration (AMD) is a leading cause of visual impairment in older adults and often coexists with cataracts. The indication of presbyopia-correcting intraocular lenses (IOLs) in these patients remains controversial. This study aimed to evaluate the clinical performance of a non-diffractive extended depth-of-focus (EDOF) IOL (LuxSmart™) compared to a monofocal plus IOL (Tecnis Eyhance™) in cataract patients with early-stage dry AMD. Methods: In this prospective observational study, 41 patients with early-stage AMD underwent bilateral cataract surgery with either LuxSmart™ or Tecnis Eyhance™ IOL implantation, targeting postoperative emmetropia. The eye selected for analysis was the first eye scheduled for surgery. Preoperative and postoperative evaluations included high and low-contrast distance visual acuity, intermediate and near visual acuity, defocus curves, ocular light scatter (halometry), and quality of life assessment (NEI VFQ-25). Postoperative biometric accuracy and refractive outcomes were also analyzed. Results: Both IOLs showed high refractive accuracy, with 100% of eyes within ±0.50 D of target. Postoperative uncorrected distance visual acuity was 0.10 ± 0.06 LogMAR for Eyhance and 0.07 ± 0.02 for LuxSmart (p = 0.06). Low contrast VA at 20% was 0.22 ± 0.11 (Eyhance) and 0.26 ± 0.16 (LuxSmart) (p = 0.49). Depth of focus was approximately 1.75 D for both lenses. Light scatter (LDI) improved postoperatively in both groups with no significant differences (p = 0.54). VFQ-25 scores showed improvement in daily activities, though no changes were observed in driving or mental health domains. Conclusions: Both lenses are safe and effective options for early AMD patients undergoing cataract surgery, providing good functional vision at multiple distances Full article

In this preliminary study, the thermoregulatory response in individuals diagnosed with Parkinson’s disease was investigated by infrared thermography. Parkinson’s disease is a complex neurodegenerative disorder primarily known for motor impairments, significantly reducing the quality of life of affected people. However, in most cases, such disease is accompanied or preceded by non-motor symptoms, including autonomic dysfunction. As in the case of neurovegetative dysautonomia, this dysfunction involves a malfunction of the autonomic nervous system, which also plays a key role in thermoregulation. In general, such conditions are not always easy to detect; a valid method could be represented by the vasomotor response of the skin to cold stimuli. In this context, infrared thermography can provide insights into the thermoregulatory patterns associated with autonomic dysfunction, representing a valuable tool for non-invasive assessment of Parkinson’s research. Early biomarkers of the disease can be obtained through changes in skin temperature, allowing for timely intervention and management. The study was conducted on a cohort of 16 subjects (8 patients with Parkinson’s disease and 8 healthy controls), who were monitored with infrared images captured from their hands, following a specific protocol established by a preliminary analysis. Experimental results revealed that thermography can detect focal points and regions exhibiting either hyper- or hypothermia across the skin surface and muscular regions. This capability allows for extracting and categorizing precise medical data, which could inform future research aimed at identifying early markers of the disease. However, as this is a preliminary observational study, no diagnostic claims are made, and further investigations on larger cohorts with controlled comorbidities are needed. Full article

Spinal cord injury (SCI) profoundly affects motor–sensory functions, reducing mobility and quality of life. Robotic exoskeletons offer a promising solution to support gait training, improve mobility, and prevent secondary complications. Existing research predominantly focuses on complete SCI, with limited exploration of long-term effects and tailored training for incomplete SCI. This study investigates device-based outcomes of personalized exoskeleton gait training in 33 individuals with incomplete SCI, with different lesion levels: cervical, thoracic, and lumbar. Participants underwent up to 39 sessions of gait training with a commercially available lower limb exoskeleton. Session parameters, including duration, intensity, and modality, were tailored to each individual’s clinical needs as determined by a medical team. Analysis focused on endurance, performance on the device, and patient-reported outcomes related to walking fluidity, safety, and satisfaction. Results showed overall improvement in endurance and performance, with the most significant gains observed in participants with thoracic-level injuries. All participants reported increased perceived safety, walking fluidity, and high satisfaction with the training. These findings support the potential of personalized exoskeleton training to enhance outcomes and experiences for individuals with incomplete SCI. The difference in improvement between lesion levels highlights the need for customized approaches to address the diverse clinical conditions within this population. Full article

Chronic liver disease is a significant global cause of morbidity and mortality. While early-stage liver cirrhosis is often asymptomatic, it can progress to a decompensated phase known as end-stage liver disease (ESLD), resulting in a high symptom burden, diminished quality of life, and frequent hospitalizations. Palliative care is a form of specialized care aimed at addressing the needs of patients; however, it remains underutilized in ESLD patients. Globally, the integration of palliative care into ESLD is impeded by several barriers. Certain factors—such as advanced age, the presence of hepatocellular carcinoma (HCC), and transplant listing status—have been associated with higher rates of palliative care referral. This review provides a comprehensive analysis of the current literature, emphasizing the benefits of palliative care interventions in ESLD, including improved symptom control and enhanced quality of life. It also underscores the impact on caregivers and healthcare systems, notably in reducing hospital readmissions. We advocate for a paradigm shift toward proactive, patient-centered models that integrate symptom management, advance care planning, and psychosocial support alongside disease-specific treatments for patients with ESLD. Full article

Objective: This umbrella review aims to analyze the effectiveness of exercise therapy for low back pain through an analysis of systematic reviews that evaluate pain reduction, quality of life improvement, and functional outcomes. Methods: This review adhered to PRISMA guidelines and systematic review of review recommendations by searching across PubMed, Scopus, and the Cochrane Library. This study searched for systematic reviews alongside meta-analyses that evaluated exercise interventions in treating low back pain (LBP). This study included reviews that examined exercise therapy for LBP patients and presented data regarding their pain intensity, disability, and quality-of-life outcomes. Data extraction and quality assessment were performed independently by several reviewers. The methodological quality of the included systematic reviews was assessed using the AMSTAR 2 tool. Results: This research yielded 88 systematic reviews from 997 evaluated records. Reduction of pain emerged as the primary measured outcome in systematic reviews (81.8%, n = 72), and these studies showed significant improvement rates of 83.0%. The proportion of studies that concluded no change was 9.1%. The most frequently studied exercises were strengthening, aerobic, and mind–body exercises. The reviews reported quality of life improvements in 27.3% (n = 24), but most reviews (68.2%) did not assess this outcome. No studies indicated worsening outcomes. Exercise interventions demonstrated various forms that effectively contribute to LBP management, according to the study results. Conclusions: This umbrella review of 88 systematic reviews highlights that exercise therapy is a safe, effective, and commonly used strategy for managing low back pain. However, key limitations include the low methodological quality of several included reviews, risk of bias, imprecision, limited reporting of adverse effects, and confounding from multicomponent interventions. While there is limited certainty that any one type of exercise is more effective than others, individualized approaches and patient adherence appear to be critical factors in optimizing outcomes. Full article

Musculoskeletal disorders (MSDs) remain a critical occupational health issue for nursing personnel worldwide, resulting from physically demanding tasks such as patient handling and prolonged working hours. These injuries not only compromise nursing staff’s health but also impair their performance, productivity, and overall well-being. This review analyzes the current state of assistive technologies aimed at preventing MSDs in nursing staff, highlighting their effectiveness, implementation challenges, and potential benefits. A systematic selection of the scientific literature from major databases including Web of Science, Scopus, ScienceDirect, PubMed, Taylor & Francis, and ProQuest was conducted, complemented by open-access patent records. The screening process, involving two independent reviewers, achieved moderate agreement (Cohen’s Kappa = 0.418). The findings reveal that the most affected anatomical areas include the back, shoulders, and knees. Technological interventions are classified into three main categories: physical assistance devices, digital monitoring tools, and training programs. These integrated approaches offer promising avenues to enhance occupational safety, reduce injury rates, and improve nurses’ quality of life and professional performance. Full article

Aromatase inhibitors (AIs), with or without gonadotropin-releasing hormone analogs, are the cornerstone of adjuvant endocrine therapy for women with hormone receptor-positive early-stage breast cancer, offering significant reductions in recurrence risk and improving long-term survival. Their use is frequently accompanied by treatment-related toxicities that can adversely affect patients’ quality of life (QoL) and adherence to therapy. Commonly reported side effects include vasomotor symptoms, such as hot flashes; musculoskeletal disorders, such as arthralgia and myalgia; mood disorders; and genitourinary discomfort, such as vaginal dryness and dyspareunia. Additionally, AIs are associated with a heightened risk of bone loss, leading to osteoporosis and fractures, and may have implications for cardiovascular health. Effective management of these adverse events is pivotal in maintaining treatment adherence and preserving QoL. Evidence-based strategies to address these toxicities include pharmacological interventions, such as analgesics for joint pain, bisphosphonates or denosumab for bone health, and hormonal or non-hormonal approaches for vasomotor and genitourinary symptoms. Non-pharmacological measures, including physical activity, dietary adjustments, and complementary therapies, can also help mitigate symptoms. This review examines the broad spectrum of AI-associated toxicities, discusses their clinical implications, and provides an overview of evidence-based management strategies. These insights aim to support clinicians in optimizing patient care while minimizing the toxicities of therapy. Full article

Background/Objectives: Knee osteoarthritis (OA) significantly affects quality of life and poses substantial treatment challenges in patients with severe comorbidities that contraindicate total knee arthroplasty. Transarterial periarticular embolization (TAE) has developed as a minimally invasive alternative targeting pathological periarticular hypervascularity. Bilateral embolization in a single session has not yet been clearly documented. This case report describes the application of bilateral genicular artery embolization using bioresorbable gelatin microspheres. Case report: A 68-year-old male patient with severe bilateral knee OA and multiple cardiovascular comorbidities underwent simultaneous bilateral TAE using Nexsphere-F microspheres (100–300 µm). Embolization targeted hypervascular genicular branches identified through digital subtraction angiography preserving normal capsular and osseous perfusion. Results: At one-month follow-up, the patient’s pain score decreased dramatically (VAS from 8/10 to 2/10), accompanied by marked functional improvement (WOMAC score: from 64 to 84; KOOS score: from 49 to 72). No intraoperative or postoperative complications occurred and the patient required no analgesics post-procedure. Conclusions: Bilateral, same-session genicular artery embolization using bioresorbable gelatin microspheres provided short-term clinical benefits in a patient with advanced knee OA contraindicated for surgery. Full article

Chronic pancreatitis (CP) precipitates complex malnutrition through synergistic mechanisms: exocrine pancreatic insufficiency–driven maldigestion, duodenal or pancreatobiliary strictures limiting nutrient flow, cholestasis impairing micelle formation, alcohol-related anorexia, pain-induced hypophagia, proteolytic catabolism from type 3c diabetes, and a chronic inflammatory milieu that accelerates sarcopenia and bone demineralisation. Consequent calorie–protein depletion, micronutrient and fat-soluble vitamin deficits, and metabolic derangements markedly amplify morbidity. Pancreatic enzyme replacement therapy (PERT) with targeted micronutrient repletion is foundational; high-protein regimens co-administered with PERT curb muscle loss, and medium-chain triglycerides (MCTs) can augment caloric delivery by bypassing lipase dependence, although their benefit over personalised dietetic counselling is marginal. Optimal dietary fat thresholds and timing of escalation from oral to enteral or parenteral feeding remain unresolved. Comprehensive care also demands alcohol abstinence, effective analgesia and stringent glycaemic control. Serial monitoring—biochemical indices, densitometry, dual-energy X-ray absorptiometry and imaging-based body-composition metrics—permits early detection of high-risk patients and precision tailoring of interventions. Intensified multidisciplinary programmes already improve prognostic endpoints and are unveiling biomarkers of nutritional resilience. A structured, evidence-based strategy integrating PERT, macronutrient engineering, micronutrient repletion and metabolic surveillance is essential to mitigate nutrition-related morbidity, enhance long-term outcomes and optimise quality of life in CP. Full article

Context and objective: Post-amputation pain (PAP) is an umbrella term that includes residual limb pain (RLP) and phantom limb pain (PLP), posing a significant challenge to recovery and quality of life after limb loss. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has gained interest for its potential to manage PAP, particularly in refractory cases. This narrative review explores the efficacy of ketamine for PAP and the emerging role of pharmacogenomics in guiding its use. Methods: A literature review of PubMed, Embase, and Cochrane databases was conducted, focusing on clinical trials, systematic reviews, and genetic influences on ketamine metabolism and response. Studies suggest that perioperative ketamine can reduce PAP severity and opioid use. However, outcomes vary, with some patients experiencing transient relief and others achieving prolonged benefit. Results: This variability may be linked to genetic differences in CYP2B6, CYP3A4/5, COMT Val158Met, SLC6A2, and KCNS1, which affect ketamine’s metabolism, efficacy and side effect profile. Understanding these pharmacogenomic factors could enable more personalized and effective ketamine therapy. Conclusion: Despite its promise, inconsistent dosing regimens and limited integration of genetic data hinder standardization. Further research into genotype-guided ketamine protocols may improve treatment outcomes and support precision analgesia in amputee care. Full article

Cognitive decline among older people is a growing concern worldwide since it impacts quality of life and independence. Recently, we reported that an epicatechin-enriched product improves cardiometabolic status, physical performance/mobility, and quality of life (QoL) in over-60-year-old subjects. Here, we explored the effects of an (−)-epicatechin-enriched cacao supplement on the cognitive conditions of older and sedentary individuals residing in a community center. Twelve persons with the inclusion criteria were included in this proof-of-concept study. We evaluated reasoning, memory, attention, coordination, and perception using CogniFit software, version 4.6.18. Patients received a mixture of cacao flour and 15 mg of free (−)-epicatechin twice daily for 3 months. The main results from the trial suggested a positive and significant improvement in perception, coordination, reasoning, attention, and memory. Full article