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• UI can be disabling and is often difficult to treat effectively. • Current treatments for refractory UI are mostly invasive and uncomfortable. • Introducing the concept of a novel, non-invasive catheter device for managing UI. • The device aims to improve patient outcomes with real-time monitoring and tailored care. Urinary incontinence, characterized by the involuntary leakage of urine, significantly impacts millions globally, affecting their quality of life, social interactions, and psychological well-being. Traditional diagnostic methods and treatments often fall short, especially for refractory urinary incontinence, due to their invasive nature and limited scope for continuous, real-time assessment. This narrative review critically examines current approaches to diagnosing and managing urinary incontinence, highlights significant gaps in practice, and underscores the urgent need for innovative solutions. We explore the evolution of diagnostic and treatment modalities and introduce a preliminary method involving a conceptual catheter device that promises to shift toward non-invasive, real-time monitoring and management. This review synthesizes prevailing research and provides a visionary outlook on how emerging technologies could revolutionize urinary incontinence care, offering a future of personalized, patient-centered strategies. Our discussion extends to the limitations of conventional urodynamic studies, which are often uncomfortable and fail to capture the dynamic nature of urinary incontinence in everyday settings. The proposed preliminary method features an advanced, smart-device solution integrating sensors and artificial intelligence to offer precise, real-time insights into bladder activity. This device, still in the conceptual stages, has the potential to transform the landscape of urinary incontinence management by enhancing diagnostic accuracy and therapeutic efficacy. By bridging the gap between current limitations and future possibilities, this paper aims to inspire ongoing innovation and research in the field of urogynecology. [ABSTRACT FROM AUTHOR]

Background: New daily persistent headache (NDPH) is a continuous, unremitting headache from onset that yields suboptimal results with traditional medicines. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive treatment for other headache disorders, such as migraine, and neuromodulation has not been well-studied in NDPH. The objective of the study was to evaluate the efficacy of rTMS in reducing the frequency and severity of headaches, and associated anxiety and depressive symptoms in NDPH patients. Methods: This was an open label prospective, single arm, interventional pilot study conducted between October 2022 and September 2023. All eligible participants received 10 Hz rTMS (600 pulses, 10 trains), delivered to the left prefrontal cortex for three consecutive days. The post-rTMS headache severity was recorded weekly for four weeks and headache free days/functional disability, PHQ-9, and GAD-7 scores at the end of four weeks and compared with pre-rTMS parameters. The primary outcome was defined by ≥ 50% reduction in headache severity on Visual Analogue Scale (VAS) score, decrease in headache days from the baseline and secondary outcome was ≥ 6 point reduction in HIT-6 score at 4 weeks. Results: Fifty NDPH patients (mean [SD] age, 35.06 [13.91] years; 31 females [62%]) participated in this study. Thirty-five patients (70%) reported ≥ 50% improvement in pain severity (p-value < 0.001), with a mean reduction of 10.84 (4.88) headache days per 28 days from a baseline of 28 headache days (p-value < 0.001). Thirty-eight patients (76%) reported a ≥ 6 point's reduction in HIT score at 4 weeks. Maximum improvement in the above parameters was observed in NDPH patients with chronic migraine. Two patients reported intolerance to the sound of the rTMS. The median (IQR) PHQ-9 and GAD-7 scores reduced from 11.5(3.75,20) to 7(2,15) (p-value < 0.001) and 10(3,14) to 5.5(0,9) (p-value < 0.001) respectively. Conclusion: rTMS was well tolerated and effective in reducing pain severity, headache days and headache related disability, depressive and anxiety symptoms. Trial registration: CTRI/2023/05/053247. [ABSTRACT FROM AUTHOR]

Abstract Plants offer a cost-effective and scalable pharmaceutical platform devoid of host-derived contamination risks. However, their medical application is complicated by the potential for acute allergic reactions to external proteins. Developing plant-based protein therapeutics for localized diseases with non-invasive treatment modalities may capitalize on the benefits of plant proteins while avoiding their inherent risks. Dupilumab, which is effective against a variety of allergic and autoimmune diseases but has systemic responses and injection-related side effects, may be more beneficial if delivered locally using a small biological form. In this study, we engineered a single-chain variable fragment (scFv) of dupilumab, termed Dup-scFv produced by Nicotiana benthamiana, and evaluated its tissue permeability and anti-inflammatory efficacy in air–liquid interface cultured human nasal epithelial cells (HNECs). Despite showing 3.67- and 17-fold lower binding affinity for IL-4Ra in surface plasmon resonance assays and cell binding assays, respectively, Dup-scFv retained most of the affinity of dupilumab, which was originally high, with a dissociation constant (KD) of 4.76 pM. In HNECs cultured at the air–liquid interface, Dup-scFv administered on the air side inhibited the inflammatory marker CCL26 in hard-to-reach basal cells more effectively than dupilumab. In addition, Dup-scFv had an overall permeability of 0.8% across cell layers compared to undetectable levels of dupilumab. These findings suggest that plant-produced Dup-scFv can be delivered non-invasively to cultured HNESc to alleviate inflammatory signaling, providing a practical approach to utilize plant-based proteins for topical therapeutic applications.

Objectives: The use of nebulized tranexamic acid (TXA) in massive pulmonary hemorrhage is well-described. Published utilization in post-tonsillectomy bleeding (PTB) is limited to a single case. This study examines whether TXA resulted in change of operative intervention necessity and narcotic utilization. Methods: This was a retrospective cohort study at a single, urban academic medical center in the United States. Chart review was conducted of all patients who presented to the hospital for post-tonsillectomy bleed (PTB) between 3/1/2018 and 7/1/2020. Demographic data, intervention modality, need for control under general anesthesia, and opioid use were collected and analyzed. Results: Twenty-one patients underwent a total of 23 visits for PTB over the study period. Control of hemorrhage without need for operating room intervention for PTB was 100% (6/6) for patients receiving TXA nebulizer and 53% (9/17) for those receiving other treatment modalities. Opioid usage in hospital and on discharge was also lower in patients receiving TXA nebulizers. All results were statistically significant. Conclusions: Our study supports nebulized TXA as an effective, non-invasive mode of hemostasis in patients presenting to the emergency department for post-tonsillectomy hemorrhage. Nebulized TXA may prevent the need for general anesthesia and operative intervention. Otolaryngologists should consider addition of this novel treatment appropriation of TXA to their management options for postoperative tonsillar hemorrhage. [ABSTRACT FROM AUTHOR]

This narrative review of kinesiotherapy methods in the treatment of Achilles tendinopathy (AT) encompassed a diverse range of studies, including athletes and untrained people, healthy or injured, undergoing kinesiotherapy treatments. Most experimental studies (86%) reported results related to pain perception, 27% to the range of motion, and 27% to biomechanical assessment. However, the studies showed notable heterogeneity in the outcomes associated with the interventions, and, in this review of kinesiotherapy protocols for AT, a prominent observation emerged regarding their efficacy, suggesting a more favorable impact on pain and tendon stiffness management when comparing the measured parameters between the trained and untrained groups. The importance of tailoring the treatment approach based on the individual's athletic background and conditioning status is underscored. There is a need for personalized rehabilitation strategies in athletic populations. The average duration of kinesiotherapy in the treatment of tendinopathy was 15.3 weeks. This observation underscores the potential of kinesiotherapy interventions as a viable treatment option for individuals with Achilles tendon issues. These findings underscore the urgent need for further research to provide stakeholders with more comprehensive directions for future studies. The results may be helpful for doctors, physiotherapists, trainers, and researchers interested in this topic. [ABSTRACT FROM AUTHOR]

Abstract Background This study explores the effectiveness of ultrasonography (USG)-guided saline enema reduction for ileocecal intussusception. It investigates factors, ascertainable through physical examination, ultrasound, and medical history, that impact the success of the procedure and the likelihood of recurrence. Results Conducted at a tertiary referral center, the study included 323 pediatric cases diagnosed with intussusception between 2017 and 2023. Patient data, symptoms, signs, and outcomes were collected. Hydrostatic saline enema, performed under USG guidance, served as the primary non-operative treatment. Logistic regression models assessed the impact of clinical factors on success and recurrence rates. Out of 323 patients examined for eligibility, 184 met inclusion criteria and were analyzed. Successful reduction with saline enema was achieved in 86.7%. In-hospital recurrence occurred in 17.1%, notably higher for intussusceptions extending into the rectum (p 24 (p = 0.4) and 48–72 (p = 0.2) hours did not decrease chances for successful reduction. Conclusions Prolonged symptom duration of over 24 and 48–72 h should not be a definitive contraindication for non-operative treatment. Cumulation of symptoms typical for intussusception might reduce the chances of success. These findings contribute valuable insights into optimizing non-operative strategies for managing pediatric intussusception.

Background: This study explores the effectiveness of ultrasonography (USG)-guided saline enema reduction for ileocecal intussusception. It investigates factors, ascertainable through physical examination, ultrasound, and medical history, that impact the success of the procedure and the likelihood of recurrence. Results: Conducted at a tertiary referral center, the study included 323 pediatric cases diagnosed with intussusception between 2017 and 2023. Patient data, symptoms, signs, and outcomes were collected. Hydrostatic saline enema, performed under USG guidance, served as the primary non-operative treatment. Logistic regression models assessed the impact of clinical factors on success and recurrence rates. Out of 323 patients examined for eligibility, 184 met inclusion criteria and were analyzed. Successful reduction with saline enema was achieved in 86.7%. In-hospital recurrence occurred in 17.1%, notably higher for intussusceptions extending into the rectum (p < 0.03). Pathologic lead point was identified in 33.3% of operated cases. The study revealed a correlation between the increasing number of symptoms (p < 0.001) and reduced success rates in enema reduction, with vomiting (p < 0.02), diarrhea (p < 0.05), and peritoneal fluid (p < 0.008) negatively affecting outcomes. Symptom duration of 1–9 h (p < 0.001) and 10–24 (p < 0.01) correlated with higher success rates, but prolonged symptom duration of > 24 (p = 0.4) and 48–72 (p = 0.2) hours did not decrease chances for successful reduction. Conclusions: Prolonged symptom duration of over 24 and 48–72 h should not be a definitive contraindication for non-operative treatment. Cumulation of symptoms typical for intussusception might reduce the chances of success. These findings contribute valuable insights into optimizing non-operative strategies for managing pediatric intussusception. [ABSTRACT FROM AUTHOR]

Bladder dysfunction, particularly neurogenic detrusor overactivity (DO), poses a substantial challenge in multiple sclerosis (MS) patients, detrimentally impacting their quality of life (QoL). Conventional therapies often fall short, necessitating alternative approaches like posterior tibial nerve stimulation (PTNS) for effective management. This narrative review critically examines the application of PTNS in treating DO among MS patients, aiming to provide a comprehensive synthesis of its efficacy, underlying mechanisms, and clinical outcomes. By evaluating a spectrum of studies, including randomized controlled trials and long-term follow-up research, the review elucidates PTNS's role in enhancing bladder control and ameliorating symptoms of urgency and incontinence, thereby improving patient well-being. Despite its potential, the review acknowledges the limited scope of existing research specific to MS-induced neurogenic DO and calls for further investigation to optimize PTNS protocols and understand its long-term benefits. Highlighting PTNS's minimal invasiveness and favorable safety profile, the review advocates for its consideration as a viable third-line treatment option in MS-related bladder dysfunction management. Through this analysis, the review contributes to the broader narrative of seeking effective, patient-centered therapeutic strategies for MS-related complications, underscoring the importance of personalized care in improving patient outcomes. [ABSTRACT FROM AUTHOR]

Peyronie's disease (PD) is a connective tissue disorder affecting the tunica albuginea. It can cause pain and penile deformation, and its prevalence increases with age. Although surgery is the gold standard for the chronic phase of the disease, there are several conservative treatment methods available, and the optimal management of the acute phase of the disease remains a matter of debate. In this article, we aim to summarize the recent trends in research on the subject of non‐surgical treatment of PD. The search was performed in PubMed, Scopus, and Web of Science databases and included studies in English published between 2012 and 2022 investigating the clinical outcomes of non‐surgical PD management in humans. We have identified 20 distinct conservative treatment strategies. Among the oral therapeutics, only the use of phosphodiesterase type 5 inhibitors is currently recommended for clinical use in patients with concomitant erectile dysfunction. The use of collagenase from Clostridium histolyticum is supported by the best quality evidence in terms of intralesional injections for patients suffering from significant penile curvature; however, interferon alpha‐2b can also be an option in such patients. Among other non‐invasive methods, extracorporeal shockwaves can be useful for pain reduction, and penile traction therapy can lead to a reduction in penile curvature and plaque size. Despite a wide range of non‐surgical methods available for PD treatment, the majority are not supported by sufficient scientific evidence, and the treatment efficacy is underwhelming. Further research on the subject of non‐surgical management of PD is highly warranted. [ABSTRACT FROM AUTHOR]

In recent years, pediatric dentistry has evolved considerably in terms of both the techniques and materials used. A clear, odorless liquid called silver diamine fluoride (SDF) is recommended for molars affected by hypoplasia and dentinal hypersensitivity. In adults and children who are at a high risk of developing caries, it is also helpful to prevent the progression of carious lesions. Teeth too compromised to be reconstructed that are not accompanied by discomfort or infection can be treated with SDF. The current review aims to provide an overview of the most recent research over the last 10 years on the potential of SDF, focusing on the clinical evidence of professionally applied fluoride therapy to prevent and arrest caries in children's primary molars. Research was conducted according to the guidelines of the PRISMA statement. "silver diamine fluoride", "primary molar", and "primary molars" were the search terms utilized on the databases Scopus, Web of Science, and PubMed, with the Boolean operator "AND" and "OR". Of these 195 studies, 13 primary studies were included in this review. The quality of the included papers was assessed using the reputable Cochrane risk of bias assessment for randomized trials. The studies reviewed consistently support the effectiveness of SDF in stopping the progression of existing caries in deciduous molars; on the contrary, there is insufficient evidence to draw conclusions about SDF being effective for the prevention of carious lesions in deciduous molars. [ABSTRACT FROM AUTHOR]

Background: Orthodontic treatment often induces pain, especially post appliance placement. This study compares transcutaneous electrical nerve stimulation (TENS) and acetaminophen for orthodontic pain management. Materials and Methods: A randomized trial included 120 fixed orthodontic patients divided into three groups (n = 40): Group A received TENS, group B received acetaminophen, and group C was the control. Data were expressed as mean ± SD. Repeated ANOVA analysis compared mean values, followed by post-hoc Tukey analysis. Pain levels were assessed using a visual analog scale before any intervention and at 30 minutes, 6 hours, and 24 hours post activation. Results: TENS and acetaminophen significantly reduced pain compared to the control. Group A (TENS) showed significant pain reduction post activation. Group B (acetaminophen) exhibited comparable pain relief, with no significant difference between groups. Conclusion: Both TENS and acetaminophen effectively manage orthodontic appliance activation pain.

Inhibiting IL-4 and IL-13 are critical cytokines that induce the pathogenic responses of allergic airway diseases. Currently, monoclonal antibodies targeting IL-4Rα are administered subcutaneously to treat eosinophilic rhinosinusitis and allergic asthma. However, these treatments have several drawbacks. To address these issues, we have developed a novel IL-4Rα-targeting nanobody designed for non-invasive delivery to local inflammatory sites in allergic airway diseases. H5, selected via the ribosomal display applied screening from synthetic nanobody library, underwent dimerization and in-silico affinity maturation using AlphaFold2 and GROMACS resulting in a substantial/dramatic enhancement of its binding affinity. H5 effectively controlled inflammatory markers such as MUC5AC, CCL26, and FOXJ1 in human nasal epithelial cells (HNECs) by inhibiting IL-4 and IL-13 signaling. The bivalent form of H5 showed efficacy in easily accessible cells, such as multi-ciliated cells, while the monovalent variant targeted hard-to-reach cells, such as basal cells of HNECs. In summary, we developed a nanobody that could effectively inhibit inflammatory signaling in HNECs via intranasal administration, showing promise as a non-invasive rhinitis treatment.

This narrative review of kinesiotherapy methods in the treatment of Achilles tendinopathy (AT) encompassed a diverse range of studies, including athletes and untrained people, healthy or injured, undergoing kinesiotherapy treatments. Most experimental studies (86%) reported results related to pain perception, 27% to the range of motion, and 27% to biomechanical assessment. However, the studies showed notable heterogeneity in the outcomes associated with the interventions, and, in this review of kinesiotherapy protocols for AT, a prominent observation emerged regarding their efficacy, suggesting a more favorable impact on pain and tendon stiffness management when comparing the measured parameters between the trained and untrained groups. The importance of tailoring the treatment approach based on the individual’s athletic background and conditioning status is underscored. There is a need for personalized rehabilitation strategies in athletic populations. The average duration of kinesiotherapy in the treatment of tendinopathy was 15.3 weeks. This observation underscores the potential of kinesiotherapy interventions as a viable treatment option for individuals with Achilles tendon issues. These findings underscore the urgent need for further research to provide stakeholders with more comprehensive directions for future studies. The results may be helpful for doctors, physiotherapists, trainers, and researchers interested in this topic.

Brain cancer has the lowest survival percentage among different cancers and it has caused the death of people under 40 more than others. Therefore, in this paper, the treatment of brain cancer with non-invasive photothermal therapy is investigated and the effect of various treatment factors including laser power full width at half maximum (FWHM) of the laser beam profile on the success of the treatment is evaluated. The simulations are performed by solving the three-dimensional Pennes bioheat transfer equation, Beer–Lambert law, and by considering the presence of gold nanorods, the Gaussian laser profile, as well as the initial and boundary conditions with the finite element method (FEM). The results of the investigations demonstrate that the laser power and radius of the laser spot are two important quantities in the success of the treatment. These two quantities affect the dose of thermal energy received by the cancerous tissue and control the temperature and fraction of tumour and tissue damage in different positions. Also, smaller and larger radii of laser spot than 1.1R (R is the radius of the brain tumour) lead to more and less temperature differences, respectively, in different parts of the tumour. However, the highest temperature and temperature rate can be obtained at the upper center point of the cancerous tissue in all treatment conditions. In addition, increasing the laser power from 0.5 to 1 W causes an increase in the temperature in different points of the tumour and irreversible destruction continues even after turning off the laser due to the tumor temperature in a different position beeing higher than 42 °C, as well as heat transfer due to conduction and convection.

Objective: Skin laxity and wrinkling are common signs of the aging process. This physiological condition of the skin is often accompanied by psychological and social concerns, especially for females, entailing considerable expenses for cosmetics and pharmaceuticals to cease or slow down its advancement. The objective of this study was to evaluate the short‐term impact of a new non‐ablative radiofrequency device available in the skin face cosmetic field. Methods: A randomized study was run on 62 healthy subjects with normal‐age related–grade skin laxity, subdivided into two groups. Group 1 received one treatment with Modula RF device (Wavemed, San Cesareo RM, Italy) over the whole face surface. Group 2 received three monthly treatments. Results: Clinical improvements of the exposed areas were detected by measuring skin parameters, such as total water content, elasticity, and sebum levels at baseline and 1 h after the treatment. Data showed significant effects of Med‐RF treatment on skin hydration (p < 0.001), skin elasticity (p < 0.0001), and sebum (p = 0.0009). Moreover, a negative linear correlation was obtained between women's age and hydration. Conclusion: In conclusion, the results of this study suggest that radiofrequency significantly improves the subjective and objective judgment of patients and doctors, supported by the positive results obtained on the skin quality parameters evaluated. These results confirm that Med‐RF technology represents an important tool to achieve face rejuvenation in the field of non‐invasive procedures. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of root caries is increasing globally, especially in the elderly population, and even though the number of patients with root caries lesions is augmenting, there are still many discrepancies in how dentists manage this condition. The present study aimed to develop and validate a questionnaire to evaluate how dentists diagnose, record and manage root caries lesions, and to verify the validity and reliability of this questionnaire. Materials and methods: An expert panel developed a self-administered questionnaire survey with three domains: (1) dentists' knowledge on diagnosis, recording, and managing root caries; (2) information about their current general clinical routines; (3) their demographics. The original English [E] version was translated into three different languages (French [F], German [G], Italian [I]), and subsequently back-translated into English by independent dentists. For the validation, 82 dentists (20–22 for each of the translated versions) accepted to answer the questionnaire at two different time-points (with 1-week interval). The data was quality checked. Construct validity, internal reliability, and intra-class correlation (ICC) were assessed. Results: Seventy-seven dentists completed the questionnaire twice [E: 17; F: 19; G: 19; I: 22]. The mean ICC (standard deviation) was 0.98(0.03) for E, 0.90(0.12) for F, 0.98 (0.04) for G, and 0.98 (0.01) for I. Overall, the test–retest reliability was excellent (mean ICC (SD): 0.96 (0.08)). Furthermore, the questionnaire demonstrated good internal reliability (inter-observer reliability; Fleiss kappa: overall:0.27(fair); E:0.30 (fair); F: 0.33(fair); G: 0.33(fair); I: 0.89 (almost perfect)). Conclusion: The questionnaire was validated and is suitable to be used in the four languages to assess the knowledge of dentists on diagnosing, recording and managing root caries. Clinical significance: The present questionnaire was validated and seems to be a good tool to evaluate how dentists diagnose, record, and manage root caries lesions both in its original (English) and its translated (French, German, and Italian) versions. [ABSTRACT FROM AUTHOR]

Varicose veins in the lower limb are a common and progressive venous disorder that can significantly reduce patients' quality of life and pose a threat to their overall health if left untreated. However, current treatment approaches often involve invasive intervention. High-intensity focused ultrasound (HIFU) technology has the potential to treat varicose veins non-invasively, but most systems are bulky and expensive. This study proposes an innovative, integrated system that uses a 4.5 MHz therapeutic probe guided by a 12 MHz ultrasound imaging probe to treat varicose veins in the lower limb. The system aims to achieve high accuracy in repeated treatments by using a high-speed scanning positioning structure, increasing the imaging framerate, and reducing the system's overall volume. The system's accuracy is evaluated through reset error tests on an acrylic board, and its effectiveness is tested through in vivo experiments on rabbit marginal ear veins. Tests on porcine arteries are conducted to identify suitable focal points for vascular treatment. The experimental results demonstrate the system's high accuracy, with a reset error of less than 0.07 mm, and an obvious shrinkage of the predetermined treatment area of the marginal ear veins after therapy. The study identifies that setting the focus on the vascular wall can improve the efficiency of vascular treatment, resulting in significant vasoconstriction changes. These experimental findings provide sufficient evidence for the system's potential for clinical application in vascular treatment. [ABSTRACT FROM AUTHOR]

Background: To assess the long-term functional orthodontic outcome of the Tübingen palatal plate (TPP) in children with Robin sequence (RS) in comparison to age- and sex-matched healthy controls. Methods: Between 09/2019 and 10/2020, we performed orthodontic assessments in 41 children at our Department of Orthodontics. Included were patients with RS (17 non-syndromic; four syndromic) and healthy controls (n = 22, average age in both groups 9.9 y). Facial analyses of 2D images, digital study casts and cephalometric measurements were made. Results: The orthodontic examinations showed no statistically significant group differences regarding functional extraoral, intraoral and pharyngeal parameters, or in skeletal patterns. The relationship between the upper and lower incisors was significantly increased (overjet 4 (2–10) vs. 3 (0–9) mm; p = 0.01) with a significant deficit in the lower face proportions (Jaw Index 4.15 (1.9–9.6) vs. 2.98 (0–9); p = 0.02; Facial convexity angle 157 (149–173) vs. 159 (149–170); p = 0.01). Conclusion: Children with RS treated with the TPP showed normal long-term functional orthodontic outcomes, thanks to the functional adaption of the stomatognathic system. However, soft tissue growth did not completely match skeletal growth, resulting in a more convex facial profile. [ABSTRACT FROM AUTHOR]

Neonatal retropharyngeal abscess (RPA) is a rare and life-threatening entity. Most of the cases are idiopathic in nature. We encountered a case of RPA in a newborn secondary to extravasation injury. The presence of neck swelling with clinical deterioration following extravasation of total parenteral nutrition (TPN) infused via a peripherally inserted central catheter at the right upper limb raised the suspicion of neck abscess. This was later confirmed to be RPA based on magnetic resonance imaging of the neck. She was treated with prolonged intravenous antibiotics in the Neonatal Intensive Care Unit (NICU). Her condition gradually improved, evidenced by resolution of the collection on serial imaging. Early recognition and prompt management are crucial to reduce the morbidity and mortality from RPA.

This research is aimed to look at the existing literature on the effects of photobiomodulation (PBM) on a variety of medical illnesses with a high severity rate. Photobiomodulation, also known as non-thermal laser treatment, is an approaching field in the technology of medicine that involves exposing tissues to precise wavelengths of light to generate therapeutic effects. Photomedicine is based on the outcomes of coherent and noncoherent visible light on cells and tissues, like low-level lasers and light-emitting diodes (LEDs). This therapy method has an impact on cell function, proliferation, and migration, as well as tissue regeneration. Thus, this therapy's mechanism is particularly effective in displaying favorable benefits in neurological, pulmonary, inflammatory, dermatological, and wound healing illnesses and oncology. Using the biphasic dose-response technique, each ailment is addressed with a specific type of laser and within a defined wavelength range to produce the required effect of the therapy. [ABSTRACT FROM AUTHOR]

Aim of this randomized clinical trial was to assess the development of root caries lesions with and without (adjuvant) professional prevention treatment over 24 months. 20 participants with two or three non-cavitated root carious lesions were included (n = 52), whereby lesions were randomly assigned to one out of three groups depending on varnish application (CF: Cervitec F [n = 20], P: placebo [n = 20], DP: Duraphate [n = 12]). All lesions were assessed by quantitative light-induced fluorescence (QLF; QRayCam); following outcome parameters were analyzed: fluorescence loss (ΔF %), lesion volume (ΔQ %µm2) and bacterial activity (ΔR %). Professional tooth cleaning and adjuvant varnish application were performed at baseline, after 3, 6, and 9 months. A follow-up examination was performed 1 year after preventive care with varnish application 24 months after baseline. ∆F showed a significant time effect in CF (p = 0.03), which was not confirmed in post hoc analysis (p > 0.05). For P and DP, no time effect was detected (p > 0.05). ∆Q was significantly higher 12 months after baseline in CF (p = 0.02). In P, a significant time effect occurred (p = 0.01), without significant results in post hoc testing. ∆R showed higher values at baseline vs. 12 months in CF (p = 0.03) and 24 months compared to 12 months in DP (p = 0.02). Professional preventive treatment inhibited the progression of root caries lesions beyond their termination for 12 months, irrespective of an adjunctive varnish application. Preventive measures have a long-term effect on root carious lesions, even 1 year after their termination. [ABSTRACT FROM AUTHOR]

Photodynamic therapy (PDT) and photothermal therapy (PTT) have demonstrated great potential to diagnose and combat localized cancers. As a matter of fact, these techniques are less invasive and have fewer side effects than traditional cancer treatments like surgery, chemotherapy or radiotherapy. This review summarizes the clinical progress in the theranostics (diagnosis and treatment) of various types of regional cancers using these two light stimuli techniques, PDT and PTT. Therefore, clinical advances in cancer diagnosis based on PDT are detailed, including fluorescence-guided PDT for intraoperative cancer detection, optical coherence tomography (OCT)-guided PDT for early cancer detection, and imaging by magnetic resonance imaging (MRI) or computed tomography (CT) assisted through PDT/PTT. Moreover, clinical studies of breast, prostate, skin, gynecologic, head, neck and other varieties of cancer have been addressed to compare the main conditions of these treatments. This work also discussed the principal advantages and drawbacks of PDT and PTT in tumor targeting and cancer therapy. Finally, the usage of nanoparticles as photosensitizers (PSs) and photothermal agents (PAs) have been analyzed. In this manner, the authors have compiled relevant updated studies so that researchers interested in these areas can access it speedily., (Copyright © 2024. Published by Elsevier B.V.)

Maxwell-Faraday equation and Lorentz force law have remarkable effects on technological innovations in the field of magnetically driven micro- and nano-machines. Here a remotely applied magnetic field provides the energy of motion, sensing capability and controlled directional guidance to a microscopic locomotive. These microscopic machines provide unprecedented technological breakthrough in biomedical field and non-invasive targeted treatment methods. This article presents detailed discussion about advanced materials, fabrication methods and magnetically assisted techniques for manipulating micro- and nano-scale robots, swimmers and core-shell nanovehicles for non-reciprocal movement in biological Newtonian fluids. Extensive discussion has been presented on the biological applications of the magnetically excited locomotive behaviour of these miniaturized machines such as crock-screw motion of helical and needle type microrobots for targeted drug delivery to tumor microtissues, wobbling and rolling motion of peanut shaped hematite colloid micromotor for single fibroblast cell manipulation, propulsion mechanism of microrobots similar to sperm cell motion, walking micromachine for microsurgery of cancer cells and magnetic field modulated movement of core-shell magnetoelectric nanorobots to electroporate, permeate or transport a targeted human epithelial cell. This review is a unique and extensive discussion about the latest innovative and magnetically assisted swiftest techniques of targeted drug delivery, cell migration, bio-molecule delivery, tumour cell detection, and in vitro experiments to solve significant hurdles in medical science and treatment methods.

Abstract Background Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME. Methods MEDLINE was searched for relevant literature with no time constraints. Both randomized and non-randomized trials were included. Case reports and conference abstracts were excluded. Titles and abstracts were screened and full-text articles of included studies were retrieved. Data on the effect of ESWT on pain, function, and the BME area on magnet resonance imaging were extracted. Results Pain, function, and magnet resonance imaging results all improved across the studies — regardless of whether it was a randomized or non-randomized study. This effect was consistent across multiple pathologies such as osteonecrosis of the femoral head, BME associated with knee osteoarthritis, Kienböck’s disease, and osteitis pubis. The meta-analysis showed that pain (after 1 month: weighted mean difference (WMD) = − 2.23, 95% CI − 2.58 to − 1.88, P < 0.0001; after 3–6 month: WMD = − 1.72, 95% CI − 2.52 to − 0.92, P < 0.00001) and function (after 1 month: WMD = − 1.59, 95% CI − 2.04 to − 1.14, P < 0.0001; after 3–6 month: WMD = − 2.06, 95% CI − 3.16 to − 0.96, P = 0.0002; after ≥ 12 month: WMD = − 1.20, 95% CI − 1.83 to − 0.56, P = 0.0002) was reduced in terms of ESWT treatment compared to a control group. Conclusions Based on the available evidence, ESWT may be an adequate option for conservative therapy in pathologies involving BME. Trial registration PROSPERO, CRD42021201719 . Registered 23 December 2020

IntroductionRecent studies have shown that specific cases of post-appendectomy abscess (PAA) in children could be treated conservatively. However, due to the lack of high-quality evidence, choice of treatment still depends on preferences of the treating surgeon, leading to heterogeneity in clinical practice. Therefore, we aimed to provide an update of recent literature on the management of PAA in children and subsequently evaluate the outcomes of a large multicenter cohort of children treated for PAA.MethodsA literature search was performed in Pubmed and Embase, selecting all randomized controlled trials, prospective and retrospective cohort studies, and case series published from 2014 and onward and reporting on children (

Objective: A caesarean scar defect (CSD), a niche in the uterus, is an emerging long-term complication after caesarean section (CS). With rising rates of CS, the risk of post-caesarean iatrogenic complications has increased, although many women may be diagnosed incidentally while asymptomatic. We present a review of the diagnosis and treatment of CSD. Mechanism: We describe the current state of treatment of CSD in terms of diagnosis and the different treatment options. Findings in Brief: The diagnosis can be confirmed by transvaginal sonography, hysteroscopy and other imaging examinations. At present, therapy is dependent on the presence of symptoms, the size of the CSD, and secondary infertility. Non-invasive management includes oral contraceptives and the levonorgestrel-releasing intrauterine system (LNG-IUS), which can improve the clinical symptoms of prolonged menstrual periods to some certain extent. Currently, the principal therapy is surgery, and micro-invasive surgical management includes transvaginal, hysteroscopic and laparoscopic procedures. However, there is no unified surgical selection standard, and the selection of surgical methods and the effect of surgical management are also controversial and need to be further studied. Conclusions: The aim of this review is to summarize and compare the selection of diagnostic and therapeutic methods and the differences in the curative effects of these therapeutic methods for CSD.

Varicose veins in the lower limb are a common and progressive venous disorder that can significantly reduce patients’ quality of life and pose a threat to their overall health if left untreated. However, current treatment approaches often involve invasive intervention. High-intensity focused ultrasound (HIFU) technology has the potential to treat varicose veins non-invasively, but most systems are bulky and expensive. This study proposes an innovative, integrated system that uses a 4.5 MHz therapeutic probe guided by a 12 MHz ultrasound imaging probe to treat varicose veins in the lower limb. The system aims to achieve high accuracy in repeated treatments by using a high-speed scanning positioning structure, increasing the imaging framerate, and reducing the system’s overall volume. The system’s accuracy is evaluated through reset error tests on an acrylic board, and its effectiveness is tested through in vivo experiments on rabbit marginal ear veins. Tests on porcine arteries are conducted to identify suitable focal points for vascular treatment. The experimental results demonstrate the system’s high accuracy, with a reset error of less than 0.07 mm, and an obvious shrinkage of the predetermined treatment area of the marginal ear veins after therapy. The study identifies that setting the focus on the vascular wall can improve the efficiency of vascular treatment, resulting in significant vasoconstriction changes. These experimental findings provide sufficient evidence for the system’s potential for clinical application in vascular treatment.

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory, burdensome skin disease where medical first-line treatment is still limited to long-term, topical and/or systemic antibiotics. The RELIEVE study aimed at evaluating the efficacy of LAight® therapy – a combination of intense pulsed light and radiofrequency – as an adjunct treatment to first-line therapies in Hurley stage I and II HS. Methods: The RELIEVE study was performed as a two-period multicenter randomized controlled trial with blinded assessment. For period A from week 0 to week 16, the 88 participating subjects were randomized into either an intervention group (IG) or a control group (CG). The IG received topical clindamycin 1% solution combined with 8 additional bi-weekly treatments with LAight® therapy. The CG was treated with topical clindamycin 1% solution only. After 16 weeks, patients entered open-label period B and both groups were treated exclusively with LAight® therapy for an additional 16 weeks (8 sessions). The primary efficacy endpoint was the change in International Hidradenitis Suppurativa Score System (∆IHS4) at week 16 to baseline. Secondary endpoints were DLQI, HiSCR, Pain-NRS, and HADS. Results: In total, from the 88 patients enrolled in RELIEVE, 81 patients were included in the endpoint analysis after period A. After 16 weeks of treatment, the ∆IHS4 of the group treated with the combination of LAight® therapy and topical clindamycin 1% solution was −7.2 ± 6.7 (−60.0%), which was significantly higher in magnitude than the ∆IHS4 in the group treated with clindamycin 1% solution alone (−1.8 ± 5.6, −17.8%, p < 0.001). Secondary endpoints, including other clinical scores as well as patient-reported outcomes, confirmed that the efficacy of the combined treatment was superior to monotherapy. Conclusion: The results of the primary endpoint analysis of period A of the RELIEVE study show that the combined therapy with LAight® and topical clindamycin 1% solution, resulted in a significantly higher decrease in disease severity and an improvement of quality of life in comparison to topical clindamycin 1% solution monotherapy. Treatment was well tolerated, and side effects were all mild and transitory. These data speak for the implementation of the combined treatment as a first-line therapy in Hurley stage I and II HS. LAight® therapy as long-term monotherapy (results from period B), will be analyzed in a consecutive paper. [ABSTRACT FROM AUTHOR]

Conventional transcranial electrical stimulation (tES) is a non-invasive method to modulate brain activity and has been extensively used in the treatment of Parkinson's disease (PD). Despite promising prospects, the efficacy of conventional tES in PD treatment is highly variable across different studies. Therefore, many have tried to optimize tES for an improved therapeutic efficacy by developing novel tES intervention strategies. Until now, these novel clinical interventions have not been discussed or reviewed in the context of PD therapy. In this review, we focused on the efficacy of these novel strategies in PD mitigation, classified them into three categories based on their distinct technical approach to circumvent conventional tES problems. The first category has novel stimulation modes to target different modulating mechanisms, expanding the rang of stimulation choices hence enabling the ability to modulate complex brain circuit or functional networks. The second category applies tES as a supplementary intervention for PD hence amplifies neurological or behavioral improvements. Lastly, the closed loop tES stimulation can provide self-adaptive individualized stimulation, which enables a more specialized intervention. In summary, these novel tES have validated potential in both alleviating PD symptoms and improving understanding of the pathophysiological mechanisms of PD. However, to assure wide clinical used of tES therapy for PD patients, further large-scale trials are required. [ABSTRACT FROM AUTHOR]

Conventional transcranial electrical stimulation (tES) is a non-invasive method to modulate brain activity and has been extensively used in the treatment of Parkinson’s disease (PD). Despite promising prospects, the efficacy of conventional tES in PD treatment is highly variable across different studies. Therefore, many have tried to optimize tES for an improved therapeutic efficacy by developing novel tES intervention strategies. Until now, these novel clinical interventions have not been discussed or reviewed in the context of PD therapy. In this review, we focused on the efficacy of these novel strategies in PD mitigation, classified them into three categories based on their distinct technical approach to circumvent conventional tES problems. The first category has novel stimulation modes to target different modulating mechanisms, expanding the rang of stimulation choices hence enabling the ability to modulate complex brain circuit or functional networks. The second category applies tES as a supplementary intervention for PD hence amplifies neurological or behavioral improvements. Lastly, the closed loop tES stimulation can provide self-adaptive individualized stimulation, which enables a more specialized intervention. In summary, these novel tES have validated potential in both alleviating PD symptoms and improving understanding of the pathophysiological mechanisms of PD. However, to assure wide clinical used of tES therapy for PD patients, further large-scale trials are required.

This double-blinded and split-mouth design, randomized feasibility study aimed to assess the efficacy of prophylactic and therapeutic use of a new age NitrAdineTM-based brushing solution (PerioTabs®) on the clinical parameters before and after periodontal therapy. Four subjects were randomly assigned to two treatment groups according to periodontal infection: PerioTabs® and placebo. At the first appointment, a split-mouth scaling was performed in all participants. All oral care instructions concerning the use of effervescent tablets were explained to the participants in detail. The morning after the tablets were finished, a full-mouth scaling was completed in all participants. All parameters were recorded at 0, 11, and 40 days. According to the results, both the therapeutic and prophylactic interventions showed similar impacts on the gingival index and probing depth compared to the placebo in all patients. The bleeding on probing was further reduced at the PerioTabs® group at baseline until day 40 compared to the placebo in the gingivitis patients with both interventions; at both 11 and 40 days in the periodontitis patients receiving the therapeutic intervention; and at baseline to day 40 in the periodontitis group receiving the prophylactic intervention. While the preliminary results of this new-age brushing solution appear to be a promising approach for a future therapy of periodontal diseases, further research on a larger sample size is needed to draw firm conclusions. [ABSTRACT FROM AUTHOR]

Remineralization treatment, which offers the advantage of being non-invasive, is increasingly being used as a minimal intervention treatment in managing incipient enamel caries. The aim of this review was to develop EBM guideline for optimized strategies for non-invasive treatment of incipient enamel caries.Japanese Society of Conservative Dentistry (JSCD) guideline committee formulated a Guideline for treating incipient enamel caries using the GRADE system, which is the global, mainstream standard for guideline development. The committee selected the most frequent clinical questions (CQs) in treating incipient enamel caries and identified clinically important outcomes in evaluating the efficacy of treatments. Using extensive electronic and manual searches, relevant randomized controlled trials and controlled clinical trials were identified. Based on evidence profiles produced by the committee, the panel discussed the effects, benefits and disadvantages of the selected treatments, as well as their cost effectiveness and feasibility, in order to achieve a consensus in treating incipient enamel caries non-invasively. A recommendation was made for each clinical question after voting by the panel members. Based on the evidence profile and panel discussions for each CQ, the experts strongly recommended application of topical fluoride to inhibit cavitation of incipient enamel caries, and to diminish white spot lesions.

Inhibiting IL-4 and IL-13 are critical cytokines that induce the pathogenic responses of allergic airway diseases. Currently, monoclonal antibodies targeting IL-4Rα are administered subcutaneously to treat eosinophilic rhinosinusitis and allergic asthma. However, these treatments have several drawbacks. To address these issues, we have developed a novel IL-4Rα-targeting nanobody designed for non-invasive delivery to local inflammatory sites in allergic airway diseases. H5, selected via the ribosomal display applied screening from synthetic nanobody library, underwent dimerization and in-silico affinity maturation using AlphaFold2 and GROMACS resulting in a substantial/dramatic enhancement of its binding affinity. H5 effectively controlled inflammatory markers such as MUC5AC , CCL26 , and FOXJ1 in human nasal epithelial cells (HNECs) by inhibiting IL-4 and IL-13 signaling. The bivalent form of H5 showed efficacy in easily accessible cells, such as multi-ciliated cells, while the monovalent variant targeted hard-to-reach cells, such as basal cells of HNECs. In summary, we developed a nanobody that could effectively inhibit inflammatory signaling in HNECs via intranasal administration, showing promise as a non-invasive rhinitis treatment., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: Orthodontic treatment often induces pain, especially post appliance placement. This study compares transcutaneous electrical nerve stimulation (TENS) and acetaminophen for orthodontic pain management., Materials and Methods: A randomized trial included 120 fixed orthodontic patients divided into three groups (n = 40): Group A received TENS, group B received acetaminophen, and group C was the control. Data were expressed as mean ± SD. Repeated ANOVA analysis compared mean values, followed by post-hoc Tukey analysis. Pain levels were assessed using a visual analog scale before any intervention and at 30 minutes, 6 hours, and 24 hours post activation., Results: TENS and acetaminophen significantly reduced pain compared to the control. Group A (TENS) showed significant pain reduction post activation. Group B (acetaminophen) exhibited comparable pain relief, with no significant difference between groups., Conclusion: Both TENS and acetaminophen effectively manage orthodontic appliance activation pain., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME. Methods: MEDLINE was searched for relevant literature with no time constraints. Both randomized and non-randomized trials were included. Case reports and conference abstracts were excluded. Titles and abstracts were screened and full-text articles of included studies were retrieved. Data on the effect of ESWT on pain, function, and the BME area on magnet resonance imaging were extracted. Results: Pain, function, and magnet resonance imaging results all improved across the studies — regardless of whether it was a randomized or non-randomized study. This effect was consistent across multiple pathologies such as osteonecrosis of the femoral head, BME associated with knee osteoarthritis, Kienböck's disease, and osteitis pubis. The meta-analysis showed that pain (after 1 month: weighted mean difference (WMD) = − 2.23, 95% CI − 2.58 to − 1.88, P < 0.0001; after 3–6 month: WMD = − 1.72, 95% CI − 2.52 to − 0.92, P < 0.00001) and function (after 1 month: WMD = − 1.59, 95% CI − 2.04 to − 1.14, P < 0.0001; after 3–6 month: WMD = − 2.06, 95% CI − 3.16 to − 0.96, P = 0.0002; after ≥ 12 month: WMD = − 1.20, 95% CI − 1.83 to − 0.56, P = 0.0002) was reduced in terms of ESWT treatment compared to a control group. Conclusions: Based on the available evidence, ESWT may be an adequate option for conservative therapy in pathologies involving BME. Trial registration: PROSPERO, CRD42021201719. Registered 23 December 2020 [ABSTRACT FROM AUTHOR]

The pathologies of the temporomandibulary (ATM) and hip joints affect the articulations, the supporting structures and their biomechanics. The objective of any recovering treatment for ATM and AS pathologies is pain elimination or reduction and recovery of the normal biomechanic function of the temporomandibulary and hip joint. The initial treatment preferred by numerous specialists is an non-invasive, conservative one. The present study evaluates the value of a recovering treatment for joint biomechanics, by reviewing all non-invasive treatment methods now in use. [ABSTRACT FROM AUTHOR]

Background: For patients with carpal tunnel syndrome (CTS), the only long-term effective treatment option is carpal tunnel release surgery. Up to one-third report recurrent symptoms, and 12% needs repeated surgery. This study aimed to evaluate the long-term effects of mechanical traction as a non-invasive treatment option for CTS compared to care as usual. Methods: Patients with electrodiagnostically confirmed CTS [ N = 181; mean age, 58.1 (13.0) years; 67% women] were recruited from an outpatient neurology clinic in the Netherlands. Patients completed baseline questionnaires and randomized to the intervention group (12 treatments with mechanical traction, twice a week for 6 weeks) or care as usual. The primary clinical outcome measure was surgery during the 12-month follow-up. Secondly, we assessed symptom severity with the Boston Carpal Tunnel Questionnaire (BCTQ) at baseline and at the 12-month follow-up. Changes in CTS symptom severity between baseline and the 12-month follow-up were analyzed between groups using t -tests and a multiple linear regression analyses, adjusting for duration of complaints, age, gender, and symptom severity at baseline. Results: At the 12-month follow-up, 35 of 94 (37%) patients in the intervention group had surgery, compared to 38 of 87 (44%) in the care-as-usual group ( χ 1 2 = 0.78, p = 0.377). Symptom severity and functional status scores did not significantly differ between the intervention (n = 81) and care-as-usual group (n = 55) at follow-up. For patients who did not have surgery, BCTQ scores decreased significantly more from baseline to the 12-month follow-up in the intervention group (n = 53) compared to patients in the care-as-usual group (n = 25). For patients who did not have surgery, belonging to the intervention group and a higher BCTQ score at baseline were related to a greater decrease in BCTQ scores from baseline to the 12-month follow-up, as well as symptom severity and functional status. Conclusions: Mechanical traction is effective in reducing symptom severity compared to current conservative treatment options in standard care and can therefore benefit the large number of patients that prefer conservative treatment for CTS. Clinical Trial Registration: Clinical Trials NL44692.008.13. Registered 19 September 2013, https://clinicaltrials.gov/ct2/show/NCT01949493 [ABSTRACT FROM AUTHOR]

Background: For patients with carpal tunnel syndrome (CTS), the only long-term effective treatment option is carpal tunnel release surgery. Up to one-third report recurrent symptoms, and 12% needs repeated surgery. This study aimed to evaluate the long-term effects of mechanical traction as a non-invasive treatment option for CTS compared to care as usual.Methods: Patients with electrodiagnostically confirmed CTS [N = 181; mean age, 58.1 (13.0) years; 67% women] were recruited from an outpatient neurology clinic in the Netherlands. Patients completed baseline questionnaires and randomized to the intervention group (12 treatments with mechanical traction, twice a week for 6 weeks) or care as usual. The primary clinical outcome measure was surgery during the 12-month follow-up. Secondly, we assessed symptom severity with the Boston Carpal Tunnel Questionnaire (BCTQ) at baseline and at the 12-month follow-up. Changes in CTS symptom severity between baseline and the 12-month follow-up were analyzed between groups using t-tests and a multiple linear regression analyses, adjusting for duration of complaints, age, gender, and symptom severity at baseline.Results: At the 12-month follow-up, 35 of 94 (37%) patients in the intervention group had surgery, compared to 38 of 87 (44%) in the care-as-usual group (χ12 = 0.78, p = 0.377). Symptom severity and functional status scores did not significantly differ between the intervention (n = 81) and care-as-usual group (n = 55) at follow-up. For patients who did not have surgery, BCTQ scores decreased significantly more from baseline to the 12-month follow-up in the intervention group (n = 53) compared to patients in the care-as-usual group (n = 25). For patients who did not have surgery, belonging to the intervention group and a higher BCTQ score at baseline were related to a greater decrease in BCTQ scores from baseline to the 12-month follow-up, as well as symptom severity and functional status.Conclusions: Mechanical traction is effective in reducing symptom severity compared to current conservative treatment options in standard care and can therefore benefit the large number of patients that prefer conservative treatment for CTS.Clinical Trial Registration: Clinical Trials NL44692.008.13. Registered 19 September 2013, https://clinicaltrials.gov/ct2/show/NCT01949493

Endometrial angiogenesis plays crucial roles in determining the endometrial receptivity. Defects in endometrial receptivity often cause repeated implantation failure, which is one of the major unmet needs for infertility and contributes a major barrier to the assisted reproductive technology. Despite the numerous extensive research work, there are currently no effective evidence-based treatments to prevent or cure this condition. As a non-invasive treatment strategy, botulinum toxin A (BoTA) was administered into one side of mouse uterine horns, and saline was infused into the other side of horns for the control. Impact of BoTA was assessed in the endometrium at 3 or 8 days after infusion. We demonstrated that BoTA administration enhances the capacity of endothelial cell tube formation and sprouting. The intrauterine BoTA administration significantly induced endometrial angiogenesis displaying increased numbers of vessel formation and expression levels of related marker genes. Moreover, BoTA intrauterine application promoted the endometrial receptivity, and the rates of embryo implantation were improved with BoTA treatment with no morphologically retarded embryos. Intrauterine BoTA treatment has a beneficial effect on vascular reconstruction of functional endometrium prior to embryo implantation by increasing endometrial blood flow near the uterine cavity suggesting BoTA treatment as a potential therapeutic strategy for patients who are suffering from repeated implantation failure with the problems with endometrial receptivity. [ABSTRACT FROM AUTHOR]

Abstract Background Pulmonary interstitial emphysema (PIE) in very low birth weight infants is a rare but severe complication. Although most of these air leaks develop in mechanically ventilated infants, they have also been reported in infants exposed only to nasal continuous positive airway pressure (CPAP). The optimal treatment for PIE is still under discussion and includes different approaches such as unilateral intubation, high frequency oscillation ventilation and even surgical lobectomy. However, as yet, there has been no report on complete resolution of unilateral PIE by positioning therapy without mechanical ventilation. Case presentation We report the case of a 28+1gestational week twin, 990 g birth weight, Apgar 9–10-10. After stabilization with nasal CPAP the baby received surfactant by less invasive surfactant application (LISA) technique in the delivery room after 35 min of life, and continued respiratory support with nasal CPAP. At day 5 X-ray presented unilateral PIE, while pCO2 increased from 40 mmHg to 55 mmHg and FiO2 from 0.21 to 0.28 to achieve SpO2 in the target range of 89–94%. The baby was treated by strict positioning on the affected hemithorax in a special splint while spontaneously breathing on High Flow Nasal Cannula (HFNC). Complete resolution of the unilateral PIE was observed after 96 h. No chronic lung disease developed. Conclusion For unilateral PIE in very preterm infants, positioning on the affected hemithorax without mechanical ventilation is a therapeutic option.

The article discusses the possibility that the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) could negatively impact the utilization of non-invasive and minimally invasive paediatric dental treatments for issues such as dental caries. It discusses the Hall technique (HT) in mixed caries treatment, attempting to minimize the risk of infection and transmission, and the use of traditional treatment.

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The aging population warrants the increase of mild cognitive impairment (MCI) prevalence, a condition that could progress to dementia. Efforts have been made to improve the MCI and prevent its progression, including the introduction of Tai Chi, a Chinese traditional exercise. The aim of this systematic review and meta-analysis was to evaluate the efficacy of Tai Chi in attenuating MCI among the elderly population. Records investigating the effect of Tai Chi exercise intervention on cognitive function among elderly patients were searched systematically from PubMed, ScienceDirect, Google Scholar, and Europe PMC as of April 13, 2023. The risk of bias (RoB 2.0) quality assessment was employed in the quality appraisal of the studies included. Review Manager 5.4.1 was used for data extraction and meta-analysis, where the standard mean difference (SMD) and 95% confidence interval (95%CI) were computed. Eight randomized control trials with a total of 1379 participants were included in this meta-analysis. Six trials assessed Montreal Cognitive Assessment scores, where its pooled analysis suggested that Tai Chi was as effective as conventional exercise (SMD=0.15, 95%CI: -0.11 to 0.40, p =0.26). However, pooled analysis of the Mini-Mental Status Examination suggested that Tai Chi intervention more effectively improved cognitive function and reduced the rate of cognitive impairment in elderly patients (SMD=0.36, 95%CI: 0.18 to 0.54, p <0.01) as compared to the control group. This systematic review and meta-analysis suggest that, in some extent, Tai Chi is efficacious in improving cognitive function and slowing down the rate of cognitive impairment among elderly patients., Competing Interests: All the authors declare that there are no conflicts of interest., (© 2024 by the authors.)

Objectives: Despite the increase in the root caries prevalence, little is still known about how dentists manage this condition. The present study aimed to evaluate the knowledge of dentists on diagnosing and recording root caries lesions (RCL)., Methods: The survey consisted of three domains: (1) dentists' knowledge on diagnosing, recording and managing RCL; (2) information about their current general clinical routines; and (3) their demographics. The four Swiss Universities distributed the survey via e-mail lists for alumni or professionals participating in continuing education. The data was quality checked. Construct validity, internal reliability and intraclass correlation (ICC) were assessed., Results: The survey was answered by 383 dentists from 25(out of 26) cantons [mean(SD) working experience: 22.5(12) years]. The majority replied that they see less than 5 patients with RCL per week, whereas 41 have at least 5 per week, and 40 % (157 dentists) do not distinguish RCL from coronal caries in their patients' medical records. When diagnosing active RCL, tactile sensation was the most predominant criterion (n = 380), whereas color (n = 224) and visual appearance (n = 129) of the lesion were less often selected. The most often chosen risk factors for RCL were poor oral hygiene and presence of biofilm.The responses were significantly influenced by the participants' place of education, their age and working area., Conclusion: The present survey highlights the huge diversity in diagnosing, recording and assessing risk factors of RCL. The benefits of an appropriate diagnosis, recording and management of risk factors of RCL should be highlighted in under- and postgraduate dental education., Clinical Significance: A great diversity in diagnosing, recording and assessing risk factors of RCL was observed, which migh strongly impact how dentists manage RCL. The study emphasizes the necessity for intensive efforts to bridge the gap between guideline recommendations and their implementation in private dental practices., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This double-blinded and split-mouth design, randomized feasibility study aimed to assess the efficacy of prophylactic and therapeutic use of a new age NitrAdineTM-based brushing solution (PerioTabs®) on the clinical parameters before and after periodontal therapy. Four subjects were randomly assigned to two treatment groups according to periodontal infection: PerioTabs® and placebo. At the first appointment, a split-mouth scaling was performed in all participants. All oral care instructions concerning the use of effervescent tablets were explained to the participants in detail. The morning after the tablets were finished, a full-mouth scaling was completed in all participants. All parameters were recorded at 0, 11, and 40 days. According to the results, both the therapeutic and prophylactic interventions showed similar impacts on the gingival index and probing depth compared to the placebo in all patients. The bleeding on probing was further reduced at the PerioTabs® group at baseline until day 40 compared to the placebo in the gingivitis patients with both interventions; at both 11 and 40 days in the periodontitis patients receiving the therapeutic intervention; and at baseline to day 40 in the periodontitis group receiving the prophylactic intervention. While the preliminary results of this new-age brushing solution appear to be a promising approach for a future therapy of periodontal diseases, further research on a larger sample size is needed to draw firm conclusions.

Remineralization treatment, which offers the advantage of being non-invasive, is increasingly being used as a minimal intervention treatment in managing incipient enamel caries. The aim of this review was to develop EBM guideline for optimized strategies for non-invasive treatment of incipient enamel caries. Japanese Society of Conservative Dentistry (JSCD) guideline committee formulated a Guideline for treating incipient enamel caries using the GRADE system, which is the global, mainstream standard for guideline development. The committee selected the most frequent clinical questions (CQs) in treating incipient enamel caries and identified clinically important outcomes in evaluating the efficacy of treatments. Using extensive electronic and manual searches, relevant randomized controlled trials and controlled clinical trials were identified. Based on evidence profiles produced by the committee, the panel discussed the effects, benefits and disadvantages of the selected treatments, as well as their cost effectiveness and feasibility, in order to achieve a consensus in treating incipient enamel caries non-invasively. A recommendation was made for each clinical question after voting by the panel members. Based on the evidence profile and panel discussions for each CQ, the experts strongly recommended application of topical fluoride to inhibit cavitation of incipient enamel caries, and to diminish white spot lesions. [ABSTRACT FROM AUTHOR]

Purpose: Non-invasive treatment of pectus carinatum (PC) deformity includes the use of a compression brace and exercises. In this study, we aimed to examine the effect of a physiotherapy protocol applied as adjunct to compression brace treatment in patients with PC.Methods: The study included 30 male patients between 11 and 18 years of age. Patients were randomly assigned into two groups: a brace treatment only group (Group 1) and a brace and physiotherapy group (Group 2). Patient demographics and disease-related properties, protrusion measurements, postural evaluations, deformity perceptions, life quality, and treatment satisfaction were evaluated.Results: Although both groups showed improvements based on external chest measurements related to PC protrusion following treatment (p < 0.001), Group 2 had more benefit from the treatment (effect size > 0.36) and displayed greater improvement in maximum protrusion degree and lateral length values (p < 0.05). Additionally, we found that patient perception of deformity, posture, psychological life quality, and treatment satisfaction scores were significantly better in Group 2 (p < 0.05).Conclusion: Owing to the satisfaction and additional benefits observed in the physiotherapy group, we think that a proper cardiopulmonary and musculoskeletal exercise program should be applied concurrently with brace treatment for patients with PC deformity. Nevertheless, long-term outcomes need to be clarified in future studies. [ABSTRACT FROM AUTHOR]