Journal of Clinical Medicine最新文献

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Improving Image Quality of Chest Radiography with Artificial Intelligence-Supported Dual-Energy X-Ray Imaging System: An Observer Preference Study in Healthy Volunteers.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062091
Sung-Hyun Yoon, Jihang Kim, Junghoon Kim, Jong-Hyuk Lee, Ilwoong Choi, Choul-Woo Shin, Chang-Min Park
{"title":"Improving Image Quality of Chest Radiography with Artificial Intelligence-Supported Dual-Energy X-Ray Imaging System: An Observer Preference Study in Healthy Volunteers.","authors":"Sung-Hyun Yoon, Jihang Kim, Junghoon Kim, Jong-Hyuk Lee, Ilwoong Choi, Choul-Woo Shin, Chang-Min Park","doi":"10.3390/jcm14062091","DOIUrl":"10.3390/jcm14062091","url":null,"abstract":"<p><p><b>Background/Objectives:</b> To compare the image quality of chest radiography with a dual-energy X-ray imaging system using AI technology (DE-AI) to that of conventional chest radiography with a standard protocol. <b>Methods:</b> In this prospective study, 52 healthy volunteers underwent dual-energy chest radiography. Images were obtained using two exposures at 60 kVp and 120 kVp, separated by a 150 ms interval. Four images were generated for each participant: a conventional image, an enhanced standard image, a soft-tissue-selective image, and a bone-selective image. A machine learning model optimized the cancellation parameters for generating soft-tissue and bone-selective images. To enhance image quality, motion artifacts were minimized using Laplacian pyramid diffeomorphic registration, while a wavelet directional cycle-consistent adversarial network (WavCycleGAN) reduced image noise. Four radiologists independently evaluated the visibility of thirteen anatomical regions (eight soft-tissue regions and five bone regions) and the overall image with a five-point scale of preference. Pooled mean values were calculated for each anatomic region through meta-analysis using a random-effects model. <b>Results:</b> Radiologists preferred DE-AI images to conventional chest radiographs in various anatomic regions. The enhanced standard image showed superior quality in 9 of 13 anatomic regions. Preference for the soft-tissue-selective image was statistically significant for three of eight anatomic regions. Preference for the bone-selective image was statistically significant for four of five anatomic regions. <b>Conclusions:</b> Images produced by DE-AI provide better visualization of thoracic structures.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719545","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}
引用次数: 0
Three-Dimensional-Planned Patient-Specific Guides for Scaphoid Reconstruction: A Comparative Study of Primary and Revision Nonunion Cases.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062082
Michael A Wirth, Mauro Maniglio, Benedikt C Jochum, Sylvano Mania, Ladislav Nagy, Andreas Schweizer, Lisa Reissner
{"title":"Three-Dimensional-Planned Patient-Specific Guides for Scaphoid Reconstruction: A Comparative Study of Primary and Revision Nonunion Cases.","authors":"Michael A Wirth, Mauro Maniglio, Benedikt C Jochum, Sylvano Mania, Ladislav Nagy, Andreas Schweizer, Lisa Reissner","doi":"10.3390/jcm14062082","DOIUrl":"10.3390/jcm14062082","url":null,"abstract":"<p><p><b>Background:</b> Scaphoid reconstruction after an established non- or malunion is challenging and recent developments have shown the feasibility to reconstruct it with 3D-planned and -printed patient-specific instrumentation. <b>Methods:</b> Our study compared the clinical outcome of computer assisted 3D-reconstructions of the scaphoid using patient-specific guides for primary and revision reconstructions of scaphoid nonunion regarding clinical outcome. Therefore, 39 patients with primary scaphoid nonunion or malunion and 15 patients with nonunion or malunion after a previous operative treatment were treated with patient-specific guides and followed up for a mean of 10.5 months. The consolidation was assessed with a CT-scan, and the time to consolidation was recorded. Pain level, satisfaction, wrist range of motion, and grip strength were measured and compared. <b>Results:</b> The wrist range of motion and grip strength of the two groups were similar, except for the wrist extension, which was significantly reduced in the revision group. Consolidation was observed in 36/39 patients (92%) in the primary group and in 13/15 patients (87%) in the revision group. Our results showed similar clinical results postoperatively between primary reconstructions and revision surgery. <b>Conclusions:</b> The use of 3D-planned and -printed patient-specific instrumentation proves to be similarly effective in revision surgeries for the reconstruction of the scaphoid as it is in primary surgeries.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719703","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}
引用次数: 0
Long-Term Outcomes of Femorofemoral Crossover Bypass Versus Endovascular Revascularization in Iliac Artery Occlusions: A Retrospective Study.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062109
Edin Ahmic, Paul Swatek, Iurii Mykoliuk, Anton Busau, Muhammed Abdallah, Wolfgang Hitzl, Klaus Linni, Ara Ugurluoglu, Jörg Lindenmann
{"title":"Long-Term Outcomes of Femorofemoral Crossover Bypass Versus Endovascular Revascularization in Iliac Artery Occlusions: A Retrospective Study.","authors":"Edin Ahmic, Paul Swatek, Iurii Mykoliuk, Anton Busau, Muhammed Abdallah, Wolfgang Hitzl, Klaus Linni, Ara Ugurluoglu, Jörg Lindenmann","doi":"10.3390/jcm14062109","DOIUrl":"10.3390/jcm14062109","url":null,"abstract":"<p><p><b>Objective</b>: The objective of this study is to compare the long-term outcomes of femorofemoral crossover bypass (FCOB) and endovascular treatment (ET) in managing iliac artery occlusions. <b>Methods</b>: The data of 200 patients with iliac artery lesions who were treated at a single center within 7 years were evaluated retrospectively. Of these, 82 (41%) underwent FCOB, and 118 (59%) received ET. Primary outcomes included patency, limb salvage, and survival rates, while secondary outcomes assessed complications, including wound infections and restenosis. Follow-up was conducted over a median of 4.98 years. <b>Results</b>: Primary patency (PP) rates after 3 years were 80% for FCOB and 88% for ET. Primary assisted patency (PAP) was 95% for FCOB and 93% for ET. Secondary patency (SP) was 97% for FCOB and 98% for ET. Both FCOB and ET achieved comparable long-term outcomes in limb salvage, 94% in both groups at 8 years. ET demonstrated advantages in shorter hospital stays (1.49 ± 2.51 vs. 8.21 ± 9.82 days, <i>p</i> < 0.0001) and lower perioperative complications, including transfusion rates (3.4% vs. 13.4%, <i>p</i> = 0.01226). However, FCOB exhibited lower restenosis rates (6.1% vs. 20.39%, <i>p</i> = 0.00441), despite a higher rate of reocclusion (19.5% vs. 6.8%, <i>p</i> = 0.00800). Survival rates at 8 years were 54% for FCOB and 67% for ET. <b>Conclusions</b>: ET is the preferred first-line approach due to its minimally invasive technique, shorter recovery time, and fewer complications. FCOB remains essential for patients with complex lesions or when ET is not feasible, offering durable long-term outcomes. Appropriate treatment selection should consider both the patient's condition and clinical and anatomical factors to optimize the best possible patient outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719676","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}
引用次数: 0
Outcomes of the Surgical Stone Management in Pelvic Ectopic Kidneys: A Retrospective Comparison of Three Different Approaches.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062081
Fatih Bicaklioglu, Mahmut Selman Mert, Resul Sobay, Ozgur Arikan, Mehmet Erhan Aydin, Mehmet Uslu, Salih Yildirim, Kemal Sarica
{"title":"Outcomes of the Surgical Stone Management in Pelvic Ectopic Kidneys: A Retrospective Comparison of Three Different Approaches.","authors":"Fatih Bicaklioglu, Mahmut Selman Mert, Resul Sobay, Ozgur Arikan, Mehmet Erhan Aydin, Mehmet Uslu, Salih Yildirim, Kemal Sarica","doi":"10.3390/jcm14062081","DOIUrl":"10.3390/jcm14062081","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study evaluates and compares the surgical outcomes of open pyelolithotomy, laparoscopic pyelolithotomy, and retrograde intrarenal surgery (RIRS) in the management of pelvic ectopic kidney stones. <b>Methods</b>: A retrospective analysis was conducted on 47 adult patients with pelvic ectopic kidney stones who underwent surgery between January 2009 and January 2024. Patients were categorized as open pyelolithotomy (n = 15), laparoscopic pyelolithotomy (n = 14), or RIRS (n = 18). Stone-free (SF) rates were assessed in the early postoperative period (1st or 2nd day), in the 1st month, and in the 3rd month. Demographic data, stone characteristics, operative data, and complications were recorded. <b>Results</b>: RIRS had significantly shorter operative and hospitalization times but a lower SF rate in the 3rd month (44.4%) compared to laparoscopy (92.9%) and open pyelolithotomy (86.7%). Additional procedures were required in 50% of RIRS cases to achieve SF status, while none were needed in the other groups. Complications included three Grade 2 cases (two bleeding; transient creatinine elevation) in open pyelolithotomy, two Grade 2 (urinary leakage; infection) and two Grade 3 cases (conversion to open surgery; trapped stent removal) in laparoscopic pyelolithotomy, and one Grade 2 case (febrile infection) in RIRS. <b>Conclusions</b>: Laparoscopic pyelolithotomy demonstrated the highest efficacy and comparable complication rates; making it the preferred approach for pelvic ectopic kidney stones. Open pyelolithotomy remains a valuable alternative where laparoscopic expertise or resources are limited. Although less invasive, RIRS showed lower efficacy due to the challenging anatomy of pelvic ectopic kidneys.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719636","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}
引用次数: 0
Comparison of SENSIMED Triggerfish® (TF) 24-Hour Monitoring in Open-Angle Glaucoma Patients Before and After Trabeculectomy.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062112
Anna Beck, Michael Uhrig, Alexander Schuster, Christina Korb, Norbert Pfeiffer, Katrin Lorenz
{"title":"Comparison of SENSIMED Triggerfish<sup>®</sup> (TF) 24-Hour Monitoring in Open-Angle Glaucoma Patients Before and After Trabeculectomy.","authors":"Anna Beck, Michael Uhrig, Alexander Schuster, Christina Korb, Norbert Pfeiffer, Katrin Lorenz","doi":"10.3390/jcm14062112","DOIUrl":"10.3390/jcm14062112","url":null,"abstract":"<p><p><b>Background/Objectives</b>: In glaucoma patients, the fluctuation in intraocular pressure during the day seems to have an influence on the progression of the disease. The contact lens sensor (CLS) Triggerfish<sup>®</sup> from the company SENSIMED records ocular dimensional changes for 24 h. The aim was to determine the amplitude of the measurements with a contact lens sensor before and after trabeculectomy (TE) in glaucoma patients. <b>Methods</b>: Twelve patients with glaucoma were included in this prospective, single-arm, single-center, interventional study. All patients received a CLS measurement for 24 h 8 ± 2 days before and 12 weeks (±1 week) after surgery. The raw data of the measurements were modeled using a double-harmonic cosine function. Fluctuation in the raw CLS data, amplitude, and the MESOR (midline estimating statistic of rhythm, rhythm-adjusted mean) of the modeled data were investigated. The safety and feasibility of the CLS measurements were evaluated. <b>Results</b>: Nine patients underwent the complete 24-h wearing period before and after surgery. Whereas the MESOR changed significantly before and after surgery (<i>p</i> = 0.04), the amplitude of the modeled data did not change significantly and the daytime fluctuation and circadian rhythm also did not vary significantly. The CLS could be safely removed from all study eyes after surgery. <b>Conclusions</b>: The non-significant change in amplitude suggests that diurnal fluctuations persist after TE. This contrasts with reports in the literature that show that TE reduces diurnal fluctuations. It can be assumed that the significant reduction in the MESOR represents the reduction in the average intraocular pressure over 24 h. The CLS can be used safely three months after TE.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719434","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}
引用次数: 0
Accuracy of the "Timed Up and Go" Test for Predicting Low Muscle Mass in a Preoperative Prehabilitation Program for Colorectal Cancer.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062088
Leticia Pérez-Santiago, Luisa Paola Garzón-Hernández, José Martín-Arévalo, Vicente Pla-Martí, David Moro-Valdezate, David Casado-Rodrigo, Marina Riera-Cardona, Noelia Tarazona, Bianca Tabita Muresan, Ning Yun Wu Xiong, Alejandro Espí-Macías, Stephanie García-Botello
{"title":"Accuracy of the \"Timed Up and Go\" Test for Predicting Low Muscle Mass in a Preoperative Prehabilitation Program for Colorectal Cancer.","authors":"Leticia Pérez-Santiago, Luisa Paola Garzón-Hernández, José Martín-Arévalo, Vicente Pla-Martí, David Moro-Valdezate, David Casado-Rodrigo, Marina Riera-Cardona, Noelia Tarazona, Bianca Tabita Muresan, Ning Yun Wu Xiong, Alejandro Espí-Macías, Stephanie García-Botello","doi":"10.3390/jcm14062088","DOIUrl":"10.3390/jcm14062088","url":null,"abstract":"<p><p><b>Background:</b> Preoperative sarcopenia is associated with increased morbidity and mortality in patients undergoing colorectal cancer (CRC) surgery. The assessment of muscle mass is crucial in identifying at-risk patients, but standard imaging methods like computed tomography (CT) scans require significant resources. Functional tests, such as the Timed Up and Go (TUG) test, may serve as simple and effective alternatives for sarcopenia screening. <b>Objective:</b> To evaluate the accuracy of the TUG test in predicting preoperative sarcopenia in patients scheduled for CRC surgery. <b>Methods:</b> A prospective observational study was conducted at a tertiary colorectal unit from January 2022 to June 2023. Patients underwent a prehabilitation assessment, including the TUG test, four weeks before surgery. Sarcopenia was diagnosed based on reduced muscle mass measured at the third lumbar vertebra on CT images. Statistical analyses included the sensitivity, specificity, and overall accuracy of the TUG test in predicting sarcopenia. <b>Results:</b> The study included 199 CRC patients (58.3% male, mean age 71.76 ± 10.42 years). Sarcopenia was present in 48.7% of patients. The mean TUG test length was 12.52 ± 7.95 s. A TUG test time of ≥10.19 s predicted sarcopenia with 70.1% sensitivity, 75.5% specificity, and an overall accuracy of 72.9% (95% CI = 0.660-0.790). <b>Conclusions:</b> The TUG test is a reliable, simple, and non-invasive tool for identifying sarcopenia in patients scheduled for colorectal cancer surgery, reducing reliance on CT scans. Early detection allows for timely interventions, improving surgical outcomes and overall patient prognosis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719480","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}
引用次数: 0
C-Reactive Protein in Peritoneal Fluid for Predicting Anastomotic Leakage After Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062099
Tharith Vun, Zhanghao Wu, Chetra Chea, Weidong Liu, Ran Tao, Youming Deng
{"title":"C-Reactive Protein in Peritoneal Fluid for Predicting Anastomotic Leakage After Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis.","authors":"Tharith Vun, Zhanghao Wu, Chetra Chea, Weidong Liu, Ran Tao, Youming Deng","doi":"10.3390/jcm14062099","DOIUrl":"10.3390/jcm14062099","url":null,"abstract":"<p><p><b>Background</b>: Anastomotic leakage (AL) is a serious and potentially fatal complication that can occur after colorectal cancer (CRC) surgery, and it significantly affects patient recovery and increases morbidity. While serum C-reactive protein (CRP) is a recognized systemic inflammatory marker, the level of CRP in peritoneal fluid may serve as a more specific and localized biomarker for early AL detection. This meta-analysis explores the diagnostic potential of peritoneal fluid CRP, aiming to enhance postoperative care for CRC patients. <b>Methods:</b> A comprehensive literature search was conducted following the PRISMA guidelines. Eligible studies were included based on strict inclusion and exclusion criteria. Diagnostic accuracy was pooled using a random-effects model. The risk of bias was assessed using the QUADAS-2 tool. <b>Results:</b> The pooled sensitivity and specificity were 0.74 and 0.83, respectively, with an area under the curve (AUC) of 0.84, indicating good diagnostic accuracy. The overall diagnostic performance was consistent for sensitivity with no significant heterogeneity, but high heterogeneity was observed for specificity, suggesting variability between studies. Subgroup analysis revealed improved diagnostic performance between postoperative days 5-7 and higher CRP cut-off values (70-150 mg/L). The analysis confirmed the stability of the results through a sensitivity analysis and found no significant publication bias. <b>Conclusions:</b> Peritoneal fluid CRP is a reliable biomarker for detecting AL after CRC surgery, especially in the later postoperative period. However, heterogeneity in study methodologies and patient populations limits the generalizability of the findings. Future research should focus on standardizing protocols and exploring additional biomarkers to improve diagnostic accuracy.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719486","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}
引用次数: 0
Reviewing Mobile Dental Apps for Children with Cognitive and Physical Impairments and Ideating an App Tailored to Special Healthcare Needs.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062105
Massimo Pisano, Alessia Bramanti, Federica Di Spirito, Maria Pia Di Palo, Giuseppina De Benedetto, Alessandra Amato, Massimo Amato
{"title":"Reviewing Mobile Dental Apps for Children with Cognitive and Physical Impairments and Ideating an App Tailored to Special Healthcare Needs.","authors":"Massimo Pisano, Alessia Bramanti, Federica Di Spirito, Maria Pia Di Palo, Giuseppina De Benedetto, Alessandra Amato, Massimo Amato","doi":"10.3390/jcm14062105","DOIUrl":"10.3390/jcm14062105","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Children with special healthcare needs (SHCNs) face various physical, developmental, sensory, behavioral, or cognitive challenges affecting oral health and highlighting the need for specialized and more accessible oral and dental care. Mobile health (m-health) applications have emerged as a promising solution to bridge oral health education gaps and improve dental care access. This narrative review aimed to examine the available dental m-health applications designed for children with cognitive and physical impairments, exploring the perspectives of children, parents/caregivers, and dentists regarding their use and potential contribution to oral health. Based on these insights, a concept for a tailored dental m-health app is proposed, considering the interactions between children, caregivers, and dentists to support oral care. <b>Methods</b>: A literature search was conducted using MEDLINE/PubMed, Scopus, and Web of Science to identify studies on the use of m-health apps in pediatric dentistry for SHCN children. <b>Results</b>: Six studies were included in this review. M-health applications helped manage anxiety, behavioral issues, and compliance in children and were generally well received by parents and caregivers, thus improving oral hygiene practices and regular dental visits, and having the potential to reduce oral health disparities in children with cognitive and physical impairments and their families. However, current apps designed for children are limited and may not fully accommodate the diverse sensory needs of these SHCN children. <b>Conclusions</b>: The development of a tailored dental m-health app that adapts to the individual characteristics of SHCN children could enhance oral health awareness and support better compliance among children, parents/caregivers, and dentists.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719685","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}
引用次数: 0
The Present and Future of Robotic Surgery in Breast Cancer and Breast Reconstruction.
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062100
Brett Allen, Alexis Knutson, Noama Iftekhar, Casey Giles, Jarrell Patterson, Joshua MacDavid, Richard Baynosa
{"title":"The Present and Future of Robotic Surgery in Breast Cancer and Breast Reconstruction.","authors":"Brett Allen, Alexis Knutson, Noama Iftekhar, Casey Giles, Jarrell Patterson, Joshua MacDavid, Richard Baynosa","doi":"10.3390/jcm14062100","DOIUrl":"10.3390/jcm14062100","url":null,"abstract":"<p><p><b>Background:</b> Breast cancer is the second most common cancer in women with an improving mortality rate and a growing need for reconstruction following oncologic resection. Advancements in robotic surgery and minimally invasive techniques have offered refinement to traditional open techniques of flap harvest for reconstruction, particularly regarding improved donor site morbidity. <b>Methods:</b> The literature review was based on a PubMed database search using the keyword \"Robotic breast reconstruction\" in conjunction with the Boolean operators \"Flap\", \"Latissimus\", and \"DIEP\" to specify the search. In total, 106 results were generated, which were then manually reviewed and condensed for a comprehensive stance on the current status, technique, variations, and outcomes for robotic breast reconstruction. <b>Results:</b> Robotic technique has been described for the latissimus dorsi (LD) and deep inferior epigastric perforator (DIEP) flaps for breast reconstruction. For LD, robotic flap harvest reduces donor site morbidity, incisional length, and hospital length of stay, with similar complication rates for seroma/hematoma/infection, and longer operative times. Robotic LD procedures have been described in conjunction with single-site nipple-sparing mastectomy and flap elevation leading to a full minimally invasive resection and reconstruction from one lateral incision. Robotic DIEP harvest offers a considerably smaller fascial incision/rectus muscle dissection and has a comparable complication rate to traditional techniques with shorter hospital length of stay, and improved pain, at the expense of longer operating times. Data on hernia/bulge reduction from robotic techniques is limited and not yet available. <b>Conclusions:</b> Robotic breast reconstruction offers great potential for improving breast reconstruction in terms of donor site morbidity, length of incision, hospital length of stay at the cost of longer operating times, and increased technical skill/specialization, but it has yet to be proven on a large scale with long-term outcome data. Multi-center, prospective clinical data and trials are needed to help elucidate the potential for equivalence and superiority of the minimally invasive approach compared to standard open techniques, but the future is promising for robotic surgery in breast cancer and breast reconstruction.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719694","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}
引用次数: 0
Image-Based Fractional Flow Reserve: Art and Science. Reply to Taylor et al. Single View Techniques for Modelling Coronary Pressures Losses. Comment on "Tsigkas et al. Rapid and Precise Computation of Fractional Flow Reserve from Routine Two-Dimensional Coronary Angiograms Based on Fluid Mechanics: The Pilot FFR2D Study. J. Clin. Med. 2024, 13, 3831".
IF 3 3区 医学
Journal of Clinical Medicine Pub Date : 2025-03-19 DOI: 10.3390/jcm14062086
Grigorios G Tsigkas, George C Bourantas, Athanasios Moulias, Grigorios V Karamasis, Fivos V Bekiris, Periklis Davlouros, Konstantinos Katsanos
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