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Clin. Pract., Volume 13, Issue 3 (June 2023) – 15 articles

Cover Story (view full-size image): Dysregulation in serotonergic and noradrenergic systems may be implicated in the neurobiophysiological mechanisms underlying pain-related cognitive impairment in chronic whiplash-associated disorders (CWADs). This study aimed to unravel the role of serotonergic and noradrenergic descending pathways in cognitive functioning at rest and in response to exercise in people with CWAD. A single dose of Atomoxetine improved selective attention only in one Stroop condition, and a single dose of Citalopram had no effect on cognitive functioning at rest in people with a CWAD. Only without medication intake did selective attention improve in response to exercise, whereas both centrally acting medications worsened the cognitive performance of people with a CWAD in response to a bout of submaximal aerobic exercise. View this paper
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16 pages, 668 KiB  
Review
Effect of Exercise Training on Quality of Life, Symptoms, and Functional Status in Advanced-Stage Lung Cancer Patients: A Systematic Review
by Tena Nguyen, Katharine Tracy, Asad Ullah and Nagla Abdel Karim
Clin. Pract. 2023, 13(3), 715-730; https://doi.org/10.3390/clinpract13030065 - 13 Jun 2023
Cited by 1 | Viewed by 1800
Abstract
Advanced-stage lung cancer (LC) causes significant morbidity and impacts patients’ quality of life (QoL). Exercise has been proven to be safe, feasible, and beneficial for symptom reduction and QoL improvement in many types of cancers, but research is limited in advanced-stage LC patients. [...] Read more.
Advanced-stage lung cancer (LC) causes significant morbidity and impacts patients’ quality of life (QoL). Exercise has been proven to be safe, feasible, and beneficial for symptom reduction and QoL improvement in many types of cancers, but research is limited in advanced-stage LC patients. This systematic review evaluates the effect of exercise interventions on the symptoms and QoL in patients with advanced-stage LC. Twelve prospective studies (744 participants) were included, evaluating different combinations of exercises and training such as aerobics, tai chi, strength, inspiratory muscle training, and relaxation. Studies found outcomes including but not limited to improved QoL, symptom burden, psychosocial health, functional status, and physical function. The results of this review support that exercise is safe and feasible with evidence supporting improved QoL and symptom mitigation. Integration of exercise should be considered in the individualized management of advanced-stage LC patients under the guidance of their healthcare providers. Full article
(This article belongs to the Special Issue Thoracic Oncology in the Era of Precision Medicine)
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14 pages, 2273 KiB  
Article
The Perception and Awareness of the Public about Cancer and Cancer Screening in the United Arab Emirates, a Population-Based Survey
by Sarah Humaid Al-Shamsi, Abdulla Humaid Al-Shamsi, Mohammed Humaid Al-Shamsi, Adil Sajwani, Mouza Sultan Alzaabi, Omar Al Hammadi, Faryal Iqbal and Humaid O. Al-Shamsi
Clin. Pract. 2023, 13(3), 701-714; https://doi.org/10.3390/clinpract13030064 - 13 Jun 2023
Viewed by 3194
Abstract
The United Arab Emirates (UAE) has one of the fastest growing economies in the world, which has resulted in an increase in the detection of noncommunicable diseases such as cancer. Despite its screening and early detection efforts falling short of the target coverage [...] Read more.
The United Arab Emirates (UAE) has one of the fastest growing economies in the world, which has resulted in an increase in the detection of noncommunicable diseases such as cancer. Despite its screening and early detection efforts falling short of the target coverage of the intended population, the number of reported cases and deaths in UAE has increased over the years. A few studies have been conducted to understand the hurdles to cancer screening in UAE, mostly focusing on breast and colorectal malignancies. There are no studies or surveys that have addressed the barriers and hurdles to overall cancer screening in UAE’s population. Through this is the largest survey to date, we aimed at assessing UAE society’s perception of cancer and early screening and detection. The survey was constructed using the SurveyPlanet platform. The survey was then distributed on social media for direct and snowball sampling, including Instagram, WhatsApp, LinkedIn, Meta (Facebook), and Twitter. Interestingly, 71.3% of the respondents reported that they were fine mentioning or discussing cancer, while 28.2% reported that they were not comfortable with it. Moreover, 91.8% of the respondents knew the meaning of the early detection or screening of cancer, while 8.2% did not. The ability of respondents to correctly identify different types of cancer screening varied. This study suggests that regulatory authorities need to raise more awareness about cancer, especially among younger generations, and create screening recommendations and guidelines that should include younger people. Lastly, hospitals, cancer charity organizations, educational institutes, and the media should address target audiences to raise cancer awareness among them. Full article
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17 pages, 2080 KiB  
Article
The Role of Serotonergic and Noradrenergic Descending Pathways on Performance-Based Cognitive Functioning at Rest and in Response to Exercise in People with Chronic Whiplash-Associated Disorders: A Randomized Controlled Crossover Study
by Iris Coppieters, Jo Nijs, Mira Meeus, Margot De Kooning, Emma Rheel, Eva Huysmans, Roselien Pas, Wouter Van Bogaert, Ives Hubloue and Kelly Ickmans
Clin. Pract. 2023, 13(3), 684-700; https://doi.org/10.3390/clinpract13030063 - 06 Jun 2023
Cited by 1 | Viewed by 1278
Abstract
(1) Background: Dysregulation in serotonergic and noradrenergic systems may be implicated in the neurobiophysiological mechanisms underlying pain-related cognitive impairment in chronic whiplash-associated disorders (CWAD). This study aimed to unravel the role of serotonergic and noradrenergic descending pathways in cognitive functioning at rest and [...] Read more.
(1) Background: Dysregulation in serotonergic and noradrenergic systems may be implicated in the neurobiophysiological mechanisms underlying pain-related cognitive impairment in chronic whiplash-associated disorders (CWAD). This study aimed to unravel the role of serotonergic and noradrenergic descending pathways in cognitive functioning at rest and in response to exercise in people with CWAD. (2) Methods: 25 people with CWAD were included in this double-blind, randomized, controlled crossover study. Endogenous descending serotonergic and noradrenergic inhibitory mechanisms were modulated by using a single dose of a selective serotonin reuptake inhibitor (Citalopram) or a selective norepinephrine reuptake inhibitor (Atomoxetine). Cognitive performance was studied at rest and in response to exercise (1) without medication intake; (2) after intake of Citalopram; and (3) after intake of Atomoxetine. (3) Results: After Atomoxetine intake, selective attention improved compared with the no medication day (p < 0.05). In contrast, a single dose of Citalopram had no significant effect on cognitive functioning at rest. When performing pairwise comparisons, improvements in selective attention were found after exercise for the no medication condition (p < 0.05). In contrast, after intake of Citalopram or Atomoxetine, selective and sustained attention worsened after exercise. (4) Conclusions: A single dose of Atomoxetine improved selective attention only in one Stroop condition, and a single dose of Citalopram had no effect on cognitive functioning at rest in people with CWAD. Only without medication intake did selective attention improve in response to exercise, whereas both centrally acting medications worsened cognitive performance in response to a submaximal aerobic exercise bout in people with CWAD. Full article
(This article belongs to the Special Issue 2023 Feature Papers in Clinics and Practice)
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14 pages, 722 KiB  
Article
“The Key Is to Value Every Little Achievement”: A Qualitative Study of the Psychological Experience of Parent Caregivers in Paediatric Palliative Care
by Alexandra Jóni Nogueira and Maria Teresa Ribeiro
Clin. Pract. 2023, 13(3), 670-683; https://doi.org/10.3390/clinpract13030062 - 06 Jun 2023
Cited by 1 | Viewed by 1389
Abstract
In Europe, Portugal has been identified as the country with the most rapid evolution of paediatric palliative care provision, which is a highly complex experience for families. The present descriptive–exploratory study seeks to contribute to the understanding of the psychological experience of life-limiting [...] Read more.
In Europe, Portugal has been identified as the country with the most rapid evolution of paediatric palliative care provision, which is a highly complex experience for families. The present descriptive–exploratory study seeks to contribute to the understanding of the psychological experience of life-limiting conditions in parent caregivers. A total of 14 families completed a sociodemographic and clinical data sheet and answered a structured online interview based on an incomplete narrative resulting from the Unwanted Guest Metaphor. A thematic analysis of the various narratives was performed through an inductive–deductive process. The results provide a holistic view of 10 essential dimensions in the parental psychological experience and contribute to the design of intervention methodologies in an eco-systemic approach. The importance of clear communication with health professionals, an awareness of the unpredictability of the disease, the desire for more self-care, the difficulty in understanding their children’s needs and the threat implicit in everyday life are some of the main findings. This research emphasizes the importance of having opportunities of emotional expression and psychoeducation about anxiety’ management, enhancing the perception of positive characteristics in children with palliative needs and creating time for the couple. The study has some limitations, such as the small sample size, and suggests that further research should explore the father’s experience. Full article
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4 pages, 210 KiB  
Editorial
Clinics and Practice: Consolidating Best Practices in Periodontal Management
by Francesco D’Ambrosio
Clin. Pract. 2023, 13(3), 666-669; https://doi.org/10.3390/clinpract13030061 - 02 Jun 2023
Viewed by 1099
Abstract
Periodontitis is a multifactorial inflammatory disease [...] Full article
10 pages, 868 KiB  
Article
Awareness of Anterior Cruciate Ligament Injury—Preventive Training Programs among Saudi Athletes
by Ali H. Alyami, Hussam Darraj, Sulaiman Hamdi, Abdulaziz Saber, Nawaf Bakri, Rawan Maghrabi, Khalid M. Hakami and Anwar Darraj
Clin. Pract. 2023, 13(3), 656-665; https://doi.org/10.3390/clinpract13030060 - 29 May 2023
Cited by 1 | Viewed by 1636
Abstract
Background: Anterior cruciate ligament (ACL) tear is a common medical condition that entails a stretch or sprain of the ACL, which is present in the knee joint. The incidence of ACL injury in the Kingdom of Saudi Arabia is estimated to be 31.4%. [...] Read more.
Background: Anterior cruciate ligament (ACL) tear is a common medical condition that entails a stretch or sprain of the ACL, which is present in the knee joint. The incidence of ACL injury in the Kingdom of Saudi Arabia is estimated to be 31.4%. Prevention training programs (PTPs) can be used to reduce ACL injuries sustained during physical activity, as they primarily focus on improving strength, balance, and lower limb biomechanics and reducing landing impact. This study aimed to assess Saudi athletes’ awareness of ACL injury PTPs. Methods: A cross-sectional survey in the form of a self-administered questionnaire in the Arabic language was carried out from 22 December 2022 to 7 March 2023 and included 1169 Saudi athletes. Statistical analyses were performed on the collected data using frequency and percentages. Binary logistic regression was used for the adjusted analysis and determining associations between athletes playing high- and low-risk sports. Results: Overall, 52% of participants were female athletes, and 48% were male athletes. The western region of the country had the highest response rate (28.9%). The most common sport played was football at 36.6%. Most participants (70.97%) reported that their information on ACL injury was taken by their coaches. When assessing whether participants were familiar with the concept of an ACL injury PTP, the majority of the participants answered no, representing 971 (662 high-risk, 309 low-risk), compared to those who answered yes, representing only 198 (167 high-risk, 31 low-risk), with a statistically significant difference (adjusted OR: 2.106; 95% confidence interval: 1.544–2.873; p-value < 0.001). Conclusion: In general, the level of awareness of ACL injury PTPs among Saudi athletes was poor. Full article
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8 pages, 458 KiB  
Article
The Efficacy of Regeneration Oil and Almond Oil on Split-Thickness Skin Graft Donor Sites: A Single-Blinded Randomized Controlled Trial
by Karoline Riedler, Andrzej Hecker, Birgit Bauer, Christa Tax, Daniel Georg Gmainer, Anna-Lisa Pignet, Lars-Peter Kamolz and David Benjamin Lumenta
Clin. Pract. 2023, 13(3), 648-655; https://doi.org/10.3390/clinpract13030059 - 25 May 2023
Viewed by 1723
Abstract
Background and Objectives: Essential oils are a complementary treatment and can play an important role in scar care. The aim of this study was to evaluate and compare the efficacy of a new essential oil (regeneration oil) with a control group on scar [...] Read more.
Background and Objectives: Essential oils are a complementary treatment and can play an important role in scar care. The aim of this study was to evaluate and compare the efficacy of a new essential oil (regeneration oil) with a control group on scar quality in healed split-thickness skin graft donor sites. Materials and Methods: A single-center blinded randomized controlled study was performed on 30 patients with healed split-thickness skin graft donor site. The patients were randomly allocated into blended regeneration oil (n = 14) and pure almond oil (n = 16) groups. Application of the assigned oil occurred twice a day for 6 months. Scarring (Patient and Observer Scar Assessment Scale), itching (ITCH Assessment Scale) and scar discoloration (colorimetry) of the donor sites were assessed after 1, 3 and 6 months. Results: We found no statistically significant differences between the groups in any applied parameter. We observed comparable outcomes (scar quality, itchiness, colorit) in healed split-thickness skin graft donor sites for both oils. Conclusions: Regeneration oil and control oil presented comparable results regarding scar quality, itchiness and colorit in healed split-thickness skin graft donor sites after 6 months of application. Both oils are suitable for skin/scar care in split-thickness skin graft donor sites. Full article
(This article belongs to the Special Issue Clinical Nursing and Quality of Healthcare)
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10 pages, 251 KiB  
Article
Dentists’ Perspective on the Impact of COVID-19 on the Utilization of Emergency Dental Services in Kuwait: A Cross-Sectional Study
by Nour Alonaizi, Sarah Alharran and Jagan Kumar Baskaradoss
Clin. Pract. 2023, 13(3), 638-647; https://doi.org/10.3390/clinpract13030058 - 18 May 2023
Viewed by 1198
Abstract
This cross-sectional study intends to evaluate dentists’ perceptions of COVID-19’s effects on the use of emergency dental care both during and after Kuwait’s lockdown periods. A convenience sample of dentists employed by the Ministry of Health’s various emergency dental clinics and School Oral [...] Read more.
This cross-sectional study intends to evaluate dentists’ perceptions of COVID-19’s effects on the use of emergency dental care both during and after Kuwait’s lockdown periods. A convenience sample of dentists employed by the Ministry of Health’s various emergency dental clinics and School Oral Health Programs (SOHP) throughout Kuwait’s six governorates were invited to take part in this study. To determine the impact of various demographic and occupational characteristics on the mean perception score of the dentist, a multi-variable model was developed. The study was conducted between June–September 2021, and a total of 268 dentists (61% males and 39% females) participated in this study. When compared to pre-lockdown periods, the overall number of patients seen by dentists had significantly decreased after the lockdown period. After lockdown, there were significantly more cases of acute pulpitis with apical periodontitis, abscesses, and pericoronitis than there were before lockdown (p < 0.05). After the lockdown, a significantly higher percentage of dentists (p < 0.05) reported using fewer droplets-generating procedures to manage patients with dental emergencies. After correcting for the other variables in the model, female dentists (β = 0.146; 95% CI = 0.071 to 1.451) and non-Kuwaiti dentist (β = 0.012; 95% CI = 0.234 to 1.854) had a significantly (p < 0.05) more positive perception of the utilization of dental services than others after adjusting for the other variables in the model. The majority of dentists perceive that the COVID-19 pandemic has had a negative impact on Kuwait’s use of emergency dental services. Full article
17 pages, 299 KiB  
Article
Quality of Life in Patients Undergoing Percutaneous Coronary Intervention
by Vasiliki Tsoulou, Georgios Vasilopoulos, Theodore Kapadochos, Niki Pavlatou, Antonia Kalogianni, Georgia Toulia, Evangellos Dousis, George Panoutsopoulos, Michael Kourakos and Maria Polikandrioti
Clin. Pract. 2023, 13(3), 621-637; https://doi.org/10.3390/clinpract13030057 - 17 May 2023
Cited by 2 | Viewed by 1487
Abstract
Introduction: Percutaneous coronary intervention (PCI) is a non-surgical invasive procedure to treat coronary artery occlusion. The quality of life (QoL) is a way to measure the impact of illness and additionally its treatments to traditional measures of clinical outcomes. Purpose: The aim of [...] Read more.
Introduction: Percutaneous coronary intervention (PCI) is a non-surgical invasive procedure to treat coronary artery occlusion. The quality of life (QoL) is a way to measure the impact of illness and additionally its treatments to traditional measures of clinical outcomes. Purpose: The aim of the present study was to explore the levels of QoL pre-PCI, 6 and 12 months after PCI, as well as the factors associated with the QoL pre-PCI. Methods: In the present study, 100 patients undergoing PCI were enrolled. Data were collected through the completion of the SF-36 Health Survey (SF-36), which included participants’ characteristics. The statistical significance level was p < 0.05. Results: Patients had moderate levels of QoL at baseline, with a median general health score of 45 (IQR: 30–65). A gradual statistically significant increase in scores was observed in all subcategories of the patients’ QoL at 6 and 12 months after PCI (p < 0.001). A greater increase in scores was observed in physical functioning, physical role, emotional role and social functionality. In terms of the pre-PCI phase, it was found that physical functionality was statistically significantly associated with educational level (p = 0.005), occupation (p = 0.026) and whether the patients had children (p = 0.041). The physical and emotional role was significantly associated with gender (p = 0.046 and p = 0.040) and educational level (p = 0.030 and p = 0.001). Energy–fatigue was significantly associated with gender (p = 0.001), age (p = 0.028), marital status (p = 0.001), educational level (p = 0.001), whether the patients had children (p= 0.012) and other diseases (p = 0.001). Emotional well-being was significantly associated with family history of coronary artery disease (p = 0.011) and the frequency of physical exercise (p = 0.001). Social functioning was significantly associated with gender (p = 0.033), marital status (p = 0.034) and educational level (p = 0.002). Pain was not found to be significantly associated with patients’ demographics. General health was significantly associated with gender (p = 0.003), age (p = 0.043), educational level (p = 0.001), other diseases (p = 0.005) and the frequency of physical exercise (p = 0.001). Conclusion: Information about the QoL of PCI and its determinants is important to define an effective and comprehensive care plan. Full article
(This article belongs to the Special Issue Clinical Nursing and Quality of Healthcare)
5 pages, 224 KiB  
Case Report
Survival with Good Neurological Outcome despite Prolonged Cardiopulmonary Resuscitation and Extreme Acidosis after Out-of-Hospital Cardiac Arrest Due to Acute Myocardial Infarction: A Case Report and Review of the Literature
by Sylvère Störmann, Kristina Busygina, Ralph Hein-Rothweiler, Julius Steffen, Stefanie Förderreuther, Nora Salein and Matthias W. Angstwurm
Clin. Pract. 2023, 13(3), 616-620; https://doi.org/10.3390/clinpract13030056 - 15 May 2023
Viewed by 1361
Abstract
We report the case of a 49-year-old male who suffered from a myocardial infarction with subsequent cardiac arrest. The emergency medical team began cardiopulmonary resuscitation, including defibrillation of ventricular fibrillation. Although a return of spontaneous circulation was achieved after approximately 30 min of [...] Read more.
We report the case of a 49-year-old male who suffered from a myocardial infarction with subsequent cardiac arrest. The emergency medical team began cardiopulmonary resuscitation, including defibrillation of ventricular fibrillation. Although a return of spontaneous circulation was achieved after approximately 30 min of continued efforts, the patient went back into cardiac arrest on the way to the hospital and resuscitation had to be resumed. On admission, the patient was severely acidotic with a pH of 6.67, lactatemia of 19 mmol/L, and pronounced hypercapnia (pCO2 127 mmHg). Despite the poor prognosis, all possible efforts including coronary intervention and therapeutic hypothermia were carried out and the patient made a quick recovery with discharge from the intensive care unit on day 5. Survival of extreme acidosis, such as in this case, is rare. This is the first report of survival with good neurologic outcome in a patient with myocardial infarction, cardiac arrest, and pH of under 6.7 on admission at the clinic. Full article
6 pages, 226 KiB  
Opinion
Second Opinion in the Italian Organ Procurement Transplantation: The Pathologist Is In
by Albino Eccher, Deborah Malvi, Luca Novelli, Claudia Mescoli and Antonietta D’Errico
Clin. Pract. 2023, 13(3), 610-615; https://doi.org/10.3390/clinpract13030055 - 28 Apr 2023
Cited by 2 | Viewed by 1356
Abstract
Second opinion consultation is a well-established practice in different clinical settings of diagnostic medicine. However, little is known about second opinion consultation activity in transplantation, and even less is known about it concerning donor assessment. The consultations provided by the second opinion service [...] Read more.
Second opinion consultation is a well-established practice in different clinical settings of diagnostic medicine. However, little is known about second opinion consultation activity in transplantation, and even less is known about it concerning donor assessment. The consultations provided by the second opinion service led to the safer and homogeneous management of donors with a history of malignancy or ongoing neoplasm by transplant centers. Indeed, two of the most important aspects are the reduction of semantic differences in cancer reporting and the standardization of procedures, which are mainly due to the different settings and logistics of different pathology services. This article aims to discuss the role and the future of the second opinion in Italy during organ procurement, highlighting the critical issues and areas for improvement. Full article
(This article belongs to the Special Issue 2023 Feature Papers in Clinics and Practice)
14 pages, 912 KiB  
Article
Stress, Anxiety, and Depression Levels among University Students: Three Years from the Beginning of the Pandemic
by Dimitrios Kavvadas, Asimoula Kavvada, Sofia Karachrysafi, Vasileios Papaliagkas, Maria Chatzidimitriou and Theodora Papamitsou
Clin. Pract. 2023, 13(3), 596-609; https://doi.org/10.3390/clinpract13030054 - 27 Apr 2023
Cited by 2 | Viewed by 3722
Abstract
Background: Three years after the outbreak of the COVID-19 pandemic, psychological distress among college students remains increased. This study assesses stress, anxiety, and depression levels among students of the Aristotle University of Thessaloniki by the end of the third year of the pandemic [...] Read more.
Background: Three years after the outbreak of the COVID-19 pandemic, psychological distress among college students remains increased. This study assesses stress, anxiety, and depression levels among students of the Aristotle University of Thessaloniki by the end of the third year of the pandemic (November 2022), revealing demographic characteristics and probable stressors. Methods: A questionnaire was distributed in November 2022 via the academic students’ e-mails. The evaluation was performed with the DASS21 survey tool. The correlation analysis and the effect size calculation were performed with the t-test. Results: The majority of participants were undergraduates, on their first or second academic year, female students (67%), age of 18 to 21, unmarried or single (91%), and vaccinated against COVID-19 infection (83.4%). Severely increased levels of stress, anxiety, and depression (21.3%, 23.3%, and 25.1%, respectively) were measured. The normal and mild levels of stress, anxiety, and depression were 64.0%, 66.5%, and 57.2%, respectively. Female and younger students were at a higher risk of extremely severe stress, anxiety and depression prevalence (ORs up to 2.07, p-Values < 0.00001). Participants who were receiving psychological or psychiatric treatment exhibited severe stress, anxiety, and depression levels (ORs above 2.9, p-Values < 0.00001). Conclusions: Despite the undeniable withdrawal of the COVID-19 pandemic, the community of the Aristotle University of Thessaloniki presents high stress, anxiety, and depression levels, similar to those reported during the first year of the pandemic (November 2020). Stressors and risk factors were according to the reported literature and previous studies on Greek students. Academic psychological support offices should consider the students’ “profile” in order to evaluate properly the potential risk for emotional and psychological distress. Evidence suggest that new technology (virtual reality, tele-psychiatry or tele-support apps and sessions) should also be implemented in universities. Full article
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13 pages, 1251 KiB  
Article
Effectiveness of Hyperbaric Oxygen for Fibromyalgia: A Meta-Analysis of Randomized Controlled Trials
by Chunfeng Cao, Qianlu Li, Xinran Zhang, Giustino Varrassi and Haiqiang Wang
Clin. Pract. 2023, 13(3), 583-595; https://doi.org/10.3390/clinpract13030053 - 26 Apr 2023
Cited by 1 | Viewed by 2282
Abstract
Background: Hyperbaric oxygen therapy (HBOT) has been reported as an emerging treatment regimen for fibromyalgia syndrome (FMS), with a paucity of solid evidence. Accordingly, a systematic review and meta-analysis were performed to address the effectiveness of HBOT on FMS. Methods: We searched the [...] Read more.
Background: Hyperbaric oxygen therapy (HBOT) has been reported as an emerging treatment regimen for fibromyalgia syndrome (FMS), with a paucity of solid evidence. Accordingly, a systematic review and meta-analysis were performed to address the effectiveness of HBOT on FMS. Methods: We searched the Cochrane Database, EMBASE, Medline, PubMed, Clinicaltrials.gov, and PsycINFO, and the reference sections of original studies and systematic reviews from inception to May 2022. Randomized controlled trials (RCTs) on the treatment of FMS with HBOT were included. Outcome measures included pain, Fibromyalgia Impact Questionnaire (FIQ), Tender Points Count (TPC), and side effects. Results: Four RCTs, with 163 participants, were included for analysis. Pooled results showed that HBOT could benefit FMS with significant improvement at the end of treatment, including FIQ (SMD = −1.57, 95% CI −2.34 to −0.80) and TPC (SMD = −2.50, 95% CI −3.96 to −1.05). However, there was no significant effect on pain (SMD = −1.68, 95% CI, −4.47 to 1.11). Meanwhile, HBOT significantly increased the incidence of side effects (RR = 24.97, 95% CI 3.75 to 166.47). Conclusions: Collectively, emerging evidence from RCTs indicates that HBOT can benefit FMS patients in FIQ and TPC throughout the observation time phrases. Although HBOT has some side effects, it does not cause serious adverse consequences. Full article
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14 pages, 861 KiB  
Review
Fast Track Protocols and Early Rehabilitation after Surgery in Total Hip Arthroplasty: A Narrative Review
by Alberto Di Martino, Matteo Brunello, Davide Pederiva, Francesco Schilardi, Valentino Rossomando, Piergiorgio Cataldi, Claudio D’Agostino, Rossana Genco and Cesare Faldini
Clin. Pract. 2023, 13(3), 569-582; https://doi.org/10.3390/clinpract13030052 - 25 Apr 2023
Cited by 6 | Viewed by 4771
Abstract
The Enhanced Recovery After Surgery (ERAS) or Fast Track is defined as a multi-disciplinary, peri- and post-operative approach finalized to reduce surgical stress and simplify post-operative recovery. It has been introduced more than 20 years ago by Khelet to improve outcomes in general [...] Read more.
The Enhanced Recovery After Surgery (ERAS) or Fast Track is defined as a multi-disciplinary, peri- and post-operative approach finalized to reduce surgical stress and simplify post-operative recovery. It has been introduced more than 20 years ago by Khelet to improve outcomes in general surgery. Fast Track is adapted to the patient’s condition and improves traditional rehabilitation methods using evidence-based practices. Fast Track programs have been introduced into total hip arthroplasty (THA) surgery, with a reduction in post-operative length of stay, shorter convalescence, and rapid functional recovery without increased morbidity and mortality. We have divided Fast Track into three cores: pre-, intra-, and post-operative. For the first, we analyzed the standards of patient selection, for the second the anesthesiologic and intraoperative protocols, for the third the possible complications and the appropriate postoperative management. This narrative review aims to present the current status of THA Fast Track surgery research, implementation, and perspectives for further improvements. By implementing the ERAS protocol in the THA setting, an increase in patient satisfaction can be obtained while retaining safety and improving clinical outcomes. Full article
(This article belongs to the Special Issue 2023 Feature Papers in Clinics and Practice)
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16 pages, 787 KiB  
Review
Use of Pharmacological and Non-Pharmacological Strategies by Community-Dwelling Adults to Manage Migraine: A Systematic Review
by Srujitha Marupuru, Ziyad Almatruk, Marion K. Slack and David R. Axon
Clin. Pract. 2023, 13(3), 553-568; https://doi.org/10.3390/clinpract13030051 - 23 Apr 2023
Viewed by 2020
Abstract
Migraine is a prevalent disease associated with high levels of disability and is often underdiagnosed and undertreated. This systematic literature review aimed to identify the types of pharmacological and non-pharmacological strategies that community-dwelling adults report using to manage migraine. A systematic literature review [...] Read more.
Migraine is a prevalent disease associated with high levels of disability and is often underdiagnosed and undertreated. This systematic literature review aimed to identify the types of pharmacological and non-pharmacological strategies that community-dwelling adults report using to manage migraine. A systematic literature review of relevant databases, grey literature, websites, and journals was conducted from 1 January 1989 to 21 December 2021. Study selection, data extraction, and risk of bias assessment were completed independently by multiple reviewers. Data were extracted on migraine management strategies and categorized as opioid and non-opioid medications and medical, physical, psychological, or self-initiated strategies. A total of 20 studies were included. The sample sizes ranged from 138 to 46,941, with a mean age of 34.7 to 79.9 years. The data were typically collected using self-administered questionnaires (nine studies), interviews (five studies), online surveys (three studies), paper-based surveys (two studies), and a retrospective database (one study). Community-dwelling adults with migraine reported they primarily used medications, specifically triptans (range 9–73%) and non-steroidal anti-inflammatory drugs (NSAIDs) (range 13–85%) to manage migraine. Except for medical strategies, the use of other non-pharmacological strategies was low. Common non-pharmacological strategies included consulting physicians (range 14–79%) and heat or cold therapy (35%). Full article
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