Journal of Clinical Medicine最新文献

{"title":"Description of the Risk Factors for Ischemic Stroke in the Lebanese Population: Their Association with Age at First Stroke Incidence and the Predictors of Recurrence.","authors":"Jad El Masri, Diala El Masri, Maya Ghazi, Ahmad Afyouni, Hani Finge, Jad El Ahdab, Maryam Tlayss, Soltan Al Chaar, Wassim Abou-Kheir, Pascale Salameh, Hassan Hosseini","doi":"10.3390/jcm14062034","DOIUrl":"10.3390/jcm14062034","url":null,"abstract":"<p><p><b>Background</b>: Stroke is the third most common cause of death in Lebanon. With many preventive strategies identified, stroke remains a national burden, especially in developing countries, where risk factors and epidemiological states are understudied. This study aims to investigate the association of sociodemographic factors and health-related risk factors with age at first ischemic stroke and its recurrence in the Lebanese population. <b>Methods</b>: A retrospective study including 214 ischemic stroke cases was carried out. Sociodemographic characteristics and health-related risk factors were assessed, in addition to disability levels (modified Rankin score (mRS)), age at first ischemic stroke incidence, and number of ischemic strokes. Data were analyzed using SPSS software version 25, including descriptive, bivariate, and multivariate analyses. <b>Results</b>: This study showed that stressful factors were significantly associated with a younger age at first ischemic stroke, such as having no partner (<i>p</i> < 0.001), having employment (<i>p</i> < 0.001), and having migraines (<i>p</i> < 0.001). However, metabolic risk factors were associated with an older age of ischemic stroke, such as hypertension (<i>p</i> < 0.001) and hyperlipidemia (<i>p</i> < 0.001). Moreover, having a partner (OR: 2.136), having a family history of stroke (OR: 2.873), having hyperlipidemia (OR: 3.71), and having atrial fibrillation (OR: 2.521) were associated with ischemic stroke recurrence. <b>Conclusions</b>: Many modifiable factors are associated with age at first ischemic stroke and its recurrence. This study sheds light on the necessity of increasing knowledge and awareness of well-known risk factors in the Lebanese population. These results suggest implementing targeted preventive strategies and highlight the importance of complying with early detection and follow-up measures.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719490","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":"Impact of Sarcopenia and Functional Relationships Between Balance and Gait After Total Hip Arthroplasty.","authors":"So-Yeong Kim, Woon-Su Cho, Chi-Bok Park, Byeong-Geun Kim","doi":"10.3390/jcm14062036","DOIUrl":"10.3390/jcm14062036","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Total hip arthroplasty (THA) is an effective surgical intervention for restoring hip function and alleviating pain caused by osteoarthritis, femoral head avascular necrosis, or fractures. Despite its benefits, postoperative recovery is influenced by various factors, among which sarcopenia plays a critical role. This study aimed to analyze the characteristics of sarcopenia in THA patients admitted to a convalescent rehabilitation hospital and examine its relationship with functional variables such as balance and gait independence. <b>Methods</b>: This cross-sectional study included 84 THA patients, categorized into sarcopenia and non-sarcopenia groups using the Asian Working Group for Sarcopenia 2019 criteria. Data were collected on demographic characteristics (e.g., age, gender, height, weight, range of motion (ROM), manual muscle test (MMT)) and functional variables, including balance (Berg Balance Scale, BBS) and gait independence (Functional Ambulation Category, FAC). <b>Results</b>: The prevalence of sarcopenia among THA patients was 44.05%. Significant differences were observed between the sarcopenia and non-sarcopenia groups in sex, age, height, weight, ROM, MMT, BBS, and FAC (<i>p</i> < 0.05). Logistic regression analysis showed that advanced age increased the likelihood of sarcopenia (OR: 1.072, <i>p</i> < 0.05), whereas higher body weight reduced it (OR: 0.784, <i>p</i> < 0.05). However, sarcopenia was not significantly associated with balance (BBS: <i>p</i> = 0.710) or gait independence (FAC: <i>p</i> = 0.990). Instead, a significant positive correlation was found between FAC and BBS (OR: 0.413, <i>p</i> < 0.001), as well as BBS and FAC (OR: 0.467, <i>p</i> < 0.001), indicating that better balance was associated with greater gait independence and vice versa. Additionally, patients who underwent THA due to fractures had a lower FAC compared to those with osteoarthritis (OR: -0.276, <i>p</i> = 0.018). <b>Conclusions</b>: Sarcopenia is prevalent among THA patients, and functional variables such as balance and gait independence are closely associated. Additionally, age and body weight were identified as key factors related to sarcopenia. These findings emphasize the importance of early detection and management of sarcopenia in rehabilitation hospital settings and highlight the significance of functional variables in recovery.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719497","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":"Review of the Diagnosis and Management of Pulmonary Hypertension Associated with Interstitial Lung Disease (ILD-PH).","authors":"Zein Kattih, Ho Cheol Kim, Shambhu Aryal, Steven D Nathan","doi":"10.3390/jcm14062029","DOIUrl":"10.3390/jcm14062029","url":null,"abstract":"<p><p>Pulmonary hypertension associated with interstitial lung disease (ILD-PH) frequently complicates the course of patients with fibrotic ILD. In this narrative review, the authors assess current diagnostic tools and management considerations in ILD-PH patients. ILD-PH is associated with increased morbidity and mortality and may be suggested by the presence of symptoms out of proportion to the extent of the ILD. There are other clues to the presence of PH in the context of ILD including the need for supplemental oxygen, a reduced DLCO especially if accompanied by a disproportionately higher forced vital capacity, imaging demonstrating an enlarged pulmonary artery or a dilated right ventricle, or objective evidence of a reduced exercise capacity. While echocardiography is one screening tool, right heart catheterization remains the gold standard for the diagnosis of PH. When appropriate, treatment with inhaled treprostinil, or possibly other pulmonary vasodilators, may be indicated.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719684","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":"The Effectiveness of the GnRH Agonist/Antagonist Protocols for Different Poseidon Subgroups of Poor Ovarian Responders.","authors":"Jelena Havrljenko, Vesna Kopitovic, Aleksandra Trninic Pjevic, Stevan Milatovic, Sandro Kalember, Filip Katanic, Tatjana Pavlica, Nebojsa Andric, Kristina Pogrmic-Majkic","doi":"10.3390/jcm14062026","DOIUrl":"10.3390/jcm14062026","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Poor responder patients represent the greatest challenge in ART. An inadequate response to COS strongly correlates with a reduced chance of conception. A novel classification of poor responders overcame a deficiency in the Bologna criteria and distinguished an expected and unexpected low ovarian response, allowing for an individual treatment approach to be created. In this study, we compared the clinical outcomes in poor responders, according to two different ovarian stimulation protocols, GnRH agonists and antagonists, classified according to the Poseidon criteria, to determine the most effective protocol for each group. <b>Methods:</b> This retrospective study involved 1323 low-prognosis women ranked according to the Poseidon classification and a control group of normal responders. <b>Results:</b> The GnRH-antagonist protocol showed some advantage in the Poseidon 1b group whereas the GnRH-agonist protocol was more effective in the Poseidon 4 group. There were no differences in live births or miscarriage rates in poor responders among these two protocols. <b>Conclusions:</b> Using both the agonist/antagonist approaches, live birth rates are two or even three times less in Poseidon patients in comparison to normal responders. The number of obtained oocytes, their maturity and quality, and women's ages were found to be the most influential determinants for a successful outcome. Further investigations into ovarian stimulation strategies are required to enhance oocyte number and live birth occurrence.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719099","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":"Acute Liver Failure During Early Pregnancy-Case Report and Review of Literature.","authors":"Banach Paulina, Justyna Kuczkowska, Yulia Areshchanka, Weronika Banach, Jakub Rzepka, Bartosz Kudliński, Rafał Rzepka","doi":"10.3390/jcm14062028","DOIUrl":"10.3390/jcm14062028","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This article presents the case of a 31-year-old primigravida who experienced acute liver failure in the 23rd week of pregnancy, along with a review of the literature on this rare condition during pregnancy. The purpose of this publication is to highlight the diagnostic and therapeutic challenges associated with acute liver failure in pregnant women. <b>Methods:</b> The patient presented with jaundice, pruritus, and dark-colored urine. Laboratory tests revealed a significant increase in aminotransferase, bilirubin, and bile acid levels, suggesting liver problems; however, due to the patient's rapidly deteriorating condition and test results, autoimmune hepatitis was considered. Viral infections and other causes of liver damage were excluded. No clear diagnosis was established. The patient was administered ursodeoxycholic acid and due to her worsening condition, a cesarean section was performed at 23 weeks of gestation. After delivery, the patient's condition improved, although she did experience cardiac arrest during hospitalization. The patient was discharged with a diagnosis of acute liver failure in the course of an overlap syndrome of autoimmune hepatitis and primary cholangitis or intrahepatic cholestasis of pregnancy. No abnormalities were noted during a follow-up visit 6 weeks after delivery. Despite a detailed case analysis, a final diagnosis was not established, which complicates planning for future pregnancies. <b>Discussion:</b> Several liver conditions can occur during pregnancy, including intrahepatic cholestasis of pregnancy, primary biliary cholangitis, and autoimmune hepatitis. Diagnosing these conditions can be challenging due to overlapping symptoms and metabolic and immunological adaptations during pregnancy that can affect the course of liver diseases. Rapid intervention is crucial to protect the health of both the mother and the fetus. <b>Conclusions:</b> In summary, this article aims to increase awareness of the complexities surrounding acute liver failure during pregnancy, highlighting the diagnostic challenges and importance of prompt medical intervention for the well-being of both the mother and the child. This paper aims to provide a comprehensive overview of the complexities surrounding acute liver failure during pregnancy, aiming to improve the understanding, diagnosis, and management of this condition.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718939","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":"Low Back Pain Among Health Sciences Undergraduates: Results Obtained from a Machine-Learning Analysis.","authors":"Janan Abbas, Malik Yousef, Kamal Hamoud, Katherin Joubran","doi":"10.3390/jcm14062046","DOIUrl":"10.3390/jcm14062046","url":null,"abstract":"<p><p><b>Background and objective.</b> Low back pain (LBP) is considered the most common and challenging disorder in health care. Although its incidence increases with age, a student's sedentary behavior could contribute to this risk. Through machine learning (ML), advanced algorithms can analyze complex patterns in health data, enabling accurate prediction and targeted prevention of medical conditions such as LBP. This study aims to detect the factors associated with LBP among health sciences students. <b>Methods.</b> A self-administered modified version of the Standardized Nordic Questionnaire was completed by 222 freshman health sciences students from May to June 2022. A supervised random forest algorithm was utilized to analyze data and prioritize the importance of variables related to LBP. The model's predictive capability was further visualized using a decision tree to identify high-risk patterns and associations. <b>Results.</b> A total of 197/222 (88.7%) students participated in this study, most of whom (75%) were female. Their mean age and body mass index were 23 ± 3.8 and 23 ± 3.5, respectively. In this group, 46% (n = 90) of the students reported having experienced LBP in the last month, 15% (n = 30) were smokers, and 60% (n = 119) were involved in prolonged sitting (more than 3 h per day). The decision tree of ML revealed that a history of pain (score = 1), as well as disability (score= 0.34) and physical activity (score = 0.21), were significantly associated with LBP. <b>Conclusions.</b> Approximately 46% of the health science students reported LBP in the last month, and a machine-learning approach highlighted a history of pain as the most significant factor related to LBP.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719677","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":"Reoperation Strategy for Failure of Cervical Disc Arthroplasty at Index and Adjacent Levels.","authors":"Chae-Gwan Kong, Jong-Beom Park","doi":"10.3390/jcm14062038","DOIUrl":"10.3390/jcm14062038","url":null,"abstract":"<p><p>Cervical disc arthroplasty (CDA) is a motion-preserving alternative to anterior cervical discectomy and fusion (ACDF) for cervical degenerative disease, reducing adjacent segment degenerative disease (ASD). Despite its benefits, some patients experience CDA failure due to prosthesis-related complications, heterotopic ossification, segmental kyphosis, ASD, or facet joint degeneration, necessitating revision surgery. Reoperation strategies depend on the failure mechanism, instability, sagittal malalignment, and neural compression. Anterior revision is suited for prosthesis failure, recurrent disc herniation, or ASD, enabling prosthesis removal, decompression, and fusion. In select cases, reimplantation may restore motion. Posterior approaches are preferred for facet degeneration, multilevel stenosis, or posterior hypertrophy, with options including foraminotomy, laminoplasty, or laminectomy and fusion. Complex cases may require combined anterior and posterior surgery for optimal decompression and stability. This narrative review outlines revision strategies, emphasizing biomechanical assessment, radiographic evaluation, and patient-specific considerations. Despite surgical challenges, meticulous planning and execution can optimize outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719678","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 Dynamic Multimodality Imaging Assessment of Right Ventricular Thrombosis in a Middle-Aged Man with Lymphocytic Interstitial Pneumonia: The Additive Role of Tissue Doppler Imaging.","authors":"Andrea Sonaglioni, Alessandro Lucidi, Francesca Luisi, Antonella Caminati, Gian Luigi Nicolosi, Gaetana Anna Rispoli, Maurizio Zompatori, Michele Lombardo, Sergio Harari","doi":"10.3390/jcm14062035","DOIUrl":"10.3390/jcm14062035","url":null,"abstract":"<p><p><b>Background:</b> Right ventricular thrombosis (RVT) is rarely detected in clinical practice. Depending on its aetiology, RVT may originate from a deep venous thrombosis (type A) or in situ (type B). Type A is characterized by increased mobility and frequent pulmonary embolization, whereas type B is nonmobile and is associated with significant right ventricular (RV) dilatation and dysfunction. <b>Methods:</b> A type B RVT complicated by subsegmental pulmonary embolism (PE) was diagnosed in a 46-year-old man with acute-on-chronic respiratory failure secondary to acute exacerbation of interstitial lung disease. He underwent a multimodality imaging assessment of the RV mass that comprehensively incorporated TTE, TEE, contrast-enhanced chest CT, and LGE-CMR. <b>Results:</b> During the clinical course, a serial echocardiographic assessment of the RV mass allowed for a dynamic evaluation of its features and cardiac haemodynamics. Conventional TTE was implemented with colour tissue Doppler imaging (TDI) and pulsed wave (PW) TDI to improve the visualization of the RV mass and to objectively measure its mobility. The increased RVT mass peak antegrade velocity (>10 cm/s) was predictive of subsequent RVT fragmentation and PE. <b>Conclusions:</b> Colour TDI and PW-TDI may aid in the differential diagnosis of RV masses and may improve the prognostic risk stratification of patients with right-sided intracardiac masses.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719431","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 Traditional and AI-Based Methods: Barrett Universal II vs. Ladas Super Formula in IOL Power Calculation.","authors":"Ionela-Iasmina Yasar, Servet Yasar, Leila Al Barri, Nadina Mercea, Mihnea Munteanu, Horia Tudor Stanca","doi":"10.3390/jcm14062023","DOIUrl":"10.3390/jcm14062023","url":null,"abstract":"<p><p><b>Background:</b> Pursuing optimal visual outcomes following cataract surgery remains a cornerstone of modern ophthalmology. Central to this objective is the precise calculation of intraocular lens power. However, despite significant advancements in biometric measurements and computational algorithms, variability in refractive outcomes continues to pose a challenge. This study aims to analyze the outcomes comprehensively by reviewing established and newer techniques. <b>Methods:</b> The eyes included in this study were evaluated based on various criteria, and a total of 210 eyes which met these criteria were included in the research. Our study is a retrospectively designed observational research study. The study included individuals who had experienced successful IOL implantation to correct refractive errors or cataracts. The ARGOS SS-OCT device, a spectral-domain optical coherence tomography system, was used in this study. In measuring the lens power, values were obtained using the Barrett Universal II and Ladas Super Formulas. These values were compared. Postoperative assessments were conducted at 1-3 months and 3-12 months, including spherical equivalents. <b>Results:</b> The mean age of the participants was 63.44 ± 11.62 years. The study's two most frequently used lens brands were ALCON and ZEISS. The lens powers calculated using the Barrett Universal II and Ladas Super Formulas were compared. The mean values calculated using both formulas were highly similar, with no statistically significant differences observed. We compared the spherical equivalent values calculated during the participants' first and second postoperative follow-ups. The spherical equivalent values were similar, with no statistically significant differences. <b>Conclusions:</b> Formulas represent significant advances in ophthalmology and significantly improve visual outcomes; however, differences in their methodology and predictive accuracy warrant further analysis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719483","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":"Surgical Management of Oro-Nasal Communication in Cocaine-Induced Lesions: Temporalis Muscle Flap with Le Fort I Osteotomy.","authors":"Ettore Lupi, Alessandra Ciccozzi, Roberto Becelli, Mario Mannino, Sara Bernardi, Filippo Giovannetti","doi":"10.3390/jcm14062033","DOIUrl":"10.3390/jcm14062033","url":null,"abstract":"<p><p><b>Background:</b> Cocaine is a recreational drug known for its negative impact on health and social and economic life. One of the complications for cocaine abusers is cocaine-induced midline destructive lesion (CIMDL) syndrome, which includes the extensive destruction of the osteocartilaginous structures of the nose, the sinus, and the palate. <b>Methods:</b> Here, we describe three cases of the surgical management of CIMDL using a temporalis muscle flap combined with a Le Fort I osteotomy, which allows sufficient space for the muscle to settle. <b>Results:</b> The addition of the osteotomy allowed better handling of the pedicled flap, with no signs of relapse in the reported cases and high patient satisfaction. <b>Conclusions:</b> CIMDL syndrome is an impairing disease that negatively affects the functionality of the nasal and oral cavities, as well as the aesthetic. Surgical repair using a pedicled flap is a valid option in rehabilitated and sober patients with endothelial damage.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719761","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}