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Simple Summary: Melanoma is a common and aggressive malignant skin tumor with the capacity to metastasize in both internal organs and skin. It has traditionally been resistant to conventional systemic chemotherapeutic drugs. With the development of systemic immunotherapy and new targeted therapies, the management and prognostic paradigm for advanced melanoma has changed. Along with the development of these new therapeutic agents, topical and intralesional treatments for metastatic cutaneous melanoma have also emerged and may be an alternative to surgical management when surgery is not feasible. The selection of the most adequate approach depends on the availability of the different treatments, the size of the lesion, the stage of the disease, the characteristics of the patient and the physician's experience and knowledge. In this narrative review, we focus on the outcomes offered by different topical and intralesional therapies for cutaneous metastatic melanoma, alone or in combination with systemic therapies. Cutaneous melanoma is a malignant neoplasm with local and distant metastatic potential. When feasible, surgery is the first line of treatment in locoregionally advanced disease. Topical and intralesional treatments can be an alternative second-line treatment. The aim of this article was to perform a narrative review of the most widely used topical and intralesional treatments for locoregionally advanced melanoma. Diphenciprone, imiquimod and 5-florouracil were included as topical treatments and bacillus Calmette-Guerin, interleukin 2, rose bengal, talimogene laherparepvec and electrochemotherapy were included as intralesional treatments. Brief comments on other alternatives in development such as interferon-alpha, interleukin-12, ipilimumab and intralesional daromun are presented. Topical treatments generally have higher response rates in epidermal metastases than in deeper metastases. In addition, the larger the lesions, the worse they tend to respond to local treatments. Some reports show that combining certain systemic treatments and topical or intralesional therapies can improve response rates. It has also been described in a few papers that non-injected lesions may respond after the application of a local therapy in distant skin-metastases. Many of these intralesional treatments are being combined in different investigations with systemic immunotherapies, with the aim of obtaining synergic responses in those patients with refractory disease. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff repair (RCR) is one of the most prevalent procedures to manage rotator cuff tears (RCT). Postoperative shoulder pain is a common complication following RCR and may be aggravated by activation of myofascial trigger points (MTrP) associated with the injury to the soft tissues surrounding the surgical incision. This study aimed to describe a preliminary, randomized, sham-controlled trial to evaluate the effectiveness of implementing 4 sessions of myofascial trigger point dry needling (MTrP-DN) as a muscle treatment approach along with 10 sessions of multimodal rehabilitation protocol (MRh) consisting of therapeutic exercise, manual therapy, and electrotherapy on postoperative shoulder pain, range of motion (ROM), strength, and functional outcome scores for patients following RCR surgery. Methods: Forty-six patients aged 40–75 following RCR surgery were recruited and randomly allocated into 2 groups: (1) MTrP-DN plus MRh (experimental group), and (2) sham dry needling (S-DN) plus MRh (control group). This trial had a 4-week intervention period. The primary outcome was the Numeric Pain Rating Scale (NPRS) for postoperative shoulder pain. Secondary outcomes were the Shoulder Pain and Disability Index (SPADI), ROM, and strength. The mentioned outcomes were measured at baseline and week 4. In the current study, adverse events were recorded as well. Results: No statistically significant differences were observed between groups when adding MTrP-DN to MRh for postoperative shoulder pain after 4 weeks of intervention (mean difference 0.32, [95% CI -0.41,1.05], p = 0.37). However, this trial found a small effect size for postoperative shoulder pain. No significant between-group differences were detected in any of the secondary outcomes (p > 0.05) either. We found significant within-group changes in all studied outcome measures. (p < 0.001). This study also reported minor adverse events. following the needling approach. Conclusion: The lack of statistically significant differences in the outcomes and small clinical significance in shoulder pain highlights the complexity of pain management, suggesting that alternative methodologies may be needed for meaningful clinical benefits. Future studies should consider different control groups, long-term follow ups, larger sample sizes, and more MTrP-DN sessions to better understand their potential impact. Trial registration: This trial was registered at (https://www.irct.ir), (IRCT20211005052677N1) on 19/02/2022. [ABSTRACT FROM AUTHOR]

Simple Summary: Although in most cases breast cancer is curable, some specific subtypes and late stages of the disease are difficult to treat, and treatment-related side effects often are severe. Two methods that focus on the local treatment of breast cancer, regional chemotherapy and electroporation, can be combined to increase the treatment efficacy at the tumor site and decrease systemic side effects. This publication explains the technique, systemic impact on circulating tumor cells, and first results of this treatment approach. Background: Relapsed unresectable triple-negative breast cancer is a demanding disease with only a few treatment options. Especially for patients with unresectable tumor masses, a treatment that offers rapid tumor shrinkage is needed. If patients are exhausted from several treatment lines, systemic side effects have to be avoided. Reversible electroporation has shown to be effective for breast cancer if combined with systemic bleomycin and/or cisplatin. To enhance the local effect and reduce the systemic side effects, we combined reversible electroporation with regional chemotherapy. Materials and Methods: Patients with advanced metastasized and relapsed breast cancer received regional chemotherapy via intra-arterial infusion and isolated thoracic perfusion combined with percutanous reversible electroporation. Circulating tumor cells (CETCs/CTCs) were counted before and 24 h after the treatment. Tumor response was evaluated by CT (computer tomography) control. Results: A total of 21 treatments were conducted for 14 patients who had a mean tumor size of 7.6 cm (standard deviation 3.3 cm). Higher local drug levels are present with arterial infusion compared to venous infusion and result in enhanced response rates. Circulating tumor cells decreased or stayed stable for 24 h after the treatment for 11 and 8 cases, respectively. An increase was observed in two cases. A total of 13 patients showed a clinical response with tumor shrinkage that led to resectability. One patient did not respond to the treatment regimen. Conclusions: The combination of reversible electroporation with intra-arterial chemotherapy is feasible and results in a good clinical response with neglectable side effects. The treatment is repeatable and can lead to resectability. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of interferential current (IFC) therapy combined with quadriceps strengthening exercise versus sham IFC plus exercise for pain relief and functional improvement in patients with knee osteoarthritis. Study Design: Double-blind randomised controlled trial. Setting: Outpatient rehabilitation clinic. Subjects: Knee osteoarthritis patients aged 50–85 years with a pain score ≥4/10. Methods: One hundred forty-four participants were randomly allocated into the study and control groups. The study group received 20 min of IFC therapy (carrier frequency: 4000 Hz, beat frequency: 100 Hz) five times per week for three weeks, while the control group received sham IFC following the same protocol, followed by 10 min of exercise in both groups. Outcome measures included Numeric Rating Scale for Pain, Western Ontario and McMaster Universities Index (WOMAC) score, gait speed, and EuroQol-Five Dimensions-Five Levels questionnaire assessed at baseline, Week 3, and Week 6. Adverse events and patient satisfaction were evaluated at Week 3. Results: At Week 3, the study group demonstrated statistical improvement compared to the control group for Numeric Rating Scale for Pain, WOMAC Total, WOMAC Pain, and WOMAC Stiffness. The mean difference (95% confidence interval) between groups was 0.76 (0.21–1.30), 0.49 (0.03–0.95), 0.63 (0.13–1.13), and 0.62 (0.04–1.20), respectively. However, the mean differences between groups were below the Minimally Clinically Important Difference values for each outcome. Additionally, there were no significant differences between groups at Week 6 for any outcome measure. Conclusion: IFC had no effect on pain reduction and functional improvement in patients with mild to moderate knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: Bell palsy is a sudden facial nerve paralysis that affects many individuals annually. It significantly impacts patients and their families, leading to a reduced quality of life if left untreated. The International Classification of Functioning, Disability, and Health (ICF) framework focuses on outcome measures, functional limitations, and overall quality of life of the patients. Early diagnosis is crucial for effective management of the condition. In order to standardize clinical practice and contribute to recommendations of certain interventions, this paper focuses on the optimal dosage of physiotherapy intervention for Bell palsy patients, which includes exercise therapy and electrotherapy. Case presentation: An Indian 33-year-old male visited our physiotherapy department 15 days after being diagnosed with right-sided Bell palsy with unknown aetiology. His chief complaints were right-eye dryness, facial pain, drooping of the face, and difficulty performing facial activities. The outcome measures are the strength duration curve (SD curve), House-Brackmann grading, manual muscle testing, and visual analogue scale (VAS) scale. The physiotherapy intervention includes two primary components: electrotherapy and exercise therapy. Conclusion: The Kabat rehabilitation technique, along with nerve stimulation and an active exercise regimen, is significantly effective in treating Bell palsy, and the outcome measures show significant improvement with optimal therapy dosage. [ABSTRACT FROM AUTHOR]

Purpose: Electrotherapies are commonly used to treat adult musculoskeletal pathologies. However, there is insufficient evidence supporting the use of electrotherapies for lower limb conditions in children. Currently, it is unknown how electrotherapies are used in paediatric clinical practice. This study aimed to investigate if practitioners use electrotherapy to treat children's lower limb conditions, frequency and why. Materials and methods: A custom-built online survey was disseminated via social media targeting international medical and healthcare practitioners who treat children with lower limb conditions using electrotherapy. Practitioners were asked if they did or did not use electrotherapies, and their reasons. Responses were described in frequencies and with thematic analysis. Results: There were 445 practitioners who responded. From these, 301(68%) indicated they used electrotherapy, with the most frequently used being Transcutaneous Electrical Nerve Stimulation (n = 110). The most common reason cited for using electrotherapy was practitioner preference due to the alleged effectiveness of the chosen modality. The remaining 144 (32%) practitioners reported not using electrotherapy, the most common reason being lack of evidence. Conclusions: We found that a majority of practitioners used electrotherapies on children. The reasons for using or not using electrotherapy were practitioner centred. IMPLICATIONS FOR REHABILITATION: Electrotherapy modalities are commonly used to treat musculoskeletal injuries in adults The management of children differs from adults due to physiological and psychological differences. The use of electrotherapy to treat musculoskeletal lower limb pathologies children is currently not supported by evidence, and the frequency of use of these modalities in children is not known. This study found that despite that, a majority of medical and health practitioners surveyed in this study routinely use electrotherapy to treat paediatric musculoskeletal injuries. [ABSTRACT FROM AUTHOR]

Simple Summary: In-transit metastases (ITM) are a challenging aspect of advanced melanoma, traditionally treated with surgery. However, recent advances in systemic therapies, such as immune checkpoint inhibitors and targeted treatments, have significantly improved patient outcomes. These modern therapies are now often preferred over surgery alone. This article reviews the benefits of combining systemic and locoregional treatments, highlighting their potential to enhance survival and quality of life for patients with ITM. By integrating these approaches, we aim to provide a comprehensive strategy for optimizing melanoma treatment outcomes. In-transit metastases (ITM) in melanoma present a significant therapeutic challenge due to their advanced stage and complex clinical nature. From traditional management with surgical resection, ITM treatment has evolved with the advent of systemic therapies such as immune checkpoint inhibitors and targeted therapies, which have markedly improved survival outcomes. This study aims to review and highlight the efficacy of both systemic and locoregional treatment approaches for ITM. Methods include a comprehensive review of clinical studies examining the impact of treatments like immune checkpoint inhibitors, targeted therapies, Isolated Limb Perfusion, and electrochemotherapy. The results indicate that combining systemic therapies with locoregional treatments enhances both local disease control and overall survival rates. The introduction of modern immunotherapies has not diminished the effectiveness of locoregional therapies but rather improved patient outcomes when used in conjunction. The conclusions emphasize that a multidisciplinary approach integrating systemic and locoregional therapies offers a promising strategy for optimizing the management of ITM in melanoma patients. This integrated treatment model not only improves survival rates but also enhances the quality of life for patients, suggesting a shift in standard care practices toward more comprehensive therapeutic regimens. [ABSTRACT FROM AUTHOR]

Post-stroke depression (PSD) is a common neurological and psychiatric sequelae following a stroke, often surpassing the primary effects of the stroke due to its strong correlation with high mortality rates. In recent years, non-pharmacological therapy has garnered significant attention as a supplementary treatment for PSD, becoming widely adopted in clinical practice. However, the efficacy of specific intervention strategies remains unclear. This study aimed to conduct a network meta-analysis (NMA) of published studies to compare the efficacy of different non-pharmacological therapies for treating PSD. We systematically searched five databases from inception through March 2024 to identify randomized controlled trials (RCTs) evaluating non-pharmacological therapies for the treatment of PSD. We considered individual intervention and intervention class. Intervention classes included traditional Chinese medicine (TCM), non-invasive electrotherapy stimulation (NIES), psychotherapy (PT), exercise therapy, hyperbaric oxygen, and combined interventions. The NMA was conducted using R and Stata software, following a frequency-based methodology. Assessment of methodological quality and risk of bias was conducted using the Risk of Bias assessment tool 2.0. Therapies were ranked using the P-score, and box-plots visualization, meta-regression, and sensitivity analysis, were performed to assess transitivity, heterogeneity, and consistency, respectively. The NMA included 43 studies with a total of 3138 participants. Random-effects models revealed significant efficacy for acupuncture (ACUP) (P-score = 0.92; pooled standardized mean difference (95% CI): −3.12 (−4.63 to −1.60)) and transcranial direct current stimulation (P-score = 0.85; −2.78 (−5.06 to −0.49)) compared to the treatment as usual (TAU) group. In categorical comparisons, TCM_PT (P-score = 0.82; −1.91 (−3.54 to −0.28)), TCM (P-score = 0.79; −1.65 (−2.33 to −0.97)), and NIES (P-score = 0.74; −1.54 (−2.62 to −0.46)) showed significant differences compared to TAU group. Furthermore, our results indicated no significant difference between PT and the control groups. However, Confidence in Network Meta-Analysis results indicated very low overall evidence grade. Limited evidence suggests that ACUP may be the most effective non-pharmacological therapy for improving PSD, and TCM_PT is the best intervention class. However, the evidence quality is very low, underscoring the need for additional high-quality RCTs to validate these findings, particularly given the limited number of RCTs available for each therapy. • Acupuncture showed the greatest improvement in depression symptoms in patients with post-stroke depression. • Given the overlap between stroke and depression symptoms, passive therapiesmay be more appropriate and efficacious for patients. • Categorical comparisons suggest that traditional Chinese medicine combined with psychotherapy may have the best efficacy in treating post-stroke depression. [ABSTRACT FROM AUTHOR]

Objective Ultrasound-guided tibial nerve pulsed radiofrequency (US-guided TN PRF) and fluoroscopy-guided intralesional radiofrequency thermocoagulation (FL-guided intralesional RFT) adjacent to the painful calcaneal spur are two interventions for pain management in painful calcaneal spur and plantar fasciitis. This study aimed to compare the effectiveness of the two procedures. Design A prospective, randomized, single-blind study. Setting Single-center pain clinic. Subjects Forty-nine patients who met the inclusion criteria were randomized into two groups. Methods Group U (25 patients) received US-guided TN PRF at 42°C for 240 s, whereas Group F (24 patients) received FL-guided intralesional RFT at 80°C for 90 s. The most severe numeric rating scale (NRS) score during the first morning steps and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were used to evaluate the effectiveness of the procedures. The study's primary outcome assessed treatment effectiveness via the NRS, whereas the secondary outcomes included changes in the AOFAS score and the incidence of procedure-related mild adverse events. Results NRS and AOFAS scores significantly improved in Groups U and F at 1 and 3 months compared with baseline (P  < .05), and there was no significant difference between the groups. At month 1, 50% or greater pain relief was achieved in 72% of patients in Group U and 75% of patients in Group F. No significant difference was observed in the incidence of mild adverse events between the groups. Conclusions US-guided TN PRF and FL-guided intralesional RFT have shown significant effectiveness in the treatment of painful calcaneal spur and plantar fasciitis. Larger randomized controlled trials are needed. Clinical Trial Number NCT06240507. [ABSTRACT FROM AUTHOR]

This systematic review with meta-analysis aimed to assess the effectiveness of electrophysical agents in improving pain, function, disability, range of motion, quality of life, perceived stiffness, and time to recovery in subjects with frozen shoulder (FS). A thorough search of MEDLINE, Cochrane Library, PEDro, and EMBASE yielded 1143 articles, of which 23 randomized controlled trials were included. Risk of bias (RoB) was assessed through Cochrane Risk of Bias 2 tool. The certainty of evidence was evaluated through the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The analysis included a total of 1073 subjects. None of the studies were judged as low RoB. Potentially clinically significant differences were observed in pain at 6 weeks and 5 months after extracorporeal shockwave therapy (ESWT), and in disability up to 3 months with laser therapy, albeit with uncertain results due to the high RoB and to the study heterogeneity. Ultrasound (US) therapy did not yield significant differences in any outcomes. The certainty of evidence was very low. Based on the high heterogeneity and low quality and certainty of evidence, ESWT, laser, and US cannot be recommended for FS treatment. Caution should be exercised in interpreting the findings. Although a clinical difference in pain and disability was observed, the certainty of the evidence was low. Ultrasound therapy is not recommended in patients with frozen shoulder. Electrophysical agents may not ensure adequate therapeutic efficacy. [ABSTRACT FROM AUTHOR]

The article discusses research which investigated the effectiveness of electroacupuncture in treating chondromalacia patella (CMP) in soldiers. Topics explored include a comparison between electroacupuncture and physical therapy in terms of treatment efficacy and complications, the management of clinical symptoms of CMP particularly anterior knee pain, and the pain and disability Visual Analog Scale (VAS) scores recorded following treatment.

Objective: To investigate the effect of diadynamic currents administered prior to exercises on pain and disability in patients with osteoarthritis of the knee. Design: A randomized-controlled trial. Setting: Special Rehabilitation Services in Taboão da Serra. Participants: Patients with bilateral knee osteoarthritis. Intervention: Participants were randomly allocated to Group I (diadynamic currents and exercises; n = 30, 60 knees) or Group II (exercises alone; n = 30, 60 knees) and were treated three times a week for 8 weeks. Main outcome measures: The primary outcome measures were change in knee pain evaluated by visual analog scale and disability Index Score (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscle strength (dynamometer), a composite score for pain and disability (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and a drug diary to measure consumption of rescue pain medication (paracetamol). All measurements were collected at baseline, 8 weeks, and 6 months from baseline (follow-up). Results: There were 60 participants with a mean (SD) age of 63.40 (8.20) years. Between-group differences in the follow-up (8 weeks and 6 months) were observed for pain at rest, pain during activities of daily living and disability. There was improvement in Group I that was maintained for the three variables 6 months after treatment. Mean difference for pain at rest was −3.08 points (95% confidence interval −4.13; −2.02), p < 0.01 with an effect size of 1.4; mean difference for pain during activities of daily living was −2.40 points (95% confidence interval −3.34; −1.45), p < 0.01 with an effect size of 1.24; and mean difference for disability was −4.08 points (95% confidence interval −5.89; −2.26), p < 0.01 with an effect size of 1.04. Conclusion: Patients with symptomatic knee osteoarthritis receiving 8 weeks of treatment with diadynamic currents as an adjunct to a program of exercises had significantly greater improvements in pain and disability than those receiving exercises alone. Beneficial effects were sustained for 6 months. [ABSTRACT FROM AUTHOR]

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rehabilitation Sciences: Nursing, Physiotherapy, Occupational Therapy / Reabilitacijos Mokslai: Slauga, Kineziterapija, Ergoterapija is the property of Lithuanian Sports University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses various surgical interventions and their outcomes in urological treatments, focusing on pediatric and adult cases. Topics discussed include the use of sacral neuromodulation for pediatric bladder and bowel dysfunction, outcomes of continent catheterizing channels in high-risk patients, and comparisons between different surgical approaches for vesicoureteral reflux and post-prostatectomy urinary incontinence.

Background: Chemotherapy‐induced peripheral neuropathy (CIPN) is a debilitating disturbance among patients who received chemotherapy, with no effective treatment available. Scrambler therapy (ST) is a noninvasive treatment capable of improving multiple quality‐of‐life symptoms beyond pain. We aimed to evaluate the efficacy of ST for pain and nonpain symptoms related to CIPN. Methods: Ten patients with moderate to severe CIPN symptoms for >3 months were enrolled in a single‐arm trial of ST for 10 daily sessions. CIPN‐related symptoms were measured throughout the treatment period and up to 6 months thereafter. Results: The worst pain was reduced by 6 months (p = 0.0039). QST demonstrated the greatest improvement in pressure of 60 g (p = 0.308, Cohen's d = 0.42) and cold temperature threshold of 2.5°C (p = 0.9375, Cohen's d = 0.51) in the gastrocnemius area. Symptoms of numbness, tingling, trouble walking, and disturbed sleep had significant improvements at 6 months. Pain medication use decreased by 70% at the end of treatment and by 42% at 6 months. Patient satisfaction was high (82%) and no adverse events with ST treatment were reported. Conclusions: The results of this pilot trial support the use of ST by demonstrating improvement in multiple domains of quality of life for CIPN patients during an extended follow‐up of 6 months. However, further large‐scale studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to evaluate the efficacy of electrotherapy and manual therapy for the treatment of women with primary dysmenorrhea. Methods Systematic searches were conducted in Scopus, Web of Science, PubMed, CINAHL, and MEDLINE. The articles must have been published in the last 10 years, had a sample exclusively of women with primary dysmenorrhea, had a randomized controlled trial design, and used interventions that included some form of manual therapy and/or electrotherapy techniques. Two reviewers independently screened articles for eligibility and extracted data. Difference in mean differences and their 95% CIs were calculated as the between-group difference in means divided by the pooled standard deviation. The I2 statistic was used to determine the degree of heterogeneity. Results Twelve selected studies evaluated interventions, with 5 evaluating electrotherapy techniques and 7 evaluating manual therapy techniques. All studies analyzed identified improvements in pain intensity and meta-analysis confirmed their strong effect. Conclusions Manual therapy and electrotherapy are effective for the treatment of women with primary dysmenorrhea. Transcutaneous electrical nerve stimulation combined with thermotherapy and effleurage massage stands out for its effects on the intensity and duration of pain with the application of a few sessions and their long-term effects. Impact Manual therapy techniques and electrotherapy methods reduce the pain intensity of women with primary dysmenorrhea. Quality of life and degree of anxiety improved significantly with manual therapy interventions. Transcutaneous electrical nerve stimulation combined with thermotherapy and effleurage massage are the interventions with which positive effects were achieved with fewer sessions. [ABSTRACT FROM AUTHOR]

Background: This work aimed to analyze serum S100B levels and brain-derived neurotrophic factor (BDNF) in patients with lumbar disc prolapse to test their predictive values concerning the therapeutic efficacy of pulsed radiofrequency. Methods: This prospective interventional study was carried out on 50 patients candidates for radiofrequency for treating symptomatic lumbar disc prolapse. Pain severity and functional disability were assessed using the Numeric Rating Scale (NRS) and Functional rating index (FRI) before as well as two weeks, 1, 3, and 6 months after the radiofrequency. Quantitative assessment of serum S100B level and BDNF was done for all the included patients one day before radiofrequency. Results: The scores of NRS and FRI were significantly improved at two weeks, 1, 3, and 6 months following radiofrequency (P-value < 0.001 in all comparisons). Statistically significant positive correlations were found between duration of pain, NRS, and S100B serum level before radiofrequency, and both NRS (P-value = 0.001, 0.035, < 0.001 respectively) and FRI (P-value = < 0.001, 0.009, 0.001 respectively) 6 months following radiofrequency. Whereas there were statistically significant negative correlations between BDNF serum level before radiofrequency and both NRS and FRI 6 months following radiofrequency (P-value = 0.022, 0.041 respectively). NRS and S100B serum levels before radiofrequency were found to be independent predictors of NRS 6 months following radiofrequency (P-value = 0.040. <0.001, respectively). Conclusion: Serum level of S100B is a promising biomarker that can predict functional outcomes after pulsed radiofrequency in patients with lumbar disc prolapse. [ABSTRACT FROM AUTHOR]

This article compares two forms of electrical stimulation therapy, Transcutaneous Electrical Nerve Stimulation (TENS) and H-Wave® Device Stimulation (HWDS), for managing chronic musculoskeletal pain. TENS and HWDS have different technical parameters and applications, with HWDS providing longer-term pain relief and other therapeutic benefits. HWDS has received more FDA clearances for pain and neuromuscular conditions compared to TENS. Studies show mixed results for TENS, with some showing no improvement in pain scores and others showing slight short-term improvement in functional disability. In contrast, studies consistently demonstrate significant pain reduction, improved function, and overall quality of life with HWDS. Further research is needed to improve both therapies. [Extracted from the article]

Simple Summary: Electrochemotherapy (ECT) should be considered a valid therapeutical strategy for the local control of widespread and advanced CKS cutaneous and subcutaneous lesions. The aim of our study is not only to validate and confirm that ECT represents the best therapeutical choice in terms of the risk–benefit ratio for the treatment of cutaneous and subcutaneous lesions in non-advanced forms of Kaposi's sarcoma, but also to demonstrate the valid use of ECT for the local control of locally advanced classic Kaposi's sarcoma (CKS). Among 19 patients treated, acceptable results have also been obtained in those patients with widespread CKS lesions due to the silent course of the KS classic variant and the excellent impact of the disease on quality of life. Electrochemotherapy (ECT) is one of the newest therapeutic strategies employed as a medical procedure for skin neoplasms' treatment, especially for classic Kaposi's sarcoma (CKS). The aim of this study was to demonstrate ECT clinical response and the local control of CKS disease. The primary endpoint was to value the worth and efficacy of this local therapy in CKS skin lesions' treatment. In total, 19 CKS patients were enrolled, 14 males and 5 females with median age at diagnosis of 72. Complete response (CR) has been gained in 12 patients after first ECT attempt; meanwhile, 3 and 4 out of 19 patients obtained a partial response (PR), so they underwent a second and third ECT treatment, respectively. Clinical response was evaluated during the entire timeframe of the follow-up, which ranged between 3 months and 4 years with a median of 18 months. The control of CKS skin lesions still represents a challenge for surgeons and oncologists. Nevertheless, according to this and other authors' recent experiences, ECT could be considered the gold standard strategy for early-stage patients, but at the same time it could be considered as a valid option in controlling Kaposi's sarcoma locally advanced lesions. [ABSTRACT FROM AUTHOR]

Background: One of the unique advances in neuromodulation for chronic pain has been spinal cord stimulators (SCS) and dorsal root ganglion stimulators (DRG‐S). These devices have aided in conditions such as neuropathic pain, complex regional pain syndromes, failed back surgery, and peripheral neuropathies. With these benefits, however, complications from implantable stimulators have included lead fractures and migration. The authors reviewed a lead migration, kinking, and subsequent fracture event involving a patient with complex regional pain syndrome (CRPS) II, who was treated with a DRG‐S. Case Presentation: The case report follows this patient, from their past medical history to assessment of appropriate qualifications for neuromodulation, to successful surgical placement, to follow‐up care. The authors further monitored assessment of inefficacy of pain relief, and identification of lead migration and kinking through imaging. In the process of removal, due to lead stress, lead fracturing occurred. After lead removal, the leads were fully replaced, and the patient was followed up and experienced improved pain relief. Conclusion: The case report assesses probable mechanisms of lead fracture and considerations for physicians for future assessment and triage of neuromodulation efficacy. [ABSTRACT FROM AUTHOR]

Lipoedema is characterised by abnormal subcutaneous fat deposition associated with oedema. Given its complexity, different treatments, including shock waves and deep oscillation therapy, are used in its treatment. Objective: To investigate the effects of shock waves and deep oscillations on lipoedema. Methodology: This is an experimental study. Thirty-three women were evaluated using anthropometric analysis (perimetry and bioimpedance) and ultrasonography of the lower limb region. The volunteers were divided into three groups: G1 received the treatment with deep oscillations, G2 with shock waves, and G3 with shock waves and deep oscillations. The intervention was unilateral on the right lower limb, while the left lower limb was considered a control. The duration of treatment was five sessions, being performed once a week. The shockwave treatment followed the parameters: variation of 1, 8, and 2, 5 Bar; 12 Hz; 500 pulses in the ankle area; 500 pulses in the inner knee area (upper third). For deep oscillations, 150 to 70 Hz was used for 3 min; 30 to 10 Hz for 4 min; and 75 to 50 Hz for 3 min, for a total of 10 min on a single limb. Reassessment was done after the last session was performed. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Despite high prevalence and increased severity and burden of overactive bladder (OAB) and fecal incontinence (FI) in the elderly, sacral neuromodulation (SNM) is often overlooked as a potential treatment option for this demographic. In this study, we report the outcomes of SNM in patients aged 75 years or older at the time of surgery. METHODS: We conducted a retrospective cohort study of patients who underwent SNM implantation between 2013 and 2022 performed by a single, high-volume urologist at a tertiary center. Success, complication, and adjunct therapy rates were analyzed by Fisher's or Wilcox rank-sum test as appropriate. We compared outcomes between patients aged 75-79 years and octogenarians. RESULTS: Of 632 patients, 50 were ≥75 years. Patients had a mean age of 78.4±2.6 years and were predominantly female (84%). The indications for SNM were 66% OAB, 16% FI, 16% non-obstructive urinary retention, and 4% pelvic pain. Within the first year, 94% of patients reported satisfaction and improvement in symptoms, while 76% continued to experience improvement beyond one year. SNM insertion led to reduced oral medication use from 68% to 24% (p<0.0001). The complication rate was 16% and mostly included device pain. No significant difference was observed in treatment success, complication, or adjunct therapy rate between age groups. CONCLUSIONS: SNM is a safe and effective option in well-selected patients over the age of 75 years. Treatment success rate is comparable to younger cohorts. Advanced age should not preclude third-line therapy options in this population. [ABSTRACT FROM AUTHOR]

Background: This study was designed to compare the effectiveness of Microcurrent therapy versus Ultrasound therapy in subjects with Chronic Temporomandibular Joint Dysfunctions. Purpose: To compare the effectiveness of Microcurrent therapy versus Ultrasound therapy using the McGill Pain Questionnaire. Materials and Methods: This experimental study has been conducted from November 2022 to April 2023. A total of 24 adults with Chronic Temporomandibular Joint Dysfunctions have been selected using the inclusion and exclusion criteria. They have been split into 2 groups Group A (n=12) and Group B (n=12) were assigned. Group A got Microcurrent therapy, whereas Group B received Ultrasound therapy. The McGill Pain Questionnaire was used to evaluate the subjects. Results: The mean value of Microcurrent therapy at the post-test was found to be higher than the mean value of Ultrasound therapy with a p-value of <0.0001. Conclusion: The result suggests that Microcurrent therapy shows a significant effect in reducing pain in Chronic Temporomandibular Joint Dysfunctions when compared to Ultrasound therapy. [ABSTRACT FROM AUTHOR]

Background: An approach known as Kinesio-taping will be used to support the knee joint and muscle. MET is a sort of manual therapy that uses moderate isometric contractions to relax the muscles and reduces discomfort, stress and strain. It also prevents knee instability by enhancing quadriceps and hamstring muscle strength and function in patients with OA knees. Objective: The purpose of the study was to investigate the effectiveness of Kinesio-taping and muscle energy techniques for pain and function in terms of NPRS and KOOS in subjects with OA knee. Methodology: Forty osteoarthritis patients were randomly assigned to one of two groups (A or B). Group A (n=20) will receive Kinesio-taping and (MET) post-isometric relaxation for the hamstring, quadriceps, and gastrocnemius muscles along with interferential therapy. Group B (n=20) will receive knee strengthening exercises for both hamstring and quadriceps and interferential therapy for a period of thrice a week for 6 weeks. The NPRS (numerical pain rating scale) and KOOS (knee injury and osteoarthritis outcome score) were used to assess pain and functional improvement before and after the tests. Results: Group A showed a significant mean difference (P = >0.001) between the NPRS and KOOS. Hence Group-A Kinesio-taping and muscle energy technique along with IFT are significant in treating individuals with pain and function in Osteoarthritis of the knee. Conclusion: This study concluded that the Kinesio-taping and MET (post isometric relaxation) with IFT (Group A) shows effectiveness in improving the pain and function in the OA knee. [ABSTRACT FROM AUTHOR]

Background: Many factors might lead to the development of patellofemoral pain syndrome (PFPS), a prevalent cause of anterior knee discomfort. Overuse from intense athletics or training, as well as issues with the alignment of the kneecap, are frequently important contributors. Purpose: The purpose of this article is to analyse the effectiveness of capacitive resistive diathermy on patellofemoral pain syndrome among the adult population. Methodology: Fifty subjects were based on inclusion and exclusion standards. The study's safety measures, risk considerations, and methodology were disclosed to the participants. The participants were all chosen using a practical sampling approach. The subjects were tested with Clarke's grind test and Vastus medialis coordination test and the treatment given to the patient is TECAR therapy for the duration of 15 minutes each day regularly for a period of 10 days under RET mode with the intensity of temperature according to patients sensitivity and tolerance. Results: The subjects who received TECAR therapy were significantly improved, the pain was much more reduced with the p value of <0.001 Conclusion: This study concluded that TECAR therapy was effective in subjects with patellofemoral pain syndrome. [ABSTRACT FROM AUTHOR]

BACKGROUND: As a result of restricted joint range of motion due to spasticity in patients with spastic cerebral palsy, the patient's ability to regain normal functioning may be hindered. PURPOSE: To evaluate the effectiveness of Myofascial Release Therapy (MFR) versus Deep Oscillation Therapy (DOT) in helping children with spastic cerebral palsy to relax and extend their hamstring range of motion. METHODOLOGY: A total of 32 individuals with spastic cerebral palsy, aged 2 to 10, were recruited for this comparative experimental study through a method of random sampling. Sixteen subjects were assigned to each group. Group 1(N=16) received two sessions of MFR with conventional exercise per day, whereas Group 2(N=16) received a single session of DOT with conventional exercise per day. Throughout the course of four weeks, both groups got therapy five days per week. A universal goniometer was used to compare the knee extension passive range of motion (PROM), active range of motion (AROM), and Popliteal angle (POP angle) measurements between the pre- and post-treatment periods. Statistical analyses were conducted using ANOVA 2x2 and Post hoc tables. RESULT: Both groups' post-mean values for each of the dependent variables (AROM, PROM, and POP angle) statistically improved (p< 0.05). Both groups' mean differences in the PROM and POP angles were statistically significant, and Group 1's spastic hamstring muscle was more improved than Group 2's, but both groups' AROM showed almost equal improvement. CONCLUSION: In children with spastic cerebral palsy, both MFR and DOT, when combined with conventional therapy, reduce spasticity and increase length (AROM & PROM) in the hamstring muscle. However, our study clearly shows that MFR is more successful than DOT. [ABSTRACT FROM AUTHOR]

Introduction: The Ilizarov method, a circular external fixator, is the most commonly used approach to assist in bone union for tibial fractures. Electrophysical agents play a crucial role in rehabilitation, offering significant benefits in speeding up the recovery process and reducing treatment time. Objective: To evaluate the efficacy and safety of using electrophysical agents as adjunct treatment in the rehabilitation of tibial lengthening with the Ilizarov method. Methods: A systematic review of randomized clinical trials (RCTs) will be conducted. The review protocol has been registered on the PROSPERO platform (CRD42023432698). Adults aged 18 years and older undergoing tibial lengthening using the Ilizarov method will be included. Searches will be performed in the following databases: Medical Literature Analysis and Retrieval System Online (Medline) via PubMed, Brazil Scientific Eletrononic Library Online (SciElo), Latin American and Caribbean Health Sciences Literature (LILACS) via Virtual Health Library, Physiotherapy Evidence Database (PEDro), Web Of Science, Sciverse Scopus and Excerpta Medica dataBASE (Embase) via Elsevier, with no language or publication year restrictions. The methodological rigor and certainty of evidence of the included studies will be assessed using the Risk of Bias tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, respectively. Study selection, data extraction, and methodological quality assessment will be conducted by two independent researchers. Expected outcomes: To provide robust information on how rehabilitation through electrophysical agents can impact bone lengthening using the Ilizarov method [ABSTRACT FROM AUTHOR]

Background: High baseline pain self-efficacy (PSE) predicts a better outcome for people attending physiotherapy for musculoskeletal shoulder pain. A potential contributing factor is that PSE moderates the relationship between some treatment modalities and outcome. Our aim was to investigate whether there is a difference in outcome between participants with high compared to low PSE receiving manual therapy, acupuncture, and electrotherapy. Methods: Participants were stratified into high or low baseline (i) PSE, (ii) shoulder pain and disability index (SPADI), and (iii) did or did not receive the treatment. Whether the effect of treatment differs for people with high compared to low PSE was assessed using the 95% confidence interval of the difference of difference (DoD) at a 5% significance level (p < 0.05). Results: Six-month SPADI scores were consistently lower (less pain and disability) for those who did not receive passive treatments compared to those who did (statistically significant less pain and disability in 7 of 24 models). However, DoD was statistically insignificant. Conclusion: PSE did not moderate the relationship between treatment and outcome. However, participants who received passive treatment experienced equal or more pain and disability at 6 months compared to those who did not. Results are subject to confounding by indication but do indicate the need for further appropriately designed research. Level of Evidence: Level of evidence II-b. [ABSTRACT FROM AUTHOR]

The article focuses on a qualitative study on the long-term effectiveness of occipital nerve stimulation (ONS) in patients with medically intractable chronic cluster headache (MICCH). It reveals positive overall benefits of ONS on various aspects of quality of life, including increased mood, energy levels, control over symptoms, enhanced social participation, and improved daily activities, providing valuable insights for patients and practitioners considering this treatment for severe MICCH.

Background: Various treatment methods are available for calcaneal spur, which can cause disability. Objective: To evaluate the efficacy of pulsed electromagnetic field therapy (PEMFT) added to extracorporeal shock wave therapy (ESWT) on pain and functional capacity in treating calcaneal spurs. Methods: Patients with calcaneal spurs who were recommended ESWT or ESWT + PEMFT and whose Foot Function Index (FFI) and visual analogue scale (VAS) values were available in their records were retrospectively analyzed. The two groups were ESWT (n = 35) and ESWT + PEMFT (n = 40). FFI and VAS scores were obtained from their records before treatment, after treatment, and in the third month after treatment. Results: The two groups were similar regarding their pre-treatment FFI and VAS scores. In intra-group evaluation, statistically significant decreases were found in terms of the FFI pain, disability, and activity limitation and VAS scores in both groups after treatment and in the third month after treatment compared to the pre-treatment period. In the comparison between the groups, the post-treatment and post-treatment third-month FFI pain, disability, and activity limitation and VAS scores were significantly lower in the PEMFT + ESWT group than the ESWT group (P < 0.001). Conclusion: A calcaneal spur is a condition that can cause pain and functional limitation in patients. Various studies have demonstrated the efficacy of ESWT in the treatment of calcaneal spurs. In our study, we observed that PEMFT added to ESWT significantly improved the pain and functionality of the patients. Further studies are needed to evaluate the efficacy of PEMFT in calcaneal spurs. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to evaluate the effectiveness of interferential current treatment on a range of motion of joint and shoulder pain, functional status, and quality of life in patients with subacromial impingement syndrome and to compare interferential current with transcutaneous electrical nerve stimulation and sham interferential current. Materials and Methods: Patients complaining of shoulder discomfort participated in the present study. Diagnosis of subacromial impingement syndrome is based on anamnesis, clinical examinations, and shoulder magnetic resonance imaging. A total of 52 patients divided into 3 groups: Group 1 (17 patients, mean age 51.8 years) received interferential current, group 2 (18 patients, mean age 51.8 years) received transcutaneous electrical nerve stimulation, and group 3 (17 patients, mean age 49.1 years) received sham interferential current. Hot pack and exercise treatments were added to all groups. All groups were treated for 3 weeks, 5 times a week, for 15 sessions and 20 minutes for each session. Evaluations were made before treatment (T0), in the middle of treatment (T1; end of 8th session), and at the end of treatment (T2; end of 15th session) using active range of motion and visual analog scale for pain, the Arm, Shoulder, and Hand Problems Questionnaire for functional status, and Short Form-36 for quality of life. Results: There were significant improvement effects on all of the range of motion, visual analog scale, and the Arm, Shoulder, and Hand Problems Questionnaire scores at T2 and on the scores in some subparameters of Short Form-36 in all groups (P < .05). However, there was no statistically significant difference at T2 between the groups (P > .05). Conclusion: Interferential current and transcutaneous electrical nerve stimulation exhibited equivalent results regarding range of motion, pain, function, and quality of life of patients with subacromial impingement syndrome, with no significant difference between interferential current and transcutaneous electrical nerve stimulation. Adding interferential current or transcutaneous electrical nerve stimulation treatments to hot pack +exercise therapy did not result in any extra benefits to the patients. [ABSTRACT FROM AUTHOR]

Interferential current (IFC) is a non-pharmacological therapy often used to reduce pain intensity. However, there is no scientific evidence of the biological effects of the adjustment of IFC intensity of stimulation. To investigate whether the adjustment of IFC intensity influences pain on cutaneous sensory threshold (CST), pressure pain threshold (PPT) and pain intensity in healthy subjects under mechanically induced pain. This is a placebo-controlled randomized trial. One hundred and two healthy university students blinded to intervention were randomized using opaque sealed envelopes to the following groups: 1) sensory IFC (n = 24); 2) fixed motor IFC (n = 26); 3) adjusted motor IFC (n = 27); and 4) placebo IFC (n = 25). After 40 minutes of stimulation or placebo, subjects were evaluated by an investigator blinded to group allocation. CST (von Frey filaments), PPT (algometry), and pain intensity (11-point numerical scale) were measured. Adjusted motor IFC promoted a significant reduction of CST (hand: mean difference (MD) = 2.39, confidence intervals (CI) = 1.39–3.38; and forearm: MD = 3.01, CI = 2.87–3.14) compared to placebo. Adjusted motor IFC increased PPT significantly (hand: MD = 27.59, CI = 26.80–28.37; and forearm: MD = 34, CI = 25.74–42.25) when compared to placebo. Adjusted motor IFC reduced pain intensity by 4.01 points (CI = 3.64–4.55) when compared to placebo. No adverse events were observed. Adjusted motor IFC intensity increased PPT and CST and also reduced pain intensity in healthy subjects under mechanically induced pain. [ABSTRACT FROM AUTHOR]

Tumor Treating Fields (TTFields) is a non-invasive modality for cancer treatment that utilizes a specific sinusoidal electric field ranging from 100 kHz to 300 kHz, with an intensity of 1 V/cm to 3 V/cm. Its purpose is to inhibit cancer cell proliferation and induce cell death. Despite promising outcomes from clinical trials, TTFields have received FDA approval for the treatment of glioblastoma multiforme (GBM) and malignant pleural mesothelioma (MPM). Nevertheless, global acceptance of TTFields remains limited. To enhance its clinical application in other types of cancer and gain a better understanding of its mechanisms of action, this review aims to summarize the current research status by examining existing literature on TTFields' clinical trials and mechanism studies. Through this comprehensive review, we seek to stimulate novel ideas and provide physicians, patients, and researchers with a better comprehension of the development of TTFields and its potential applications in cancer treatment. [ABSTRACT FROM AUTHOR]

Blinding in research is important, and the field of physical medicine and rehabilitation poses special consideration owing to the patient populations and treatment methodologies used. Historically, blinding has been increasingly relevant to conducting good-quality research. The main reason to blind is to reduce bias. There are several strategies to blinding. At times, when blinding is not possible, alternatives to blinding include sham control and description of study and control groups. Illustrative examples of blinding used in physical medicine and rehabilitation research are described in this article, along with how to assess success and fidelity of blinding. [ABSTRACT FROM AUTHOR]

Introduction. Musculoskeletal pain (MSP) is one of the main causes of chronic pain in adults and the main reason for disability. Diadynamic currents (DD C) are described as classic electrotherapy modalities for the management of MSP, however, the available information and studies that support their use are limited. The aim of this report is therefore to describe the efficacy of DD C in the treatment of MSP. Methods. Randomised clinical trials (RCTs) were identified in the PubMed, Scopus, Web of Science, Cinahl, and Science Direct databases as of August 1, 2021. Three independent investigators reviewed the articles' titles and abstracts to determine their eligibility, risk of bias, and quality using the Cochrane Rob2 tool and the PEDro scale. Pain reduction was considered as the main outcome and changes in the range of motion, strength, or disability/functionality as secondary outcomes. Results. Thirteen RCTs were obtained after eliminating duplicates, reviewing the titles and abstracts and applying the selection criteria. The MSP conditions included joint (n = 9) and soft tissue (n = 5) disorders. The studies had a low risk of bias and good quality, with average scores of 7 for the PEDro scale. Pain reduction was observed for DD C treatments, as well as an improvement in functionality in favour of the experimental groups (p < 0.05). Conclusions. DD C are effective in reducing MSP and improving functionality compared to other electrotherapy modalities. This review made it possible to generate dosage recommendations and establish that the best therapeutic results are achieved with combined diadynamic applications. [ABSTRACT FROM AUTHOR]

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Simple Summary: Electrochemotherapy has proven to be an efficient treatment for cutaneous metastases of various cancers including breast cancer (BC). The large number of patients collected within the INSPECT database provides the possibility of a differentiated analysis on BC with different receptor statuses (estrogen receptor and HER2 receptor). Patients with BC presenting cutaneous metastases were retrieved from the INSPECT database and divided by their receptor status: HER2+, HR+ (ER/PgR+), and TN (triple negative). ECT treatment is equally effective among groups, despite different conditions, age, time since diagnosis, previous or concomitant treatments, and treatment characteristics. Response and local tumor control seem to be better in multiple small lesions than in big armor-like lesions, suggesting that treating smaller, even multiple, lesions at the time of occurrence is more effective than treating bigger long-lasting armor-like cutaneous lesions. Electrochemotherapy has been proven to be an efficient treatment for cutaneous metastases of various cancers. Data on breast cancer (BC) patients with cutaneous metastases were retrieved from the INSPECT database. Patients were divided by their receptor status: HER2+, HR+ (ER/PgR+), and TN (triple negative). Groups were similar for histological subtype and location of the nodules. Most patients were previously treated with surgery/systemic therapy/radiotherapy. We found no differences in the three groups in terms of response ratio (OR per patient 86% HER2+, 80% HR+, 76% TN, p = 0.8664). The only factor positively affecting the complete response rate in all groups was small tumor size (<3 cm, p = 0.0105, p = 0.0001, p = 0.0266, respectively). Local progression-free survival was positively impacted by the achievement of complete response in HER2+ (p = 0.0297) and HR+ (p = 0.0094), while overall survival was affected by time to local progression in all groups (p = 0.0065 in HER2+, p < 0.0001 in HR+, p = 0.0363 in TN). ECT treatment is equally effective among groups, despite different receptor status. Response and local tumor control seem to be better in multiple small lesions than in big armor-like lesions, suggesting that treating smaller, even multiple, lesions at the time of occurrence is more effective than treating bigger long-lasting armor-like cutaneous lesions. [ABSTRACT FROM AUTHOR]

The efficacy and frequency of physiotherapy in the prognosis of congenital muscular torticollis (CMT) that involves the entire sternocleidomastoid (SCM) muscle continues to be unclear. This study investigated the therapeutic effect of intensive inpatient therapy given to infants with CMT that involves the whole SCM using clinical measurements and ultrasound (US). This study included 54 infants (27 boys and 27 girls; mean corrected age of 18.57 days) evaluated for CMT at our outpatient clinic from January 2014 to May 2021. The included patients were divided into three groups (groups 1, 2, and 3). Patients in group 1 underwent outpatient treatment 12 times. Patients in groups 2 and 3 underwent therapeutic exercise followed by US diathermy with microcurrent twice daily for 1 or 2 weeks, respectively. Passive range of motion of the cervical rotation (PCRROM) and SCM thickness were evaluated pre- and post-treatment. Among the three groups, the demographic data at baseline were not significantly different, SCM thickness and PCRROM were significantly decreased/increased at post-treatment compared to pre-treatment (p < 0.05), mean PCRROM change was significantly greater in group 3 (p < 0.05), and mean SCM thickness reduction between pre-treatment and 3 months post-treatment was significantly greater in groups 2 and 3 (p < 0.05). Therefore, intensive inpatient therapeutic exercise and US diathermy with microcurrent may enhance the prognosis of CMT involving the entire SCM muscle. [ABSTRACT FROM AUTHOR]

Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Health Bulletin / Zdravstveni Glasnik is the property of Faculty of Health Studies, University of Mostar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancer diagnosis is increasing rapidly worldwide and pain is a common feature reported by cancer patients. Therapeutical approach on cancer pain is complex where less invasive methods with little side effects have been sought. The aim of this study was to compare transcutaneous electrical nerve stimulation (TENS) and interferential current (IC) therapies effects on cancer pain. Double blind study with 81 cancer pain patients. Subjects were set up into two groups: one treated with TENS VIF (n=42) and other with IC (n=39). Age, gender, duration of pain, tumor site and histology, medications, treatments, Karnofsky score and clinical state were evaluated. Pain was measured by EMADOR and McGill scores. Electroanalgesia was performed for 30 minutes, the equipments used were Neurodyn III Ibramed® and Neurovector generation 2000 Ibramed®. Electrodes were placed where there was higher intensity of pain according to what was shown by the patient through EMADOR, and each one got only one electrotherapy session. Pain intensity was significantly reduced in both groups (p<0.001) soon after and until 6th hour post electrotherapy. IC group had better results at 4th, 5th (p<0.001) and 6th hour (p=0.022). McGill score in TENS VIF group was significant until 4th hour and in the IC group was highly significant in all evaluated times (p<0.001). Analgesic effect of TENS VIF and IC electrotherapy was clinically effective, however, IC did cause better results regarding analgesia duration. [ABSTRACT FROM AUTHOR]

Electrochemotherapy has good local effectiveness in the treatment of vulvar cancer. Most studies have reported the safety and effectiveness of electrochemotherapy for palliative treatment of gynecological cancers and mostly vulvar squamous cell carcinoma. Some tumors, however, fail to respond to electrochemotherapy. The biological features/determinants for the nonresponsiveness are not determined yet. A recurrence of vulvar squamous cell carcinoma was treated by electrochemotherapy using intravenous administration of bleomycin. The treatment was performed by hexagonal electrodes according to standard operating procedures. We analyzed the factors that could determine nonresponsiveness to electrochemotherapy. Based on the presented case of nonresponsive vulvar recurrence to electrochemotherapy, we hypothesize that the vasculature of the tumors prior to treatment may predict the response to electrochemotherapy. The histological analysis showed minimal presence of blood vessels in the tumor. Thus, low perfusion may reduce drug delivery and lead to a lower response rate because of the minor antitumor effectiveness of vascular disruption. In this case, no immune response in the tumor was elicited by electrochemotherapy. In this case, of nonresponsive vulvar recurrence treated by electrochemotherapy, we analyzed possible factors that could predict treatment failure. Based on histological analysis, low vascularization of the tumor was observed, which hampered drug delivery and distribution and resulted in no vascular disrupting action of electro-chemotherapy. All these factors could contribute to ineffective treatment with electrochemotherapy. [ABSTRACT FROM AUTHOR]

Simple Summary: Liver malignancy affects thousands of people, and its treatment is constantly evolving. Ablative therapies are a series of minimally invasive modalities that treat these tumors in combination with other established forms of treatment such as chemotherapy and surgery. Ablative therapy is well-studied in the case of the most common type of liver malignancy, hepatocellular carcinoma. There is much less information on ablative therapy in non-hepatocellular carcinoma liver malignancy treatment. Therefore, we have described the available literature, focusing on ablative therapy's promising results, shortcomings, and detail areas for future research on the topic of non-hepatocellular carcinoma of the liver. Surgical extirpation of liver tumors remains a proven approach in the management of metastatic tumors to the liver, particularly those of colorectal origin. Ablative, non-resective therapies are an increasingly attractive primary therapy for liver tumors as they are generally better tolerated and result in far less morbidity and mortality. Ablative therapies preserve greater normal liver parenchyma allowing better post-treatment liver function and are particularly appropriate for treating subsequent liver-specific tumor recurrence. This article reviews the current status of ablative therapies for non-hepatocellular liver tumors with a discussion of many of the clinically available approaches. [ABSTRACT FROM AUTHOR]

The North American opioid epidemic has resulted in over 800,000 related premature overdose fatalities since 2000, with the United States leading the world in highest opioid deaths per capita. Despite increased federal funding in recent years, intended to address this crisis, opioid overdose mortality has continued to increase. Legally prescribed opioids also chronically induce a problematic reduction in affect. While an ideal analgesic has yet to be developed, some effective multimodal non-opioid pharmacological regimens for acute pain management are being more widely utilized. Some investigators have suggested that a safer and more scientifically sound approach might be to induce "dopamine homeostasis" through non-pharmacological approaches, since opioid use even for acute pain of short duration is now being strongly questioned. There is also increasing evidence suggesting that some more robust forms of electrotherapy could be applied as an effective adjunct to avoid the problems associated with opioids. This 4-patient case-series presents such an approach to treatment of severe pain. All 4 of these chiropractic treatment cases involved a component of knee osteoarthritis, in addition to other reported areas of pain. Each patient engaged in a home recovery strategy using H-Wave® device stimulation (HWDS) to address residual extremity issues following treatment of spinal subluxation and other standard treatments. A simple statistical analysis was conducted to determine the change in pain scores (Visual Analogue Scale) of pre and post electrotherapy treatments, resulting in significant reductions in self-reported pain (p-value = 0.0002). Three of the four patients continued using the home therapy device long-term as determined by a post-analysis questionnaire. This small case-series demonstrated notably positive outcomes, suggesting consideration of home use of HWDS for safe, non-pharmacological and non-addictive treatment of severe pain. [ABSTRACT FROM AUTHOR]

Simple Summary: There is a large gap in knowledge amongst the oncology community of moderate hyperthermia use in cancer management. This review provides an overview of clinical data on the use of loco-regional and superficial hyperthermia in the adjunct management of cancers. It is updated using higher-level evidence from prospective, comparative studies and meta-analyses. The methodology and results are summarised and tabulated according to tumour type for easy reference. Regional hyperthermia therapy (RHT) is a treatment that applies moderate heat to tumours in an attempt to potentiate the effects of oncological treatments and improve responses. Although it has been used for many years, the mechanisms of action are not fully understood. Heterogenous practices, poor quality assurance, conflicting clinical evidence and lack of familiarity have hindered its use. Despite this, several centres recognise its potential and have adopted it in their standard treatment protocols. In recent times, significant technical improvements have been made and there is an increasing pool of evidence that could revolutionise its use. Our narrative review aims to summarise the recently published prospective trial evidence and present the clinical effects of RHT when added to standard cancer treatments. In total, 31 studies with higher-quality evidence across various subsites are discussed herein. Although not all of these studies are level 1 evidence, benefits of moderate RHT in improving local tumour control, survival outcomes and quality of life scores were observed across the different cancer subsites with minimal increase in toxicities. This paper may serve as a reference when considering this technique for specific indications. [ABSTRACT FROM AUTHOR]

Background: Central sleep apnea (CSA) is a disorder defined by lack of respiratory drive from the brain stem on breathing efforts. There is a lack of established therapies for CSA and most available therapies are limited by poor patient adherence, limited randomized controlled studies, and potentially adverse cardiovascular effects. The remedē System (ZOLL Respicardia, Inc., Minnetonka, Minnesota) uses transvenous phrenic nerve stimulation to stimulate the diaphragm, thereby restoring a more normal breathing pattern throughout the sleep period.Methods: The remedē System Therapy (rēST) Study is a prospective non-randomized multicenter international study evaluating long-term safety and effectiveness of the remedē System in the post-market setting. Up to 500 adult patients with moderate to severe CSA will be enrolled and followed up to 5 years at approximately 50 sites in the United States and Europe. Safety objectives include evaluation of adverse events related to the implant procedure, device or delivered therapy, death, and hospitalizations. Effectiveness endpoints include assessment of changes in sleep-disordered breathing metrics from polysomnograms and home sleep tests, changes in daytime sleepiness using the Epworth Sleepiness Scale, and changes in QoL using the PROMIS-29 and Patient Global Assessment questionnaires. The subgroup of patients with heart failure will undergo additional assessments including echocardiography to assess cardiac reverse remodeling, 6-min walk distance, QoL assessment by Kansas City Cardiomyopathy Questionnaire and measurement of biomarkers.Conclusion: This will be the largest prospective study evaluating long-term safety and effectiveness of transvenous phrenic nerve stimulation for the treatment of moderate to severe CSA in adult patients. [ABSTRACT FROM AUTHOR]

Objectives: Chronic low back pain (CLBP), along with physical limitations that affect the quality of life, is one of the most important problems in the health community. The pain causes a wide range of structural, functional, and neurological changes in the brain. However, these changes have not been well studied, as brain changes in other chronic pains. This study aimed to evaluate the changes in the electroencephalogram (EEG) of patients with nonspecific CLBP, and also to evaluate the effects of interferential current (IFC), as one of the common treatment methods in these patients, on the EEG. Methods: This randomized control trial was performed in the Physiotherapy Clinic of Rehabilitation Faculty of Tabriz University of Medical Sciences from July 2021 to February 2022. A total of 20 patients with nonspecific CLBP and 20 healthy individuals participated in this study. Healthy subjects were in the control group, and the patients were randomly divided into two groups: intervention and placebo. Participants' EEG and pain intensity were recorded before and after one session of IFC. Results: The results of statistical analyses to compare the EEG of patients and healthy individuals did not show a significant difference between the two groups. The results of statistical tests to evaluate the effects of IFC on participants' EEG showed a significant increase in alpha frequency in all three groups. In addition, a significant increase in theta frequency was recorded in the placebo group, and an increase in the beta frequency in the intervention group. Pain intensity showed a significant decrease only in the intervention group. Discussion: The results of this study suggest that changes in EEG in patients with low back pain may be related to the severity of pain and neurological involvement. In addition, the increased power of EEG following the application of IFC may be due to sensory stimulation of the skin surface. [ABSTRACT FROM AUTHOR]

Simple Summary: This review provides a summary of the head-and-neck squamous cell carcinoma (HNSCC) biological characteristics and its current treatments. Furthermore, insight and outlook on the relationship between electroporation and its implementation (combination with nanotechnology and immunotherapy) in the treatment of H&N cancers are provided. Squamous cell carcinoma is the most common malignancy that arises in the head-and-neck district. Traditional treatment could be insufficient in case of recurrent and/or metastatic cancers; for this reason, more selective and enhanced treatments are in evaluation in preclinical and clinical trials to increase in situ concentration of chemotherapy drugs promoting a selectively antineoplastic activity. Among all cancer treatment types (i.e., surgery, chemotherapy, radiotherapy), electroporation (EP) has emerged as a safe, less invasive, and effective approach for cancer treatment. Reversible EP, using an intensive electric stimulus (i.e., 1000 V/cm) applied for a short time (i.e., 100 μs), determines a localized electric field that temporarily permealizes the tumor cell membranes while maintaining high cell viability, promoting cytoplasm cell uptake of antineoplastic agents such as bleomycin and cisplatin (electrochemotherapy), calcium (Ca2+ electroporation), siRNA and plasmid DNA (gene electroporation). The higher intracellular concentration of antineoplastic agents enhances the antineoplastic activity and promotes controlled tumor cell death (apoptosis). As secondary effects, localized EP (i) reduces the capillary blood flow in tumor tissue ("vascular lock"), lowering drug washout, and (ii) stimulates the immune system acting against cancer cells. After years of preclinical development, electrochemotherapy (ECT), in combination with bleomycin or cisplatin, is currently one of the most effective treatments used for cutaneous metastases and primary skin and mucosal cancers that are not amenable to surgery. To reach this clinical evidence, in vitro and in vivo models were preclinically developed for evaluating the efficacy and safety of ECT on different tumor cell lines and animal models to optimize dose and administration routes of drugs, duration, and intensity of the electric field. Improvements in reversible EP efficacy are under evaluation for HNSCC treatment, where the focus is on the development of a combination treatment between EP-enhanced nanotechnology and immunotherapy strategies. [ABSTRACT FROM AUTHOR]