Journal of Clinical Medicine最新文献

{"title":"Outcomes of Iso-Elastic Acetabular Cup in Primary Total Hip Arthroplasty with 5-Year Minimum Follow-Up: A Systematic Review.","authors":"Vincenzo Longobardi, Marco Minelli, Giacomo Pietrogrande, Giuseppe Anzillotti, Federico Della Rocca, Mattia Loppini","doi":"10.3390/jcm14186621","DOIUrl":"10.3390/jcm14186621","url":null,"abstract":"<p><p><b>Background:</b> Long-term survivorship in total hip arthroplasty (THA) is influenced by implant stability and stress distribution to surrounding bone. Isoelastic acetabular components are monoblock polyethylene cups with a low elastic modulus, which were developed to reduce stress shielding and enhance periacetabular bone preservation. This systematic review aimed to evaluate the mid- to long-term clinical outcomes, wear rate, and survivorship of isoelastic cups in primary THA with a minimum follow-up of five years. <b>Materials and methods:</b> A systematic literature search was performed in April 2025 across PubMed, Embase, Cochrane Library, and Google Scholar following PRISMA 2020 guidelines. Inclusion criteria comprised clinical studies on isoelastic acetabular cups in primary THA with a minimum of five years of follow-up. Data on survivorship, complications, clinical outcomes, wear, and radiological performance were extracted and analyzed. Risk of bias in each study was assessed through the Newcastle-Ottawa Scale (NOS) for observational studies and the Cochrane Risk of Bias 2 (RoB 2) tool for randomized controlled trials. <b>Results:</b> Twelve studies, encompassing 1491 hips, met the inclusion criteria. Mean follow-up was 8.1 years. Overall implant survival rate ranged from 82.7% to 100%. Mean Harris Hip Score was 92.6, with low reported pain and high satisfaction. Mean annual wear was 0.05 mm/year. Vitamin E-infused highly cross-linked polyethylene (VEHXLPE) cups demonstrated lower femoral head penetration compared to UHMWPE. A randomized trial showed reduced bone loss in the polar region with isoelastic cups versus modular titanium cups (4.9% versus 15.9%, <i>p</i> = 0.005). Complication and revision rates were low, though heterogeneity in cup positioning reporting and variable follow-up durations were noted. <b>Conclusions:</b> Isoelastic acetabular components demonstrate excellent survivorship, low wear rates, and favorable clinical outcomes at mid- to long-term follow-up. High-quality, long-term comparative studies are needed to confirm these findings across broader patient populations.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on Factors Affecting Toric Intraocular Lens Rotation Using Intraoperative OCT-Factors Influencing IOL Deployment and Proximity to Posterior Capsule After Insertion.","authors":"Kei Ichikawa, Seiji Tokiwa, Yoshiki Tanaka, Hiroto Toda, Yukihito Kato, Yukihiro Sakai, Kazuo Ichikawa, Naoki Yamamoto","doi":"10.3390/jcm14186599","DOIUrl":"10.3390/jcm14186599","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Cataract surgery often reveals preexisting corneal astigmatism, which can be corrected using a toric intraocular lens (T-IOL). However, postoperative T-IOL rotation may compromise correction. We investigated T-IOL rotation, focusing on deployment time and proximity to the posterior capsule (PC), using intraoperative optical coherence tomography (iOCT). <b>Methods</b>: Six different T-IOL models were inserted into acrylic simulated lens capsule models under different tacking durations (5 s, 30 s, and 60 s) and temperature conditions (23 °C, 28 °C, and 32 °C). The selection criteria for porcine lenses for examination required that they match human lens dimensions, typical of those used to train cataract surgeons. T-IOL misalignment due to vibration was assessed. Additionally, the impact of temporary intraocular pressure (IOP) reduction on T-IOL proximity to the PC was measured using iOCT in porcine eyes. <b>Results</b>: Tacking time and temperature independently affected T-IOL deployment, with shorter tacking durations and higher temperatures leading to faster deployment. Among lenses tested under identical tacking time and temperature conditions, iSert Micro Toric Aspheric 1-Piece IOL (355T3) had the slowest expansion time, while Avansee™ Preload 1-Piece Toric (YP-T3) had the fastest. Porcine eyes with a corneal white-to-white major axis < 16.0 mm fell within the 95% confidence interval for matching human lens size. Temporarily reducing IOP during surgery improved T-IOL adhesion to the PC, reducing both the occurrence and degree (from 14.0° to nearly 0°) of postoperative rotation. <b>Conclusions</b>: Optimal T-IOL deployment, temporary IOP reduction during surgery, and enhanced adhesion to the PC can reduce the risk and degree of T-IOL rotation. Intraoperative iOCT aids in monitoring T-IOL positioning, which is essential to prevent rotation. Accumulated fluid between the T-IOL and PC may contribute to rotation, which requires further investigation. These findings provide practical strategies for enhancing T-IOL stability and improving the effectiveness of astigmatism correction in cataract surgery.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Multi-Organ Morbidity in Neo-Transfusion-Dependent Thalassemia: A Cross-Sectional Analysis.","authors":"Antonella Meloni, Paolo Ricchi, Laura Pistoia, Filomena Longo, Valerio Cecinati, Zelia Borsellino, Francesco Sorrentino, Elisabetta Corigliano, Michela Zerbini, Priscilla Fina, Ada Riva, Giuseppe Peritore, Vincenzo Positano, Alberto Clemente","doi":"10.3390/jcm14186602","DOIUrl":"10.3390/jcm14186602","url":null,"abstract":"<p><p><b>Background:</b> This multicenter cross-sectional study aimed to assess the prevalence of vascular, hepatic, cardiac, endocrine, and bone complications and to identify factors associated with their occurrence in adult patients with neo-transfusion-dependent thalassemia (neo-TDT). <b>Methods:</b> A total of 140 adult neo-TDT patients (defined as receiving >4 transfusions/year; mean age 44.3 ± 12.1 years; 56.4% female) were retrospectively enrolled from the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) network. Iron overload (IO) was assessed by magnetic resonance imaging and complications were classified according to established clinical criteria. Logistic regression analyses were performed to investigate associations of complications with age, sex, splenectomy status, chelation therapy, hemoglobin < 9 g/dL, ferritin ≥ 1000 ng/mL, and hepatic, pancreatic, and cardiac IO. <b>Results:</b> Complications affecting fewer than 5% of patients-including leg ulcers, cirrhosis, thrombosis, heart failure, and hypoparathyroidism-were excluded from statistical analysis. Bone metabolism disorders were the most prevalent complications (68.6%), followed by impaired glucose metabolism (15.7%). The prevalence of other complications was: extramedullary hematopoiesis (EMH) 19.3%, pulmonary hypertension (PH) 7.1%, arrhythmias 12.1%, hypogonadism 11.4%, and hypothyroidism 15.0%. Male sex was independently associated with EMH (odds-ratio [OR] = 2.67; <i>p</i> = 0.027). Hepatic IO was the only significant predictor of PH (OR = 4.12; <i>p</i> = 0.047). Arrhythmias were strongly associated with older age (OR = 22.67; <i>p</i> < 0.0001), while both older age (OR = 4.42; <i>p</i> = 0.004) and pancreatic IO (OR = 7.40; <i>p</i> = 0.012) were independently associated with impaired glucose metabolism. No significant associations were identified for hypogonadism, hypothyroidism, or bone metabolism disorders. <b>Conclusion:</b> This study offers updated insights into the burden of complications in neo-TDT patients and highlights specific risk factors that may inform comprehensive, multidisciplinary surveillance strategies.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Trial on the Benefits of Refitting Symptomatic Contact Lens Wearers with Daily Disposable Lenses.","authors":"José Miguel Sánchez-Ruiz, A Eusebio López-Hernández, Youssef Abidi, Johnny Di Pierdomenico, Diego García-Ayuso","doi":"10.3390/jcm14186575","DOIUrl":"10.3390/jcm14186575","url":null,"abstract":"<p><p><b>Background/Objective</b>: Contact lens discomfort (CLD) is a prevalent issue affecting up to 50% of wearers and contributes to discontinuation in approximately 30% of cases. This study aimed to evaluate the impact of refitting symptomatic monthly replacement contact lens (CL) wearers with a new daily, disposable contact lens (Kalifilcon A DDCL) and to compare its effectiveness against a placebo CL. <b>Methods</b>: Seventy-nine symptomatic wearers (CLDEQ-8 ≥ 12; mean age 27.07 ± 8.38 years; 77% female) were recruited and randomly assigned to wear either Kalifilcon A DDCLs or placebo CLs. Participants were assessed at baseline and after one month of CL wear. Subjective measures included the CLDEQ-8 and the NEI VFQ-25 questionnaire. Objective assessments included tear film stability and ocular surface health. Statistical analysis was performed using paired <i>t</i>-tests and repeated-measures ANOVA. Bonferroni correction was applied for multiple comparisons, and results were reported with effect sizes (Cohen's d) and 95% confidence intervals. Statistical significance was set at <i>p</i> < 0.05. <b>Results</b>: Kalifilcon A DDCL wearers showed a significant reduction in CLDEQ-8 scores (18.5 ± 4.6 to 10.8 ± 8.5; <i>p</i> < 0.005; Cramer's V: 0.594; 95% CI: 13.35-15.34), with only 33% remaining symptomatic. Vision-related quality of life improved (75.83 ± 8.0 to 83.5 ± 8.6; <i>p</i> < 0.005; Cramer's V: 0.977; 95% CI: 78.54-80.81), especially in ocular pain (<i>p</i> < 0.001; Cramer's V: 0.755; 95% CI: 54.73-58.88), role difficulties (<i>p</i> < 0.001; Cramer's V: 0.812; 95% CI: 35.12-42.77), and color vision (<i>p</i> < 0.05; Cramer's V: 0.575; 95% CI: 93.07-95.63). Compared to the placebo CL, Kalifilcon A DDCLs led to greater improvements in comfort (<i>p</i> < 0.0001; Cramer's V: 0.329; 95% CI: 7.22-7.74), visual acuity (<i>p</i> < 0.0001; Cramer's V: 0.267; 95% CI: 7.38-7.85), and satisfaction (<i>p</i> = 0.005; Cramer's V: 0.208; 95% CI: 7.70-8.18). Tear film stability also improved significantly (<i>p</i> < 0.05), with no changes observed in the placebo group. <b>Conclusions</b>: Refitting symptomatic CL wearers with Kalifilcon A DDCLs significantly improves comfort, reduces CLD symptoms, and enhances vision-related quality of life. These results support its use as a beneficial alternative to monthly CLs in symptomatic individuals.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Infants Under Two Years of Age with Early Sensitization to House Dust Mites.","authors":"Hye-In Jeong, You Hoon Jeon","doi":"10.3390/jcm14186587","DOIUrl":"10.3390/jcm14186587","url":null,"abstract":"<p><p><b>Background:</b> Early-life sensitization to house dust mites (HDMs) is a recognized risk factor for adverse respiratory allergic outcomes. <b>Methods:</b> We investigated the clinical characteristics of infants under two years of age who visited our allergy clinic for evaluation with detectable HDM-specific IgE (sIgE) and compared them to HDM-sIgE-negative infants. <b>Results:</b> Among 1793 infants tested for HDM sIgE, 96 (5.4%) demonstrated sensitization. In the HDM-positive cohort, the prevalence of atopic dermatitis was 74.0% (90.9% among those <12 months), food allergy was 57.3% (100% among those <12 months), egg white sensitization was 71.9% (90.9% among those <12 months), and cow's milk sensitization was 56.3% (81.8% among those <12 months). Atopic dermatitis, food allergy, ≥4 wheezing episodes, physician-diagnosed asthma, allergic rhinitis, egg white sensitization, cow's milk sensitization, and sensitization to three or more food allergens were significantly more common in the HDM-positive group compared with the HDM-negative group. Significant correlations were observed between HDM sIgE and total IgE levels, as well as between HDM sIgE and egg white sIgE levels. Overall, HDM sensitization in infants was most frequently accompanied by atopic dermatitis and egg white sensitization. <b>Conclusions:</b> These findings suggest that early HDM sensitization should be closely monitored, particularly in infants with atopic dermatitis and food allergies who exhibit elevated total IgE and egg white sIgE levels.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Induced Hyponatremia: Insights into Pharmacological Mechanisms and Clinical Practice Management.","authors":"Miguel Capinha, Marta Lavrador, Joana Liberato, Adriana Pinheiro, Ana Aveiro, Isabel Vitória Figueiredo, Margarida Castel-Branco","doi":"10.3390/jcm14186584","DOIUrl":"10.3390/jcm14186584","url":null,"abstract":"<p><p><b>Background:</b> Hyponatremia (serum sodium concentration < 135 mmol/L) represents the most common electrolyte disturbance in clinical practice, particularly among high-risk populations such as older adults. Its severity ranges from moderately severe to life-threatening symptoms, contributing to increased mortality. Its etiology is widely heterogeneous and leads to different classifications according to volume status such as hypovolemic, euvolemic and hypervolemic hyponatremia. Drug-induced hyponatremia presents itself as one of the most prevalent but frequently overlooked causes, since many confounding factors like associated comorbidities and polypharmacy complicate the identification of specific medicines as the main offenders. <b>Objectives</b>: This narrative review was performed to provide a comprehensive analysis on drug-induced hyponatremia, focusing not only on the underlying pharmacological mechanisms, but also on management strategies in clinical practice. <b>Methods</b>: A narrative literature review was conducted using PubMed, Science Direct and Google Scholar. <b>Results</b>: This narrative review focused not only on the most common drug classes to induce hyponatremia through different mechanisms, including diuretics, antidepressants, anticonvulsants, and antipsychotics, but also on other pharmacological classes, that, although to a lesser extent, might also be associated with decreasing serum sodium levels (antineoplastic and immunomodulating agents, drugs acting on digestive and locomotor systems, anti-infective drugs, endocrine diseases drugs, among others). It also explores recommendations on the management of drug-induced hyponatremia and it emphasizes the role of healthcare providers in addressing this electrolyte disorder. <b>Conclusions</b>: As drug-induced hyponatremia poses significant challenges in clinical practice, understanding its mechanisms, coupled with effective management strategies, can enhance patient safety.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Castleman Disease and Kaposi Sarcoma: A Review of the Literature and a Case Series.","authors":"Nerina Denaro, Lucia Brambilla, Federica Scarfì, Athanasia Tourlaki, Antonio Muscatello, Cinzia Solinas, Nicolò Rampi, Alessandra Bandera, Ornella Garrone","doi":"10.3390/jcm14186563","DOIUrl":"10.3390/jcm14186563","url":null,"abstract":"<p><p>Castleman disease and Kaposi sarcoma (KS) are both associated with infection by human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV). This virus plays a critical role in the pathogenesis of both conditions, particularly in immunocompromised individuals, such as those with HIV/AIDS. Multicentric Castleman disease (MCD) generally presents with systemic inflammatory symptoms, lymphadenopathy, and organ dysfunction, while Kaposi sarcoma typically appears as vascular tumors on the skin, with occasional involvement of mucous membranes or internal organs. We present four clinical cases, with concurrent KS and MCD, treated with chemotherapy and rituximab, with a satisfactory response. We highlighted the essential role of prompt investigation of systemic or inflammatory manifestations (fever, vital parameter alterations such as palpitation, high breath frequency, edema, and kidney impairment) as underlined in our case series, which might underscore possible complications. Multiorgan failure, opportunistic infections, or rapid clinical deterioration might occur if the diagnosis is not adequately assessed. Therefore, this paper emphasizes the importance of timely diagnosis, as it enables the prompt initiation of appropriate antiviral, immunomodulatory, or oncologic therapies-interventions that can significantly improve outcomes and may be life-saving in advanced or aggressive disease presentations.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Fracture Resistance Using Two Different Major Cemented Stems in Osteoporotic Bone Models.","authors":"Kohei Hashimoto, Yukio Nakamura, Nobunori Takahashi, Takkan Morishima","doi":"10.3390/jcm14186558","DOIUrl":"10.3390/jcm14186558","url":null,"abstract":"<p><p><b>Background:</b> Periprosthetic hip fractures (PPFs) are one of the major complications in total hip arthroplasty (THA). Therefore, it is important to identify a mechanism for fracture resistance in THA. This study aimed to clarify the differences in fracture torque and fracture type analysis between two different types of cemented stems. <b>Methods:</b> We conducted biomechanical testing of bone analogues using six cemented stems of two different types with osteoporotic bone models: Anterior minimally invasive surgery (AMIS)-K and Charnley-Marcel-Kerboull (CMK) stems. Experienced surgeons implanted each of these types of stems into six bone analogues, and the analogues were compressed and internally rotated until failure. Torque-to-fracture and fracture type were recorded. <b>Results:</b> There was no significant difference in fracture torque of AMIS-K stem, compared to the CMK stem (<i>p</i> = 0.94). The AMIS-K stem showed one comminuted oblique fracture of Vancouver type B2 and five fractures of type C at the tip of the stem. The CMK stem showed five comminuted oblique fracture of Vancouver type B2 and one of type C at the tip of the stem. Conclusion: The AMIS-K stem demonstrated comparable fracture resistance to the CMK stem in an osteoporotic model.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Analysis of Early Changes in Upper Adjacent Segments After Fusion Surgery: OLIF vs. PLIF.","authors":"JooYoung Lee, JaeHwan Cho, Dong-Ho Lee, ChangJu Hwang, SeHan Park","doi":"10.3390/jcm14186570","DOIUrl":"10.3390/jcm14186570","url":null,"abstract":"<p><p><b>Background:</b> Oblique lumbar interbody fusion (OLIF) has recently gained popularity as a minimally invasive surgical technique for lumbar fusion. While OLIF is superior in restoring disc height and lumbar lordosis compared to posterior lumbar interbody fusion (PLIF), its biomechanical effect on adjacent segments remains unclear. <b>Methods:</b> We retrospectively analyzed 236 patients who underwent one- or two-level OLIF (<i>n</i> = 95) or PLIF (<i>n</i> = 141) between 2013 and 2020. Radiographic outcomes, including lumbar lordosis, upper adjacent segmental lordosis, retrolisthesis, and foraminal height, were evaluated preoperatively and at 3 days and 1, 3, 6, and 12 months postoperatively. Patient-reported outcomes (VAS for back/leg pain and Oswestry Disability Index [ODI]) were assessed preoperatively and at 12 months. <b>Results:</b> OLIF provided superior restoration of lumbar lordosis (4.03 ± 4.38° vs. 1.63 ± 5.11°, <i>p</i> = 0.001) and disc height (5.50 ± 3.39 mm vs. 2.71 ± 2.18 mm, <i>p</i> < 0.0001) compared with PLIF. However, OLIF was associated with higher incidence (76.9% vs. 24.6%, <i>p</i> < 0.0001) and degree of retrolisthesis (1.69 ± 1.09 mm vs. 0.29 ± 0.70 mm, <i>p</i> < 0.0001), and decreased foraminal height (-1.43 ± 2.12 mm vs. 0.54 ± 2.53 mm, <i>p</i> < 0.0001) in the upper adjacent segment. Importantly, there was no significant difference in clinical outcomes (VAS and ODI) between the two groups at 12 months (all <i>p</i> > 0.05). <b>Conclusions:</b> While OLIF achieves superior restoration of lumbar lordosis and disc height compared to PLIF, it also induces early radiographic deterioration in the upper adjacent segment. Importantly, these findings represent radiographic changes observed within 1 year, without significant differences in clinical outcomes, and longer-term follow-up is required to determine their clinical relevance.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal Health and Well-Being Determinants Associated with the Day-to-Day Variability of Sedentary Behaviour in Community-Dwelling People with Stroke.","authors":"Lisa van Oirschot, Wendy Hendrickx, Martijn F Pisters","doi":"10.3390/jcm14186560","DOIUrl":"10.3390/jcm14186560","url":null,"abstract":"<p><p><b>Background:</b> To improve personalized behavioural interventions for people with stroke, it is crucial to understand which factors influence fluctuations in sedentary behaviour. This study aimed to explore the association between health and well-being determinants and daily variability in sedentary behaviour over time within community-dwelling people with stroke. <b>Methods:</b> An n-of-1 study design was conducted to examine the associations between determinants and sedentary behaviour during the RISE-intervention randomized multiple baseline study. The percentage of sedentary behaviour was measured daily with the ActivPAL activity monitor. The Visual Analogue Scale scores of the determinants were collected with diaries. Dynamic regression modelling (time-series analysis) was performed, starting with univariable and followed by multivariable linear regressions. <b>Results:</b> The analysis included twelve community-dwelling people with stroke (median age 65 years), with daily sedentary behaviour ranging from 55.5 to 81.4 percent. Objectively measured sleep length was positively associated with the percentage of sedentary behaviour in three participants (<i>p</i> = 0.001, <i>p</i> < 0.0001, and <i>p</i> = 0.045), and negatively associated in one participant (<i>p</i> = 0.002). Subjective sleep length (<i>p</i> = 0.016), fatigue (<i>p</i> = 0.013) and pain (<i>p</i> = 0.0098) were exclusively associated with the percentage of sedentary behaviour in one participant. No significant associations were found for sleep quality, happiness, stress or time pressure in five participants. <b>Conclusions:</b> The findings indicate inconsistent association patterns between health and well-being determinants and the day-to-day variability of sedentary behaviour across participants. This highlights the need for a personalized approach, as the determinants associated with the daily variability of sedentary behaviour in one individual may differ from those influencing another individual.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}