Journal of Clinical Medicine最新文献

{"title":"Human-in-the-Loop Performance of LLM-Assisted Arterial Blood Gas Interpretation: A Single-Center Retrospective Study.","authors":"Sergio Ayala-De la Cruz, Paola Elizabeth Arenas-Hernández, María Fernanda Fernández-Herrera, Rebeca Alejandrina Quiñones-Díaz, Jorge Martín Llaca-Díaz, Erik Alejandro Díaz-Chuc, Diana Guadalupe Robles-Espino, Erik Alejandro San Miguel-Garay","doi":"10.3390/jcm14186676","DOIUrl":"10.3390/jcm14186676","url":null,"abstract":"<p><p><b>Background and Objectives</b>: Interpreting acid-base disorders is challenging, particularly in complex or mixed cases. Given the growing potential of large language models (LLMs) to assist in cognitively demanding tasks, this study evaluated their performance in interpreting arterial blood gas (ABG) results. <b>Materials and Methods</b>: In this single-center retrospective study, 200 ABG datasets were curated to include 40 cases in each of five diagnostic categories: metabolic acidosis, respiratory acidosis, metabolic alkalosis, respiratory alkalosis, and no acid-base disorder. Three medical students, each assigned to one LLM (ChatGPT GPT-4o, Copilot GPT-4, or Gemini 1.5-flash/2.5-flash), perform ABG interpretation using two evaluation methods: interpretation (LLM-I) and interpretation with supervision model (LLM-S). Two clinical pathologists independently performed the conventional evaluation to serve as the reference standard. <b>Results</b>: Agreement for identifying the primary acid-base (APD) disorder was strong across all approaches (Cohen's κ ≥ 0.88). For identifying both primary and secondary disorders regardless of order (APSD), LLM-I showed moderate agreement (ChatGPT κ = 0.65, Copilot κ = 0.61, Gemini κ = 0.62), whereas LLM-S achieved strong agreement (ChatGPT κ = 0.91, Copilot κ = 0.81, Gemini κ = 0.81). <b>Conclusions</b>: LLM-assisted ABG interpretation demonstrates strong concordance with expert interpretation in detecting primary acid-base disorders. These tools may enhance the understanding of acid-base disorders while reducing calculation-related errors among medical students.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175870","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":"Lipid Profile, Obesity Indicators and Cardiometabolic Risk Factors in School-Aged Children and Adolescents: Sex-Specific Associations.","authors":"Rafał Baran, Joanna Baran, Justyna Leszczak, Anna Bartosiewicz, Justyna Wyszyńska","doi":"10.3390/jcm14186677","DOIUrl":"10.3390/jcm14186677","url":null,"abstract":"<p><p><b>Background</b>: Childhood obesity and cardiometabolic disturbances are growing global health concerns. This study aimed to assess the prevalence of excess body weight, body fat, and selected cardiometabolic risk factors in school-aged children and adolescents, focusing on sex- and age-related differences. <b>Methods</b>: A cross-sectional study was conducted among 318 Polish participants aged 6-17 years, including 169 children (6-12 years) and 149 adolescents (13-17 years). Anthropometric, blood pressure (BP), and fasting blood lipid and glucose measurements were collected and analyzed by age group (children 6-12 years; adolescents 13-17 years) and sex. <b>Results</b>: The prevalence of overweight and obesity was 18.5% (BMI-based) and 26.1% (body fat-based). Abdominal obesity and stage I-II hypertension were observed in 24.5% and 23.6% of participants, respectively. Children had higher rates of excess body fat, abdominal obesity, elevated BP, and lipid abnormalities than adolescents. Among adolescents, girls more frequently presented with borderline/high total cholesterol and Low-Density Lipoprotein (LDL cholesterol) and borderline/low High-Density Lipoprotein (HDL cholesterol), while boys more often had elevated BP. In girls, elevated triglycerides (TGs) were independently associated with abdominal obesity (odds ratio (OR) = 2.36, <i>p</i> = 0.015) and hypertension (OR = 2.47, <i>p</i> = 0.023); no such associations were observed in boys. <b>Conclusions</b>: Cardiometabolic risk factors may appear early in life and differ by age and sex. Routine screening and early interventions, particularly targeting lipid abnormalities in girls, are essential to prevent long-term health consequences.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175931","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":"Optimizing Perioperative Glycaemic Control with Continuous Glucose Monitoring in Pregestational Diabetes: Feasibility and Comparative Analysis of Two Systems: A Pilot Study.","authors":"Joanna Kacperczyk-Bartnik, Aleksandra Urban, Paweł Bartnik, Piotr Świderczak, Aneta Malinowska-Polubiec, Aleksandra Bender, Ewa Romejko-Wolniewicz, Krzysztof Czajkowski, Jacek Sieńko","doi":"10.3390/jcm14186670","DOIUrl":"10.3390/jcm14186670","url":null,"abstract":"<p><p><b>Background:</b> Continuous glucose monitoring (CGM) has changed the clinical practice in diabetes management during pregnancy; however, its application during caesarean section remains understudied. This feasibility study evaluates the performance, reliability, and clinical utility of two CGM systems-FreeStyle Libre 2 and Medtronic Guardian Connect-during caesarean delivery and the early postpartum period in a patient with pregestational diabetes mellitus (PGDM). <b>Methods</b>: A prospective, single-patient study was conducted. A 32-year-old woman with type 1 diabetes underwent elective caesarean section at 38 weeks of gestation. Both CGM systems were applied over 18 h prior to surgery and monitored continuously through the intraoperative and five-day postpartum period. Glucose data, device performance, and usability were assessed. <b>Results</b>: Both CGM systems provided uninterrupted, high-quality glucose data throughout the perioperative period, including during spinal anaesthesia, surgical manipulation, and postoperative recovery. No sensor displacement nor signal loss occurred. Glycaemic readings remained within the normoglycaemic range (90-100 mg/dL) during surgery, with mild elevations observed during anaesthesia initiation. Postoperatively, both systems showed comparable glucose trends, with slightly lower readings from FreeStyle Libre 2. <b>Conclusions</b>: CGM is feasible and reliable during caesarean section in PGDM patients. These findings support the integration of CGM into obstetric surgical care and highlight the need for larger studies to validate clinical benefits.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175935","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":"Minimally Invasive Mitral Valve Replacement in the Gray Zone: Bioprosthetic vs. Mechanical Valves in Patients Aged 50-69 Years.","authors":"Alexander Weymann, Sadeq Ali-Hasan-Al-Saegh, Sho Takemoto, Nunzio Davide De Manna, Jan Beneke, Lukman Amanov, Fabio Ius, Ruemke Stefan, Bastian Schmack, Alina Zubarevich, Aburahma Khalil, Arjang Ruhparwar, Jawad Salman","doi":"10.3390/jcm14186666","DOIUrl":"10.3390/jcm14186666","url":null,"abstract":"<p><p><b>Background</b>: Mitral valve replacement presents considerable challenges in the field of cardiothoracic surgery, particularly in patients aged 50 to 69, where the decision between bioprosthetic and mechanical valves is critical. Nevertheless, the optimal selection of prosthetic valves for candidates within this age-related gray zone remains inadequately defined, necessitating a thorough evaluation of long-term outcomes and associated risks. <b>Objective</b>: This study aims to assess mid-term outcomes of MIMVR in patients aged 50 to 69, comparing reoperation rates, prosthesis-related morbidity, and overall survival between bioprosthetic and mechanical valves. While many prior studies on valve choice in patients aged 50 to 69 years are derived from sternotomy cohorts, the novelty of our work lies in the exclusive focus on patients undergoing minimally invasive techniques. <b>Methods</b>: A retrospective analysis was conducted in accordance with the <i>Strengthening the Reporting of Observational Studies in Epidemiology</i> (STROBE) guidelines, including 172 patients aged 50-69 years who underwent minimally invasive mitral valve replacement via right minithoracotomy at a high-volume center in Germany between 2011 and 2023. Of the 172 patients, 95 underwent MIMVR using biological prostheses, while 77 received mechanical prostheses. Comprehensive data on demographics, surgical procedures, and postoperative complications, as well as long-term outcomes, were analyzed. <b>Results</b>: With a mean follow-up of 7.1 years, early outcomes revealed no significant differences in 30-day mortality (7.4% for bioprosthetic vs. 2.6% for mechanical; <i>p</i> = 0.06). There was no significant differences in all-cause mortality at 1 year (8.4% vs. 3.9%; <i>p</i> = 0.22), 3-year (9.5% vs. 7.8%; <i>p</i> = 0.69), and 5-year (13.7% vs. 10.4%; <i>p</i> = 0.19), or at the longest follow-up (13.7% vs. 10.4%; <i>p</i> = 0.51). Kaplan-Meier analysis showed no significant difference in long-term survival between the groups (<i>p</i> = 0.5427). Postoperative arrhythmia occurred significantly more frequently in the biologic group compared to the mechanical group (18.9% vs. 6.5%; <i>p</i> = 0.01). <b>Conclusions</b>: For patients aged 50-69 undergoing MIMVR using a bioprosthetic or mechanical valve, the mid-term survival and incidence of reoperation and re-hospitalization were comparable up to 7 years. This provides evidence supporting the safe application of the MICS approach with either valve type in this gray-zone age group.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175706","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":"Recurrence of Glomerular Diseases (GN) After Kidney Transplantation: A Narrative Review.","authors":"Abbal Koirala, Aditi Singh, Duvuru Geetha","doi":"10.3390/jcm14186686","DOIUrl":"10.3390/jcm14186686","url":null,"abstract":"<p><p>Recurrence of the original glomerular disease (GN) poses a significant threat to kidney transplant function and longevity. The probability and severity of this recurrence vary, with C3 glomerulopathy and certain forms of FSGS exhibiting particularly high rates. Kidney transplant GN recurrence risk hinges on the characteristics of the initial GN, recipient/donor genetics, recipient age, donor type, end-stage kidney disease (ESRD) progression rate, and proteinuria levels. Standard immunosuppression has limited efficacy in preventing primary disease recurrence; however, agent selection and induction therapy can influence the risk for specific GNs. Diagnosing recurrent GN involves a comprehensive approach, including clinical evaluation, laboratory tests (such as proteinuria, hematuria, and specific biomarkers like anti-PLA2R for membranous nephropathy or complement for C3G), and, critically, an allograft biopsy analyzed with light, immunofluorescence, and electron microscopy. Treatment strategies are evolving towards targeted therapies, such as rituximab for antibody-mediated GN and complement inhibitors for C3G, moving away from broad immunosuppression. This narrative literature review provides practical monitoring algorithms for post-transplant settings, synthesizing information on the incidence, predictors, diagnostic strategies, and therapeutic options for various glomerular disease subtypes. The methodology involved searching MEDLINE, Embase, and Cochrane databases from 1996 to 2025, prioritizing systematic reviews, cohort studies, registries, and interventional reports. Eligibility criteria included adult transplant recipients and English-language reports on recurrent glomerular disease outcomes, excluding most single-patient case reports. Limitations include potential selection bias, omission of relevant studies, and the absence of a formal risk-of-bias assessment or meta-analysis. The evidence base is heterogeneous, with inconsistent outcome reporting and scarce randomized controlled trials. Future efforts should focus on developing predictive biomarkers, standardizing diagnostic and response criteria, conducting multicenter prospective cohorts and pragmatic trials, and creating shared registries with harmonized data.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175947","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 VincerEmo Pilot Study: Prospective Analysis of Controlled Physical Activity in People with severe Hemophilia.","authors":"Federica Valeri, Cristina Dainese, Piera Merli, Mariella Galizia, Samuel Agostino, Nicolas Cunsolo, Carola Sella, Alessandra Valpreda, Mariagiulia Bailon, Marco Miniotti, Annamaria Porreca, Giuseppe Massazza, Benedetto Bruno, Alessandra Borchiellini","doi":"10.3390/jcm14186652","DOIUrl":"10.3390/jcm14186652","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The approach to physical activity in people with hemophilia (PwH) is still conditioned by many difficulties. Thus, a prospective observational pilot study has been carried out aiming to evaluate how an adequate and controlled training program can slow down the onset or evolution of arthropathy and improve musculoskeletal health and quality of life. <b>Methods</b>: Performed from April 2022 to April 2023, this study involved nine severe hemophilic A and B patients, aged > 18 years old, on regular prophylaxis with replacement products. Participants, without changing the usual prophylaxis schedule and maintaining a trough level of at least 20% FVIII/FIX before training, were involved in physical activity twice a week. <b>Results</b>: After 12 months, no increase in annual bleeding ratio (ABR) was observed, and baseline joint status (as assessable by HEAD US score, HJHS, and NRS) was maintained. Even if not statistically significant, a trend toward improvement in mean HEAD US score (15.55 vs. 13.11) and HJHS (14.4 vs. 11) from baseline was observed. Some of the physical tests performed showed a significant improvement at 6 months and 12 months from baseline (5 Rep Sit to Stand, Sit and Reach, and 6-minute Walking Test), meaning an improvement in leg strength, dorsal flexibility, and aerobic resistance. <b>Conclusions</b>: This is the first pilot study evaluating at 360 degrees the safety and impact of a controlled physical activity in PwH. No participant experienced bleedings or a worsening in joint status, but they experienced an improvement in articular functionality. Without changing the usual prophylaxis, scheduling training sessions according to individual pharmacokinetics turned out to be a safe and a cost-effective approach.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175874","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":"Healthcare Providers' Perspectives on the Communication Challenges When Discussing Palliative Sedation: A Qualitative Study Across Eight European Countries.","authors":"Éva Pozsgai, Csilla Busa, Holger Brunsch, Michael Van der Elst, Sheila Payne, Nancy Preston, Ian Koper, Jeroen Hasselaar, Rocio Roji, Claudio Adile, Daniela Mosoiu, Camelia Ancuta, Ágnes Csikós","doi":"10.3390/jcm14186653","DOIUrl":"10.3390/jcm14186653","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Studies have shown that healthcare providers struggle to discuss difficult end-of-life issues, including palliative sedation (PS), with patients and relatives. This qualitative study aimed to evaluate communication challenges related to PS among healthcare providers in eight European countries. <b>Methods:</b> In each country, two clinical settings providing palliative care were selected. Two moral case deliberation (MCD) sessions were conducted, each with 3 to 9 palliative healthcare professionals (HCPs). They discussed patient cases involving PS and refractory symptom management. Sessions were audio-recorded, transcribed, anonymized, and analyzed using a framework analysis. <b>Results:</b> Key issues included core communication values-open, empathetic, and honest dialogue-which were consistent across countries but varied in practice. In The Netherlands, Germany, Belgium, and the UK, communication prioritized patient autonomy through timely discussions and family dialogue. In Spain and Italy, family-centered communication approaches predominated, while in Romania and Hungary, tendencies for selective disclosure were also evident, along with delegated decision-making and complex family dynamics. Certain challenges reflected professional experience rather than national culture. Nurses mediated across contexts, while terminology surrounding palliative sedation remained a source of ambiguity. <b>Conclusions:</b> This is the first study to present HCPs' perceptions of communication issues related to PS across Europe. Despite variations between settings, consistently open dialogue among patients, families, and HCPs emerged as the most valued element. These findings highlight the need to better understand how end-of-life communication about PS varies in practice and underscore the importance of considering healthcare providers' real-world experiences to improve communication with patients and families.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175934","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":"Battery Life of Pulse Generators in Spinal Cord Stimulation: Analysis and Comparison Between Surgical and Percutaneous Leads in Energy Efficiency.","authors":"Marta Antonia Gómez González, Nicolás Cordero Tous, Carlos Sánchez Corral, Beatriz Lechuga Carrasco, Manuel Alejandro Sánchez García, Rafael Gálvez Mateos, Gonzalo Olivares Granados","doi":"10.3390/jcm14186646","DOIUrl":"10.3390/jcm14186646","url":null,"abstract":"<p><p><b>Background:</b> Spinal cord stimulation (SCS) is an established therapy for chronic neuropathic pain. Although rechargeable and non-rechargeable pulse generators (PGs) are widely used, their real-world battery life and the influence of lead type on energy efficiency remain underexplored. <b>Objective:</b> To evaluate PG battery longevity and compare the performance of surgical versus percutaneous leads in terms of energy efficiency. <b>Methods:</b> We conducted a retrospective study of 283 PGs implanted at Hospital Virgen de las Nieves (Granada, Spain) from 1996 to 2023. Data on patient demographics, pain etiology, lead type and placement, stimulation modality, and PG status were extracted. A competing risks analysis was used to assess PG shutdown and early explantation over time. <b>Results:</b> Of the PGs analyzed, 43.5% were non-rechargeable and 56.5% rechargeable. Rechargeable PGs showed significantly longer battery life (mean: 82.7 vs. 38.9 months, <i>p</i> < 0.05), with a lower probability of shutdown at 50, 100, and 150 months. No significant differences in battery longevity were observed regarding lead location, stimulation type, or pain etiology. A trend toward longer battery life was observed with percutaneous leads, although not statistically significant. <b>Conclusions:</b> Rechargeable PGs demonstrated superior longevity compared to non-rechargeable models and should be considered the preferred option in most cases. While both surgical and percutaneous leads are effective, percutaneous systems may offer improved battery efficiency. Further prospective studies are warranted to confirm these findings and assess cost-effectiveness.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175631","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":"Evaluation of the Effectiveness of TECAR and Vibration Therapy as Methods Supporting Muscle Recovery After Strenuous Eccentric Exercise.","authors":"Łukasz Oleksy, Anna Mika, Maciej Daszkiewicz, Martyna Sopa, Miłosz Szczudło, Maciej Kuchciak, Artur Stolarczyk, Olga Adamska, Paweł Reichert, Zofia Dzięcioł-Anikiej, Renata Kielnar","doi":"10.3390/jcm14186648","DOIUrl":"10.3390/jcm14186648","url":null,"abstract":"<p><p><b>Background/Objectives</b>. Despite growing interest in capacitive-resistive electric transfer TECAR) and Vibration therapy (VT), their comparative effectiveness in sports recovery remains unclear. This study aimed to evaluate and contrast the short-term effects of TECAR and VT on neuromuscular recovery following eccentric muscle fatigue, relative to passive rest, in active young adults. We hypothesized that both interventions would accelerate recovery and potentially reduce injury risk. <b>Methods</b>. Forty-one participants were randomized into two groups: TECAR therapy (Group 1) and VT (Group 2). Neuromuscular function was assessed at baseline, post-exercise, and post-intervention using tensiomyography (TMG) and electromyography (EMG). <b>Results</b>. Both groups showed a significant increase in EMG MDF intercept after exercise. Post-intervention, VT induced a further rise in this parameter, whereas TECAR stabilized values without significant change. In the contralateral resting limb, increases persisted after exercise and passive recovery. Between-limb differences were significant only in the TECAR group. TMG analysis revealed a non-significant but large-effect increase in contraction delay (Td) post-exercise, followed by significant reductions after both interventions. In the left limb, Td changes were not significant. For maximal displacement (Dm), both VMO and VLO muscles demonstrated a significant decrease post-exercise and a marked recovery after both therapies. Other TMG parameters (Ts, Tc, Tr) showed no significant changes. <b>Conclusions</b>. Both TECAR and VT effectively enhanced neuromuscular recovery after eccentric exercise. TECAR demonstrated a modest but consistent advantage, particularly in normalizing muscle recruitment and restoring mechanical properties, making it suitable in contexts requiring rapid recovery. VT, however, remains a more accessible and cost-effective modality. These findings support the application of both techniques in sports recovery, while highlighting the need for further research in professional athletes and diverse exercise settings to optimize regeneration strategies and reduce injury risk.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175533","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":"Assessment of Biomechanics Following Calcaneal Fracture Treatment with Internal Plate Fixation or Ilizarov External Fixation: A Retrospective, Two-Center Study.","authors":"Igor Kowal, Marcin Pelc, Daniele Pili, Łukasz Tomczyk, Radosław Operacz, Piotr Morasiewicz","doi":"10.3390/jcm14186651","DOIUrl":"10.3390/jcm14186651","url":null,"abstract":"<p><p><b>Background:</b> There is no consensus on the best treatment method for calcaneal fractures. The topic of lower limb biomechanics following calcaneal fracture treatment with various fixation methods has not been fully explored. The aim of the study was to assess the balance and load distribution of the lower limbs in patients after various methods of stabilization of calcaneal fractures. <b>Methods:</b> In this two-center study, we retrospectively collected data from 19 patients treated with internal plate fixation at a mean age of 46 years and 27 patients treated with Ilizarov external fixation at a mean age of 50 years. Using the Zebris Medical pedobarophragmatic platform, we assessed the percentage distribution of lower limb loads and balance. <b>Results:</b> There were no significant differences in total load distribution for both the operated (<i>p</i> = 0.489) and non-operated limb (<i>p</i> = 0.46), between the Ilizarov method group and the internal plate group. In the Ilizarov fixation group, total load distribution was 46.89% on the treated limb, and 53.11% on the uninjured limb, <i>p</i> = 0.077. In the internal plate fixation group, the mean total load distribution was 41.57% in the treated limb, and 57.89% in the uninjured limb, <i>p</i> = 0.008. The median CoG (center or gravity) sway path length was 132.41 cm and 170.21 cm in the Ilizarov and internal plate group, respectively, <i>p</i> = 0.023. The median CoG sway areas were 0.84 cm² and 7.57 cm² in the Ilizarov method group and internal plate fixation group, respectively, <i>p</i> < 0.001. <b>Conclusions:</b> The Ilizarov method was associated with more symmetrical load distribution and improved balance performance compared to internal plate fixation. Static biomechanical parameters of calcaneal fracture treatment were better in the Ilizarov group compared to patients with internal plate fixation.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175747","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}