Cureus最新文献

{"title":"Penile Abscess Complicating Chronic Penile Calciphylaxis in a Heart Transplant Recipient and End-Stage Renal Disease Patient.","authors":"Bharath P Bhushan, Sharath Rajagopalan, Vikash Kumar, David Shi, Eric Huang","doi":"10.7759/cureus.85607","DOIUrl":"10.7759/cureus.85607","url":null,"abstract":"<p><p>Calciphylaxis, also known as calcific uremic arteriolopathy, is a rare but severe and life-threatening condition that is characterized by cutaneous arteriolar calcification and subsequent tissue necrosis. Calciphylaxis is more commonly seen in patients with end-stage renal disease (ESRD) and has a one-year mortality of greater than 50%. Penile calciphylaxis is extremely rare and carries a high mortality risk. Oftentimes, diagnosis and treatment are challenging. We present a case of a 71-year-old heart transplant recipient and end-stage renal disease patient with a history of chronic penile calciphylaxis who developed penile abscesses, highlighting the challenges of managing this complicated condition.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85607"},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259691","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 Impact of Sleeve Gastrectomy Combined With Lifestyle Interventions on Anthropometric and Health Outcomes in Adults: A Systematic Review and Meta-Analysis.","authors":"Anees A Alyafei, Said K AlMukhaini, Aysha Ma Hussein, Sara Tariq Al Abdulla","doi":"10.7759/cureus.85587","DOIUrl":"10.7759/cureus.85587","url":null,"abstract":"<p><p>Weight loss from obesity is a global health concern associated with increased risk of chronic illness and significant healthcare costs. Sleeve gastrectomy is an increasingly popular bariatric surgery option for substantial weight reduction; however, sustained success depends on lifestyle modification. Integrating food, exercise, behavioral, and technology-based interventions into surgery can potentially enhance outcomes and promote weight maintenance. A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) 2020 guidelines, encompassing randomized controlled trials published between 2014 and 2025. Databases like PubMed, Cochrane Library, Embase, Web of Science, and Scopus were searched. Studies included adults (age ≥18 years) with obesity undergoing sleeve gastrectomy and subjected to post-operative lifestyle interventions. The primary outcomes were weight changes, BMI, and body composition, while the secondary outcomes included comorbidities and quality of life. Risk of bias was assessed using the ROB-2 tool (www.cochrane.org). Thirty-one studies with varying follow-up durations (1-60 months) were included. The combined intervention resulted in greater weight loss (5%-30% decrease), improvement in fat mass, BMI, and cardiometabolic profiles compared to usual care. The meta-analysis revealed a high overall effect size for weight reduction, with a value of 2.56 (2.15-2.88) for the high weight reduction group and 1.88 (1.76-1.91) for the low weight reduction group. Heterogeneity among studies was moderate, with I² values ranging from 18% to 46%, indicating some variation in study populations and intervention effects. Technology-augmented interventions, such as wearable devices and mobile apps, provided additional gains in adherence and long-term efficacy. Long-term weight loss maintenance remained a difficulty. Sleeve gastrectomy combined with structured lifestyle interventions significantly improves anthropometric and health outcomes in adults. Technology-derived interventions and behavioral therapy have the potential for improving long-term weight management, but additional studies are required to optimize intervention approaches.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85587"},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259692","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":"Isoperistaltic Versus Antiperistaltic Side-to-Side Ileocolic Anastomoses After Right Colectomies: A Systematic Review and Meta-Analysis.","authors":"Bernardo F Pompeu, Julia Hoici Brunini, Marília Piassi Velucci, Lucas Guedes, Gabriel Leal Barone, Beatriz D Andrea Pigossi, Sérgio Mazzola Poli De Figueiredo, Fernanda Formiga","doi":"10.7759/cureus.85603","DOIUrl":"10.7759/cureus.85603","url":null,"abstract":"<p><p>After right colectomy, ileocolic anastomoses can be configured as isoperistaltic (ISO) or antiperistaltic (ANTI), with the choice largely based on the surgeon's experience. This study aimed to evaluate these configurations regarding postoperative complications and operative outcomes. We searched PubMed, Scopus, and the Cochrane Central Register of Clinical Trials for studies published up to January 2025. Odds ratios (ORs) and mean differences (MDs), with 95% confidence intervals (CIs), were pooled using a random-effects model. Heterogeneity was assessed using the I² statistic, and analyses were conducted with R Software version 4.4.1. Twelve studies involving patients undergoing colorectal surgery were included, comparing ISO and ANTI ileocolic anastomoses. ISO was associated with a significantly earlier return of flatus (MD: -0.3 days; 95% CI: -0.6 to -0.1; p<0.01). No statistically significant differences were found in anastomotic leak (OR: 0.61; 95% CI: 0.29-1.28; p=0.189), postoperative ileus (OR: 1.47; 95% CI: 0.87-2.50; p=0.149), anastomotic bleeding (OR: 0.70; 95% CI: 0.20-2.49; p=0.582), surgical site infection (SSI) (OR: 0.91; 95% CI: 0.38-2.17; p=0.829), reoperation (OR: 0.92; 95% CI: 0.47-1.82; p=0.813), time to first stool (MD: -0.3 days; 95% CI: -0.7 to 0.1; p=0.19), anastomotic time (MD: -0.2 minutes; 95% CI: -1.9 to 1.4; p=0.79), blood loss (MD: -4.0 mL; 95% CI: -17.8 to 9.8; p=0.57), operative time (MD: 4.2 minutes; 95% CI: -3.0 to 11.3; p=0.25), hospital stay (MD: -0.7 days; 95% CI: -1.7 to 0.4; p=0.19), or 30-day mortality (OR: 0.85; 95% CI: 0.25-2.86; p=0.787). Based on our findings, ISO and ANTI ileocolic anastomoses demonstrated comparable postoperative complication rates and operative outcomes. However, ISO was associated with a faster return of bowel function, evidenced by earlier passage of flatus.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85603"},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268212","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":"Hilar Bile Duct Granuloma Misdiagnosed As Hilar Cholangiocarcinoma: A Case Report.","authors":"Feng Wei, Zhou Fan, Xiao Mengzhi, Yu Jun, Tan Xingguo","doi":"10.7759/cureus.85583","DOIUrl":"10.7759/cureus.85583","url":null,"abstract":"<p><p>Schistosomiasis is the second most common human parasitic infection after malaria. The granulomatous inflammatory damage to the liver caused by its eggs and the resulting liver fibrosis are the basic characteristics of schistosomiasis and also the main cause of death. We report an elderly male patient from an endemic area who presented with abdominal distension and jaundice. He was initially diagnosed with hilar cholangiocarcinoma, but postoperative biopsy indicated schistosomal granulomatous inflammation. This case has provided us with a deeper understanding of the diagnosis and treatment of hilar schistosomal granuloma.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85583"},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259690","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":"Multimodal Artificial Intelligence Using Endoscopic USG, CT, and MRI to Differentiate Between Serous and Mucinous Cystic Neoplasms.","authors":"Katsushi Seza, Katsunobu Tawada, Akitoshi Kobayashi, Kazuyoshi Nakamura","doi":"10.7759/cureus.85547","DOIUrl":"10.7759/cureus.85547","url":null,"abstract":"<p><p>Introduction Serous cystic neoplasms (SCN) and mucinous cystic neoplasms (MCN) often exhibit similar imaging features when evaluated with a single imaging modality. Differentiating between SCN and MCN typically necessitates the utilization of multiple imaging techniques, including computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS). Recent research indicates that artificial intelligence (AI) can effectively distinguish between SCN and MCN using single-modal imaging. Despite these advancements, the diagnostic performance of AI has not yet reached an optimal level. This study compares the efficacy of AI in classifying SCN and MCN using multimodal imaging versus single-modal imaging. The objective was to assess the effectiveness of AI utilizing multimodal imaging with EUS, CT, and MRI to classify these two types of pancreatic cysts. Methods We retrospectively gathered data from 25 patients with surgically confirmed SCN and 24 patients with surgically confirmed MCN as part of a multicenter study. Imaging was conducted using four modalities: EUS, early-phase contrast-enhanced abdominal CT, T2-weighted MRI, and magnetic resonance pancreatography. Four images per modality were obtained for each tumor. Data augmentation techniques were utilized, resulting in a final dataset of 39,200 images per modality. An AI model with ResNet was employed to categorize the cysts as SCN or MCN, incorporating clinical features and combinations of imaging modalities (single, double, triple, and all four modalities). The classification outcomes were compared with those of five experienced gastroenterologists with over 10 years of experience. The comparison is based on three performance metrics: sensitivity, specificity, and accuracy. Results For AI utilizing a single imaging modality, the sensitivity, specificity, and accuracy were 87.0%, 92.7%, and 90.8%, respectively. Combining two imaging modalities improved the sensitivity, specificity, and accuracy to 95.3%, 95.1%, and 94.9%. With three modalities, AI achieved a sensitivity of 96.0%, a specificity of 99.0%, and an accuracy of 97.0%. Ultimately, employing all four imaging modalities resulted in AI achieving 98.0% sensitivity, 100% specificity, and 99.0% accuracy. In contrast, experts utilizing all four modalities attained a sensitivity of 78.0%, specificity of 82.0%, and accuracy of 81.0%. The AI models consistently outperformed the experts across all metrics. A continuous enhancement in performance was observed with each additional imaging modality, with AI utilizing three and four modalities significantly surpassing single-modal imaging AI. Conclusion AI utilizing multimodal imaging offers better performance compared to both single-modal imaging AI and experienced human experts in classifying SCN and MCN.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85547"},"PeriodicalIF":1.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251556","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":"Milia En Plaque Associated With Prayer-Related Frictional Changes.","authors":"Moosa A Hira, Fahad S Siddiqui, Robert Moore, Zain U Syed","doi":"10.7759/cureus.85507","DOIUrl":"10.7759/cureus.85507","url":null,"abstract":"<p><p>Milia en plaque (MEP) is an uncommon dermatologic condition characterized by grouped milia on an erythematous plaque. Its underlying cause remains unclear, though various internal and external factors may contribute. We present the first reported case of MEP linked to prayer-related frictional changes. A 67-year-old South Asian male developed a well-demarcated plaque with agminated milia on his forehead at the site of chronic mechanical friction from prayer-related prostration. Histopathology revealed cystically dilated follicles and inclusion cysts without atypia. Surgical excision led to complete resolution without recurrence at two months, with an excellent cosmetic outcome. This case highlights not only a novel trigger for MEP but also suggests that surgical excision may be an effective treatment option for localized lesions, offering favorable aesthetic results. Awareness of mechanical factors in MEP pathogenesis may guide prevention and individualized management strategies.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85507"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251489","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":"Three-Dimensional Printing in Cardiothoracic Surgery: Workflow and Clinical Applications.","authors":"Charles G Jenkinson, Tristan L Wood, Jason Chuen","doi":"10.7759/cureus.85530","DOIUrl":"10.7759/cureus.85530","url":null,"abstract":"<p><p>Rapid advances have been made in the field of three-dimensional (3D) printing in recent times. The hardware required to create high-fidelity, anatomically accurate 3D models of intrathoracic structures, including the great vessels and bony structures, is accessible and easy to use and utilizes consumables that are cost-effective. The quality of 3D printers, especially in consumer-level machines, has improved in recent times, while the price of the hardware has decreased. We have developed a toolchain to create 3D-printed models for use in patient education and consent, operative planning, and student/resident teaching. We outline our approach using a free and open-source toolchain, highlighting the utility of our models so that others may reproduce our techniques in their own clinical and teaching practice.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85530"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251559","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 Trisomy 9 Mosaicism Diagnosed Following Detection of Placental Trisomy 9.","authors":"Yuri Hasegawa, Shoko Miura, Koh Nagata, Ai Nagata, Kiyonori Miura","doi":"10.7759/cureus.85532","DOIUrl":"10.7759/cureus.85532","url":null,"abstract":"<p><p>We report a case in which fetal growth restriction was observed during pregnancy. A placental chromosomal analysis was performed to investigate the cause of the fetal growth restriction and it showed trisomy 9. Prompt chromosomal testing of the neonate led to the diagnosis of trisomy 9 mosaicism. Although the neonate was small for gestational age and had mild respiratory distress and feeding difficulties, her clinical symptoms were minimal. Trisomy 9 mosaicism is extremely rare and shows considerable variability in its clinical presentation. This case report is important because trisomy 9 was detected by a placental chromosome analysis that was conducted to investigate the cause of fetal growth restriction. Additionally, a newborn with mild clinical findings was unexpectedly diagnosed with trisomy 9 mosaicism.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85532"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251484","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 Hidden Hazard of Hypothyroidism: Statin-Associated Rhabdomyolysis With Life-Threatening Complications.","authors":"George Bechir, Angelina Bechir","doi":"10.7759/cureus.85506","DOIUrl":"10.7759/cureus.85506","url":null,"abstract":"<p><p>Statins are among the most widely prescribed medications for reducing cardiovascular morbidity and mortality. While generally well tolerated, they carry a rare but potentially fatal risk of rhabdomyolysis - a condition marked by massive skeletal muscle breakdown, electrolyte abnormalities, and acute kidney injury (AKI). We report the case of a 76-year-old man who developed profound rhabdomyolysis, severe transaminitis, and dialysis, requiring AKI shortly after initiating atorvastatin. His initial symptoms included excruciating bilateral lower extremity pain and progressive weakness, ultimately rendering him unable to walk. Laboratory evaluation revealed a creatine kinase level exceeding 25,000 U/L, marked elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and a creatinine of 9.6 mg/dL. Despite prompt initiation of aggressive intravenous hydration, bladder decompression, and supportive care, the patient remained anuric and progressed to volume overload, necessitating initiation of hemodialysis. Further evaluation revealed profoundly uncontrolled hypothyroidism, with a thyroid-stimulating hormone (TSH) of 121.7 µIU/mL and a free T4 level of less than 0.4 ng/dL, despite reported use of levothyroxine. MRI of the thigh showed diffuse muscular edema without myonecrosis, and an autoimmune myositis panel was negative. Atorvastatin was promptly discontinued, and thyroid hormone therapy was intensified. Over the next several days, his biochemical parameters slowly improved, and he was ultimately discharged to acute rehabilitation with plans for outpatient dialysis and endocrine follow-up. This case underscores the synergistic danger of statin therapy in the presence of untreated or undertreated hypothyroidism. Routine screening for thyroid dysfunction, particularly in elderly patients or those with known thyroid disease, may help prevent catastrophic complications such as rhabdomyolysis and irreversible renal injury.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85506"},"PeriodicalIF":1.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251558","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":"Incidental Olfactory Groove Meningioma: A Case Report.","authors":"Hani Aljohani, Abdulrahman H Alashkar, Mohammad A Aljawash, Salah A Kassab","doi":"10.7759/cureus.85470","DOIUrl":"10.7759/cureus.85470","url":null,"abstract":"<p><p>Olfactory groove meningiomas (OGMs) are midline meningiomas of the anterior cranial fossa. They often grow to large sizes before producing symptoms. This, together with the increasing use of neuroimaging, has made diagnosing OGMs incidentally a more likely scenario. Due to the position of OGMs in relation to the frontal lobe, these tumors are likely to cause neuropsychiatric symptoms. In this report, we present a 41-year-old female who was diagnosed with incidental OGM and focus on the patient's perspective; she reported anxiety and frontal headaches only after being diagnosed with the tumor.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85470"},"PeriodicalIF":1.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251486","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}