Medical Science Monitor最新文献

BACKGROUND Lumbodorsal fasciitis (LF) is a condition in which muscle and fascial lesions cause low back pain (LBP) and limited mobility. This retrospective study aimed to explore the efficacy and safety of ultrasound-guided fascial hydrodissection combined with eperisone for treating LF. MATERIAL AND METHODS A total of 103 patients with LF were selected and divided into a combined therapy (CT) group (ultrasound-guided fascial hydrodissection and oral drugs of eperisone) and single medication (SM) group (oral drugs of celecoxib and eperisone). Outcomes were evaluated using the visual analog scale (VAS) and Oswestry disability index (ODI) at baseline and at 2 weeks, 1 month, and 3 months after treatment. The adverse reactions and complications of the 2 groups were recorded. RESULTS There were no significant differences in the baseline characteristics of the 2 groups (P>0.05). After treatment, all scores showed a statistically significant improvement at 2 weeks and 1 month (P<0.05). The VAS and ODI scores showed a significant effect by time and group (P<0.001). The results also showed significant group-by-time interactions (P<0.001). Patients in the CT group had lower scores at any follow-up time (P<0.05). At 3 months, the scores slightly increased. There were no adverse reactions or complications in the CT group; however, the SM group had 4 cases of gastrointestinal reactions. CONCLUSIONS Ultrasound-guided fascial hydrodissection combined with eperisone therapy can effectively relieve LBP and improve lumbar function in treating LF. Moreover, this procedure is considered safe.

It is well established that breastfeeding provides significant health benefits for both the mother and the infant. The World Health Organization recommends initiating breastfeeding within the first hour after birth and continuing exclusive breastfeeding for 6 months. Successful breastfeeding is influenced not only by the proper physiological preparation of the body and the action of pregnancy-related hormones but also by the mother's overall health status. However, the role of maternal body composition and metabolic condition in breastfeeding success has received little attention. To better understand the impact of these factors on breastfeeding effectiveness, we reviewed the latest research on this topic, with particular emphasis on the role of hydration and lipid metabolism. Our narrative review indicates that the amount and distribution of water and adipose tissue are crucial for successful lactation and that various hormonal imbalances and metabolic disorders increase the risk of delayed breastfeeding initiation, shortened breastfeeding duration, or insufficient milk production. In light of our findings, measurement methods for assessing described parameters were also introduced. This article aims to review the effects of maternal body composition, hydration status, and metabolic and social factors on lactation and breastfeeding.

BACKGROUND Preventing oral diseases is a critical aim in maintaining general health. Non-dental professionals (NDPs) should understand oral health-related knowledge to help patients maintain oral and general health. We investigated the oral health knowledge, behaviors, and attitudes of NDPs regarding patient education and intersectoral collaborations for oral health. MATERIAL AND METHODS For this cross-sectional study, a web-based questionnaire of 36 questions was designed to collect characteristics, oral health knowledge, behaviors, and attitudes of spreading oral health knowledge. A total of 406 NDPs, including 166 doctors and 240 nurses, at 3 randomly selected hospitals in Chongqing, China, were included. Data were collected electronically and statistically analyzed using the chi-square test. RESULTS Only 35.96% and 39.41% of respondents disagreed with "extraction can cause loosening of adjacent tooth" and "tooth loss is a natural part of aging", respectively. Of the respondents, 92.12% were aware of oral healthcare needs before pregnancy; 67.48% agreed with cleaning the gums before the eruption of children's teeth; only 57.14% and 56.16% knew the start time of dental cleaning for children and the relatively safe period of dental treatment for pregnant women, respectively; 73.40% of respondents were interested in oral health knowledge, and they mainly consulted dental professionals; 95.56% agreed with intersectoral collaborations for oral health; and 68.47% thought to conduct oral health education in the future. CONCLUSIONS NDPs knew about common oral health knowledge; however, the oral healthcare knowledge for special groups was insufficient. NDPs should improve their ability to educate the public on oral health and establish intersectoral collaborations.

BACKGROUND Although Indigenous Taiwanese are generally known for having excellent athleticism and balance abilities, the correlation between foot characteristics and balance abilities has rarely been discussed. This study aimed to explore the characteristics of plantar pressure profiles associated with foot posture and balance abilities among Indigenous Taiwanese. MATERIAL AND METHODS We recruited 165 Indigenous college students and 183 healthy age-matched students. Bipedal static plantar pressure distributions (PPDs) with arch index (AI) and centers of gravity balance were examined using the JC Mat. Foot posture was determined by estimating the rearfoot postural alignment. RESULTS Indigenous Taiwanese in the study generally had low-arched feet with increased plantar loads at the medial (left: 1.21±0.43%; right: 1.20±0.46%) and lateral longitudinal arches (left: 24.51±5.26%; right: 24.45±6.64) (P<0.01) and the medial metatarsals (left: 21.78±3.81%; right: 22.19±3.91) (P<0.01). Footprint images illustrated pronounced cuboid and navicular collapses. Performances of balance abilities (left: 49.53±4.38%; right: 50.47±4.38) (P<0.01) and rearfoot postural angles (left: 1.37±1.25°; right: 1.32±1.17°) (P<0.05) were better than those of controls. CONCLUSIONS The feet in Indigenous Taiwanese had low arches and higher plantar loads at the medial and lateral longitudinal arches and medial metatarsals, while their centers of gravity were symmetrical and rearfoot posture was normal. These results may facilitate further studies on the relationship between foot characteristics, potential athleticism, and musculoskeletal injuries in Indigenous Taiwanese.

BACKGROUND Lumbar fusion and internal fixation techniques have shown promise in treating lumbar disc herniation (LDH), yet the impact on lumbar function in young patients remains unclear. This study aimed to investigate the impact of lumbar fusion on lumbar function in young patients. MATERIAL AND METHODS A retrospective analysis was conducted on 330 patients diagnosed with LDH admitted to our hospital. Patients were divided into 2 groups: a control group (n=264) that underwent a minimally invasive procedure with a keyhole lens, and a research group (n=66) that underwent lumbar fusion internal fixation. Clinical features and therapeutic outcomes were assessed using Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) Lumbar Scores before surgery and 12 months postoperatively. Additionally, intervertebral space height, degree of vertebral spondylolisthesis (grades I, II, and III), incidence of adverse effects, and treatment efficacy were measured pre-and post-surgically. RESULTS No significant difference in ODI and JOA scores was found between the groups before surgery (P>0.05). Postoperatively, the research group had lower ODI scores, higher JOA scores, and lower intervertebral space heights compared to the control group (P=0.001). While grade 1 and 2 spondylolisthesis showed slight improvement (P>0.05), a significant difference was observed in grade III spondylolisthesis between the 2 groups (P=0.001). Additionally, the research group had a lower incidence of adverse effects (P=0.049) and higher treatment efficacy, although the difference was not statistically significant (P>0.05). CONCLUSIONS Lumbar fusion with internal fixation produced better postoperative outcomes and fewer adverse effects than minimally invasive procedures in young patients with lumbar disc herniation.

BACKGROUND Anterior cruciate ligament (ACL) reconstruction commonly uses a hamstring tendon autograft, but the peroneus longus tendon can also be used. This study aimed to compare outcomes of anterior cruciate ligament reconstruction in 106 patients using peroneus longus tendon and hamstring tendon autografts. MATERIAL AND METHODS ACL repair was performed on 54 patients using a hamstring tendon autograft and 52 patients with a peroneus longus tendon autograft. Knee function was assessed using the International Knee Documentation Committee (IKDC) and Lysholm scores, while the ankle was evaluated using the American Orthopedic Foot and Ankle Score (AOFAS) and the Foot & Ankle Disability Index (FADI) scores. Donor-site morbidity and graft characteristics were compared. RESULTS There was no difference between the 2 groups in terms of knee IKDC and Lysholm scores (p=0.49, p=0.68, respectively). The diameter of the peroneus longus tendon graft (8.56±0.93) was significantly larger than the hamstring tendon (7.44±0.6) (p<0.001). The peroneus graft harvesting time was significantly shorter (p<0.001). Thigh hypotrophy and donor-site morbidity were significantly higher in the hamstring group (p<0.001 and p=0.006). The donor ankle AOFAS score was 93.46±3.8, and the FADI score was 93.48±4.6. No morbidity associated with the peroneus longus graft was observed. CONCLUSIONS Patients who underwent ACL reconstruction using the peroneus longus tendon experienced faster knee rehabilitation and less donor-site morbidity, such as thigh hypotrophy and knee pain. The peroneus longus tendon, with its larger diameter, fewer graft-related complications, and similar knee scores compared to the hamstring group, is considered a suitable alternative graft source.

BACKGROUND The relationship between different subgroups of type 2 diabetes (T2D) and the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis has not been thoroughly studied. This study aims to determine the association between T2D subgroups and the risk of developing advanced liver fibrosis using the Fibrosis-4 (FIB-4) index, a non-invasive marker for assessing liver fibrosis risk. MATERIAL AND METHODS A total of 1205 patients with T2D were categorized into 4 distinct subgroups: severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). The FIB-4 index was calculated for each patient to estimate the degree of liver fibrosis, with the following cutoff points: <1.3 indicating no or mild fibrosis, 1.3-2.67 suggesting moderate fibrosis, and >2.67 indicating advanced fibrosis (F3-F4). Logistic regression was used to compare the odds of advanced fibrosis across these subgroups. RESULTS The SIRD subgroup exhibited significantly higher odds of advanced liver fibrosis (F3-F4), compared with the other subgroups, as indicated by elevated FIB-4 scores (P<0.05). In contrast, the SIDD and MOD subgroups had lower odds of advanced fibrosis, while the MARD subgroup showed an intermediate association. CONCLUSIONS The findings suggest that the FIB-4 index, as a noninvasive assessment tool, effectively stratifies liver fibrosis risk among different T2D subgroups. This stratification can inform more personalized management strategies for patients with MASLD, underscoring the importance of accounting for the heterogeneity within T2D in clinical assessments of liver fibrosis risk.

Fractures are prevalent among the pediatric population, with approximately 1 in 3 children experiencing at least 1 fracture during childhood. Children are not just little adults; they have unique needs in pain management. With a lack of knowledge in pediatric pain management, medical staff primarily focus on the fractures, often overlooking and inadequately addressing pain. There is a scarcity of literature on acute fracture pain for children, while a wealth of literature summarizes chronic and tumor-related pain in children, which is not suitable for addressing pain caused by fractures. Therefore, a pain management literature review grounded in clinical experience is essential to provide guidance to doctors and parents on safely and effectively reducing the pain associated with children's fractures. We conducted a thorough review of existing literature and summarized treatment experiences into the 3 areas of pain assessment, non-pharmacological treatments, and pharmacological treatments. First, we evaluated and analyzed existing pain assessment methods, identifying the most suitable tools for different age groups. Second, we explored non-pharmacological treatments suitable for children with fractures to alleviate mild to moderate pain and reduce the need for analgesics. Lastly, we reviewed pharmacological treatments. For moderate pain, we recommend administering non-steroidal anti-inflammatory drugs. For severe pain, we suggest opioid medications, providing detailed information on usage and contraindications for different age groups. Therefore, this article aimed to review the evaluation and management of pain in children with bone fracture, and covers aspects of pediatric pain characteristics, pain assessment tools, pharmacological therapy, and non-pharmacologic therapy.

With medical technology development, endovascular intervention has been widely used in clinical practice, and the establishment of surgical access through the femoral artery, where most vascular interventions are performed, is a common method. Postoperative hemostasis at the femoral artery puncture site is a key part of interventional procedures and is particularly important to ensure the safety and effectiveness of hemostasis. Some patients undergoing interventional therapy also use anticoagulant and antiplatelet drugs preoperatively and undergo systemic heparin session intraoperatively, which leads to abnormal coagulation, thus increasing the difficulty of hemostasis at the puncture point postoperatively. Certain patients with specific conditions, such as combined vascular calcification, obesity, diabetes mellitus, and renal impairment, present more challenging cases for postoperative puncture point hemostasis. Femoral artery puncture site hemostasis methods include manual compression, arterial compression devices, and vascular closure devices, which are a kind of equipment that helps interventional doctors stop bleeding quickly at the femoral artery puncture site. From the 1990s to the present, vascular occluders with many different concepts and mechanisms have emerged. Based on different hemostatic principles and materials, the mechanisms and principles of action are varied and include sealant occlusion, collagen patch embolization, polyester suture closure, absorbable polyethanol embolic agents, nickel-titanium alloy clips, polydiethanol sealant embolization, and suture bioabsorbable patches. Many studies have compared the hemostatic effect of vascular closure devices with those of manual compression. In this article, we review the hemostatic effects of the 2 modalities and the advances in the use of vascular closure devices in vascular intervention.

Cardiac cachexia, the terminal stage of chronic heart failure, is characterized by severe systemic metabolic imbalances and significant weight loss, primarily resulting from skeletal muscle mass depletion. Despite the detrimental consequences, there is no standardized and clinically-approved intervention currently available for cardiac cachexia. In the context of cardiac cachexia, accelerated protein turnover, that is, inhibited protein synthesis and enhanced protein degradation, plays a crucial role in skeletal muscle wasting. This process is primarily mediated by various proteins encoded by atrogenes. Among them, the atrogene Trim63 (tripartite motif family 63) and its encoded protein MuRF1 have been extensively studied. This review article aims to elucidate the pathogenic mechanisms underlying skeletal muscle wasting in cardiac cachexia, describe the biochemical characteristics of MuRF1, and provide an overview of the investigation into MuRF1-targeting inhibitors. The ultimate goal is to offer novel strategies for the clinical treatment for skeletal muscle wasting associated with cardiac cachexia.