Subjective Patient Satisfaction Research Articles

Predicting good clinical outcomes after revision rotator cuff repair: the revision cuff repair prediction score.

The aim of this study was to develop a scoring system based on preoperative characteristics to predict clinical outcomes 2 years after revision rotator cuff repair. This retrospective study included 195 patients (mean age, 55.1 years) who underwent revision rotator cuff repair between July 2001 and December 2020 in 12 treatment centers in France. All patients were evaluated preoperatively and at least 2 years after surgery in terms of Constant score, subjective shoulder value (SSV) and patient satisfaction. Variables associated with these clinical outcomes in a multivariable logistic regression model were included in the scoring system and weighted according to their association with 1, 2 or 3 of the considered clinical outcomes (Constant score, SSV, patient satisfaction). The ability of the scoring system to predict Constant scores > 70 points and SSVs > 70% 2 years after surgery was optimized using receiver operating characteristic (ROC) curves. In multivariate analysis, an isolated supraspinatus tear was associated with higher Constant scores (p = 0.019), SSVs (p < 0.001) and patient satisfaction (p = 0.004); work-related tendon tears were associated with lower Constant scores (p = 0.019) and SSVs (p = 0.005); female sex was associated with lower Constant scores (p = 0.002); manual work was associated with lower SSVs (p = 0.046); and smoking and a delay between primary and revision repair > 6 months were associated with lower patient satisfaction (p = 0.049 and p = 0.020). These variables were weighted in the scoring system from 0 to 9 points as follows: 3 points for an isolated supraspinatus tear, 2 points for a non-work-related tendon tear, and 1 point each for non-manual work, non-smoking status, male sex, and a delay to revision < 6 months. The AUCs of the scoring system to predict a Constant score > 70 points and an SSV > 70% two years after revision repair in these patients were 72% and 73%, respectively. The positive predictive value of a score ≥ 6/9 points was 80% for a Constant score > 70 points, 91% for an SSV > 70% and 91% for patient satisfaction, two years after revision repair. A simple scoring system for patients with recurrent rotator cuff tear based on six preoperative characteristics was optimized to predict good clinical outcomes 2 years after revision rotator cuff repair. This revision rotator cuff repair prediction (RCRP) score could be used in patient counseling and to identify those most likely to benefit from revision repair.

Similar patient-reported satisfaction and professional appraisal of implant-supported fixed dental prosthesis fabricated by different workflows.

A triple-armed, double-blind randomized controlled trial with cross-over design investigated patient-reported satisfaction and objective dental evaluation of a 3-unit, monolithic zirconium dioxide (ZrO2), implant-supported fixed dental prosthesis (iFDP) fabricated with 2 completely digital workflows and 1 mixed analog-digital workflow. Participants enrolled required rehabilitation of 2 dental implants in posterior region of either of the arches with a 3-unit, ZrO2 iFDP. A total of 20 participants received the 3 types of ZrO2, iFDP fabricated by 3 different methods. Thus, a total of 60 iFDPs were fabricated in the study. 20 iFDP were fabricated by complete digital workflow by using 3Shape Trios 3 Intraoral scanner (IOS) and 3 Shape designing software (Test-1). In second group (Test-2) 20 iFDPs were fabricated by using Dental Wings Virtuo Vivo IOS and Dental Wings original software (DWOS) for CAD designing. 20 iFDPs (control) were fabricated by mixed analogue-digital workflow by using Polyether impression and Exocad Lab software. The primary clinical outcome was blinded, subjective evaluation on visual analogue scale (VAS) by the participant, and an objective evaluation on VAS by a dentist at the time of prosthetic try-in of each of the 3 types of prosthesis. Secondary outcome was patients' perception about the impression procedures in the 3 different workflows on VAS. The study was conducted at 2 instances during the prosthetic rehabilitation. The primary outcomes were assessed at the time of prosthetic try-in. The secondary outcome was observed after the impression session. Clinical parameters were measured on VAS from 0 to 100 score. For the primary outcome, VAS score was recorded for each iFDP as observed for patient perception (satisfaction) and dentist evaluation (objective). The perception about impression was also recorded on VAS. Descriptive analysis of all scores was done by mean and standard deviation. ANOVA test was used for comparisons among the 3 different types of iFDP. Tukey's HSD was used for pairwise comparisons within ANOVA. Linear regression analyses was done to compare overall satisfaction of the patients and the dentist within each group. The level of significance was set at α = 0.05. After the start of recruitment in January 2020, there were no losses and exclusions. VAS for patient satisfaction was higher than VAS for dentist evaluation. Patient satisfaction among Test-1, Test-2, and Control showed no significant difference (P = 0.876). Dentist satisfaction among workflows were also not significantly different (P = 0.22). The relationship between VAS scores of patients and dentists was weak for Test-1 (R-value = -0.424, P = 0.062), Test-2 (R-value = 0.116, P = 0.068), and Control (R-value = -0.183, P = 0.441). Significant differences for patients' perceptions related to the treatment time for impression procedure (P = 0.005), convenience of impression procedure (P < 0.001), bad oral taste with the impression procedure (P < 0.001), and nausea with the impression procedure (P < 0.001) were observed. Subjective patient satisfaction was similar when comparing iFDPs fabricated with 3 different workflows. Objective dentist evaluation was also similar when comparing the 3 types of iFDPs. However, patient satisfaction of the workflow was higher than dentist evaluation, although there was no correlation between the two. Lower VAS in dentist's evaluation has been attributed to strict standardized clinical criteria and critical expert view. The study also reveals that patients have a favorable perception and preference in favor of digital impressions as compared to use of elastomeric impression materials.

The impact of virtual reality on patient experience during wide-awake surgery: a randomized controlled trial.

This study aimed to establish whether virtual reality can reduce patient anxiety and improve surgical satisfaction during wide-awake local anaesthetic no tourniquet hand procedures. Previously validated questionnaires were used to assess subjective anxiety and patient satisfaction. Objective anxiety was determined using patient blood pressure and heart rate measured four times during the procedure. The median difference in intra-operative minus pre-operative diastolic blood pressure was significantly lower in the virtual reality group compared with the control group (p = 0.003). There was a significant decrease in heart rate from pre-operative to post-operative within the virtual reality group (p < 0.001). No differences were observed in subjective anxiety or surgical satisfaction between the groups. Virtual reality can benefit wide-awake patients during hand procedures, particularly where patient preference exists.Level of evidence: Level I, Randomized Controlled Trial.

A Combination of Conventional Transconjunctival Lower Blepharoplasty and Percutaneous Nanofat Grafting in a Young Chinese Population With Eyelid Bags and Tear Trough Deformities.

A simple and minimally invasive combined procedure, including transconjunctival orbital fat removal and transcutaneous resected orbital fat injection, was performed based on the anatomical characteristics of the lower eyelids in our young Chinese patients. Our study aimed to investigate the efficacy and safety of this procedure in our study population. In our retrospective study, a total of 183 consecutive patients underwent a combination of traditional transconjunctival blepharoplasty and nanofat grafting between February 2020 and June 2024. After transconjunctival septal fat removal, the resected orbital fat was processed into fat emulsion (nanofat) and then injected percutaneously into the depressed tear trough zone. The mean age of the 183 patients was 26.9 years old, and the average surgery time was 36.1 min. The mean volume of nanofat injected for bilateral lower eyelids in each patient was 1.1 mL. All the patients were followed for at least 6 months after surgery, and the subjective patient satisfaction was 96.6% (175/183) with fewer complications. In the objective assessment of the surgical outcomes according to the five anatomical elements of lower eyelids, orbital fat prolapse, tear trough depression and dark circles were all improved, orbicularis prominence was more evident, while skin elasticity did not vary significantly after operation. Our study provided a simple, effective, and safe combination of transconjunctival lower blepharoplasty and percutaneous nanofat grafting for the treatment of lower eyelid bags with high patient satisfaction, quick recovery and low complication rate. Thus, this combined application may be a promising alternative choice for the young Chinese with lower eyelid bags.

Discrepancies in Subjective Perceptions of Hydrocephalus Management and Self-Reported Outcomes.

Background/Objectives: Despite surgical interventions with advances in endoscopic procedures as well as shunt technologies, the quality of life in patients with hydrocephalus can be poor. Clinical experience suggests discrepancies between objective measures of treatment success and subjective patient satisfaction. With this study, we retrospectively investigated patients' knowledge of their treatment as well as their satisfaction with received interventions. Methods: Retrospective analysis of self-reporting forms, routinely handed out in the hydrocephalus clinic of a tertiary neurosurgical center, was performed. Clinical data were gathered between 1 January 2020 and 31 March 2023. Correlation of self-reporting forms and available clinical data was performed. Results: A total of 261 forms from 215 patients were obtained. The mean age at visit was 57.5 ± 18.5 years (range 19-88). The most common pathology was normal pressure hydrocephalus (NPH, 31.6%); 31.2% had an occlusive etiology, 22.3% posthemorrhagic, 9.8% benign intracranial hypertension and 5.1% another pathology. Overall, 53% of patients (n = 114) indicated the correct therapy on the self-reporting forms (χ2 (56) = 100.986, p < 0.001). Symptoms and subjective benefit did not differ in the different types of provided therapy. Conclusions: Merely half of the patients with hydrocephalus are able to correctly indicate the treatment they had received. The type of shunt valve did not affect the rate of self-reported symptoms. The symptoms and subjective benefits did not differ in the different types of provided therapy. Poor patient knowledge could correlate with poor self-reported quality of life. Medical professionals should emphasize and advocate for better patient education.

МЕТОДИКА КОМПЛЕКСНОЙ ОЦЕНКИ ИСКУССТВЕННЫХ КОРОНОК В ПОЛОСТИ РТА

According to statistics collected by domestic and foreign authors, the number of patients in need of orthopedic treatment is increasing every year. [7,8] Modern dental prosthetics includes not only an integrated approach to rehabilitation and restoration of lost functions, but also a high level of aesthetics of the prostheses themselves, which has a significant impact on the comfort and quality of life of dental patients [7,8,15]. The patient's subjective satisfaction with the result of treatment is one of the main tasks of an orthopedic dentist, no less important than rational prosthetics itself. Thus, in order to achieve success, it is necessary to carefully analyze the initial clinical situation, draw up a comprehensive treatment plan, perform dental prosthetics and evaluate the results obtained. The purpose of the work: to propose a fast and effective method for the comprehensive assessment of an artificial tooth crown, which would have practical application by dentists, would not require significant efforts to interpret the results, and also took into account the general subjective assessment of the patient's quality of life. We have created a web page on the Internet where the proposed two-stage questionnaire is posted. The following technologies and libraries were used to implement the project: HTML5: The main markup language for creating the structure of a web page, including a table with evaluation parameters. CSS: A style language used for the visual design of a table and other elements of a web page to provide a user-friendly and intuitive interface for users. JavaScript: A scripting programming language used to implement the logic of calculating the W coefficient and dynamically displaying the results on the page. The first part is an assessment of artificial crowns according to the method of patent No. 2619386 From the Russian Federation, IPC A61B 10/00 [3], supplemented by an assessment of galvanosis phenomena. The second part is presented by the standardized questionnaire OHIP-14RU [1]. The proposed technique allows for a quick, effective, comprehensive and unified assessment of artificial crowns and their impact on the comfort of the patient's quality of life. Conclusions. This work is aimed at improving the results of comprehensive orthopedic treatment and rehabilitation of patients. The technique allows for a comprehensive assessment, is fast and effective, and is suitable for direct use at a clinical appointment and in research activities in the field of medicine.

Safety and Efficacy of Minimally Invasive Sacrospinous Ligament Fixation for Apical Pelvic Organ Prolapse in Older Women.

Background: This study aimed to evaluate the safety and efficacy of minimally invasive sacrospinous ligament (SSL) fixation of apical pelvic organ prolapse (POP) in older patients compared to younger patients. Methods: A cohort of 271 older (≥65 years) patients (mean age 71.8 ± 5.2 years) and 60 younger patients (mean age 47.6 ± 7.1 years) with stage III or IV apical POP who underwent SSL fixation by the EnPlace® device was retrospectively analyzed. The age range of older patients was further divided into early old (65-74 y, N = 209), old (75-84 y, N = 58), and late old (>85 y, N = 4). Patient characteristics, surgical safety, and 6-month postoperative outcomes were compared between the four age groups. Results: Duration of surgery and blood loss were similar among all age groups. Most patients (99.4%) were discharged on the day of surgery or the day after. Subjective patient satisfaction rates were high among all patients. Point C measurements at six months postoperatively were less favorable among the younger patients. Furthermore, four (6.7%) younger patients versus six (2.2%) older patients required surgical repair of recurrent apical POP within the follow-up period. Conclusions: The short-term outcomes of minimally invasive SSL fixation suggest that it is a safe and effective procedure for significant apical POP repair among older patients.

A Study on Septoplasty and Functional Septorhinoplasty in Children.

Surgical techniques that are safe and effective in adults can produce bad results in children. The study was done To present the results of septoplasty and functional septorhinoplasty (FSR) in children in order to restore the anatomy and function of the nose. In a prospective study done in a tertiary care hospital between May, 2016 and November, 2022, twenty-five children (14 males and 11 females) aged 8 to 14 years having significant nasal obstruction due to deviated septum with or without external nasal deviation were included in this study. Septoplasty was done in 16 patients and FSR was done in 9 patients by endonasal technique. Surgical outcomes were evaluated by comparing preoperative and postoperative photographs, NOSE scores, anterior rhinoscopy and subjective satisfaction. The follow-up period ranged from 15 to 90 months with a mean follow-up period of 43 months. Out of the 25 patients, the mean NOSE scores preoperatively and postoperatively were 72 and 22 (a significant improvement of mean 50.00 with p-value of < 0.05). Anterior rhinoscopy postoperatively showed that 19 patients (76%) had a straight septum while 6 patients (24%) had some residual deviation. Subjective patient satisfaction was "much improved" in 13 (52%) patients, and "improved" in 12 (48%) patients. In photographic evaluation of 9 patients with external nasal deviation the result was very good in 3, good in 5 and average in 1 patient. Septoplasty and FSR in children resulted in significant improvements in nasal airway and external nasal deviation.

(204) INITIATING HIGH-DOSE ORAL TESTOSTERONE UNDECANOATE THERAPY IN HYPOGONADAL MEN: SAFETY, EFFICACY, AND PATIENT SATISFACTION

Abstract Introduction Hypogonadism in men is commonly treated with testosterone replacement therapy. Kyzatrex (Marius Pharmaceuticals), a novel oral testosterone undecanoate (TU) formulation, is conventionally initiated at a dose of 200 mg BID. However, many patients attain greater symptomatic benefit at higher doses. In our practice we often initiate therapy at a starting dose of 400 mg BID. This retrospective chart review examines the outcomes of initiating therapy at 400 mg BID. Objective Retrospectively report the safety, efficacy, patient satisfaction, and adherence of starting hypogonadal men on oral TU at the maximum available dose of 400 mg BID. Methods This retrospective, single-center chart review included hypogonadal men treated with oral TU at 400 mg BID from August 2023 to April 2024. Medical records were reviewed for baseline and follow-up levels of serum total testosterone (TT), sex hormone binding globin (SHBG), calculated free testosterone (fT), Estradiol, Hematocrit (Hct), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Satisfaction was subjectively recorded in the medical record and adherence was measured by prescription refill records. Results A total of 27 patients met the inclusion criteria and had complete data. At a mean follow up time of 6 months, patients demonstrated a significant increase in TT (263 to 798 ng/dL), drop in SHBG (32.4 to 17.83 nmol/L), and increase in calculated fT (7.24 to 26.74 ng/dL). FSH and LH, while lower, were maintained at non-zero levels (FSH from 5.7 to 2.9 mIU/mL and LH from 3.3 to 1.9 mIU/mL). Estradiol modestly increased (20.5 to 24.7 pg/mL) while hematocrit did not significantly increase (44.9% to 47.4%). No patients reported testicular atrophy or were initiated on aromatase inhibitors. One patient had a hematocrit rise above 52% (53.2%) and was reduced to 300 mg BID. Patient reported side effects were rare with 2 patients (7.4%) reporting transient GI upset. Subjective patient satisfaction was high, with 26/27 (96%) of patients reporting improvement in symptoms and continuing on therapy. One patient opted to convert to testosterone cypionate injections instead. Conclusions Initiating oral TU therapy with Kyzatrex at 400 mg BID is safe and effective in achieving therapeutic serum testosterone levels. The high dose was well-tolerated and resulted in substantial symptom improvement, high patient satisfaction, and adherence. These findings support considering a higher starting dose for hypogonadal men considering oral TU therapy. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Senior author serves as consultant for Marius Pharmaceuticals, Boston Scientific, Endo Pharmaceuticals.

Polyetheretherketone split post and core for restoration of multirooted molar with insufficient dental tissue remnants by digital techniques: a case report and 3-year follow up

BackgroundMulti-rooted teeth with extensive dental defects often face challenges in stability and biomechanical failure. High-performance polymer PEEK materials, with properties closer to dentin, show promise in reducing stress concentration and preserving tooth structure. This report aimed to explore the use of a highly retentive polyetheretherketone (PEEK) for manufacturing custom-made split post and core for the restoration of grossly destroyed endodontically treated molars.Clinical considerationsA 40-year-old female patient presented with complaints of loss of tooth substance in the posterior mandibular tooth. This case involved the digital design and fabrication of PEEK split post and core to restore multirooted molar with insufficient dental tissue remnants. The restorations were evaluated over a 3-year follow-up using the World Federation criteria (FDI). The restoration was clinically evaluated through intraoral examination, radiographic assessment, and subjective patient satisfaction, and was deemed clinically good according to FDI criteria.ConclusionThe outstanding mechanical properties of PEEK, coupled with the structure of the split post, provide an effective treatment option for weakened multirooted teeth. Simultaneously, the restoration configuration effectively addressed the challenge of varying postinsertion directions, and the interlocking mechanism between the primary and auxiliary posts enhanced the stability of the post and core.

An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension – a comprehensive assessment of patient satisfaction

BackgroundManagement of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop concept. Here, we aimed to evaluate effects of this one-stop concept on subjective patient satisfaction and economic outcome in patients with IIH.MethodsIn a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding subjective patient satisfaction (assessed by the Vienna Patient Inventory). Multivariable binary linear regression models were used to adjust for confounders.ResultsBaseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, management within IC concept was associated with statistically significantly higher subjective patient satisfaction (beta = 0.93; p < 0.001) with the strongest effects observed in satisfaction with treatment accessibility and availability (beta = 2.05; p < 0.001). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of IC in these groups.ConclusionsInterdisciplinary integrated management of IIH statistically significantly and clinically meaningfully improves patient satisfaction – particularly in socioeconomically underprivileged patient groups. Providing structured central coordination to facilitate and improve access to interdisciplinary management provides means to further improve outcome.

Clinical examples of correct orientation of a toric intraocular lens in patients with postkeratotomic corneal ectasia

BACKGROUND: Surgical treatment of cataract in patients with postkeratotomic corneal ectasia has various features. First, difficulties arise when calculating the optical strength of an intraocular lens and its cylindrical component and determining the location of the main axes of astigmatism for toric intraocular lens implantation. Additionally, not all modern keratotopography installations are able to accurately determine the refractive power of the cornea in such patients owing to pronounced irregular astigmatism and a large difference in keratometric parameters in the main meridians. CLINICAL CASES DESCRIPTION: Two clinical cases of surgical treatment of cataract in combination with postkeratotomic keratectasia are presented. Patients underwent a standard preoperative ophthalmological examination. TMS-4 Tomey keratotopograph was used to accurately determine the refractive power of the cornea. The optical power of toric intraocular lens were calculated using the Holladay 2 formula with amendments for radial keratotomy and the Johnson Johnson VISIC online calculator. SN6AT9 intraocular lens (Alcon) and a Tecnis ZCT800 toric intraocular lens (Johnson Johnson) were implanted in patients. The orientation of the position of the cylinder axis of toric intraocular lens was performed perpendicular to the most flattened meridian, corresponding to the position of the keratectasia zone, determined by the most expanded keratotomy scar. Before surgery, the best corrected visual acuity of patient M was OD=0.2, OS=0.4 and that of patient K was OD=0.4, OS=0.2. After surgery, the best corrected visual acuity of patient M was OD=0.8, OS=0.8 and that of patient K was OD=0.8, OS=0.7. CONCLUSION: This study aimed to familiarize practicing ophthalmologists, clinical residents, and postgraduates with a possible treatment option for cataracts by phacoemulsification with implantation of a toric intraocular lens in patients with postkeratotomic keratectasia. The resulting high visual acuity and subjective satisfaction of patients indicate the accuracy of chosen treatment tactics. A reliable visual guide for choosing the cylinder axis is the meridian of the greatest degree of keratectasia (cornea flattening), which is determined by the maximally expanded keratotomy scar position. The intraocular lens cylinder axis is oriented perpendicular to the keratectasia meridian. Ultrasound phacoemulsification of cataract with implantation of a toric intraocular lens is an effective method for correcting induced ametropia after radial keratotomy against the background of postkeratotomy keratectasia with high astigmatism.

Dorsal Metatarsal Closed Wedge Osteotomy in the Treatment of Freiberg's Disease: A Prospective Observational Study.

The aim of this study was to prospectively evaluate the clinical and radiological results of dorsal metatarsal closed wedge osteotomy and headless screw fixation in the surgical treatment of Freiberg's disease.Thirty-four patients who were treated with dorsal metatarsal closed wedge osteotomy (DMCWO) for Freiberg's disease between February 2018 and March 2022 were included in the study. Patients were staged according to the classification system described by Smillie. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society's (AOFAS) lesser metatarsophalangeal-interphalangeal scale, the visual analog scale (VAS), the range of motion (ROM) of the metatarsophalangeal (MTP) joint, and a subjective patient satisfaction questionnaire. For radiological evaluation, the amount of preoperative shortening of the involved metatarsal, the amount of metatarsal shortening developed after osteotomy, and radiological recovery times were recorded.Thirty-two (94.1%) of the patients were female, and two (5.9%) were male. The average postoperative follow-up period for patients was 33.7 months (range: 24 months to 41 months). The mean AOFAS scores increased from 53.24 to 86.26 (p<0.01). The mean VAS scores decreased from 8.59 to 1.79, and it was observed that the patients' pain improved significantly (p<0.01). The mean ROM of the MTP joint increased from 48.76 degrees to 70.76 degrees (p<0.01). An average of 2.5mm (range 1mm to 4.1mm) of shortening of the metatarsal length developed postoperatively (p<0.01). Arthrosis developed in 1 case (2.9%), and transfer metatarsalgia developed in 2 cases (5.8%).DMCWO is an effective treatment for both the early and advanced stages of symptomatic Freiberg's disease, leading to high patient satisfaction.

Scleral Lenses for Managing Dry Eye Disease in the Absence of Corneal Irregularities: What Is the Current Evidence?

Scleral lenses (SLs) are large-diameter rigid contact lenses that are a mainstay treatment for eyes with corneal irregularities. In recent years, there has been increased interest in the role of managing dry eye disease (DED) with SLs, as many patients with DED have reported symptomatic relief with SL wear. The role of SLs for DED management when there are associated corneal irregularities is supported by individual case reports and studies. This has prompted practitioners to begin advocating using SLs in DED cases, even in the absence of associated corneal irregularities and other ocular surface diseases (OSDs). There have also been discussions on potentially placing SLs earlier in the treatment hierarchy of DED, where it currently sits at a more advanced level of intervention (Step 3) in the TFOS DEWS II Report. This review will present the currently available, albeit sparse, evidence that supports and suggests this practice, as well as ancillary evidence supporting the purported benefits of SL wear in DED. The advantages of SL wear, such as corneal healing, absence of tear evaporation and contact lens dehydration, and improved visual acuity with associated increased wear comfort, and how this will benefit DED patients will be explored. Conversely, the challenges associated with fitting SLs in DED patients, including increased midday fogging, poor wettability, and subjective patient satisfaction, will also be presented, as well as a discussion on the key considerations for SL fitting in this population. Overall, while more research is needed to support the use of SLs in DED patients without associated corneal irregularities and other forms of OSD, the use of these lenses may prove to have a potentially wider role given their reported ancillary benefits in these populations.

A Comparative Study of Correction of Caudal Septal Deviations.

There are multiple surgical approaches for the correction of caudal septal deviation. To compare the surgical outcomes of the widely used techniques of correction of caudal septal deviation. In a prospective study done over a period of 3 years, 36 patients with caudal septal deviation were selected and randomly divided into 3 groups of 12 each who underwent surgery by the following techniques: Group A - Swinging Door technique. Group B- Tongue-in-groove technique. Group C- The cutting and suture technique with unilateral bony batten grafting. The preoperative and postoperative (at 6 months) NOSE score, anterior rhinoscopy and subjective assessment were used to measure surgical outcomes and the techniques were compared. Out of the 36 patients, the mean NOSE score preoperatively and postoperatively were as follows. For Group A- 72.5 and 23.33. For Group B- 73.75 and 19.17. For Group C- 72 and 22. A significant improvement of mean 49.17, 54.58 and 50.00 with p-value of < 0.05 respectively. Anterior rhinoscopy done at 6 months postoperatively showed that 30 patients (83%) had a straight septum while 6 patients (17%) had some residual deviation. Subjective patient satisfaction was "much improved" in 17 (47.2%) patients, and "improved" in 19 (52.8%) patients. Four patients had postoperative synechia which were managed conservatively. Surgical correction of caudal septal deviation resulted in significant improvements in nasal airway. The tongue-in -groove technique was found to be the most effective among the three.

Platelet-Rich Plasma Injections in Chronic Lateral Ankle Instability: A Case Series.

The platelet-rich plasma (PRP) approach may be an effective treatment for joint and cartilage pathologies. However, the rationale for its effectiveness on joint instability is limited. This study aimed to assess the safety and effectiveness of PRP injections in patients with chronic lateral ankle instability (CLAI). This retrospective study was performed at a single-center outpatient clinic between January 2015 and February 2023 and included pre-intervention assessment and short-term follow-up. Patients were excluded if they had received previous surgical treatment or had constitutional hyperlaxity, systemic diseases, or grade II or III osteoarthritis. The clinical and functional evaluation consisted of the Karlsson score, the Cumberland Ankle Instability Tool (CAIT), Good's grading system, the patient's subjective satisfaction level, and the time required to return to exercise. The entire PRP therapy regime consisted of three PRP administrations at 7-day intervals and follow-up appointments. PRP was administered both intraarticularly and into talofibular ligaments. A total of 47 consecutive patients with CLAI were included, 11 were female (23.4%), with a mean age at intervention of 31.19 ± 9.74 years. A statistically significant improvement was found in the CAIT and Karlsson scores at 3 months (27.74 ± 1.68 and 96.45 ± 4.28, respectively) relative to the pre-intervention status (10.26 ± 4.33 and 42.26 ± 14.9, respectively, p < 0.000). The mean follow-up of patients with CLAI was 17.94 ± 3.25 weeks. This study represents successful short-term functional and clinical outcomes in patients with CLAI after PRP treatment, with no adverse effects. It demonstrates the feasibility of a randomized controlled trial to further assess this therapy.

Could the different surgical goals of fusion and non-fusion also be achieved in combination within the same patient? Clinical and radiological outcome of hybrid cervical spine surgery.

Hybrid cervical spine surgery (HS) is a novel surgical strategy wherein an artificial disc replacement is done with a cervical fusion nearby with a stand-alone titanium cage to combine the advantages in both procedures. The aim of this study was to evaluate interactions of these devices within the same patient, and to analyze, if the different goal of each implant is accomplished. Thirty-six patients were treated surgically within a non-randomized retrospective study framework with HS. Patients were examined preoperatively followed by clinical and radiological examination at least one year postoperative. Clinical outcome was detected with NDI, VAS arm/neck, pain self-assessment questionnaires and subjective patient satisfaction. Radiological assessments included RoM, segmental lordosis, cervical lordosis of C2-C7, subsidence, ap-migration and heterotopic ossifications (HO) at the cTDR levels. Statistically significant improvement of all clinical scores was observed (NDI 37.5 to 5.76; VASarm 6.41 to 0.69; VASneck 6.78 to 1.48). Adequate RoM was achieved at cTDR levels. RoM in the ACDF levels was reduced statistically significant (p < 0.001), and solid fusion (> 2°) was achieved in all evaluated fusion level. Global lordosis (C2-C7) increased statistically significant (2.4° to 8.1°). Subsidence and HO at the cTDR levels did not occur. HS results in preservation of the segmental motion in the cTDR and fast and solid fusion in the cage cohort simultaneously. Patient safety was proven. In carefully selected cases, HS is a safe and viable treatment option by choosing the right "philosophy" level per level.

Autologous fat grafting and adipose-derived stem cells therapy for acute burns and burn-related scar: A systematic review.

The objective of this study was to analyze all available research on the application of autologous fat grafting (AFG) and adipose-derived stem cells (ADSC) to present evidence-based recommendations, particularly in the clinical treatment of acute burns and burn-related scars. We conducted a systematic search of PubMed, COCHRANE, and EMBASE, as well as a manual search of previous reviews' reference lists up. The risk of bias (RoB) was assessed using RoB 2.0 and ROBINS-I, where appropriate. Six eligible studies were selected (2 randomized clinical trials [RCT], 1 retrospective cohort, and 3 experimental studies) with subjects ranging from 3 to 100. Only one study evaluated the use of AFG for acute burns. Improvements in wound healing, vascularization, scar characteristics, and tissue architecture were generally observed in some studies, supported by molecular markers, while one study reported nonsignificant results. Subjective patient satisfaction was reported to have improved. Functional outcomes improvement in the treated regions was minimal. However, study heterogeneity arose mainly from treatment protocols. Cautious results interpretation due to potential bias, especially in selection and confounding domains, and limited clinical trials are important to note. More studies are needed to evaluate. AFG and ADSC hold potential as valuable treatment options for burn-related scars, supported by a body of evidence, but further well-designed RCT are needed. The efficacy of acute burn settings is yet to be further evaluated since evidence is limited.

Liposuction-Only Breast Reduction: A Systematic Review of Outcomes.

Over the past few decades, there have been multiple reports of liposuction assisted breast reduction. This technique appeals to patients due to the limited scars and complication profile, compared to traditional reduction mammaplasty techniques. We aimed to systematically review the literature, to elucidate the outcomes and safety of liposuction-only breast reduction. A systematic review was performed using the Ovid (Medline/PubMed) database, in accordance with the PRISMA checklist. In total 7 articles were included within this systematic review. A total of 652 patients were included. Liposuction-only breast reduction appears to lead to improvements in subjective outcome measures, patient satisfaction, and objective outcomes such as moderate breast volume reduction and reduction in breast ptosis. Overall, the procedure had a low complication profile. Liposuction did not preclude further surgery. No evidence of malignancy or difficulty in future breast cancer screening was noted. Macromastia leads to a considerable health burden, especially in health-related costs. From the current evidence base, liposuction-only breast reduction appears to be a safe and effective procedure, especially in patients requiring a mild-moderate breast volume reduction and mild ptosis correction. More research is required, with standardised subjective and objective outcome measures, and longer follow-up periods to confirm the effectiveness and safety of this technique. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

Evaluation of Clinical Results of Implantation of Toric Intraocular Lenses Including their Rotational Stability.

The aim of the study was to evaluate the clinical results of the implantation of the toric intraocular lens Acrysof IQ Toric SN6AT3_8(Alcon Laboratories, Inc., Fort Worth, TX, USA), including an evaluation of its rotational stability. 30 eyes of 16 patients (4 males, 12 females; mean age 68 years) with regular corneal astigmatism ranging from -1.5 to -4.0 Dcyl were included in this retrospective study. All the patients underwent uncomplicated cataract surgery with the implantation of a toric intraocular lens (TIOL) at the Department of Ophthalmology of the Faculty of Medicine and Dentistry of Palacký University in Olomouc and University Hospital Olomouc during the course of 2020. Follow-up examinations were performed 3-6 months after cataract surgery. We monitored the resulting uncorrected distance visual acuity (UDVA), postoperative refraction, rotational stability of the implanted lens and subjective patient satisfaction. mean preoperative corneal astigmatism was -2.41 ±0.67 Dcyl. UDVA improved from a mean value of 0.45 ±0.25 (expressed in decimal Snellen optotype values) to 0.91 ±0.16. The spherical equivalent value of 0.41 ±2.92 improved to -0.11 ±0.27 postoperatively. The mean deviation from the planned axis was 4.87 ±4.75. Subjective satisfaction was rated by patients on a scale of 1-5, with a mean score of 1.5. TIOL implantation is a safe and effective solution for patients with corneal astigmatism and cataract. Our results demonstrate improved UDVA, rotational stability of the TIOL and subjective patient satisfaction with the outcome of the surgery.