Clinics and Practice最新文献

{"title":"Prevalence of and Factors Associated with Overactive Bladder, Anxiety, and Depression Among Patients with Multiple Sclerosis: A Cross-Sectional Study in Saudi Arabia.","authors":"Mohammed Alqwaifly, Samer A Almuqairsha, Emad Alwashmi, Yousef M Alharbi, Adi A Aldubaiyan, Raghad H Aldligan, Abdulmajeed A Alkhamees, Ayham Abazid, Rehana Khalil, Osama Al-Wutayd","doi":"10.3390/clinpract16060114","DOIUrl":"10.3390/clinpract16060114","url":null,"abstract":"<p><strong>Background: </strong>Over the years, it has become increasingly clear that neurological conditions, such as multiple sclerosis (MS), commonly exhibit other health problems. Therefore, this is the first study aimed at investigating the prevalence of and factors associated with three binary outcomes: depression, anxiety, and an overactive bladder (OAB) among MS patients in the Qassim region, Saudi Arabia.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in the neurological department of King Fahad Specialist Hospital in the Qassim region, Saudi Arabia, from January to December 2024. Data on age, sex, marital status, occupation, body mass index (BMI), MS duration, comorbidities, anxiety, depression, and OAB symptoms (frequency, nocturia, urgency, and urge incontinence) were obtained.</p><p><strong>Results: </strong>Of the 262 MS patients in this study, 184 (70.2%) were females, and 78 (29.8%) were males. The median values [IQR] of age and MS duration were 34 [26-40] and 5 [2-9] years, respectively. The prevalence of depression, anxiety, and OAB were 53.4%, 43.9%, and 50%, respectively. Nocturia was the most frequent urinary symptom, and urge incontinence was significantly higher among females. Multiple logistic regression analyses were conducted to assess factors associated with three binary outcomes: depression, anxiety, and OAB. For depression, being single and anxiety were associated with increased risk. Regarding anxiety, being a student was related to decreased risk, while being female and having depression were associated with increased risk. For OAB, only anxiety was associated with increased risk.</p><p><strong>Conclusions: </strong>Approximately one in two MS patients experience either depression or OAB, while anxiety was reported by fewer than half of the patients. This high prevalence of the three outcomes has critical implications for healthcare policy and resource allocation. Thus, screening, early diagnosis, and intervention, as well as integrated care, should be prioritized by healthcare institutions and practitioners to address these conditions and improve MS patients' quality of life.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319918","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":"Beyond Coiling: A Comparative Analysis of Survey-Reported Preferences for Endovascular Cerebral Aneurysm Occlusion.","authors":"Sanjana R Salwi, Thilan Tudor, Oleg Shekhtman, Georgios S Sioutas, Pious D Patel, Irina-Mihaela Matache, Mohamed M Salem, Sonia Ajmera, Sandeep Kandregula, Jan-Karl Burkhardt, Visish M Srinivasan","doi":"10.3390/clinpract16060112","DOIUrl":"10.3390/clinpract16060112","url":null,"abstract":"<p><strong>Background: </strong>Aneurysm treatment options are rapidly evolving, as evidenced by the recent introduction and widespread adoption of flow diversion and intrasaccular devices. However, there is a need to understand how these newer technologies are used for difficult-to-treat aneurysms. The main aims of this study were to investigate the variation in aneurysm treatment recommendations among neurosurgeons, interventional radiologists, and interventional neurologists and to generally describe trends in endovascular treatment.</p><p><strong>Methods: </strong>In this survey-based study conducted from June to September 2024, participants were presented with clinical vignettes and asked to choose preferred treatment options, with responses analyzed based on demographic variables including specialty, age, and training prior to and after the introduction of flow diversion.</p><p><strong>Results: </strong>A total of 108 respondents completed the study with a representative mix of specialties-(45 (42.5%) radiologists, 22 (20.8%) neurologists, and 39 (36.8%) neurosurgeons. Sixty-six (61.1%) trained after the introduction of flow diversion. Treatment recommendations were significantly different by specialty (<i>p</i> < 0.001). The Kappa statistic to assess variation in responses showed significant variation in treatment preferences across aneurysm subtypes, ranging from poor (κ = 0.07) to fair (0.31). Treatment of ruptured aneurysms varied by specialty with radiologists opting for stent-assisted coiling at a higher rate than neurologists or neurosurgeons (<i>p</i> < 0.001). There was no significant difference in rates of recommending flow diversion or intrasaccular devices between those who had trained before and after their introduction (<i>p</i> = 0.97).</p><p><strong>Conclusion: </strong>The study highlights the dynamic nature of aneurysm management and considerable variability among different specialties. Further exploration into the rationale for each decision is needed to understand how specialty training affects these decisions.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319907","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":"Ultrasound-Guided Intra-Articular Infiltration of Hyaluronic Acid, Lidocaine, and Methylprednisolone in Patients with Temporomandibular Disorders (TMD): A Preliminary Pilot Case Series.","authors":"Giuseppe Messina, Francesco Mantia, Pietro Cataldo, Angelo Iovane","doi":"10.3390/clinpract16060111","DOIUrl":"10.3390/clinpract16060111","url":null,"abstract":"<p><strong>Background/objectives: </strong>This preliminary pilot case series aims to evaluate the feasibility and temporal evolution of pain and function following an ultrasound-guided infiltration technique with hyaluronic acid and methylprednisolone in a specific patient population with Temporomandibular Disorders (TMD) characterized by MRI-confirmed retrodiscal tissue hyperemia. Given the absence of a control group, this study represents a preliminary exploration of a clinical approach utilizing individualized interocclusal devices during infiltration.</p><p><strong>Methods: </strong>Twenty-eight patients (16 females, 12 males) with TMD and MRI evidence of retrodiscal tissue hyperemia were enrolled in this prospective, uncontrolled study. A unique protocol was employed, utilizing individualized interocclusal devices to optimize joint space access during bilateral ultrasound-guided infiltration of a mixture containing low-molecular-weight hyaluronic acid, lidocaine, and methylprednisolone acetate. Pain intensity (VAS 0-100 mm) and associated symptoms (tinnitus, vertigo, headache, joint clicking) were assessed at baseline and at 30, 60, and 90 days' follow-up.</p><p><strong>Results: </strong>A statistically significant temporal reduction in pain was observed at all follow-up points (<i>p</i> < 0.001), with the mean VAS score decreasing from 70.5 ± 11.4 mm at baseline to 43.0 ± 11.1 mm at 90 days. Joint clicking disappeared in 80% of patients immediately after treatment.</p><p><strong>Conclusions: </strong>The ultrasound-guided infiltration technique, combined with personalized interocclusal support, demonstrated preliminary feasibility and short-term temporal improvement in pain and joint clicking in this specific patient cohort. Due to the lack of a control group and the multimodal nature of the intervention, these findings should be considered preliminary and do not allow for causal inferences regarding the efficacy of individual components.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319875","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":"Intranasal Esketamine Versus Other Pharmacological Strategies in Treatment-Resistant Depression with High Suicide Risk: A Six-Month Naturalistic Study.","authors":"Ana María de Granda-Beltrán, Alejandro Porras-Segovia, Daniel Núñez-Arias, Alba Rodríguez-Jover, Maria Paula Jassir Acosta, Philippe Courtet, Enrique Baca-García, Inmaculada Peñuelas-Calvo","doi":"10.3390/clinpract16060110","DOIUrl":"10.3390/clinpract16060110","url":null,"abstract":"<p><p><b>Background:</b> Treatment-resistant depression (TRD) poses a major clinical challenge, particularly when accompanied by suicidal behavior. Intranasal esketamine has demonstrated rapid antidepressant effects in TRD, but real-world comparative evidence remains limited. <b>Methods:</b> We conducted a six-month naturalistic prospective cohort study in two Spanish mental health centers, including 62 TRD patients with high suicide risk undergoing fourth-line treatment. Thirty patients received intranasal esketamine and thirty-two alternative pharmacological interventions. Suicidal ideation (C-SSRS), depressive symptoms (HAM-D-17) and functional status (FAST) were assessed at baseline and at 1-, 3- and 6-month follow-ups. <b>Results:</b> Both groups showed significant improvement during follow-up; however, esketamine-treated patients exhibited a faster and greater reduction in suicidal ideation and depressive symptoms than those receiving alternative pharmacological strategies. The number needed to treat to prevent one case of high suicide risk was 1.35. Functional improvement was comparable between groups. <b>Conclusions:</b> In real-world clinical settings, intranasal esketamine was associated with a faster and greater reduction in suicidal ideation and depressive symptoms among TRD patients with high suicide risk, supporting its role as a rapid-acting therapeutic option within comprehensive and closely monitored care.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319686","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":"Clinical and Radiological Findings in Endorectal Migration of a Metallic Ureteral Stent.","authors":"Szabolcs André, Daniela Dobru, Árpád-Olivér Vida, Miheler Dora, Rares-Florin Vascul, Călin Chibelean, Lorand Tibor Reman, Raul-Dumitru Gherasim, Edva Anna Frunda, Orsolya Katalin Ilona Martha","doi":"10.3390/clinpract16060109","DOIUrl":"10.3390/clinpract16060109","url":null,"abstract":"<p><p>Hydronephrosis caused by malignant ureteral obstruction or radiotherapy-induced ureteral stenosis is a frequent complication in patients with cervical cancer. Effective management requires continuous urinary drainage, which can be achieved either internally through ureteral stent placement or externally via percutaneous nephrostomy. Among available devices, the Allium^TM fully covered nitinol mesh ureteral stent is designed to treat ureteral or urethral strictures while allowing safe and easy removal. However, serious complications have been reported, including uretero-enteric, uretero-arterial, and uretero-vaginal fistulas, pseudoaneurysm, ureteral perforation and sepsis. We report the case of a 44-year-old woman diagnosed in 2020 with stage IIIC1 cervical cancer (FIGO classification) who underwent surgery followed by adjuvant radiotherapy. In 2021, a right metallic ureteral stent was placed to treat ureteral obstruction. Two years later, she presented with right lumbar pain, and abdominal ultrasonography revealed grade III right hydronephrosis. CT scan demonstrated migration of the metallic ureteral stent into the rectal wall. Endoscopic extraction of the migrated stent was successfully performed via colonoscopy. Retrograde pyelography and CT imaging confirmed the presence of a recto-ureteral fistula. A 6 Ch/26 cm double-J ureteral stent was subsequently placed with good positioning and drainage. At the six-month follow-up, replacement of the double-J stent was performed. Imaging studies showed only minor residual hydronephrosis. Although metallic ureteral stents are effective for managing malignant ureteral obstruction, particularly in complex oncologic cases, they are not free of severe complications. The risk appears increased in patients who have undergone radiotherapy, emphasizing the need for careful monitoring and long term follow-up.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319920","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":"Successful Limb Salvage in MRSA Bacteremic Septic Charcot Midfoot Using Continuous Local Antibiotic Perfusion and Circular External Fixation: A Case Report.","authors":"Koji Nozaka, Naohisa Miyakoshi","doi":"10.3390/clinpract16060108","DOIUrl":"10.3390/clinpract16060108","url":null,"abstract":"<p><p><b>Background</b>: Septic Charcot neuroarthropathy is a limb- and life-threatening condition characterized by the coexistence of neuropathic joint destruction and infection. In patients with severe systemic compromise, major amputation is often considered inevitable. <b>Case Presentation</b>: A 47-year-old man with untreated diabetes mellitus presented with progressive painless swelling of the left foot. He had morbid obesity (120 kg, 165 cm; body mass index 44.1 kg/m²), severe hypoalbuminemia, and chronic kidney disease associated with nephrotic syndrome. Laboratory tests showed marked inflammation and poor glycemic control, and blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA). Radiographs and computed tomography demonstrated destructive changes involving the talonavicular and subtalar joints, consistent with septic Charcot neuroarthropathy involving the midfoot. Because of sepsis, pulmonary edema, and heart failure, below-knee amputation was proposed at the referring hospital. However, limb salvage was attempted using aggressive debridement, continuous local antibiotic perfusion (CLAP; gentamicin 1200 μg/mL) administered for 14 days, and temporary circular external fixation. Serum gentamicin concentrations and renal function were regularly monitored to ensure systemic safety and avoid nephrotoxicity. <b>Results</b>: Repeat irrigation and final debridement were performed 20 days after the index surgery, at which time the external fixator was removed and intraoperative cultures were negative. The patient was discharged 2 months after surgery without evidence of recurrent infection. At 4-year follow-up, no recurrence had occurred, and the patient was able to walk independently. <b>Conclusions</b>: Limb salvage may be feasible even in severely compromised patients with septic Charcot midfoot and MRSA bacteremia when aggressive debridement, CLAP, and temporary external fixation are combined with careful systemic safety monitoring. This case suggests that limb salvage may be considered in selected high-risk patients, although further studies are required.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319940","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":"Developing the Spanish Version of the Fraboni Scale of Ageism: Cross-Cultural Adaptation with Initial Reliability and Content Validity Findings.","authors":"Juan Ramón de-Moya-Romero, Alexis Caballero-Bonafé, Laura Fernández-Puerta, Raquel Valera-Lloris, Antonio Martínez-Sabater","doi":"10.3390/clinpract16060104","DOIUrl":"10.3390/clinpract16060104","url":null,"abstract":"<p><p><b>Background:</b> Ageism is a global public health concern associated with poorer health outcomes and inequities in care. Culturally adapted instruments are needed to assess ageist attitudes among healthcare professionals in Spain. This study aimed to cross-culturally adapt and evaluate the preliminary psychometric properties of the Spanish version of the Fraboni Scale of Ageism (FSA-SV). <b>Methods:</b> A methodological study was conducted, including translation and back-translation, expert review, and a pilot test. Content validity was assessed using the content validity index (CVI), the modified kappa coefficient, and Aiken's V. A descriptive cross-sectional pilot study was conducted with 101 healthcare professionals from a single health department in Valencia to evaluate comprehension and reliability. Internal consistency was examined using Cronbach's alpha and McDonald's omega. <b>Results:</b> Content validity indices indicated acceptable agreement among experts (S-CVI = 0.745; Aiken's V = 0.770). All items were retained to preserve conceptual and structural equivalence with the original instrument. The FSA-SV demonstrated high internal consistency (Cronbach's alpha = 0.903; McDonald's omega = 0.915). The mean total score was 51.2 (SD = 9.62), with no significant associations observed between ageism and participants' sociodemographic or professional variables. <b>Conclusions:</b> This pilot study represents a first step in the cross-cultural adaptation and preliminary psychometric evaluation of the FSA-SV for use among healthcare professionals in Spain. The results suggest that the instrument shows promising initial properties for the preliminary assessment of ageism, supporting its potential utility in future research and in evaluating educational and organizational interventions aimed at reducing ageism and improving the quality and safety of care for older adults. Further studies with larger, more diverse samples are required to evaluate additional psychometric properties, including the factorial structure.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319934","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":"Rare Implantation Sites of Ectopic Pregnancy: A Case Series of Ovarian and Hepatic Pregnancy and Review of Diagnostic Challenges.","authors":"Stefan Ivanovic, Ljubomir Srbinovic, Milica Ivanovic, Dragana Maglic, Nenad Kokošar, Rastko Maglic","doi":"10.3390/clinpract16060107","DOIUrl":"10.3390/clinpract16060107","url":null,"abstract":"<p><p><b>Background:</b> Ectopic pregnancy remains a significant cause of maternal morbidity in early pregnancy. While most ectopic pregnancies happen within the fallopian tube, implantation may rarely occur in atypical locations such as the ovary or abdominal cavity. These rare forms often present with nonspecific clinical findings and may represent a considerable diagnostic challenge. <b>Methods:</b> We report a case series of three rare ectopic pregnancies managed at a tertiary referral center. Two cases involved ovarian pregnancy, and one case represented an exceptionally rare hepatic ectopic pregnancy. Clinical presentation, diagnostic pathway, surgical management, and outcomes were analyzed and compared with available literature. <b>Results:</b> In the first two cases, ovarian pregnancy was confirmed intraoperatively and treated surgically, with ovarian preservation in one patient and adnexectomy in the other due to active bleeding. The third case had an unusual course: initial surgery was performed for hemoperitoneum caused by a ruptured corpus luteum cyst, while persistent β-hCG elevation later led to identification of hepatic ectopic pregnancy, confirmed by imaging and surgery. All patients recovered favorably, with complete β-hCG negativization. <b>Conclusions:</b> Rare ectopic implantation sites may mimic acute abdominal conditions and remain difficult to diagnose preoperatively. High clinical suspicion, serial β-hCG monitoring, and appropriate imaging are essential. Surgical management remains central, particularly in life-threatening bleeding. Standard algorithms for tubal ectopic pregnancy may not be fully applicable and should be adapted to the clinical context.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319952","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":"Challenges in Diagnosis and Management of Spondylodiscitis of L-5/S-1 Due to <i>Propionibacterium acnes</i> in a Patient with a Twenty-Year History of Tetraplegia.","authors":"Vaidyanathan Subramanian, Bakulesh Madhusudan Soni, Peter Lyndon Hughes, Tun Oo","doi":"10.3390/clinpract16060106","DOIUrl":"10.3390/clinpract16060106","url":null,"abstract":"<p><p><b>Objectives:</b> To present novel strategies in the diagnosis and management of spondylodiscitis in a patient with tetraplegia. <b>Case Presentation:</b> A 44-year-old man presented with increased spasms despite having a SynchroMed II Medtronic for intrathecal infusion of baclofen. The C-reactive protein level was raised. Infection was suspected, but there were no localising signs. Positron Emission Tomography (PET) was performed to identify the focus of infection. PET showed an increased Fluorodeoxyglucose uptake in the L-5 vertebral body and the associated ill-defined soft tissue anteriorly. There was significant erosion and destruction of the S-1 vertebra. Magnetic Resonance Imaging of the lumbo-sacral spine revealed destruction and collapse of the S-1 vertebral body and a 6 cm × 2 cm anterior paravertebral abscess collection. This patient was managed in his home. Intravenous administration of 1 g of Ertapenem daily was provided by community nurses for eight weeks. Blood tests were performed in the community setting, and the patient was monitored by spinal unit doctors. Results: Follow-up CT revealed abnormal soft tissue, expanding and replacing the S-1 vertebral body, with appearances in keeping with an infective process. Using CT guidance and the Madison bone biopsy kit, multiple cores were obtained from the left sacral bone. Four of the five specimens showed no growth after extended incubation. <i>Propionibacterium acnes</i> were isolated after 10 days of incubation from the tissue from the sacral bone biopsy only. A shared decision was made towards active surveillance. Follow-up CT of the abdomen showed a stable appearance of the lumbar and sacral spine. <b>Conclusions:</b> A complex case of spondylodiscitis can be diagnosed and managed while the patient stays mainly in their home, avoiding prolonged admission to the spinal unit, in alignment with the \"hospital to community\" aspect of the National Health Service's 10-year Health Plan for England. A diagnostic pathway with PET-CT as the first approach proved useful when the site of infection was unclear. Active surveillance obviated the need for extended periods of antibiotic therapy, which could have led to complications such as antibiotic-induced toxicity and microbial resistance to antibiotics.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319881","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":"Factors Associated with Long COVID in the Pediatric Population: A Retrospective Case-Control Study.","authors":"Ioana Maria Otilia Lică, Iulia Florentina Țincu, Anca Cristina Drăgănescu, Doina Anca Pleșca","doi":"10.3390/clinpract16060105","DOIUrl":"10.3390/clinpract16060105","url":null,"abstract":"<p><p><b>Background:</b> Long COVID in children is increasingly recognized, yet its clinical predictors and objective biological correlates remain insufficiently characterized. <b>Objectives:</b> The objective was to compare clinical, demographic, and laboratory characteristics between children with and without long COVID and to identify associated variables. <b>Methods:</b> We conducted a retrospective observational case-control study at the \"Dr. Victor Gomoiu\" Children's Clinical Hospital, including pediatric patients with confirmed SARS-CoV-2 infection. Cases were defined as children with symptoms persisting ≥12 weeks after acute infection, while controls had no persistent symptoms at ≥12 weeks. <b>Results:</b> Eighty-nine children with long COVID and 88 matched controls were included. Children with long COVID were significantly older (1.79 ± 0.90 vs. 1.14 ± 0.80 years, <i>p</i> < 0.001) and more frequently from urban areas (86.5% vs. 69.3%, <i>p</i> = 0.0099). Lymphocyte, monocyte, and basophil counts were significantly lower in the Long COVID group, while D-dimer, ferritin, serum iron, urea, and creatinine levels were significantly higher. A multivariate predictive model demonstrated excellent discrimination (AUC = 0.94), with optimal sensitivity (84.3%) and specificity (89.8%) at a probability threshold of 0.48. <b>Conclusions:</b> Long COVID in children was associated with identifiable clinicobiological features. An exploratory composite model showed good discrimination but requires external validation.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319725","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}