Clinica Terapeutica最新文献

{"title":"Physiopathology and pharmacological protection of periprosthetic bone.","authors":"L Molfetta, S Rosini, G Saviola, L Dalle Carbonare, M Muratore, M A Mazzei, N Malavolta, B Frediani","doi":"10.7417/CT.2025.5255","DOIUrl":"10.7417/CT.2025.5255","url":null,"abstract":"<p><strong>Abstract: </strong>Over the years, prosthetic surgery has seen improvements in materials, design, component fixation, and surgical techniques to optimize the bone-prosthesis interface. A prosthetic joint acquires a new normality, but may still develop joint pathology. Today, the pathogenetic mechanisms, clinical manifestations, and medical-surgical treatment of these complications are becoming increasingly well understood. In the last two decades, the concept of continuous implant monitoring has emerged, along with the potential for pharmacological protection if necessary. This begins with preoperative treatment of articular Bone Marrow Lesions (BMLs), followed by therapy addressing the postope-rative decrease in Bone Mineral Density (BMD) due to immediate stress shielding, and continues with constant bone remodeling over the years, ultimately addressing potential prosthetic joint pathologies. Thus, long-term prosthetic implant monitoring involves surveillance of bone metabolism and pharmacological treatment with antiresorptive agents, particularly bisphosphonates, as a prerequisite for implant longevity.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"504-511"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between insulin resistance and fibrotic liver changes in Ultrasound-detected Non-Alcoholic Fatty Liver Disease patients (case-control study).","authors":"A M M Omar, M A R Hussein, A M Ghazy, A M Ewis, H K A Mahrose, M E Abdelraouf, A A F Elfar, A H Shalaby, M E M Mahmoud, A F A E Elbwab, T A Shawky, A A H Ali, F M Elsayed, A A M Abotaha, A M S Nafie, H A A Aladl, K M Tayee, E Y A Aggour, M S Imam","doi":"10.7417/CT.2025.5247","DOIUrl":"10.7417/CT.2025.5247","url":null,"abstract":"<p><strong>Objectives: </strong>Insulin resistance is a hallmark of diabetes mellitus, which is intimately linked to non-alcoholic fatty liver disease (NAFLD). It is believed that NAFLD is a hepatic manifestation of metabolic syndrome. A significant prognostic importance is associated with liver fibrosis in non-alcoholic steatohepatitis (NASH). This study examined the association between insulin resistance and fibrotic alterations in the liver in individuals with nonalcoholic fatty liver disease (NAFLD) identified by ultrasound.</p><p><strong>Methods: </strong>Fifty individuals with NAFLD identified by ultrasonography and laboratory investigations (liver functions and lipid profile) and fifty healthy control participants were included in the research. For insulin resistance, Fasting blood glucose and insulin level were measured for calculation of \"homeostasis model assessment of insulin resistance\" (HOMA-IR).</p><p><strong>Results: </strong>We found that when basic fatty liver develops into NASH and the degree of fibrosis rises, insulin resistance statistically substantially rises as well along with increased liver functions, total cholesterol, triglyceride, LDL and decreased HDL and apoliprotein A1. Calculated HOMA-IR was statistically higher in group 1 compared to control group (7.8± 3.2 in group I vs in group II 0.9 ±0.2 with P <0.05).</p><p><strong>Conclusion: </strong>Patients with fibrosis who had NAFLD had elevated HOMA-IR values. One easy-to-measure indicator of fibrosis independently of other factors is HOMA-IR.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"445-450"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of modifications of complete mandibular dentures on the electrical activity of masticatory muscles in edentulous patients: an interventional analytical clinical study.","authors":"C Lamartine de Moraes Melo Neto, D Micheline Dos Santos, F Pereira de Caxias, I C de Sousa Ervolino, E V Freitas da Silva, J Siqueira Azarias, E Cinel Agostineli, M Coelho Goiato","doi":"10.7417/CT.2025.5241","DOIUrl":"10.7417/CT.2025.5241","url":null,"abstract":"<p><strong>Background: </strong>To assess whether two modifications of complete mandibular dentures (relining and restoration of the vertical dimension of occlusion, VDO) affect the electrical activity of the masseter and temporal muscles, bite force, and oral health-related quality of life in edentulous individuals.</p><p><strong>Materials and methods: </strong>Fifteen complete denture users were included. Evaluations of quality of life (Oral Health Impact Profile for Edentulous-OHIP-EDENT), bite force, and electromyography of the masseter and temporal muscles were performed at five different times: T1-original dentures; T2-after 18 days of using the relined mandibular denture; T3-after 18 days following the definitive restoration of the vertical dimension of occlusion; and T4 and T5-30 and 100 days after using the new dentures. A one-way analysis of variance (ANOVA) (time) was performed for each muscle's electromyography data and the bite force of each region. For the OHIP-EDENT, descriptive analysis (frequency of responses \"never,\" \"sometimes,\" and \"always\") for each question was followed by a non-parametric two-way Friedman ANOVA (p < 0.05).</p><p><strong>Results: </strong>There was no statistically significant difference between the time points for the electrical activity of the masseter and temporal muscles and bite force. The OHIP-EDENT showed that patients perceived less (or no) food retention under the mandibular denture and better fitting at T2, T3, T4, or T5 compared to T1. Additionally, at T2, patients reported more comfort while eating food and overall comfort with their dentures than at T1. At T3, patients reported difficulty chewing some foods, discomfort while eating, and uncomfortable dentures compared to T2.</p><p><strong>Conclusion: </strong>Relining the complete mandibular denture increased masticatory comfort, while the definitive restoration of the VDO caused discomfort for the patients. The modifications made before rehabilitation did not significantly alter the values of the electrical activity of the masseter and temporal muscles, as well as the bite force.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"399-407"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Treatment of Legg-Calve-Perthes Disease in Children: Comparative Effectiveness of the Method of Hardware Unloading and the Method of Tunnelization of the Femoral Head and Neck.","authors":"N Tuktiyeva, B Dossanov, A Dossanova, V Trofimchuk, Z Baubekov","doi":"10.7417/CT.2025.5245","DOIUrl":"10.7417/CT.2025.5245","url":null,"abstract":"<p><strong>Background: </strong>Legg-Calve-Perthes Disease poses a significant challenge in modern medicine. This study aimed to compare the efficacy of hardware unloading of the hip joint on an external fixation device and tunnelization of the femoral head and neck with autogenous cancellous bone grafting in the management of Legg-Calve-Perthes disease in pediatric patients.</p><p><strong>Methods: </strong>Conducted in Astana, Kazakhstan, from 2018 to 2022, the research involved 10 children diagnosed with Legg-Calve-Perthes disease (main group) and 15 patients using tunnelization of the femoral head and neck with autogenous cancellous bone grafting. The patients were stratified into 2 groups, each undergoing distinct treatment moda-lities: hardware unloading of the hip joint on an external fixation device method (10 patients), and method of tunnelization of the femoral head and neck with autogenous cancellous bone grafting (15 patients). Standardized clinical assessments, radiological evaluations, and functional tests were employed for comprehensive analysis.</p><p><strong>Results: </strong>The group undergoing hardware unloading of the hip joint on an external fixation device treatment exhibited statistically significant improvements in both clinical and radiological parameters compared to the other cohort. While the group using tunnelization of the femoral head and neck with autogenous cancellous bone grafting showed a beneficial effect, its efficacy fell short of that observed with hardware unloading of the hip joint on an external fixation device.</p><p><strong>Conclusions: </strong>The findings underscore the efficacy of hardware unloading of the hip joint on an external fixation device in the management of Legg-Calve-Perthes disease in pediatric patients.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"427-435"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone marrow edema in osteoarthritis and bone trauma. Diagnose and treatment.","authors":"G Saviola, S Rosini, L Molfetta, L Dalle Carbonare, N Malavolta, M A Mazzei, M Muratore, B Frediani","doi":"10.7417/CT.2025.5254","DOIUrl":"10.7417/CT.2025.5254","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow edema (BME) is a nonspecific response of bone to several different diseases with various pathogenesis or to traumatic events. At the moment BME can clearly be evidenced with RMI only, overall with T2 and STIR sequences, or with dual-energy CT scan. Osteoarthritis (OA) is the most frequent and disabling rheumatological disease affecting millions patients all over the world. Nevertheless traumatic events (TE) are also very common. Both conditions are able to induce BME, but in case of TE diagnosis can be often easy and immediate. Contrary, in OA, BME is not always present, depending on the subtype of the disease. Moreover a correct and meticulous anamnesis and a differential diagnosis with other rheumatological diseases should be performed to avoid false roads.</p><p><strong>Conclusions: </strong>Bisphosphonates (BPs), in particular Neridronate (NER) and Clodronate (CLO) are, at the moment, the most studied treatments for BME. However other cares with hyperbaric oxygen treatment or pulse electromagnetic fields can be also used in TE. In this review GEODEIT (Gruppo Edema Osseo, Diagnosi e Interventi Terapeutici), an italian scientific society discusses about diagnose and treatment of both, OA and TE conditions.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"498-503"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine atony and postpartum haemorrhage: predisposing genetic factors and postmortem findings.","authors":"V Cianci, C Mondello, D Sapienza, A D Genazzani, L Tornese, A Cianci, A Cracò, L Pepe, V Fiorentino, A Ieni, D Speranza, P Gualniera, A Asmundo, C Battipaglia","doi":"10.7417/CT.2025.5250","DOIUrl":"10.7417/CT.2025.5250","url":null,"abstract":"<p><strong>Abstract: </strong>Uterine atony (UA) represents a serious medical condition characterized by ineffective contraction of the uterine muscle after placenta delivery and is responsible for up to 80% of postpartum hemorrhages (PPH) worldwide. UA onset prediction before delivery is still an ongoing challenge, even if many risk factors for UA onset have been identified almost 50% of atonic PPH occur in women without identifiable antepartum risks, making high vigilance during labor essential for all the healthcare providers involved in labor assistance. To prevent the onset of UA in high-risk women, prophylactic measures such as active management of third stage of labor, presence of intravenous access during labor, and presence of cross-matched blood available are recommended. If UA occurs, a conservative management based on uterotonic drugs, tranexamic acid and intrauterine tamponade should be preferred while surgical methods such as arteries ligation or hysterectomy should be considered as a last resort. Finally, the influence of genetic factors on predisposing to the onset, severity, and variable responses to treatment of this pathology was analyzed. Among these genetic factors, it has been observed that mutations affecting the genes encoding for the oxytocin receptor (OXTRs), but also for \"uterine contraction-associated proteins\" (CAPs) such as connexin43, prostaglandin-endoperoxide synthase 2 (Ptgs2), Gap junction protein alpha 1 (Gja1) and COX-2 - determining an abnormal response to hypoxia - may be responsible for the development of postpartum haemorrhage (PPH) due to uterine atony (UA).</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"468-477"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Patient Education on Knowledge, Self-Efficacy, and Quality of Life in Chronic Obstructive Pulmonary Disease.","authors":"L Joseph, R Mahadevan, K S Rashmi, V S Raj","doi":"10.7417/CT.2025.5248","DOIUrl":"10.7417/CT.2025.5248","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a progressive inflammatory lung condition with no definitive cure. Acute exacerbations (AE) are critical events that accelerate disease progression, leading to significant deterioration in lung function, reduced health-related quality of life (HRQoL), and increased mortality risk. Effective disease education and self-management strategies play a vital role in mitigating these adverse effects.</p><p><strong>Objective: </strong>This study aims to assess the impact of patient education on disease knowledge using the Bristol COPD Knowledge Questionnaire (BCKQ), self-efficacy via the COPD Self-Efficacy Scale (CSES), HRQoL measured by the St. George Respiratory Questionnaire (SGRQ), and patient satisfaction through the Patient Survey Instrument (PSI). Additionally, the study evaluates the frequency of physician consultations and hospital admissions due to AE through monthly follow-ups over six months.</p><p><strong>Methods: </strong>This pre-post experimental study included 23 COPD patients and was conducted in three phases. The initial phase involved obtaining ethical clearance. The second phase focused on the development, translation, and validation of educational materials, including questionnaires and an educational booklet. The final phase comprised the assessment of patient knowledge, tailored education based on identified knowledge gaps, and follow-up evaluations of disease understanding.</p><p><strong>Results: </strong>Post-education analysis revealed significant improvements in disease knowledge (p=0.000), clinically and statistically meaningful enhancement in HRQoL (mean difference = 11.5, p = 0.003), and increased patient confidence (p=0.005). While consultation frequency remained statistically insignificant (p=0.635), hospitalization rates demonstrated a notable reduction (p=0.000). Patients in GOLD stage 2 exhibited the most pronounced improvements. Overall, 80% of participants expressed satisfaction with healthcare services, treatment, and therapist support.</p><p><strong>Conclusion: </strong>Targeted disease education and self-management interventions effectively enhance patient knowledge, self-efficacy, and HRQoL, while reducing hospitalization rates due to AE. These findings highlight the importance of integrating educational strategies into COPD management, particularly in the early stages of the disease.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"451-458"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and Depression among Hypertensive Patients and Its Effect on Medication Adherence.","authors":"A N Alkadi, A H Alajlani, A K Alnawah, F M Alturkie, A N Almutawah, E Elsheikh","doi":"10.7417/CT.2025.5244","DOIUrl":"10.7417/CT.2025.5244","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a prevalent chronic condition with significant health implications. Effective management critically relies on patient adherence to prescribed medication regimens. However, mental health disorders like anxiety and depression may influence adherence behaviors. This study aimed to examine the association between anxiety, depression, and medication adherence among hypertensive patients in Saudi Arabia.</p><p><strong>Methods: </strong>This cross-sectional study involved 296 hypertensive patients from ten primary health care centers in Al-Ahsa, Saudi Arabia. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depression levels, respectively. Medication adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8). Data were analyzed using descriptive statistics, chi-square tests, and multiple linear regression.</p><p><strong>Results: </strong>The prevalence of anxiety and depression varied, with 34.5% reporting mild anxiety, 22.0% moderate anxiety, and 30.4% mild depression. Medication adherence was suboptimal, with 49.3% classified as low adherence. A statistically significant association was observed between anxiety and medication non-adherence (p = 0.007), with higher anxiety levels linked to poorer adherence. However, the relationship between depression and adherence was not significant (p = 0.419). Multiple linear regression analysis confirmed anxiety as a significant negative predictor of medication adherence (B = -1.103, p = 0.016), while depression did not significantly influence adherence.</p><p><strong>Conclusions: </strong>The findings highlight the detrimental impact of anxiety on medication adherence among hypertensive patients in Saudi Arabia. Routine screening for anxiety and implementation of integrated care approaches addressing mental health concerns are crucial for improving adherence and overall disease management.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"418-426"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping systems and services through multi-stakeholder perspectives of mental health care provision through non-governmental organizations in Palakkad and Chennai districts of Southern India.","authors":"S Korakkottil, V Gopal, V C Sekaran, A Ramasamy","doi":"10.7417/CT.2025.5246","DOIUrl":"10.7417/CT.2025.5246","url":null,"abstract":"<p><strong>Background: </strong>India has a serious dearth of mental health experts in the field, with only 0.3 psychiatrists for every 100,000 people, far below the global average, which is significantly appearing as a barrier for SDG number 3. Mental health NGOs in India are crucial in filling this gap by providing essential services including counselling, therapy, and medication management and raising mental health awareness. This study aims to map the mental health services provided and explore the stakeholder perspectives on NGO-provided mental health services to identify facilitators and barriers to improving service delivery.</p><p><strong>Methods: </strong>This qualitative, multicentric exploratory study was conducted in two districts of Southern India, Palakkad in Kerala and Chennai in Tamil Nadu. The study mapped NGOs' mental health systems and services, drawing on the perspectives of 30 stakeholders, including key informants, psychologists, counsellors, social workers, volunteers, and psychiatrists. Data was collected between January and April 2024 following ethics clearance and analysed by manual coding and ATLAS.ti software trial version 24.1.0.</p><p><strong>Results: </strong>Thematic analysis revealed key challenges and facilitators, with stigma and funding constraints emerging as commonly discussed barriers, while community engagement and collaborative efforts were frequently cited as enablers of effective service delivery. The study identified the diverse mental health services provided by the NGOs in both places, such as direct counselling, teleconsultations, awareness classes, workshops, and community outreach sessions. Stakeholders highlighted effective community engagement, flexibility, continuous professional development, and strategic public-private partnerships as the facilitators for delivering good-quality services. Challenges for the service implementation included stigma surrounding mental health, competition in the field, and inadequate funding.</p><p><strong>Conclusion: </strong>By addressing identified barriers and leveraging facilitators, NGOs can significantly enhance mental health service provision and outcomes in Palakkad and Chennai districts. Effective communication, local language use, and increased collaboration, including enhancing Public-Private Partnerships, are essential for sustainable mental health initiatives.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"436-444"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Strategies for Hip Synovial Chondromatosis and Its Medico-Legal Implications.","authors":"G Basile, L Bianco Prevot, V Bolcato, M Basile, L P Tronconi","doi":"10.7417/CT.2025.5253","DOIUrl":"10.7417/CT.2025.5253","url":null,"abstract":"<p><strong>Abstract: </strong>Primary synovial chondromatosis of the hip is a rare pathology characterized by metaplastic changes in the synovium, leading to the formation of cartilage nodules and, eventually, free intra-articular bodies. Early manifestations, such as pain, stiffness, and limited mobility, require timely differential diagnostic process through imaging techniques, with magnetic resonance imaging being the gold standard diagnostic method, complemented by histopathological analysis. Considering the rarity of the condition, the diagnostic suspicion is linked to the expertise of the professional and the referral to specialized centers/professionals. While, the evolution toward minimally invasive surgical techniques and a multidisciplinary approach has improved clinical outcomes, the level of evidence in the different surgical approach are worthy of further long-term investigation. Furthermore, the definition of multidisciplinary diagnostic-therapeutic protocols based on evidence is of importance. In conclusion, the careful management of the condition, along with detailed docu mentation, is essential to minimize medico-legal implications associated with potential diagnostic delays, interpretative errors or improper surgical approach indication.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"495-497"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}