Cureus最新文献

{"title":"Increasing Incidence of Coronary Artery Disease in Younger Men: Case Study of a 39-Year-Old.","authors":"Jad Elgaali, Patrick Coello de la Cruz, Syed I Hussaini, Mehjabeen Naseer","doi":"10.7759/cureus.74516","DOIUrl":"https://doi.org/10.7759/cureus.74516","url":null,"abstract":"<p><p>Coronary artery disease (CAD) is the leading cause of death globally. While it is usually diagnosed after years of declining health or after a myocardial infarction (MI), we found that patients can be asymptomatic, posing a latent and life-threatening risk. We present the case of a man less than 40 years old, in whom heart disease was incidentally discovered during a CT scan performed for an unrelated condition. We examine the most common causes of CAD, the pathophysiology and discuss potential methods to screen for it before patients are in need of urgent or emergent interventional care due to an MI or other ischemic events. We also discuss the risk factors, many of which are modifiable, as well as the financial burden CAD places on the healthcare system and the patient. This case report contributes to the body of knowledge in the field of cardiology by bringing forward and emphasizing that CAD is no longer solely a disease of the elderly and that we need to begin rethinking how and when we screen for the leading cause of death in the world.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74516"},"PeriodicalIF":1.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11594535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735250","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: Evaluation of the Efficacy of the HaeNaem Zero Bone Loss Kit in Indirect Sinus Lift Using Osseodensification.","authors":"Rachel Changrani, Amod P Patankar, Swapna A Patankar, Pranjali Kulkarni, Amisha Sharma","doi":"10.7759/cureus.r152","DOIUrl":"https://doi.org/10.7759/cureus.r152","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.73130.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"r152"},"PeriodicalIF":1.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11592051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735348","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":"The Usefulness of Exosomes in Accelerating Healing and Preventing Complications in Behçet's Disease: A Case Report.","authors":"Marwa H Elajami","doi":"10.7759/cureus.74476","DOIUrl":"https://doi.org/10.7759/cureus.74476","url":null,"abstract":"<p><p>Behçet's disease (BD) is a systemic auto-inflammatory vasculitis. The clinical pictures of BD involve the skin and mucosal membranes such as oral and genital ulcers, ocular lesions, cardiovascular, gastrointestinal, muscular, nervous systems, and joints. A 38-year-old woman was repeatedly suffering from oral, genital, and ocular lesions, wound dehiscence after any surgical procedure, and joint pain. She has a family history where multiple relatives were affected by BD. The patient had an abdominoplasty two years ago with delayed wound healing and keloid formation. The patient presented with an asymmetrical labia majora with multiple lumps after fat transfer, multiple vaginal cysts, and a chronic Bartholin's cyst for three years. She consulted surgeons to correct the deformity and for cyst excision, but there was a great risk of keloid formation, dehiscence, and infections. This was a challenge for her surgery. The patient was on colchicine and corticosteroids. BD affects multiple systems, most commonly the healing of the skin and the mucous membranes. This causes difficulties in deciding to undergo surgery because of the risks. The diversity of the manifestations of BD requires a spectrum of pre-surgical adjustments in inflammatory markers, medication doses, and improving general patient conditions. Furthermore, the intra-operative and post-operative use of the recent regenerative medicine methods might provide the best surgical healing outcomes in these groups of patients. This is most challenging with BD but can be achieved regardless.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74476"},"PeriodicalIF":1.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735354","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 Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty in the Treatment of Cervical Degenerative Disc Disease, Radiculopathy, and Myelopathy: A Systematic Review.","authors":"Fakhri Awawdeh, Ali Salam, Varun Soti","doi":"10.7759/cureus.74418","DOIUrl":"https://doi.org/10.7759/cureus.74418","url":null,"abstract":"<p><p>Cervical degenerative disc disease (DDD) is a condition in which the discs in the neck deteriorate, causing symptoms including neck and arm pain, muscle weakness, and incoordination. In severe cases, it can lead to nerve and spinal cord compression, resulting in radiculopathy and myelopathy. This review aimed to assess the effectiveness of two surgical treatments, anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA), for addressing cervical DDD, radiculopathy, and myelopathy. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted in the PubMed and BioMed Central databases, from January to March 2024. Thirty-one studies were included, comparing the outcomes of ACDF and CDA in patients with cervical DDD, radiculopathy, and myelopathy. Data were analyzed to evaluate outcomes such as the Neck Disability Index (NDI), pain levels, neurological status, incidence of secondary surgeries, range of motion (ROM) maintenance, and occurrence of adjacent segment disease. CDA demonstrated comparable or superior clinical success to ACDF. Both the techniques showed similar improvements in NDI, pain levels, and neurological status during medium- and long-term follow-ups. CDA had lower rates of secondary surgeries and adverse events related to surgery or implants compared to ACDF. It also demonstrated a lower incidence of adjacent segment disease and better ROM preservation. The evidence supports CDA as a safe and effective alternative to ACDF for patients with cervical DDD, particularly those who may benefit from motion preservation. However, further long-term, multicenter randomized controlled trials are needed to provide more definitive guidance for clinical practice.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74418"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735278","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":"Aspirin-Exacerbated Respiratory Disease Complicated by Eosinophilic Esophagitis: A Case Report.","authors":"Eiichi Kakehi, Kazuhiko Kotani","doi":"10.7759/cureus.74384","DOIUrl":"10.7759/cureus.74384","url":null,"abstract":"<p><p>A 59-year-old woman developed sudden dyspnea after taking non-steroidal anti-inflammatory drugs (NSAIDs) for epigastralgia. She had a history of bronchial asthma after childbirth. Computed tomography showed bilateral peripheral bronchial wall thickening, lumen narrowing, obstruction, and circumferential lower esophageal mucosal edema. The patient was diagnosed with aspirin-exacerbated respiratory disease (AERD), a hypersensitivity reaction. Respiratory symptoms improved with intravenous dexamethasone. Endoscopy confirmed lower esophageal mucosal edema; mucosal biopsy detected eosinophilic infiltration, suggesting eosinophilic esophagitis (EoE). Although EoE is often diagnosed after AERD, the patient was simultaneously diagnosed with AERD and EoE after taking NSAIDs. Thus, EoE should be considered as a potential comorbidity when AERD develops after NSAID administration for abdominal symptoms.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74384"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717806","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":"Pulmonary Vein Thrombosis: An Unlikely Cause of Chest Pain.","authors":"Sonia I Vicenty-Rivera, Alex P Rodriguez","doi":"10.7759/cureus.74408","DOIUrl":"10.7759/cureus.74408","url":null,"abstract":"<p><p>Pulmonary vein thrombosis (PVT) is a rare but potentially lethal source of arterial thromboembolism. We present a case of a 59-year-old female patient who presented with worsening shortness of breath and was found on a cardiac computed tomography angiography (CTA) with the right lower pulmonary vein partially occluded with a filling defect. This case report highlights the diagnostic challenges and management options associated with this rare entity.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74408"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717810","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":"Experiences and Perspectives of the COVID-19 Pandemic and Vaccinations in Culturally and Linguistically Diverse (CALD) Populations in Australia: A Qualitative Study.","authors":"Tasnia Rafi, Mohammad A Rahman","doi":"10.7759/cureus.74463","DOIUrl":"https://doi.org/10.7759/cureus.74463","url":null,"abstract":"<p><p>Qualitative research surrounding the impacts of COVID-19 and vaccine hesitancy has been extensively studied in the European context; however, limited research has been conducted within communities in the Australian context. This research paper highlights the issues experienced by culturally and linguistically diverse (CALD) members during the COVID-19 pandemic and vaccination rollout. The purpose of this study is to strengthen our understanding of the challenges experienced by CALD communities and enable healthcare policies to be developed and implemented to prevent these communities from being disadvantaged in a healthcare crisis. The methods of this study include focus group sessions with 12 participants from CALD backgrounds across different states including Victoria, Northern Territory, and Queensland. They were divided into two separate Zoom sessions and aimed to amplify the voices in Victoria, as the state had the nation's longest and most challenging COVID-19 lockdown laws. Key findings of the study highlighted the language barriers, racism, and lack of cultural awareness experienced among CALD communities during the pandemic. Additionally, there was a significant division in views and experiences within CALD communities and families. Social media played a prominent role in dividing the perceptions and understanding of health information during the pandemic. Participants were motivated to be vaccinated due to workplace protocols or to protect their family members and move toward normality. Lastly, the government's mandatory vaccination policies limited personal choice, resulting in a loss of skilled workers and pressured some participants into making healthcare decisions within a limited period of time. The study's findings reflect that the CALD communities and families were disproportionately impacted during the COVID-19 pandemic and vaccination rollout, further highlighting and adding to the health inequities among CALD communities in Australia.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74463"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735288","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":"Appendicitis Within an Incarcerated Inguinal Hernia Presenting as Acute Testicular Pain: A Case Report.","authors":"Fred A Lepore, Daniel Schnick","doi":"10.7759/cureus.74414","DOIUrl":"10.7759/cureus.74414","url":null,"abstract":"<p><p>Testicular pain is a common complaint in emergency departments, with a wide range of underlying pathologies. Incarcerated inguinal hernias are an emergent and often overlooked cause of testicular pain, necessitating prompt diagnosis and management. These cases can be complex, especially when the hernia contents obscure the clinical picture. Here, we present the case of a 34-year-old male patient who presented with testicular pain and swelling, ultimately diagnosed with appendicitis within the scrotum. This appendicitis led to an incarcerated inguinal hernia requiring emergent surgical intervention. The patient had an uneventful postoperative course and remained well at the two-month follow-up.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74414"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717798","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":"Carbon Dioxide Levels as a Key Indicator for Managing SARS-CoV-2 Airborne Transmission Risks Across 10 Indoor Scenarios.","authors":"Narumichi Iwamura, Kanako Tsutsumi, Takafumi Hamashoji, Yui Arita, Takashi Deguchi","doi":"10.7759/cureus.74429","DOIUrl":"https://doi.org/10.7759/cureus.74429","url":null,"abstract":"<p><p>Background The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 has led to a global pandemic through contact, droplets, and aerosolized particles. Aim This study aimed to quantify the airborne transmission risk of SARS-CoV-2 in various indoor environments. Methods Using indoor carbon dioxide (CO₂) levels, we estimated the probability of airborne transmission and the basic reproduction number (R₀) across 10 hypothetical indoor scenarios, including a college classroom, restaurant, classical music concert, live event, city bus, crowded train, hospital room, home, shogi match, and business meeting, using an analysis based on the modified Wells-Riley model. Results The relationship between airborne transmission rates and indoor CO₂ concentrations was visualized with and without the use of masks. Without masks, at an indoor CO₂ concentration of 1,000 ppm, airborne transmission rates were high in a home (100%), business meeting (100%), and hospital room (95%); however, they were moderate in a restaurant (55%), at a shogi match (22%), and at a live concert (21%); and low in a college classroom (1.7%), on a city bus (1.3%), at a classical music concert (1.0%), and on a crowded train (0.25%). In contrast, R₀ was high at a live event (42.3), in a restaurant (15.9), in a home (3.00), and in a hospital room (2.86), indicating a greater risk of cluster infections. An examination of reduced airborne infection risk through surgical mask use and improved ventilation across various scenarios revealed that mask-wearing was highly effective in hospital rooms, in restaurants, at shogi matches, and in live concerts. Ventilation was particularly useful in hospital rooms, in restaurants, and at shogi matches. Discussion and conclusion In all indoor scenarios, a positive linear relationship existed between airborne transmission risk and indoor CO₂ levels. The risk varied markedly across scenarios and was influenced by factors such as mask use, ventilation quality, conversation, and exposure duration. This model indicates that the risk of SARS-CoV-2 airborne transmission can be easily predicted using a CO₂ meter.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74429"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735272","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":"Leptomeningeal Disease Secondary to Invasive Ductal Carcinoma of the Breast: A Rapidly Progressive and Fatal Complication.","authors":"Saurav Dhawan, Fredwin Mattathil, Isha Malik, Mantripragada Khyathi, Bhawna Bhakar","doi":"10.7759/cureus.74421","DOIUrl":"https://doi.org/10.7759/cureus.74421","url":null,"abstract":"<p><p>Leptomeningeal disease (LMD) is a rare yet serious complication of advanced malignancy, often seen in breast cancer and associated with a poor prognosis.  This case report highlights the rapid progression and diagnostic challenges encountered in a woman in her 40s with advanced breast cancer who presented with severe headaches, absence seizures, and diplopia. The patient's complex past history included invasive ductal carcinoma, prior brain metastasis, and recent craniotomy, which added significant challenges to diagnosis and management.  Clinical investigations included computed tomography (CT) of the head, magnetic resonance imaging (MRI) of the orbit and head, electroencephalography (EEG), and lumbar puncture, which indicated optic nerve sheath enhancement, ventricular prominence, coating of facial and vestibulocochlear nerves, and cerebrospinal fluid abnormalities suggestive of LMD. Although empiric treatment for bacterial and tuberculous meningitis was initiated, the patient's rapid decline necessitated an aggressive multimodal approach. Management included high-dose corticosteroids, broad-spectrum antibiotics, antitubercular drugs, and anticonvulsants, though her seizures persisted. Ultimately, comfort-focused care was prioritized as her condition remained refractory to interventions, and she was transitioned to palliative care.  This case emphasizes the need for early suspicion, prompt multidisciplinary involvement, and the challenges in managing complex oncological cases with atypical neurological manifestations. The poor prognosis associated with LMD reflects the limitations of current therapeutic strategies and the need for a nuanced approach to care.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 11","pages":"e74421"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735254","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}