Journal of Clinical Medicine最新文献

{"title":"Evidence for the Necessity of Objective Hearing Tests in Cochlear Implantation Assessment: Excluding Functional Hearing Loss Cases.","authors":"Anita Gáborján, Márton Kondé, Marianna Küstel, Nóra Kecskeméti, László Tamás, Ildikó Baranyi, Gábor Polony, Judit F Szigeti","doi":"10.3390/jcm14103585","DOIUrl":"https://doi.org/10.3390/jcm14103585","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Cochlear implantation is a crucial intervention for individuals with severe hearing loss, aiming to restore auditory function and improve quality of life. The decision to recommend cochlear implantation critically depends on accurate audiological evaluations. However, challenges arise when subjective assessments of hearing loss do not align with objective audiological measurements, leading to potential misdiagnoses. Comparisons are to be made between subjective and objective results, with an investigation into the characteristics, warning signs, and risk factors of functional hearing loss (FHL). <b>Methods</b>: A retrospective study of hearing loss presentations at an otorhinolaryngological university clinic between 2020 and 2024 was performed, whereby we collected FHL cases. The evaluation process included measurements of subjectively perceived hearing loss through pure-tone audiometry, speech understanding, and communication testing. The objective assessments comprised impedance measurement, otoacoustic emission measurement, auditory brainstem responses, auditory steady-state responses, and medical imaging. <b>Results</b>: During the studied period, 11 patients, with an average age of 35.2 years (13 to 64 years), who were originally referred for cochlear implantation evaluation and subsequently diagnosed with FHL, were identified. The majority (10 patients) were female. No organic cause was identified in four cases, while seven cases exhibited some organic ear abnormalities insufficient to justify the reported hearing loss. The degree of FHL ranged from 30 dB to 90 dB, with an average of 60 dB. <b>Conclusions</b>: Diagnosing FHL is challenging and requires comprehensive assessment and interdisciplinary collaboration. Failure to recognize it may lead to inappropriate treatment, including unnecessary cochlear implantation. This study advocates for the mandatory integration of ABR and ASSR in the clinical evaluation of all cochlear implant candidates to ensure accurate diagnosis and optimal treatment.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159429","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":"The Effect of Eight Weeks of Passive Heat Therapy on Mental Health, Sleep, and Chronic Pain in Persons with Spinal Cord Injury: A Pilot Study.","authors":"Hannah Uhlig-Reche, Sven Hoekstra, Yubo Wu, Dean Lundt Kellogg, Terry Romo, Christof A Leicht, Michelle B Trbovich","doi":"10.3390/jcm14103566","DOIUrl":"https://doi.org/10.3390/jcm14103566","url":null,"abstract":"<p><p><b>Background</b>/<b>Objectives</b>: Rates of depression, anxiety, sleep disturbances, and chronic pain are higher in people with spinal cord injury (SCI) compared with able-bodied individuals. Passive heat therapy (PHT), which raises core body temperature, may be an accessible therapeutic intervention. The effects of PHT on mental health, sleep, and pain in persons with SCI are unknown. <b>Methods</b>: We performed a time-controlled pre-post intervention pilot study in which ten veterans with chronic SCI underwent an 8-week supervised PHT intervention to raise oral temperature by 1 °C each session. Outcome measures were the 5-item Mental Health Inventory, Epworth Sleepiness Scale, and International Spinal Cord Injury Pain Extended Data Sets version 1.0. <b>Results</b>: There were no adverse events related to the intervention and nine out of ten participants completed all their intervention sessions. There was a reduction in pain intensity (<i>p</i> = 0.039) upon completing the intervention (from a median (IQR) of 2.0 (0.0, 3.5) to 1.0 (0.0, 4.5) on a 0-10 scale). However, there were no improvements in self-reported mental health or sleep outcomes (<i>p</i> > 0.339). <b>Conclusions</b>: This pilot study suggests that supervised repeated passive heat therapy may confer benefits for chronic pain in veterans with chronic SCI. Follow-up studies with larger sample sizes and more extensive sets of chronic pain outcomes are needed to confirm these findings.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159515","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":"Real-Time Measurement of Intrarenal Pressure Using LithoVue™ Elite: Focus on Small Ureteral Access Sheaths and Appropriate Irrigation Settings.","authors":"Naoto Tanaka, Jose Carlo Elises, Fukashi Yamamichi, Yasuhiro Kaku, Yosuke Fukiishi, Masaichiro Fujita, Takaaki Inoue","doi":"10.3390/jcm14103573","DOIUrl":"https://doi.org/10.3390/jcm14103573","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Intrarenal pressure (IRP) plays a critical role in ensuring the safety of retrograde intrarenal surgery (RIRS), as elevated IRP is associated with complications such as pyelovenous backflow, infection, and renal injury. LithoVue™ Elite (LVE) is the first commercially available ureteroscope (URS) capable of providing real-time IRP measurements. Conventionally, IRP has been measured via a percutaneous nephrostomy catheter (PNC), which may not accurately reflect dynamic changes during endoscopic procedures. Recently, small ureteral access sheaths (UASs) have been increasingly used to minimize ureteral injury risk. This study aimed (1) to assess the accuracy of LVE compared with that of IRP measured by a PNC and (2) to evaluate appropriate irrigation settings suitable for small UASs using porcine kidney models and LVE. <b>Methods</b>: An 11/13-Fr UAS and a 10/12-Fr UAS were inserted into each model, and an automatic irrigation pump (AIP) and hand pumping (HP) with a 20-cc syringe were used. IRP was measured at various LVE tip positions (renal pelvis and upper, middle, and lower calyces) with different irrigation settings, repeated four times in each. Simultaneously, the IRP via the PNC located in the upper calyx and renal pelvis was measured. <b>Results</b>: LVE showed high concordance with the PNC across the upper, middle, and lower calyces (<i>p</i> > 0.05). However, at the renal pelvis, LVE measured IRP values that were significantly higher than the PNC by a mean of 1.93 ± 0.93 mmHg (<i>p</i> < 0.001). For the 11/13-Fr UAS, the IRP remained below 30 mmHg across all irrigation settings with an AIP and HP. In contrast, the 10/12-Fr UAS maintained 30 mmHg only with limited AIP settings, while HP resulted in high IRP, exceeding 100 mmHg at any location. Intergroup comparisons demonstrated that the IRP with the 10/12-Fr UAS was significantly higher than that with the 11/13-Fr UAS at any irrigation pressure setting across all URS tip positions (<i>p</i> < 0.05). Intragroup comparisons indicated a significant pressure difference between the upper, middle, and lower calyces and the renal pelvis in both models at all irrigation settings (<i>p</i> < 0.05). <b>Conclusions</b>: LVE provided accurate IRP measurements compared to the PNC. The IRP was significantly influenced by UAS size, irrigation setting, and URS tip position. When using small UASs, selecting appropriate irrigation settings is essential to maintain the safe threshold.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159186","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":"Exploring the Potential of Digital Twins in Cancer Treatment: A Narrative Review of Reviews.","authors":"Daniele Giansanti, Sandra Morelli","doi":"10.3390/jcm14103574","DOIUrl":"https://doi.org/10.3390/jcm14103574","url":null,"abstract":"<p><p><b>Background:</b> Digital twin (DT) technology, integrated with artificial intelligence (AI) and machine learning (ML), holds significant potential to transform oncology care. By creating dynamic virtual replicas of patients, DTs allow clinicians to simulate disease progression and treatment responses, offering a personalized approach to cancer treatment. <b>Aim:</b> This narrative review aimed to synthesize existing review studies on the application of digital twins in oncology, focusing on their potential benefits, challenges, and ethical considerations. <b>Methods:</b> The narrative review of reviews (NRR) followed a structured selection process using a standardized checklist. Searches were conducted in PubMed and Scopus with a predefined query on digital twins in oncology. Reviews were prioritized based on their synthesis of prior studies, with a focus on digital twins in oncology. Studies were evaluated using quality parameters (clear rationale, research design, methodology, results, conclusions, and conflict disclosure). Only studies with scores above a prefixed threshold and disclosed conflicts of interest were included in the final synthesis; seventeen studies were selected. <b>Results and Discussion:</b> DTs in oncology offer advantages such as enhanced decision-making, optimized treatment regimens, and improved clinical trial design. Moreover, economic forecasts suggest that the integration of digital twins into healthcare systems may significantly reduce treatment costs and drive growth in the precision medicine market. However, challenges include data integration issues, the complexity of biological modeling, and the need for robust computational resources. A comparison to cutting-edge research studies contributes to this direction and confirms also that ethical and legal considerations, particularly concerning AI, data privacy, and accountability, remain significant barriers. <b>Conclusions:</b> The integration of digital twins in oncology holds great promise, but requires careful attention to ethical, legal, and operational challenges. Multidisciplinary efforts, supported by evolving regulatory frameworks like those in the EU, are essential for ensuring responsible and effective implementation to improve patient outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158787","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":"Peri-Procedural Continuation Versus Interruption of Anticoagulation for Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis.","authors":"Jacinthe Khater, Marco Frazzetto, Filippo Luca Gurgoglione, Jasim Hasan, Davide Donelli, Guilherme Attizzani, Bernardo Cortese","doi":"10.3390/jcm14103563","DOIUrl":"https://doi.org/10.3390/jcm14103563","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Oral anticoagulation therapy (OAC) is crucial for reducing the risk of ischemic complications in patients with atrial fibrillation (AF). However, OAC also increases the risk of major bleeding events. The optimal management of OAC in patients with AF undergoing transaortic valve implantation (TAVI) is unclear. This study aimed to compare the efficacy and safety of OAC interruption vs. continuation in patients with AF scheduled for TAVI. <b>Methods</b>: PubMed, EMBASE, and Cochrane were searched to include all pertinent randomized and observational studies. The primary endpoint was the occurrence of net adverse clinical events (NACE), a composite of all-cause death, major vascular complications, and major bleeding at 30-day follow-up. Secondary endpoints included all-cause death, cardiovascular death, major vascular complications, major bleeding, any bleeding, stroke, non-fatal myocardial infarction, and the need for red-packed blood transfusion. <b>Results</b>: A total of three studies and 2773 patients were included in the analysis (1314 were allocated to continuation of OAC therapy and 1459 to interruption of OAC therapy during TAVI). The two study groups experienced a similar rate of NACE (OR = 0.89 [95% CI 0.61 to 1.31], I² = 77%, <i>p</i> = 0.56) compared to the OAC-interruption group. No significant differences were observed in the rate of all-cause death (<i>p</i> = 0.21), cardiovascular death (<i>p</i> = 0.35), major vascular complications (<i>p</i> = 0.84), major bleeding events (<i>p</i> = 0.47), total bleeding events (<i>p</i> = 0.62), or non-fatal MI (<i>p</i> = 0.55). Interestingly, the OAC-continuation group experienced a lower occurrence of stroke (OR = 0.62 [95% CI 0.39 to 0.97], I² = 0%, <i>p</i> = 0.04) and the need for red packed blood cells (OR = 0.66 [95% CI 0.50 to 0.86], I² = 20%, <i>p</i> < 0.01) compared to the OAC-interruption group. <b>Conclusions</b>: In patients with AF undergoing TAVI, there was no significant difference between interruption and continuation of OAC in terms of NACE, composite of all-cause death, major vascular complications, or major bleeding at 30-day follow-up. Of interest, the OAC-continuation group patients experienced lower rates of stroke and the need for blood transfusion.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159285","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":"Giant Popliteal Venous Aneurysm-A Rare Cause of Recurrent Pulmonary Embolism.","authors":"Victor Raicea, Oana Mirea, Sebastian Militaru, Mihaela Berceanu, Alexandru Munteanu, Ionuț Donoiu, Liviu Moraru","doi":"10.3390/jcm14103548","DOIUrl":"https://doi.org/10.3390/jcm14103548","url":null,"abstract":"<p><p><b>Background:</b> A popliteal vein aneurysm (PVA) is a rare vascular abnormality that can lead to the formation of venous thrombi, resulting in potentially life-threatening pulmonary embolism (PE). <b>Methods:</b> We present the case of a 30-year-old female who presented with recurrent pulmonary embolism complicated by cardiorespiratory arrest. Emergency thrombolysis was initiated, which successfully stabilized the patient. Further diagnostic evaluation, including imaging studies, revealed the presence of a giant popliteal vein aneurysm (60/70 mm) as the underlying cause of recurrent embolism. <b>Results:</b> The patient underwent surgical repair of the popliteal vein aneurysm to prevent further thromboembolic events. The procedure was performed successfully, and the patient recovered favorably. <b>Conclusions:</b> This case underscores the importance of recognizing PVA as a potential cause of recurrent PE, particularly in young patients without typical risk factors.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159250","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":"Prevalence of Osteosynthesis Hardware Removal Due to Surgical Site Infections Following Sagittal Split Osteotomy: A Systematic Review and Meta-Analysis.","authors":"Maria Kantzanou, Evangelos Kostares, Vasiliki Koumaki, Georgia Kostare, Michael Kostares, Athanasios Tsakris","doi":"10.3390/jcm14103558","DOIUrl":"https://doi.org/10.3390/jcm14103558","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Sagittal split ramus osteotomy (SSRO) is a commonly performed procedure in orthognathic surgery. Despite its effectiveness, surgical site infections (SSI) represent a significant postoperative complication, often necessitating the removal of osteosynthesis materials. This study aims to quantify the prevalence of hardware removal due to SSI following SSRO highlighting its impact on clinical outcomes. <b>Methods:</b> A systematic review and meta-analysis were conducted according to the PRISMA statement. Databases including Medline/PMC Central, Scopus, and Web of Science were searched up until 27 December 2024. Observational studies reporting osteosynthesis material removal due to SSI after SSRO were included. Data were extracted and analyzed using a random-effects model, calculating pooled prevalence and 95% confidence intervals (CI). Meta-regression was performed to explore potential predictors. <b>Results:</b> Twenty-nine studies published between 1992 and 2024 were included, encompassing 4489 patients. The pooled prevalence of osteosynthesis material removal due to SSI was 1.9% (95% CI: 0.7-3.4%), with substantial heterogeneity (I² = 87%). Meta-regression demonstrated that the mean age of patients was significantly associated with the prevalence of osteosynthesis hardware removal due to SSI. On the other hand, no significant association was demonstrated between the year of publication, the proportion of males, or the mean age with the prevalence of removal. <b>Conclusions:</b> SSI following SSRO clearly impacts patient outcomes and healthcare resources, while removal of osteosynthesis materials is often required. The substantial heterogeneity among studies included in the present systematic review may point to variability in patient characteristics, surgical techniques, and healthcare practices. The present findings underscore the importance of standardized prevention protocols and targeted management strategies. Future research should focus on understanding microbial profiles, patient-specific risk factors, and innovative surgical approaches to minimize SSI risks and improve patient outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159494","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":"The Experience of Frail Older Patients in the Boarding Area in the Emergency Department: A Qualitative Systematic Review.","authors":"Pasquale Iozzo, Giovanna Cannizzaro, Stefano Bambi, Luana Maria Amato, Simona Fanuli, Dhurata Ivziku, Giuliano Anastasi, Alberto Lucchini, Noemi Spina, Roberto Latina","doi":"10.3390/jcm14103556","DOIUrl":"https://doi.org/10.3390/jcm14103556","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Boarding refers to the period when patients deemed stable in the emergency department (ED) are temporarily monitored, wait to be admitted, and receive appropriate care. As life expectancy increases, so does the importance of understanding the dynamics and experiences of older adults with frailty in emergency settings. The absence of a care environment tailored to specific needs could diminish the overall quality of care provided, threatening the health and well-being of this population. To our knowledge, how frail older adults experience this has not yet been synthesized in a qualitative systematic review. The aim of this study was to explore the lived experiences of frail older adults during the emergency department (ED) boarding phase <b>Methods:</b> This systematic review was conducted using PubMed, OVID, and Scopus in October 2024. No time restrictions were settled and only articles published in English were included. Following the predefined inclusion criteria, two researchers independently extracted and synthesized the data using the Joanna Briggs Institute (JBI) meta-aggregation methodology and instruments. <b>Results:</b> Seven studies were included. Thirty-one findings were identified and grouped into seven categories and three themes regarding the lived experiences of frail people in ED boarding areas. The themes we identified were discomfort, distress, frustration, the experience of positive/negative attitudes of healthcare providers, and the supportive role of family members during ED LOS (length of stay). <b>Conclusions:</b> Older frail adults experience significant physical and psychological distress during ED boarding. It is necessary to manage their specific needs through targeted actions aimed at improving their overall experience and quality of care in emergency settings.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159584","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":"Predictive Factors for Adverse Cardiac Events and Mortality in Patients with Hypertrophic Cardiomyopathy.","authors":"Hazem Omran, Tanja K Rudolph, Lothar Faber, Volker Rudolph, Zisis Dimitriadis","doi":"10.3390/jcm14103546","DOIUrl":"https://doi.org/10.3390/jcm14103546","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Risk stratification for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) remains challenging, especially in high-risk cohorts. This study evaluated the predictive utility of the ESC HCM Risk Score and the additive value of myocardial fibrosis assessment via cardiac magnetic resonance (CMR) in HCM patients with implantable cardioverter-defibrillators (ICDs) for primary prevention. <b>Methods</b>: A retrospective analysis was conducted on 108 HCM patients (mean age 49.4 ± 14.2 years; 30.6% female; 63.9% with LVOT obstruction) with ICDs for primary SCD prevention. The primary endpoint was a composite of all-cause mortality or appropriate ICD therapy for ventricular arrhythmia over a mean follow-up of 69.5 ± 22.8 months. ESC HCM Risk Scores, the presence of fibrosis on CMR, and clinical outcomes were analyzed using univariate and multivariate models, ROC curves, and Kaplan-Meier survival estimates. <b>Results:</b> The primary endpoint occurred in 25 patients (23.1%; 3.1%/year). An ESC HCM Risk Score ≥ 4% was common (81.5%) but did not significantly predict the primary outcome (the c-statistic 0.54; <i>p</i> = 0.08) and demonstrated low positive (25%) and high negative predictive values (85%). Severe fibrosis on CMR was significantly associated with events in univariate analysis (<i>p</i> = 0.04), and its inclusion improved the model's predictive accuracy (the c-statistic increased to 0.65; <i>p</i> = 0.03). Kaplan-Meier analysis revealed worse event-free survival in patients with both elevated ESC scores and more than mild fibrosis (<i>p</i> = 0.028). <b>Conclusions</b>: In this high-risk HCM cohort with ICDs, the ESC risk score showed limited predictive performance, while myocardial fibrosis on CMR added significant prognostic value. Incorporating the fibrosis assessment into future risk models may enhance SCD prediction and refine ICD decision-making in HCM. Further multicenter studies are needed to validate these findings.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159449","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":"Psychosocial Impact of Maxilla-For-All^® Treatment Using Standard and Long Implants (Pterygoid, Trans-Sinus and Zygomatic) on Patients with Severe Maxillary Atrophies: A 1-Year Prospective Study with PIDAQ-23 and OHIP-14.","authors":"Tommaso Grandi, Paolo Toti, Cesare Paoleschi, Matteo Giorgi, Ugo Covani, Giovanni Battista Menchini-Fabris","doi":"10.3390/jcm14103544","DOIUrl":"https://doi.org/10.3390/jcm14103544","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The satisfaction of patients following maxillary full-arch rehabilitation is crucial in assessing treatment effectiveness. This one-year study evaluated patients' satisfaction, quality of life, and aesthetic perception after receiving the Maxilla-for-All^®/All-On-X treatments, which combine standard, pterygoid, trans-sinus, and zygomatic implants to support a fixed prosthesis and offer a graftless solution that reduces morbidity and treatment time. <b>Methods</b>: A prospective cohort study using convenience sampling of subjects treated for severe maxillary atrophies was conducted on patients receiving immediate implant-supported full-arch fixed prostheses. The Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ-23) were administered preoperatively and one year post-treatment. Patients were grouped based on the presence or absence of complications (surgical, technical, and mechanical) and Wilcoxon tests were used for comparison (significance level = 0.05). <b>Results</b>: A total of 56 patients (29 female, 27 male) participated, with no implant or prosthesis failures. Eleven patients reported unilateral sinus membrane perforation, and seven had technical or mechanical complications. Preoperatively, 69% of patients rated their oral condition as unfavorable according to the OHIP-14; this dropped significantly to 21.8% post-treatment (<i>p</i>-value < 0.0001). After one year, the average PIDAQ-23 score improved significantly from 44.7 ± 16.6 to 6.8 ± 5.3 (<i>p</i>-value < 0.0001). No significant differences were observed between patients with or without complications (<i>p</i>-values ranging from 0.5270 to 0.8920). <b>Conclusions</b>: Full-arch rehabilitation using Maxilla-for-All^®/All-On-X treatments significantly improved both aesthetic perception and chewing function in patients with severe maxillary atrophies. They reported a substantial reduction in oral health-related discomfort, as shown by a significant decrease in OHIP-14 scores one year post-treatment. Clinical or technical complications did not significantly impact patients' quality-of-life outcomes or satisfaction, supporting the reliability of this treatment protocol.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159521","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}