Cureus最新文献

{"title":"Correction: Bovine Dermal Collagen Matrix Promotes Vascularized Tissue Generation Supporting Early Definitive Closure in Full-Thickness Wounds: A Pre-clinical Study.","authors":"Katie A Bush, Barbara A Nsiah, Jayson W Jay, Rachel A Penny, Sohail Jahid, Ghaidaa Y Kashgari, Niraj K Doshi, Ian L Valerio","doi":"10.7759/cureus.c351","DOIUrl":"https://doi.org/10.7759/cureus.c351","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.81517.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"c351"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254125","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":"Prolonged Analgesia Following Short, Pulsed Meloxicam in Generalized Osteoarthritis: A Case Report and Focused Evidence Review.","authors":"Akhtar Purvez, Mudhasir Bashir","doi":"10.7759/cureus.94026","DOIUrl":"10.7759/cureus.94026","url":null,"abstract":"<p><p>Oral nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to treat osteoarthritis (OA), but their risks rise with cumulative exposure across the gastrointestinal, cardiovascular, and renal systems. We report a 67-year-old individual with generalized OA, no other chronic illnesses, no medication allergies, and no history of trauma, who self-administers meloxicam 15 mg once daily for seven consecutive days each month. Each monthly pulse is followed by approximately three weeks of analgesia without NSAID use between pulses, and no adverse effects have been observed. Prior evidence suggests that NSAID analgesia peaks early while minor adverse events increase after longer continuous use; this patient's real-world response supports a pragmatic, exposure-sparing approach. Although trials specifically testing fixed weekly or monthly NSAID pulses are lacking, careful patient selection and monitoring may allow short, structured courses that maintain function while minimizing cumulative risk.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94026"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254136","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: Myopia Prevalence in Latin American Children and Adolescents: A Systematic Review and Meta-Analysis.","authors":"Jaime Guedes, Alexandre B da Costa Neto, Bruno F Fernandes, Adriano C Faneli, Marcelo Alves Ferreira, Dillan Cunha Amaral, Denisse J Mora-Paez, Renato Ambrósio","doi":"10.7759/cureus.c349","DOIUrl":"https://doi.org/10.7759/cureus.c349","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.63482.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"c349"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254162","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":"When the Pupils Lie: Unmasking an Unnoticed High Spinal Anesthesia During Orthopedic Surgery.","authors":"Kartik Sonawane, Sumeet Patil, Satheesh Kumar, Tuhin Mistry, Palanichamy Gurumoorthi, Chelliah Sekar","doi":"10.7759/cureus.94047","DOIUrl":"10.7759/cureus.94047","url":null,"abstract":"<p><p>High spinal anesthesia is a rare but potentially serious complication of neuraxial techniques. Unlike total spinal anesthesia, which typically presents dramatically with profound cardiovascular collapse, high spinal anesthesia may evolve more insidiously and manifest primarily with neurological signs. We report the case of a 23-year-old polytrauma patient undergoing femur and tibia fixation under combined spinal-epidural anesthesia (CSEA) who developed sudden unresponsiveness with fixed, dilated pupils shortly after femoral canal reaming. An epidural top-up of 10 mL 0.25% bupivacaine was administered 2.5 hours into surgery, with neurological deterioration occurring approximately 30 minutes later. Despite this alarming presentation, his hemodynamics and spontaneous ventilation remained stable, and he regained consciousness within 30 minutes without airway intervention. Postoperative evaluation revealed intrathecal migration of the epidural catheter, with the block extending above T2 and causing bilateral upper limb weakness. Arterial blood gas analysis demonstrated metabolic and respiratory acidosis, reflecting transient hypoventilation. This case illustrates how an unnoticed high spinal anesthesia can mimic catastrophic neurological or embolic events yet remain fully reversible. It underscores the importance of careful catheter management, structured differential diagnosis, and preparedness for airway intervention.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94047"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260152","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":"Five-Year Outcomes of Endovascular Aneurysm Repair (EVAR) Performed Using a Polymer-Based Aortic Endograft System.","authors":"Faris Saleh, Ibraheem Obaidat, Prashant Neupane, Mohammed Ashrafi, Hiren Patel","doi":"10.7759/cureus.93970","DOIUrl":"10.7759/cureus.93970","url":null,"abstract":"<p><p>Background Endovascular aneurysm repair (EVAR) is a widely used, minimally invasive alternative management option to open surgical repair for infrarenal abdominal aortic aneurysms (infrarenal AAAs). However, standard stent grafts have their challenges for complex aortic anatomies. The Ovation Abdominal Stent Graft System (Endologix Inc., Santa Rosa, CA), which is a polymer-filled sealing ring endograft, has emerged as a promising solution for patients with challenging anatomical features. This study aims to evaluate the Technical success, effectiveness, and long-term outcomes, including reintervention and survival, of the Ovation system in treating complex infrarenal AAAs. Methods We conducted a single-centre, retrospective observational study of 103 patients with anatomically challenging infrarenal AAAs treated with the Ovation stent graft between January 2015 and November 2017 in a UK-based tertiary centre. Anatomical parameters included short necks, severe angulation (>60°), significant thrombus or calcification (>180 degree of the wall diameter), non-cylindrical neck shapes, or an iliac access diameter <6 mm. Outcomes assessed included technical procedural success, Endoleak incidence, Conversion to open, reintervention rates, 30-day aneurysm-related mortality, and all-cause mortality over a 5-year follow-up. Results A total of 103 patients underwent EVAR using the Ovation stent graft between January 2015 and November 2017, with a 5-year follow-up. All patients had at least one adverse anatomical feature, including short necks, significant thrombus or calcification, severe neck angulation, or narrow iliac access. The cohort was predominantly male, comprising 80 patients (77.7%) with a mean age of 76.4 years (SD = 6.67). Technical success was achieved in 97% of cases, with Type I endoleak observed intraoperatively in 3 patients (2.9%). Intraoperative complications occurred in 4.8% of patients, with no aneurysm rupture or conversions to open surgery. The 30-day aneurysm-related mortality was 0%, and the overall reintervention rate over five years was 9.7%. The five-year all-cause mortality rate was 16.5%. Conclusions The Ovation polymer-based endograft demonstrates excellent technical success and favourable long-term outcomes in patients with infrarenal AAA with unfavourable anatomy, including low rates of type I endoleaks, reintervention, and aneurysm-related mortality. These findings support its use as a durable and effective EVAR solution in anatomically challenging cases beyond the standard IFU. Further multicentre prospective studies are warranted to confirm these promising results.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93970"},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254181","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":"Adult-Onset Still's Disease Presenting as Antibiotic-Refractory Sepsis.","authors":"Mohammed Alnims, Ahmer A Longi, Misbah Fazlani, Arsheena Mohamed, Ahmed Saleh","doi":"10.7759/cureus.93933","DOIUrl":"10.7759/cureus.93933","url":null,"abstract":"<p><p>Adult-onset Still's disease (AOSD) is a rare autoinflammatory disorder typified by quotidian fevers, an evanescent salmon-colored rash, arthralgia, neutrophilic leukocytosis, and markedly elevated inflammatory markers. Diagnosis is clinical and by exclusion, supported by classification frameworks like the Yamaguchi criteria. A previously healthy lady in her 20s presented with fever above 39°C, severe generalized myalgia, pharyngitis, a transient salmon-colored rash, neutrophilic leukocytosis, and markedly elevated inflammatory markers. Competing infectious, autoimmune, and malignant etiologies were excluded. Based on clinical features and Yamaguchi criteria, AOSD was suspected. She improved rapidly with intravenous methylprednisolone pulse therapy. During steroid taper as an outpatient, she developed a biochemical flare with ferritin rising to 8,807 ng/ml; tocilizumab was initiated for disease control. This case underscores prompt recognition of AOSD after exclusion of mimics, the interpretive value of ferritin trends, and successful escalation to interleukin-6 (IL-6) blockade for relapse, consistent with emerging data emphasizing targeted cytokine inhibition.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93933"},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245883","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":"Serum Calcium as a Determinant of Fibroblast Growth Factor 23 Levels in Patients With Primary Hyperparathyroidism and Graves' Disease.","authors":"Hiroyuki Yamashita, Yusuke Mori, Yasuo Imanishi, Hisakazu Shindo, Daisuke Tatsushima, Seigo Tachibana, Takashi Fukuda, Hiroshi Takahashi, Yuji Nagayama, Shinya Satoh","doi":"10.7759/cureus.93972","DOIUrl":"10.7759/cureus.93972","url":null,"abstract":"<p><strong>Objective: </strong>Fibroblast growth factor 23 (FGF23) is a phosphate-regulating hormone with an emerging role in calcium homeostasis. However, its role in hypercalcemic conditions remains unclear. This study aimed to investigate the relationship between serum calcium and FGF23 levels in two hypercalcemic disorders: primary hyperparathyroidism (PHPT) and Graves' disease.</p><p><strong>Methods: </strong>A cross-sectional analysis was performed in 98 patients with PHPT and 45 patients with Graves' disease. Clinical and biochemical parameters, including parathyroid hormone (PTH), phosphate, and 1,25-dihydroxyvitamin D3 (1,25(OH)₂D), were analyzed.</p><p><strong>Results: </strong>In PHPT, serum calcium was the only independent determinant of FGF23 levels (P < 0.0001), whereas in Graves' disease, both serum calcium (P < 0.001) and 1,25(OH)₂D (P < 0.005) were independently associated with FGF23. A significant positive correlation between calcium and FGF23 was observed in both conditions. Interestingly, FGF23 levels were elevated despite different phosphate profiles: hypophosphatemia in PHPT and hyperphosphatemia in Graves' disease.</p><p><strong>Conclusions: </strong>These findings suggest that hypercalcemia may directly contribute to FGF23 elevation, independent of phosphate levels. However, the compensatory effect of FGF23 in modulating calcium homeostasis appears to be limited. This study provides new insights into the calcium sensitivity of FGF23 in endocrine disorders characterized by altered mineral metabolism.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93972"},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246143","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":"Vertical Dimension in Prosthodontics Theory and Practice (Part II): A Comprehensive Review of Vertical Dimension Determination in Prosthodontics From Classical Methods to Digital Innovation.","authors":"Mostafa I Fayad, Rania Moussa, Nourhan A Ragheb, Yousra Ahmed, Sherif Sultan, Mahmoud R AbdulSalam, Hussein A Ismail, Mohamed O Elboraey, Mohammed H AbdElaziz, Mohamed A Helal","doi":"10.7759/cureus.93987","DOIUrl":"10.7759/cureus.93987","url":null,"abstract":"<p><p>The determination of vertical dimension of occlusion (VDO) represents one of the most challenging and critical aspects of prosthodontic treatment, particularly in edentulous patients. Accurate establishment of VDO is essential for optimal function, esthetics, and patient comfort in prosthetic rehabilitation. This comprehensive literature review aims to analyze the current evidence regarding various methods for determining vertical dimension (VD) in prosthodontic practice, examining their reliability, clinical applicability, and evolution from traditional to modern digital approaches. A search was conducted across multiple databases, including PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library. The search strategy included terms related to VD, prosthodontics, complete dentures, and measurement techniques. A total of 1,259 articles were initially identified, with 903 remaining after duplicates were removed. Following screening and quality assessment, 79 high-quality studies were included in this comprehensive review. The analysis identified two main categories of VDO determination: (a) pre-extraction record methods and (b) post-extraction assessment methods, the latter encompassing anthropometric/biometric approaches, physiological and functional techniques, mechanical methods, measurement devices, radiographic or imaging modalities, and esthetic evaluations. While traditional techniques hold historical value, their reliability and reproducibility remain limited. In contrast, contemporary digital methods offer greater precision and patient comfort, though their use demands advanced equipment and practitioner training. While no single method has emerged as universally superior, the integration of multiple assessment techniques with digital technology offers enhanced accuracy and reproducibility. Contemporary evidence supports a multifactorial approach combining traditional clinical judgment with digital precision and novel radiographic formulas for optimal VDO determination.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93987"},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253833","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":"Pre- and Post-bronchodilator Spirometry in Asthmatic Smokers Versus Non-smokers: A Hospital-Based Cross-Sectional Study.","authors":"Yassine Wael Mohamed Elshammaa, Dana Mhd Nabil Bendakji, Sherif Elseedy, Mohammed Faeq, Mostafa Afifi, Ahmed Yehia Zakaria Khaled, Ali Abdallah, Basma Alleelwa, Toka Ghazy, Mohamed Nasr, Mohamed Ashraf Hussien Abdelhady, Naglaa Abdelsamea, Ahmed Mamdouh Elshafei Khaled, Afnan Elwafi, Mohsen Mosallam, Ibtihal Khider Fagir Salih, Nermeen Hassan, Marwa Harb, Mohamed Abdelfattah, Ahmed Mostafa, Abdulmabod Omar","doi":"10.7759/cureus.93986","DOIUrl":"10.7759/cureus.93986","url":null,"abstract":"<p><p>Background Cigarette smoking is a major risk factor for impaired lung function and the development of chronic respiratory diseases. Early detection of pulmonary changes using spirometry can help in timely intervention and prevention of long-term complications. Objective To compare spirometry parameters between smokers and non-smokers, and to evaluate the effect of bronchodilator administration on pulmonary function in both groups. Methods A cross-sectional study was conducted involving 60 participants (30 smokers and 30 non-smokers). Spirometry was performed before and after bronchodilator administration to measure vital capacity (VC%), forced vital capacity (FVC%), forced expiratory volume in the first second (FEV₁%), FEV₁/FVC ratio, forced expiratory flow over the middle one half of the FVC (FEF25-75%), maximal voluntary ventilation (MVV%), and expiratory time. Paired t-tests were used for within-group comparisons, and independent t-tests for between-group comparisons. A p-value < 0.05 was considered statistically significant. Results Smokers had significantly lower baseline spirometry values compared to non-smokers across all parameters (p < 0.001). Both groups showed statistically significant improvements post-bronchodilator (p < 0.001), with smokers exhibiting a smaller magnitude of improvement. Notably, FEV₁% increased from 47.2 ± 6.8 to 60.3 ± 11.5 in smokers and from 56.3 ± 7.1 to 73.3 ± 7.4 in non-smokers. The FEV₁/FVC ratio and other flow rates showed similar patterns. Expiratory time also increased post-bronchodilator in both groups. Conclusion Smoking is associated with marked reductions in lung function and diminished bronchodilator responsiveness. Early spirometric screening in smokers is essential to identify functional decline and guide smoking cessation and treatment strategies to prevent progression of pulmonary disease.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93986"},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254108","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":"Investigating the Sustainability of Urological Surgery: A Retrospective Analysis.","authors":"Rupert Vicary-Watts","doi":"10.7759/cureus.93904","DOIUrl":"10.7759/cureus.93904","url":null,"abstract":"<p><p>Climate change is the major health concern of the 21st century, and paradoxically, healthcare is one of the leading contributors to global warming. This study intends to investigate how urology can reduce its carbon footprint. A review of the literature highlighted how energy consumption - through air conditioning in particular - medical waste, and anaesthetic gases are the main causes of emissions from the theatre. A retrospective analysis of the number of general anaesthetics (GAs) and anaesthetic gases used for all urological procedures over one month was conducted using electronic records. A questionnaire was provided to 30 theatre staff, assessing their insight into the carbon footprint of the department. It investigated waste management and engagement with the issue of the climate crisis. An analysis of the current waste streams and the amount of waste produced was also conducted. Thirty-nine operations were done under GA, with sevoflurane used in 48% (n = 30) of all cases, and desflurane used in 3% (n = 7). Education and appropriate recycling facilities were identified as key areas within waste management that needed addressing. Clinical waste produced 850 tonnes per year at this Trust; domestic waste production was 725 tonnes per year; and recycling produced 160 tonnes of cardboard and 9 tonnes of plastic bottles. Discussion with the waste minimisation officer led to a planned introduction of a new waste stream into theatres. Poor staff knowledge on waste disposal and the new waste stream introduction was addressed with an in-person educational update on waste disposal. Second-cycle results showed a large improvement in staff scores prior to the new waste stream introduction. This study identifies simple measures that can be introduced to greatly reduce the carbon footprint of urological operations. Energy consumption can be reduced with efficient theatre management, air conditioning awareness, and appropriate waste streams. Furthermore, the implementation of a well-structured educational programme, and readily available recycling bins, addresses high levels of inappropriate waste disposal.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93904"},"PeriodicalIF":1.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246029","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}