Cureus最新文献

{"title":"Time-Trend Analysis of Low Birthweight in Greece: Mapping a Heavy Public Health Burden.","authors":"Nikolaos Vlachadis, Dimos Sioutis, Chryssi Christodoulaki, Nikolaos Machairiotis, Dimitrios Panagiotopoulos, Konstantinos Louis, Maria Siori, Amalia Koutsoukou, Anastasia Barbouni, Periklis Panagopoulos","doi":"10.7759/cureus.81657","DOIUrl":"https://doi.org/10.7759/cureus.81657","url":null,"abstract":"<p><strong>Introduction: </strong>Low birthweight is a critical determinant of neonatal and infant mortality and is further associated with several long-term adverse health outcomes. This study aims to comprehensively analyze low birthweight rate (LBWR) trends in Greece from 1980 to 2023.</p><p><strong>Materials and methods: </strong>National official data on live births in Greece from 1980 to 2023 were obtained from the Hellenic Statistical Authority, based on birth certificate records. A total of 4,593,229 live births were analyzed and categorized by birthweight. The annual LBWR (birthweight < 2,500 g) and very low birthweight rate (VLBWR) (birthweight < 1,500 g) were calculated per 100 total live births. Additionally, the annual moderately low birthweight rate (MLBWR) was computed separately for two subgroups: 1,500-1,999 g and 2,000-2,499 g. Time trends for these rates were evaluated using joinpoint regression analysis, and the annual percent change (APC) was calculated with 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>After a decade of stability from 1980 to 1990, the LBWR in Greece entered a 20-year period of consistent increase (1990-2010), with an APC of 2.3 (95% CI: 1.9 to 4.9). In the most recent period (2010-2023), the LBWR has plateaued at high levels. The LBWR reached its lowest point in 1982 at 5.58% and increased by 80%, reaching historically high levels in 2022 and 2023 at 10.07% and 10.02%, respectively. Since 2008, it has consistently remained above 9%. The VLBWR exhibited a steady upward trend throughout the entire 1980-2023 period with an APC of 0.9 (95% CI: 0.7 to 1.1) and increased from a low of 0.70% in 1980 to a peak of 1.20% in 2010. For the 2,000-2,499 g category, the MLBWR rose steadily over three decades (1980-2010: APC = 2.0, 95% CI: 1.8 to 2.3) and remained essentially unchanged from 2010 to 2023. In contrast, the MLBWR for the 1,500-1,999 g group showed a non-significant trend during 1980-1990, followed by a rapid increase between 1990 and 2001 (APC = 3.9, 95% CI: 2.9 to 7.9), which continued at a slower pace from 2001 to 2023 (APC = 1.0, 95% CI: 0.5 to 1.3).</p><p><strong>Conclusions: </strong>During 1980-2023, the LBWR increased by 80%, with significant rising trends in the 1990s and 2000s, resulting in Greece having the highest rates among high-income countries. Whereas the overall LBWR has stabilized since 2010, there has been a continued rise in the proportion of neonates with birthweight < 2,000 g, who face the highest risk of adverse outcomes. Continued monitoring of LBWR is essential, alongside investments in the implementation of effective, targeted interventions.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"e81657"},"PeriodicalIF":1.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slicing Through the Options: A Systematic Review of Esophageal Leiomyoma Management.","authors":"Shelleen Gowrie, Anniesha Noel, Candace Wooten, Jennifer Powel, Jerzy Gielecki, Anna Zurada, Michael Montalbano, Marios Loukas","doi":"10.7759/cureus.81614","DOIUrl":"10.7759/cureus.81614","url":null,"abstract":"<p><p>Esophageal leiomyomas are rare, benign tumors that can remain asymptomatic or cause dysphagia and chest discomfort when they grow large. Despite advancements in diagnostic and therapeutic strategies, optimal management remains debated. This systematic review evaluates current diagnostic modalities and treatment approaches, synthesizing findings from a comprehensive PubMed search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 51 studies were included, comprising six original studies, 26 case reports, nine retrospective cohort studies, nine case series, and two cross-sectional studies. Findings indicate that endoscopic ultrasonography (EUS) is the most accurate diagnostic tool (89% accuracy), while computed tomography (CT) and barium swallow studies provide complementary structural assessments. Immunohistochemical staining differentiates leiomyomas from gastrointestinal stromal tumors (GISTs), with leiomyomas expressing desmin and smooth muscle actin (SMA) but lacking CD34 and KIT. Surgical intervention is recommended for symptomatic tumors or those exceeding 5 cm. Minimally invasive techniques, including robotic-assisted thoracoscopic surgery (RATS) and submucosal tunneling endoscopic resection (STER), offer superior outcomes compared to traditional open surgery. RATS demonstrates a negligible mucosal injury rate versus 1-15% for other approaches, while STER minimizes blood loss and accelerates recovery. Postoperative outcomes are generally favorable, though transient gastroesophageal reflux disease (GERD) is the most common complication. While STER and RATS present effective alternatives with reduced morbidity, this review highlights limitations, including variability in study designs, small sample sizes, and a lack of long-term follow-up data. Further prospective studies are needed to optimize patient selection and establish long-term efficacy. This review provides insights to inform clinical practice and guide future research in the management of esophageal leiomyomas.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"e81614"},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Exploring Pharmacological and Non-Pharmacological Approaches to Managing Hypertension During Pregnancy: A Systematic Review.","authors":"Saeeda Bano, Shahida Husain Tarar, Precious D Atung, Abdullah Shehryar, Abdur Rehman, Ahmad Irshad, Oluwatobiloba T Ogungbemi, Nahal Ijaz, Maryam Nour, Hafsah Abdirahiim Maalim","doi":"10.7759/cureus.r172","DOIUrl":"https://doi.org/10.7759/cureus.r172","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.75534.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"r172"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Role of Statins in Reducing Cardiovascular Mortality: A Systematic Review of Long-Term Outcomes.","authors":"Bipasha Seth, David Okello, Syed Saad Ullah, Rabia Yousaf, Shaikha B Alfalasi, Muhammad Hafeez, Naveed Rasool, Gurman Bhullar, Tchapleu Nana Ian Gidley, Syed Ali Hussein Abdi, Khakan Murtaza","doi":"10.7759/cureus.r171","DOIUrl":"https://doi.org/10.7759/cureus.r171","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.78137.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"r171"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Absorption and Safety of MuscleBlaze CreAMP™: A Comparative Analysis With Regular Micronized Creatine Monohydrate in Healthy Male Adults.","authors":"Anupam Trehan, Rachna Anand, Puja Kumari, Harinder Singh, Neha Soni, Ravij Madan, Raman Matta, Sameer Maheshwari, Manoj K Verma","doi":"10.7759/cureus.81555","DOIUrl":"https://doi.org/10.7759/cureus.81555","url":null,"abstract":"<p><p>Background Creatine monohydrate is a widely utilized dietary supplement in sports nutrition, valued for its role in enhancing muscle energy availability, power output, and performance during high-intensity, short-duration activities. Creatine monohydrate is effective but limited by absorption inefficiencies and side effects. Enhanced forms can improve uptake, reduce gastrointestinal discomfort, and optimize muscle energy utilization, meeting athletes' evolving performance needs. Methods This study involved 32 healthy male volunteers aged 18-50 years, with a BMI of 18.5-25.0 kg/m² and body weight of ≥50 kg. This study evaluated the bioavailability and safety of MuscleBlaze Creatine Monohydrate (CreAMP™) (Bright Lifecare Pvt Ltd, Gurugram, India), containing 3.0 g creatine monohydrate and 0.1 g Creabsorb™ (Indian Patent: IN202311057466), against a standard 3.0 g micronized creatine dose. In a double-blind, randomized crossover trial (CTRI/2024/08/073021), 32 healthy males (18-50 years) received both formulations under fasting conditions. The study compared two oral creatine monohydrate formulations: CreAMP™ Micronized Creatine Monohydrate (test) and Regular Micronized Creatine Monohydrate (reference) (Bright Lifecare Pvt Ltd, Gurugram, India). Blood samples were collected pre-dose and up to six hours post-dose over two periods, separated by a washout period of one week. Pharmacokinetic parameters were analyzed using Phoenix® WinNonlin® 8.5 (Certara, Radnor, PA). Results CreAMP™ has significantly higher bioavailability, absorption, and plasma retention compared to the reference formulation. With a 38.97% increase in bioavailability, an 18.10% higher C_max, a 21.37% longer half-life, 34.67% lower clearance, and a 10.13% higher mean residence time, CreAMP™ demonstrates superior pharmacokinetic properties. These findings suggest that CreAMP™ offers improved creatine uptake, sustained plasma levels, and the potential for reduced dosing frequency, making it a more effective formulation for creatine supplementation. Conclusion The study findings establish CreAMP™ as a superior creatine formulation, offering enhanced bioavailability, faster absorption, and prolonged plasma retention. These pharmacokinetic advantages indicate that CreAMP™ offers more efficient creatine uptake, improved energy availability, and optimized performance support for athletes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"e81555"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptomatic Common Carotid Artery Stenosis With a Persistent Primitive Hypoglossal Artery Presenting With Posterior Circulation Symptoms and Technical Challenges in Stenting.","authors":"Keisuke Kadooka, Roselyn Pamatmat, Kotaro Ueda, Shimpei Tsuboki, Takafumi Mitsutake, Michihiro Tanaka","doi":"10.7759/cureus.81562","DOIUrl":"https://doi.org/10.7759/cureus.81562","url":null,"abstract":"<p><p>The persistent primitive hypoglossal artery (PPHA) is a rare variant of the persistent carotid-vertebrobasilar anastomoses. When PPHA coexists with carotid artery stenoses, it typically presents ischemic symptoms of the anterior circulation. However, we report a unique case of common carotid artery (CCA) stenosis with PPHA presenting exclusively ischemic symptoms of the posterior circulation, which posed significant diagnostic challenges and required innovative modifications in embolic protection strategies during carotid artery stenting. A 65-year-old woman experienced recurrent bilateral ptosis, diplopia, and transient bilateral visual loss, suggestive of posterior circulation ischemia. Imaging revealed significant left CCA stenosis with a PPHA supplying the posterior circulation. Due to the large diameter of the CCA, standard distal protection was unfeasible. Instead, distal balloon protection was innovatively applied at the bifurcation of the PPHA and the internal carotid artery, where the slightly narrower diameter facilitated successful stenting. The postoperative course was favorable, with no recurrence of symptoms. PPHA-associated carotid stenosis can cause posterior circulation symptoms, complicating diagnosis. Understanding anatomical and hemodynamic variations like PPHA is crucial for effective treatment and ensuring optimal outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"e81562"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Minimally Invasive Approaches for High-Risk and Elderly Patients With Acute Cholecystitis: A Systematic Review of Techniques and Outcomes.","authors":"Mark Abdelmaseeh, Asem Mhmndar, Ayesha Siddiqa, Shoaib S Ahamed, Kanwal Sheraz, Ahmad F Mohd, Haider Ali, Abdullah Shehryar, Abdur Rehman, Khakan Murtaza","doi":"10.7759/cureus.r174","DOIUrl":"https://doi.org/10.7759/cureus.r174","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.78271.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"r174"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Impact of Dual Antiplatelet Therapy Versus Monotherapy in Acute Stroke Management: A Systematic Review.","authors":"Muhammad Adil Areeb, Rakesh Mohanty, Hiren B Hisoriya, Javeria Mithani, Oluwatobiloba T Ogungbemi, Kesha Pathak, Umar Farooq, Rauda Al Dhaheri, Ahmad Zubair Aziz, Nishath Kausar, Ali Raza","doi":"10.7759/cureus.r176","DOIUrl":"https://doi.org/10.7759/cureus.r176","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.78138.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"r176"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Clinical Study on Early Prediction of Anastomotic Leak After Esophageal Cancer Resection Based on the Combination of Platelet Count and Neutrophil-to-Lymphocyte Ratio.","authors":"Shu Wu, Linxiang Zhang, Yamen Muad, Zhong Xu, Lin Ye","doi":"10.7759/cureus.81589","DOIUrl":"https://doi.org/10.7759/cureus.81589","url":null,"abstract":"<p><strong>Objective: </strong> The systemic inflammatory response may influence the occurrence of postoperative complications. This study aimed to evaluate the predictive potential of combining platelet count and neutrophil-to-lymphocyte ratio (COP-NLR) for esophagogastric anastomotic leak (AL) following esophageal cancer surgery.</p><p><strong>Methods: </strong> We enrolled patients who developed AL after radical surgery for esophageal cancer and those who did not develop AL after the surgery at the First Affiliated Hospital of Chongqing Medical University, China, from June 2019 to February 2022. We analyzed the correlation between AL and several risk factors, including COP-NLR. Patients were categorized as COP-NLR 2 if both platelet count and neutrophil-to-lymphocyte ratio (NLR) were elevated, COP-NLR 1 if either parameter was elevated, and COP-NLR 0 if neither parameter showed elevation.</p><p><strong>Results: </strong> A total of 190 patients were included in this study. The incidence of AL after esophageal cancer surgery was 14.7%. The critical values of preoperative NLR and preoperative platelet count were 2.41 (sensitivity 48.8%, specificity 92.9%, and area under the curve (AUC) 0.728) and 186 × 10⁹/L (sensitivity 45.3%, specificity 78.9%, and AUC 0.667), respectively. According to multivariate analysis, COP-NLR was identified as an independent risk factor for AL (COP-NLR 1 vs. COP-NLR 0: odds ratio (OR) 4.98, 95% confidence interval (CI) 1.05-23.61; COP-NLR 2 vs. COP-NLR 0: OR 11.12, 95% CI 2.31-53.41).</p><p><strong>Conclusion: </strong> COP-NLR is a new predictor for AL after esophageal cancer resection.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"e81589"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Outcomes of Direct-Acting Antivirals Versus Interferon-Based Therapy in Chronic Hepatitis C Infection.","authors":"Ratna Chowdhury, Wardah Rashid, Taranpreet Singh, Abdur Rehman, Nida F Daterdiwala, Varaidzo Mkosi, Bhumikala Limbu, Syeda Alliza Bukhari, Afif Ramadhan, Muath M Dabas, Abdullah Shehryar, Ramadan Khan","doi":"10.7759/cureus.r173","DOIUrl":"https://doi.org/10.7759/cureus.r173","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.75902.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 4","pages":"r173"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}