Clinica Terapeutica最新文献

{"title":"Systematic review of iatrogenic lesions during endoscopic procedures and medico-legal implications.","authors":"G Lacasella, I Aquila, M A Sacco, S Gualtieri, M A Karaboue, M Arcangeli","doi":"10.7417/CT.2025.5284","DOIUrl":"https://doi.org/10.7417/CT.2025.5284","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic procedures, while minimally invasive and generally safe, carry inherent risks, including the potential for iatrogenic lesions that can lead to significant complications and, in some cases, medico-legal implications. This narrative review with a forensic focus aims to evaluate the incidence, types, and medico-legal considerations of iatrogenic lesions resulting from endoscopic proce-dures, with an analysis of selected case studies to underscore clinical and forensic aspects.</p><p><strong>Methods: </strong>We assessed data from peer-reviewed publications focusing on complications associated with endoscopic procedures and other adverse outcomes, following a PRISMA-guided search for transparency.</p><p><strong>Results: </strong>Findings indicate that factors such as procedural complexity, patient comorbidities, and operator experience significantly influence the risk of iatrogenic injury. From a medico-legal perspective, delayed recognition or inadequate management of such lesions can lead to patient harm and subsequent legal actions. This review highlights the importance of meticulous technique, thorough informed consent, and prompt post-procedural assessment to mitigate these risks.</p><p><strong>Conclusions: </strong>By synthesizing insights from clinical cases with forensic analyses, this study underscores the need for enhanced procedural guidelines, improved training, and proactive risk management to minimize both patient harm and medico-legal repercussions associated with endoscopic procedures.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 5","pages":"691-700"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138948","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":"Correlation of soluble urokinase plasminogen activator receptor (suPAR) with HbA1c in predicting vascular complications in young adults - A cross sectional study.","authors":"A Sowmya, K Reshma, K Sudha, K Himaniv","doi":"10.7417/CT.2025.5266","DOIUrl":"https://doi.org/10.7417/CT.2025.5266","url":null,"abstract":"<p><strong>Background: </strong>suPAR is a soluble form of a membrane protein \"Urokinase-type plasminogen activator receptor\" which is connected by glycosyl-phosphatidylinositol present in a large number of \"immunologically active cells\". A number of clinical diseases have shown elevated serum suPAR levels, which increase with immune system activation. This study aimed to evaluate serum suPAR levels, serum creatinine, serum lipid profile and eGFR in patients with different levels of glycaemic control, and correlate suPAR concentration with study parameters across various groups of HbA1c.</p><p><strong>Methods: </strong>A cross-sectional study was done in the blood samples from 88 subjects in the age group of 25-40 years. These subjects were categorised into 4 groups based on their HbA1c levels namely prediabetes (Group 1). good glycemic control (Group 2), fair glycemic control (Group3), and normal glycemic control (Group 4). Serum creatinine was estimated by autoanalyzer. HbA1c was estimated using BIORAD D10 and estimation of total cholesterol, triglycerides, and HDL was done by semi-autoanalyzer. suPAR levels were estimated by ELISA. LDL was calculated from the Friedewald's equation and eGFR was calculated from the MDRD equation. Pearson's correlation analysis was done to find out the association of suPAR concentrations with the biochemical parameters in various groups.</p><p><strong>Results: </strong>Serum triglycerides, was highly significantly increased in good and fairly controlled diabetics (Groups 2 and 3)when compared to control group(Group 4). No statistical significance was observed between any two independent groups when suPAR was correlated with HbA1c. A negative correlation of suPAR with HDL and suPAR with eGFR in controls, prediabetic and fairly or good controlled diabetics was observed but not to the level of significance.</p><p><strong>Conclusion: </strong>Our study does not establish a correlation of suPAR in diabetic population with varying degrees of glycaemic control. It may also reflect that suPAR is not useful as a marker of inflammation in younger diabetics in particular.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 5","pages":"562-566"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139225","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":"A longitudinal study on Association of Alcohol-Induced Liver Dysfunction with Neurological Consequences and Clinical Implications.","authors":"Aradhya A Shetty, Balachandra A Shetty, Sneha B Shetty, K Bhagyalakshmi, A K Nayanatara, Aathish B Shetty","doi":"10.7417/CT.2025.5267","DOIUrl":"https://doi.org/10.7417/CT.2025.5267","url":null,"abstract":"<p><strong>Purpose: </strong>Alcoholism is a significant global public health issue associated with substantial morbidity and mortality. Chronic alcoholic liver disease (CLD) not only impacts hepatic function but also contributes to neurological complications. This study aims to explore the correlation between the amount and duration of alcohol consumption and the neurological manifestations in patients with CLD.</p><p><strong>Methods: </strong>The study included 110 participants with a history of alcohol consumption for at least five years and clinical evidence of CLD. Data were collected through structured questionnaires, clinical examinations, and medical records. Alcohol consumption was quantified in standard units, and liver function was assessed through laboratory and ultrasound findings.</p><p><strong>Results: </strong>The study included 110 participants aged 2284 years (mean age: 41.5 ± 11.9 years), with the majority in the 41-50 age group (33.6%). Males comprised 91.8% of the participants. Peripheral neuropathy was the most prevalent neurological manifestation, affecting 84.5% of participants. Patients with neurological manifestations had consumed alcohol for a significantly longer duration (13.9 ± 6.1 years) compared to those without (9.6 ± 4.6 years, p < 0.05). Liver function tests revealed elevated total bilirubin (median: 4.2 mg/dl), AST (median: 89 U/L), ALT, and ALP in 95.5% and 87.3% of cases, respectively. Hypoalbuminemia (<3.5 g/dl) and low globulin levels (<2.5 g/dl) were observed in 99.1% and all participants, respectively. Ultrasound findings showed chronic parenchymal liver changes in 60% of participants, fatty liver in 40%, and decompensated chronic liver disease in 40.9%. A strong positive correlation was found between the amount and duration of alcohol consumption (r = 0.728, p = <<0.001). The study found no significant gender differences in the prevalence of neurological manifestations (p = 0.627).</p><p><strong>Conclusions: </strong>The present findings underscore the need for targeted interventions to mitigate the neurological burden in patients with chronic alcoholic liver disease.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 5","pages":"567-572"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139262","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":"Euthanasia in Italy: A Comparative Analysis in the European Context.","authors":"M Marrone, F Pititto, G Pulin, R Bellacicco, N Nuzzo, D Isceri, A Dell'Erba, E Paladini","doi":"10.7417/CT.2025.5279","DOIUrl":"10.7417/CT.2025.5279","url":null,"abstract":"<p><strong>Background: </strong>The term \"euthanasia\" refers to medical procedures involving the direct administration of a lethal drug to a patient who requests it and meets specific legal and medical criteria. The legal and ethical debate surrounding euthanasia and assisted suicide remains a highly controversial issue across Europe, with significant variations in national legislation.</p><p><strong>Methods: </strong>This study provides a comparative analysis of the Italian legal framework on euthanasia and assisted suicide in relation to European regulations. Italy maintains one of the most restrictive legal stances, categorizing euthanasia as voluntary homicide (Article 579 of the Penal Code) and assisted suicide as a criminal offense (Article 580). The Italian referendum \"Free Until the End\" sought to legalize euthanasia through the partial repeal of Article 579 of the Penal Code. Despite constitutional rulings (Nos. 242/2019 and 135/2024) that in-troduced limited exceptions for assisted suicide under strict conditions, legislative progress has been minimal. In contrast, several European countries - including the Netherlands, Belgium, Luxembourg, Spain, and Portugal - have enacted comprehensive laws regulating euthana-sia and/or assisted suicide. Other nations, such as Germany, Austria, and Switzerland, have legalized assisted suicide while maintaining restrictions on active euthanasia. Recent developments in France and the United Kingdom signal an evolving legal landscape, while nations like Hungary and Norway uphold prohibitive stances.</p><p><strong>Results: </strong>The article critically examines the ethical and medico-legal implications of these disparities, emphasizing the role of palliative care and the physician's duty within end-of-life decision-making. It highlights the need for a more structured regulatory approach in Italy that balances the right to life with the principle of individual self-determination.</p><p><strong>Conclusions: </strong>The findings suggest that while legal frameworks across Europe continue to evolve, Italy must reconsider its rigid legal position to address the complex realities of end-of-life care, ensuring both the protection of life and respect for personal autonomy.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 5","pages":"665-671"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139277","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":"Correlation of RDW-CV and CEA Levels as Tumor Markers in the Incidence of Colorectal Cancer.","authors":"M I Rettobyaan, S Sampetoding, A A Zainuddin, P Prihantono, M Faruk","doi":"10.7417/CT.2025.5265","DOIUrl":"10.7417/CT.2025.5265","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) is the third most malignant cancer and has the second-highest mortality rate. Carcinoembryonic antigen (CEA) is commonly used as a CRC diagnostic and prognostic factor. Recently, many prognostic tumor markers, including red blood cell distribution width (RDW), have been identified, but few reports have focused on RDW coefficient of variation (CV). This study studied the correlation between RDW-CV and CEA levels in terms of CRC incidence.</p><p><strong>Material and methods: </strong>This study was conducted at Dr. Wahidin Sudirohusodo Makassar Hospital using an observational, retrospective approach. Data covering a 5-year span (2016-2020) was collected, then serum levels of RDW-CV and CEA in CRC patients were compared.</p><p><strong>Results: </strong>There was a correlation between RDW-CV and CEA. CRC patients had an average RDW-CV level of 34%, with a range from 6.0% to 30.20%, A total of 334 patients had high RDW-CV levels, whereas 49 patients had levels within normal limits. These patients had an average CEA value of 34 ng/mL, with a range between 0.34 ng/mL and 180 ng/mL. Three-hundred sixty-five patients had high CEA levels, and 18 patients had levels within normal limits. The patients with high RDW-CV scores all had high CEA scores. There were 31 patients with normal RDW-CV scores and high CEA scores. Finally, all 18 patients with normal CEA scores also had normal RDW-CV scores.</p><p><strong>Conclusion: </strong>Based on the results, RDW-CV has the potential to become a marker for CRC. Therefore, RDW-CV levels should be che-cked when there is suspicion of CRC.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 5","pages":"558-561"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139206","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":"Oral Health Conditions, Cytological Changes, and Prevalence of Opportunistic Fungal Growth in Patients with Chronic Kidney Disease Undergoing Haemodialysis. A Case-Control Study.","authors":"Nandita Shenoy, Mayoor V Prabhu, Ashok Shenoy, Junaid Ahmed, Nanditha Sujir, Akash Nayak Karopadi","doi":"10.7417/CT.2025.5264","DOIUrl":"10.7417/CT.2025.5264","url":null,"abstract":"<p><strong>Background: </strong>Chronic Kidney Disease (CKD) is an increasingly common health concern worldwide and is characterized by systemic signs such as hematologic changes, bone metabolic errors, and compromised immune status. It significantly impacts oral health, and there is a bidirectional relationship between CKD and various oral diseases.</p><p><strong>Objectives: </strong>This case-control study evaluated the state of oral health, cytological alterations, and opportunistic fungal growth, such as Candida, in CKD patients receiving dialysis ranging in age from 30 to 65 years.</p><p><strong>Materials and methods: </strong>A case-control study was conducted on 80 adult patients with CKD on dialysis attending KMC Mangalore. Forty adult patients with CKD on dialysis (experimental group) and 40 healthy adult volunteers (control group) were included in this study. Controls of the same age and sex were chosen from the Manipal College of Dental Sciences Mangalore. Oral health was evaluated clinically, and cytological smears were taken from the patients and subjects. Smears taken were sent for morphometric analysis of buccal mucosal cells and cultured to check for the growth of fungal species. Statistical analysis was performed using SPSS Version 13. A chi-square test was performed to compare categorical variables between the groups.</p><p><strong>Results: </strong>In our study, the average age of CKD patients was 45.65 ± 10.52 years, while the average age of controls was 42.6 ± 12.11 years. With a p-value of less than 0.001, CKD patients had significantly higher levels of creatinine and urea.There was a statistically significant correlation (p = 0.011) between educational attainment and chronic kidney disease (CKD); 17.5% of the control group held a graduate degree, whereas none of the CKD patients did. Of CKD patients, 42.5% experienced subjective dryness, and 35% reported dysgeusia. In 48.7% and 15.4% of CKD patients, respectively, moderate to severe changes in cell yield and cohesion were noted. In 41% of CKD patients, the nuclear to cytoplasmic ratio (NC ratio) increased. Among CKD patients, fungal growth was found in 5.1%, while it was absent in the control group. This difference was statistically significant.</p><p><strong>Conclusion: </strong>The study shows that there are notable variations in renal function markers and oral health between patients with chronic kidney disease (CKD) and controls. Specifically, CKD patients have higher levels of urea and creatinine, as well as more changes to oral epithelial cells and fungal development. In order to maintain a stable internal environment and homeostasis, oral health care providers should use a holistic approach to managing patients with complicated medical issues, particularly disorders of the renal system.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 5","pages":"550-557"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139275","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":"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":"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 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":"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}