Medical Science Monitor最新文献

{"title":"Development and Clinical Feasibility of a Computer-Assisted Shape Design and Bending System for Spinal Fixation Rods.","authors":"Xingye Li, Weijun Zhang, Zhongning Xu, Yongqiang Zhao, Yan An, Qingyun Li, Da He","doi":"10.12659/MSM.952722","DOIUrl":"10.12659/MSM.952722","url":null,"abstract":"<p><p>BACKGROUND Spinal pedicle screw-rod fixation is widely used, but manual rod bending is time-consuming and prone to contour inconsistencies. Although computer-assisted technologies have been explored, existing systems remain limited by cost, complexity, and insufficient precision. This study evaluated a novel computer-assisted rod design and bending system, with the goal of testing whether computer-assisted rod bending reduces bending plus installation time vs manual bending in unilateral paired cases and to evaluate safety, feasibility, and rod-screw fitting accuracy. MATERIAL AND METHODS A prospective trial enrolled 26 patients (18-75 years) undergoing spinal pedicle screw-rod fixation (≥4 segments) for fractures or degenerative diseases. Twenty patients received unilateral computer-assisted bending (contralateral manual for comparison) and 6 received bilateral assisted bending. The primary outcome was bending plus installation time; secondary outcomes included complications and fitting accuracy. Wilcoxon signed-rank test was used (P<0.05). RESULTS No instrument-related complications were observed (n=26; median age 60.5 years). For 20 unilateral cases, computer-assisted bending (183.3±70.8 seconds) was significantly shorter than manual bending (236.1±119.1 s; mean reduction 52.75 seconds, P=0.017). Subgroup analyses indicated signals of greater time savings in more than 4 segments (93.9 seconds, P=0.039) and BMI of 25 kg/m2 or higher (95.3 seconds, P=0.005), although these were exploratory and not adjusted for multiplicity. CONCLUSIONS The computer-assisted system reduced bending plus installation time vs manual bending, with no instrument-related complications. Subgroup findings were exploratory and require further validation.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e952722"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life and Symptoms of Anxiety and Depression Among Patients With Cancer: Insights From a Tertiary Care Hospital.","authors":"Maheen Ijaz, Adeel Aslam, Maham Fatima, Mudassir Anwar, Sumera Saeed Akhtar, Shazia Jamshed, Ayesha Iqbal, Wajid Syed, Naji Alqahtani","doi":"10.12659/MSM.952446","DOIUrl":"10.12659/MSM.952446","url":null,"abstract":"<p><p>BACKGROUND Cancer is a leading cause of global mortality and morbidity, accounting for millions of deaths each year. This study aimed to assess quality of life (QoL), examine the demographic, clinical, and psychological factors associated with QoL, evaluate the prevalence of anxiety and depressive symptoms, and assess the associations between treatment modalities and QoL domains among patients with cancer receiving anticancer therapy in Lahore, Pakistan. MATERIAL AND METHODS A cross-sectional study included 385 cancer patients using a convenience sampling. Data were collected using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, which assesses 4 QoL domains: physical well-being (PWB), social well-being (SWB), emotional well-being (EWB), and functional well-being (FWB). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression levels. RESULTS The median overall FACT-G score was 68 (IQR: 24), with EWB scoring the highest median of 19 (IQR: 7) and PWB the lowest at 14 (IQR: 12). SWB and FWB had median scores of 16 (IQR: 4) and 18 (IQR: 9), respectively. HADS results indicated that 56.1% of participants had normal depression scores, while 23.4% had high depression. For anxiety, 60% were in the regular category, and 15.3% had clinical anxiety. Higher levels of anxiety and depression were associated with poorer QoL across all domains. Educational level and sex were significantly associated with QoL. CONCLUSIONS Overall, patients with cancer maintained a moderate QoL, with particularly low PWB scores, highlighting the physical burden of cancer treatment. These findings highlight the importance of routine psychological assessment and supportive care to address the physical, emotional, and social needs of cancer patients during treatment.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e952446"},"PeriodicalIF":2.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Sexual Quality of Life and Associated Factors After Loop Electrosurgical Excision Procedure Versus Cold Knife Conization in 185 Sexually Active Women With Preinvasive Cervical Lesions.","authors":"Yesim Ozkaya Ucar, Taner Turan","doi":"10.12659/MSM.954246","DOIUrl":"10.12659/MSM.954246","url":null,"abstract":"<p><p>BACKGROUND Excisional treatment is widely used for preinvasive cervical lesions, but its effect on postoperative sexual quality of life remains uncertain. This study aimed to compare postoperative Sexual Quality of Life-Female (SQoL-F) scores and examine associated factors in women treated with cold knife conization or loop electrosurgical excision procedure (LEEP). MATERIAL AND METHODS This study included 185 sexually active women treated with cold knife conization (n=99) or LEEP (n=86) for histologically confirmed preinvasive cervical lesions during 2022-2024 and assessed at least 6 months postoperatively. The primary outcome was the total score on the validated 18-item SQoL-F questionnaire, transformed to a 0-100 scale. Between-group comparisons and multivariable linear regression with heteroskedasticity-consistent type 3 robust standard errors were performed. RESULTS Mean SQoL-F scores were similar after conization and LEEP (48.74±14.76 vs 49.70±12.76; P=0.640; Hedges' g=-0.07). In multivariable analysis, surgical technique was not associated with SQoL-F scores (ß=4.03; 95% confidence interval, -1.13 to 9.20; P=0.125). Age, marital status, weekly sexual frequency, family structure, preoperative sexual life perception, postoperative expectation, and body perception were associated with SQoL-F scores. The model explained 23.7% of the variance (R²=0.237), and internal consistency was high (Cronbach's alpha=0.886). CONCLUSIONS SQoL-F scores did not differ significantly between women who underwent cold knife conization and those who underwent LEEP. Several demographic, psychosocial, and interpersonal factors, rather than surgical technique, were associated with SQoL-F scores, although the cross-sectional design precludes causal inference.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e954246"},"PeriodicalIF":2.5,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Error Patterns of References Generated by Large Language Models in Endodontics: The Role of Prompt Design and Model Selection.","authors":"Mehmet Adıgüzel, Alparslan Mustafa Çeler","doi":"10.12659/MSM.953782","DOIUrl":"10.12659/MSM.953782","url":null,"abstract":"<p><p>BACKGROUND Large language models (LLMs) are increasingly used in healthcare; concerns persist regarding the accuracy of generated bibliographic references. The effect of prompt design on reference reliability has not been clearly established. This comparative experimental study evaluated the impact of prompt specificity on LLM-generated reference accuracy in endodontics and compared model performance. MATERIAL AND METHODS We used ChatGPT 5 and Claude Sonnet 4.6. Ten predefined endodontic queries were combined with 3 prompt types of increasing specificity. Each model generated 5 references per query-prompt combination (total: 300 references). References were verified using PubMed, Google Scholar, and CrossRef. Accuracy was classified as fabricated (0), partially accurate (1; existing references containing ≥1 bibliographic inaccuracy), or fully accurate (2). Digital object identifier (DOI) accuracy was assessed separately. Statistical analyses were performed using mixed-effects models and Pearson's chi-square test or Fisher's exact test. RESULTS Accuracy scores tended to increase with greater prompt specificity (P=0.249). Claude demonstrated significantly higher accuracy than ChatGPT (mean score: 1.79 vs 1.25; P<0.001). DOI accuracy did not differ among prompt groups (P=0.338); it was significantly higher for Claude than for ChatGPT (90.0% vs 35.3%; P<0.001). ChatGPT produced significantly more title, journal, and DOI errors (P<0.001); author and year errors were similar between models. CONCLUSIONS Prompt specificity had limited effects on reference accuracy; model selection played a greater role. DOI accuracy was strongly model-dependent and largely unaffected by prompt design under the test conditions, highlighting the need for external verification of LLM-generated references.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953782"},"PeriodicalIF":2.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetics-Informed Mapping Identifies a CRIM1-Associated Endocardial Inflammatory Remodeling State in Acute Myocardial Infarction.","authors":"Ruyi Ruan, Xiaofeng Xu, Quan Liu, Fu Xiang, Lan Luo, Lijie Shi, Quankun Yang","doi":"10.12659/MSM.953619","DOIUrl":"10.12659/MSM.953619","url":null,"abstract":"<p><p>BACKGROUND Acute myocardial infarction (AMI) reflects inherited susceptibility and inflammatory remodeling, but the cellular contexts linking genetic risk to disease remain unclear. MATERIAL AND METHODS We integrated a meta-transcriptome-wide association study (TWAS) with a human cardiac single-nucleus RNA-sequencing atlas contained 11 individuals (5 AMI and 6 donor) to identify genetics-informed cellular programs. Composite program states were defined by global score quartiles. A fixed 5-gene panel was evaluated for nucleus-level endocardial low-transcriptional-state (Endo_LTS) vs endocardial high-transcriptional-state (Endo_HTS) discrimination within the AMI endocardium using 5-fold leave-1-patient-out cross-validation. Functional follow-up used CRIM1 silencing in hypoxia-treated human induced pluripotent stem cell (hiPSC)-derived endocardial endothelial-like cells and complementary peripheral blood analyses. RESULTS The endocardium exhibited the most prominent infarction-associated increase in TWAS-anchored program activity, with expansion of program-high states and higher CytoTRACE scores. A consensus 5-gene panel (RPS8, PLEC, CFDP1, CRIM1, TNS2) was identified. Among 2163 AMI endocardial nuclei from 5 patients, the state classifier included 364 Endo_LTS and 751 Endo_HTS nuclei; 1048 Endo_MTS nuclei were excluded. Pooled out-of-fold ROC-AUCs ranged from 0.665 to 0.831. The panel also showed discriminatory value in an independent peripheral-blood AMI-vs-control cohort. CRIM1 was prioritized as a candidate linked to the remodeling program. CRIM1 silencing attenuated ACTA2/alpha-SMA, vimentin, LDHA, CCL2, and VEGFA and partially restored CD31, whereas TGF-ß remained elevated. CONCLUSIONS These findings identify a genetics-informed endocardial inflammatory remodeling state in AMI and define a 5-gene surrogate of its activated state. CRIM1 is prioritized as a candidate linked to selected inflammatory, metabolic, and structural outputs. Persistent TGF-b elevation after CRIM1 silencing argues against a simple linear regulatory model and indicates that further mechanistic validation is required.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953619"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of Astragaloside IV and Tetramethylpyrazine Promotes Angiogenesis via the MALAT1-CXCL12/CXCR4 Axis in Brain Endothelial Cells After Ischemic Injury.","authors":"Guangya Li, Yunwei Lu, Liuling Huang, Jingwen Zhu, Liling Li, Peize Li, Shanshan Li, Xiude Qin","doi":"10.12659/MSM.953474","DOIUrl":"10.12659/MSM.953474","url":null,"abstract":"<p><p>BACKGROUND Ischemic stroke causes severe neurological damage, and promoting angiogenesis in the ischemic penumbra is critical for neurovascular reconstruction and functional recovery. Astragaloside IV (AS-IV) and Tetramethylpyrazine (TMP) are a classic Chinese medicine combination for treating ischemic stroke, yet their synergistic mechanisms are unclear. This study aimed to investigate the enhanced effects of AS-IV combined with TMP on cerebral microvascular endothelial cells following ischemia-reperfusion injury and to explore the regulatory role of the lncRNA MALAT1-CXCL12/CXCR4 signaling axis. MATERIAL AND METHODS An oxygen-glucose deprivation/reperfusion (OGD/R) model was established using the bEnd.3 mouse brain microvascular endothelial cell line. Cells were treated with AS-IV, TMP, or their combination to evaluate therapeutic efficacy. Cell viability and migration capacity were assessed using CCK-8, wound healing, and Transwell assays. The expression levels of MALAT1 and angiogenesis-related markers (VEGFA, Ang1, Ang2, CXCL12, and CXCR4) were analyzed via qPCR, western blot, and immunofluorescence. To verify the mechanism, a stable MALAT1 knockdown model was constructed using lentiviral-mediated shRNA transduction. RESULTS OGD/R insult significantly reduced cell viability and migration, downregulated MALAT1 expression, and disrupted the Ang1/Ang2 balance. While AS-IV or TMP monotherapy partially mitigated these injuries, the combined treatment demonstrated a greater protective effect than either monotherapy. This enhancement was characterized by upregulation of MALAT1, activation of the CXCL12/CXCR4 pathway, and restoration of VEGFA and Ang1 protein expression. Furthermore, lentiviral-mediated MALAT1 silencing (shMALAT1) markedly impaired cell migration and angiogenic marker expression, effects that were partially rescued by the combined AS-IV and TMP intervention. CONCLUSIONS The combination of AS-IV and TMP exhibits an enhanced effect compared to either monotherapy in promoting endothelial migration and marker expression in vitro. These findings suggest that the protective mechanism is consistent with the involvement of the MALAT1-CXCL12/CXCR4 signaling axis. This study provides a preliminary cellular rationale for further in vivo validation of this combination therapy in rodent stroke models.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953474"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subgroup Differences in Agreement Between an Algorithm Guided Large Language Model and Routine Emergency Department Triage.","authors":"Ali Halıcı, Ezgi Cesur, Fikret Çelik","doi":"10.12659/MSM.953573","DOIUrl":"10.12659/MSM.953573","url":null,"abstract":"<p><p>BACKGROUND Large language models (LLMs) are increasingly discussed as decision-support tools in emergency care, but their agreement with routine emergency department (ED) triage and subgroup behavior remain insufficiently characterized. We evaluated an algorithm-guided LLM against routine ED triage with emphasis on subgroup heterogeneity and safety-relevant discordance. MATERIAL AND METHODS This retrospective study included 1960 adult ED visits with complete triage data. A standardized prompt provided age, sex, chief complaint, comorbidities, systolic/diastolic blood pressure, heart rate, oxygen saturation, temperature, and Glasgow Coma Scale. The LLM assigned 1 triage category within a 5-level Emergency Severity Index-based system (green, yellow-1, yellow-2, red-1, red-2). Outputs were compared with routine ED triage. Performance for urgent vs non-urgent classification was assessed using AUC, sensitivity, specificity, positive predictive value, negative predictive value, F1, and accuracy. Five-level agreement was assessed using quadratic weighted Cohen's kappa and accuracy. Discordance (lower- and higher-acuity LLM vs routine triage) was analyzed across prespecified subgroups. RESULTS LLM achieved 71.3% five-level accuracy and substantial agreement with routine triage (weighted kappa=0.824). For urgent/non-urgent classification, AUC was 0.768, sensitivity 0.630, specificity 0.906. Lower- and higher-acuity discordance rates were 9.8% and 18.9%. Discordance varied across subgroups; lower-acuity assignments vs routine triage were more frequent in older adults, trauma, and diabetes, while infectious presentations showed the highest concordance. CONCLUSIONS The algorithm-guided LLM showed substantial concordance with routine ED triage but non-uniform subgroup discordance, particularly lower-acuity assignments in patients with older age, diabetes, and trauma. As routine triage served as an operational comparator rather than a gold standard, findings reflect agreement with local practice, not definitive accuracy or safety. Prospective outcome validation is required.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953573"},"PeriodicalIF":2.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microwave Ablation for Granulomatous Lobular Mastitis: A Narrative Review.","authors":"Hongxi Yao, Longquan Li, Jieting Yin, Wanqun Li, Aili Saiding","doi":"10.12659/MSM.953292","DOIUrl":"10.12659/MSM.953292","url":null,"abstract":"<p><p>Granulomatous lobular mastitis (GLM) is a rare, chronic, and benign inflammatory breast disease predominantly affecting women of reproductive age. It is clinically characterized by breast masses, pain, erythema, and the potential development of abscesses and fistulas. The etiology remains complex, involving autoimmune responses, bacterial infections, and hormonal imbalances. Currently, there is no standardized consensus on the optimal management of GLM. Conventional treatment modalities, including systemic corticosteroids, immunosuppressants, and surgical excision, are frequently constrained by elevated recurrence rates, poor aesthetic outcomes, and severe systemic adverse effects. Consequently, there is an urgent clinical need for alternative, minimally invasive interventions. Microwave ablation (MWA) has emerged as a novel therapeutic approach that utilizes electromagnetic energy to induce localized coagulative necrosis of pathological tissues. This narrative review synthesizes recent clinical research to evaluate the potential efficacy and safety of MWA for treating GLM. Current preliminary evidence suggests that ultrasound-guided MWA may reduce the recurrence rate of GLM while achieving promising clinical and pathological remission rates. Furthermore, compared to traditional surgical and pharmacological therapies, MWA may offer advantages, including the preservation of breast tissue, improved cosmetic outcomes, reduced postoperative complications, and shorter recovery times. However, it is crucial to note that the current evidence base is limited by a small number of predominantly retrospective studies, a lack of long-term comparative data, and limited geographic diversity. Despite the necessity for specialized equipment, advanced operator expertise, and careful patient selection, MWA may serve as a promising and well-tolerated treatment option for managing GLM.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953292"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal Microbiota and Pelvic Floor Dysfunction: Mechanistic Insights and Therapeutic Implications.","authors":"Ruichen Wang, Wenyan Li, Bing Xie","doi":"10.12659/MSM.953348","DOIUrl":"10.12659/MSM.953348","url":null,"abstract":"<p><p>Pelvic floor dysfunction (PFD) encompasses a spectrum of prevalent chronic conditions, including urinary incontinence, pelvic organ prolapse, and female sexual dysfunction, arising from the impaired integrity of the pelvic floor muscles, ligaments, and connective tissues. The vaginal microbiota (VM) plays a critical role in maintaining mucosal barrier function and homeostasis within the lower reproductive tract. The integrity of the levator hiatus and urogenital hiatus maintains the closure of the pelvic floor and the stability of the VM. Emerging evidence indicates a bidirectional relationship between PFD and the VM, mediated through anatomical, hormonal-metabolic, and immunological pathways. Recent studies indicate that some of these interventions are associated with shifts in VM composition. Emerging evidence suggests that microbiota-targeted approaches, including probiotics and VM transplantation, demonstrate potential in restoring microbial balance and modulating local inflammatory responses in the lower genital tract. Although large-scale clinical trials are lacking, several studies have demonstrated that microbiota-targeted interventions, including probiotics, VM transplantation, and estriol-containing pessaries, can improve vaginal dysbiosis and modulate local inflammatory responses, with potential implications for PFD management. This review synthesizes current evidence on the interaction among the VM, pelvic floor supports, and PFD development, with a focus on underlying mechanisms and clinical associations, and discusses the potential role of microbiome-based diagnostics and therapeutics in PFD management. This article aims to review the roles and therapeutic implications of the VM and VM dysbiosis in PFD.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953348"},"PeriodicalIF":2.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Adding Muscle Energy Technique to Joint Mobilization on Pain, Range of Motion, and Shoulder Function After Arthroscopic Rotator Cuff Repair: An Observational Cohort Study.","authors":"Cui Xianchao, Zheng Xiuqiong, Chen Sheng, Li Wei, Huang Xiaoqun, Wei Chunxia","doi":"10.12659/MSM.953484","DOIUrl":"10.12659/MSM.953484","url":null,"abstract":"<p><p>BACKGROUND Although muscle energy technique (MET) and joint mobilization (JM) are individually used in shoulder rehabilitation, evidence for their combined application following arthroscopic rotator cuff repair (ARCR) remains limited. This study evaluated whether adding MET to JM yields superior outcomes compared with JM in patients after ARCR. MATERIAL AND METHODS Forty patients who underwent ARCR were enrolled in this observational cohort study and assigned to either a control group (n=20) receiving JM or an experimental group (n=20) receiving MET in addition to the same JM. Shoulder function was assessed using the University of California at Los Angeles (UCLA) shoulder rating scale, pain using the visual analog scale (VAS), and joint range of motion using active range of motion (AROM). Assessments were performed at baseline and after 4 weeks. RESULTS Baseline characteristics were comparable between groups (all P>0.05). Both groups improved significantly after the 4-week intervention (all P<0.001). However, the experimental group demonstrated significantly greater gains: lower VAS scores (1.45±0.69 vs 2.35±0.81, P<0.001), greater AROM in all directions (flexion P=0.021; abduction and external rotation both P=0.003; internal rotation P = 0.006), and higher UCLA shoulder rating scale scores (23.15±2.03 vs 19.05±2.26, P 0.001). CONCLUSIONS Combined MET and JM significantly improved shoulder AROM, reduced pain, and enhanced shoulder motor function compared with JM in patients after ARCR.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953484"},"PeriodicalIF":2.5,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}