Journal of Clinical Medicine最新文献

{"title":"Mineralocorticoid Receptor Antagonists in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.","authors":"Mithila Zaheen, Fardin Ferdous, Anjalee T Amarasekera, Johannes Petutschnigg, Frank Edelmann, Timothy C Tan","doi":"10.3390/jcm14103598","DOIUrl":"https://doi.org/10.3390/jcm14103598","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome with limited therapeutic options. Mineralocorticoid receptor antagonists (MRAs) have been shown to improve clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF), but their use in patients with HFpEF remains controversial. The aim of this review is to evaluate whether the use of MRAs improves diastolic function, functional capacity, and quality of life in patients with HFpEF. <b>Methods</b>: A systematic literature search of scientific databases was performed to identify studies comparing the use of MRAs to placebo or no treatment in adult patients with HFpEF (2000-2024; English; PROSPERO registration CRD42022300783). Data were meta-analysed using a random-effects model for overall effect size measured as the standardised mean difference. <b>Results</b>: Pooled data revealed a significant benefit of MRA use compared to the control in decreasing E/e' (SMD -0.21; 95% CI: -0.33 to -0.10, <i>p</i> = 0.00), with greater improvement seen with longer duration of treatment. A substantial reduction in systolic blood pressure (SMD -0.27; 95% CI: -0.53 to -0.02, <i>p</i> = 0.03) and diastolic blood pressure (SMD -0.18; 95% CI: -0.32 to -0.04, <i>p</i> = 0.01) was also noted. There was no significant difference in the 6 min walk distance, peak exercise capacity, or quality-of-life measures. Adverse events such as hyperkalaemia and worsening renal function were frequently reported in the MRA group. <b>Conclusions</b>: MRAs improve echocardiographic parameters of diastolic function and BP control; however, this did not translate into clinical outcomes of improved functional capacity or quality of life.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Mouth Posture Syndrome (OMPS): Classification.","authors":"Can-Florian Keleş, David Morais, Anand Marya, Omar Fawzi Chawshli, Adith Venugopal, Ute Ulrike Botzenhart","doi":"10.3390/jcm14103586","DOIUrl":"https://doi.org/10.3390/jcm14103586","url":null,"abstract":"<p><p><b>Objectives</b>: This narrative review aims to redefine Open Mouth Posture Syndrome (OMPS) as a multifactorial condition with overlapping symptoms and a cyclical pathophysiology. A novel classification system for OMPS subtypes is proposed to standardize research approaches and enhance clinical understanding. <b>Methods</b>: An interdisciplinary literature review was conducted, focusing on structural, functional, and adaptive mechanisms underlying OMPS. Subtype definitions were refined based on recent findings. <b>Results</b>: OMPS is categorized into five subtypes: Obstructive, Habitual, Anatomical, Sleep-Disordered Breathing, and Tongue-Related Pathologies. These subtypes share interconnected etiologies and manifestations, contributing to a feedback loop that complicates diagnosis and management. <b>Conclusions</b>: This classification system lays the foundation for future research and clinical protocols, emphasizing the need for a systematic approach to understanding OMPS.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Function and Nocturnal Hypoxemia Patterns in Patients with Obstructive Sleep Apnea.","authors":"Claudia Lucia Toma, Filip Radu, Dragos-Cosmin Zaharia, Ionela Belaconi, Stefan Dumitrache-Rujinski","doi":"10.3390/jcm14103589","DOIUrl":"https://doi.org/10.3390/jcm14103589","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objective:&lt;/b&gt; Obesity is a documented risk factor for impaired pulmonary function and abnormal oxyhaemoglobin levels during sleep. This functional impairment becomes more significant when there are additional respiratory pathologies, such as obstructive sleep apnea (OSA) and/or chronic obstructive pulmonary disease (COPD). Overnight pulse oximetry may offer an effective evaluation of nocturnal oxyhaemoglobin levels/waveform patterns. We evaluated the correlation between obesity, overnight pulse oximetry (parameters, waveform patterns) and pulmonary function in patients diagnosed with moderate-severe OSA and normal oxyhaemoglobin saturation levels during waking hours. We also compared the overnight oxyhaemoglobin saturation levels between patients with OSA alone and those with associated COPD. &lt;b&gt;Methods:&lt;/b&gt; This was a retrospective, transversal, non-interventional study on consecutive patients with moderate-severe OSA diagnosed using overnight cardiorespiratory polygraphy over a period of 18 months. After analyzing the study population's characteristics, the patients were divided into two subgroups: one consisting of patients with OSA alone (Group A), and the second with coexisting OSA and COPD (Group B). &lt;b&gt;Results:&lt;/b&gt; Seventy-six patients were included in the study, and 18% were diagnosed with COPD. A higher body mass index (BMI) correlated with a higher number of ≥3% SpO&lt;sub&gt;2&lt;/sub&gt; drops/h (ODI3) and percentage of time with oxyhaemoglobin saturation &lt; 90% (t90) and a lower average nocturnal oxyhaemoglobin saturation (avgSpO&lt;sub&gt;2&lt;/sub&gt;). ODI3 correlated negatively with avgSpO&lt;sub&gt;2&lt;/sub&gt; and positively with t90. After eliminating BMI as a confounding factor, lower values of forced expiratory volume in the first second (FEV1) were associated with lower avgSpO&lt;sub&gt;2&lt;/sub&gt; and higher t90. FEV1 did not corelate with ODI3. After dividing the study population into the two subgroups, patients from Group B had a tendency towards lower average nocturnal SpO&lt;sub&gt;2&lt;/sub&gt; levels compared to Group A. &lt;b&gt;Conclusions:&lt;/b&gt; Different phenotypes/patterns of nocturnal hypoxemia can be identified using quantitative and qualitative analyses of overnight pulse oximetry: repetitive, consecutive obstructive respiratory events with a characteristic intermittent (saw-tooth) hypoxemia pattern and alveolar hypoventilation, resulting in a continuous (plateau) hypoxemia pattern. According to our findings, nocturnal hypoxemia is more important at lower FEV1 values (correlating with lower avgSpO&lt;sub&gt;2&lt;/sub&gt;/higher t90, but not with ODI3). The presence of a continuous hypoxemia pattern in patients with OSA may suggest that pulmonary function tests should be performed in order to differentiate patients with alveolar hypoventilation secondary to obesity (restrictive syndrome) from those with associated COPD (obstructive syndrome). This can have an impact on the management of the case and the therapeutic approach (positive pressure therapy with/without su","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus-Based Recommendations for Assessing Post-Intensive Care Syndrome: A Systematic Review.","authors":"Helmar Bornemann-Cimenti, Johanna Lang, Sascha Hammer, Kordula Lang-Illievich, Sebastian Labenbacher, Stefan Neuwersch-Sommeregger, Christoph Klivinyi","doi":"10.3390/jcm14103595","DOIUrl":"https://doi.org/10.3390/jcm14103595","url":null,"abstract":"<p><p><b>Background:</b> Post-intensive care syndrome encompasses physical, cognitive, and psychological impairments that persist in patients after discharge from an intensive care unit. There is considerable variation in the tools used for assessment. This systematic review aimed to summarize the consensus-based recommendations for assessing post-intensive care syndrome. <b>Methods:</b> A comprehensive literature search identified four consensus-based guidelines. A quality assessment carried out using the Appraisal of Guidelines for Research and Evaluation II tool demonstrated high methodological standards across all the included papers. <b>Results:</b> The guidelines consistently emphasize assessing cognition, mental health, and physical function as the core domains. However, there are notable differences in the specific tools recommended. Major et al. focused on physical examinations, while Mikkelsen et al. proposed a fundamental package of five tools covering the key domains. Spies et al. aimed for a pragmatic set of freely available instruments administrable within 30 min. Nakanishi et al. provided a detailed ranking of instruments for each domain. The availability of validated translations varied considerably across languages. Some tools developed specifically for post-intensive care syndrome were not considered by any consensus conference. <b>Conclusions:</b> Further work is needed to establish a universally accepted standard for assessing post-intensive care syndrome that considers practical implementation across diverse settings and languages.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Significance in Estimating Tumor Burden Using Extracellular Salivary Biomarkers in Gastric Cancer Patients.","authors":"Sung Eun Oh, Jong Bae Seo, Jeongeun Noh, Sung Kim, Yong Kim, Ji Yeong An","doi":"10.3390/jcm14103596","DOIUrl":"https://doi.org/10.3390/jcm14103596","url":null,"abstract":"<p><p><b>Background:</b> We investigated the possibility of predicting tumor burden with salivary extracellular RNA (exRNA) biomarkers in gastric cancer patients. <b>Methods:</b> Saliva samples were prospectively collected from 50 gastric cancer patients who underwent gastrectomy with curative intent. Approximately 5 mL of saliva was collected before surgery and on the 5th to 7th days after surgery. The expression of three mRNAs (SPINK7, PPL, and SEMA4B) and two miRNAs (miR140-5p and miR301a) that were previously validated was determined by reverse transcription quantitative real-time PCR. <b>Results:</b> There were significant differences in the pre-operative expression of PPL (<i>p</i> = 0.025), SEMA4B (<i>p</i> = 0.012), and miR140-5p (<i>p</i> = 0.036) between pathologic stage I/II and III/IV groups. The area under the curve (AUC) of each respective multivariable model in predicting stage III/IV, which was adjusted for age and sex, was 75.4% (PPL), 82.5% (SEMA4B), and 75.5% (miR140-5p). In the multivariable model, including all three biomarkers, the AUC was 89.2%. On the other hand, none of the conventional tumor markers (CEA, CA19-9, and CA72-4) could predict tumor burden before surgery. The AUC of the multivariable model, including CEA, CA19-9, and CA72-4, was 67.2%, 66.2%, and 67.4%, respectively. When all three tumor markers were included in the multivariable model, the AUC was 70.5%. <b>Conclusions:</b> Noninvasively detected salivary biomarkers have been shown to have higher diagnostic accuracy than conventional tumor markers detected by invasive blood tests for estimating pre-operative tumor burden. This study demonstrates the potential utility of these biomarkers in pre-operative risk assessment and monitoring surgical treatment response to gastric cancer.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cluster Analysis in Diabetes Research: A Systematic Review Enhanced by a Cross-Sectional Study.","authors":"Binura Taurbekova, Radmir Sarsenov, Muhammad M Yaqoob, Kuralay Atageldiyeva, Yuliya Semenova, Siamac Fazli, Andrey Starodubov, Akmaral Angalieva, Antonio Sarria-Santamera","doi":"10.3390/jcm14103588","DOIUrl":"https://doi.org/10.3390/jcm14103588","url":null,"abstract":"<p><p><b>Background:</b> Diabetes mellitus is a heterogeneous metabolic disorder that poses substantial challenges in the management of patients with diabetes. Emerging research underscores the potential of unsupervised cluster analysis as a promising methodological approach for unraveling the complex heterogeneity of diabetes mellitus. This systematic review evaluated the effectiveness of unsupervised cluster analysis in identifying diabetes phenotypes, elucidating the risks of diabetes-related complications, and distinguishing treatment responses. <b>Methods:</b> We searched MEDLINE Complete, PubMed, and Web of Science and reviewed forty-one relevant studies. Additionally, we conducted a cross-sectional study using K-means cluster analysis of real-world clinical data from 558 patients with diabetes. <b>Results:</b> A key finding was the consistent reproducibility of the five clusters across diverse populations, encompassing various patient origins and ethnic backgrounds. MOD and MARD were the most prevalent clusters, while SAID was the least prevalent. Subgroup analysis stratified by ethnic group indicated a higher prevalence of SIDD among individuals of Asian descent than among other ethnic groups. These clusters shared similar phenotypic traits and risk profiles for complications, with some variations in their distribution and key clinical variables. Notably, the SIRD subtype was associated with a wide spectrum of kidney-related clinical presentations. Alternative clustering techniques may reveal additional clinically relevant diabetes subtypes. Our cross-sectional study identified five subgroups, each with distinct profiles of glycemic control, lipid metabolism, blood pressure, and renal function. <b>Conclusions:</b> Overall, the results suggest that unsupervised cluster analysis holds promise for revealing clinically meaningful subgroups with distinct characteristics, complication risks, and treatment responses that may remain undetected using conventional approaches.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Esophagectomy Dumping Syndrome: Assessing Quality of Life of Long-Term Survivors.","authors":"Dionysios Dellaportas, Ioannis Margaris, Eleftherios Tsalavoutas, Zoi Gkiafi, Anastasia Pikouli, Despoina Myoteri, Nikolaos Pararas, Panagis M Lykoudis, Constantinos Nastos, Emmanuel Pikoulis","doi":"10.3390/jcm14103587","DOIUrl":"https://doi.org/10.3390/jcm14103587","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Survival rates for esophageal cancer patients have markedly improved. Inevitably, attention has been drawn to functional and quality-of-life problems. The aim of the current study was to investigate the prevalence of dumping syndrome in patients following esophageal resection and its correlation with postoperative quality of life. <b>Methods</b>: This cross-sectional study involved disease-free patients who underwent a potentially curative resection for esophageal or gastroesophageal junction carcinoma between January 2019 and January 2024 in a single academic institution. Patients were asked to fill in two questionnaires: the Dumping Syndrome Rating Scale (DSRS) and the QLQ-OG25. A Composite Dumping Syndrome Index (CDSI) was calculated by adding the summary severity and frequency scores for each patient. <b>Results:</b> During the study period, 42 patients underwent esophagectomy for malignant esophageal or junctional tumors. In total, 14 eligible patients responded to the questionnaires at a mean time of 19.7 (±20.8) months following their operation. Three patients (21%) reported having at least quite severe problems related to at least two dumping symptoms. Six patients (43%) reported that they avoid certain foods in order to alleviate related problems. A high CDSI score was associated with significantly increased OG25 scores for dysphagia, eating restriction, odynophagia, pain and discomfort, and reflux (<i>p</i> < 0.05). <b>Conclusions</b>: Early dumping syndrome can occur in a significant proportion of patients following esophagectomy and may adversely affect quality of life.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications Associated with Immunosuppressive Agents in Solid Organ Transplant Recipients: A Nationwide Analysis.","authors":"Ah Young Lee, Jonghyun Jeong, Kyu-Nam Heo, Soyoung Park, Young-Mi Ah, Ji Min Han, Ju-Yeun Lee, Sang Il Min","doi":"10.3390/jcm14103602","DOIUrl":"https://doi.org/10.3390/jcm14103602","url":null,"abstract":"<p><p><b>Background:</b> Immunosuppressive therapies are vital for solid organ transplant (SOT) recipients to ensure graft survival, but long-term use can lead to complications. This study aimed to comprehensively evaluate the complications associated with immunosuppressive agents across different types of major SOTs. <b>Methods:</b> In a retrospective cohort study using a national claims database, we analyzed adult SOT recipients who began immunosuppressive therapy from 2007 to 2018. We identified complications such as infections, acute kidney injury, hypertensive emergencies, chronic kidney disease, hypertension, diabetes, dyslipidemia, and osteoporosis. These outcomes were determined through diagnostic codes, medication usage data, and hospital or emergency department visits. <b>Results:</b> Among 30,997 transplants with three-year follow up, complication rates varied by transplant type. Pancreatic transplant recipients had the lowest complication rate (225.9 per 1000 patient-years), while lung transplant recipients experienced the highest rate (823.9 per 1000 patient-years). Serious infections and chronic kidney disease were most common 2 to 6 months post transplant. Other complications, like acute kidney injury, hypertensive emergencies, hypertension, diabetes, dyslipidemia, and osteoporosis, were predominantly observed in the first month. Opportunistic infections peaked between 7 months and 1 year after transplantation. <b>Conclusions:</b> This study emphasizes the varied complications related to immunosuppressive therapy among different SOT recipients, delineating specific timeframes for each complication and maintenance regimen.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health and Metabolic Outcomes in Early Postpartum in Women with Prediabetes After Gestational Diabetes: A Secondary Analysis of the MELINDA Trial.","authors":"Yana Vanlaer, Caro Minschart, Karolijn Van den Keybus, Nele Myngheer, Toon Maes, Christophe De Block, Niels Bochanen, Inge Van Pottelbergh, Pascale Abrams, Wouter Vinck, Liesbeth Leuridan, Sabien Driessens, Jaak Billen, Christophe Matthys, Annick Bogaerts, Annouschka Laenen, Chantal Mathieu, Katrien Benhalima","doi":"10.3390/jcm14103592","DOIUrl":"https://doi.org/10.3390/jcm14103592","url":null,"abstract":"<p><p><b>Aims:</b> To examine the association between depressive symptoms and metabolic profile in women with prior gestational diabetes mellitus (GDM) and early postpartum prediabetes, and to explore whether a mobile-based lifestyle intervention affected mental health outcomes. <b>Methods:</b> Secondary, exploratory analysis of a multi-centric randomized controlled trial (MELINDA), evaluating a mobile-based lifestyle intervention versus standard follow-up (control group) in women with prediabetes after GDM. The analysis included 166 participants who completed the Center for Epidemiologic Studies-Depression (CES-D) questionnaire [score of ≥16 being suggestive for (sub)clinical depression] at baseline (6-16 weeks postpartum) and one year post-randomization. <b>Results:</b> At one year, 26.5% of women (n = 44) reported depressive symptoms, with no significant difference between the intervention and control groups (30.5% vs. 22.6%, <i>p</i> = 0.293). Women with depressive symptoms (symptomatic women) were younger (30.9 ± 4.9 vs. 32.5 ± 3.8 years, <i>p</i> = 0.033) and were less often highly educated (61.4% vs. 80.3%, <i>p</i> = 0.028). At baseline, symptomatic women had a higher rate of metabolic syndrome (38.6% vs. 21.9%, <i>p</i> = 0.044), higher LDL-cholesterol [3.2 ± 0.8 vs. 2.8 ± 0.8 mmol/L, <i>p</i> = 0.009], lower quality of life (lower SF-36 scores, <i>p</i> < 0.050) and a higher level of anxiety based on the STAI-6 questionnaire (14.5 ± 3.6 vs. 11.2 ± 2.6, <i>p</i> < 0.001). These differences persisted at one year postpartum with worse metabolic profile, more anxiety and lower quality of life in symptomatic women. <b>Conclusions:</b> Depressive symptoms are common in women with prediabetes in early postpartum after GDM and are associated with a persistent worse metabolic profile, increased anxiety and lower quality of life postpartum. The mobile-based lifestyle intervention did not improve mental health.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality as an Adjuvant Treatment for Acute Pain During an Interventional Process with Capsaicin: A Feasibility Study.","authors":"Anna Server, Maria Sonsoles Cepeda Diez, Carlos Suso-Ribera, Sara Guila Fidel Kinori, Diana Castilla, Francisco Javier Medel, Azucena García-Palacios","doi":"10.3390/jcm14103590","DOIUrl":"https://doi.org/10.3390/jcm14103590","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This feasibility study explores the use of virtual reality (VR) as an adjunct therapy during capsaicin administration for individuals with chronic neuropathic pain. Chronic neuropathic pain poses significant management challenges due to its complex biopsychosocial nature. This study aimed to assess the acceptability, usability, and preliminary effectiveness of VR in reducing pain, anxiety, aversiveness, and rumination during painful procedures. <b>Methods</b>: A total of 24 patients participated in the study and received either capsaicin treatment with VR (n = 12) or treatment as usual (n = 12). The VR group engaged with \"SnowWorld\", an immersive, interactive environment designed to promote distraction and relaxation. Outcomes including pain (average and worst), aversiveness, rumination, and anxiety, were assessed via 11-point scales. <b>Results</b>: Participants in the VR condition reported significantly lower scores for worst pain (2.83 vs. 6.33), average pain (2.08 vs. 5.42), aversiveness (1.50 vs. 6.08), rumination (1.17 vs. 5.75), and anxiety (0.83 vs. 5.17) compared to the controls (all <i>p</i> < 0.001). Participants reported high satisfaction regarding the VR experience, noting its immersive nature and ease of use. The qualitative feedback highlighted the VR's ability to foster relaxation and distraction during capsaicin administration. <b>Conclusions</b>: These findings support the feasibility and preliminary efficacy of VR as an adjunctive tool for acute pain management during capsaicin treatment. Further studies with larger samples are warranted to confirm these effects and explore long-term outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}