Medical Science Monitor最新文献

BACKGROUND This study compared the clinical efficacy and complication profiles of classical midline versus paramedian incision techniques in coccygectomy for chronic refractory coccygodynia. We hypothesized that the paramedian approach would reduce wound-related complications and improve early postoperative pain and function. MATERIAL AND METHODS A retrospective cohort of 41 patients (32 women, 9 men) who underwent coccygectomy between 2015 and 2023 was analyzed. Patients were divided into a classical midline incision group (n=18) and a paramedian incision group (n=23). Outcomes included wound healing time, wound dehiscence, surgical site infections, intraoperative blood loss, visual analog scale (VAS) pain scores, and Oswestry Disability Index (ODI). Statistical comparisons were performed. RESULTS The paramedian group had significantly lower wound dehiscence rates than the midline group (0% vs 27.8%, P=0.01). There were fewer surgical site infections in the paramedian group than in the midline group (4.3% vs 22.2%), but the difference was not statistically significant (P=0.16). Early postoperative pain at 3 months was significantly lower in the paramedian group than midline group (mean VAS 3.22 vs 4.06, P=0.045). Long-term VAS and ODI scores showed no significant difference. Mean wound healing time was shorter in the paramedian group (4.46 vs 5.12 months), with higher, yet not significant, patient satisfaction. Intraoperative blood loss and operative duration were similar. CONCLUSIONS Both incision techniques offer comparable long-term outcomes. However, the paramedian approach provides better early pain relief and fewer wound complications, representing a safer, more effective alternative for refractory coccygodynia.

BACKGROUND Plantar fasciitis is a common cause of chronic heel pain. Corticosteroid injections provide short-term relief but carry long-term risks of fascia degradation. Zhengqing Fengtongning (ZQFTN), a sinomenine hydrochloride-based herbal extract, shows anti-inflammatory effects in musculoskeletal disorders, although evidence for plantar fasciitis remains limited. Ultrasound-guided injection enables precise pathological targeting. MATERIAL AND METHODS In this single-center RCT, 54 patients with chronic plantar fasciitis were randomized to ultrasound-guided ZQFTN (n=27) or corticosteroid (n=27) injections. Primary outcomes included VAS pain scores, AOFAS foot function, and plantar fascia thickness via ultrasound at baseline, 1 week, 1 month, and 3 months. RESULTS Both groups demonstrated significant improvements over time: within-group analyses showed progressive reductions in VAS scores (P<0.05) and increases in AOFAS scores (P<0.05) at all follow-up points, alongside significant thinning of plantar fascia thickness at 1 and 3 months (P<0.05). Between-group comparisons revealed that at 3 months, the observation group exhibited significantly lower VAS scores (P<0.05) and higher AOFAS scores (P<0.05) than the control group. Ultrasonographic measurements further indicated more pronounced reductions in plantar fascia thickness in the observation group at 1 month (P<0.05) and 3 months (P<0.05). CONCLUSIONS Ultrasound-guided injection therapy ensures precise targeting of the pathological fascia, with Zhengqing Fengtongning demonstrating superior long-term efficacy and a better safety profile compared to corticosteroids.

During the last century, there were four influenza pandemics, and in 1968, the A(H3N2) influenza virus caused the third-largest pandemic of the 20th century (Hong Kong 'flu). On December 10, 2025, the World Health Organization (WHO) reported a global increase in seasonal influenza, predominantly driven by the H3N2 subclade K (J.2.4.1) viral variant, which is now detected in most countries. On November 20, 2025, the European Centre for Disease Prevention and Control (ECDC) published an assessment of the threat posed by circulating H3N2 subclade K in the European Union and the European Economic Area (EU/EEA), which was identified in up to 50% of cases. On January 5, 2026, the US Centers for Disease Control and Prevention (CDC) reported that the 2025-2026 influenza season, which ended on December 27, 2025, reached a 30-year high in respiratory illness incidence. The 21st century has yet to experience a pandemic-level influenza outbreak. This editorial aims to highlight the status of infections caused by the H3N2 subclade K influenza virus and highlights the importance of influenza surveillance, monitoring, and the development of effective influenza vaccines.

BACKGROUND Misophonia provokes intense reactions to everyday sounds and is linked to sensory and psychiatric symptoms; the role of dissociation remains unclear, so we compared these features in adults with misophonia and controls. MATERIAL AND METHODS In a cross-sectional online survey, adults aged 18-65 years (n=86) were classified into a misophonia group (n=35) and controls (n=51) using the Misophonia Questionnaire (MisoQuest; cut-off ≥7). Sensory processing was assessed with the Adolescent/Adult Sensory Profile (A/ASP), dissociation with the Dissociative Experiences Scale (DES), and depression, anxiety, and stress with the Depression Anxiety Stress Scale-21 (DASS-21). Between-group comparisons used independent t tests or Mann-Whitney U and χ² (Monte Carlo when needed); associations used Spearman correlations; predictors were examined via hierarchical multiple regression (two-tailed alpha=.05). RESULTS The misophonia group scored higher than controls on misophonia symptoms, sensory sensitivity, avoidance, dissociative experiences, depression, anxiety, and stress (all P<.001). Misophonia symptoms correlated with sensory sensitivity (r=.717, P<.001), dissociation (r=.348, P<.001), and psychological distress (r=.440, P<.001). In regression, sensory sensitivity (ß=.308, P=.025), avoidance (ß=.319, P=.010), and seeking (ß=.239, P=.004) independently predicted MisoQuest scores; demographic and psychiatric covariates were non-significant (all P≥.05). CONCLUSIONS Misophonia is characterized by heightened sensory sensitivity and avoidance, with moderate links to dissociation, supporting routine assessment of these sensory and psychiatric domains.

Chemotherapy-induced peripheral neuropathy (CIPN) is the primary dose-limiting toxicity in albumin-bound paclitaxel chemotherapy regimens. Current assessment methods based on clinical scales are limited by strong subjectivity and insufficient sensitivity, while most emerging technologies remain in the preclinical stage. Therefore, the development of objective and non-invasive imaging biomarkers is urgently needed. This review focuses on the transformative role of non-invasive imaging techniques in addressing unmet clinical needs such as the accurate imaging assessment of CIPN, and systematically analyzes the complementary value of musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) in evaluating nervous system damage induced by albumin-bound paclitaxel-related CIPN. For key peripheral nerves including the radial nerve, ulnar nerve, median nerve, and common peroneal nerve, MSUS can visualize morphological abnormalities and hemodynamic changes in real time through high-frequency probes, enabling rapid, radiation-free anatomical assessment, and serial monitoring. MRI can detect early neurostructural damage, nerve edema, and abnormal nerve fascicle signals, while also evaluating soft-tissue lesions in the nerve trajectory area. Future research should conduct systematic validation of standardized imaging data to clarify the clinical value of these techniques as predictive biomarkers for risk stratification of CIPN. This article aims to construct a novel clinical diagnostic approach for CIPN, provide a more precise and efficient diagnostic pathway for patients with peripheral neuropathy symptoms, further support the timely formulation and implementation of targeted clinical treatment plans, and ultimately contribute to improving patient prognosis.

BACKGROUND Patellofemoral pain syndrome (PFPS) limits physical activity and quality of life, especially during weight-bearing tasks. Although high-load resistance exercises are recommended for rehabilitation, they may worsen symptoms in pain-sensitive individuals. Low-intensity blood flow restriction (BFR) training has emerged as a potential alternative. However, its effects on functional performance and mechanical properties remain unclear. MATERIAL AND METHODS In this assessor-blinded, randomized controlled trial, 41 individuals with PFPS were randomly assigned to either the experimental group (EG, n=20) or the control group (CG, n=19). The EG performed multi-joint resistance exercises combined with BFR, while the CG performed the same program without BFR. Both groups completed the same multi-joint resistance exercise program twice weekly for 6 weeks. Outcome measures included pressure pain threshold (PPT), muscle mechanical properties such as tone and stiffness in the vastus medialis and vastus lateralis, isometric knee extensor strength, and balance ability. Balance was evaluated using the Y-Balance Test and the stair-descending task. RESULTS The EG showed significantly greater improvements in knee strength, PPT, and balance (P<0.05). Notably, significant increases in muscle tone were observed in the vastus medialis and lateralis muscles, as well as muscle stiffness in the vastus medialis and semitendinosus muscles. CONCLUSIONS Low-intensity BFR multi-joint resistance exercise may be an effective intervention for improving physical function, pain, and mechanical properties in patients with PFPS.

BACKGROUND Clinical trials provide opportunities for patients with cancer to access novel treatment regimens in many developing countries. Next-generation sequencing (NGS) plays a key role in the treatment of various cancer types in today's clinical practice. The aim of this study is to investigate accessibility of clinical trials and NGS in Turkish oncology clinics. MATERIAL AND METHODS This cross-sectional survey was conducted among medical oncologists in 86 oncology centers across Turkey. Responses to a 14-item questionnaire were analyzed based on the centers. Final analyses included 86 oncology centers across 38 cities (n=86). These centers were classified as public (n=63) and private (n=23) hospitals and as those in the 3 largest metropolitan areas (n=33) or in other cities (n=53). RESULTS The median numbers of ongoing clinical trials were 1 (0-50) and 2 (0-50) in public and private hospitals, respectively (P=0.961), and clinical trials actively recruiting were 0 (0-42) and 0 (0-30) in public and private hospitals, respectively (P=0.862). Hospitals located in the largest metropolitan areas had significantly higher median numbers of ongoing clinical trials, 2 (0-50) vs 0 (0-25) (P=0.002), and actively recruiting trials, 2 (0-42) vs 0 (0-25) (P=0.008), compared with hospitals in other cities The availability of NGS was also higher in metropolitan hospitals (75.8%) than in other cities (20.8%) (P<0.001). CONCLUSIONS Geographic location creates significant inequalities in the number of clinical trials and access NGS in oncology centers, in contrast to the uniform coverage provided by general health insurance. Tailored region-specific improvements are required to enhance cancer care in Turkey.

BACKGROUND This retrospective study of 128 patients admitted to an intensive care unit (ICU) who required renal replacement therapy (RRT) aimed to compare outcomes from 3 treatment approaches: intermittent hemodialysis (IHD), continuous renal replacement therapy (CRRT) with heparin, and CRRT with citrate anticoagulation. MATERIAL AND METHODS We analyzed data from 128 medical histories of patients treated in the Department of Anesthesiology and Intensive Care of the Regional Specialist Hospital (RSH) in Olsztyn between January 2003 and December 2011. Depending on the type of renal replacement therapy and anticoagulation used, the patients were assigned to one of the 3 cohorts: cohort I - 41 patients receiving IHD (IHD), cohort II - 40 patients receiving CRRT with heparin anticoagulation (unfractionated and low-molecular-weight heparin) (HEP), and cohort III - 47 patients receiving CRRT with citrate anticoagulation (CITR). RESULTS No statistically significant differences were found in ICU, 90-day, in-hospital, and long-term mortality (ie, at the end of the observation period [31/12/2020]), between IHD, HEP, and CITR cohorts (P=0.744, P=0.763, P=0.833, P=0.958, respectively). Patients in the IHD cohort were significantly more likely to be dependent on long-term dialysis treatment than all the other patients combined after discharge from the hospital (P=0.001). CONCLUSIONS The renal replacement modality and the type of anticoagulation did not affect mortality. However, IHD was associated with a higher percentage of long-term dialysis-dependent patients after hospital discharge.

BACKGROUND Periscapular pain involves the muscles surrounding the shoulder blade, which can result from trauma, overuse or repetitive use, and poor posture. This study aimed to evaluate the prevalence of periscapular pain and the association between it and seating posture while using electronic devices, utilizing the American Shoulder and Elbow Score (ASES). MATERIAL AND METHODS This was a cross-sectional study conducted using an online questionnaire. The calculated sample size required 372 participants. The questionnaire was divided into 3 sections; sociodemographic information, risk factors for periscapular and shoulder pain, and ASES used for periscapular pain and disability assessment. RESULTS We included 379 patients. The lifetime prevalence of periscapular pain was 82.1%, and 48.5% reported current periscapular pain. Females were more likely to experience it (P value <.001). Most respondents who experienced periscapular pain worked in jobs that combined office and fieldwork (away from the office). Periscapular pain was significantly associated with forward tilt of the neck while using electronic devices (P=0.017). The mean ASES was 62.18. As age advances, worse ASESs were reported. CONCLUSIONS Periscapular shoulder pain is a very common and under-acknowledged problem among the general population, and poor posture while using an electronic device is significantly associated with periscapular pain.

BACKGROUND Although propofol is widely used for painless gastrointestinal endoscopy, cardiopulmonary adverse events associated with its use are still common. Ciprofol is a novel intravenous anesthetic with respiratory and hemodynamic stability. The aim of this study was to evaluate the benefits of ciprofol combined with nalbuphine for painless gastrointestinal endoscopy in reducing the occurrence of cardiopulmonary adverse events and improving postendoscopic recovery. MATERIAL AND METHODS In this single-center randomized study, a total of 128 patients undergoing painless gastrointestinal endoscopy were randomly assigned to 2 groups: propofol combined with nalbuphine or ciprofol combined with nalbuphine. All patients received 0.15 mg/kg nalbuphine intravenously before the study drugs were administered. The propofol group received a bolus of 2 mg/kg propofol intravenously, whereas the ciprofol group received a bolus of 0.4 mg/kg ciprofol intravenously. The primary endpoint was the incidence of intraprocedural cardiopulmonary adverse events (hypotension, bradycardia, and hypoxemia). RESULTS The ciprofol group demonstrated a significantly lower rate of cardiopulmonary adverse events during induction, compared with the propofol cohort (4.8% vs 18.7%; P=0.028). Furthermore, ciprofol administration was associated with lower procedural complications, including injection pain, cough reflex, and body movement (P=0.011). CONCLUSIONS Ciprofol-nalbuphine sedation demonstrates a superior safety profile, with fewer hemodynamic and respiratory perturbations and improved procedural tolerance, compared with propofol-nalbuphine in painless gastrointestinal endoscopy, while maintaining equivalent sedative efficacy and enhanced recovery characteristics.