Cureus最新文献

{"title":"Prevalence and Risk Factors of Dry Eye Syndrome Among Medical Students in the Northern Philippines: A Cross-Sectional Survey.","authors":"Mary Arsenia N Mondiguing, Karl Coycoyen, Monique Goygoyan, Jay Adrian Taguiling, Kc Chakiwag, Winston Calde, Kiarei Dao-Ayan, Clar Renzel Bombase, Mark Rigor, Athena May Catores","doi":"10.7759/cureus.86740","DOIUrl":"10.7759/cureus.86740","url":null,"abstract":"<p><p>Introduction Dry eye syndrome (DES) accounts for the majority of ophthalmological consultations and should be considered a high-priority health concern. DES can be progressive and has significant consequences for an individual's vision and quality of life. This study aims to fill the information gap regarding the prevalence and risk factors of DES among medical students at Saint Louis University (SLU) in the northern part of the Philippines during the \"New Normal\" period. Methods A cross-sectional survey was conducted among 236 medical students. The dependent variable, the Ocular Surface Disease Index (OSDI), and independent variables were assessed using a questionnaire created with Google Forms (Google, Inc., Mountain View, CA). The Perceived Stress Scale-4 (PSS-4) was used to determine the level of stress of the students. Descriptive and analytical statistics were used to determine the risk factors associated with the OSDI scores of the participants. Results The prevalence of DES, as determined by the OSDI questionnaire, was 194 out of 236 (82.20%). The mean OSDI score of the cohort was 30.16 ± 6.99, with a 95% confidence level. This study revealed that the factors of sex, error of refraction (EOR), and psychological stress showed significant correlations with the OSDI score, as determined by Chi-square analysis with p-values of 0.013, 0.001, and 0.006, respectively. The female sex and those with errors of refraction (EOR) had a higher risk of developing DES. There is also a direct relationship between psychological stress and DES. The higher the perceived psychological stress, the higher the OSDI score. Psychological stress among the students was at 231/236 (97.87%). Conclusion Dry eye syndrome is increasingly recognized as a significant health issue among young individuals due to the increasingly demanding nature of their lifestyles. This study identified a high prevalence of dry eye syndrome among medical students with female sex, error of refraction, and a high level of perceived stress as the significant risk factors. A longitudinal study involving different medical schools in the country, including clinical tests for DES, is recommended to better elucidate the relationship among the various risk factors. The results of this study serve as a basis for crafting policies to increase awareness, modify risk factors, and implement appropriate preventive measures.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86740"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499895","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":"Simplified Algorithm for Determining Value-Based Pricing of High-Tech Medical Devices in the Tuscany Region of Italy.","authors":"Andrea Messori, Beatrice Tognarelli, Janette Monzillo, Sabrina Trippoli","doi":"10.7759/cureus.86743","DOIUrl":"10.7759/cureus.86743","url":null,"abstract":"<p><p>In Europe, value-based pricing (VBP) is widely used for pharmaceuticals but less frequently for medical devices. Medical device prices are generally set at the regional level and rarely at the national level. Therefore, a simple algorithm for estimating VBP can be useful. In Tuscany (a region with 3.7 million inhabitants), prices for high-tech medical devices have been set by a regional organization since 2018. These prices represent a mandatory condition for purchasing these devices but are generally determined empirically. In this context, we present a simplified algorithm for VBP estimation, which we have applied retrospectively to devices approved in the first half of 2024. The algorithm is based on the primary clinical endpoint used in the device studies and on health-care costs. It represents a modified version of the previously described added therapeutic value (ATV) model. To analyze the results of our experience, we performed a correlation analysis between VBPs and real prices. Our algorithm was applied to 17 devices. In 13 cases, the VBP could be estimated, while in the remaining four cases, the algorithm failed. In cases where the calculation was successful, the correlation between VBP and real prices was highly significant (R²=0.929; 95% confidence interval (CI), 0.7747 to 0.9789; p<0.001). In our previous experiences between 2019 and 2023, we attempted to apply a complete economic analysis to 239 newly approved devices and found that such an analysis was unfeasible in 80% of the cases. This simplified algorithm can be useful to determine a preliminary estimate of VBP when a more complete economic analysis is unfeasible.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86743"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510009","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":"Outcome of Pulmonary Large Cell Neuroendocrine Carcinoma After Definitive Treatment: A Single-Center Retrospective Review.","authors":"Leone Sutanto, Ka Man Cheung, Chung Hang James Chow, Ho Yin Harry Yiu","doi":"10.7759/cureus.86698","DOIUrl":"10.7759/cureus.86698","url":null,"abstract":"<p><p>Introduction Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive form of lung cancer. Given its poor prognosis and limited representation in clinical trials, the optimal treatment strategy remains undefined. This study aims to evaluate treatment modalities and clinical outcomes among LCNEC patients who received definitive treatment. Methods A retrospective review was conducted for patients diagnosed with LCNEC from 2000 to 2022 in a tertiary center. Clinical characteristics, staging, treatment modalities, molecular testing, and survival outcomes were collected. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier estimates. Results Twenty-seven patients were included. The median age was 69.6 years; most were male (92.6%) and smokers (92.6%). Distribution by stage was as follows: I (29.6%), II (22.2%), and III (48.1%). Surgery was performed in 77.8%, and 33.3% received chemoradiotherapy. Adjuvant platinum-etoposide chemotherapy was administered in 42.8% of surgical cases. With a median follow-up of 75.9 months, the median PFS and OS were 9.6 and 20.8 months, respectively. The median OS by stage was as follows: I (30.2 months), II (23.5 months), and III (14.9 months). The recurrence rate was high (85.2%), with distant relapse being the most common (63%). Locoregional control was achieved in 40.7% of patients. Actionable mutations were detected in one patient (3.7%), and comprehensive molecular testing was underutilized. Conclusion LCNEC remains a clinically aggressive tumor with poor outcomes despite definitive treatment. The high recurrence rate, particularly in advanced stages, highlights the need for improved systemic strategies. Broader adoption of molecular profiling may uncover therapeutic targets and support the integration of emerging treatments, including immunotherapy.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86698"},"PeriodicalIF":1.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510007","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":"Improving Acute Care Preparedness Amongst Medical Students: A Systematic Review.","authors":"Haider Merchant, Joanna Tarr","doi":"10.7759/cureus.86688","DOIUrl":"10.7759/cureus.86688","url":null,"abstract":"<p><p>Evidence suggests that there is inadequate preparation for acute care within the undergraduate medical curriculum. Although previous attempts have been made to address this concern, a lack of formal evaluation of intervention effectiveness limits their utility. This review aimed to identify educational interventions seeking to prepare medical students for acute care and evaluate their effectiveness. MEDLINE, CENTRAL, Embase, Scopus and Web of Science were systematically searched. Primary research studies published between 2000 and 2020 and reporting changes in outcomes related to medical student preparation for acute care were included. Study outcomes were described as either highly effective, effective, ineffective, negative or variable. Study quality was appraised using the Medical Education Research Study Quality Instrument (MERSQI). Studies with an MERSQI score of ≥14 were classed as high-quality. Overall, 72 studies were included in this review. The majority were single-group pre- and post-test studies (n=39, 54.2%) and none measured changes in student behaviour or patient/healthcare outcomes. Courses, clerkships, and simulation were found to be the most effective interventions. All Clerkship studies measuring improvements in acute care skills were effective or highly effective. Mean MERSQI score was 12.4 (range=7.8-15.5, SD=1.7) and 18 studies (25%) were classed as high-quality. This review favours the use of clerkships, as well as courses and simulation. However, considerable heterogeneity and numerous study limitations prevent firm conclusions from being drawn. Future high-quality studies, especially those measuring behavioural changes and patient/healthcare outcomes, are subsequently needed. Reviews with a more focused area of research, those assessing long-term outcomes and cost-effectiveness, would additionally prove beneficial.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86688"},"PeriodicalIF":1.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499893","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 Rare Case of Lambert-Eaton Myasthenia Syndrome With Dysphasia and Dysarthria.","authors":"Hridya Harimohan, Mia Yasonova, Marah Sukkar, Katayoun Sabetian","doi":"10.7759/cureus.86700","DOIUrl":"10.7759/cureus.86700","url":null,"abstract":"<p><p>Lambert-Eaton Myasthenic Syndrome (LEMS) is a rare autoimmune disorder resulting in muscle weakness. LEMS typically presents with progressive proximal muscle weakness, especially in the lower extremities, areflexia, and autonomic dysfunction. Bulbar involvement and respiratory compromise tend to occur later in the disease course and usually in severe, advanced cases. We report a unique case of a 50-year-old male with a known history of LEMS, autoimmune retinopathy, erectile dysfunction, and prediabetes who presented with progressive bulbar symptoms - slurred speech and difficulty swallowing - without accompanying weakness in the upper or lower extremities. Despite receiving four doses of intravenous immunoglobulin (IVIG) prior to admission with no improvement, he showed a significant clinical response to six sessions of plasmapheresis. Notably, the absence of limb weakness and preserved motor strength throughout his hospital stay raised diagnostic uncertainty, prompting evaluation for myasthenia gravis, which was ruled out through negative acetylcholine receptor antibody testing and reaffirmed voltage-gated calcium channel (VGCC) antibody positivity. Chest imaging showed no underlying malignancy. This case illustrates an atypical LEMS presentation dominated by severe bulbar dysfunction in the absence of limb involvement or respiratory failure, which is uncommon and may mimic other neuromuscular junction disorders such as myasthenia gravis. The favorable response to plasmapheresis emphasizes the importance of early recognition and aggressive immunomodulatory treatment in preventing clinical deterioration. Clinicians should maintain a high index of suspicion for LEMS even in unusual presentations to ensure timely and appropriate management.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86700"},"PeriodicalIF":1.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510006","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":"Diagnostic Performance of ChatGPT-4o in Detecting Hip Fractures on Pelvic X-rays.","authors":"Turgut Emre Erdem, Alper Kirilmaz, Ahmet Fevzi Kekec","doi":"10.7759/cureus.86654","DOIUrl":"10.7759/cureus.86654","url":null,"abstract":"<p><strong>Introduction: </strong>Hip fractures are a major orthopedic problem, especially in the elderly population. Hip fractures are usually diagnosed by clinical evaluation and imaging, especially X-rays. In recent years, new approaches to fracture detection have emerged with the use of artificial intelligence (AI) and deep learning techniques in medical imaging. In this study, we aimed to evaluate the diagnostic performance of ChatGPT-4o, an artificial intelligence model, in diagnosing hip fractures.</p><p><strong>Methodology: </strong>A total of 200 anteroposterior pelvic X-ray images were retrospectively analyzed. Half of the images belonged to patients with surgically confirmed hip fractures, including both displaced and non-displaced types, while the other half represented patients with soft tissue trauma and no fractures. Each image was evaluated by ChatGPT-4o through a standardized prompt, and its predictions (fracture vs. no fracture) were compared against the gold standard diagnoses. Diagnostic performance metrics such as sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curve, Cohen's kappa, and F1 score were calculated.</p><p><strong>Results: </strong>ChatGPT-4o demonstrated an overall accuracy of 82.5% in detecting hip fractures on pelvic radiographs, with a sensitivity of 78.0% and specificity of 87.0%. PPVs and NPVs were 85.7% and 79.8%, respectively. The area under the ROC curve (AUC) was 0.825, indicating good discriminative performance. Among 22 false-negative cases, 68.2% were non-displaced fractures, suggesting the model had greater difficulty identifying subtle radiographic findings. Cohen's kappa coefficient was 0.65, showing substantial agreement with actual diagnoses. Chi-square analysis revealed a strong correlation (χ² = 82.59, <i>P</i> < 0.001), while McNemar's test (<i>P</i> = 0.176) showed no significant asymmetry in error distribution.</p><p><strong>Conclusions: </strong>ChatGPT-4o shows promising accuracy in identifying hip fractures on pelvic X-rays, especially when fractures are displaced. However, its sensitivity drops significantly for non-displaced fractures, leading to many false negatives. This highlights the need for caution when interpreting negative AI results, particularly when clinical suspicion remains high. While not a replacement for expert assessment, ChatGPT-4o may assist in settings with limited specialist access.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86654"},"PeriodicalIF":1.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487554","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":"Acute Respiratory Failure and Metabolic Acidosis Due to Excessive Normal Saline Absorption During Hysteroscopic Myomectomy: A Case Report.","authors":"Haruka Naiki, Shinji Sugita","doi":"10.7759/cureus.86591","DOIUrl":"10.7759/cureus.86591","url":null,"abstract":"<p><p>Hysteroscopic myomectomy commonly employs fluid irrigation to maintain visualization of the uterine cavity, with normal saline often used as the distension medium due to its favorable safety profile. However, significant intravascular absorption of isotonic fluids can result in life-threatening complications. We report a case of acute respiratory failure and severe hyperchloremic metabolic acidosis caused by excessive absorption of normal saline during hysteroscopic myomectomy. The patient required mechanical ventilation and intensive care but recovered fully with timely and appropriate management. This case underscores the need for vigilant fluid balance monitoring during hysteroscopic procedures, even when isotonic irrigation solutions are used.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86591"},"PeriodicalIF":1.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487552","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 Narrative Review of Selective Versus Routine Histopathological Examination of Gallbladders in Low-Risk Patients.","authors":"Sathyaseelan Arumugam, Shaurya Aggarwal","doi":"10.7759/cureus.86609","DOIUrl":"10.7759/cureus.86609","url":null,"abstract":"<p><p>Gallbladder diseases are common surgical conditions that often necessitate a cholecystectomy. Traditionally, gallbladder specimens are sent for routine histopathological examination to detect incidental gallbladder carcinoma (IGBC). However, the need for this in low-risk patients remains a subject of debate, particularly considering the low incidence of IGBC and the strain on pathology services. This narrative review aimed to compare selective versus routine histopathological examination of gallbladder specimens in low-risk patients undergoing cholecystectomy. This review complies with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted for studies between 2000 and 2022 across PubMed, Scopus, Embase, Web of Science, Cochrane Library, and ScienceDirect. Included studies involved patients with low preoperative suspicion of malignancy who were later diagnosed with gall bladder cancer via either routine or selective histopathological examination. Sixteen studies met the inclusion criteria. Studies supporting selective histopathology reported that all cases of IGBC were suspected either preoperatively on imaging or intraoperatively based on macroscopic features. In contrast, studies advocating routine histology identified significant numbers of IGBC in patients with no intraoperative suspicion, including some with advanced-stage disease. These findings suggest that while selective examination may be safe in low-incidence regions with experienced surgical assessment, routine histology remains a more sensitive method in other areas. Selective histopathological examination of gall bladder specimens may be considered in carefully selected low-risk patients, provided a thorough intraoperative evaluation is performed. However, routine examinations remain important in regions with higher disease prevalence.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86609"},"PeriodicalIF":1.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478264","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":"Effective Management of Transuretero-Ureterocutaneostomy (TUUC)-Related Stenosis Using a Combined Antegrade and Retrograde Approach With Holmium Laser Endoureterotomy: A Case Report.","authors":"Indrawarman Soerohardjo, Ahmad Zulfan Hendri, Ahmad Shafwan Natsir, Narpati Wesa Pikatan, Toni Febriyanto","doi":"10.7759/cureus.86594","DOIUrl":"10.7759/cureus.86594","url":null,"abstract":"<p><p>Bladder cancer (BC) is the seventh most common cancer globally, with significant morbidity and mortality. Radical cystectomy is the primary treatment for muscle-invasive bladder cancer (MIBC), often followed by urinary diversion techniques such as transuretero-ureterocutaneostomy (TUUC). While TUUC can be an effective alternative to urinary diversions, it is associated with complications, including anastomotic stenosis. A 60-year-old male with BC underwent radical cystectomy followed by TUUC. Postoperatively, the patient developed anastomotic stenosis, initially managed with stent placement. However, left flank pain and oliguria persisted, and imaging revealed grade 2 left hydronephrosis and elevated creatinine levels. Two operators performed the procedure, using antegrade access percutaneously as a guiding approach and retrograde access through the TUUC orifice to perform the holmium laser endoureterotomy. The holmium laser endoureterotomy was successfully performed using a dual-access technique, combining both antegrade and retrograde approaches to enhance precision and minimize tissue damage. Post-procedure, the patient experienced significant relief from symptoms, and renal function improved markedly, with decreased creatinine levels. This case underscores the effectiveness of a combined approach of holmium laser endoureterotomy in managing TUUC-related stenosis. It offers a minimally invasive solution for maintaining patency and enhancing patient outcomes after complex urinary diversion procedures.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86594"},"PeriodicalIF":1.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478295","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":"Axial Skeletal Assessment in Osteoporosis Using Radiofrequency Echographic Multi-spectrometry: Diagnostic Performance, Clinical Utility, and Future Directions.","authors":"Mohammed As'ad","doi":"10.7759/cureus.86625","DOIUrl":"10.7759/cureus.86625","url":null,"abstract":"<p><p>Osteoporosis, a prevalent skeletal disorder, necessitates accurate and accessible diagnostic tools for effective disease management and fracture prevention. While dual-energy X-ray absorptiometry (DXA) remains the clinical standard for bone mineral density (BMD) assessment, its limitations, including ionizing radiation exposure and susceptibility to artifacts, underscore the need for alternative technologies. Ultrasound-based methods have emerged as promising radiation-free alternatives, with radiofrequency echographic multi-spectrometry (REMS) representing a significant advancement in axial skeleton assessment, specifically at the lumbar spine and proximal femur. REMS analyzes unfiltered radiofrequency ultrasound signals, providing not only BMD estimates but also a novel fragility score (FS), which reflects bone quality and microarchitectural integrity. This review critically evaluates the underlying principles, diagnostic performance, and clinical applications of REMS. It compares REMS with DXA, quantitative computed tomography (QCT), and trabecular bone score (TBS), highlighting REMS's potential advantages in artifact-prone scenarios and specific populations, including children and patients with secondary osteoporosis. The clinical utility of REMS in fracture risk prediction and therapy monitoring is explored alongside its operational precision, cost-effectiveness, and portability. In addition, the integration of artificial intelligence (AI) within REMS software has enhanced its capacity for artifact exclusion and automated spectral interpretation, improving usability and reproducibility. Current limitations, such as the need for broader validation and guideline inclusion, are identified, and future research directions are proposed. These include multicenter validation studies, development of pediatric and secondary osteoporosis reference models, and deeper evaluation of AI-driven enhancements. REMS offers a compelling, non-ionizing alternative for axial bone health assessment and may significantly advance the diagnostic landscape for osteoporosis care.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86625"},"PeriodicalIF":1.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487553","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}