Cureus最新文献

{"title":"Recent Status of Low-Birth-Weight Infants in Japan.","authors":"Shunji Suzuki, Atsuo Itakura, Jun Takeda, Naho Morisaki","doi":"10.7759/cureus.81008","DOIUrl":"10.7759/cureus.81008","url":null,"abstract":"<p><p>Objective In this study, we examined the recent trends in neonatal birth weight in Japan with the precise gestational age distinctions of 39 weeks, which is the period internationally considered to be the most optimal for delivery based on the perinatal outcomes. Materials and methods Firstly, we calculated the frequency of low-birth-weight (LBW) infants beyond 22 weeks of gestation in Japan using the birth notifications from 2000, 2010, and 2020. Secondary, we analyzed the birth weight trends of the first singleton male and female infants born to primiparous women at 39 weeks of gestation. Results The frequency of LBW infants increased significantly in 2010 compared to 2000 (odds ratio 1.13, 95% confidence interval 1.12-1.14, p < 0.01); however, it decreased significantly in 2020 (odds ratio 0.952, 95% confidence interval 0.943-0.961, p < 0.01), although it did not reach the level in 2000 (p < 0.01). The average neonatal birth weight born to primiparous women at 39 weeks of gestation in 2010 was significantly lower than in 2000 (p < 0.01); however, in 2020 it was significantly higher than in 2000 although some differences were observed between the neonatal sexes (p < 0.01). Conclusion The frequency of LBW infants has been declining from 2010 to 2020 in Japan. In addition, the average neonatal birth weight born to primiparous women at 39 weeks of gestation in 2020 was significantly higher than in 2010.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81008"},"PeriodicalIF":1.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702540","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":"Prospective Evaluation of the Safety and Compression Performance of Novel Compression Denim Jeans in Healthy Volunteers and Patients With Lymphedema.","authors":"Daiki Ousaka, Kiyoshi Yamada, Noriko Sakano, Satoe Kirino, Kazumasa Miyake, Takumi Takahashi, Akihiro Matsuoka, Shintaro Yamada, Akira Shinaoka, Susumu Oozawa","doi":"10.7759/cureus.80971","DOIUrl":"10.7759/cureus.80971","url":null,"abstract":"<p><strong>Objectives: </strong>The treatment of lower-extremity lymphedema, whether congenital or acquired, remains challenging. Long-term management aimed at reducing complications and maximizing quality of life is essential. Compression stockings are crucial in this management; however, their application is limited by patient experience (ease of wear, texture, breathability, and appearance). This highlights the need to evaluate alternative compression garments that maintain therapeutic efficacy while improving patient adherence.</p><p><strong>Methods: </strong>We developed a novel compression denim product (Flow plus Jeans®) using advanced sewing technology. Its baseline performance (compression ability) was evaluated by measuring pressure gradients at three points (ankle, calf, and thigh) using a mannequin-based compression testing system and compared with those of existing stockings. Thereafter, a safety assessment was conducted on healthy volunteers to evaluate potential adverse effects, including changes in lower limb circumference, signs of deep vein thrombosis (DVT) via ultrasound, and skin complications. A clinical trial in patients with lymphedema was then performed to compare its efficacy with that of conventional compression stockings.</p><p><strong>Results: </strong>Baseline performance testing with a mannequin revealed that Flow plus Jeans demonstrated compression levels and pressure gradients at three calf points comparable to those of standard compression stockings. A safety study involving nine healthy volunteers confirmed that Flow plus Jeans caused no significant changes in lower-limb circumferences after three days of wear, with no cases of DVT or skin complications. In a subsequent clinical trial involving nine female patients with lymphedema, the jeans showed non-inferiority to existing stockings concerning lower-limb circumference measurements at six points (pre-use vs. six months post-use), with patient-reported experiences assessed via questionnaires. Notably, patients reported enhanced satisfaction regarding the jeans' fashionability, which could serve as an incentive for long-term adherence.</p><p><strong>Conclusion: </strong>Our findings suggest that Flow plus Jeans represent a promising novel option for the long-term management of lymphedema, offering an alternative that balances medical efficiency with improved patient satisfaction and demonstrates safety in healthy individuals.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80971"},"PeriodicalIF":1.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702538","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":"Rapid Reversal of Forearm Supinator Rigidity With Topical Isomerized Potassium Linoleate: A Novel Perspective on Microbiome-Induced Tetany.","authors":"David G Changaris","doi":"10.7759/cureus.80896","DOIUrl":"10.7759/cureus.80896","url":null,"abstract":"<p><p>Microbes can alter host behavior, immunity, and neurological function at a distance without extension into the brain and spinal cord. Clostridia provides a predicate for such an infection in the periphery by causing \"lock jaw\" and generalized tetany. This case series presents five patients who showed rigidity or tetany of the forearm. All were diagnosed with vertigo of central origin by video nystagmography (VNG) and posturography. Each had an apparent slow-rolling tetany, most visible in the forearm. Each had a consistent focus of pain within the supinator, diminution of extended wrist rotation, and tender, taut bands. None had clinical evidence of injury to the ulnar, radial, or median nerves, ulnar epicondyles, or wrist. The author applied a commercial preparation of a cleanser containing isomerized potassium linoleate (KCLA) to the skin overlying the forearm's biceps, supinator, and pronator as an \"alternative\" medical approach to refractory rigidity and tenderness. The tenderness resolved within two to four minutes. After 3-10 minutes, follow-on extended wrist rotation improved toward the norm (p < 0.01). The improved range of motion lasted beyond discharge from the clinic visit. The rapid response in this series suggests the commensal skin biome may contribute to clinical tetany in the forearm supinator.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80896"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671936","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":"Comparison of Durability Between Rezum Water Vapor Therapy and UroLift in Treating Benign Prostatic Hyperplasia: A Multicenter Propensity Score-Matched Analysis.","authors":"Chye-Yang Lim, Chih-Cheng Lai, Ya-Wen Tsai","doi":"10.7759/cureus.80914","DOIUrl":"10.7759/cureus.80914","url":null,"abstract":"<p><p>Background Rezum water vapor therapy and UroLift are among the minimally invasive surgical therapies (MISTs) gaining popularity in the treatment of benign prostatic hyperplasia (BPH). This study aims to evaluate and compare the reintervention rates, a measure of durability, for Rezum water vapor therapy and UroLift as MISTs for BPH. Methods We conducted a retrospective cohort study using data from the TriNetX Global Collaborative Network, a large database of electronic health records from January 2014 to June 2024. Current Procedural Terminology (CPT) and International Classification of Diseases 10th Revision codes (ICD-10) were used to build the cohorts of men aged over 18 years who underwent either Rezum water vapor therapy or UroLift. Reintervention rates and complication profiles were evaluated over a follow-up period of up to five years. Results Cumulative reintervention rates were collected for both Rezum water vapor therapy and UroLift at the 1st, 3rd, and 5th years (2.83% vs. 3.59%, 5.99% vs. 8.76%, 6.81% vs. 10.85%). The average annual increase rate was 1% for Rezum water vapor therapy compared with 1.82% for UroLift, respectively. Most complications were more prominent in the Rezum water vapor therapy group, with urinary retention accounting for 23.42%. Discussion Rezum water vapor therapy demonstrates a more durable effect with lower reintervention rates compared to UroLift, based on this large multicenter cohort study. The higher reintervention rate observed with UroLift may reflect differences in the mechanisms of action between the two procedures. Conclusions These findings elucidate the superiority of Rezum water vapor therapy in sustaining the therapeutic effect over the long term compared to UroLift. However, more complications were noted in the Rezum water vapor therapy group. Thus, clinicians should take into account the durability and complication profiles in shared decision-making when considering MISTs for BPH.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80914"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694905","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":"Causality of Childhood and Adult Body Mass Index on Sick Sinus Syndrome: A Mendelian Randomization Study.","authors":"Guanzhen Xu, Zhuang Liu, Ping Hou","doi":"10.7759/cureus.80913","DOIUrl":"10.7759/cureus.80913","url":null,"abstract":"<p><p>Background The relationship between body mass index (BMI) and the risk of sick sinus syndrome (SSS) remains unclear. Clarifying the impact of BMI on SSS at different life stages is essential for advancing precision medicine and implementing effective prevention strategies to reduce the burden of SSS. Methods The causalities of childhood and adult BMI with SSS were investigated by univariate and multivariate Mendelian randomization. Reverse causalities were also explored to improve the accuracy of causality findings. Different sources of exposure data were used for replication analysis, and the effects of sample overlap were investigated using MRlap. The stability of the results was further enhanced through meta-analysis. Results There was a positive correlation of adult BMI with the risk of SSS in both the FinnGen (odds ratio (OR) = 1.17, 95% confidence interval (CI) 1.01-1.35, P = 0.031) and Integrative Epidemiology Unit (IEU) open genome-wide association study (GWAS) project (OR = 1.18, 95% CI 1.04-1.34, P = 0.009) databases. The causality remained valid after the correction of telomere length. There was no causality detected between childhood BMI and SSS, as determined by independent studies of the Early Growth Genetics (EGG) 2020 (OR = 1.06, 95% CI 0.89-1.27, P = 0.513) and EGG2015 (OR = 1.02, 95% CI 0.97-1.09, P = 0.423). Meta-analysis results further confirmed the reliability of the causal inference. Conclusions The findings indicate that elevated BMI in adults, particularly among middle-aged and elderly populations, increases the risk of developing SSS. In contrast, no causal relationship was observed between childhood BMI and SSS, suggesting that the influence of BMI on SSS susceptibility may predominantly emerge during later life stages. These results highlight the need for targeted public health interventions to address adult obesity as a modifiable risk factor for SSS.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80913"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694889","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 Embolization for Chronic Subdural Hematomas: A Literature Review of the Current Evidence.","authors":"Andrés Sebastián Estrella López, Naomi Pauleth Espin Jiménez, Patricio Alejandro Montalvo Ramos, Gabriela Alejandra Castillo López","doi":"10.7759/cureus.80898","DOIUrl":"10.7759/cureus.80898","url":null,"abstract":"<p><p>Chronic subdural hematoma (cSDH) primarily affects elderly patients along with those who have multiple health problems, while it develops when blood collects between the dura mater and the brain. The condition results in substantial disability while also causing surgical treatment failures in certain cases. The occurrence of cSDH becomes more frequent as people age beyond 65 years old, which establishes this condition as a major health issue. The standard surgical evacuation method for treating this condition shows limited success because patients experience frequent recurrences, which motivates researchers to study endovascular embolization as an alternative treatment option. The promising endovascular embolization technique uses middle meningeal artery (MMA) embolization to target the blood supply of the neo-membrane surrounding the hematoma, thus preventing rebleeding and reducing recurrence. The available data shows that embolization of the MMA leads to better recurrence prevention than conventional surgical procedures among patients who face restrictions for surgery because of multiple health issues. The review analyzes current research about MMA embolization safety together with its effectiveness and appropriate applications for cSDH treatment. The existing evidence about endovascular embolization as adjunctive therapy to surgical procedures such as burr hole drainage or craniotomy provides a significant impact over standalone treatment for complex and recurrent cSDH cases, reducing recurrence, rescue rates, and complications. However, endovascular embolization also shows better clinical outcomes in reducing these outcomes, but for less complex cSDH cases. There is unclear or inconclusive evidence for overall cSDH patients because current research lacks large multicenter randomized controlled studies together with stringent quality standards and contains various patient groups and minimal study durations. The procedure's effectiveness remains unclear because researchers have not determined the best patient selection criteria, the most suitable embolic agent, or the most economical approach.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80898"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694907","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 Association Between Anesthetist Leadership Styles and Their Resilience: A Single-Center Study.","authors":"Laurence Weinberg, Elizabeth P Hu, Mark M Youssef, Benjamin Churilov, Dong-Kyu Lee","doi":"10.7759/cureus.80848","DOIUrl":"10.7759/cureus.80848","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the association between the leadership styles and resilience of anesthetists in leadership roles.</p><p><strong>Methodology: </strong>This prospective study of all anesthetists in leadership roles within a university teaching hospital in Melbourne, Australia, employed three validated, anonymous questionnaires (Multifactor Leadership Questionnaire, Authentic Leadership Questionnaire, and the Resilience Scale). Questionnaire data were summarized using descriptive statistics and presented as counts and proportions. Spearman's rank correlation was used to evaluate quantitative continuous variables to identify linear relationships.</p><p><strong>Results: </strong>Of the 14 anesthetists in leadership roles, 14 completed all three questionnaires (response rate 100%). Ten participants (71.5%) displayed behaviors consistent with transformational leadership. Three participants (21.4%) displayed behaviors typically associated with transactional leadership, and one (7.1%) exhibited characteristics consistent with passive-avoidant leadership. Anesthetists with transformational leadership styles exhibited significantly higher resilience scores than those with transactional or passive-avoidant leadership styles. Those with transformational leadership qualities also had increased job satisfaction overall.</p><p><strong>Conclusion: </strong>Anesthetists who exhibit transformational and authentic leadership are likely to be more resilient than those with transactional or passive-avoidant leadership styles. Higher levels of resilience were also associated with greater role effectiveness and experiencing greater levels of job satisfaction.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80848"},"PeriodicalIF":1.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665829","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":"Intertransverse Process Block With Catheter Placement for Postoperative Pain Management in a Patient With Alcoholic Liver Disease and Portal Hypertension: A Case Report.","authors":"Keisuke Nakazawa, Ayano Takenaka, Takahiro Suzuki","doi":"10.7759/cureus.80788","DOIUrl":"10.7759/cureus.80788","url":null,"abstract":"<p><p>Epidural analgesia is typically avoided in patients with portal hypertension due to multiple risk factors: engorgement of epidural venous plexuses, platelet dysfunction despite normal counts, and potential postoperative coagulopathy following liver surgery. These risks persist even when preoperative coagulation parameters appear normal. While peripheral nerve blocks are increasingly utilized for minimally invasive laparoscopic procedures, intertransverse process block (ITPB) with catheter placement offers a high-quality analgesic strategy that supports early ambulation and postoperative recovery with a significantly reduced risk profile in such patients. A 76-year-old male patient with alcoholic liver cirrhosis (Child-Pugh class A) and a history of esophageal variceal bleeding underwent laparoscopic partial hepatectomy of segment 3 for suspected hepatocellular carcinoma. Despite normal coagulation parameters (prothrombin time-international normalized ratio 1.1 and activated partial thromboplastin time 33 seconds), epidural analgesia was contraindicated due to portal hypertension with multiple vascular anomalies. Bilateral ultrasound-guided ITPB was performed at the Th8-9 level with catheter placement in the intertransverse tissue complex. Analgesia was maintained with intermittent boluses of 0.25% levobupivacaine (10 mL bilaterally, twice daily) for three postoperative days, supplemented with intravenous patient-controlled analgesia (IV-PCA) fentanyl (baseline infusion 10 μg/hour, bolus dose 10 μg, lockout time 10 minutes). The patient reported minimal pain scores (numerical rating scale 0-2 at rest, 2-3 with movement), achieved early mobilization, and did not require any PCA boluses throughout recovery. Cold testing confirmed adequate sensory blockade from Th8 to Th11 on each postoperative day until catheter removal. ITPB with catheter placement provided safe and effective analgesia in a patient with portal hypertension, enabling early mobilization and rehabilitation without risking complications associated with epidural techniques. This approach represents a viable alternative to epidural analgesia in high-risk patients with compromised liver function and vascular abnormalities.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80788"},"PeriodicalIF":1.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694909","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":"Role of Preoperative Neutrophil-Lymphocyte Ratio in Predicting Prognosis After Liver Transplantation for Chronic Liver Failure.","authors":"Surbhi Abrol, Manish Tandon, Arun M Raghu, Chandrakant Pandey","doi":"10.7759/cureus.80749","DOIUrl":"10.7759/cureus.80749","url":null,"abstract":"<p><strong>Introduction: </strong>The neutrophil-lymphocyte ratio (NLR) is an easily calculable biomarker known to have a predictive value in cardiac disease, malignancy, and renal failure. However, it has not been studied before in chronic liver disease patients undergoing liver transplantation. We aimed to evaluate the role of the pre-transplantation NLR in predicting the prognosis of patients with chronic liver failure undergoing liver transplantation.</p><p><strong>Method: </strong>Data was retrospectively collected from 46 patients with chronic liver disease who underwent liver transplantation. The patients were divided into two groups. Group A had 23 patients who survived after liver transplantation. Group B had 23 patients who did not survive. NLR was calculated by dividing the percentage of neutrophils by the percentage of lymphocytes in peripheral blood. The NLR cut-off value was based on a receiver operating characteristic curve analysis. Postoperative complications were also noted.</p><p><strong>Results: </strong>Preoperative NLR of 3.46 can predict post-transplantation mortality, with the area under the curve (AUC) of 0.86, having a sensitivity of 86.96% and a specificity of 73.91%. NLR emerged as an independent predictor of mortality (hazard ratio (HR) = 4.1, p = 0.028) after adjusting for the Model for End-Stage Liver Disease-Sodium (MELD-Na), creatinine, and neutrophil count. A rising NLR trend was significantly associated with the development of postoperative complications like neurological disease (p < 0.001), coagulopathy (p = 0.004), and acute kidney injury (p = 0.043).</p><p><strong>Conclusion: </strong>A high preoperative NLR is a predictor of poor outcomes in liver transplantation patients with chronic liver disease.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80749"},"PeriodicalIF":1.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671939","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 Wolf in Sheep's Clothing: Pseudohypobicarbonatemia in a Patient With Multiple Myeloma.","authors":"Ziad Alahmadi, Zain Haq, Ami Patel, Joshua D King","doi":"10.7759/cureus.80782","DOIUrl":"10.7759/cureus.80782","url":null,"abstract":"<p><p>There are multiple methods to measure serum bicarbonate level which is crucial for diagnosis and management of acid-base disturbances. The most common method is directly measuring the total serum carbon dioxide (CO₂) concentration in a basic metabolic panel. Another method is by indirect calculation of the bicarbonate concentration via the Henderson-Hasselbalch equation using the measured pH and partial pressure of CO₂ (pCO₂) in plasma. Multiple confounders can cause discrepancies in the measured bicarbonate in each method, such as increased concentration of serum lipids or proteins, that can alter measurement assays, leading to spuriously low serum bicarbonate values. In our case, we present a patient with falsely low reported bicarbonate levels in the setting of increased paraproteins due to multiple myeloma.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80782"},"PeriodicalIF":1.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659934","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}