Cureus最新文献

{"title":"Direct Inferior Hip Dislocation With Intertrochanteric Fracture in an Adult: A Rare Case and Review of the Literature.","authors":"Mark S Ayoub","doi":"10.7759/cureus.94109","DOIUrl":"10.7759/cureus.94109","url":null,"abstract":"<p><p>Direct inferior hip dislocation is the rarest type, sometimes referred to as luxatio erecta. To the author's knowledge, an adult inferior hip dislocation with an associated displaced intertrochanteric fracture has only been reported once in the literature. Accordingly, there are few described treatment options for this injury. An 18-year-old male presented after a motor vehicle collision with an inferior hip dislocation and an associated ipsilateral intertrochanteric hip fracture. He was taken to the operating room urgently for the reduction of the dislocation and definitive treatment. In this case, a fracture table was utilized along with a Schanz pin to reduce the hip dislocation and for the reduction and intramedullary nailing of his intertrochanteric fracture.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94109"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260073","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":"Cervical Adenocarcinoma in the Shadows: The Impact of Missed Screening.","authors":"Ei Mon Mon Kyaw, Baian Alhindawi, Alexandra French","doi":"10.7759/cureus.94089","DOIUrl":"10.7759/cureus.94089","url":null,"abstract":"<p><p>Cervical adenocarcinoma is a rising concern in women's health, particularly due to its increasing incidence among younger women and its ability to evade early detection through conventional cytology-based screening. Unlike squamous cell carcinoma, adenocarcinoma often arises higher in the endocervical canal, making it more challenging to detect, especially in patients who default on cervical screening. We report the case of a 39-year-old British lady who presented with severe anemia secondary to heavy vaginal bleeding. She had never attended cervical screening despite living in a country with an established national screening program. Clinical examination revealed a friable cervical mass. Initial investigations revealed profound microcytic hypochromic anemia requiring urgent transfusion. Imaging with CT demonstrated a bulky, irregular cervix with suspicious pelvic lymphadenopathy, while MRI confirmed a large cervical mass (7.4 × 6.5 × 6.0 cm) with parametrial extension and para-aortic nodal disease, consistent with International Federation of Gynecology and Obstetrics (FIGO) Staging stage IIIC2 cervical carcinoma. Histopathology revealed Human Papillomavirus (HPV)-associated adenocarcinoma, Silva pattern C, with strong carcinoembryonic antigen (CEA) positivity and no lymphovascular invasion. Following multidisciplinary team review, the patient was referred for definitive chemoradiotherapy. This case illustrates how defaulted cervical screening can result in delayed diagnosis and advanced disease, even within high-resource healthcare systems. It highlights the diagnostic challenges specific to adenocarcinoma, the limitations of Pap smear in detecting glandular lesions, and the importance of HPV-based screening and public education to improve participation. Early recognition of abnormal bleeding and systematic evaluation with MRI and histopathology are crucial for timely diagnosis and management.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94089"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260034","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":"Efficacy of Platelet-Rich Plasma as an Adjunct to Hair Transplantation: A Systematic Review.","authors":"Sasipaka Sindhusen, Weeratian Tawanwongsri, Chime Eden","doi":"10.7759/cureus.94116","DOIUrl":"10.7759/cureus.94116","url":null,"abstract":"<p><p>Hair transplantation is a well-established treatment for androgenetic alopecia (AGA), yet the long-term success of grafts can vary due to multiple influencing factors. Platelet-rich plasma (PRP) has gained attention as a potential adjunctive therapy aimed at enhancing graft survival and promoting hair regrowth. This systematic review evaluated the clinical efficacy of PRP when used alongside hair transplantation. A comprehensive search of Scopus, MEDLINE (via PubMed), and DOAJ was conducted from database inception to June 2025. Eligible studies were prospective clinical trials with control groups that investigated the use of PRP in patients undergoing hair transplantation. Three studies, including two randomized controlled trials and one non-randomized controlled study, met the inclusion criteria, encompassing a total of 217 participants. Across all studies, the addition of PRP was associated with improved outcomes, including increased hair density, enhanced follicle survival, and earlier initiation of hair growth. However, notable heterogeneity was observed in PRP preparation methods, treatment protocols, and outcome measures. Furthermore, none of the studies employed standardized evaluation tools or trichoscopic analysis, limiting the consistency and comparability of findings. While the current evidence suggests that PRP may offer clinical benefits as an adjunct to hair transplantation, further high-quality randomized trials with standardized protocols and long-term follow-up are needed to establish its therapeutic role with greater confidence.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94116"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260085","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":"Eosinophil Dynamics as Prognostic Indicators in Immunotherapy for Pulmonary Lymphoepithelioma-Like Carcinoma.","authors":"Chun Yee Ryan Ho, Ka Man Cheung, Chung Hang James Chow, Gavin Tin Chun Cheung","doi":"10.7759/cureus.94131","DOIUrl":"10.7759/cureus.94131","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary lymphoepithelioma-like carcinoma (pLELC) is a rare form of non-small cell lung cancer. As immunotherapy (IO) becomes an important treatment for advanced pLELC, identifying reliable prognostic markers is crucial for guiding clinical decisions and resource allocation.</p><p><strong>Methods: </strong>This multicentre retrospective cohort study included 26 patients with advanced or metastatic pLELC who received palliative IO at two tertiary hospitals in Hong Kong from 2010 to 2023. Clinical and haematological data, particularly eosinophil peak timing, eosinophil-to-neutrophil ratio (ENR), and neutrophil-to-lymphocyte ratio (NLR), were obtained at each treatment cycle. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier analysis. Cox regression models, complemented by landmark and sensitivity analyses, were used to determine independent prognostic factors.</p><p><strong>Results: </strong>Early eosinophil peak (≤5 weeks after starting IO) was significantly linked to shorter PFS (HR 7.0, p = 0.007), while ENR <0.054 independently predicted poorer PFS (HR 2.9, p = 0.04). Neither ENR nor NLR showed significant associations with OS in multivariate analysis. Delayed eosinophil peaks were associated with more favourable PFS, supporting the prognostic value of eosinophil kinetics. Sensitivity analyses confirmed these findings were robust across patient subgroups.</p><p><strong>Conclusions: </strong>Eosinophil peak timing is a practical, independent biomarker for identifying pLELC patients less likely to benefit from IO and may enhance patient prognostication and management. Further prospective studies in larger, multi-centre cohorts are needed to validate the clinical use of eosinophil dynamics in IO monitoring for pLELC.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94131"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260146","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":"An Elusive Diagnosis of Autosomal Dominant Alport Syndrome: Genomic Sequencing Is a Game Changer.","authors":"Achilleas Betsikos, Eleni Paschou, Virginia Geladari, Evanthia Gazouni, Nikolaos Sabanis","doi":"10.7759/cureus.94077","DOIUrl":"10.7759/cureus.94077","url":null,"abstract":"<p><p>We report the case of a 55-year-old woman with chronic asymptomatic hematuria and a longstanding diagnosis of thin basement membrane disease, presenting with worsening hypertension and a significant degree of proteinuria progressing to chronic kidney disease. Genetic sequencing identified a heterozygous pathogenic variant in the COL4A4 gene (c.1321_1369+3del), a 52-base pair deletion that disrupts normal ribonucleic acid (RNA) splicing in the exon 20/intron 20 junction. In silico analysis predicted the complete loss of the canonical splice site, leading to improper splicing and the dysfunction of the α4 chain of type-IV collagen. Genetic testing in the family confirmed the presence of the same variant in two additional generations. To our knowledge, this is the first reported family in which the c.1321_1369+3del mutation is the sole cause of autosomal dominant Alport syndrome.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94077"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260043","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":"Complete and Early Vitrectomy for Sterile Endophthalmitis After Bevacizumab: A Case Series.","authors":"Agnieszka Kudasiewicz-Kardaszewska, Malgorzata A Ozimek, Aleksandra Kardaszewska, Piotr Kardaszewski, Natalia Kapturska, Kinga Jamontt, Karolina Boninska, Slawomir Cisiecki","doi":"10.7759/cureus.93996","DOIUrl":"10.7759/cureus.93996","url":null,"abstract":"<p><p>Intravitreal anti-vascular endothelial growth factor injections are widely used for retinal disorders but may occasionally lead to sterile endophthalmitis, a condition that can be challenging to distinguish from infectious endophthalmitis. We describe a series of five patients who developed acute intraocular inflammation within 24-48 hours of receiving bevacizumab injections. These patients presented with decreased visual acuity and vitreous haze but reported minimal or no pain. All patients were managed urgently with pars plana vitrectomy according to the complete and early vitrectomy for endophthalmitis (CEVE) protocol, which included intraoperative antibiotic infusion and microbiological sampling. Cultures from the vitreous samples and the bevacizumab vial were negative. Following early vitrectomy, inflammation resolved in all patients, and visual acuity returned to baseline within 30 days. No postoperative complications were observed. None of the 38 additional patients who received injections from the same vial developed endophthalmitis. These findings support an immune-mediated, noninfectious mechanism for these cases and suggest that early vitrectomy within the CEVE framework promotes rapid resolution and favorable visual recovery. Continued vigilance and further research are warranted to refine management strategies for sterile endophthalmitis.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93996"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259993","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":"Artificial Intelligence in Electrocardiography: From Automated Arrhythmia Detection to Predicting Hidden Cardiovascular Disease.","authors":"Ramy Elantary, Samar Othman","doi":"10.7759/cureus.94065","DOIUrl":"10.7759/cureus.94065","url":null,"abstract":"<p><p>Cardiovascular diseases are among the most prevalent and deadly diseases affecting humans. The most widely used diagnostic tool to interrogate cardiovascular physiology and function is an electrocardiogram (ECG). Despite its widespread availability and use, the ECG is subject to interobserver variability and suboptimal sensitivity for asymptomatic or early-stage disease. Artificial intelligence (AI), particularly deep learning (DL) approaches, has provided a suite of methods to improve both the diagnostic and prognostic utility of the ECG in multiple cardiovascular domains. AI-enabled automated ECG interpretation (most commonly using convolutional neural networks (CNNs)) has reached and even surpassed expert-level performance for arrhythmia detection and classification. Additional data-driven approaches to ECG analysis have identified paroxysmal atrial fibrillation from a record of sinus rhythm ECGs, identified left ventricular systolic dysfunction, and predicted cardiac structure and ischemic burden (e.g., acute coronary syndromes). Pragmatic implementation has demonstrated higher diagnostic yield for asymptomatic left ventricular dysfunction in the primary care setting (EAGLE). Other emerging indications include expanded data-derived outputs, such as electrolyte disturbances, biological age, and cardiovascular risk prediction. Despite a growing list of promising applications, numerous translational hurdles remain before routine implementation. Generalizability is limited due to differences in training and target populations. Bias related to sex, race, and comorbidities is an important limiting factor to fair and equitable implementation. Other considerations include \"black box\" concerns with DL, clinical interpretability and adoption, medicolegal liability, and integration with clinical workflows and infrastructure. Related to these factors, data privacy, algorithmic fairness, accountability, and transparency are important to consider as AI-ECG continues to undergo regulatory scrutiny and outcomes-based validation. In conclusion, AI and ECG represent a major shift towards precision cardiology by improving prediction, screening, and early detection of cardiovascular disease. We anticipate continued improvements with prospective outcome studies, transparent and explainable approaches, and careful regulatory review to ensure safe and effective implementation in the clinic.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94065"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259995","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":"Correction: The Effectiveness of Anti-Interleukin-17A Treatment for Pityriasis Rubra Pilaris: A Systematic Review.","authors":"Mohammad Abduljawad, Thamer H Alsharif, Amin G Gronfula, Talah K Magadmi, Lujain I Khayat, Sarah M Fageeh, Abdulqader A Almuallim, Mohammad Ayman Mohammad, Abdullah Albadri","doi":"10.7759/cureus.c348","DOIUrl":"https://doi.org/10.7759/cureus.c348","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.41125.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"c348"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254103","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":"Correction: A Systematic Review of the Need for Guideline Recommendations; Slow Tapering vs. Maintenance Dose in Long-Term Antipsychotic Treatment: 2022.","authors":"Shanthi Potla, Yousif Al Qabandi, Savitri Aninditha Nandula, Chinmayi Sree Boddepalli, Sai Dheeraj Gutlapalli, Vamsi Krishna Lavu, Rana Abdelwahab Mohamed Abdelwahab, Ruimin Huang, Pousette Hamid","doi":"10.7759/cureus.c350","DOIUrl":"https://doi.org/10.7759/cureus.c350","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.34746.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"c350"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254183","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":"Monitoring and Assessment of Jump Performance, Workload, and Injury Risk in the Romanian Under-16 Women's National Volleyball Team.","authors":"Nicolae Stanciu, Cristian Graur, Mark Slevin, Cristian Trambitas, Ioan-Bogdan Bacos, Cezara-Ilinca Stanciu, Gabriel Koszorus, Klara Brînzaniuc","doi":"10.7759/cureus.94050","DOIUrl":"10.7759/cureus.94050","url":null,"abstract":"<p><strong>Background: </strong>Volleyball requires frequent jumping, landing, and overhead movements, predisposing athletes to acute and overuse injuries. Monitoring workload and neuromuscular performance is important for optimizing performance and preventing injuries in youth athletes.</p><p><strong>Materials and methods: </strong>A retrospective observational analysis was performed using prospectively collected data from a training camp of the Romanian Under-16 (U16) women's national volleyball team. Twenty athletes were included in the study (mean age: 14.25 ± 0.72 years). Data collection consisted of demographic information, injury history, and perceived exertion, assessed with the modified Borg Category-Ratio 10 (CR10) scale. The training workload (TWL) was derived from session ratings of perceived exertion, while the acute-to-chronic workload ratio (ACWR) was calculated across the four weeks preceding the index week. In addition, neuromuscular performance was evaluated using the OptoJump Next system (Microgate S.r.l., Bolzano, Italy). Athletes completed three standardized tests at both the beginning and end of the camp.</p><p><strong>Results: </strong>Weekly TWL was similar between groups (injured: 3,723.4; non-injured: 3,664.4). However, only 37.5% of injured athletes remained within the ACWR \"safe zone\" (0.8-1.3) compared to 75.0% of non-injured athletes. OptoJump assessments revealed no substantial performance differences, and by camp exit, previously injured athletes achieved comparable jump height, reactive strength index (RSI), and relative power to their peers.</p><p><strong>Conclusions: </strong>Although workloads were broadly similar, injured athletes demonstrated greater fluctuations in ACWR, indicating increased reinjury risk. Effective and personalized rehabilitation allows recovery of neuromuscular performance, but careful workload management remains essential. Integrating load monitoring with neuromuscular assessment may improve injury prevention strategies in youth volleyball players.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94050"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254155","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}