Randomized controlled trials (RCTs) of fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome (IBS) have produced outcomes varying from no effect at all to high efficacy and durable effects over time. This review analyzed differences in the protocols used in FMT RCTs for IBS in the recently published literature with the aim of identifying the factors responsible for the success or failure of these RCTs. The results of this analysis might be useful in formulating an effective standard protocol for FMT in IBS. A systematic search was conducted in the PubMed database of the literature published in English from January 2015 to December 2023 using several search phrases comprising MeSH expressions. Those RCTs that carefully selected donors based on environmental factors that are known to affect the gut microbiota positively and ensured bacterial diversity before and during FMT produced successful outcomes. Furthermore, direct freezing of the donor’s fecal transplant, storing it at −80°C until the FMT is performed, and then thawing it at 4°C and mixing it manually appear to be factors associated with the success of FMT in IBS. Administering the donor’s fecal transplant into the small intestine results in durable effects of FMT and long-term colonization of beneficial bacteria. A standard protocol for FMT with large and durable effects should include (1) careful donor selection, (2) handling the donor’s fecal transplant in a way that preserves its microbiota contents, and (3) administering the transplant into the small intestine.

Purpose: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines. Materials and Methods: A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method. Results: Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support. Conclusions This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

Purpose: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines. Materials and Methods: A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method. Results: Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support. Conclusions This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

Purpose: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines. Materials and Methods: A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method. Results: Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support. Conclusions This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

Purpose: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines. Materials and Methods: A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method. Results: Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support. Conclusions This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

Purpose: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines. Materials and Methods: A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method. Results: Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support. Conclusions This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

Purpose: Mouth opening limitation following maxillectomy significantly has great influence on the quality of life. The purpose of this study was to analyze the effect of scarring in the supporting ligaments of the temporomandibular joint that is recognized as one of the causes of mouth opening limitation using a three-dimensional computer simulation. Materials and Methods: Based on the CT data from a healthy adult, a computer musculoskeletal model with a maxillary palatal defect was developed. The geometry from patient’s CT data was imported into the biomechanical simulation platform Artisynth to reproduce mandibular movement. Four simulations including scar tissue in the capsular and temporomandibular ligament were established. Forty and 60 percent of the maximum voluntary muscle contraction (MVC) were applied to evaluate the mouth opening limitation. Distance between maxillary and mandibular central incisors were evaluated. Results: In all simulations, the model that had scarring in the capsular ligament showed the most significant mouth opening limitation. The simulation with scarring only in the temporomandibular ligament also showed reduced mouth opening compared to the non-scarred condition. However, the effect was less than that of the capsular ligament. Conclusion When the capsular ligament that plays a great role in mandibular movement is scarred, it might be the one of the most important factors in mouth opening limitation. Therefore, in the surgical treatment around the temporomandibular joint, the biomechanical characteristics of the joint supporting ligaments has to be considered.

Vertebral artery dissection (VAD) is a rare but serious safety concern associated with spinal manipulative therapy. This report highlights the occurrence of such condition in a 35-year-old male without predisposing risk factors. The patient has had dizziness and occipital pain of new onset following chirotherapy for the neck spines. On admission, magnetic resonance angiography depicted a dissecting dilatation at the intracranial portion of the right vertebral artery. He was placed on antithrombotic therapy and fluid supplementation. His presenting symptoms completely remitted without recurrence. Follow-up images 4 months later showed resolution of the arterial dissection without progression to rupture. The study with featured images facilitates the physicians better understand VAD in those with neurologic complaints following chiropractic manipulation of the cervical vertebra.

Chiropractic care, known for its non-invasive and hands-on approach to healthcare, can occasionally lead to adverse reactions. This case report details an unusual occurrence of intracranial hypotension (IH) in a 30-year-old female who received chiropractic care for neck pain. The patient experienced a throbbing positional headache five days after mobilization and adjustment of the cervical spine. Upon admission, lumbar puncture performed in the lateral position revealed an opening pressure of 55 mm H2O. Magnetic resonance imaging showed subdural fluid collection and diffuse pachymeningeal enhancement in the cerebral hemispheres. Radioisotope cisternography revealed dural leakage at the upper cervical level. Following unsuccessful supportive measures, the patient underwent treatment with an epidural blood patch. After the treatment, her postural headaches completely subsided without recurrence. This report underscores that IH syndrome is a rare yet clinically significant complication that may be associated with manipulation of the upper spine.

Vertebral artery dissection (VAD) is a rare but serious safety concern associated with spinal manipulative therapy. This report highlights the occurrence of such condition in a 35-year-old male without predisposing risk factors. The patient has had dizziness and occipital pain of new onset following chirotherapy for the neck spines. On admission, magnetic resonance angiography depicted a dissecting dilatation at the intracranial portion of the right vertebral artery. He was placed on antithrombotic therapy and fluid supplementation. His presenting symptoms completely remitted without recurrence. Follow-up images 4 months later showed resolution of the arterial dissection without progression to rupture. The study with featured images facilitates the physicians better understand VAD in those with neurologic complaints following chiropractic manipulation of the cervical vertebra.