UNASSIGNED: The incidence of proximal humerus fractures (PHFs) continues to increase with an aging population, and intramedullary nailing (IMN) and locking plate fixation are two commonly employed techniques for the surgical management of PHF. However, the optimal fixation method can be a source of ongoing controversy. Some influencing factors include the extent of humeral head involvement, fracture complexity, patient age, and surgeon preference. There are many studies that provide a mix of data either when comparing the two techniques or analyzing them in isolation. The aim of this review is to further elucidate the indications and technical considerations involved specifically in IMN vs. locking plate fixation for PHF to further aid orthopedic surgeons when choosing surgical management.
UNASSIGNED: A narrative approach was chosen for this review allowing for a comprehensive review of literature, including recent findings pertaining to the comparison of management options for PHF. A comprehensive literature search was conducted using the PubMed, Embase, and Cochrane Library databases. The inclusion criteria involved studies that discussed \"proximal humerus fracture\" and either \"intramedullary nail\" or \"locking plate fixation.\"
UNASSIGNED: Complications such as avascular necrosis, hardware failure, additional surgical interventions, infection, fracture redisplacement, rotator cuff rupture, and nonunion did not show significant differences between the two groups. Newer generation humeral nails have minimized early complications. As both techniques undergo further refinement and utilization when specifically indicated, functional outcomes, potential complications, and postoperative pain continue to be improved.
UNASSIGNED: The available evidence suggests that both intramedullary nails and locking plates can effectively restore shoulder function in the treatment of displaced proximal humeral fractures, with unclear superiority of either method. The choice of technique should be tailored to patient factors such as fracture type, age, bone quality, and functional expectations. Surgeon experience also plays a role. While certain presentations may exhibit trends that favor one fixation, no specific technique can be universally recommended. Both IMN and LP have shown comparable and satisfactory outcomes, and the final fixation method chosen should take into account the unique characteristics of each patient.

In recent years the number of patients treated in intensive care units by extracorporeal membrane oxygenation (ECMO) due to severe respiratory failure or cardiogenic shock has steadily increased [1]. Consequently, the number of invasive procedures and operations in these patients has also increased. A fundamental understanding of these systems and the clinical indications is therefore helpful for the practicing (non-cardiac) surgeon. This review article focuses on peripheral ECMO procedures: venovenous (V-V) ECMO for patients with respiratory failure and venoarterial (V-A) ECMO for circulatory support in cardiogenic shock.
UNASSIGNED: In den letzten Jahren haben sich die Zahlen von Patienten, die mit einer extrakorporalen Membranoxygenierung (ECMO) aufgrund einer schweren respiratorischen Insuffizienz oder eines kardiogenen Schocks auf Intensivstationen behandelt werden, stetig erhöht [1]. Damit steigt auch zwangsläufig die Anzahl an invasiven Prozeduren und Operationen bei dieser Patientenklientel. Ein prinzipielles Verständnis der Funktionsweise und der Indikationen für den Einsatz dieser Systeme ist damit auch für den (nicht kardio‑)chirurgisch tätigen Arzt hilfreich. Der Schwerpunkt dieses Übersichtsartikels liegt auf den peripheren ECMO-Verfahren: venovenöse (V-V-)ECMO bei Patienten mit respiratorischer Insuffizienz und venoarterielle (V-A-)ECMO zur Kreislaufunterstützung bei kardiogenem Schock.

Background Obesity is a major global health concern, causing significant health dilemmas. Large groups of Saudi individuals are considered obese, with significant implications for medical practice. Bariatric surgery, including sleeve gastrectomy, is a crucial intervention for severe obesity, although it is associated with potential complications. This study aims to investigate the public knowledge about the indications and consequences of sleeve gastrectomy in the Southwest region of Saudi Arabia and assess their general awareness of sleeve gastrectomy. Methodology This descriptive, cross-sectional, online-based study included 347 individuals from the Southwest region of Saudi Arabia. Data were collected via an online questionnaire and analyzed using SPSS version 27 (IBM Corp., Armonk, NY, USA). Results This study included 347 participants, with a majority being females (88.5%, n = 307) and Saudis (98.6%, n = 342). The most common age group was 21-25 years (34%, n = 118), followed by those over 40 years of age (26.5%, n = 92). Most participants resided in Al-Qunfudhah (66.3%, n = 230) and held a bachelor\'s degree (75.8%, n = 263). Nearly half were students (48.7%, n = 169), and 56.2% (n = 195) earned less than 5,000 per month. The prevalent weight range was 40-60 kg (46.1%, n = 160), and most participants\' height was 150-160 cm (58.5%, n = 203). Overall, 61% (x̄ = 211.6) of the respondents had good knowledge about sleeve gastrectomy, with 70.3% (x̄ = 244) understanding its general aspects, 56.1% (x̄ = 194.5) knowing the indications, and 60.1% (x̄ = 208.7) aware of the complications. Conclusions The majority of residents of the Southwest region of Saudi Arabia have moderate levels of knowledge regarding sleeve gastrectomy. However, the study demonstrated substantial gaps in knowledge and awareness regarding sleeve gastrectomy, mainly about its indications and potential.

Renal denervation (RDN) is a neuromodulation therapy performed using an intraarterial catheter in patients with hypertension. Recent randomized sham-operated controlled trials have shown that RDN has significant antihypertensive effects in patients with resistant, uncontrolled, and/or drug-naïve hypertension. Based on available evidence, the European Society of Hypertension 2023 guidelines include a Class II recommendation for the use of RDN in individuals with resistant and uncontrolled hypertension. The US Food and Drug Administration approved two devices, the ultrasound-based ReCor ParadiseTM RDN system and the radiofrequency-based Medtronic Symplicity SpyralTM RDN system, as adjunctive therapy for patients with resistant and uncontrolled hypertension. The indications for RDN and incorporation of RDN into clinical practice will grow as clinical evidence accumulates. This mini review summarizes latest findings focusing on the safety and effectiveness of RDN for treating hypertension in the absence and presence of antihypertensive drugs, and discusses the indications for RDN. This mini review focuses on the safety and effectiveness of RDN for treating hypertension in the absence and presence of antihypertensive drugs. The indications for RDN and incorporation of RDN into clinical practice will grow as clinical evidence accumulates and should be reviewed and updated.

UNASSIGNED: In view of the role of mechanical circulatory support in patients with severe cardiac insufficiency during perioperative period, we searched the relevant articles on mechanical circulatory support at Fuwai Hospital, and analyzed the indications and complications of different mechanical circulatory support methods.
UNASSIGNED: Relevant studies were identified by computerized searches of PubMed, Ovid, Embase, Cochrane Library, Wanfang Data, VIP Data, Chinese BioMedical Literature & Retrieval System (SinoMed), and China National Knowledge Infrastructure (CNKI), using search words (\"intra-aortic balloon counter pulsation\" OR \"IABP\" OR \"extracorporeal membrane oxygenation\" OR \"ECMO\" OR \"ventricular assist device\" OR \"VAD\") AND (\"Fuwai\" OR \"fuwai\"). All studies concerning the application of IABP, ECMO, and VAD at Fuwai Hospital were included, exclusion criteria included: (1) studies published as review, case report or abstract; (2) animal or cell studies; (3) duplicate publications; (4) studies lacking information about outcomes of interest.
UNASSIGNED: A total of 36 literatures were selected for analysis. The specific mechanical circulatory support methods of ECMO and VAD retrieved from the studies were VA-ECMO and LVAD. The number of cases using IABP, ECMO, LVAD was 1968, 972, 67; and the survival rate was 80.4%, 54.9%, 56.7%, respectively. The major complications of IABP, ECMO and LVAD were hemorrhage (1.2%, 35.9% and 14.5%), infection (3.7%, 12.7% and 9.7%), acute kidney injury (9.1%, 29.6% and 6.5%), the secondary complications were limb ischemia, neurological events, cardiovascular events and thrombosis.
UNASSIGNED: The present study suggested that, IABP, ECMO and VAD, either alone or in combination, were effective and safe mechanical circulation support when managing cardiovascular surgical patients with severe hemodynamic instability at Fuwai Hospital.

The alveolar ridge split (ARS) technique is a pivotal advancement in dental implantology, addressing the limitation of insufficient bone width for implant placement. This review traces the historical development of ARS from its initial conceptualization to current practices and future directions. Emphasizing the technique\'s development, indications, procedural overview, and osteotomy variations, we highlight its minimally invasive nature, which reduces patient morbidity and treatment time. This article reviews various osteotomy methods within ARS, examining their applications, benefits, and limitations. Furthermore, it discusses the technique\'s role in expanding treatment options for patients with compromised alveolar structures, underpinned by a high implant survival rate and the potential for immediate implant placement. We also cover the necessity of meticulous surgical technique, the importance of patient-specific factors, and the promising future of ARS facilitated by advancements in biomaterials and regenerative medicine. In summary, this review provides a comprehensive overview of ARS, offering valuable insights for dental professionals and informing future clinical practices and research in implantology.

BACKGROUND: The effectiveness of clinical ethics counselling in medicine in terms of satisfaction of the participants, support of ethical decision-making, perceived impact on clinical care, moral competence and quality of communication is now empirically well validated. In psychiatry, more and more institutions have structures for clinical ethics consultation as well; however, there is still a lack of evaluative accompanying research on the benefits and differential indications of the various forms and models of clinical ethics counselling in psychiatry.
OBJECTIVE: The article presents the principles and the step by step application of the principle-oriented clinical ethics consultation according to the Basel model 2.0.
METHODS: The article is based on material and procedures developed at the Clinical Ethics Unit of the University Hospital Basel and the University Psychiatric Clinics Basel for the principle-oriented clinical ethics consultation according to the Basel model 2.0.
CONCLUSIONS: Principle-oriented clinical ethics consultation according to the Basel model 2.0 is suitable for dealing with moral issues and conflicts in psychiatric practice and for their ethical reflection; however, further evaluative accompanying research is needed on the benefits and differential indications of this and other models of clinical ethics support in psychiatry.
UNASSIGNED: HINTERGRUND: Die Wirksamkeit klinischer Ethikberatung in der Medizin hinsichtlich der Zufriedenheit der Beteiligten, der Unterstützung ethischer Entscheidungsfindung, der wahrgenommenen Auswirkungen auf die klinische Versorgung, der moralischen Kompetenz und der Qualität der Kommunikation ist inzwischen empirisch gut belegt. Auch in der Psychiatrie verfügen immer mehr Einrichtungen über Strukturen klinischer Ethikberatung. Es fehlt jedoch nach wie vor an evaluativer Begleitforschung zum Nutzen und zur differenziellen Indikation der verschiedenen Formen und Modelle klinischer Ethikberatung in der Psychiatrie.
UNASSIGNED: Der Artikel präsentiert die Grundlagen und die schrittweise Anwendung der prinzipienorientierten klinischen Ethikkonsultation nach dem Basler Modell 2.0.
METHODS: Der Artikel stützt sich auf Materialien und Verfahren, die an der Abteilung Klinische Ethik des Universitätsspitals Basel und der Universitären Psychiatrischen Kliniken Basel zur prinzipienorientierten klinischen Ethikkonsultation nach dem Basler Modell 2.0 entwickelt wurden.
UNASSIGNED: Die prinzipienorientierte klinische Ethikkonsultation nach dem Basler Modell 2.0 eignet sich, um moralische Fragen und Konflikte in der psychiatrischen Praxis zu bearbeiten und ethisch zu reflektieren. Es braucht jedoch weitere evaluative Begleitforschung zum Nutzen und zur differenziellen Indikation dieses und weiterer Modelle klinischer Ethikberatung in der Psychiatrie.

UNASSIGNED: Botulinum toxin type A (BoNT-A) and hyaluronic acid (HA) dermal fillers are increasingly utilized in dentistry for therapeutic and aesthetic purposes. However, a comprehensive synthesis of their clinical applications and indications in dentistry is lacking. This systematic review aimed to analyze the clinical application and indications of BoNT-A and HA dermal fillers in dentistry, providing insights into their efficacy, safety profiles, and limitations.
UNASSIGNED: A systematic search was conducted in PubMed/MEDLINE databases to identify relevant studies published between 2018 and 2024. Medical Subject Headings (MeSH) terms and keywords related to BoNT-A, HA dermal fillers, dentistry, clinical applications, and indications were used. Study selection criteria included randomized controlled trials (RCTs) and non-RCTs involving human participants of any age group. Data extraction and synthesis followed established guidelines, focusing on study characteristics, participant demographics, intervention details, outcome measures, and key findings related to BoNT-A and HA dermal fillers\' clinical application in dentistry.
UNASSIGNED: Systematic searches across electronic databases and grey literature identified 857 records, with an additional 73 from hand searches. After screening titles and abstracts, 542 records were excluded, leaving 374 full-text publications for evaluation. Ultimately, 12 RCTs and 13 non-RCTs were included. The systematic review encompassed diverse geographic locations: Brazil, Italy, Spain, Syria, India, Egypt, Korea, and the Netherlands, involving samples sizes ranging from 14 to 143 participants. The review synthesized findings on HA\'s efficacy in various areas, including bone repair, gingivitis management, temporomandibular joint disorders, postoperative swelling reduction, periodontal defect treatment, chin and check projection and lips augmentation. BoNT-A exhibited promising efficacy in managing orofacial pain conditions, gummy smile treatment and neuromodulation of the lower third muscles. Safety profiles varied among studies, with some reporting minimal adverse effects while others noted dose-related concerns.
UNASSIGNED: BoNT-A and HA dermal fillers offer a wide array of clinical applications in dentistry, ranging from therapeutic interventions to aesthetic enhancements. Despite promising efficacy, careful consideration and monitoring of safety outcomes are essential when integrating these interventions into clinical practice. Further research addressing methodological limitations and safety concerns is warranted to optimize their utilization and improve patient care in dentistry.

UNASSIGNED: The therapeutic approach to pain in hemophilia should be multimodal. Intra-articular injections are a good option when joint lesions do not respond to hematological treatment or rehabilitation and orthopedic surgery is not yet indicated. Performing these procedures under ultrasound guidance has been shown to improve their accuracy and efficacy.
UNASSIGNED: This article provides a practical overview of the most frequently employed ultrasound-guided intra-articular procedures on the joints of people with hemophilia. The article describes the key elements for performing the technique on the elbow, knee and ankle as the most affected joints. The particularities of the most frequent indications, arthrocentesis, synoviorthesis and analgesic injections with various products are detailed.
UNASSIGNED: Current hematological treatments have made it possible to incorporate new therapeutic tools for pain relief for people with hemophilia, including ultrasound-guided joint procedures, which offer excellent results.

BACKGROUND: The influence of indications for Helicobacter pylori investigation on prescriptions and effectiveness is unknown. The aim of the study was to assess the impact of indications for H. pylori investigation on prescriptions, effectiveness, compliance, and tolerance.
METHODS: International, prospective, non-interventional registry of the management of H. pylori infection by European gastroenterologists (Hp-EuReg). Treatment-näive patients registered from 2013 to 2023 at e-CRF AEG-REDCap were analyzed. The effectiveness was assessed by modified intention-to-treat analysis.
RESULTS: Overall, 53,636 treatment-naïve cases from 34 countries were included. Most frequent indications were: dyspepsia with normal endoscopy (49%), non-investigated dyspepsia (20%), duodenal ulcer (11%), gastric ulcer (7.7%), and gastroesophageal reflux disease (GERD) (2.6%). Therapy effectiveness varied by indication: duodenal ulcer (91%), gastric ulcer (90%), preneoplastic lesions (90%), dyspepsia with normal endoscopy (89%), GERD (88%), and non-investigated dyspepsia (87%). Bismuth-metronidazole-tetracycline and clarithromycin-amoxicillin-bismuth quadruple therapies achieved 90% effectiveness in all indications except GERD. Concomitant clarithromycin-amoxicillin-tinidazole/metronidazole reached 90% cure rates except in patients with non-investigated dyspepsia; whereas sequential clarithromycin-amoxicillin-tinidazole/metronidazole proved optimal (≥90%) in patients with gastric ulcer only. Adverse events were higher in patients treated for dyspepsia with normal endoscopy and duodenal ulcer compared with the remaining indications (23% and 28%, p < 0.001). Therapeutic compliance was higher in patients with duodenal ulcer and preneoplastic lesions (98% and 99%, p < 0.001).
CONCLUSIONS: In Europe, patients with gastric or duodenal ulcers and preneoplastic lesions showed higher H. pylori treatment effectiveness. Bismuth and non-bismuth quadruple therapies achieved optimal results in almost all indications.
BACKGROUND: ClinicalTrials.gov identifier: NCT02328131.