Clinics and Practice最新文献

{"title":"Enhancing Smile Aesthetics and Function with Lithium Disilicate Veneers: A Brief Review and Case Study.","authors":"Jose Villalobos-Tinoco, Franciele Floriani, Silvia Rojas-Rueda, Salwa Mekled, Clint Conner, Staley Colvert, Carlos A Jurado","doi":"10.3390/clinpract15030066","DOIUrl":"10.3390/clinpract15030066","url":null,"abstract":"<p><p><i>Background</i>: Lithium disilicate ceramic veneers are considered the gold standard in aesthetic dentistry due to their translucency, strength, and adhesive bonding properties. This clinical case report details the aesthetic rehabilitation of a patient through the use of pressed lithium disilicate veneers, highlighting the treatment workflow, material selection rationale, and the long-term functional and aesthetic outcomes achieved. <i>Methods</i>: A review was conducted to evaluate the long-term success of lithium disilicate. A case study is presented that involves a 32-year-old female patient with anterior tooth discoloration, minor morphological discrepancies, and a desire for smile enhancement. A conservative approach using pressed lithium disilicate was chosen to restore harmony and enhance natural aesthetics. The treatment involved minimally invasive tooth preparation, digital smile design, and adhesive cementation using a total-etch technique with light-cured resin cement. High-resolution intra-oral and extra-oral photographs documented the case, capturing the preoperative, preparation, and final restoration stages. These images highlight shade matching, margin adaptation, and smile transformation after veneering. <i>Results</i>: Postoperative evaluation showed excellent aesthetic outcomes, color integration, and marginal adaptation, with the patient expressing high satisfaction. The veneers exhibited optimal translucency and strength, ensuring long-term durability. A one-year follow-up revealed no debonding, marginal discoloration, or surface degradation, confirming the clinical reliability of lithium disilicate veneers. <i>Conclusions</i>: Lithium disilicate provides predictability, durability, and high aesthetic results, making it an ideal choice for minimally invasive smile enhancement. The use of photographic documentation emphasizes the importance of case planning, precise preparation, and adhesive bonding for successful outcomes. Future research should focus on long-term survival rates and complication prevention to further refine material selection and bonding protocols.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review on Biochemical Markers and Emerging Treatments in Prodromal Synucleinopathies.","authors":"Jamir Pitton Rissardo, Ana Leticia Fornari Caprara","doi":"10.3390/clinpract15030065","DOIUrl":"10.3390/clinpract15030065","url":null,"abstract":"<p><p>Alpha-synuclein has been associated with neurodegeneration, especially in Parkinson's disease (PD). This study aimed to review clinical, biochemical, and neuroimaging markers and management of prodromal synucleinopathies. The prodromal state of synucleinopathies can be better understood with PD pathophysiology, and it can be separated into premotor and pre-diagnostic phases. The incidence of PD in patients with prodromal phase symptoms ranges from 0.07 to 14.30, and the most frequently studied pathology is the REM behavioral disorder (RBD). Neuroimaging markers are related to dopamine denervation, brain perfusion changes, gross anatomy changes, and peripheral abnormalities. α-synuclein assays (SAA) in CSF revealed high sensitivity (up to 97%) and high specificity (up to 92%); in the last decade, there was the development of other matrices (blood, skin, and olfactory mucosa) for obtaining quantitative and qualitative α-synuclein. Other biomarkers are neurofilament light chain, DOPA decarboxylase, and multiplexed mass spectrometry assay. Regarding genetic counseling in α-synucleinopathies, it is an important topic in clinical practice to discuss with patients with high-risk individuals and should involve basic principles of autonomy, beneficence, and non-maleficence. Some of the themes that should be reviewed are the involvement of physical activity, diet (including alcohol, coffee, and vitamin supplementation), smoking, sleep, and stress in the pathophysiology of synucleinopathies. The number of trials related to prodromal symptoms is still scarce, and the number of studies evaluating intervention is even lower.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effects of Photobiomodulation on Bone Density After Placing Dental Implants: A Pilot Study Using Cone Beam CT Analysis.","authors":"Ruxandra-Elena Luca, Alessandro Del Vecchio, Ioana-Roxana Munteanu, Mădălin-Marius Margan, Carmen Darinca Todea","doi":"10.3390/clinpract15030064","DOIUrl":"10.3390/clinpract15030064","url":null,"abstract":"<p><p><b>Background:</b> One of the parameters of maximum interest regarding the quality of the intraoral hard tissues is represented by the bone density, with direct clinical implications. The evaluation of this extremely important clinical parameter can be achieved by several imaging methods, of which the most known in dentistry is represented by the cone beam computed tomography (CBCT). <b>Objectives</b>: The purpose of the study is to obtain a quantitative analysis of bone mineral density changes in patients who underwent treatments of photobiomodulation (PBM), as complementary to a surgical approach in oral surgery and implantology. <b>Methods:</b> The study included the retrospective analysis of maxillary cone beam computed tomography of 28 patients without pathology or medication known to affect bone metabolism or its qualitative and quantitative properties. All patients from the study group followed the same laser PBM treatment protocol after placing dental implants; the PBM protocol implied the intraoral use of a gallium aluminum arsenide laser (GaAlAs) of 808 nm, 450 mW, in pulsed mode, administering an energy of 6 J in 3 points corresponding to each inserted dental implant-mesial, distal, and apical-totaling 18 J/implant. Treatment sessions were performed immediately postoperatively and at a subsequent distance of 48 h for 2 weeks (a total of eight sessions). For every patient, bone density was analyzed before and after PBM treatment, in the same areas of interest, within the same anatomical landmarks. A comparison was also made between the results obtained for the anterior maxilla and the posterior maxilla. All the measurements made were analyzed statistically, the results being presented in the dedicated section. <b>Results:</b> Based on the data analysis, the comparison between the lasered and non-lasered groups reveals that patients who underwent PBM showed a statistically significant improvement in bone mineral density, with the mean increasing from 530.91 HU before treatment to 842.55 HU after treatment (<i>t</i>-test: <i>p</i> < 0.001). In contrast, the non-lasered group showed no significant improvement, with a slight decrease in bone mineral density, as the mean dropped from 495.19 HU before treatment to 462.16 HU after treatment (<i>t</i>-test: <i>p</i> = 0.47). <b>Conclusions:</b> The study demonstrated results with statistical significance regarding the mineral bone density improvement of patients who underwent laser PBM treatment. This positive effect of laser therapy has been shown, both at the level of the vestibular cortical bone and at level of the trabecular bone, independent of the patient's sex, for the anterior maxilla and at the lateral areas also.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors for Poor Outcomes at Six Months on Pain, Disability, Psychological and Health Status in Greek Patients with Chronic Low Back Pain After Receiving Physiotherapy: A Prospective Cohort Study.","authors":"Matthaios Petrelis, Georgios Krekoukias, Ioannis Michopoulos, Vasileios Nikolaou, Konstantinos Soultanis","doi":"10.3390/clinpract15030063","DOIUrl":"10.3390/clinpract15030063","url":null,"abstract":"<p><p><b>Background:</b> Although previous studies have suggested a variety of sociodemographic and psychological factors as predictors of poor outcomes in patients with chronic low back pain (CLBP), longitudinal studies remain rare. <b>Objectives</b>: To examine the prognostic indicators for poor outcome at 6 months on pain, disability, quality of life, anxiety, depression and somatic symptom disorders (SSDs) in Greek backache patients and to evaluate the medium-term effects of a conservative physiotherapeutic approach (massage, ultrasound, transcutaneous electrical nerve stimulation, low-level laser and exercise program). <b>Methods</b>: A prospective cohort study of 145 volunteers receiving treatment for CLBP in a physiotherapy unit was conducted using random systematic sampling. The intervention was assessed by comparing pre-treatment, post-treatment and six-month measurements with Friedman's test and the Bonferroni correction, using the pain numerical rating scale (PNRS), Roland-Morris disability questionnaire (RMDQ), EuroQol-5-dimension-5-level (EQ-5D-5L), Hospital Anxiety and Depression Scale (HADS) and Somatic Symptom Scale-8 (SSS-8). Multiple linear regression analysis was carried out to determine the impact of demographics and pre-treatment scores with scores at six months. <b>Results:</b> The mean age was 60.6 years (±14.7). Post-treatment, statistically significant improvements were observed across all outcome measures, including PNRS, RMDQ, EQ-5D-5L and SSS-8 (all <i>p</i> ≤ 0.001), with anxiety showing a notable reduction (<i>p</i> = 0.002). After examining the multiple regression analysis, pre-treatment SSS-8 emerged as a predictor of elevated levels of pain, disability, anxiety and depression at 6 months. <b>Conclusions</b>: The findings yielded not only somatic symptom burden, greater age and pain intensity as prognostic indicators for poor outcomes at six months, but also reported favorable medium-term effects for a conventional physiotherapy regimen in CLBP management, as well.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency and Applicability of Virtual Surgical Planning in Maxillofacial and Mandibular Bone Reconstruction: A Narrative Review.","authors":"Mohammed Mahmoud Shalabi, Khaldoun M A Darwich, Mohammad Naem Kheshfeh, Mohammad Younis Hajeer","doi":"10.3390/clinpract15030062","DOIUrl":"10.3390/clinpract15030062","url":null,"abstract":"<p><p><b>Background:</b> Facial structures are critical to aesthetics and function. Deformities can cause significant problems. Advances in surgical techniques, including three-dimensional (3D) computer simulation and virtual surgical planning (VSP), have improved outcomes. VSP accurately predicts surgical outcomes, revolutionizing facial reconstruction. This article reviews VSP in facial bone reconstruction, highlighting its advantages and accuracy over traditional methods. <b>Methods:</b> A systematic search using Medline (PubMed), Web of Science, Scopus, and Google Scholar revealed 1645 articles that addressed the topic of this study. <b>Results:</b> The systematic search yielded 64 articles that were highly relevant to the study objective, underscoring the critical importance of virtual surgical planning (VSP) in enhancing surgical precision and patient satisfaction. VSP has become a key player in improving surgical interventions and reducing complications, reinforcing its role as the preferred method in modern reconstructive surgery and thus improving functional and aesthetic outcomes, significantly enhancing patient satisfaction, and ensuring accurate interpretation of treatment plans. When compared to traditional surgical planning (TSP), VSP offers increased accuracy, shorter operating times, and superior aesthetic outcomes. <b>Conclusions:</b> VSP has been shown to effectively manage the complex challenges of facial anatomy and has significantly enhanced the planning and execution of reconstructive surgeries. This has been achieved by leveraging advanced imaging and computer-aided design.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregivers' Knowledge and Experiences in Recognizing and Managing Dysphagia in Patients with Myopathy.","authors":"Maria Demetriou, Demetra Tziirkalli, Anastasios M Georgiou","doi":"10.3390/clinpract15030061","DOIUrl":"10.3390/clinpract15030061","url":null,"abstract":"<p><p><b>Background:</b> Dysphagia is a common complication in myopathy, significantly impacting patients' quality of life (QoL) and overall health. Caregivers play a critical role in identifying and addressing swallowing difficulties in this population. The main purpose of this study was to assess the knowledge and experiences of professional caregivers of patients with myopathy regarding the recognition and management of dysphagia in Cyprus. <b>Methods:</b> The study was designed as an anonymous, cross-sectional descriptive survey and involved 10 professional caregivers of patients with myopathy in Cyprus. <b>Results:</b> The most common dysphagia symptoms reported in myopathy patients were coughing, chewing difficulties, choking on fluids, and challenges with swallowing boluses. Only one caregiver reported difficulty managing swallowing issues, particularly in cases of reluctance to eat. Approximately 60% had received relevant training, primarily through workplace programs. Overall, caregivers did not perceive dysphagia as a significant burden. <b>Conclusions:</b> Dysphagia is a prevalent phenomenon in myopathy. The study reveals that caregivers of myopathy patients, regardless of their professional backgrounds, face hidden challenges in managing complex neurogenic dysphagia. They often misjudge the severity of the condition and overestimate their own competencies. Providing caregivers of patients with myopathy with targeted education would help them effectively manage swallowing difficulties associated with the condition. Encouragingly, our study also suggests that focused dysphagia education could reduce caregiver stress and enhance their overall well-being. Future efforts should concentrate on ensuring access to well-trained professionals, establishing specialized clinics, and promoting education to enhance MND-related dysphagia management and patient care.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triggers, Types, and Treatments for Kounis Syndrome: A Systematic Review.","authors":"Erick Rochel-Perez, Miguel Santaularia-Tomas, Mario Martin-Dorantes, Edgar Villareal-Jimenez, Amonario Olivera-Mar, Ely Sanchez-Felix, Adrian Perez-Navarrete, Jose Luis Millet-Herrera, Osvaldo Huchim-Mendez, Ricardo Alejos-Briceño, Nina Mendez-Dominguez","doi":"10.3390/clinpract15030059","DOIUrl":"10.3390/clinpract15030059","url":null,"abstract":"<p><p><b>Background</b>: Kounis syndrome (KS), also known as allergic myocardial infarction, presents in three variants. This condition is often underrecognized due to limited knowledge and its variable presentation. To address these limitations, the present review aims to describe the triggers, types, management, and patient outcomes of KS. <b>Methods:</b> In this systematic review, PubMed and Scopus were used to identify publications of clinical case reports; variables included sociodemographic characteristics, clinical manifestations, triggers, treatments, and outcomes. Data from the articles´ abstracts were assessed by two corresponding authors, and subsequently, each case was analyzed by two coauthors, validated and analyzed with Stata 12. To categorize each Kounis type, mean and proportion comparison tests were performed, and measures of association were obtained using logistic regression and expressed as odds ratios. <b>Results:</b> A global distribution was identified, with predominance in the Northern Hemisphere. Type I KS was the most reported variant, and most of the patients were adult men. Most of the patients presented variability in the treatment and outcomes. <b>Conclusions:</b> KS may represent a diagnostic challenge, and underdiagnosis could explain the lack of uniformity in the diagnostic and assessment process. Our results highlight a need for improved approaches based on patient history for correct diagnosis and preventing recurring events.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Appendicitis or Appendiceal Diverticulitis? A Case Report and Systematic Literature Review.","authors":"Stipe Vidović, Nenad Čekić, Ivica Šuvak, Mladen Ugljarević, Zenon Pogorelić","doi":"10.3390/clinpract15030060","DOIUrl":"10.3390/clinpract15030060","url":null,"abstract":"<p><p><b>Background</b>: Appendiceal diverticulitis is a rare and poorly understood condition of the appendix. The diagnosis of appendiceal diverticulitis is challenging due to its rarity and a clinical presentation that often mimics other ileocecal disorders. Unlike acute appendicitis, appendiceal diverticulitis may be associated with a higher risk of perforation, increased mortality, and a potential link to neoplasms. However, further research is necessary to enhance our understanding of its epidemiology, risk factors, clinical presentation, and outcomes. <b>Case Report</b>: A 53-year-old male presented to the emergency department with right lower abdominal pain. On physical examination, tenderness was noted in the right lower quadrant, without rebound tenderness or muscle guarding. Laboratory tests revealed leukocytosis and elevated C-reactive protein (CRP) levels. Ultrasonographic imaging of the ileocecal region suggested acute appendicitis, leading to a decision for surgical intervention. Laparoscopic exploration revealed multiple cylindrical, red, and edematous herniations, up to 4 mm in size, on the surface of the vermiform appendix. An appendectomy was performed. Histopathological examination confirmed appendiceal diverticulitis with surrounding peridiverticulitis. The surgery and early postoperative course were uneventful. <b>Literature review</b>: The study included 5 retrospective studies and 30 case reports, analyzing a total of 112 patients with appendiceal diverticulitis. Of these, 65.5% were male and 34.5% were female, with a median age of 49 years (IQR: 39-59). The most commonly reported clinical findings included pain in the right iliac fossa or right lower abdominal quadrant (56.5%), nausea (18.9%), vomiting (9.8%), rebound tenderness (24.6%), fever (15.6%), leukocytosis (25.4%), and elevated C-reactive protein levels (16.4%). Diagnosis was confirmed histopathologically in 86.9% of the cases via computed tomography imaging in 4.1% and ultrasonography in 1.6%. A histopathological analysis identified five neoplasms (4.1%), including two sessile serrated adenomas, two neuroendocrine carcinoids, and one mucinous tumor. Appendectomy was the treatment of choice, with no intraoperative or postoperative complications recorded and no mortality reported. The median hospital stay was 6.8 days (IQR: 3.0-6.8). <b>Conclusions</b>: Appendiceal diverticulitis should be considered as a differential diagnosis in patients presenting with symptoms resembling acute appendicitis. Early diagnosis and treatment are essential to reduce morbidity and mortality. Appendectomy is a safe and effective treatment approach for appendiceal diverticulitis.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyoderma Gangrenosum in a Patient with Crohn's Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature.","authors":"Fotios S Fousekis, Konstantinos Mpakogiannis, Emmanouil Karampinis, Ioanna Nefeli Mastorogianni, Dimitrios K Christodoulou, Marina Papoutsaki, Evanthia Zampeli, Konstantinos H Katsanos","doi":"10.3390/clinpract15030057","DOIUrl":"10.3390/clinpract15030057","url":null,"abstract":"<p><p><b>Background:</b> Pyoderma gangrenosum (PG) is a rare inflammatory cutaneous disorder that frequently occurs in association with systemic diseases such as inflammatory bowel disease (IBD). This case report describes a 23-year-old female with Crohn's disease (CD) who developed PG and was successfully treated with adalimumab. The objective of this study is to present the clinical course, treatment approach, and outcomes while reviewing the existing literature on the efficacy of adalimumab in PG management. <b>Methods:</b> A case report is presented, detailing clinical presentation, diagnostic evaluation, and treatment strategy. Additionally, a systematic review was conducted using PubMed to assess studies on adalimumab in PG, focusing on treatment response, remission rates, and adverse effects. <b>Results:</b> The patient presented with ulcerative lesions on her lower extremities and sacroiliitis. After corticosteroid therapy, adalimumab was initiated, leading to significant ulcer healing, reduced back pain, and CD remission. The systematic review identified seven studies on adalimumab in PG. Findings suggest that adalimumab is effective in steroid-refractory cases, with remission achieved in a significant proportion of patients. The most common adverse effects were infections, but overall, adalimumab showed a favorable safety profile. <b>Conclusions:</b> This case highlights the importance of early diagnosis and multidisciplinary management of PG in CD patients. Adalimumab appears to be a promising therapeutic option, particularly for steroid-resistant PG, though further research is needed to establish standardized treatment protocols.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular Changes in Full-Thickness Macular Hole Patients Before and After Vitrectomy: An Optical Coherence Tomography-Angiography Study.","authors":"Aleksandra Górska, Sebastian Sirek, Dawid Woszczek, Rafał Leszczyński","doi":"10.3390/clinpract15030058","DOIUrl":"10.3390/clinpract15030058","url":null,"abstract":"<p><p><b>Background:</b> This study evaluates changes in the foveal avascular zone (FAZ) area and vessel density in patients with full-thickness macular hole (FTMH) before and after vitrectomy using optical coherence tomography-angiography (OCT-A). <b>Methods:</b> A prospective analysis was conducted on 39 patients diagnosed with FTMH who underwent pars plana vitrectomy. OCT-A imaging was performed preoperatively and at 1 and 3 months postoperatively. Parameters analyzed included FAZ area, superficial (SCP) and deep retinal vessel density (DCP), and central retinal thickness (CRT). <b>Results:</b> Preoperative OCT-A images showed a significant difference in the mean FAZ area between affected and healthy eyes (p < 0.01). However, a significant reduction in superficial capillary plexus (SCP) vessel density was noted after vitrectomy. Visual acuity improved significantly after surgery (p < 0.001), but no significant changes in FAZ or total vessel density were observed postoperatively. Postoperative distance visual acuity (DBCVA) correlated with preoperative macular hole size (p < 0.01). <b>Conclusions:</b> Vitrectomy for FTMH does not significantly alter the FAZ area or DCP vessel density, but does reduce SCP vessel density. OCT-A is a valuable tool for assessing retinal microvascular changes post-vitrectomy.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}