Cureus最新文献

{"title":"Biofilm and Antibiotic Resistance Study of Bacteria Involved in Nosocomial Infections.","authors":"Nihal Ezzariga, Oumaima Zouhari, Amal Rhars, Zohra Lemkhente, Mohamed Aghrouch","doi":"10.7759/cureus.78673","DOIUrl":"10.7759/cureus.78673","url":null,"abstract":"<p><p>Nosocomial infections are increasingly problematic due to growing bacterial resistance. Biofilms play a key role in the persistence of these infections, leading to treatment failures and poor patient outcomes. Addressing antibiotic resistance within biofilms is especially critical in hospitals, making it essential to develop new strategies to manage biofilm-related infections and curb bacterial resistance. The study, conducted at the regional hospital center in Agadir, Morocco, analyzed 75 bacteria (37 antibiotic-sensitive and 38 resistant). Seven bacteria were isolated from catheters, and others from preserved samples. Biofilm formation was assessed using the tissue culture plate (TCP) method, involving strain recovery; culture on cystine, lactose, electrolyte-deficient (CLED) medium; microplate inoculation; staining with crystal violet; and optical density (OD) measurement. The results showed that 77.33% of the bacteria formed biofilms. All catheter-isolated bacteria showed biofilm formation. Strong biofilm production was observed in 66.67% of <i>Acinetobacter baumannii</i> and in most <i>Pseudomonas aeruginosa</i> strains. <i>Enterobacteriaceae</i> also demonstrated significant biofilm formation. Notably, 70% of carbapenem-resistant bacteria showed strong biofilm production. Most nosocomial bacteria form biofilms, with a higher prevalence in antibiotic-resistant strains. Sensitive bacteria also form biofilms but less frequently. Bacterial conjugation may facilitate the acquisition of carbapenem resistance within biofilms.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78673"},"PeriodicalIF":1.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384437","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 Locked Door: Hikikomori Through a Clinical Lens.","authors":"Luís Paulino Ferreira, Margarida Magalhaes, Maria Miguel Figueiredo, Ema Conde","doi":"10.7759/cureus.78600","DOIUrl":"10.7759/cureus.78600","url":null,"abstract":"<p><p>Hikikomori, first identified in Japan, refers to individuals who withdraw from society and confine themselves to their homes, often remaining isolated in their bedrooms. Those affected typically disengage from education, employment, and daily activities, leading to significant functional impairment. While initially considered a culture-bound syndrome, growing evidence in recent decades suggests that hikikomori is a global phenomenon. Individuals with this condition often come into contact with healthcare systems through legal interventions. Here, we present two cases of Portuguese males with hikikomori syndrome who have committed sexual crimes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78600"},"PeriodicalIF":1.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384434","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":"Challenges in Managing Rebleeding After Endoscopic Hemostasis With Over-the-Scope Clip for Colonic Diverticular Bleeding: A Case Series.","authors":"Takashi Nishino, Chikamasa Ichita, Chihiro Sumida, Miki Nagayama, Souichirou Nakaya, Akiko Sasaki","doi":"10.7759/cureus.78641","DOIUrl":"10.7759/cureus.78641","url":null,"abstract":"<p><p>Colonic diverticular bleeding is a leading cause of lower gastrointestinal bleeding, accounting for the increasing hospitalization rate in Japan. Although over-the-scope clips (OTSCs) have demonstrated favorable outcomes as an initial hemostatic method, their effectiveness as a rescue therapy after rebleeding from primary endoscopic hemostasis remains unclear. This study describes four patients with colonic diverticular bleeding who underwent an OTSC procedure after rebleeding from primary endoscopic hemostasis using standard methods. Immediate hemostasis was achieved in all cases; however, three patients experienced rebleeding during hospitalization, requiring interventional radiology or surgical intervention. Although immediate hemostasis can be achieved using OTSCs in cases of rebleeding after primary endoscopic hemostasis, their effectiveness in reducing short-term rebleeding might be limited. Further large-scale studies are warranted to evaluate OTSC efficacy in managing colonic diverticular bleeding after rebleeding from primary endoscopic hemostasis.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78641"},"PeriodicalIF":1.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384439","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 Assessment of the Prevalence of Impacted Third Molars, Its Relation to Space Available for Eruption, and Its Effect on the Adjacent Second Molar in Adults From 18 to 65 Years of Age Using Orthopantomograms: A Retrospective Cross-Sectional Study.","authors":"Janhavi D Modi, Shikha A Gala, Himanshi A Dave, Shreyas H Gupte, Shruti Singh","doi":"10.7759/cureus.78608","DOIUrl":"10.7759/cureus.78608","url":null,"abstract":"<p><p>Introduction Third molar impaction surgeries are part of the most common minor oral surgeries performed by maxillofacial surgeons. In spite of being part of the everyday evaluation, the importance of preoperative planning and intraoperative and postoperative complications cannot be overlooked. This study aims to evaluate the prevalence, patterns, available eruption space, and impact of third molar impaction on the adjacent second molar in an adult population. Methods A retrospective observational cross-sectional study was conducted over a total of 380 panoramic radiographs from patients aged 18-65 years, which was analyzed to assess the incidence, angulation, and space available for the eruption of impacted third molars and their effects on the adjacent second molars. Orthopantomograms (OPGs) from January 2023 to December 2023 were included in the study. A total of 1280 third molars from 380 OPGs were studied encompassing an extensive range of demographics. Results The results showed that 54.7% (208/380) of the studied population had at least one impacted third molar, with a higher prevalence in the mandibular arch. Vertical impaction was the most common pattern (224/419, 53.46%), followed by mesioangular (92/419, 21.95%), horizontal (85/419, 20.28%), and distoangular (18/419, 4.29%) impactions. Notably, the study found a relevant association between impacted third molars and the development of distal caries in the adjacent second molar (76/419, 18.13%). These findings highlight the importance of early radiographic evaluation of impacted third molars to prevent potential damage to adjacent teeth and inform clinical decisions regarding the management of such cases. The study also highlights that there is a significant amount of third molar impaction seen in women (211/380, 55.52%) compared to men, and the age group range with the highest incidence of third molar impaction is 18-25 years (399/1280, 31.20%). Additionally, a significant number of mandibular impacted third molars present with some level of nerve involvement, whereas more than 80% of maxillary impacted third molars showed sinus approximation. This study also presents a novel concept of \"eruption space ratio,\" which is the ratioof the mesiodistal width of the crown of the third molar to the space available posterior to the second molar for eruption. When it was compared to the angulation, a substantial link was seen, although none was seen in relation to the level of impaction. Conclusion This study underlines the need for proactive dental care in populations with a high prevalence of third molar impaction, aiming to mitigate the risks to the adjacent second molars and to eliminate possible postoperative complications through timely intervention.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78608"},"PeriodicalIF":1.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367049","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":"Retraction: Utilizing Artificial Intelligence Among Patients With Diabetes: A Systematic Review and Meta-Analysis.","authors":"Abdullah Alhalafi, Saif M Alqahtani, Naif A Alqarni, Amal T Aljuaid, Ghade T Aljaber, Lama M Alshahrani, Hadeel Mushait, Partha A Nandi","doi":"10.7759/cureus.r168","DOIUrl":"https://doi.org/10.7759/cureus.r168","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.58713.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"r168"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366967","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":"Full-Mouth Disinfection Using Oral Sitafloxacin for Stage III and IV Grade C Periodontitis With High Bacterial Load: A Case Series.","authors":"Satoru Morikawa, Takazumi Yasui, Taneaki Nakagawa","doi":"10.7759/cureus.78531","DOIUrl":"10.7759/cureus.78531","url":null,"abstract":"<p><p>This case series presents a novel treatment approach for severe periodontitis with high bacterial loads in four patients (aged 32-47 years), including three cases of stage III and one case of stage IV, grade C periodontitis. After conventional scaling and root planing failed in one case, we developed a protocol combining full-mouth disinfection (FMD) with oral sitafloxacin (STFX) for cases with high levels of subgingival periodontal pathogens. FMD involved thorough debridement within 1 week, with STFX (100 mg/day) administered for 7 days. Clinical and microbiological parameters were evaluated before and after treatment. The results showed marked improvements in probing pocket depth, bleeding on probing, and inflamed periodontal surface area, with substantial reductions in red complex bacteria. This approach often eliminates the need for periodontal surgery, even in deep pockets, suggesting FMD with STFX as an effective nonsurgical alternative for severe periodontitis with significant bacterial load.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78531"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384440","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":"Safety of Compounded Medications.","authors":"Rohini Garg, Harmit Singh","doi":"10.7759/cureus.78541","DOIUrl":"10.7759/cureus.78541","url":null,"abstract":"<p><p>Compounded medications are medications that are prepared by compounding pharmacies to meet individual patients' needs that cannot be met by FDA-approved brand name or generic medications. This may be the case when a patient needs a different dose or route of administration or if a patient is allergic to a certain ingredient in an FDA-approved medication. While compounded medications help to fill a necessary gap, they can have significant safety issues. Due to lesser regulatory oversight, patient safety may be compromised due to contamination or inaccurate potency of compounded medications. Compounded medications should be prescribed only when an FDA-approved medication cannot be used, and the benefits outweigh the risks. Enforcement of adequate oversight by regulatory agencies and maintenance of strict safety precautions at the compounding facilities are needed to ensure patient safety.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78541"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256488","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":"Two Cases of Prurigo Nodularis in Hematologic Malignancies: Hodgkin Lymphoma and Waldenström Macroglobulinemia.","authors":"Filipa Reis, Francisca Sarmento, Sara Sarmento, Marta Freixa","doi":"10.7759/cureus.78540","DOIUrl":"10.7759/cureus.78540","url":null,"abstract":"<p><p>Prurigo nodularis (PN) is a chronic inflammatory skin disorder marked by intense itching and firm, pruritic nodules, often linked to dermatologic, autoimmune, or systemic conditions, including malignancies such as hematologic cancers. We present two cases illustrating PN as a potential cutaneous manifestation of hematologic malignancies: a 48-year-old male with a history of psoriasis and persistent pruritus misdiagnosed as scabies, later found to have Hodgkin lymphoma, and an 86-year-old female with fatigue, anemia, and erythematous lesions diagnosed with Waldenström macroglobulinemia. These cases underscore the importance of recognizing PN as a symptom of underlying malignancy, enabling earlier diagnosis and treatment to improve outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78540"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257277","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":"Disseminated Histoplasmosis as a Presentation of Advanced HIV-1 Infection in a Non-endemic Country.","authors":"Débora A Alves, João Trêpa, José Sousa-Baptista, João Pereira-Vaz, Rui Tomé","doi":"10.7759/cureus.78581","DOIUrl":"10.7759/cureus.78581","url":null,"abstract":"<p><p>Disseminated histoplasmosis is an opportunistic fungal infection considered an AIDS-defining illness, sometimes with a fatal outcome. We report a case of disseminated histoplasmosis as the initial presentation of advanced HIV-1 infection in a migrant living in a non-endemic area. Histoplasmosis was suspected based on the clinical presentation, epidemiological factors, and observation in the peripheral blood smear of neutrophils and monocytes with yeast-like forms. The diagnosis was confirmed through a positive peripheral blood smear and subsequent culture of <i>Histoplasma capsulatum</i> from a bronchoalveolar lavage sample. The patient was treated with 14 days of liposomal amphotericin B plus oral itraconazole for two years, with a good response. Direct examination of peripheral blood has been considered a valuable diagnostic method, specifically in severely immunocompromised patients, as our case report. The presented case highlights the importance of considering disseminated histoplasmosis in the differential diagnosis of HIV-infected patients, even in non-endemic regions. Hence, the need for a high index of suspicion to ensure early diagnosis and treatment is crucial as the influx of migrants increases globally.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78581"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366981","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":"Interactions Between Anesthesia and Sleep: Optimizing Perioperative Care to Improve Sleep Quality and Surgical Recovery Outcomes.","authors":"Sahil Patel, Raymond Ownby","doi":"10.7759/cureus.78505","DOIUrl":"10.7759/cureus.78505","url":null,"abstract":"<p><p>Sleep is a fundamental physiological process that supports immunity, cognition, memory, and metabolism, making it essential for overall health and well-being. Poor-quality sleep is associated with the onset of many diseases, including cardiovascular and mental health disorders. When using anesthesia, it is essential to have a thorough understanding of the metabolic dysfunction and immunosuppression linked to sleep loss to ensure appropriate perioperative management. Commonly used agents like propofol, sevoflurane, and ketamine affect consciousness, pain levels, and autonomic responses. Inhaled anesthetics (e.g., sevoflurane and isoflurane) and intravenous anesthetics (propofol) act on gamma-aminobutyric acid (GABA) receptors and influence stages of sleep and circadian rhythms. Ketamine may uniquely preserve some aspects of restorative sleep, while most anesthetics affect rapid eye movement (REM) and slow wave sleep (SWS), altering cognitive and physical recovery. Modifying anesthetic regimes depending on the patient's sleep history and risk factors can maximize sleep health and postoperative patient outcomes. The physiological effects of anesthesia on the central nervous system persist beyond the perioperative period by influencing sleep quality, circadian regulation, and postoperative outcomes. Effective pain management is a significant component in addressing sleep quality. Opioids, while effective for pain relief, disrupt sleep architecture by reducing REM and SWS, increasing awakening frequency, and potentially causing respiratory depression. Multimodal pain therapy, including non-opioid analgesics, can reduce dependence, improve sleep quality, and lower adverse effects. Anesthetic agents can influence the body's internal clock, leading to mood changes, fatigue, and cognitive deficits. This review exploits the relationship between sleep and anesthesia, detailing the effect of anesthetic agents on the quality, architecture, and recovery of sleep patterns post-surgery. It also explores how these agents influence sleep stages, such as REM and non-REM sleep, and their implications for patient outcomes. Incorporating sleep optimization techniques can enhance recovery timelines and patient well-being. Researching anesthetic techniques that support postoperative sleep health is essential for further improving patient outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78505"},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191343","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}