Cureus最新文献

{"title":"Angle Accuracy of Intramedullary Bone Resection Guides for Total Knee Arthroplasty.","authors":"Matthew C Kane, Harold E Cates, Iou-Ren Chang","doi":"10.7759/cureus.68769","DOIUrl":"10.7759/cureus.68769","url":null,"abstract":"<p><p>The importance of proper prosthetic placement has been confirmed in numerous studies. The objective of this study was to compare the planned resection angles to the verified intraoperative angles of femoral and tibial varus/valgus, tibial slope, and femoral flexion for each total knee performed using intramedullary (IM) cut guides for both distal femur and proximal tibia cuts. A total of 1,000 total knee arthroplasties (TKAs) were evaluated for this study. Intraoperative cut-check technology was used to show real-time validation of these resection angles. Assuming an acceptable range of within 2° of the planned cuts, results show the femoral varus/valgus angles were 75% accurate, the femoral flexion angles were 50.8% accurate, the tibial cuts were 95.2% accurate in the coronal plane, and the tibial slope was the least accurate with only 50.3% within the acceptable range. This showed that IM guides are reasonably accurate in producing desired angles in the coronal plane but less accurate in the sagittal plane, with a greater number of outliers in femoral flexion and posterior slope. Surgeons need to be aware of potential cutting errors when using IM guides as they affect the overall alignment of the implant, and real-time verification technology is available to verify the accuracy of the cuts.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157016","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":"Association of Age and Neurological Severity at Intensive Care Unit Admission With Driving Resumption Within 30 Days of Stroke: A Single-Center Historical Cohort Study.","authors":"Chinatsu Morimatsu, Tasuku Sotokawa, Akio Kikuchi","doi":"10.7759/cureus.68800","DOIUrl":"10.7759/cureus.68800","url":null,"abstract":"<p><p>Objectives Guidelines in several countries recommend against driving soon after a stroke; however, some patients resume driving within one month after onset. This study aimed to examine the relationship between neurological and social background factors at intensive care unit (ICU) admission and resumption of motor vehicle driving within 30 days of the first acute stroke/cerebral hemorrhage. Materials and methods Data were extracted from medical records of a single center linked to the National Cerebral and Cardiovascular Center Administration Office for Stroke Data Bank in Japan. The data included age, sex, Japan Coma Scale (JCS), National Institutes of Health Stroke Scale (NIHSS), employment status, family situation, and outcomes of driving resumption in patients with a valid driving license transported to the ICU within 24 hours of stroke onset. Time-to-event analysis was used to explore the associations between these factors and driving resumption, with data censored 30 days from onset. Results In total, 239 patients had complete medical records, of whom 66 resumed driving. A multivariate Cox proportional hazards analysis showed that fewer patients aged ≥65 years resumed driving than those aged <65 years (hazard ratio 0.46; 95% confidence interval: 0.25-0.84; p=0.009). Patients with NIHSS scores ≥5 and JCS scores ≥1 were also less likely to resume driving compared with those with scores <5 (0.22; 0.08-0.56; p=0.008) and 0 (0.13; 0.04-0.37; p<0.001), respectively. Conclusions Age, NIHSS score, and JCS score at ICU admission are independently associated with the likelihood of resuming driving within 30 days of stroke onset. These findings may aid with the provision of support and education to facilitate the efficient resumption of driving after an acute event.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157017","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":"Severe Acute Porphyria Exacerbation Post Intravenous Iron Infusion: A Case Report.","authors":"Tarek Hammad, Sayeed Hossain, Tanweer Ahmad","doi":"10.7759/cureus.68829","DOIUrl":"10.7759/cureus.68829","url":null,"abstract":"<p><p>This case report describes a 28-year-old man with erythropoietic porphyria (EPP). After receiving an intravenous iron infusion, he experienced a significant acute aggravation of his condition. The patient had a vesicular rash on the face and arms with severe itching and burning feelings in addition to nausea, vomiting, and black-colored vomit. Abnormal liver function tests and anemia were found in the lab tests. Quick diagnosis and multidisciplinary care from dermatology, gastrointestinal, and hematology experts were essential. Strict light avoidance, symptom management techniques, and cessation of intravenous iron were all part of the treatment plan. The patient's symptoms subsided over a period of 12 months, and he resumed his regular activities. In managing EPP, key learning points stress the importance of vigilance in spotting trigger variables, prompt diagnosis, light avoidance, consistent follow-up, and genetic counseling.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157028","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":"Prefrontal, Frontal, and Temporal Theta EEG Asymmetries and Self-Reports of Emotional Regulation.","authors":"Mylorde Cherenfant, Merin Chandanathil, Raymond E Robinson, Richard M Millis","doi":"10.7759/cureus.68771","DOIUrl":"10.7759/cureus.68771","url":null,"abstract":"<p><p>Previous studies have shown that right-sided frontal alpha asymmetry (fAA) is an electroencephalography (EEG) marker for negatively valenced emotions and a marker for negative self-perceptions of a person's psychosocial interactions. Alpha activity is affected by the changes in visual stimulation associated with eye-opening and eye-closing; theta activity is not so affected. Therefore, this analysis investigates the relationship between an individual's theta asymmetry and self-perceptions of their psychosocial interactions. We used quantitative electroencephalographic (qEEG) data from eight right-handed male medical students aged between 19 and 38 years, recorded under eyes-open (EO) and eyes-closed (EC) conditions. Significant correlations were found between self-reported measures of psychosocial interactions via the Interactive Self-Report Inventory (ISI). The main finding was that greater left-sided frontal temporal asymmetry (fTA) under both EO and EC conditions was associated with lower \"regulated\" ISI scores and lower \"dependent\" ISI scores. Greater left-sided temporal theta asymmetry (tTA), under EC conditions, was associated with higher \"anxious\" ISI scores. Greater left-sided prefrontal theta symmetry (pfTA), under EO conditions, was associated with lower \"relaxed\" ISI scores. These findings suggest that theta asymmetries in the frontal, prefrontal, and temporal cortices may be indicative of negative emotional states. The results of this study underscore the potential of pfTA, fTA, and tTA to be used as biomarkers for cognitive-emotional balance. The implications for mental health interventions, particularly personalized therapeutic approaches, are significant.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157026","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":"A Comprehensive Review of the Contemporary Methods for Enhancing Osseointegration and the Antimicrobial Properties of Titanium Dental Implants.","authors":"Fahad A Bakitian","doi":"10.7759/cureus.68720","DOIUrl":"10.7759/cureus.68720","url":null,"abstract":"<p><p>Titanium dental implants with various restorative options are popular for replacing missing teeth due to their comfortable fit, excellent stability, natural appearance, and impressive track record in clinical settings. However, challenges such as potential issues with osseointegration, peri-implant bone loss, and peri-implantitis might lead to implant failure, causing concern for patients and dental staff. Surface modification has the potential to significantly enhance the success rate of titanium implants and meet the needs of clinical applications. This involves the application of various physical, chemical, and bioactive coatings, as well as adjustments to implant surface topography, offering significant potential for enhancing implant outcomes in terms of osseointegration and antimicrobial properties. Many surface modification methods have been employed to improve titanium implants, showcasing the diversity of approaches in this field including sandblasting, acid etching, plasma spraying, plasma immersion ion implantation, physical vapor deposition, electrophoretic deposition, electrochemical deposition, anodization, microarc oxidation, laser treatments, sol-gel method, layer-by-layer self-assembly technology, and the adsorption of biomolecules. This article provides a comprehensive overview of the surface modification methods for titanium implants to address issues with insufficient osseointegration and implant-related infections. It encompasses the physical, chemical, and biological aspects of these methods to provide researchers and dental professionals with a robust resource to aid them in their study and practical use of dental implant materials, ensuring they are thoroughly knowledgeable and well-prepared for their endeavors.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142104","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":"Role of Autologous Platelet-Rich Fibrin in Chronic Non-healing Ulcers With Various Etiologies in a Tertiary Care Rehabilitation Centre: A Case Series.","authors":"Arvind K Sharma, Arunpreet Kaur, Satyasheel S Asthana, Ivanah P Nongrum, Siddharth Rai, Kumari Sunaina","doi":"10.7759/cureus.68709","DOIUrl":"10.7759/cureus.68709","url":null,"abstract":"<p><p>Introduction Chronic non-healing ulcers are defined as a discontinuity or break in the integrity of skin that is not healing in a reasonable period of time due to an underlying systemic etiology. Despite using conventional initial treatment and many other available dressing options, such wounds are difficult to completely heal, thus affecting the progress of rehabilitation measures and compromising functional improvement and quality of life. Materials and methods In this case series, platelet-rich fibrin (PRF) was applied to eight wounds from six patients. The patients included had various etiologies (including spinal cord injury, peripheral vascular disease, Guillain-Barré syndrome, and diabetic foot ulcer) with chronic non-healing wounds over different anatomical locations on the body. Pressure ulcer scale for healing (PUSH) score, surface area, and volume of the wounds were evaluated and monitored weekly after PRF dressing. We have applied PRF every week. On average, two PRF dressings were applied, the maximum being three applications. Results The maximum healing rate in terms of PUSH score was observed to be 3.84% per day, and the minimum was 1.19% per day. The maximum healing rate in terms of surface area was observed to be 5.89% per day, and the minimum was 1.78% per day. Three of the wounds showed complete closure. The maximum follow-up period was 10 weeks. The percentage mean Functional Independence Measure (FIM) improvement was calculated to be 15.87% ± 14.04 during the course of hospitalization after PRF application. Conclusion Based on the results, we can conclude that PRF showed accelerated improvement in the healing of chronic non-healing ulcers of various etiologies at different anatomical locations. It has proven to be a safe and effective method, thereby improving their quality of life and functional independence in performing activities of daily living. To our knowledge till date, no other study in a rehabilitation setting has been done on patients having non-healing ulcers due to various etiologies and at different anatomical locations.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142109","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":"Clinical Success Evaluation of Ultrathin Ceramic Veneers Bonded to Nonprepared Teeth: An Observational Prospective Cohort Study.","authors":"Abdulhamid Al-Mokdad, Eyad Swed, Mohanad Kadhim, Shaza Kanout, Ahmad Al-Mokdad, Anas Abdo, Mohammad Y Hajeer","doi":"10.7759/cureus.68699","DOIUrl":"10.7759/cureus.68699","url":null,"abstract":"<p><strong>Background: </strong>Patients' increasing interest in achieving optimal cosmetic outcomes and the widespread use of ultrathin ceramic veneers offer advantages such as high esthetic results and long-term durability. Several issues related to tooth preparation have been raised, including dental sensitivity, periodontal diseases, and increased treatment phases, in addition to complications associated with previous procedures, the treatment of which remains controversial to date. With the advancement of dental ceramic and its manufacturing techniques, it was widely used to manufacture ultrathin ceramic veneers with minimal preparation. Issues such as fracture and abfraction are the most common in ceramic veneers made of feldspathic ceramic due to their weak mechanical properties against various forces, which led to the emergence of lithium disilicate glass-ceramic manufactured using the heat-press technique. This has resulted in ultrathin ceramic veneers with a thickness of up to 0.1-0.2 mm easily bonded and finished as they have high mechanical properties and esthetic qualities that mimic natural tooth color and shape. The current cohort study aimed to evaluate the success rates of this kind of treatment for patients treated at our department.</p><p><strong>Materials and methods: </strong>This observational cohort study's sample comprised 60 ultrathin ceramic veneers manufactured from lithium disilicate glass-ceramic bonded to nonprepared upper teeth. The clinical performance of the studied sample was evaluated and monitored at monthly intervals (one month, three months, six months, and one year) using the clinical success evaluation based on Walton's principles adopted for evaluating the success and failure of fixed restorations.</p><p><strong>Results: </strong>Ultrathin ceramic veneers made from lithium disilicate glass-ceramic, bonded to nonprepared teeth, proved to be a successful clinical and esthetic treatment option, with a clinical success rate of 100% during the entire follow-up period.</p><p><strong>Conclusions: </strong>This study's findings indicate that ultrathin ceramic veneers made from lithium disilicate glass-ceramic, bonded to nonprepared teeth, are a successful clinical and esthetic treatment option, with a clinical success rate of 100% during the entire follow-up period.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157018","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":"A Case of Brunner's Gland Hyperplasia Accompanied by an Increase in Endocrine Cells and Endocrine Cell Micronests.","authors":"Shiori Meguro, Hideya Kawasaki, Isao Kosugi, Yasunori Enomoto, Satoshi Osawa, Ken Sugimoto, Satoshi Baba, Toshihide Iwashita","doi":"10.7759/cureus.68688","DOIUrl":"10.7759/cureus.68688","url":null,"abstract":"<p><p>Endocrine cell micronests (ECMs) are aggregates of endocrine cells known as enterochromaffin-like cells, typically measuring approximately 50 μm and usually observed in the mucosal layer of atrophic gastric fundic glands associated with hypergastrinemia. Although there are numerous reports on gastric ECMs, reports on duodenal ECMs are exceedingly rare. We report a rare case of Brunner's gland hyperplasia with increased endocrine cells and ECMs. An approximately 40 mm polyp was found in the duodenal bulb of a 57-year-old Japanese male patient during an upper gastrointestinal endoscopy, and a polypectomy was performed. Microscopic examination revealed hyperplasia of Brunner's glands in the duodenal polyp. Compared to normal Brunner's glands, hyperplastic Brunner's glands exhibited more endocrine cells. Additionally, many ECMs were observed in the fibromuscular connective tissue, comprising smooth muscle cells and myofibroblasts, adjacent to the hyperplastic Brunner's glands. The patient presented with hypergastrinemia (2,500 pg/mL; normal range: 30-140 pg/mL), and the ECMs were considered related to this condition. This case represents the first instance of a benign duodenal lesion with an increase in endocrine cells and the presence of ECMs.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157014","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":"Hypersensitivity Pneumonitis: An Interesting Case of Acute Shortness of Breath in a Young Patient.","authors":"Mubashir Rafique, Faisal Arslan, Joohi Khan, Sameh Zaki, Ali Hussain","doi":"10.7759/cureus.68683","DOIUrl":"10.7759/cureus.68683","url":null,"abstract":"<p><p>Hypersensitivity pneumonitis (HP) is a rare disease caused by an inflammation of the distal airway caused by an immune response to inhaled allergens. The clinical presentation and radiological and histological findings can overlap with other pulmonary conditions such as idiopathic pulmonary fibrosis. Therefore, it is essential to consider focused assessment for the patient if a diagnosis of HP is suspected. We present a case involving a young female patient who presented with symptoms of cough, flu-like illness, and dyspnea. Subsequent investigations revealed a diagnosis of nonfibrotic HP. The patient experienced acute respiratory failure and was managed with high-flow oxygen therapy. A detailed investigation determined that the patient's prior exposure to pet parrots at home was a significant factor. Following treatment with steroids and counseling regarding the removal of parrots from the home environment, the patient's condition improved, and she was successfully weaned off of oxygen therapy. This case underscores the importance of a comprehensive social history in evaluating common complaints such as dyspnea. The rarity of parrot-induced HP related to the patient's age, and exposure warrants attention.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142106","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":"A Case Report on Aplasia Cutis Congenita: Insights Into the Impact of Maternal Carbimazole Use.","authors":"Hajar Elmoqaddem, Anass Ayyad, Sahar Messaoudi, Rim Amrani","doi":"10.7759/cureus.68663","DOIUrl":"10.7759/cureus.68663","url":null,"abstract":"<p><p>Congenital aplasia cutis (CAC) is a rare neonatal condition characterized by the absence of skin at birth, often associated with diverse underlying conditions. We report the case of a newborn male admitted on the second day of life with a skin defect on the anterior abdominal wall and a lesion on the left thigh. The mother was treated with carbimazole for hyperthyroidism. Notably, there were no similar cases in the family history. The patient showed favorable progress and normal development following a successful dermo-epidermal allograft. Particular attention was given to managing the risk of infection and ensuring optimal healing through tailored wound care protocols. This case underscores the complexity of CAC, highlighting the importance of early diagnosis, multidisciplinary care, and ongoing research to understand better and effectively treat this rare condition.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134824","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}