Cureus最新文献

{"title":"Artificial Intelligence in Electrocardiography: From Automated Arrhythmia Detection to Predicting Hidden Cardiovascular Disease.","authors":"Ramy Elantary, Samar Othman","doi":"10.7759/cureus.94065","DOIUrl":"10.7759/cureus.94065","url":null,"abstract":"<p><p>Cardiovascular diseases are among the most prevalent and deadly diseases affecting humans. The most widely used diagnostic tool to interrogate cardiovascular physiology and function is an electrocardiogram (ECG). Despite its widespread availability and use, the ECG is subject to interobserver variability and suboptimal sensitivity for asymptomatic or early-stage disease. Artificial intelligence (AI), particularly deep learning (DL) approaches, has provided a suite of methods to improve both the diagnostic and prognostic utility of the ECG in multiple cardiovascular domains. AI-enabled automated ECG interpretation (most commonly using convolutional neural networks (CNNs)) has reached and even surpassed expert-level performance for arrhythmia detection and classification. Additional data-driven approaches to ECG analysis have identified paroxysmal atrial fibrillation from a record of sinus rhythm ECGs, identified left ventricular systolic dysfunction, and predicted cardiac structure and ischemic burden (e.g., acute coronary syndromes). Pragmatic implementation has demonstrated higher diagnostic yield for asymptomatic left ventricular dysfunction in the primary care setting (EAGLE). Other emerging indications include expanded data-derived outputs, such as electrolyte disturbances, biological age, and cardiovascular risk prediction. Despite a growing list of promising applications, numerous translational hurdles remain before routine implementation. Generalizability is limited due to differences in training and target populations. Bias related to sex, race, and comorbidities is an important limiting factor to fair and equitable implementation. Other considerations include \"black box\" concerns with DL, clinical interpretability and adoption, medicolegal liability, and integration with clinical workflows and infrastructure. Related to these factors, data privacy, algorithmic fairness, accountability, and transparency are important to consider as AI-ECG continues to undergo regulatory scrutiny and outcomes-based validation. In conclusion, AI and ECG represent a major shift towards precision cardiology by improving prediction, screening, and early detection of cardiovascular disease. We anticipate continued improvements with prospective outcome studies, transparent and explainable approaches, and careful regulatory review to ensure safe and effective implementation in the clinic.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94065"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259995","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: The Effectiveness of Anti-Interleukin-17A Treatment for Pityriasis Rubra Pilaris: A Systematic Review.","authors":"Mohammad Abduljawad, Thamer H Alsharif, Amin G Gronfula, Talah K Magadmi, Lujain I Khayat, Sarah M Fageeh, Abdulqader A Almuallim, Mohammad Ayman Mohammad, Abdullah Albadri","doi":"10.7759/cureus.c348","DOIUrl":"https://doi.org/10.7759/cureus.c348","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.41125.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"c348"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: A Systematic Review of the Need for Guideline Recommendations; Slow Tapering vs. Maintenance Dose in Long-Term Antipsychotic Treatment: 2022.","authors":"Shanthi Potla, Yousif Al Qabandi, Savitri Aninditha Nandula, Chinmayi Sree Boddepalli, Sai Dheeraj Gutlapalli, Vamsi Krishna Lavu, Rana Abdelwahab Mohamed Abdelwahab, Ruimin Huang, Pousette Hamid","doi":"10.7759/cureus.c350","DOIUrl":"https://doi.org/10.7759/cureus.c350","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.34746.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"c350"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254183","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":"Monitoring and Assessment of Jump Performance, Workload, and Injury Risk in the Romanian Under-16 Women's National Volleyball Team.","authors":"Nicolae Stanciu, Cristian Graur, Mark Slevin, Cristian Trambitas, Ioan-Bogdan Bacos, Cezara-Ilinca Stanciu, Gabriel Koszorus, Klara Brînzaniuc","doi":"10.7759/cureus.94050","DOIUrl":"10.7759/cureus.94050","url":null,"abstract":"<p><strong>Background: </strong>Volleyball requires frequent jumping, landing, and overhead movements, predisposing athletes to acute and overuse injuries. Monitoring workload and neuromuscular performance is important for optimizing performance and preventing injuries in youth athletes.</p><p><strong>Materials and methods: </strong>A retrospective observational analysis was performed using prospectively collected data from a training camp of the Romanian Under-16 (U16) women's national volleyball team. Twenty athletes were included in the study (mean age: 14.25 ± 0.72 years). Data collection consisted of demographic information, injury history, and perceived exertion, assessed with the modified Borg Category-Ratio 10 (CR10) scale. The training workload (TWL) was derived from session ratings of perceived exertion, while the acute-to-chronic workload ratio (ACWR) was calculated across the four weeks preceding the index week. In addition, neuromuscular performance was evaluated using the OptoJump Next system (Microgate S.r.l., Bolzano, Italy). Athletes completed three standardized tests at both the beginning and end of the camp.</p><p><strong>Results: </strong>Weekly TWL was similar between groups (injured: 3,723.4; non-injured: 3,664.4). However, only 37.5% of injured athletes remained within the ACWR \"safe zone\" (0.8-1.3) compared to 75.0% of non-injured athletes. OptoJump assessments revealed no substantial performance differences, and by camp exit, previously injured athletes achieved comparable jump height, reactive strength index (RSI), and relative power to their peers.</p><p><strong>Conclusions: </strong>Although workloads were broadly similar, injured athletes demonstrated greater fluctuations in ACWR, indicating increased reinjury risk. Effective and personalized rehabilitation allows recovery of neuromuscular performance, but careful workload management remains essential. Integrating load monitoring with neuromuscular assessment may improve injury prevention strategies in youth volleyball players.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94050"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254155","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":"Hamman's Syndrome in the Context of Influenza A and Regular Vaping in a Young Adult.","authors":"Shyam Gautam, Sony Manandhar, Robin Sharma, Trishita Datta, Oluwapelumi O Akintade","doi":"10.7759/cureus.94083","DOIUrl":"https://doi.org/10.7759/cureus.94083","url":null,"abstract":"<p><p>Spontaneous pneumomediastinum, also called Hamman's syndrome, is an uncommon condition that results from alveolar rupture with air tracking into the mediastinum. It is usually triggered by events that raise intrathoracic pressure, but because of its rarity, it is often overlooked and may initially be confused with more serious conditions. The prognosis is generally excellent, as most cases resolve without intervention. We describe the case of a woman in her early 20s, with a history of regular e-cigarette use, who developed acute chest pain, shortness of breath, vomiting, and difficulty swallowing during an influenza A infection. Initial chest radiography demonstrated subcutaneous emphysema, pneumomediastinum, and a small left apical pneumothorax, raising concern for Boerhaave syndrome. CT confirmed pneumomediastinum without evidence of oesophageal perforation, which was further excluded by a water-soluble contrast swallow study. A viral screen was positive for influenza A. She was managed conservatively with broad-spectrum antimicrobials, oseltamivir, nil by mouth, and parenteral nutrition until Boerhaave syndrome was excluded, followed by gradual reintroduction of diet and supportive therapy. Her symptoms resolved completely. This case highlights the potential synergistic effect of viral respiratory infection and vaping in precipitating Hamman's syndrome in otherwise healthy young adults and underscores the importance of distinguishing this benign entity from life-threatening differential diagnoses such as oesophageal rupture.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e94083"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282459","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: 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}