Next Issue
Volume 14, April
Previous Issue
Volume 13, December
 
 

Clin. Pract., Volume 14, Issue 1 (February 2024) – 28 articles

Cover Story (view full-size image): Tuberculosis (TB), a highly infectious airborne disease caused by Mycobacterium tuberculosis (Mtb), currently ranks amongst the top three threats to global health. Therapies capitalizing on the dynamic nature of the human microbiome offer alternative TB treatment options. This review discusses the influence of the human microbiome on immunity as well as the disturbances of gut and lung bacterial compositions due to Mtb infection, resulting in dysbiosis. Because of the microbiome’s role in inflammatory pathways and production of metabolites like short-chain fatty acids, dysbiosis may compromise the host immune system. Additionally, evidence suggests antibiotic treatments and previous Mtb infection may result in increased Mtb susceptibility that can be attributed to microbial profile alterations. View this paper
  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Reader to open them.
Order results
Result details
Select all
Export citation of selected articles as:
16 pages, 3679 KiB  
Review
Phimosis in Adults: Narrative Review of the New Available Devices and the Standard Treatments
by Eleonora Rosato, Roberto Miano, Stefano Germani and Anastasios D. Asimakopoulos
Clin. Pract. 2024, 14(1), 361-376; https://doi.org/10.3390/clinpract14010028 - 18 Feb 2024
Viewed by 1077
Abstract
Background: Phimosis is the inability to completely retract the foreskin and expose the glans. The treatment of phimosis varies depending on the age of the patient and the severity of the disease; a great number of conservative or surgical treatments are currently available. [...] Read more.
Background: Phimosis is the inability to completely retract the foreskin and expose the glans. The treatment of phimosis varies depending on the age of the patient and the severity of the disease; a great number of conservative or surgical treatments are currently available. Aim: To provide the first review summarizing the available options for the treatment of adult phimosis. Methods: A PubMed, Cochrane and Embase search for peer-reviewed studies, published between January 2001 and December 2022 was performed using the search terms “phimosis AND treatment”. Results: A total of 288 publications were initially identified through database searching. Thirty manuscripts were ultimately eligible for inclusion in this review. Conservative treatment is an option. and it includes topical steroid application and the new medical silicon tubes (Phimostop™) application for gentle prepuce dilation. Concerning the surgical approach, the gold-standard treatment is represented by circumcision in which tissue synthesis after prepuce removal can be also obtained with barbed sutures, fibrin glues or staples. Laser circumcision seems to be providing superior outcomes in terms of operative time and postoperative complication rate when compared to the traditional one. Several techniques of preputioplasty and use of in situ devices (which crush the foreskin and simultaneously create haemostasis) have been also described. These in situ devices seem feasible, safe and effective in treating phimosis while they also reduce the operative time when compared to traditional circumcision. Patient satisfaction rates, complications and impact on sexual function of the main surgical treatments are presented. Conclusion: Many conservative and surgical treatments are available for the treatment of adult phimosis. The choice of the right treatment depends on the grade of phimosis, results, complications, and cost-effectiveness. Full article
Show Figures

Figure 1

17 pages, 1761 KiB  
Article
Optimizing Atrial Fibrillation Care: Comparative Assessment of Anticoagulant Therapies and Risk Factors
by Marius Rus, Adriana Ioana Ardelean, Simina Crisan, Paula Marian, Oana Lilliana Pobirci, Veronica Huplea, Claudia Judea Pusta, Gheorghe Adrian Osiceanu, Claudia Elena Stanis and Felicia Liana Andronie-Cioara
Clin. Pract. 2024, 14(1), 344-360; https://doi.org/10.3390/clinpract14010027 - 12 Feb 2024
Viewed by 1072
Abstract
Background and objectives: Atrial fibrillation (AF) is a common arrhythmia associated with various risk factors and significant morbidity and mortality. Materials and methods: This article presents findings from a study involving 345 patients with permanent AF. This study examined demographics, risk factors, associated [...] Read more.
Background and objectives: Atrial fibrillation (AF) is a common arrhythmia associated with various risk factors and significant morbidity and mortality. Materials and methods: This article presents findings from a study involving 345 patients with permanent AF. This study examined demographics, risk factors, associated pathologies, complications, and anticoagulant therapy over the course of a year. Results: The results showed a slight predominance of AF in males (55%), with the highest incidence in individuals aged 75 and older (49%). Common risk factors included arterial hypertension (54%), dyslipidemia, diabetes mellitus type 2 (19.13%), and obesity (15.65%). Comorbidities such as congestive heart failure (35.6%), mitral valve regurgitation (60%), and dilated cardiomyopathy (32%) were prevalent among the patients. Major complications included congestive heart failure (32%), stroke (17%), and myocardial infarction (5%). Thromboembolic and bleeding risk assessment using CHA2DS2-VASc and HAS-BLED scores demonstrated a high thromboembolic risk in all patients. The majority of patients were receiving novel oral anticoagulants (NOACs) before admission (73%), while NOACs were also the most prescribed antithrombotic therapy at discharge (61%). Conclusions: This study highlights the importance of risk factor management and appropriate anticoagulant therapy in patients with AF, to reduce complications and improve outcomes. The results support the importance of tailored therapeutic schemes, for optimal care of patients with AF. Full article
Show Figures

Graphical abstract

7 pages, 199 KiB  
Article
Rates of Compliance in South Indian American Communities of Southern California Regarding Cancer Screening
by Bhavana Seelam, Ria Sandhu, Mariam Alam, Akhila Kethireddy and Isain Zapata
Clin. Pract. 2024, 14(1), 337-343; https://doi.org/10.3390/clinpract14010026 - 08 Feb 2024
Viewed by 598
Abstract
Background: Studies have shown lower rates of cancer screening and high mortality rates among all Asian Americans than among non-Hispanic White populations. However, most of these studies often confound diverse Asian American subgroups with limited data on cancer screening for Indian Americans, with [...] Read more.
Background: Studies have shown lower rates of cancer screening and high mortality rates among all Asian Americans than among non-Hispanic White populations. However, most of these studies often confound diverse Asian American subgroups with limited data on cancer screening for Indian Americans, with this group being particularly interesting because of their counterintuitive socioeconomic status. For this reason, the objective of this study is to evaluate knowledge of the United States Preventive Services Task Force (USPSTF) cancer screening guidelines and compliance among South Indian Americans residing in Southern California. Methods: This was a cross-sectional study gathering community responses through an electronic survey. The survey reports knowledge of USPSTF screening guidelines and participant compliance rates. Rates were further compared to non-Hispanic White populations from official sources. Results: South Indian Americans residing in California had lower rates of compliance for colorectal, lung, and breast cancer screening when compared to that of non-Hispanic White populations in the same region, with the exception of cervical cancer screening rates. Conclusion: Understanding the cultural characteristics of special populations, such as Indian Americans, can help communities adhere to more effective screening practices that can improve outcomes. Full article
10 pages, 1272 KiB  
Article
Full Familiarisation Is Not Required for the Self-Paced 1 km Treadmill Walk to Predict Peak Oxygen Uptake in Phase IV Cardiac Patients
by Mandy L. Gault and Mark E. T. Willems
Clin. Pract. 2024, 14(1), 327-336; https://doi.org/10.3390/clinpract14010025 - 08 Feb 2024
Viewed by 344
Abstract
Exercise is a recommended part of phase IV cardiovascular rehabilitation (CR). The 1 km treadmill walk test (1-KTWT) is a submaximal continuous exercise test to predict cardiorespiratory fitness in patients with cardiovascular disease. We examined physiological, metabolic and subjective responses in patients with [...] Read more.
Exercise is a recommended part of phase IV cardiovascular rehabilitation (CR). The 1 km treadmill walk test (1-KTWT) is a submaximal continuous exercise test to predict cardiorespiratory fitness in patients with cardiovascular disease. We examined physiological, metabolic and subjective responses in patients with cardiovascular disease with self-selected, unchanging walking speed for two 1-KTWTs. Fifteen men (age: 65 ± 9 yr, height: 174 ± 5 cm, body mass: 86 ± 17 kg, BMI: 28.5 ± 5.5 kg·m−2, body fat%: 27.7 ± 7.5%, 10 on beta-blockers) were recruited from phase IV CR groups in the United Kingdom. Participants established a self-selected walking speed for the 1-KTWT and performed the 1-KTWT on separate days with recording of physiological responses to predict V˙O2peak with equations. For the two 1-KTWTs, no differences existed for walking speed, mean and maximal heart rates, oxygen uptake, predicted V˙O2peak (1st 1-KTWT (range: 41–78% V˙O2peak, 95%CI, 53–65; 2nd 1-KTWT range: 43–78% V˙O2peak, 95%CI, 52–65) and rating of perceived exertion. In phase IV cardiac patients, the 1-KTWT with self-selected, unchanging walking speed can be used for V˙O2peak prediction without the need for a full familiarisation. The self-selected constant walking speed for the first 1-KTWT can be used to support nonsupervised physical activity for phase IV CR patients. Full article
Show Figures

Figure 1