Cureus最新文献

{"title":"Association Between Longitudinal Changes in Cardio-Ankle Vascular Index and Aortic Stenosis Progression in Dialysis Patients: A Retrospective Study.","authors":"Shunsuke Todani, Kazuhiro Shimizu, Shuji Sato, Kohji Shirai, Atsuhito Saiki","doi":"10.7759/cureus.93263","DOIUrl":"10.7759/cureus.93263","url":null,"abstract":"<p><p>Objective In dialysis patients, echocardiography often underestimates the progression of aortic stenosis (AS) due to blood pressure fluctuations and extensive calcification that obscure standard indices. We evaluated whether serial changes in the cardio-ankle vascular index (CAVI), a blood pressure-independent marker of arterial stiffness, can anticipate severe AS and guide the timing of valve replacement. Methods This single-center, retrospective study screened 1,169 maintenance dialysis patients (2015-2023). Forty-one patients who underwent surgical or transcatheter aortic valve replacement (AVR/TAVR) had valid CAVI measurements at four time points: 2 years and 1 year before surgery, immediately before surgery, and 1 year after surgery. The -2-year time point served as the baseline. Hemodynamic, echocardiographic, and laboratory data were analyzed using the Friedman and Wilcoxon tests. Severe AS progression was defined as a new mean pressure gradient (meanPG) ≥ 40 mmHg. Determinants of progression were identified using multivariable logistic regression. Results Median CAVI declined from 10.2 to 9.4 over the two years preceding surgery (p < 0.001) and rose to 11.1 one year post-AVR/TAVR (p < 0.001). Simultaneously, ejection time increased, ejection fraction decreased, and Vmax, maxPG, stroke volume, and stroke volume index (SVi) all rose significantly (p < 0.01 for each), with no significant changes in blood pressure or heart rate. Patients who progressed to severe AS showed a greater CAVI decline (ΔCAVI -2.90 vs. -0.67; p = 0.022) and higher Vmax (4.0 vs. 3.0 m/s; p < 0.001). ΔCAVI was the only independent predictor of severe AS progression (OR 0.51 per 1-unit decrease; 95% CI: 0.20-0.89; p = 0.013). Age and sex were not significant. CAVI and peak PG showed a modest inverse correlation (ρ = -0.35). Conclusion In dialysis patients, a marked preoperative decline in CAVI nearly doubles the risk of emergent severe AS and normalizes after valve replacement, indicating true hemodynamic responsiveness. Serial CAVI monitoring, simple, noninvasive, and reproducible, may offer an early warning signal and help optimize intervention timing when echocardiographic findings are ambiguous.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"e93263"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188128","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: Inflammatory Bowel Disease and Its Association With Perinuclear Antineutrophil Cytoplasmic Antibodies: A Systematic Review.","authors":"Harleen Kaur, Malik Kasapoglu, Rajesh Yadavalli, Sarosh Nawaz, Abdulaziz Althwanay, Esraa M AlEdani, Ann Kashmer Yu","doi":"10.7759/cureus.c326","DOIUrl":"https://doi.org/10.7759/cureus.c326","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.57872.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"c326"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12467403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188179","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: Impact of Elevated Fibroblast Growth Factor 23 (FGF23) on the Cardiovascular System: A Comprehensive Systematic Literature Review.","authors":"Kavya Sai Satya Amaravadi, Poornachandra Nalisetty, Nandini Vadlamani, Sabina Ibrahimli, Farees Ahmad Khan, Jason A Castillo, Sai Sri Penumetcha","doi":"10.7759/cureus.c327","DOIUrl":"https://doi.org/10.7759/cureus.c327","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.59820.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"c327"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12467404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188209","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: Otolaryngological Presentations of Klippel-Feil Syndrome: A Systematic Review.","authors":"Christopher Stewart, Alex L Otto, Mitchell Fisher, Abbigail Niewchas, Salma Alkhatib, Andrew Simonsen, Randall Hansen, Suporn Sukpraprut-Braaten, Kent McIntire","doi":"10.7759/cureus.c325","DOIUrl":"https://doi.org/10.7759/cureus.c325","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.73986.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"c325"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12467432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188237","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 Case of Pseudogout Causing Thoracic Myelopathy.","authors":"Emilee A Carpenter, Zaid Siddique, Ola El-Zammar, Adriana May, Kavya Mirchia","doi":"10.7759/cureus.c329","DOIUrl":"https://doi.org/10.7759/cureus.c329","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.30258.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"c329"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188113","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":"Use of Glucagon-Like Peptide-1 (GLP-1) Agonists in Modulating Preexisting Dermatologic Disease: A Systematic Review.","authors":"Bryan Tassavor, Sultan Al Salem","doi":"10.7759/cureus.93282","DOIUrl":"10.7759/cureus.93282","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed the management of type 2 diabetes and obesity, and growing evidence suggests potential benefits in dermatologic disease. We systematically reviewed reports in the literature that linked their use to improvement of preexisting dermatologic conditions, including psoriasis, hidradenitis suppurativa, hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) syndrome, Hailey-Hailey disease, acne keloidalis nuchae, folliculitis decalvans, androgenic alopecia, and localized linear scleroderma. Through controlled trials, cohort studies, and case reports, varying degrees of clinical improvement were observed across these conditions. We also review proposed mechanisms underlying these findings, with attention to immunologic, metabolic, and barrier-modulating pathways. GLP-1RAs thus represent a promising therapeutic avenue in dermatology, warranting further investigation in larger, prospective studies.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"e93282"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188020","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: Clinical Effectiveness of N-Methyl-D-Aspartate (NMDA) Receptor Antagonists in Adult Obsessive-Compulsive Disorder (OCD) Treatment: A Systematic Review.","authors":"Asila A Ferguson, Aujala Irfan Khan, Baraa Abuzainah, Dipabali Chaudhuri, Kokab Irfan Khan, Roba Al Shouli, Akhil Allakky, Jaafar A Hamdan","doi":"10.7759/cureus.c328","DOIUrl":"https://doi.org/10.7759/cureus.c328","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.37833.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"c328"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188117","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":"Epipharyngeal Abrasive Therapy (EAT) Field Theory: A Clinical Framework for EAT in Modulating Psycho-Neuro-Endocrino-Immune (PNEI) Dynamics.","authors":"Ito Hirobumi","doi":"10.7759/cureus.93254","DOIUrl":"10.7759/cureus.93254","url":null,"abstract":"<p><p>Chronic epipharyngitis/chronic nasopharyngitis has traditionally been understood as a localized inflammatory disease, but clinically, it often presents with systemic symptoms that span the nervous, immune, and endocrine systems, such as headaches, fatigue, low-grade fever, impaired concentration, orthostatic dysregulation, joint pain, anxiety, and sleep disorders. Epipharyngeal abrasive therapy (EAT) is a treatment that applies chemical and physical stimulation to the mucous membranes of the epipharynx/nasopharynx using a cotton swab soaked in a 1% zinc chloride solution. Recently, there have been increasing reports of its efficacy in controlling chronic inflammation and improving multisystem symptoms. Regarding the mechanism of action of EAT, autonomic nervous system stimulation, immune system stimulation, and endocrine system stimulation have been reported; however, many aspects of the mechanism of action remain unclear. A review of the existing research literature shows that EAT stimulates the autonomic nervous system through changes in parasympathetic activity mediated by the trigeminal-vagus reflex and has an immediate effect of inducing inflammatory reflexes. In addition, as a long-term effect, the autonomic nervous system balance is reestablished due to changes in the plasticity of the reflex pathway, chronic inflammation is controlled, and the immune response is normalized. Furthermore, continuous EAT stimulation influences the immune and endocrine systems, leading to the resynchronization of the body's homeostasis network. This article systematizes the mechanisms by which EAT exerts its multi-systemic therapeutic effects on the nervous, immune, and endocrine systems, redefines EAT from a conventional local treatment to a systemic treatment, and presents the new framework of EAT field theory. This article is presented as a narrative and conceptual review rather than a systematic review, aiming to synthesize the clinical findings and theoretical perspectives into the proposed EAT field theory.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"e93254"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193847","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 Unusual Presentation of Paget-Schroetter Syndrome: A Reminder on the Importance of Clinical Judgment.","authors":"Ayush Isaac","doi":"10.7759/cureus.93286","DOIUrl":"10.7759/cureus.93286","url":null,"abstract":"<p><p>We discuss the case of a 36-year-old woman who presented with persistent right upper limb swelling and pain. A previous negative D-dimer (434 µg/L (normal range <500 µg/L)) resulted in an inappropriate discharge, despite a significant past medical history. The patient was sent for a right upper limb ultrasound Doppler scan due to persistent pain, and a clot in the right supraclavicular subclavian vein was observed, confirming the diagnosis of Paget-Schroetter syndrome (PSS). The clot was successfully removed under the vascular team in Cardiff without any post-op complications. The literature review demonstrates that PSS should be suspected mostly on a clinical basis; the literature does not support the use of a D-dimer to support a suspected upper limb deep vein thrombosis (DVT), as this could delay vital treatment for the patient, as demonstrated in this case.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"e93286"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188154","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":"Mononeuritis Multiplex as a Diagnostic Challenge in Eosinophilic Granulomatosis With Polyangiitis: Implications of Early Versus Delayed Recognition.","authors":"Farhaan Ahmed, Hamna Nazeer, Salamat Ullah, Rawaha Ahmad, Nichola Pugh","doi":"10.7759/cureus.93171","DOIUrl":"10.7759/cureus.93171","url":null,"abstract":"<p><p>A 63-year-old female patient presented to the acute medical unit with what appeared to be a case of progressive mobility decline, a common and often nonspecific presentation in acute medicine. She described upper and lower limb weakness and numbness affecting her ability to walk. Originally, her upper limb numbness was treated as ulnar nerve compression in the community. She also had multiple episodes of shortness of breath throughout the year, which were initially managed in the community as suspected asthma exacerbations; however, her symptoms were non-specific. Routine investigations revealed severe eosinophilia (13.37 × 10⁹/L), anaemia, and leucocytosis. Neurophysiology confirmed mononeuritis multiplex, and further autoimmune testing revealed positive anti-neutrophil cytoplasmic antibodies (P-ANCA) and elevated myeloperoxidase (MPO) antibodies. This was ultimately diagnosed as eosinophilic granulomatosis with polyangiitis (EGPA), a rare presentation that challenged initial diagnostic assumptions. This case is an example of how not all presentations of EGPA are straightforward and how it might be missed in an acute medical setting. Through this case report, we wanted to emphasise the subtle and often vague nature of mononeuritis multiplex in EGPA. We would also like to highlight the implications of a delayed diagnosis on patients with EGPA and how this affects the long-term health of patients. Lastly, we would like to discuss newer treatments with anti-interleukin-5 (IL-5) target drugs, which are used to reduce relapse rates in the disease.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 9","pages":"e93171"},"PeriodicalIF":1.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187660","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}