Clinics and Practice最新文献

{"title":"Twisted Troubles: A Rare Case of Intestinal Obstruction Due to Endometriosis and a Review of the Literature.","authors":"Ionut Eduard Iordache, Luana Alexandrescu, Alina Doina Nicoara, Razvan Popescu, Nicoleta Leopa, Gabriela Baltatescu, Andreea Nelson Twakor, Ionut Tiberiu Tofolean, Liliana Steriu","doi":"10.3390/clinpract14050160","DOIUrl":"https://doi.org/10.3390/clinpract14050160","url":null,"abstract":"<p><strong>Background and objectives: </strong>Intestinal endometriosis is an exceptionally rare cause of intestinal obstruction. This case report and literature review aim to highlight the clinical presentation, diagnostic challenges, and surgical management of this condition.</p><p><strong>Materials and methods: </strong>We report the case of a 50-year-old female patient who presented diffuse abdominal pain, nausea, vomiting, a distended abdomen, and an absence of intestinal transit for gas and faeces. Initial symptoms included flatulence and constipation, which gradually worsened for two months prior to the patient's hospital admission, leading to acute intestinal obstruction. Diagnostic investigations, including blood tests, ultrasound (USG), X-ray, and a contrast-enhanced computer tomography (CT) scan, revealed significant small bowel dilatation and an ileal volvulus. The patient underwent urgent hydro-electrolytic and metabolic rebalancing followed by a median laparotomy surgical procedure. Intraoperative findings included a distended small intestine and an obstructive ileal volvulus, and required an 8 cm segmental enterectomy and terminal ileostomy.</p><p><strong>Results: </strong>Postoperative recovery was slow but favourable, with a gradual digestive tolerance. Histopathological examination of the resected ileum revealed intestinal endometriosis characterized by a fibro-conjunctive reaction and nonspecific chronic active inflammation. Five months later, the patient underwent a successful reversal of the ileostomy with a mechanical lateral anastomosis of the cecum and ileum, resulting in a favourable postoperative course.</p><p><strong>Conclusions: </strong>This case underscores the importance of considering intestinal endometriosis in women presenting with unexplained gastrointestinal symptoms and highlights the need for timely surgical intervention and careful postoperative management. Further research is required to better understand the pathophysiology and optimal treatment strategies for intestinal endometriosis.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"2027-2043"},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510109","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":"Aesthetical and Functional Rehabilitation for an Ankylosed Maxillary Canine-A Case Report.","authors":"Tatiana Roman, Maxime Delarue, Matthieu Esquenet, Frédéric Rafflenbeul, Catherine Petit, Naji Kharouf, Olivier Etienne","doi":"10.3390/clinpract14050159","DOIUrl":"https://doi.org/10.3390/clinpract14050159","url":null,"abstract":"<p><p><b>Background:</b> As the functional and aesthetical importance of the canine cannot be overstated, the management of a missing canine is challenging. This case report describes the treatment of an infra-occluded ankylosed maxillary canine in a patient with previously failed orthodontic treatment. <b>Case description:</b> A 20-year-old patient sought a second opinion for orthodontic treatment failure. The patient presented with an impacted, ankylosed, and severely infra-occluded right maxillary canine, as well as an iatrogenic clockwise cant of the maxillary occlusal plane and several root resorptions. The treatment corrected the cant of the occlusal plane while avoiding further root resorption, partially extracted the upper right canine, improved the quality and quantity of the soft tissue in the newly edentulous area, and provided a prosthetic rehabilitation using a lithium disilicate ceramic resin-bonded cantilever bridge. <b>Conclusions:</b> The use of a cantilevered bridge resulted in an aesthetically pleasing and minimally invasive rehabilitation. This technique is reversible, does not affect pulp vitality, and is a viable solution for rehabilitating the smiles of young patients. <b>Clinical significance:</b> The smile rehabilitation for an ankylosed maxillary canine, especially in the case of a previously failed orthodontic treatment, is an important clinical challenge. A minimally invasive long-term restoration with a cantilever bridge is a viable solution. Functional and aesthetically pleasant results can be achieved with a multidisciplinary approach.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"2013-2026"},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510093","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":"Current Evidence on and Clinical Implications of Vitamin D Levels in Pain and Functional Management of Knee Osteoarthritis: A Systematic Review.","authors":"Bianca Georgescu, Adelina Elena Cristea, Doinița Oprea, Andreea Alexandra Lupu, Liliana-Elena Stanciu, Erdin Borgazi, Bogdan Marian Caraban, Viorela Mihaela Ciortea, Laszlo Irsay, Mădălina Gabriela Iliescu","doi":"10.3390/clinpract14050158","DOIUrl":"https://doi.org/10.3390/clinpract14050158","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis is a common chronic disease that affects quality of life and increases public health costs. Knee osteoarthritis is a frequent form, marked by joint degeneration, pain, stiffness, and functional restrictions. Factors such as age, genetics, joint injuries, obesity, and vitamin D deficiency can affect knee osteoarthritis progression. While the exact link between vitamin D and osteoarthritis is still being studied, recent research indicates that low vitamin D levels might influence the articular cartilage's structure and function, potentially accelerating osteoarthritis. This review aims to analyze the last decade of research on vitamin D's role in osteoarthritis.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Relevant studies from the last ten years were included to evaluate the association between vitamin D levels and knee osteoarthritis. The inclusion criteria were studies examining the role of vitamin D in cartilage health and osteoarthritis progression and the potential clinical implications for disease management.</p><p><strong>Results: </strong>This review identified a variety of studies exploring the connection between vitamin D and osteoarthritis, with mixed findings.</p><p><strong>Conclusions: </strong>The relationship between vitamin D and knee osteoarthritis remains inconclusive, highlighting the need for further research. An updated evaluation of the literature is crucial for osteoarthritis management strategies and to potentially include vitamin D supplementation in therapeutic protocols.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1997-2012"},"PeriodicalIF":1.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510096","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":"Management of Early Post-Transplant Hyperglycemia by Dedicated Endocrine Care Improves Glycemic Outcomes.","authors":"Alon Kaplan, Tslil Manela, Tammy Hod, Ronen Ghinea, Eytan Mor, Amit Tirosh, Amir Tirosh, Gadi Shlomai","doi":"10.3390/clinpract14050156","DOIUrl":"https://doi.org/10.3390/clinpract14050156","url":null,"abstract":"<p><strong>Introduction: </strong>Early post-transplant hyperglycemia (EPTH) is an independent risk factor for hospital readmissions, acute rejection, infections and developing post-transplant diabetes mellitus (PTDM). Close glycemic control is prudent in the early post-transplant period. The management of EPTH was evaluated among a cohort of kidney transplant recipients, who either received routine care (RC) or dedicated endocrine care (DEC).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on kidney transplant recipients from 2019 to 2023. The impact of DEC on post-transplant glycemic control was investigated. Hospitalized patients receiving post-transplant insulin therapy were included. DEC involved at least twice-daily blood glucose (BG) assessment by an endocrinologist, while the RC received usual care. A mixed-model analysis was employed to assess differences in BG trajectories between DEC and RC over an eight-day period. Additionally, various glycemic control metrics were compared, including glucose variability, time-in-range for target BG, rates of hypoglycemia and response to hyperglycemia.</p><p><strong>Results: </strong>The cohort comprised 113 patients. In the DEC group, 91% had pre-transplant DM compared to 15% in the RC group (<i>p</i> < 0.001). Patients under DEC had higher baseline BG and glycated hemoglobin compared to those under RC (<i>p</i> < 0.001, for both). The DEC group displayed a lower trajectory of BG over time compared to the RC group (<i>p</i> = 0.002). Patients under DEC were more likely to receive insulin if BG measured above 200 mg/dL (66% vs. 46%) and displayed less below-range BG (<110 mg/dL) compared to those under RC (12.9% vs. 23.6%, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Management of EPTH by DEC improves glycemic outcomes in renal transplant recipients.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1960-1969"},"PeriodicalIF":1.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510100","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 Potential of Intra-Articular Therapies in Managing Knee Osteoarthritis: A Systematic Review.","authors":"Ciprian Vasile Pojala, Sebastian Toma, Cristea Costache, Tunde Peter, Cristiana Elena Pojala, Nadinne Alexandra Roman, Lorena Dima","doi":"10.3390/clinpract14050157","DOIUrl":"https://doi.org/10.3390/clinpract14050157","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a common degenerative and progressive joint disorder that negatively influences patients' quality of life. Intra-articular therapies, such as hyaluronic acid (HA) and platelet-rich plasma (PRP), have garnered attention for their potential to manage osteoarthritis OA symptoms effectively. This systematic review aims to identify the effectiveness and safety of HA and PRP treatment modalities in treating KOA.</p><p><strong>Methods: </strong>A literature search was conducted across MEDLINE (PubMed), Web of Science Core Collection, and Science Direct Collection Elsevier. Twenty-three randomized controlled trials, cohort studies, and observational studies were included in the review. The selection criteria focused on studies published in English within the last 10 years, involving subjects with KOA treated with intra-articular injections of HA or PRP and reporting on pain, function, or overall treatment efficacy outcomes.</p><p><strong>Results: </strong>The analysis showed that both HA and PRP significantly improve functionality and reduce pain in KOA patients. High molecular weight HA consistently reduced pain and improved joint mobility in various studies. PRP had better long-term outcomes when combined with HA, leading to greater pain reduction and functional improvement. Both therapies had generally favorable safety profiles, with only minor adverse events reported. However, there were potential biases identified across the studies, such as selection, performance, detection, and reporting biases, which impacted the reliability of the results.</p><p><strong>Conclusions: </strong>Intra-articular treatments with HA and PRP show promise in managing knee osteoarthritis, with personalized treatment plans and further research needed to confirm these findings.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1970-1996"},"PeriodicalIF":1.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510106","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 Heart Failure in a Young Patient Treated in ICU-Diagnostic Pitfalls.","authors":"Łukasz Surówka, Paweł Andruszkiewicz, Monika Budnik, Robert Kowalik, Agnieszka Milner, Mateusz Zawadka","doi":"10.3390/clinpract14050155","DOIUrl":"https://doi.org/10.3390/clinpract14050155","url":null,"abstract":"<p><p><b>Background:</b><i>Chlamydia pneumoniae</i> and human herpesvirus 6 (HHV-6) are uncommon aetiological agents in respiratory tract infections and are rarely associated with cardiogenic shock. This case report presents a rare instance of severe cardiomyopathy linked to these infections in a 19-year-old Asian female. The case highlights the importance of considering a broad differential diagnosis in acute heart failure, especially in young adults. <b>Case report:</b> The patient was admitted with chest pain and diagnosed with ST-elevation myocardial infarction (STEMI) based on electrocardiography. She subsequently developed heart failure, with a marked reduction in myocardial contractility and a left ventricular ejection fraction (LVEF) of 20%. Treatment included broad-spectrum antibiotics and inotropic support guided by hemodynamic monitoring, leading to clinical improvement. The patient was discharged in a significantly improved condition following a stay in the intensive care unit (ICU). <b>Conclusions:</b> This case emphasizes the importance of considering Takotsubo syndrome in differential diagnoses, especially in ICU patients presenting with cardiogenic shock, to improve outcomes and reduce mortality through timely and appropriate management. Inotropic support, often used in the ICU to treat hypoperfusion, may worsen outcomes in patients with Takotsubo syndrome by exacerbating basal hypercontractility and prolonging the acute phase through catecholamine receptor activation.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1953-1959"},"PeriodicalIF":1.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510092","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":"Urinary Incontinence and Quality of Life in Women of Central Jordan: A Cross-Sectional Study.","authors":"Rana Abu-Huwaij, Rolla Al-Shalabi, Enas Alkhader, Farah N Almasri","doi":"10.3390/clinpract14050152","DOIUrl":"10.3390/clinpract14050152","url":null,"abstract":"<p><strong>Background: </strong>Considering the high prevalence of UI in the rural areas of Jordan and the limited clinical data on its occurrence in central Jordan, this study aims to investigate the prevalence, risk factors, and impact of urinary incontinence (UI) on the quality of life (QoL) of women in central Jordan.</p><p><strong>Method: </strong>This cross-sectional study was conducted from September to December 2022, using online the Incontinence Impact Questionnaire short form (IIQ-7) and Urogenital Distress Inventory short form (UDI-6). Participation was voluntary, and anonymous. Internal consistency was assessed using Cronbach's α.</p><p><strong>Results: </strong>A total of 128 women participated in the study. More than half of the participants (54.33%, N = 69) experienced UI symptoms. Body mass index was the sole statistically significant factor linked to UI. Obese patients had the highest risk (OR 35, CI 95% 2.577-475.308, <i>p</i> < 0.05) compared to those with a healthy weight. Multivariate regression indicated significant associations of severe UI with smoking and vaginal births with a moderate impact of UI on QoL.</p><p><strong>Conclusions: </strong>The study's findings emphasize the need for women's health centers in the center of Jordan to develop comprehensive UI prevention and management programs to improve women's health and well-being.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1921-1930"},"PeriodicalIF":1.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298131","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":"Guided Biofilm Therapy for Management of \"Desquamative Gingivitis\"-Clinical Cases.","authors":"Blagovesta Yaneva, Maria Mutafchieva, Petar Shentov, Georgi Tomov","doi":"10.3390/clinpract14050153","DOIUrl":"10.3390/clinpract14050153","url":null,"abstract":"<p><p><b>Background:</b> Desquamative gingivitis is a clinical manifestation often associated with various mucocutaneous disorders, characterized by red, painful, and friable gingiva. It is predominantly seen in middle-aged to elderly females and is typically linked to autoimmune conditions such as lichen planus, pemphigoid, and pemphigus, among others. Due to the chronic pain and difficulty in maintaining personal oral hygiene, professional care becomes crucial. <b>Methods:</b> This article explores the application of guided biofilm therapy as a novel, gentle approach for managing desquamative gingivitis, focusing on three clinical cases. This therapy employs erythritol-based powders for biofilm removal, offering a less abrasive and more comfortable alternative to traditional mechanical plaque removal techniques. <b>Results:</b> The cases demonstrate the effectiveness of guided biofilm therapy in reducing discomfort and improving clinical outcomes in desquamative gingivitis patients, particularly those suffering from mucous membrane pemphigoid, pemphigus vulgaris, and oral lichen planus. <b>Conclusions:</b> The guided biofilm approach underscores the importance of tailored periodontal therapy in managing nonplaque-induced gingival lesions, improving patient compliance and oral health outcomes.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1931-1939"},"PeriodicalIF":1.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298123","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":"Comparative Strength Study of Indirect Permanent Restorations: 3D-Printed, Milled, and Conventional Dental Composites.","authors":"João Paulo Mendes Tribst, Adelheid Veerman, Gabriel Kalil Rocha Pereira, Cornelis Johannes Kleverlaan, Amanda Maria de Oliveira Dal Piva","doi":"10.3390/clinpract14050154","DOIUrl":"10.3390/clinpract14050154","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Limited research has been performed to assess the strength of resin-bonded 3D-printed restorations. Based on that, this study investigates the impact of different manufacturing methods on the fracture load of indirect composite restorations (ICRs) following an aging process. <b>Methods</b>: Three manufacturing techniques-conventional (CRC), milled (MRC), and printed (PRC)-were evaluated using 60 specimens, each with a diameter of 10 mm and a thickness of 1.0 mm. Sandblasting with Al₂O₃ particles was employed to optimize the bonding process, significantly influencing surface roughness parameters (Ra, Rz, RSm). All specimens were bonded to the dentin analog using composite resin cement and subjected to either 10,000 thermocycles (TC) or storage (ST) at 37 °C in distilled water. Fracture load assessments were performed using a universal testing machine. A finite element analysis was conducted to assess stress distribution. <b>Results</b>: Two-way ANOVA results indicated that the manufacturing method significantly affected mean fracture load values (<i>p</i> < 0.001), with PRC showing the highest mean fracture load (4185 ± 914 N), followed by MRC (2495 ± 941 N) and CRC (599 ± 292 N). The aging protocol did not have a significant impact on fracture load. <b>Conclusions</b>: This study revealed that 3D-printed resin composite exhibited comparable strength to milled resin composite when adhesively cemented, suggesting it is a promising option for indirect composite restorations based on its mechanical performance. However, further research is needed to evaluate its bond strength and optimal surface treatment methods to prevent early debonding.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1940-1952"},"PeriodicalIF":1.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298115","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":"Practice-Based Management Data of Consecutive Subjects Assessed for the Median Arcuate Ligament Syndrome at a Single Tertiary Institution.","authors":"Stephanie Zbinden, Gabor Forgo, Nils Kucher, Stefano Barco","doi":"10.3390/clinpract14050151","DOIUrl":"10.3390/clinpract14050151","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of median arcuate ligament syndrome (MALS) is poorly understood. The diagnostic process remains inadequately standardized, with an absence of precise criteria to guide therapeutic management.</p><p><strong>Methods: </strong>We studied consecutive subjects referred to the Department of Angiology at the University Hospital of Zurich over the past 17 years due to suspected MALS. We focused on (1) the imaging criteria that led to diagnosis, notably the results of color duplex ultrasound and the consistency with different imaging tests; (2) the clinical consequences focusing on symptom resolution.</p><p><strong>Results: </strong>We included 33 subjects; in 8 subjects (24.2%), the diagnosis of MALS was retained. The median expiration peak systolic velocity (PSV) on ultrasound was 3.05 (Q1; 2.1-Q3; 3.3). To confirm the sonographic results, either a CT or MRI was performed on all patients, with consistent findings confirming a significant stenosis. Seven patients underwent surgery, all involving arcuate ligament release. Four procedures were laparoscopic, one was via laparotomy, and two were robot-assisted. Additionally, two patients required angioplasty with stenting as a secondary intervention. Only two (28.6%) of the seven operated patients experienced a relief of symptoms. None experienced a relief of symptoms following secondary angioplasty, despite stent patency. The prevalence of psychiatric disorders was comparable between patients with retained and rejected diagnoses, 38% and 36%, respectively.</p><p><strong>Conclusions: </strong>Our study confirmed sonography and CT/MRI consistency. However, most patients with MALS did not benefit from invasive treatment. The majority (83%) of patients without MALS were diagnosed with alternative conditions, mainly functional disorders.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 5","pages":"1911-1920"},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298128","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}