Medical sciences (Basel, Switzerland)最新文献

{"title":"Exploring the Interplay Between Kidney Dysfunction and Cardiovascular Disease.","authors":"Rajesh Yadav, Aqsa Kaim Abubakar, Richa Mishra, Saurabh Gupta, Neelesh Kumar Maurya, Vivek Kumar Kashyap, Sarvesh Rustagi, Deependra Pratap Singh, Sanjay Kumar","doi":"10.3390/medsci13020080","DOIUrl":"10.3390/medsci13020080","url":null,"abstract":"<p><p>This article reveals the various types of complications that are associated with dialysis and kidney-associated disease, including left ventricular hypertrophy, heart failure, vascular heart disease, arrhythmias, diabetes mellitus, intradialytic hypertension, and coronary heart disease. The molecular mechanisms underlying the development of cardiovascular disease in patients with chronic kidney disease (CKD), including the role of nitric oxide (NO) signaling, have been extensively studied. Patients suffering from CKD need treatment with hemodialysis at the end stages. The kidney is considered the chief excretory organ in humans, which excretes various types of waste materials from the body and balances the acid-base ratio, due to which its role in homeostasis has been considered. When kidneys fail to function properly due to various diseases, hemodialysis plays the role of the kidneys. This procedure involves removing a patient's blood, filtering it through a dialyzer to remove waste products, and returning the cleaned blood to the body. However, for the hemodialysis procedure, fistula formation is necessary, which is created by specific surgery in which the radial artery and superficial vein are connected in the forearm, near the wrist or elbow. This arteriovenous (AV) fistula creation fails sometimes and causes complications. The prolonged use of hemodialysis procedures and improper care also lead to many complications in chronic kidney patients, which have been discussed in detail in this review article.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Efficacy of Low-Temperature Plasmas on Oral Biofilms: A Scoping Review.","authors":"Carson C Davis, Fabrízio Dias Panariello, Beatriz Panariello","doi":"10.3390/medsci13020079","DOIUrl":"10.3390/medsci13020079","url":null,"abstract":"<p><p>The rise of antibiotic resistance and the limitations of conventional therapies for managing biofilm-related oral infections highlight the urgent need for novel solutions, with low-temperature plasma (LTP) emerging as a promising alternative due to its potent antimicrobial effects, tissue-safety, and reduced risk of fostering resistance. This scoping review investigates the efficacy of LTP application for the management of oral biofilms associated with dental caries, peri-implantitis, endodontic infections, and oral candidiasis. This review was conducted in accordance with the PRISMA-ScR guidelines and registered with the Open Science Framework (OSF). Studies were identified through comprehensive searches of PubMed/MEDLINE, EBSCO (Medline Ultimate and e-journals), and Google Scholar, with no publication date restrictions, and were supplemented by manual reference screening. Eligible studies included original research, published in English, examining LTP's effectiveness in oral biofilms. After systematically screening the literature, 51 studies were included in this scoping review, comprising mostly in vitro research, alongside ex vivo, in situ, and clinical studies. Data extraction revealed LTP's broad-spectrum antimicrobial potential and promising clinical implications for dentistry. This review highlights key findings, identifies research gaps, and underscores the therapeutic potential of LTP in managing complex oral biofilm-related infections.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous Versus Intravenous Vascular Access in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Alhareth Alsagban, Omar Saab, Hasan Al-Obaidi, Marwah Algodi, Amy Yu, Mohamed Abuelazm, Chad Hochberg","doi":"10.3390/medsci13020078","DOIUrl":"10.3390/medsci13020078","url":null,"abstract":"<p><p><b>Background.</b> Establishing prompt vascular access facilitates resuscitation for out-of-hospital cardiac arrest (OHCA). While intraosseous access may decrease the time to vascular access, the impact on clinical outcomes in OHCA is unclear. Therefore, we aim to compare the effect of intraosseous (IO) versus intravenous (IV) vascular access on clinical outcomes after OHCA resuscitation. <b>Methods.</b> A systematic review and meta-analysis were performed to synthesize evidence from randomized controlled trials (RCTs) obtained from PubMed, CENTRAL, Scopus, and Web of Science until January 2025. Using Stata MP v. 17, we used the fixed-effects model to report dichotomous outcomes using the risk ratio (RR) and continuous outcomes using the mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42024627354. <b>Results.</b> Four RCTs and 9475 patients were included. There was no difference between both groups regarding the prehospital return of spontaneous circulation (ROSC) (RR: 0.97, 95% CI [0.91, 1.03], <i>p</i> = 0.33), maintained ROSC (RR: 0.94, 95% CI [0.87, 1.01], <i>p</i> = 0.09), survival to discharge (RR: 1.03 with 95% CI [0.88, 1.21], <i>p</i> = 0.71), 30-day survival (RR: 0.98, 95% CI [0.82, 1.17], <i>p</i> = 0.79), or favorable neurological recovery (RR: 1.07, 95% CI [0.90, 1.29], <i>p</i> = 0.44). However, IO access significantly increased first-attempt access (RR: 1.24, 95% CI [1.19, 1.29], <i>p</i> < 0.001), decreased time to vascular access (MD: -0.24 min with 95% CI [-0.48, -0.01], <i>p</i> = 0.04), and decreased time to drug administration (MD: -0.38, 95% CI [-0.66, -0.10], <i>p</i> = 0.01). <b>Conclusions.</b> IO and IV vascular accesses showed similar clinical outcomes in OHCA patients, with no difference in ROSC, survival, or neurological recovery. Still, IO access showed a better procedural outcome with increased first-attempt success rates, faster access, and faster drug administration.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confidential Audit of Perinatal Mortality in the Republic of Kazakhstan: A Pilot Study.","authors":"Aizada Marat, Zaituna Khamidullina, Svetlana Muratbekova, Kulyash Jaxalykova, Bekturgan Karin, Nazerke Samatova, Umit Usmanova, Madina Sharipova, Aknur Kobetayeva, Milan Terzic, Yesbolat Sakko, Gulzhanat Aimagambetova","doi":"10.3390/medsci13020077","DOIUrl":"10.3390/medsci13020077","url":null,"abstract":"<p><strong>Introduction: </strong>Perinatal mortality is labeled as the loss of fetuses at or beyond 22 weeks of gestation, deaths during labor and delivery, as well as early neonatal deaths. Appropriate medical care provided in the perinatal period is an integral indicator of high-quality medical care. Although developed countries managed to decrease perinatal mortality, it remains high in the developing world. This study aims to perform a confidential audit of perinatal mortality (CAPM) across Kazakhstani maternity hospitals.</p><p><strong>Methods: </strong>A descriptive, observational cross-sectional study was conducted from January 2024 to December 2024. The structure of the underlying causes of mortality in the antenatal, intranatal, and early neonatal periods among different maternity hospitals of the Republic of Kazakhstan was analyzed.</p><p><strong>Results: </strong>A total of 116 cases were assessed: 34 antenatal deaths, 6 intranatal, and 76 early neonatal. Most deaths occurred on the second day post-delivery. The analysis revealed that 93% of cases fell into categories indicating substandard or potentially inadequate care (categories 2 and 3). Intraventricular hemorrhage and sepsis emerged as leading causes of neonatal death. Among antenatal and intranatal deaths, significant proportions were associated with comorbid maternal conditions, insufficient antenatal visits, and inadequate perinatal support.</p><p><strong>Conclusions: </strong>CAPM proves to be a critical tool for identifying systemic gaps and guiding improvements in maternity services without attributing blame to health professionals. Findings underscore that many perinatal deaths could have been avoided with timely, evidence-based interventions across antenatal and neonatal care. Broader implementation and institutionalization of CAPM in Kazakhstan could lead to measurable reductions in perinatal mortality and improvements in maternal/newborn care outcomes. Factors such as preconception planning, improving the health of reproductive-age women, administration of folic acid, and reducing primary cesarean sections could assist in achieving the reduction in the perinatal mortality rate.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Yield of Next-Generation Sequencing for Rare Pediatric Genetic Disorders: A Single-Center Experience.","authors":"Milena Stoyanova, Dinnar Yahya, Mari Hachmeriyan, Mariya Levkova","doi":"10.3390/medsci13020075","DOIUrl":"10.3390/medsci13020075","url":null,"abstract":"<p><p><b>Background:</b> Next-generation sequencing (NGS), particularly whole-exome sequencing (WES), has become a powerful diagnostic tool for rare genetic conditions. However, its success rate varies based on the underlying genetic etiology and the population studied. <b>Methods</b>: This retrospective study evaluated the diagnostic yield of NGS in a cohort of 137 pediatric patients with suspected rare genetic disorders in Bulgaria, a setting where such testing is not reimbursed and must be self-funded. The patients underwent either WES or targeted gene panel testing based on clinical presentation, family history, and genetic evaluation. <b>Results</b>: The overall diagnostic yield was 45.99%, with WES achieving 51.25% and targeted testing achieving 38.60%. The highest yield was observed in patients presenting with both dysmorphic features and neurodevelopmental delays (62.5%), while the lowest was observed among those with isolated neurodevelopmental issues (10%). A significant portion of the identified variants (35.9%) were novel. Eight patients were diagnosed with copy number variants (CNVs) detected only through WES. <b>Conclusions</b>: Our findings illustrate the value of WES as a first-line test and highlight the impact of deep phenotyping on diagnostic success. This study also emphasizes the need for a population-specific reference genome and equal access to genomic diagnostics in all European countries.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It Advisable to Use Probiotics Routinely After a Colonoscopy? A Rapid Comprehensive Review of the Evidence.","authors":"Matteo Piciucchi, Alice Rossi, Alissa Satriano, Raffaele Manta","doi":"10.3390/medsci13020076","DOIUrl":"10.3390/medsci13020076","url":null,"abstract":"<p><p>About 5-20% of patients who undergo colonoscopy, in the days and weeks following the procedure, develop various symptoms (abdominal pain, bloating, and bowel alteration) mainly related to dysbiosis induced by the propaedeutic intestinal preparation. Some studies have positively evaluated the impact of the administration of different mixtures of probiotics in preventing and/or limiting this symptomatology. The aim of this review is to evaluate and summarize the available scientific evidence supporting the use of probiotics post-colonoscopy and to define their real efficacy as a routine treatment in a clinical setting.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Celiprolol in Vascular Ehlers-Danlos Syndrome: A Systematic Review of Current Evidence.","authors":"Pandit Bagus Tri Saputra, Wynne Widiarti, Paulus Parholong Siahaan, Rendra Mahardhika Putra, Johanes Nugroho Eko Putranto, Raden Mohammad Budiarto, Nadya Luthfah, Chaq El Chaq Zamzam Multazam, Mario D'Oria, Firas Farisi Alkaff","doi":"10.3390/medsci13020074","DOIUrl":"10.3390/medsci13020074","url":null,"abstract":"<p><strong>Objectives: </strong>Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders characterized by mutations affecting collagen and extracellular matrix proteins. Vascular EDS (vEDS) stands out for its severe prognosis due to the heightened risk of arterial and organ rupture which significantly increase mortality rates. Limited strategies for treating vEDS are prompting exploration for alternatives such as celiprolol, a cardioselective beta-blocker with potential to reduce vascular stress and improve collagen integrity. This review aims to evaluate current evidence on the impact of celiprolol in managing vEDS.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across scientific databases for studies comparing celiprolol with placebo or other treatments, focusing on relevant outcomes.</p><p><strong>Results: </strong>A total of 323 participants were included across studies published from 2010 to 2023, primarily conducted in European settings. Celiprolol administration, starting at 100 mg daily and titrated up to 400 mg, significantly reduced the incidence of major vascular events such as arterial dissections and ruptures. Most studies reported improved survival rates and fewer hospitalizations due to acute arterial events. Variations in treatment response and side effects such as dizziness and hypotension were noted across studies, occasionally leading to treatment.</p><p><strong>Conclusions: </strong>Celiprolol appears to be a promising treatment for reducing vascular events in vEDS patients, potentially improving quality of life and mitigating the substantial morbidity and mortality associated with vEDS. Future research should focus on refining treatment protocols, exploring mechanisms of action, and establishing comprehensive clinical guidelines to optimize patient outcomes.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Epithelial Inflammation in Membrane Remnants on the Outcome of Tympanoplasty.","authors":"María Fernanda Galindo-Tapia, Alejandro Esteban Deras-Quiñones, Itzel Maria Montoya-Fuentes, Eduardo Osiris Madrigal-Santillán, Ángel Morales-González, Naria A Flores-Fuentes, Liliana Anguiano-Robledo, Raúl Rojas-Martínez, Beatriz Montaño-Velázquez, José A Morales-González","doi":"10.3390/medsci13020073","DOIUrl":"10.3390/medsci13020073","url":null,"abstract":"<p><strong>Background: </strong>Chronic otitis media (COM) with tympanic perforation sometimes requires tympanoplasty. Many factors can interfere with surgical success; however, the histological status of the remaining epithelium of the perforation has not been studied as a risk factor for surgical failure.</p><p><strong>Methods: </strong>This was an observational, longitudinal, and analytical study in patients with COM, candidates for tympanoplasty who met the inclusion criteria, between August and December 2024. Tympanoplasty was performed, and the tympanic ring epithelium was sent for histological analysis. After 30 days, closure or non-closure of the perforation was determined, and the results were collected. Descriptive and analytical statistics were performed according to data distribution using the SPSS 26.0 statistical package.</p><p><strong>Results: </strong>Twenty subjects were included, 80% with tubal dysfunction, 60% with central perforation, and 65% with medium-sized. In total, 13 were successful, and 7 failed. Histopathological analysis revealed dystrophic calcification, chronic lymphocytic infiltrate, histiocytic infiltrate, fibrosis, loose keratin sheets, metaplasia, and spongiosis. The logistic regression model showed an OR of 7.3 for marginal perforation and 3.4 for the OPSS score. Of the patients with surgical failure, 57.4% had epithelial inflammation.</p><p><strong>Conclusions: </strong>epithelial inflammation affected surgical success in more than 50%.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twice as Effective? Pressurized Intra-Thoracic Aerosol Chemotherapy: New Frontiers in Pleural Mesothelioma.","authors":"Maria Giovanna Mastromarino, Elena Guerrini, Raffaele Guerrieri, Gianmarco Elia, Alessandra Lenzini, Vittorio Aprile, Greta Alì, Stylianos Korasidis, Marcello Carlo Ambrogi, Marco Lucchi","doi":"10.3390/medsci13020072","DOIUrl":"10.3390/medsci13020072","url":null,"abstract":"<p><p>Pressurized intra-thoracic aerosol chemotherapy (PITAC) is a novel and promising strategy for the treatment of malignant pleural effusion (MPE). PITAC enables effective pleurodesis while potentially exerting an antineoplastic effect by delivering chemotherapeutic agents as a therapeutic aerosol into the thoracic cavity via a nebulizer. Our preliminary study involved nine patients with unresectable pleural mesothelioma (PM) treated with PITAC. Among them, one case was particularly emblematic for demonstrating notable oncological improvements in addition to well-known palliative benefits. This patient underwent two PITAC procedures, one year apart, without perioperative complications. Redo pleural biopsies from both previous and new sites revealed only fibrous tissue and inflammatory cells, with no evidence of malignancy. Beyond achieving pleurodesis, PITAC-by combining cytotoxic and sclerosing effects-may offer effective local antineoplastic control and represent a promising avenue for enhancing loco-regional therapy in PM.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologically-Based Notions About Uterine Bleeding During Myomectomy: Reasoning on Tradition and New Concepts.","authors":"Andrea Tinelli, Giovanni Pecorella, Gaetano Panese, Andrea Morciano, Antonio Malvasi, Mykhailo Medvediev, Safak Hatirnaz, Radmila Sparic, Michael Stark","doi":"10.3390/medsci13020068","DOIUrl":"10.3390/medsci13020068","url":null,"abstract":"<p><p>Uterine fibroids represent a prevalent category of tumors encountered in females of reproductive age, may present as singular or multiple entities and can manifest a variety of symptoms, which can negatively affect women's daily lives. Pharmacological interventions may prove to be ineffective, occasionally costly, and associated with adverse effects. In instances where symptoms escalate in severity, myomectomy becomes a requisite as uterine-preserving operative therapy. Myomectomy can be performed utilizing laparoscopic, robotic, laparotomic, vaginal or hysteroscopic techniques. Given the abundant vascular supply to the myometrium, with blood being delivered to the uterus via the uterine arteries, myomectomy carries a considerable risk of significant hemorrhage during and subsequent to the surgical procedure, with the related complications. This paper aims to elucidate the conventional methodologies employed to mitigate hemorrhage during myomectomy and in the immediate postoperative phase, evaluating the effect of chemical interventions (such as vasopressin, octreotide, tranexamic acid, and uterotonics) alongside mechanical strategies (including uterine artery clamps, embolization, and tourniquets) to curtail bleeding during the myomectomy process. Furthermore, the potential of employing the intracapsular myomectomy technique without reliance on other traditional approaches was explored. This surgical method is grounded in the principles of the biological and anatomical characteristics of the fibroid, facilitating the enucleation of the myoma from its pseudocapsule. This anatomical entity, which is formed by the myoma throughout its development within the myometrium, enables the fibroid to be detached from the uterine musculature and supplies the requisite neurovascular support for its sustenance. Finally, the narrative review also shows how the intracapsular approach, which uses the fibroid's biology, reduces bleeding during myomectomy.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}