Cureus最新文献

{"title":"The Effectiveness of Triton Used With XP-3D Adaptive Files and Active Irrigation on Smear Layer Removal During Root Canal Preparation: A Qualitative Scanning Electron Microscopy (SEM) Study.","authors":"Charissa Bandoo, Samiyah Suliman, Emma Trestrail, Shivaughn M Marchan","doi":"10.7759/cureus.73057","DOIUrl":"10.7759/cureus.73057","url":null,"abstract":"<p><strong>Background: </strong>Standard irrigating protocols during root canal treatment call for the use of sodium hypochlorite during chemo-mechanical preparation, followed by final irrigation with ethylenediaminetetraacetic acid (EDTA). This study determined the effectiveness of a new irrigant, Triton (Brasseler, USA), on smear layer removal during root canal treatment compared to that of 5.25% sodium hypochlorite and CanalPro EDTA 17% (Coltene).</p><p><strong>Methodology: </strong>Twenty-one extracted anterior teeth were prepared for root canal treatment. The teeth were divided into three groups: five teeth were used as control with saline as the irrigant, eight teeth with sodium hypochlorite and 17% EDTA as irrigants, and eight teeth with Triton as the irrigant. Root canal preparation was done using the XP-3D shaper and finisher files (Brasseler, USA) for all teeth with respective irrigants. A single operator performed all root canal treatment procedures. The teeth were prepared for scanning electron microscopy (SEM), and analysis was performed by a second investigator. The smear layer removal was qualitatively assessed to determine the effectiveness of irrigants.</p><p><strong>Results: </strong>Smear layer removal was most effective for teeth irrigated with 5.25% sodium hypochlorite, followed by 17% EDTA (Group B). Teeth irrigated with Triton (Group A) showed a similar appearance to the hypochlorite/EDTA group but with isolated instances of inter-tubular debris.</p><p><strong>Conclusion: </strong>Sodium hypochlorite use followed by a final rinse with EDTA remains the gold standard for the removal of the smear layer created during canal instrumentation.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585272","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":"Endovascular Aneurysm Repair Versus Open Surgical Repair in Treating Abdominal Aortic Aneurysm.","authors":"James R Vienneau, Camden I Burns, Anto Boghokian, Varun Soti","doi":"10.7759/cureus.73066","DOIUrl":"10.7759/cureus.73066","url":null,"abstract":"<p><p>Abdominal aortic aneurysm (AAA) denotes an abdominal aorta dilation exceeding 3 cm, typically asymptomatic until rupture, posing severe consequences, including fatality. Therefore, continual screening is imperative, and surgical intervention is recommended upon reaching a diameter of 5.5 cm to prevent rupture. The primary surgical approaches are open surgical repair or open repair (OR) and endovascular aneurysm repair (EVAR). This review juxtaposes EVAR's short- and long-term effectiveness, safety, and perioperative complications in AAA patients versus OR, elucidating clinical benefits and avenues for further research. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an extensive literature review was conducted using the PubMed and Clinicaltrials.gov databases. The review specifically focused on clinical studies directly comparing EVAR versus OR. The comprehensive literature review revealed that EVAR confers a survival advantage for up to four years post-procedure. However, the benefit shifts to OR after four to eight years due to aneurysm-related complications, such as ruptures, underscoring the necessity of lifelong post-EVAR monitoring. Following EVAR, AAA patients necessitate significantly more frequent secondary interventions due to graft-related issues, including endoleaks, thereby escalating long-term complexity and care costs. Conversely, following OR, a notably higher proportion of patients require mechanical ventilation and blood transfusions and experience prolonged intensive-care and mid-care unit stays, consequently extending hospitalization. After EVAR, patients recover substantially faster, returning to normal activities sooner. Nonetheless, the long-term quality of life between the two procedures becomes comparable. While EVAR presents itself as a less invasive alternative to OR, especially for high surgical risk patients, the imperative of long-term surveillance and the risk of secondary interventions pose significant challenges. Advancements in EVAR technology and technique are broadening its utility. Yet, continual research is crucial to optimize patient selection, improve long-term outcomes, and ensure that EVAR's benefits outweigh the risks. Therefore, choosing EVAR over OR in treating AAA patients must factor in a patient's overall health, anatomical considerations, and the probability of long-term success.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592200","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":"'Virtual Mentorship is a No-Brainer': The Application of a Virtual Mentorship Programme for Prospective Plastic Surgery Trainees.","authors":"Lucinda Z Motie","doi":"10.7759/cureus.73047","DOIUrl":"10.7759/cureus.73047","url":null,"abstract":"<p><p>Aims This study aimed to evaluate the effectiveness of a virtual mentorship programme in plastic surgery designed for medical students and foundation doctors in the United Kingdom. The programme sought to enhance understanding of common and emergency conditions, provide guidance on the application process for speciality training, and facilitate networking opportunities. Materials and methods The programme consisted of six sessions delivered via Microsoft Teams (Microsoft® Corporation, Redmond, WA) over a four-month period from May to August 2024. Participants completed online pre- and post-mentoring questionnaires. Wilcoxon signed-rank test was used to compare paired data responses. Results Ten participants completed both questionnaires; 90% were medical students, and 10% were foundation-year doctors. There was a significant increase in the understanding of common plastic surgery conditions and emergencies (p < 0.05), as well as improved knowledge of the application processes for core surgical training (p < 0.05) and higher speciality training (p < 0.05). Interest in the speciality significantly increased (p < 0.05), and participants were more likely to seek in-person mentorship (p < 0.05). The programme was well-received, with 100% rating it as 'excellent' or 'very good'. Conclusions The virtual mentorship programme effectively enhanced foundational knowledge, career preparation, and mentor-mentee relationships. Its implementation is recommended both alone and in combination with traditional face-to-face mentorship.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590698","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":"TFE3-Rearranged Renal Cell Carcinoma With Osseous Metaplasia: A Case Report of a Rare Entity With an Unusual Finding.","authors":"Raghad A Bokhari, Ali S Al-Zughbi, Ziyad A Bokhari","doi":"10.7759/cureus.73072","DOIUrl":"10.7759/cureus.73072","url":null,"abstract":"<p><p><i>TFE3</i>-rearranged renal cell carcinoma (RCC) is a rare subtype of renal tumor that typically affects the pediatric age group. Previous exposure to chemotherapy agents increases the possibility of having this subtype. Morphologically, it displays a broad spectrum of growth patterns, but it can be distinguished by the presence of melanin pigment or psammoma bodies. Osseous metaplasia is an uncommon morphological finding in this particular subtype, and it has been reported in two cases in the literature. We describe the third case of <i>TFE3</i>-rearranged renal cell carcinoma with osseous metaplasia in a healthy 13-year-old male, presenting with worsening abdominal pain and hematuria.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585267","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":"First-Time Successful Trial Without Catheter (TWOC) After GreenLight Laser Photoselective Vaporization of the Prostate (GLL PVP) Surgery for an Enlarged Prostate.","authors":"A B Azharul Islam, Maisha Zaman Poushi","doi":"10.7759/cureus.72982","DOIUrl":"10.7759/cureus.72982","url":null,"abstract":"<p><p>Objective We aimed to assess the success rate of the GreenLight laser photoselective vaporization of the prostate (GLL PVP) procedure for enlarged prostates in patients with and without preoperative long-term catheters. Methodology A retrospective data analysis was conducted on 46 patients. Data were collected from clinical health records and radiology images. The parameters studied in this analysis included the patient's age, prostate volume, medical management before surgery, and whether the patient had a catheter or not prior to the surgery. Results A total of 46 GLL PVP surgeries were performed over a 12-month period from May 2023 to May 2024 at West Middlesex University Hospital in London. Patients had a mean age of 73.2 ± 8.12 years, and their prostate volume was 57.7 ± 25.96 cc. Before the surgery, 14 cases (30%) were using long-term catheters, and 32 cases (70%) were not. Additionally, 40 cases (87%) were receiving medical management for lower urinary tract symptoms (LUTS). After the surgery, 39 cases (85%) passed their first trial without catheter (TWOC), and seven cases (15%) failed it, regardless of whether they had used catheters before the surgery. Patients using long-term catheters before the operation had a 71% success rate in passing their first TWOC and a 29% failure rate. Conclusion Our study found that GLL PVP has a significant positive impact on elderly individuals with a large prostate volume, regardless of whether they had long-term catheters or not prior to the operation. Additionally, our findings indicate that patients without preoperative long-term catheters experience significantly better outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585262","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":"Tuberculosis of the Cuboid: A Case Report.","authors":"Samriddhi Sarkar, Vishnu Harikrishnan, Shivam Sahu","doi":"10.7759/cureus.72974","DOIUrl":"10.7759/cureus.72974","url":null,"abstract":"<p><p>Tuberculosis (TB) is a major global health concern, with skeletal TB representing a small fraction of total cases. Foot involvement is relatively uncommon in skeletal TB, and infections of the cuboid bone are especially rare. This case report describes an 18-year-old male who presented with pain and swelling in the dorsolateral left midfoot. A CT-guided biopsy and histopathological examination confirmed necrotizing granulomatous inflammation due to Mycobacterium tuberculosis. The patient was treated with a six-month course of anti-tubercular therapy (ATT) and strict non-weight-bearing protocols, leading to significant symptom improvement. This report emphasizes the importance of histopathological confirmation in diagnosing rare forms of TB and supports existing treatment protocols.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577183","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":"Comparative Outcomes of Percutaneous K-Wires Versus Plate Fixation in the Treatment of Distal Radius Fractures: A Focus on Stability in Osteoporotic Patients and Both-Bone Distal End Fractures.","authors":"Kapil Shinde, Ketan Kantamaneni, Reshmitha Kantamneni, Emad Ahmed, Muhammad Asad Arif, Sravan Sanka, Salih Seidahmed, Christopher James","doi":"10.7759/cureus.72981","DOIUrl":"10.7759/cureus.72981","url":null,"abstract":"<p><p>Background Distal radius fractures (DRFs) are commonly treated with percutaneous K-wire or plate fixation. The relative efficacy and stability of these methods, particularly in osteoporotic patients and in cases involving both distal radius and ulna fractures, remain subjects of clinical debate. Objective This study aims to compare the outcomes of percutaneous K-wire fixation versus plate fixation in patients with distal end radius fractures, focusing on postoperative stability in osteoporotic conditions and both-bone distal end fractures. Methods A total of 50 patients were retrospectively analysed and divided into two groups: 25 underwent percutaneous K-wire fixation, and 25 underwent plate fixation. Outcomes measured included bone healing time, complication rates, functional recovery using the DASH score, and radiological outcomes through standard X-ray imaging. Results Preliminary data suggest that plate fixation offers better stability, especially in osteoporotic patients and cases with both-bone involvement. Complications with K-wire fixation were more frequent in these subgroups. Conclusion Plate fixation may provide superior stability and functional outcomes in treating DRFs, particularly in complex cases involving osteoporosis or bone injuries. Further research with larger sample sizes and prospective design is recommended.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577269","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 Frequency of Occurrence of Strabismus in Infants Post Lensectomy.","authors":"Jonas Akambase, Michael Barkley, Richa Sharma, Ann Webber, Shuan Dai","doi":"10.7759/cureus.73024","DOIUrl":"10.7759/cureus.73024","url":null,"abstract":"<p><p>Purpose To identify and characterize incident cases of strabismus and interocular visual acuity among infants post lensectomy for congenital cataract. Method This was a single-centre retrospective chart review of all children aged less than 12 months who underwent lensectomy from 1st January 2014 to 1st January 2021. Cases were identified from theatre coding and electronic medical records. Cases with strabismus prior to cataract surgery were excluded. Results Seventy-five children (114 aphakic eyes) were included, 36 (48%) had unilateral cataract surgery while 39 (52%) had bilateral. The mean age at the time of cataract surgery was 3.0±2.5 months (range 1 - 10 months). The mean follow-up period was 41.2±22.8 months (range 2 -72 months). Nineteen out of 75 patients (25%) developed strabismus, most of whom (18 cases) had unilateral surgery. Out of the 19 strabismus cases recorded, esotropia was reported in 74% of the cases, followed by exotropia -16%, while esotropia associated with dissociated vertical deviation (DVD) and esotropia associated with inferior oblique each made up 5% of the population. Most children who developed strabismus [17 patients (89.5%)] had lensectomy prior to 6 months of age. A significant difference of 0.65 logMAR was recorded in the interocular visual acuity (IOVA) difference between the strabismic and non-strabismic groups, and the unilateral and bilateral lensectomy groups. Conclusion Strabismus, most commonly esotropia, is common after congenital lensectomy, particularly in those children who underwent unilateral cataract surgery, and in those less than 6 months of age. Monitoring IOVA and strabismus incidence post-cataract surgery is crucial for early intervention and amblyopia prevention.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585282","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":"Licorice Toxicity Presenting As Refractory Hypokalemia and Hypertension in an Elderly Patient.","authors":"Rand Albahlawan, Mohamed Alafifi, Vanessa Ambrose Fistus","doi":"10.7759/cureus.72975","DOIUrl":"10.7759/cureus.72975","url":null,"abstract":"<p><p>Licorice toxicity can present with a triad of severe hypokalemia, metabolic alkalosis, and hypertension, particularly in elderly patients. We present the intriguing case of a 78-year-old male who was referred for evaluation of refractory hypokalemia and newly developed hypertension. Despite an unremarkable systemic review and minimal symptoms, a detailed dietary history revealed significant daily consumption of licorice, initially believed by the patient to support smoking cessation. Laboratory investigations confirmed the classic biochemical profile of licorice toxicity, characterized by suppressed aldosterone and renin levels, effectively differentiating it from other conditions such as Conn's syndrome. This case underscores the diagnostic challenges posed by licorice toxicity, emphasizing the importance of a thorough clinical evaluation and awareness of dietary factors that may contribute to significant health impacts. Recognizing licorice toxicity can prevent unnecessary interventions and guide appropriate management strategies. By shedding light on this uncommon condition, we aim to enhance recognition among clinicians, avoid unnecessary interventions, and improve patient outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577273","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":"Beyond the Sinus: Unmasking Pott's Puffy Tumor Through Imaging.","authors":"Aashna Sikka, Ashwin Bobby, Rakesh Gali","doi":"10.7759/cureus.73000","DOIUrl":"10.7759/cureus.73000","url":null,"abstract":"<p><p>Pott's puffy tumor (PPT) is a rare yet severe complication of frontal sinusitis, characterized by localized forehead swelling resulting from osteomyelitis and subperiosteal abscess formation. This case report discusses a 15-year-old male patient who initially presented with upper respiratory tract symptoms. These progressed to seizures, leading to the identification of extensive sinusitis and significant intra-cranial complications. The case emphasizes the benefits of integrating multiple imaging modalities to improve diagnoses and patient care. Imaging findings facilitated early diagnosis and prompted urgent referrals to pediatric neurosurgery and otorhinolaryngology, allowing for timely surgical interventions which were vital in preventing further morbidity. This report underscores the importance of a multidisciplinary team approach in managing complex conditions like PPT, ensuring comprehensive care and optimal patient outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577266","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}