Clinica Terapeutica最新文献

{"title":"Comparative Efficacy of Buprenorphine Transdermal Patch Versus Tramadol in Postoperative Analgesia for Shoulder Arthroscopy: a Prospective, Randomized Controlled Trial.","authors":"Ahmed Elsawy, Atef Alfeky, Mohamed Elsayed Ali, Mohamed Hegab, Emad Mahmoud, Tarek Mohammed, Mahmoud Elsayed, Alaa Hassan, Ahmed R Ali, Ali Esmail, Osama Mandour, Mohamad Elghonimy, Mahmoud Selim, Osama Ramadan, Ahmed Sarhan, Mahmoud Elabd, Mahmoud Gadallah, Mohamed Allam, Mohammed Abdel Hameed, Mohamed Abdelrahman, Yasser Eita, Mohamed Mostafa, Marwa Abdel-Aziz, Naglaa Elshehawy, Samah Gaml, Ahmed Khalifa","doi":"10.7417/CT.2026.2000","DOIUrl":"10.7417/CT.2026.2000","url":null,"abstract":"<p><strong>Background: </strong>Shoulder arthroscopy is a regular surgery that usually results in a lot of post operative pain. Pain management is important in order to maximize both recovery and rehabilitation. Commonly applied are traditional analgesics (tramadol) but opioid analgesics can offer better pain relief with fewer side effects like buprenorphine.</p><p><strong>Aim: </strong>The hypothesis of the research study is that buprenorphine transdermal patches (TDBP) would be more effective in managing pain and have less adverse events than oral tramadol after shoulder arthroscopy.</p><p><strong>Methods: </strong>It was a prospective, randomized, controlled trial involving 70 patients who underwent shoulder arthroscopy and who were randomly assigned to either using buprenorphine (Group P) or tramadol (Group T). The main effects were the levels of pain at different time intervals (6, 12, 24, 48, and 72 hours), and the secondary ones were the level of patient satisfaction, occurrence of adverse effects, effective analgesia time, and effective use of analgesics.</p><p><strong>Results: </strong>Buprenorphine patients were found to rate pain as significantly low at 12 hours (2.57 vs. 3.11), 18 hours (3.11 vs. 4.03), and 72 hours (2.11 vs. 2.63). Patient satisfaction was significantly greater in the buprenorphine group (4.43 ± 0.56 vs. 3.40 ± 1.19, p = 0.01). The buprenorphine group had much less adverse effects such as nausea and vomiting. The effective analgesia time was greater in the buprenorphine group (18.60 ± 3.13 hours vs. 15.14 ± 2.02 hours, p = 0.03). Moreover, fewer rescue analgesics were used by the buprenorphine group (10.35 ± 3.45 mg vs. 18.12 ± 4.22 mg, p = 0.04).</p><p><strong>Conclusion: </strong>Buprenorphine transdermal patches are effective in pain relief, more patient-satisfied, and have less side effects than oral tramadol in the postoperative treatment of shoulder arthroscopy, which makes it a promising option in postoperative analgesia.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"231-238"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345691","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":"Spontaneous Complete Recovery of Bilateral Severe Sensorineural Hearing Loss After Two Years: A Rare Case Report.","authors":"Abduallah Alhassan Mawkili","doi":"10.7417/CT.2026.2017","DOIUrl":"10.7417/CT.2026.2017","url":null,"abstract":"<p><strong>Abstract: </strong>A 17-year-old female with a two-year history of severe bilateral sensorineural hearing loss (SNHL) of unknown cause experienced a rare and complete spontaneous recovery. Despite thorough diagnostic workup, including MRI imaging, no etiology was found, and the patient remained dependent on hearing aids. Remarkably, after two years of stable hearing loss, she regained normal hearing without any medical or surgical intervention. Follow-up audiometry confirmed restoration of normal auditory function in both ears. This case underscores the unpredictable nature of cochlear recovery and suggests that even chronic cases of SNHL may warrant long-term monitoring.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"373-375"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345623","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":"Early Postmortem Interval Estimation in Forensic Radiology: A Proof-of-Concept Study Using qMRMI and Tractography in a Porcine Heart Model.","authors":"Vncenzo Cianci, Cristina Mondello, Elisa Pappalardo, Tommaso D'Angelo, Marco Cavallaro, Annalisa Cracò, Alessio Cianci, Antonio Bottari, Antonino Germanà, Maria Cristina Guerrera, Patrizia Gualniera, Alessio Asmundo, Michele Gaeta, Daniela Sapienza","doi":"10.7417/CT.2026.2005","DOIUrl":"10.7417/CT.2026.2005","url":null,"abstract":"<p><strong>Abstract: </strong>Estimating postmortem interval (PMI) is a difficult task in daily forensic practice, because of all the limitations of most of the methods used for its determination. Over the years, numerous attempts have been conducted to overcome these limitations. Among these, the improvement and innovation of postmortem radiological techniques may play an important role. In this preliminary study, a novel approach for early postmortem interval estimation (ePMI) using quantitative magnetic resonance molecular imaging (qMRMI) is proposed. The study made use of a pig heart, whose anatomical and structural characteristics are known to be like those of humans. The sample was obtained from the commercial food chain, having been taken immediately after the animal was slaughtered. The pig heart was maintained at 17 °C degree. Radiological investigations have been conducted using a 1.5 T MRI scanner, and 2 scans have been performed. Fractional anisotropy (FA), tractography and susceptibility weighted changes due to the heart degradation processes have been monitored. The image acquisition was performed at 3.5 h after death (T0) and 24 hours after death (T1). Results showed measurable time-dependent variations, with FA and AD decreasing and ADC and RD increasing, because of the progressive disorganization of normal myocardiocytes architecture in the postmortem era. Although limited to a single case and two time points, this exploratory study suggests that postmortem qMRMI could be a potentially powerful tool for early PMI estimation. In the future, further studies with larger sample sizes and multiple intervals are needed to validate these preliminary observations.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"272-278"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345681","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":"Fifteen-Year Trends in Antimicrobial Resistance of Pseudomonas aeruginosa at a South Indian Tertiary Care Centre: A Retrospective Analysis.","authors":"Anand Acharya, Abinash Panda","doi":"10.7417/CT.2026.2010","DOIUrl":"10.7417/CT.2026.2010","url":null,"abstract":"<p><strong>Background: </strong>Pseudomonas aeruginosa (P. aeruginosa) remains a major nosocomial pathogen with dynamic and evolving antimicrobial resistance (AMR) profiles, particularly in resource-constrained settings. This study aimed to analyse 15-year trends in antimicrobial susceptibility of P. aeruginosa isolates at a tertiary care centre in South India to inform local empiric therapy and stewardship strategies.</p><p><strong>Methods: </strong>A retrospective observational study was conducted between 2010 and 2024, analysing P. aeruginosa isolates from 54,208 clinical specimens. Isolates were identified using standard microbiological protocols, and antibiotic susceptibility was assessed by Kirby-Bauer disc diffusion, interpreted as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Annual susceptibility rates were analysed using descriptive statistics and linear regression to assess temporal trends.</p><p><strong>Results: </strong>Among 17,517 culture-positive specimens, 2,225 (12.7%) were P. aeruginosa, predominantly from pus (52%) and respiratory samples (34.8%). Aminoglycosides (amikacin, tobramycin) exhibited the highest overall activity, with >70% susceptibility in later years. Significant improvements were observed in meropenem and piperacillin-tazobactam susceptibility over time, while imipenem showed a significant decline. Ceftazidime-avibactam, introduced in 2016, showed a steady increase to 51% in 2024. Conversely, imipenem demonstrated a significant decline (β = -0.83%/year, p = 0.0279). Ceftazidime, although initially low (3.5% in 2015), showed modest recovery by 2024 (32.2%).</p><p><strong>Conclusion: </strong>Over 15 years, P. aeruginosa at this South Indian centre demonstrated both encouraging reversals in resistance to key β-lactam agents and concerning declines in others like imipenem. High and sustained aminoglycoside efficacy supports their selective use in empirical regimens. These findings highlight the critical role of ongoing local surveillance, antimicrobial stewardship, and integration of advanced diagnostics to combat evolving AMR in high-burden settings.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"312-319"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345732","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":"Endoscopic Papillary Large Balloon Dilatation for Difficult Common Bile Duct Stones: Clinical, Radiological, Laboratory, and Anatomical Predictors of Procedural Success: A Prospective Pilot Clinical Trial.","authors":"Mahmod Ghoname, Samir Afifi, Abdulmabod Omar, S A Mashaal, Mohamed Eldabaa, Mohamed Flefel, Ahmed Elganzory, Saeed El-Nahaas, Osama Abd Elrazik, Mohammad Alwaseef, Mohammed Shaheen, El Jahin, Amir Eldamaty, Waleed Mousa, Abdellatif Elolimy, Mohamed Elawady, Sherif Hegab, Alaa Elgohary, Mohab Elsalahi, Wahid Kandil, Mohamed Elnemr, Ihab Orabi","doi":"10.7417/CT.2026.2001","DOIUrl":"10.7417/CT.2026.2001","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic papillary significant balloon dilatation (EPLBD) has become a convenient method of treating challenging common bile duct (CBD) stones, but predictors of success remain unresolved.</p><p><strong>Aim: </strong>To analyse clinical, laboratory, radiological, and anatomical effects on a single session of CBD stone clearance with EPLBD.</p><p><strong>Methods: </strong>It was a Prospective pilot clinical trial that enrolled 25 adult patients with tough CBD stones who had undergone conventional ERCP procedures in vain. Limited biliary sphincterotomy and EPLBD with 12-18 mm balloons were done on all patients. Clinical, biochemical, radiological, and anatomical parameters were evaluated prior to the procedure. The main result was the total clearance of CBD in one session. The secondary outcomes were complications, biliary stenting necessity, duration of procedures, and length of stay.</p><p><strong>Results: </strong>The complete clearance of the stone through a single session of complete CBD was reported in 16 out of 25 patients (64%). The complications associated with the procedure were minimal and affected three patients (12%), and were mild in nature; there were no cases of perforation or excessive bleeding. Multi-variable analysis revealed that the independent variables associated with procedural success were larger CBD diameter (OR 1.48 per mm increase, p = 0.012), better distal CBD angulation 135° and above (OR 3.92, p = 0.038), and large balloon size (OR 1.67 per mm increase, p = 0.008). There was no statistically significant correlation between demographic variables and laboratory baseline parameters and EPLBD outcomes.</p><p><strong>Conclusion: </strong>EPLBD is safe and can be highly applied to challenging CBD stones. Some of the main determinants of success are anatomical and procedural factors, and not clinical or laboratory variables.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"239-248"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345760","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":"Micronutrients Levels and Their Association with Osteoporosis and Depression in Elderly Hypertensive Patients: A Case-Control Study.","authors":"M Mohammed, H Alsayed, A Omar, A Mohamed, M Ghit, Zenat Khired, Maamon Aljonaid, N Elshewy, N R Mohammed, H Ismail, Y Gazar, A Elsherbiny, H Alshammari, W Abualkheir, M El Sayed, Kamal Ibraheem, M Abdel Mageed, Y Elgazzar","doi":"10.7417/CT.2026.2012","DOIUrl":"10.7417/CT.2026.2012","url":null,"abstract":"<p><strong>Background: </strong>Older hypertensive patients frequently presented with osteoporosis and depressive symptoms. Micronutrient imbalance may contribute to this overlap, yet the combined biochemical profile of this population remains underexplored.</p><p><strong>Objective: </strong>To determine whether serum vitamin D, calcium, and zinc levels differ between elderly hypertensive patients with osteoporosis and depressive symptoms and matched hypertensive controls.</p><p><strong>Methods: </strong>A case control study was conducted among one hundred hypertensive adults aged sixty years or older. Clinical assessments and fasting laboratory tests were performed. Independent t tests, correlation coefficients, and regression models were applied.</p><p><strong>Results: </strong>Cases showed significantly lower calcium (9.24 ± 0.50 vs 9.61 ± 0.36 mg/dL), vitamin D (33.82 ± 16.63 vs 46.24 ± 16.00 ng/mL), and zinc levels (0.0108 ± 0.0015 vs 0.0144 ± 0.0043 mg/L) than controls, with all comparisons reaching p < 0.001. Strong negative correlations were observed between micronutrients and lipid markers, including calcium with cholesterol (r = -0.312) and zinc with triglycerides (r = -0.301). In reduced regression models, lower calcium and zinc independently predicted case status.</p><p><strong>Conclusion: </strong>Elderly hypertensive patients with osteoporosis and depressive symptoms exhibit marked and clinically relevant reductions in calcium, vitamin D, and zinc. These findings identify key biochemical vulnerabilities that may warrant targeted nutritional assessment and intervention.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"326-332"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345839","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":"Impact of Adjuvants on Post-Spinal Urinary Retention: A Comparative Study of Dexmedetomidine and Fentanyl in Knee Arthroscopy.","authors":"Tamer F Abd Elsalam, Doaa Mohamed Almonayery Ibrahim, Samia Sayed Ahmed, Marwa Mahmoud Abdel-Aziz, Naglaa Abdelmomen Elshehawy, Mostafa R Bakry, Warda Demerdash Khalifa Ali, Samah Abdelaty Soliman Gaml, Suzan Mohammad Abdelkareem Mohammad, Fatma Mohamed Abdelaziz, Hend Mostafa Abosaifa, Amira Sobhy Khalil Eldeeb, Wafaa Ali Abd Elhadi Ali, Eman A Salem, Gehan Abd Elrh-Man Eldesoky, Taiseer Abdulnaser Mohamad, Amira Ibrahim Lashin, Hanaa A M Khalil, Hayam Shaaban Soliman Morsy, Marwa Ibrahim Eid, Rasha Lotfy Elsaied, Ain Elmarwa Abdelmonam Abdallah Hassan, Anas Fawzy Khalil, Osama Yehia A Khalifa, Abdelkarem Hussiny Ismail Elsayed","doi":"10.7417/CT.2026.1999","DOIUrl":"10.7417/CT.2026.1999","url":null,"abstract":"<p><strong>Background: </strong>Postoperative urinary retention (POUR) is a common complication following spinal anesthesia, especially when opioids are used as adjuvants. Dexmedetomidine, a selective α2-adrenergic agonist, has shown promise in reducing urinary complications while enhancing analgesia. Yet, direct comparative data with fentanyl in orthopedic day-surgery contexts is limited.</p><p><strong>Objective: </strong>To evaluate and compare the incidence of postoperative urinary retention and analgesic profiles associated with intrathecal dex-medetomidine and fentanyl when administered alongside bupivacaine in patients undergoing knee arthroscopy.</p><p><strong>Material and methods: </strong>A prospective, randomized, double-blind trial was conducted involving 70 ASA I-II patients undergoing knee arthroscopy under spinal anesthesia. Patients were randomly assigned to receive intrathecal bupivacaine with either dexmedetomidine (Group D) or fentanyl (Group F). Primary outcomes included the incidence of POUR and need for catheterization. Secondary outcomes were block characteristics, pain scores, and adverse effects.</p><p><strong>Results: </strong>Group D exhibited significantly lower incidence of POUR (5.7%) compared to Group F (28.6%, p = 0.011). Dexmedetomidine also resulted in faster onset of sensory block, longer motor block duration, and lower postoperative VAS pain scores. No significant difference in catheterization rates or adverse events was observed between groups.</p><p><strong>Conclusions: </strong>Intrathecal dexmedetomidine is superior to fentanyl in reducing POUR and enhancing postoperative analgesia for knee arthroscopy. Its use may optimize recovery protocols, particularly in ambulatory orthopedic surgeries.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"222-230"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345728","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":"Methicillin Resistant Staphylococcus Aureus Colonization, The Tip of the Iceberg for Congenital Pulmonary Airway Malformation. A Case Report.","authors":"Sulaiman Almunaifi, Mohammed Bayoumi, Aymen Elemmawie, Mahmoud Radwan","doi":"10.7417/CT.2026.1994","DOIUrl":"10.7417/CT.2026.1994","url":null,"abstract":"<p><strong>Background: </strong>Congenital Pulmonary Airway Malformation (CPAM) is a rare congenital anomaly of the lung that is infrequently diagnosed in the neonatal period, especially in preterm infants without prenatal detection. Methicillin-Resistant Staphylococcus aureus (MRSA) colonization and infection in preterm neonates can further complicate diagnosis and clinical progression.</p><p><strong>Aim: </strong>To describe a rare presentation of CPAM diagnosed in a preterm neonate following late-onset MRSA sepsis, emphasizing the diagnostic challenge and the interplay between infection and congenital malformation.</p><p><strong>Methods: </strong>We present a case report of a preterm female infant (28+3 weeks gestational age, birth weight 1100g), the second of twins, with an initially unremarkable postnatal chest X-ray. She developed clinical deterioration on day 17 of life, and investigations revealed MRSA colo-nization and positive tracheal aspirate cultures. Progressive radiological changes led to further imaging and diagnosis of CPAM. A systematic literature review was also conducted to identify similar cases of CPAM in preterm neonates.</p><p><strong>Results: </strong>Initial imaging showed no signs of pulmonary malformation. However, after the onset of MRSA-related late-onset sepsis (LOS), follow-up imaging revealed a multiloculated cystic lesion in the right upper lobe. A CT scan confirmed a differential diagnosis of CPAM type II versus necrotizing pneumonia. Surgical lobectomy was performed on day 40 of life, and histopathology confirmed CPAM type I with focal mucinous metaplasia. Postoperative recovery was successful, and the infant was discharged home in stable condition on day 90 of life.</p><p><strong>Discussion/conclusion: </strong>This case highlights the possibility that MRSA sepsis may serve as a trigger or unmasking event for underlying CPAM in preterm neonates. The absence of antenatal diagnosis and delayed radiological changes in this case emphasize the need for a high index of suspicion in the setting of localized pulmonary pathology during systemic infection. In reviewing the literature, this represents one of the few documented cases of CPAM in a preterm neonate without prenatal suspicion. Prompt recognition and multidisciplinary management are essential for optimizing outcomes in such complex cases.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"189-194"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345741","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 Efficacy of Hook Plates Around the Elbow: A Stable Fixation.","authors":"Georgios Touloupakis, Davide Morlacchi, Matteo Giribono, Marina Benedetta Polatti, Emmanouil Theodorakis, Maria Gabriella Lettera, Stefano Ghirardelli, Guido Antonini","doi":"10.7417/CT.2026.1998","DOIUrl":"10.7417/CT.2026.1998","url":null,"abstract":"<p><strong>Abstract: </strong>Hook plates are low-profile implants commonly used for olecranon fractures and osteotomies, offering stable fixation especially in complex or osteoporotic fractures. This study evaluates the clinical and functional outcomes of hook plate fixation around the elbow. We retrospectively analyzed 20 patients (mean age 52.7 years) treated between 2016 and 2023 for olecranon or distal humerus fractures using hook plates alone or combined with other implants. Inclusion criteria were patients aged 16 years or older with at least 12 months of follow-up. Exclusion criteria included ASA ≥ IV, open fractures, or involvement of the humeral head or wrist. Radiographic and clinical follow-up included elbow range of motion and validated functional outcome scores: Mayo Elbow Performance Score (MEPS), Oxford Elbow Score (OES), and Disabilities of the Arm, Shoulder and Hand (DASH). Fracture types included 10 olecranon, 9 distal humerus, and 1 combined injury. At a mean follow-up of 18 months, mean elbow flexion was 124.0°, with a mean extension deficit of 22.0°. Functional scores were: MEPS 77.8, OES 47.5, and DASH 50.7. One patient developed a postoperative fracture-related infection treated successfully with irrigation and hardware retention, while another experienced transient ulnar nerve symptoms that resolved spontaneously. No cases of heterotopic ossification were observed. These findings suggest that hook plate fixation around the elbow provides stable fixation with low complication rates and favorable functional outcomes. Further studies with larger sample sizes are necessary to confirm these findings.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"218-221"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345587","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":"Outcomes of adherence to play therapy in children with cerebral palsy: a clinical trial.","authors":"S Lakshmi, Renukadevi Mahadevan, Lianta Linus, Aron Raju, Mohamed Ahmed Mohamed, Fahad Abdulelah Mohammed Aldauyj, Salma Ebrahim Alnuaimi","doi":"10.7417/CT.2026.2018","DOIUrl":"10.7417/CT.2026.2018","url":null,"abstract":"<p><strong>Background: </strong>Cerebral palsy (CP)is an umbrella term covering a group of non-progressive, but often changing, motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of development. Play is an occupation of childhood. Through play children improve performance skills. Research shows that play therapy has a positive effect on improving motor skills in children. Games in a way stimulate the nervous system and make the child active, they create vitality and nerve readiness which cause excitement and interaction of sensory and perceptual parts and decision making in children.</p><p><strong>Objective: </strong>The primary objective was to determine adherence to a structured play-therapy program in children with CP. The secondary objective was to explore changes in hand/upper-extremity function following the program.</p><p><strong>Methods: </strong>This pilot, single-arm clinical trial recruited 12 children (5-13 years) with hemiplegic or diplegic CP from Sneha Kiran Spastic Society, Mysore. The intervention comprised institution-based play therapy (45 minutes/day, 5 days/week for 6 weeks) with a home component (2 days/week). Adherence was calculated as the percentage of prescribed sessions completed, with ≥75% predefined as adherent. Upper-extremity function was assessed using the Quality of Upper Extremity Skills Test (QUEST) before and after the program.</p><p><strong>Results: </strong>Institutional adherence ranged from 59% to 96% (mean 86.4%); 11/12 children met the ≥75% adherence threshold. Home adherence was lower (0%-83%). QUEST scores increased from 47.65 ± 14.47 (pre) to 48.51 ± 14.61 (post), with a statistically significant pre-post change on Wilcoxon signed-rank testing (Z = -1.992, p = 0.046).</p><p><strong>Conclusion: </strong>There was good adherence to play therapy (84.6%) in children with hemiplegic and diplegic cerebral palsy with age group of 6 to 12 years. There was significant improvement in hand function after 6 weeks of play therapy. Therefore, play therapy can be implemented in children with cerebral palsy. Larger controlled studies are warranted to confirm effectiveness and to address barriers to home adherence.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"376-383"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345077","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}