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Effect of video-based exercise on premenstrual symptoms: a randomized controlled trial
No full textObjectives: This study aims to investigate the impact of Pilates exercises on premenstrual syndrome (PMS) symptoms, perceived stress levels, and pain intensity. Material and methods: Forty-six women with PMS participated in this study and were assigned to the intervention and control groups based on their willingness to participate. The intervention group undertook Pilates practices via video recording twice a week for 8 weeks, while the control group did not engage in regular exercise during the same period. PMS symptoms were assessed using the Premenstrual Syndrome Scale (PMSS), premenstrual stress levels were evaluated using the Perceived Stress Scale (PSS), and premenstrual pain levels were assessed using the McGill Melzack Pain Questionnaire (MPQ) at both the beginning and end of the study. Results: There was a significant difference observed in the PMSS, PSS and MPQ evaluations of the intervention group following their participation in Pilates practices (p < 0.05). Conversely, no significant difference was observed in the PMSS, PSS and MPQ evaluations of the control group at the end of the study (p > 0.05). There was no statistically significant difference between the two groups in PMSS evaluation (p > 0.05) at the end of the study. However, a statistically significant difference was detected in PSS and MPQ evaluations (p < 0.05). Conclusions: Pilates exercise can affectively decrease the perceived stress level and pain severity in PMS affected women. This study highlights the efficacy of Pilates for physiotherapists in PMS symptom reduction. Moreover, the implementation of a self-guided video-based home exercise program could provide patients with practical and time-efficient alternatives
Safety and efficacy of short percutaneous fixation in AO3 and AO4 lumbar fractures: a single-centre experience of 35 cases
No full textIntroduction. Spinal fractures with subsequent bone fragment dislocation are among the injuries most feared by patients and physicians. The surgical strategy is tailored to the individual patient’s characteristics and often consists of pedicle instrumentation with rod-screw systems. Short instrumentation has been associated with worse spinal correction and increased complications. However, recent studies have suggested similar results in terms of kyphosis correction and the maintenance of sagittal alignment compared to longer instrumentation.
Material and methods. This single-center retrospective study was conducted between January 2018 and April 2021. We included 35 single lumbar burst fractures AO Spine grade A3 or A4 with evidence of intra-canal fragments. Patients underwent minimally invasive percutaneous posterior lumbar instrumentation with pedicle screws. Patients received short segmental fixation involving only one level above and below the fractured vertebra.
Results. An immediate postoperative computed tomography (CT) scan demonstrated a significant reduction in vertebral kyphotic deformation (11.7° ± 1.6 vs 16.7° ± 5, p<0.001) and sagittal Cobb angle (9.8° ± 1.3 vs 11.7° ± 1.5, p < 0.001). The correction was slightly reduced but remained significant at 12 months for both kyphotic (12.3° ± 1.4, p = 0.03) and sagittal Cobb (10.3° ± 0.9, p = 0.04). Upper lumbar vertebrae showed even larger correction indices compared to lower lumbar segments. No implant failure or screws pullout was seen at the last follow-up.Conclusions. Short spinal fixation is a safe and effective treatment of complete and incomplete burst fractures with posterior bone fragment dislocation. All included patients fared well and achieved good kyphotic correction with no perioperative or long-term complications
Framework guidelines for the process of caring for the health of adolescent transgender (T) and non-binary (NB) people experiencing gender dysphoria — the position statement of the expert panel
Get PDFThis article presents framework guidelines for the care of adolescent transgender (T) and non-binary (NB) individuals experiencing gender dysphoria (GD) and/or gender incongruence (GI). Developed by a multidisciplinary expert panel, these guidelines aim to address the complex medical, psychological, and social needs of this diverse population.
The document emphasises the importance of individualised, affirmative care that respects the autonomy, identity, and rights of adolescents. It outlines best practices for psychiatric, psychological, and sexological assessment; criteria and protocols for gender-affirming hormonal interventions (GAHI) and puberty suppression; and ethical considerations for medical decision-making. The guidelines advocate for comprehensive support systems, including family involvement and multidisciplinary team collaboration, while addressing co-occurring mental health conditions and neurodiversity.
The article also highlights global perspectives on gender-affirming care, comparing practices and policies across countries to provide a contextualised approach that aligns with international standards while addressing local legal and healthcare frameworks. The proposed care model is designed to enhance the mental and physical well-being of adolescents, reduce stigma, and improve their overall quality of life.
This work serves as a vital resource for healthcare professionals, policymakers, and advocates seeking to advance equitable, effective, and compassionate care for gender-diverse youths
Subcortical gray matter changes in juvenile myoclonic epilepsy: a volBrain study
Get PDFBackground: Routine magnetic resonance imaging (MRI) in juvenile myoclonic epilepsy (JME) often shows no obvious abnormalities. However, recent neuroimaging investigations have highlighted potential structural and functional abnormalities in the thalamus of JME patients. This study aimed to investigate brain anatomical differences in JME patients using volBrain, a quantitative assessment method that, to the best of our knowledge, represents one of the first such analyses in the literature.
Materials and methods: Seventeen patients diagnosed with JME, 18 patients with generalised tonic-clonic seizures alone (GTCA), and 15 healthy controls (HCs) were included in the study. Before starting antiepileptic treatment, we analysed subcortical grey matter volumes in patients with JME, those with GTCA, and HCs, using the volBrain method.
Results: Seventeen patients with JME (11 females, mean age = 16.1 ± 3.2), 18 patients with GTCA (10 females, mean age = 15.5 ± 2.9), and 15 HCs (10 females, mean age = 15.9 ± 2.8) were included in the analysis. No significant difference was found for relative globus pallidus, caudate, or putamen volumes among the groups with JME, GTCA, and the HC group. In pairwise comparisons, both right and left thalamic volumes were lower in patients with JME than in HCs, and in patients with JME than in patients with GTCA.
Conclusions: This study underlines the role of volume analysis and the volBrain method in detecting thalamic microstructural changes in JME patients, even when conventional MRI results are normal
Early treatment with inhibitors of P2Y12 receptor in patients with ST-segment elevation myocardial infarction — 2023 ESC recommendations and scientific evidence. Is clinical evidence sufficient to suggest a move towards precision medicine? The ELECTRA-SIRIO 2 investigators’ viewpoint
Get PDFThe 2023 ESC guidelines changed previously recommended a strategy of early treatment in patients with STEMI. Pre-treatment with a P2Y12 receptor inhibitor may be considered in patients undergoing a primary PCI strategy (Class IIb, Level of evidence B). However, the available scientific evidence justifies a personalized approach differentiating the indications for pre-treatment with oral P2Y12 receptor inhibitors depending on the concomitant administration of opioids. In our opinion, in patients undergoing primary PCI not treated with opioids, pre-treatment with an oral P2Y12 receptor inhibitor should be applied, while in patients undergoing primary PCI treated with opioids, pre-treatment with an oral P2Y12 receptor inhibitor should be considered
CMR-defined transmural myocardial infarction with area of microvascular obstruction in the MINOCA patient: How many undiagnosed cases are there?
No full text99mTc/Tricine/HYNIC ubiquicidin 29–41 uptake in a giant cell tumor of the hallux: insights into the importance of time-activity curve analysis for accurate scan interpretation
No full textA 37-year-old man presented with swelling and erythema in the left first toe after a prior trauma, suspicious for osteomyelitis. X-ray and computed tomography (CT) scans revealed a radiolucent lesion with cortical disruption. A 99mTc/tricine/HYNIC ubiquicidin 29–41 (UBI) scintigraphy showed increased uptake but a non-accumulative time-activity curve, indicating a false positive for infection. Surgical excision confirmed a giant cell tumor. This case underscores the importance of integrating time-activity curve analysis with target-to-reference ratios in [99mTc]Tc-UBI scintigraphy for accurate diagnosis
Physical activity variability with the risk of type 2 diabetes: findings from a National Prospective Cohort Study
No full textIntroduction: The objective was to investigate the association between physical activity variability (PAVar) and the risk of type 2 diabetes mellitus (T2DM) among middle-aged and older adults.
Material and methods: This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), following participants from 2011 to 2020. A total of 3970 individuals with sufficient physical activity (PA) data were categorized into quartiles based on the coefficient of variation (CV) for PAVar. The incidence of T2DM was assessed using Cox proportional hazards models adjusted for demographic, socioeconomic, and lifestyle factors. Mediation analysis was performed to evaluate whether sleep duration influenced the relationship between PAVar and T2DM risk. Sensitivity analyses excluded individuals with missing baseline data to ensure the reliability of the findings.
Results: Higher PAVar was associated with an elevated risk of T2DM. In fully adjusted models, participants in the highest CV quartile had a 70% greater risk of developing T2DM [hazard ratio (HR): 1.70, 95% confidence interval (CI): 1.54–1.88] compared to those in the lowest quartile. Mediation analysis showed that sleep duration accounted for 18.5% of the total effect of PAVar on T2DM risk. Sensitivity analyses confirmed the robustness of these findings.
Conclusions: This study demonstrates the harmful effects of high PAVar on T2DM risk and underscores the need to promote consistent physical activity patterns and adequate sleep to prevent diabetes, particularly in aging populations
The urinary calcium–magnesium product as a potential indicator of nephrolithiasis in primary hyperparathyroidism
No full textIntroduction: Nephrolithiasis is a common complication of primary hyperparathyroidism (PHPT), but the mechanisms underlying stone formation remain incompletely understood. Calcium-sensing receptor (CaSR) activity, indirectly assessed by serum calcitriol levels and urinary excretion of calcium and magnesium, may influence the risk of nephrolithiasis. Current diagnostic methods are cumbersome, prompting the need for more practical biomarkers. This study aimed to evaluate a novel parameter — calcium and magnesium fractionalexcretion (CAMFE) — as a predictor of nephrolithiasis risk in patients with PHPT.
Material and methods: A retrospective analysis was conducted on 109 patients with PHPT. CAMFE was calculated from 24-hour urine collection under a standard diet. Associations with nephrolithiasis were analyzed using logistic regression and receiver operating characteristic (ROC) curve analysis.
Results: Nephrolithiasis was present in 40% of patients. The CAMFE index was correlated significantly with kidney stone formation. Calcitriol levels were higher in stone formers, supporting its role in enhanced intestinal calcium absorption. CAMFE showed good predictive power with an optimal cut-off value of 6.18, offering a simpler alternative to dual urine collection protocols.
Conclusions: Low CAMFE (< 6.18) may be connected with a higher risk of nephrolithiasis, potentially serving as a useful marker for assessing the risk of renal complications in patients with PHPT