Cureus最新文献

{"title":"Forecasting Daily Radiotherapy Patient Volumes in a Tertiary Hospital Using Autoregressive Integrated Moving Average (ARIMA) Models.","authors":"Thanarpan Peerawong, Chaichulee Chaichulee, Pasuree Sangsupawanich","doi":"10.7759/cureus.72752","DOIUrl":"10.7759/cureus.72752","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose is to predict the volume of patients treated daily with radiotherapy using the autoregressive integrated moving average (ARIMA) model.</p><p><strong>Methods: </strong>In this retrospective study, data from the billing records detailing daily radiotherapy treatment sessions were extracted from the Hospital Information System and analyzed. The study included all patients treated from January 2004 to December 2022. The analysis was divided into two parts: First, the data were summarized using descriptive statistics. Second, time series forecasting with the implementation of an ARIMA model for estimating patient volumes. For the ARIMA modeling process, the Akaike Information Criterion (AIC) was used for classical model optimization. The Mean Absolute Percentage Error (MAPE) was used for evaluating between different models. Residual analysis was performed in each model using the Ljung-Box test, Jarque-Bera test, and heteroskedasticity test to identify autocorrelation, normal distribution, and variances that could undermine the reliability of the model.</p><p><strong>Results: </strong>A total of 895,808 radiotherapy sessions were included in the study. The median number of radiotherapy sessions per day was 181 (150, 205). A clear transition to more modern radiotherapy equipment, particularly the Truebeam accelerator, was observed, indicating a growing dependency on advanced techniques such as volumetric-modulated arc therapy (VMAT), stereotactic body radiation therapy (SBRT), and stereotactic radiosurgery (SRS). The best ARIMA model predicted an increase in demand, projecting an average daily patient volume of 279.40 by 2030.</p><p><strong>Conclusion: </strong>The study highlights the need for advanced forecasting methodologies in healthcare resource planning and emphasizes the importance of considering environmental and external factors for effective and accurate resource allocation strategies.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592175","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":"Acceptability and Scalability of a Meditation App Among Adolescents With Type 1 Diabetes Mellitus.","authors":"Ejura Y Salihu, Helen Omuya, Deborah T Joseph, Judith H Hassan, Asma Ali, Betty Chewning","doi":"10.7759/cureus.72700","DOIUrl":"10.7759/cureus.72700","url":null,"abstract":"<p><p>Background Adolescents with type 1 diabetes mellitus (T1DM) experience stress from general life stressors and diabetes-specific stressors. This stress manifests in a range of ways, such as mood swings, heightened frustration, strained familial relationships, and difficulties in T1DM self-management, which then leads to worse health outcomes. There is small to moderate evidence that frequent use of mental health applications (MHapps) improves mental and physical health outcomes. Meditation apps may help reduce some of the stress associated with living with T1DM. This study explores the acceptability and scalability of a self-guided, smartphone-based meditation app, the Healthy Minds Program (HMP) app, among adolescents with T1DM using the Unified Theory of Acceptance and Use of Technology. Methods Eight adolescents ages 15-19 were recruited from a pediatric clinic in a Midwestern state and introduced to the HMP app. After using the HMP app for one week, they were invited to participate in three successive focus group meetings. During the meetings, they shared their perspectives on the content, navigation, and acceptability of the HMP app and strategies to introduce and scale app utilization among adolescents with T1DM. Researchers conducted conventional content analysis using a hybrid coding approach. Data was managed and analyzed using NVivo 10 (Lumivero, Denver, Colorado, USA). Findings Participants believed that the HMP app has the potential to enhance their stress management, mood, and coping abilities when dealing with the challenges of T1DM management. They found the app enjoyable and easy to use but expressed concerns about time constraints as a potential barrier. To address this, they shared recommendations for facilitating app uptake and usage. Conclusions This study's results provide an in-depth understanding of how positively this subset of adolescents with T1DM viewed the HMP app. The participants also offered valuable suggestions that can promote the adoption and sustained use of MHapps by adolescents living with T1DM.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559773","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":"Enterocolic Lymphocytic Phlebitis Masquerading as a Malignant Stricture in the Caecum: A Case Report and Literature Review.","authors":"Dakshita Agrawal, Rakshita Agrawal, Sangara Narayanasamy, Sadhasivam Ramasamy, Ali Yasen Mohamedahmed, Pradeep Thomas, Najam Husain","doi":"10.7759/cureus.72699","DOIUrl":"10.7759/cureus.72699","url":null,"abstract":"<p><p>Enterocolic lymphocytic phlebitis (ELP) is an idiopathic form of venous inflammation that is limited to the gastrointestinal tract. It is characterised by inflammation of the veins with no involvement of the arteries. Usually, it presents with gastrointestinal symptoms such as abdominal pain, and imaging may suggest malignancy. The reported case is a 56-year-old female presented with rectal bleeding, abdominal pain and diarrhoea. All blood test results were normal; however, she had an elevated C-reactive protein (CRP) level. Computed tomography colonography showed caecal wall thickening, suggesting caecal malignancy. Following a multidisciplinary discussion, the patient had a right hemicolectomy, and the histology showed no malignancy and typical features of ELP. This is a rare idiopathic form of venous inflammation localised to the gastrointestinal tract, which can occasionally present similarly to bowel malignancy. ELP most commonly presents with abdominal pain, followed by hematochezia and diarrhaea. The duration of symptoms varies widely, from hours to a year. Diagnosis is usually confirmed by histopathological assessment. We present this case and literature review considering its rarity, which adds to the literature on this condition.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559793","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 Optimal Entry Point and Trajectory for Pedicle Screws to Avoid Superior Facet Joint Violation and Pedicle Penetration.","authors":"Hüseyin Doğu","doi":"10.7759/cureus.72719","DOIUrl":"10.7759/cureus.72719","url":null,"abstract":"<p><p>Background Accuracy is crucial in surgeries involving pedicle screws. This study aimed to determine the optimal screw entry points and trajectory angles for the pedicle screw technique used in the surgical treatment of lumbar instability. Methods To achieve this goal, a comparison was made between the screw entry points and trajectories determined using the commonly used intersection technique and those created in a three-dimensional (3D) simulation environment. Thirty-two cases of lumbar degenerative spondylolisthesis, selected from surgeries between 2018 and 2023, were included. Preoperative lumbar computed tomography (CT) images were converted into 3D models, and simulations for pedicle screw placement were conducted. Results Using the intersection technique, upper facet damage was noted in 31.3% of L1, 37.5% of L2, 6.3% of L3, and 31.3% of L5 segments. Adjustments to entry points and angles in the 3D environment were made to determine optimal trajectories. The revised screw angles showed statistically significant improvements at L1, L2, and L5 segments compared to the intersection technique. Conclusions The intersection technique does not appear safe in preserving the superior facet joint. A more lateral and caudal pedicle entry should be preferred in the upper segments, and at L5, a more lateral pedicle entry should be used. Consequently, the screw angles should be adjusted accordingly.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559823","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":"Aplastic Anemia With Non-Occlusive Mesenteric Ischemia.","authors":"Rithvik Rai, Abiola Kehinde","doi":"10.7759/cureus.72727","DOIUrl":"10.7759/cureus.72727","url":null,"abstract":"<p><p>This case highlights the multifaceted challenges of managing aplastic anemia, especially when complicated by non-occlusive mesenteric ischemia (NOMI). The patient's clinical course underscores the importance of a conservative, multidisciplinary approach in balancing the risks of invasive procedures with the need for effective diagnostics and treatment. Recognizing the risks associated with pancytopenia, including life-threatening bleeding and infections, is critical in managing such patients. Careful monitoring and timely interventions, particularly in an intensive care setting, are essential to improve outcomes in complex cases like this one.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549724","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":"Efficacy and Efficiency of Cyanoacrylate Glue in Fistula-in-Ano.","authors":"Rajat Sharma, Siddharth B Lonare, Saurabh Nagar, Sushant Badhal, Samir Anand","doi":"10.7759/cureus.72701","DOIUrl":"10.7759/cureus.72701","url":null,"abstract":"<p><strong>Aims and objective: </strong>Most research on fistula-in-ano (FIA) is being done to improve surgical outcomes and reduce complications. Cyanoacrylate glue (CAG) is one of the promising options. We evaluated the efficacy and efficiency of CAG in the treatment of FIA.</p><p><strong>Materials and methods: </strong>A cohort of 30 patients were included who underwent treatment using CAG. Each patient followed up at one, three, and six months to evaluate improvement in pain, discomfort, and recurrence. Patients with recurrence were treated with fistulectomy.</p><p><strong>Result: </strong>The mean age of the cohort was 48.2±14.5 years, with a male-to-female ratio of 6:1, having four diabetic patients. Inter-sphincteric (16.54%) and trans-sphincteric (13.43%) fistulae were more common than extra-sphincteric (1.4%) fistula. The efficacy of CAG was 73%, and the procedure was found efficient with significant improvement in discomfort (p-value: 0.017). The recurrence rate was 27%, which occurred more in diabetic patients (p-value: 0.001) and trans-sphincteric fistula (p-value: 0.035).  Conclusion: The CAG application is a simple and safe daycare procedure. However, the incidence of discharge and relief in pain was significantly less, but it cannot be advised to every patient of FIA. A young patient without comorbidities and with inter-sphincteric low fistula can best be treated by this method.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549727","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: A Case of Accidental Autoerotic Death by Hanging Linked to Erotic Photography.","authors":"Teodora Kiryakova, Biliana Mileva, Pavel Timonov, Antoaneta Fasova, Metodi Goshev, Alexandar Alexandrov, Ivan I Tsranchev","doi":"10.7759/cureus.r150","DOIUrl":"https://doi.org/10.7759/cureus.r150","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.65087.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549734","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":"Anthropometric Indices of Obstructive Sleep Apnea Patients in Mauritius.","authors":"Vibhootee Sant Bakshsingh, Meera Manraj, Devaraj Keser-I-Hind Pillai, Fateemah Suhootoorah, Abdool Arbaaz Boodhun, Sidrah Bibi Soreefan","doi":"10.7759/cureus.72708","DOIUrl":"10.7759/cureus.72708","url":null,"abstract":"<p><p>Background Obstructive sleep apnea (OSA) is the most prevalent sleep-related breathing disorder, affecting a significant number of individuals globally. It is associated with poor quality of life and an increased risk of all-cause mortality. It is estimated that most of the patients suffering from OSA are obese. Anthropometric indices can help guide doctors toward the diagnosis. Objectives This study aimed to establish specific anthropometric thresholds associated with OSA risk, allowing clinicians to identify individuals more likely to have OSA and who may need further evaluation, such as polysomnography. This targeted screening approach would enable better resource allocation to those at higher risk, potentially enhancing the efficiency of OSA diagnosis and management. Methods We conducted a descriptive study using data from the sole private sleep clinic in Mauritius. We analyzed case files of consecutive patients diagnosed with OSA over a 3.5-year period from January 2015 to June 2018. Results The study population comprised 170 patients (79.4% males) diagnosed with OSA by a polygraphy test. The mean age of OSA diagnosis in men and women was 51.7 ± 14.0 years and 53.8 ± 12.5 years, respectively. The mean neck circumference (NC) for males and females was 41.9 ± 3.9 cm and 38.2 ± 3.9 cm, while the mean waist circumference (WC) was 105.6 ± 12.2 cm for men and 103.4 ± 14.5 cm for women. The body mass index (BMI) was 29.1 ± 5.0 kg/m² and 31.4 ± 6.8 kg/m² for males and females, respectively. The apnea-hypopnea index (AHI) averaged to 42.1 ± 19.7 events/hour for men and 33.3 ± 16.4 events/hour for women. In male patients, we found a positive significant correlation (p<0.001) between AHI and the following parameters: BMI (r=0.443), WC (r=0.337), WC-to-height ratio (WHr) (r=0.378), NC (r =0.274), and neck-to-height ratio (NHr) (r =0.321). In women, we observed a positive significant correlation between apnea severity and the following: BMI (r=0.396, p=0.029), WC (r=0.462, p=0.005), and WHr (r=0.494, p=0.003). No significant relationships were observed between AHI and the following parameters in women: NC (r=0.317, p=0.064) and NHr (r=0.311, p=0.069). A total of 83.5% of patients had a Mallampati score of 3-4. Conclusion This study represents a pioneering effort on the island. While further research is necessary to establish exact anthropometric cutoff values, the findings offer crucial insights for physicians to identify high-risk individuals. With just a scale, measuring tape, and calculator, healthcare professionals can detect important health markers that extend beyond diagnosing OSA. These simple measurements not only help in predicting OSA but also provide a broader view of an individual's overall health, identifying risks that go beyond sleep issues. This research sets an important foundation for future OSA studies within the Mauritian population.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559774","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 Weight on Sight: Exploring the Links Between Obesity and Ocular Diseases.","authors":"Ahmed Bilal, Muslim Bilal, Alia Hathaf, Danyal Usman, Nadim Haboubi","doi":"10.7759/cureus.72742","DOIUrl":"10.7759/cureus.72742","url":null,"abstract":"<p><p>Obesity is a significant public health concern with escalating levels worldwide creating a variety of socioeconomic challenges and imposing a serious risk factor for a range of complications which include diabetes, hypertension, cardiovascular disease, and stroke, all of which are primary causes of early death. Furthermore, there is growing evidence connecting obesity to the development of several ocular disorders. Excessive weight is a common denominator in the aetiology of many ocular pathologies such as diabetic retinopathy, idiopathic intracranial hypertension, cataract, high intraocular pressures, age-related macular degeneration, and retinal vascular diseases through the association with diabetes, hypertension, and dyslipidemia. This review highlights the risks weight gain and a sedentary lifestyle imposes on patients' ocular health and aims to inform the public and raise awareness about the consequences obesity has on sight. This review explores articles available on Ovid-MEDLINE (Medical Literature Analysis and Retrieval System Online) and PubMed regarding the impact of obesity on ocular health and the pathogenesis of obesity-linked ocular diseases.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559828","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":"Study of Complete Surgical Response of Stage III Oral Carcinoma Patients in Comparison to Primary Surgery Versus Neoadjuvant Methotrexate With Surgery.","authors":"Siddharth B Lonare, V Manoj Babu, Rajat Sharma, Krunal A Chendkapure, Abhijeet S Velip, Nirbhay Bind","doi":"10.7759/cureus.72680","DOIUrl":"10.7759/cureus.72680","url":null,"abstract":"<p><p>Objective This study aims to compare the efficacy of neoadjuvant methotrexate therapy followed by surgery versus primary surgical management in patients with stage III oral carcinoma. Methods Thirty patients diagnosed with stage III oral carcinoma were enrolled in this prospective study at a tertiary cancer research center. The patients were divided into two groups: 15 patients received neoadjuvant methotrexate therapy followed by surgery, while 15 underwent primary surgical management. Outcomes were evaluated based on tumor downstaging, surgical margins, postoperative complications, and the requirement for adjuvant radiotherapy. Results Patients in the neoadjuvant methotrexate group demonstrated significant tumor downstaging, allowing for less extensive surgical procedures, with 33.3% (n=5) undergoing wide local excision (WLE) compared to 13.3% (n=2) in the primary surgery group. Negative surgical margins were achieved in 93.33% (n=14) of patients in the neoadjuvant group versus 53.33% (n=8) in the surgical group. Additionally, only 13.3% (n=1) of patients in the neoadjuvant group required postoperative radiotherapy, compared to 53.33% (n=8) in the surgical group. The recurrence rate over a six-month follow-up period was comparable between the two groups. Discussion Neoadjuvant methotrexate therapy resulted in better surgical and oncological outcomes by downstaging the tumor, reducing the extent of surgery, and minimizing the need for postoperative radiotherapy. The findings suggest that methotrexate, as a neoadjuvant agent, is effective in improving patient outcomes with fewer side effects compared to standard cisplatin-based regimens. Conclusion Neoadjuvant methotrexate therapy offers a viable treatment option for stage III oral carcinoma, demonstrating improved oncological and surgical outcomes, including less invasive surgery, higher rates of negative surgical margins, and reduced postoperative radiotherapy requirements. Further research with long-term follow-up is necessary to validate these findings and explore the long-term impact on survival and recurrence rates.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549736","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}