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<h4>Background</h4>Aggressive vertebral hemangiomas are uncommon vascular spinal lesions that may enlarge during pregnancy due to hormonal and hemodynamic changes. Elevated estrogen and progesterone levels, increased blood volume, and venous congestion can lead to rapid lesion expansion and epidural extension, causing neurological deficits. Although rare, these lesions should be considered in pregnant or postpartum women presenting with back or radicular pain.<h4>Observations</h4>A 30-year-old woman with epilepsy controlled by lamotrigine developed progressive low back and right leg pain during late pregnancy, worsening postpartum. MRI revealed an aggressive L4 vertebral hemangioma with epidural extension compressing the thecal sac and right L4 nerve root. The patient underwent L4 laminectomy, excision of the epidural component, and vertebroplasty. Persistent bleeding after initial posterior cement injection required a second injection through the left pedicle to fill the superior vertebral body, followed by fibrin glue application. She was mobilized on the 1st postoperative day, and her symptoms resolved completely.<h4>Lessons</h4>Pregnancy-related aggressive vertebral hemangioma should be suspected in women with new-onset neurological symptoms during pregnancy or postpartum. Early diagnosis, multidisciplinary planning, and timely decompression with vertebroplasty yield excellent neurological recovery and functional outcomes. https://thejns.org/doi/10.3171/CASE25860.…

PMID: 41587448

<h4>Background</h4>In livestock, identifying physiological and reproductive stages is crucial for informed decisions in nutrition, healthcare, and breeding management.<h4>Objective</h4>This study aimed to evaluate hematobiochemical and Doppler echocardiographic changes in dromedary camels during three key stages: non pregnant, late pregnancy, and early lactation.<h4>Methodology</h4>Thirty healthy camels were monitored across three physiological stages. Blood samples were analyzed for complete blood count (CBC) and serum metabolic parameters, including Beta-hydroxy-butyric acid (BHBA) and non-esterified fatty acids (NEFA). Doppler echocardiography assessed cardiac morphology and function.<h4>Results</h4>Late pregnancy was associated with a significant (P < 0.05) increase in red blood cell (RBC) count, hemoglobin (Hb), and neutrophils, while packed cell volume (PCV), total white blood cell (WBC) count, and monocytes decreased. Serum glucose and cholesterol declined significantly (P < 0.05) in late pregnancy and early lactation, while Beta-hydroxy-butyric acid (BHBA) increased. Late-pregnant camels showed elevated levels of albumin, globulin, potassium (K), and cardiac troponin, but lower total protein (TP). Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were highest in non-pregnant camels. NEFA levels rose significantly in early lactation. Echocardiographic findings revealed increased left ventricular wall thickness and decreased systolic diameter (LVIDs) in early lactation. Heart rate (HR) increased in late pregnancy. No significant changes were observed in pulsed-wave Doppler indices.<h4>Conclusions</h4>Distinct physiological stages in dromedary camels are associated with significant hematobiochemical alterations and minor echocardiographic changes, offering valuable insights for clinical and reproductive management.…

PMID: 40619378

Postoperative rehabilitation is essential for orthopedic patients to restore physical function (PF), relieve pain, and improve overall quality of life. This study explores the effects of integrating acupuncture and massage therapy into postoperative care for orthopedic surgery patients, aiming to evaluate its impact on recovery outcomes and psychological well-being. A retrospective cohort analysis was conducted involving 110 patients who underwent orthopedic surgery between January 2023 and June 2024. Based on differences in their rehabilitation methods, participants were grouped into 2 categories: one receiving standard rehabilitation care (n = 54) and the other receiving a combination of acupuncture and massage therapy alongside routine rehabilitation (n = 56). Recovery indicators such as duration of hospital stay, joint stiffness, and chronic pain were compared between the 2 groups. Functional and psychological outcomes were assessed using the SF-36 health survey, Barthel index (BI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) at both 1 week and 1 month after surgery. The group treated with acupuncture and massage demonstrated significantly enhanced postoperative recovery. Their average hospital stay was shorter (6.18 ± 2.11 days) compared to the conventional group (7.23 ± 2.31 days, P = .015). Furthermore, the incidence of joint stiffness (3.6% vs 16.7%, P = .035) and chronic pain (7.1% vs 22.2%, P = .045) was notably reduced. Assessments using the SF-36 and BI showed greater improvements in quality of life and daily functioning at both evaluation points (P < .05). Additionally, the acupuncture and massage group exhibited significantly lower levels of anxiety and depression 1 month post-surgery (P < .05). Incorporating acupuncture and massage therapy into postoperative rehabilitation for orthopedic patients can yield meaningful benefits in terms of faster recovery, improved joint function, reduced pain, and enhanced psychological health. These findings support the clinical value of integrative approaches in orthopedic postoperative care.…

PMID: 40958329

<h4>Objective</h4>This study aimed to compare the effects of five post-exercise recovery interventions-massage, cold-water immersion (CWI), vibration therapy, functional electrical stimulation (FES), and static stretching-on central nervous modulation, neuromuscular function recovery, and inflammatory response following exercise-induced muscle fatigue (EIMF).<h4>Methods</h4>This randomized controlled trial employed a two-way repeated-measures analysis of variance (ANOVA; group × time) to evaluate the effects of different recovery interventions over time. Thirty healthy male participants were randomly assigned to six groups (n = 5 each): massage (Group A), CWI (Group B), vibration therapy (Group C), static stretching (Group D), FES (Group E), and control (Group F). EIMF was induced using a standardized exercise model. Physiological and biochemical measurements were taken at baseline, immediately post-exercise, and at 24, 48, and 72 h. Physiological indicators included muscle contraction time (TC), maximal radial displacement (DM),peak concentric power, The blood biochemical indicators include gamma-aminobutyric acid (GABA), creatine kinase (CK),and interleukin-6 (IL-6).<h4>Results</h4>Vibration therapy demonstrated a significant advantage in reducing TC at 72 h post-exercise (p = 0.027,p < 0.05); Although no statistically significant differences were found for DM,the massage group showed a more favorable recovery trend; FES significantly improved peak concentric power at 48 h post-exercise (p = 0.000, p < 0.01). Massage significantly increased GABA levels (p = 0.001, p < 0.05) and reduced CK concentrations (p = 0.000, p < 0.01) at 48 h. CWI demonstrated a significant inhibitory effect on IL-6 at 48 h (p = 0.000, p < 0.01).<h4>Conclusion</h4>Massage therapy showed favorable effects in central modulation and muscle repair. CWI effectively controlled acute inflammation. FES improved muscle explosive power, while vibration therapy enhanced neuromuscular responsiveness. Static stretching group showed no significant recovery benefit, as stretching primarily enhances ROM and flexibility and has only limited impact on the critical physiological pathways necessary for EIMF recovery.…

PMID: 41141855

Recent clinical studies and scientific literature increasingly support the use of essential oils (EOs) as adjuncts in enhancing sports performance and recovery. They have demonstrated potential in modulating mood, alleviating fatigue, facilitating muscle recovery, and contributing to the overall physiological and psychological well-being of athletes. Specifically, EOs such as peppermint and eucalyptus exhibit analgesic and anti-inflammatory properties, making them beneficial for managing exercise-induced muscle soreness and discomfort. Conversely, oils like lavender are recognized for their anxiolytic and sedative effects, which may improve sleep quality and promote relaxation. But both are essential for effective post-exercise recovery. As such, their strategic application may represent a valuable, complementary approach within the broader context of sports medicine and athletic training. Although EOs have been used for centuries in traditional medicine of various cultures to support physical performance, scientific research in the field of sports medicine remains still limited. Preliminary findings suggest promising effects on fatigue reduction, sleep, sympathetic activity, and endurance improvement. However, results are inconsistent, with some studies even showing no significant differences compared to placebo. Further rigorous research is needed to establish the efficacy and mechanisms of EOs in athletic settings.…

PMID: 41011665

Sepsis and septic shock are leading causes of maternal morbidity and mortality. Sepsis complicates an estimated 1 in 1,000 pregnancies and is responsible for 24% of in-hospital maternal deaths. Because most cases occur outside of the hospital, it is crucial to educate patients about warning signs to seek early medical care and for clinicians to engage in critical listening and evaluation of patient concerns. In the hospital, screening patients for vital sign aberrancy, followed by bedside and laboratory evaluation for signs of end-organ injury, prompt antibiotic therapy, and restoration of perfusion (through fluid resuscitation and vasopressor administration), is critical for optimal outcomes. Long-term sequelae are common and include psychological sequelae, cognitive dysfunction, and weakness. Screening for these long-term effects and referrals for treatment are key to patient recovery.…

PMID: 40570351

Background Maternal morbidity and mortality remain significant public health concerns, particularly in resource-limited settings. Early warning score systems, such as the Maternal Early Obstetric Warning System (MEOWS), have been recommended to facilitate the timely recognition of clinical deterioration in obstetric patients. This study evaluates the utility of MEOWS in predicting maternal morbidity and mortality in a tertiary care center in India. Objectives To determine whether MEOWS "track-and-trigger" charts can serve as an effective bedside screening tool to predict obstetric morbidity and mortality in women beyond 28 weeks of gestation through six weeks postpartum. Methodology A prospective observational study was conducted in the obstetrics department of a tertiary teaching hospital. A total of 500 women (≥28 weeks of gestation or up to six weeks postpartum) were monitored using the standard MEOWS chart. Vital signs and obstetric parameters were recorded at admission and regular intervals. A MEOWS "trigger" was defined as the occurrence of one red (severely abnormal) value or any two simultaneous yellow (moderately abnormal) values. Management followed standard hospital protocols without clinical interventions dictated solely by triggers. Maternal outcomes were classified as no morbidity versus morbidity/mortality by discharge. Statistical analysis included chi-square tests to compare characteristics and outcomes, alongside calculations of MEOWS performance metrics (sensitivity, specificity, predictive values) and relative risk (RR) for physiological parameters. Results Out of 500 patients, 93 (18.6%) triggered MEOWS, while 407 (81.4%) did not. The triggered group had significantly higher proportions of advanced age, grand multiparity, urban residence, referrals, and low socioeconomic status. On admission, 71% of triggered patients presented with obstetric complications compared to only 5.4% of non-triggered patients. Obstetric outcomes revealed a stark contrast: 37.6% of triggered women required emergency intervention versus 4.4% of the non-triggered group. All 15 maternal deaths occurred in the triggered group (16.1% case fatality). Overall, 76.3% of triggered women suffered severe morbidity or mortality, compared to only 2.0% of the non-triggered group. MEOWS demonstrated high diagnostic accuracy with a sensitivity of 76.3%, specificity of 98.0%, positive predictive value (PPV) of 89.9%, and negative predictive value (NPV) of 94.8%. A positive screen was associated with an approximate 38-fold higher risk of severe morbidity. Analysis of individual parameters indicated that tachypnea was the strongest single predictor of morbidity (RR: ~19.5), followed by diastolic hypertension (RR: ~15.4) and maternal tachycardia (RR: ~13.5). Conclusion In this prospective cohort, the MEOWS "track-and-trigger" system proved to be a valuable predictor of maternal morbidity and mortality. Women breaching trigger criteria were significantly more likely to experience severe complications or death. The MEOWS chart demonstrated high specificity and strong predictive value, correctly identifying the majority of women who developed obstetric morbidity with few false alarms. These findings support the incorporation of MEOWS into routine obstetric care to facilitate the early recognition of critical illness and improve maternal outcomes.…

PMID: 41960012

<h4>Background</h4>Recognizing the signs of life-threatening maternal complications and receiving timely, quality care can help prevent pregnancy-related deaths and adverse health consequences.<h4>Objectives</h4>This study evaluated the scale-up of the EMPOWER Moms initiative, one of the first statewide efforts to strengthen and standardize maternal warning signs education provided in home and community settings.<h4>Design</h4>The EMPOWER Moms initiative supported home visitors, community nurses, and other family support staff with training and tools to educate families in Maryland and Washington D.C. on urgent maternal warning signs. Support included online training for these educators, monthly collaborative calls, an implementation manual, and a client education toolkit with a 3-min video, illustrated handout, magnet, and discussion guide.<h4>Methods</h4>This mixed-methods, observational study evaluated implementation and behavioral outcomes among educators and their clients using surveys, monitoring forms, and semi-structured interviews.<h4>Results</h4>Two hundred and thirty-seven educators completed the training, and more than 3,300 pregnant and 3,600 postpartum clients received education between July 2022 and December 2023. The use of standardized printed materials on warning signs increased from 50.0% before training to 92.5% after (<i>p</i> < 0.001), and use of informational videos increased from 9.7% to 53.8% (<i>p</i> < 0.001). Educators showed significant improvement in their self-rated ability to educate clients about warning signs, help clients find answers to their questions, and build clients' self-confidence to discuss concerns with healthcare providers (all <i>p</i> < 0.001). Qualitative feedback endorsed the intervention's benefits in encouraging care-seeking. Educators shared stories of clients obtaining necessary care for urgent complications and suggested education had encouraged quick action when they might have otherwise hesitated. Feedback also highlighted how women were more proactively sharing their concerns and asking questions during healthcare visits.<h4>Conclusion</h4>We found EMPOWER training and tools were effective in improving educators' confidence and skills to engage families in conversations about pregnancy-related complications and to support them in recognizing and obtaining prompt care.…

PMID: 41757788