Clinics and Practice最新文献

{"title":"Maternal Vitamin D Deficiency and the Risk of Placental Abruption: A Cross-Sectional Study in a Greek Obstetric Population.","authors":"Artemisia Kokkinari, Evangelia Antoniou, Eirini Orovou, Maria Dagla, Maria Tzitiridou-Chatzopoulou, Antigoni Sarantaki, Kleanthi Gourounti, Georgios Iatrakis","doi":"10.3390/clinpract15060102","DOIUrl":"10.3390/clinpract15060102","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency (VDD) during pregnancy has been associated with various obstetric complications, including preeclampsia, gestational diabetes, and premature rupture of membranes. However, its potential link to placental abruption remains underexplored. The aim of this study was to investigate whether low maternal vitamin D levels are associated with an increased risk of placental abruption in pregnancies considered otherwise low-risk.</p><p><strong>Methods: </strong>We conducted a cross-sectional study involving 248 pregnant women who were admitted for delivery at a public hospital in Athens, Greece. Serum levels of 25-hydroxyvitamin D [25(OH)D] were measured upon admission. Levels below 30 ng/mL were classified as insufficient. Although this threshold corresponds to insufficiency according to the Endocrine Society, for the purposes of this study, levels < 30 ng/mL were treated as indicative of vitamin D deficiency in order to capture broader physiological implications. Cases of placental abruption were identified based on obstetric history and clinical documentation at the time of delivery. A Chi-square test was used to assess the association between vitamin D status and placental abruption, and a multivariate logistic regression model was applied to control for potential confounders, including hypertensive disorders of pregnancy, smoking, and preterm birth. The potential role of vitamin D supplementation during pregnancy was also explored as part of the analysis.</p><p><strong>Results: </strong>Our analysis revealed that women with VDD had a significantly higher incidence of placental abruption (<i>p</i> < 0.05). In the multivariate model, VDD remained an independent risk factor (adjusted OR: 3.2, 95% CI: 1.1-9.6). Additional risk factors that showed significant associations with placental abruption included pregnancy-induced hypertension and maternal smoking.</p><p><strong>Conclusions: </strong>These findings support the hypothesis that insufficient maternal vitamin D levels may contribute to adverse pregnancy outcomes, including placental abruption. Further prospective studies are warranted to clarify the causal mechanisms and to evaluate whether early detection and correction of vitamin D deficiency could serve as a preventive strategy in prenatal care.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486510","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":"Rising Threats and Evolving Trends: Five Years of Urinary Tract Infection Prevalence in a Portuguese Hospital.","authors":"Francisco José Barbas Rodrigues, Patrícia Coelho, Sónia Mateus, Miguel Castelo-Branco","doi":"10.3390/clinpract15060100","DOIUrl":"10.3390/clinpract15060100","url":null,"abstract":"<p><p><b>Background/Objective:</b> Urinary tract infections (UTIs) are a significant public health concern worldwide, yet longitudinal data from Portuguese hospital settings remain limited. This study aimed to characterize epidemiological trends, microbial etiology, antimicrobial resistance patterns, and associated risk factors of UTIs over a five-year period (2018-2022) in a central Portuguese hospital. <b>Methods:</b> In this retrospective observational study, 23,682 positive urine cultures were analyzed from specimens collected between January 2018 and December 2022. Data were extracted from the laboratory information system and included patient demographics, clinical service of origin, isolated microorganisms, resistance profiles, and annual antibiotic consumption (Defined Daily Dose (DDD) per 1000 patient-days). UTI prevalence was calculated as the proportion of positive cultures among all urine samples processed annually. <b>Results:</b> The positivity rate increased from 18.7% in 2018 to 22.7% in 2022, with a peak in 2019. Women represented around 70% of cases throughout the study period. Most infections originated from inpatient wards, followed by emergency services. <i>Escherichia coli</i> remained the leading pathogen (≈62%), followed by <i>Klebsiella pneumoniae</i> (≈14%) and <i>Enterococcus faecalis</i> (≈8%). Risk factors included catheterization (37.2%), prior UTI history (22.1%), and diabetes mellitus (18.5%). Longer hospital stays (>7 days) were associated with increased positivity. For <i>E. coli</i>, resistance ranged from 2% (amikacin) to 41% (ampicillin), with increasing resistance to ertapenem and fosfomycin and decreasing resistance to several key antibiotics. <i>K. pneumoniae</i> showed 4-36% resistance across antimicrobials, with notable increases for fosfomycin, meropenem, and cefuroxime axetil. Antibiotic usage trends reflected these patterns, with declining use of amikacin and rising use of cefuroxime axetil and meropenem. <b>Conclusions:</b> Over the five-year period, both UTI prevalence and resistance to critical antimicrobials increased, reinforcing the need to update empirical treatment guidelines. Identified risk factors may inform targeted prevention strategies. Ongoing surveillance and antimicrobial stewardship are crucial to mitigate the rising burden of UTIs and resistance.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486515","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":"Unicortical Locking Screws Provide Comparable Rigidity to Bicortical Compression Screws in Tranverse Mid-Shaft Clavicle Fracture Plate Fixation Constructs.","authors":"Curtis W Hartman, Nicholas C Branting, Matthew A Mormino, Timothy J Lackner, Bradford P Zitsch, Edward V Fehringer, Hani Haider","doi":"10.3390/clinpract15060101","DOIUrl":"10.3390/clinpract15060101","url":null,"abstract":"<p><p><b>Background</b>: Mid-shaft clavicle fracture fixation carries neurovascular injury risk. The purpose of this study was to compare bicortical compression and unicortical locked clavicle plate constructs biomechanically. <b>Materials and Methods</b>: Ten fourth-generation composite transverse mid-shaft clavicle osteotomy specimens were assigned to two groups, and each clavicle was fixed with an eight-hole second-generation 3.5 mm pelvic reconstruction plate placed superiorly. Group one included five fixed with bicortical compression screws and group two included five fixed with unicortical locking screws. All were tested on a four-axis servohydraulic testing frame in three modes: axial rotation, anterior/posterior bending, and cephalad/caudad bending. <b>Results</b>: Mean construct stiffness for AP bending was 1.255 ± 0.058 Nm/deg (group 1) and 1.442 ± 0.065 Nm/deg (group 2) (<i>p</i> = 0.001). Mean construct stiffness for axial rotation was 0.701 ± 0.08 Nm/deg (1) and 0.726 ± 0.03 Nm/deg (2) (<i>p</i> = 0.581). Mean construct stiffness for cephalad bending was 0.889 ± 0.064 Nm/deg (1) and 0.880 ± 0.044 Nm/deg (2) (<i>p</i> = 0.807). Mean construct stiffness for caudal bending was 2.523 ± 0.29 Nm/deg (1) and 2.774 ± 0.25 Nm/deg (2) (<i>p</i> = 0.182). <b>Conclusions</b>: With transverse mid-shaft clavicle fractures, unicortical locking fixation provided comparable rigidity to bicortical compression fixation in axial rotation, cephalad bending, and caudal bending; it provided greater rigidity in AP bending.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486517","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":"Online Occupational Therapy as a Rehabilitation Intervention for Parkinson's Disease: A Systematized Review.","authors":"Antigoni Kountoura, Thomas Tegos, Marianthi Arnaoutoglou, Magdalini Tsolaki","doi":"10.3390/clinpract15060098","DOIUrl":"10.3390/clinpract15060098","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Occupational therapy (OT) plays a crucial role in addressing functional limitations and promoting independence in Parkinson's disease (PD) patients. OT interventions target motor skills, daily activities, and engagement in meaningful tasks. Telehealth, the remote delivery of healthcare services, has expanded access to rehabilitation, including OT for PD. While several studies have examined the benefits of online OT, a comprehensive assessment of its impact on functional outcomes and quality of life (QoL) is needed. This review aimed to evaluate the effects of online OT interventions on functional outcomes and QoL of patients with PD. <b>Methods</b>: This review employed a systematized approach, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, though it did not constitute a full systematic review or meta-analysis. A comprehensive search was conducted across PubMed, Web of Science, Scopus, and Embase databases between August 2023 and September 2024. The search targeted randomized controlled trials (RCTs) investigating telerehabilitation interventions in OT for individuals with PD. Studies were excluded if they were not published in English, did not employ an RCT design, or lacked a focus on telerehabilitation within the scope of occupational therapy for PD. Additionally, systematic reviews, meta-analyses, qualitative studies, and studies without measurable outcomes were excluded. Nine studies met the inclusion criteria, with four involving occupational therapists directly and five evaluating interventions within the scope of OT practice. <b>Results</b>: The primary outcomes of this review focused on mobility improvements in PD patients, assessed through gait metrics such as gait speed, stride length, and gait variability. Secondary outcomes evaluated the impact of telerehabilitation on QoL, using tools such as the Parkinson's Disease Questionnaire (PDQ-39) and other disease-specific instruments. The findings demonstrated that online OT interventions significantly improved motor skills, cognitive function, and activities of daily living in PD patients. Furthermore, these interventions enhanced overall well-being and QoL. The remote format fostered sustained engagement and adherence to therapy, contributing to better long-term outcomes. <b>Conclusions</b>: Online OT interventions show promising potential for improving functional outcomes and QoL in PD patients. These findings underscore the potential of telehealth to expand access to OT services, thereby enhancing long-term rehabilitation outcomes for this population.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486512","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":"Evaluating the Impact of Community-Based Medical Education on Health Literacy and Patient Empowerment in Underserved Populations: A Pilot Cohort Study.","authors":"Aida Aljafri, Persia Abba, Anita Sedghi, Andreas Conte, Waseem Jerjes","doi":"10.3390/clinpract15060097","DOIUrl":"10.3390/clinpract15060097","url":null,"abstract":"<p><p><b>Background:</b> Traditionally, community-based education (CBE) programmes have been utilised for teaching medical students clinical and interpersonal skills through placement in underserved environments. This pilot cohort study tested an extended model of CBE by infusing patient education into student-conducted consultations with the dual objectives of stimulating improved learning for the students and improved health literacy for the patients. <b>Methods:</b> The intervention involved 38 final-year medical students and 85 adult patients and from underprivileged communities in North West London. The students first undertook online preparatory workshops on health literacy, communication skills, and cultural competence. Subsequently, they imparted 20-30 min educational sessions on chronic disease management and preventive care to the patients on their clinical placements. The quantitative measurement used pre- and post-intervention questionnaires, and the qualitative measurement was based on reflective diaries and patient feedback. Paired <i>t</i>-tests were used for statistical comparisons, while a thematic analysis was used for textual answers. <b>Results:</b> Student confidence in breaking down medical jargon improved from 2.8 ± 0.7 to 4.4 ± 0.5 (<i>p</i> < 0.01), and confidence in making use of visual aids improved from 2.5 ± 0.8 to 4.2 ± 0.6 (<i>p</i> < 0.01). Understanding among the patients of their health conditions improved from 27% to 74% (<i>p</i> < 0.001), and self-confidence in their ability to manage their health improved from 31% to 79% (<i>p</i> < 0.001). The qualitative feedback noted improved empathy, cultural sensitivity, and a positive effect on patient empowerment through tailored education. <b>Conclusions:</b> This CBE intervention had two benefits: improving teaching and communication skills in students and greatly enhancing health literacy in underserved patients. The integration of structured education into usual care encounters holds the promise of a scalable, sustainable method for addressing health disparities. Longer longitudinal studies are necessary to assess its long-term success and incorporation into medical education.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486569","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":"Intra-Articular Injection of Bupivacaine and Adrenaline Reduces Intraoperative and Postoperative Blood Loss in Total Knee Arthroplasty: A Retrospective Case-Control Study.","authors":"Ahmad Biadsi, Mor Bracha Akselrad, David Segal, Shanny Gur, Michael Markushevich, Yaron Shraga Brin","doi":"10.3390/clinpract15050096","DOIUrl":"10.3390/clinpract15050096","url":null,"abstract":"<p><p><b>Objective</b>: To evaluate the effect of preoperative intra-articular injection of bupivacaine and adrenaline (BAD) on blood loss and postoperative hemoglobin levels in primary total knee replacement. <b>Methods</b>: We retrospectively assessed 38 consecutive patients who underwent primary total knee arthroplasty at our institution between 2018 and 2019, as performed by two chief orthopedic surgeons. The study group included 22 patients who received an intra-articular injection of 40 mL solution of BAD 0.25% preoperatively. The control group included 16 patients who did not receive the BAD injection preoperatively. Both groups received an IV tranexamic acid (TXA) 1 g treatment prior to the first incision. The posterior capsule and soft tissues were infiltrated after femoral chamfer cuts with a 60 mL BAD solution in both groups. Blood loss was evaluated in all patients by measuring the volume collected in the suction container before the first irrigation and prior to cementation. Additional assessments included the volume of blood drained during the first 24 h postoperatively, as well as changes in hemoglobin levels (delta hemoglobin) 24 h after surgery and at hospital discharge. <b>Results</b>: The study and the control groups were similar in age, sex, demographics, and comorbidities. The mean patient age was 71.4 ± 6.5 in the injected group and 70.6 ± 7.5 in the control group. The volume of blood suctioned during surgery was significantly lower in the study group compared to the control group (201 ± 84.3 mL vs. 261.25 ± 83.3 mL; <i>p</i> = 0.04). Similarly, the amount of blood drained within the first 24 h postoperatively was also reduced in the study group (204.3 ± 91.1 mL vs. 363.44 ± 131.9 mL; <i>p</i> = 0.0001). Ultimately, the decrease in hemoglobin levels from baseline to discharge was less pronounced in the study group compared to the control group (1.7 ± 0.9 g/dL vs. 2.44 ± 1.3 g/dL; <i>p</i> = 0.038). <b>Conclusions:</b> Intra-articular injection of 40 mL bupivacaine and 0.25% adrenaline solution before skin incision may reduce intraoperative and postoperative blood loss among patients undergoing total knee arthroplasty.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152386","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":"Association Between Diabetes and Vertical Bone Defects in Periodontitis Using Cone Beam Computed Tomography: A Cross-Sectional Study in the Eastern Province, Saudi Arabia.","authors":"Eman Aljoghaiman, Abdullah Alzahrani, Rakan Albarqi, Saad Alqbbani, Hamad Alshiddi, Mishali AlSharief, Mohammed Alsaati, Faisal E Al Jofi","doi":"10.3390/clinpract15050095","DOIUrl":"10.3390/clinpract15050095","url":null,"abstract":"<p><p><b>Background</b>: The association between diabetes and periodontal disease is well established, but its impact on intrabony periodontal defects remains unclear. Aims: This study examines the relationship between diabetes and intrabony periodontal defects using cone beam computed tomography (CBCT). <b>Methods:</b> A retrospective analysis of 99 CBCT images from Imam Abdurrahman bin Faisal University (2010-2022) was conducted. Intrabony periodontal defects were assessed, and logistic regression was used to analyze their association with diabetes. <b>Results</b>: Intrabony periodontal defects were detected in 66% of the sample, with 36% exhibiting multiple defects. Crude logistic regression showed a significant association between diabetes and intrabony periodontal defects (OR 3.986, 95% CI 1.454-10.922) and defect count (OR 3.382, 95% CI 1.430-8.003). However, multiple regression analysis did not confirm diabetes as an independent predictor (adjusted OR 0.740, 95% CI 0.087-6.314). <b>Conclusions:</b> Diabetes was not significantly associated with the prevalence or number of intrabony periodontal defects after adjusting for the confounders. However, these findings highlight the multifactorial nature of periodontal bone loss and the need for comprehensive patient assessment. Clinically, this underscores the importance of integrating both systemic and local periodontal evaluations in diabetic patients to improve early detection and personalized treatment planning. Further research with larger, more diverse samples and integrated clinical assessments is needed to refine our understanding of this relationship and enhance patient management.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152377","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":"\"Walking a Day in My Shoes\": A Clinical Shadowing Program to Enhance Medical Students' Understanding of Chronic Disease Management Beyond Clinical Settings.","authors":"Aidan Hilton, Waseem Jerjes","doi":"10.3390/clinpract15050094","DOIUrl":"10.3390/clinpract15050094","url":null,"abstract":"<p><strong>Aims/background: </strong>Medical education is largely clinical and biomedical with little emphasis being put upon the social determinants of health (SDH) and patient-centredness. A programme entitled \"Walking a Day in My Shoes\" was devised as a pilot cohort study with the view of evaluating the impact of a clinical shadowing experience upon the empathy, SDH awareness, and patient-centredness of medical students.</p><p><strong>Methods: </strong>A prospective cohort study, involving 28 final-year London-area medical students, employing a three-phase teaching programme comprising preparation, observation, and reflection was carried out. Students' confidence in the management of non-medical barriers, SDH awareness, and empathy before and after shadowing were measured using pre- and post-shadowing questionnaires. Qualitative analysis of patient feedback and journals also occurred.</p><p><strong>Results: </strong>Statistically significant improvements were observed in students' empathy (mean score increase from 6.8 to 8.9, <i>p</i> < 0.001), understanding of SDH (advanced comprehension rose from 35% to 93%), confidence in addressing non-clinical barriers (from 39% to 86%), and awareness of logistical challenges (from 31% to 81%). Qualitative analysis highlighted key themes, including systemic barriers (transportation, polypharmacy, and social isolation) and students' increased awareness of the emotional toll of chronic illness. Patients expressed high satisfaction, with 97% agreeing that the programme improved students' understanding of chronic disease management. These findings suggest the programme's practicality and scalability in medical education.</p><p><strong>Conclusions: </strong>This pilot cohort study demonstrated the significant enhancement of the students' empathy, perception of SDH, and patient-centredness preparation through immersive shadowing. The findings support the use of experiential learning programmes as curricular interventions.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152376","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 Role of Ancient Greek Physicians in the Development of Tracheostomy: Pioneering Airway Interventions and Early Thoracic Surgery.","authors":"Vasileios Leivaditis, Francesk Mulita, Nikolaos G Baikoussis, Elias Liolis, Andreas Antzoulas, Levan Tchabashvili, Konstantinos Tasios, Dimitrios Litsas, Manfred Dahm","doi":"10.3390/clinpract15050093","DOIUrl":"10.3390/clinpract15050093","url":null,"abstract":"<p><p>Tracheostomy, a critical airway intervention, has a long and complex history that dates back to antiquity. While the earliest references to the procedure appear in Egyptian and Indian medical texts, its development within ancient Greek medicine remains a subject of historical debate. This study explores the evolution of tracheostomy in ancient Greece, analyzing its theoretical foundations, historical accounts, and surgical advancements. Despite Hippocratic opposition, which largely discouraged invasive airway procedures due to the risk of fatal complications, later physicians such as Asclepiades, Aretaeus, and Antyllus made significant contributions to refining airway management techniques. The anatomical studies of Galen further advanced the understanding of respiratory physiology, including early concepts of artificial ventilation. Additionally, this study examines archaeological evidence, such as a marble relief discovered in Abdera, which may depict an early attempt at tracheostomy, providing valuable insight into the practical application of airway interventions in antiquity. By comparing ancient Greek surgical techniques with modern tracheostomy practices, this research highlights the continuity of medical knowledge and innovation. It underlines the role of ancient Greek physicians in shaping the principles of thoracic surgery, offering a broader understanding of how early medical practices have influenced contemporary airway management. The findings contribute to the historical perspective on tracheostomy, emphasizing the timeless pursuit of life-saving surgical advancements and the evolving relationship between theoretical medical knowledge and practical surgical application.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152340","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":"Job Demands and Resources Perceived by Dentists in a Digital Dental Workplace and Perceived Effects on Job Satisfaction and Stress: A Qualitative Study.","authors":"Julia Sofie Gebhardt, Volker Harth, David A Groneberg, Stefanie Mache","doi":"10.3390/clinpract15050092","DOIUrl":"10.3390/clinpract15050092","url":null,"abstract":"<p><p><b>Background:</b> Digitalisation is becoming increasingly integrated into the field of dentistry; therefore, it is crucial to understand both the challenges it introduces and the opportunities it provides. By doing so, the research will offer insights into how digital tools can affect the work environment and contribute to the overall well-being and performance of dental professionals. <b>Objectives:</b> The present study aims to explore how dentists perceive the demands and resources within a digitalised dental practice. <b>Methods:</b> The present study adopted a qualitative design, incorporating guideline-based interviews. A total of 30 interviews were conducted with dentists from various German dental practices, with a focus on key topics such as job demands, job resources, digital stress factors, job satisfaction, and support needs in the context of digital dentistry. The interview data were analysed using qualitative content analysis. <b>Results:</b> The findings highlight that digital systems in dental practices offer benefits such as reduced errors and time savings, but also pose challenges, especially for less experienced users. While they improve efficiency, precision, and professional development, they can also lead to negative effects like dependence on technology, loss of manual skills, technical failures, and increased stress, particularly during the adaptation phase. These results suggest that successful integration of digital technologies requires adequate support to overcome initial learning curves and ensure long-term benefits. <b>Conclusions:</b> The results of the study underline the importance of effective implementation, comprehensive staff training, and technological reliability to maximise the benefits of digital tools and minimise their drawbacks. Maintaining a balance between digital stressors and resources is crucial to promoting a healthy work environment. Future research should focus on the long-term effects of training programmes and the integration of digital technologies into dental practices to increase their effectiveness in terms of job satisfaction and reduce potential risks.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152387","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}