Clinics and Practice最新文献

{"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}

{"title":"Exploring the Role of Guilt in Eating Disorders: A Pilot Study.","authors":"Fabiola Raffone, Danilo Atripaldi, Eugenia Barone, Luigi Marone, Marco Carfagno, Francesco Mancini, Angelo Maria Saliani, Vassilis Martiadis","doi":"10.3390/clinpract15030056","DOIUrl":"10.3390/clinpract15030056","url":null,"abstract":"<p><strong>Background/objectives: </strong>Eating disorders (EDs) are complex psychopathological conditions involving dysfunctional eating behaviors, excessive body image concerns, and impaired emotional regulation. Among moral emotions, guilt plays a significant role in ED dynamics, influencing both symptomatology and interpersonal relationships. This study examines specific guilt subtypes (normative and altruistic guilt) using a specific psychometric tool.</p><p><strong>Methods: </strong>Forty-three adults with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) were recruited from the Eating Disorder Center of the University of Campania \"Luigi Vanvitelli\" or referred by psychotherapists. Diagnoses followed DSM-5 criteria. Participants completed the Moral Orientation Guilt Scale (MOGS), assessing guilt subtypes, and the Eating Disorder Inventory-2 (EDI-2), measuring ED symptomatology. Spearman's rank correlation and stepwise multiple regression analyses were used to identify relationships between guilt dimensions and ED-related symptoms.</p><p><strong>Results: </strong>MOGS subscales were positively correlated with ED symptomatology. Normative guilt was significantly associated with binging and purging (ρ = 0.26, <i>p</i> < 0.05), while altruistic guilt predicted higher interpersonal distrust (t = 3.4, <i>p</i> < 0.01). Regression analysis revealed that age negatively influenced interpersonal distrust (t = -2.9, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>In the population examined, guilt significantly influences ED symptomatology and interpersonal functioning, with specific dimensions linked to distinct behaviors and traits. Therapeutic interventions targeting guilt may enhance treatment outcomes by addressing ED emotional underpinnings. However, the results should be interpreted with caution due to the small sample size and lack of longitudinal data to establish causality. Further research with larger samples and longitudinal designs is necessary to validate these findings.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711609","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":"Two Long-Acting Antipsychotics in a Patient with Treatment-Resistant Schizophrenia: A Case Report.","authors":"Salvatore Cipolla, Flora Delli Carpini, Pierluigi Catapano, Valeria De Santis, Antonio Volpicelli, Francesco Perris, Francesco Catapano","doi":"10.3390/clinpract15030055","DOIUrl":"10.3390/clinpract15030055","url":null,"abstract":"<p><p>Treatment-resistant schizophrenia (TRS) poses significant therapeutic challenges due to persistent symptoms, poor adherence, and high relapse rates. Long-acting injectable (LAI) antipsychotics offer a promising approach, yet limited evidence exists regarding the combination of two LAI formulations. We report the case of a 62-year-old woman with TRS, characterized by recurrent hospitalizations and inadequate responses to oral and monotherapy treatments. During her latest hospitalization, she received alternating intramuscular administrations of haloperidol decanoate (100 mg/28 days) and aripiprazole (400 mg/28 days). The dual LAI strategy resulted in a marked improvement in psychotic symptoms, functional recovery, and treatment adherence, with no reported side effects. This case highlights the potential benefits of dual LAI therapy in managing TRS, particularly in patients with non-adherence to oral medications or limited response to standard treatments. Additional studies are required to evaluate the long-term effectiveness and safety of this innovative therapeutic approach.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710676","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":"High Polyphenol Extra Virgin Olive Oil and Metabolically Unhealthy Obesity: A Scoping Review of Preclinical Data and Clinical Trials.","authors":"Konstantina Liva, Athanasios A Panagiotopoulos, Alexandra Foscolou, Charalampia Amerikanou, Alkistis Vitali, Stavros Zioulis, Konstantina Argyri, Georgios I Panoutsopoulos, Andriana C Kaliora, Aristea Gioxari","doi":"10.3390/clinpract15030054","DOIUrl":"10.3390/clinpract15030054","url":null,"abstract":"<p><p><b>Background/Objectives</b>: During the last decade, there has been an increased interest in phenolic compound-rich natural products as natural therapies for regulating the molecular pathways behind central obesity and associated metabolic disorders. The present scoping review presents the outcomes of clinical and preclinical studies examining the anti-obesity effects of high phenolic extra virgin olive oil (HP-EVOO) and its possible underlying molecular mechanisms. <b>Methods:</b> Studies published between 2014 and 2024 were searched via MEDLINE, Scopus, Cochrane, the Web of Science, Semantic Scholar, Google Scholar, Science.gov, and Clinicaltrials.gov databases. A combination of keywords and Boolean logic was used to search throughout the last decade in all databases, including \"hyperglycemia\" or \"hypertension\" or \"metabolic syndrome\" or \"dyslipidemia\" or \"hyperlipidemia\" or \"hypoglycemia\" or \"obesity\" or \"macrovascular diabetic complications\" or \"microvascular diabetic complications\" or \"cardiovascular disease\" or \"overweight\" or \"insulin sensitivity\" or \"insulin resistance\" and \"extra virgin olive oil\" or \"high phenolic olive oil\" and \"human\" or \"animal model\". <b>Results</b>: The 10-year literature survey identified 21 studies in both animal models and humans, indicating that HP-EVOO improves inflammation, glycemic control, oxidative stress and endothelial function, potentially protecting against metabolic syndrome, hypertension and type 2 diabetes, even compared to EVOO. Moreover, HP-EVOO's antiplatelet effect and improvement in HDL functionality reduce cardiovascular risk. <b>Conclusions</b>: The evidence presented in this study demonstrates that HP-EVOO represents an effective preventive and therapeutic dietary approach to cardiometabolic diseases.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711612","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":"The Effect of Nordic Walking Intervention (NORDIN-JOY) on Individuals with Intellectual Disabilities and Their Families: A Multicenter Randomized Crossover Study.","authors":"Daniel González-Devesa, Carlos Ayán-Pérez, Eva González-Devesa, Jose Carlos Diz-Gómez","doi":"10.3390/clinpract15030053","DOIUrl":"10.3390/clinpract15030053","url":null,"abstract":"<p><strong>Background: </strong>We aim to evaluate the effect of the Nordic Walking program on the quality of life and functionality of individuals with intellectual disabilities; Methods: The NORDIN-JOY study is designed as a multicenter, randomized crossover trial. Participants in the experimental group will engage in a Nordic Walking intervention, while those in the control group will participate in a Fit 5-Fitness Cards intervention. Both physical training programs will consist of two 60 min sessions per week over a three-month period. The study will assess measures of quality of life and physical fitness. Additionally, the feasibility and cost-effectiveness of both programs, as well as the average weekly physical activity levels during the six months following the intervention, will be evaluated; Results: The results of this study are anticipated to provide valuable insights into the effects of structured exercise interventions on individuals with intellectual disabilities. These findings will be disseminated through peer-reviewed journals and academic conferences; Conclusions: This protocol seeks to establish evidence on the impact of exercise programs in individuals with intellectual disabilities. The findings have the potential to inform specific recommendations for healthcare professionals, caregivers, and policymakers, promoting physical activity as a cost-effective strategy for improving care and quality of life in this population.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710214","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":"Insurance Payor Status and Outcomes in Pediatric Sports-Related Injuries: A Rapid Review.","authors":"Katherine M Kutzer, Lulla V Kiwinda, Daniel Yang, John Kyle Mitchell, Emily J Luo, Emily J Harman, Stephanie Hendren, Kendall E Bradley, Brian C Lau","doi":"10.3390/clinpract15030052","DOIUrl":"10.3390/clinpract15030052","url":null,"abstract":"<p><p><b>Introduction</b>: The rise in youth sports participation has led to an increase in pediatric sports-related injuries in the United States, contributing to growing healthcare costs and exacerbating socioeconomic disparities. Insurance payor status is a critical factor influencing access to care, treatment delays, and health outcomes. This study examines the association between insurance payor status and outcomes in pediatric sports-related injuries. <b>Methods</b>: A systematic review of the Medline database was conducted. Included studies reported insurance payor status and pediatric sports orthopedic patient outcomes following surgery. Outcomes included time to be seen by a provider, treatment access, complication and revision rates, postoperative Emergency Department (ED)/Urgent Care utilization, readmission rates, hospital length of stay, pain, functional scores, discharge destinations, return to activity, and follow-up. <b>Results</b>: A total of 35 studies comprising 535,891 pediatric patients were included. Publicly insured or uninsured patients consistently experienced significant delays in accessing care, with average wait times for clinic visits, imaging, and surgery up to six times longer compared to privately insured patients. These delays were associated with worsened injury severity, higher rates of postoperative complications, and poorer functional outcomes. Publicly insured patients were less likely to receive advanced treatments such as bracing or physical therapy, further compounding disparities. Minority groups faced delays even when controlling for insurance status. <b>Conclusions</b>: Public and uninsured pediatric patients face systemic barriers to timely and equitable care, resulting in worse outcomes following sports-related injuries. Future research should explore targeted solutions to ensure equitable care for this vulnerable population.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711613","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}