Cureus最新文献

{"title":"Emirates Society of Radiation Oncology (ESRO): Advancing Cancer Care in the UAE.","authors":"Nandan M Shanbhag, Abdulrahman Bin Sumaida, Aly A Razek, Yashaswini Shivashankara, Khalifa AlKaabi, Khalid Balaraj","doi":"10.7759/cureus.80500","DOIUrl":"10.7759/cureus.80500","url":null,"abstract":"<p><p>Radiation oncology plays a crucial role in cancer treatment, with more than half of all cancer patients requiring radiotherapy at some stage. Despite rapid advancements in oncology services in the United Arab Emirates (UAE), the country has lacked a dedicated professional society for radiation oncology until now. The Emirates Society of Radiation Oncology (ESRO) was established in 2025 to address critical gaps in education, research, clinical practice, and policy advocacy within the field. This editorial highlights the rationale for ESRO's formation, including workforce training deficits, limited research collaboration, and the absence of unified clinical guidelines. ESRO aims to enhance professional development, foster multicenter research, advocate for evidence-based policy reforms, and standardize radiation oncology practices across the UAE. Through these efforts, ESRO seeks to elevate the quality of radiotherapy services, improve patient outcomes, and position the UAE as a key contributor to global advancements in radiation oncology. We call on all stakeholders, including oncologists, medical physicists, radiation therapists, policymakers, and healthcare institutions, to collaborate in realizing this vision for a stronger and more integrated radiation oncology community in the region.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80500"},"PeriodicalIF":1.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627113","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":"Hip Fracture Patterns Among Hispanic Seniors: Risk Factors and Implications.","authors":"Nikhil Mathur, John Knight, Monica Betancourt-Garcia, Gregery Pequeno, Michael Serra-Torres","doi":"10.7759/cureus.80463","DOIUrl":"https://doi.org/10.7759/cureus.80463","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Background Hip fractures are a major cause of morbidity and mortality in the growing US geriatric population, with the majority resulting from falls. They are associated with a significant loss of independence and impose a substantial financial burden on healthcare systems worldwide. The Rio Grande Valley (RGV), a medically underserved region with a predominantly Hispanic population, faces high rates of chronic conditions such as diabetes and obesity, which may influence fracture patterns and outcomes. This study examines hip fractures in a predominantly Hispanic geriatric cohort, focusing on the impact of diabetes and obesity on fracture type, with the goal of informing targeted prevention and treatment strategies. Methods This retrospective cohort study was conducted at a Level 1 Trauma Center along the US-Mexico border. The study included hip fracture cases caused by falls in patients aged 65 and older over a three-year period, excluding periprosthetic and pathologic fractures. Fractures were stratified as intracapsular (femoral head/neck) or extracapsular (intertrochanteric, subtrochanteric, and greater/lesser trochanter). Treatment strategies included arthroplasty, osteosynthesis, or conservative management. Outcome measures included one-year all-cause mortality, length of stay (LOS), readmission rates, and complications such as deep vein thrombosis (DVT), pulmonary embolism (PE), fat embolism, pressure ulcers, and surgical site infections (SSIs). Statistical analyses assessed associations between fracture type, patient characteristics, treatment strategies, and outcomes. Results The study included 412 patients, of whom 85.2% (351) were Hispanic and 71.4% (294) were female, with a mean age of 80.6 years and a body mass index (BMI) of 25.5 kg/m&lt;sup&gt;2&lt;/sup&gt;. Higher age (mean: 81.3 years, p=0.033), lower BMI (25.0 vs. 26.2, p=0.019), and Hispanic ethnicity (OR: 1.98, p=0.026) were associated with extracapsular fractures. Non-surgical management was associated with a significantly higher one-year mortality rate (n=6; 20.7%; p=0.004). Surgery performed more than 48 hours after arrival prolonged hospital stay (7.96 vs. 5.73 days for &lt;24 hours, p&lt;0.001). The overall one-year mortality rate was 5.6% (23), with older age (OR: 1.08, p=0.034), COPD (OR: 5.24, p=0.015), and cirrhosis (OR: 8.69, p=0.024) as significant predictors. Prolonged immobilization (OR: 2.68, p=0.016) and diabetes (OR: 3.89, p=0.002) increased complication rates. Conclusion  Aging, comorbidities, and Hispanic ethnicity increased extracapsular fracture risk, while a higher BMI was predictive for intracapsular fractures. The one-year mortality rate of 5.6% highlighted the Hispanic paradox, suggesting a survival advantage despite the presence of multiple comorbidities and risk factors. Ultimately, these findings emphasize the necessity of targeted intervention strategies, including fall prevention programs, bone health education, and culturally tailored healthcare approaches. A","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80463"},"PeriodicalIF":1.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652781","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":"Morel-Lavallée Lesion in a Patient With Metformin-Induced B12 Deficiency: A Rare Complication Following a Fall.","authors":"Vyshnavi Rallapalle, Yuyuan Wu, William Curry","doi":"10.7759/cureus.80480","DOIUrl":"10.7759/cureus.80480","url":null,"abstract":"<p><p>A Morel-Lavallée lesion (MLL) is a type of closed injury resulting in the internal shearing of superficial skin and subcutaneous tissue from the underlying fascial layer, usually occurring after traumatic accidents such as sports injuries or motor vehicle accidents. In this case, a 68-year-old man developed an MLL as a complication following a moderate-impact fall due to metformin-induced vitamin B12 deficiency. A known complication of metformin use is vitamin B12 deficiency, but this is often underdiagnosed due to a lack of routine screening. This case illustrates the importance of being aware of this complication and the many roles of vitamin B12 in terms of its effects on balance, proprioception, blood vessel integrity, and wound healing, emphasizing the importance of routine vitamin B12 screening in metformin users.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80480"},"PeriodicalIF":1.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627118","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":"Bioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) Framework for Bioethical Clinical Decision Support.","authors":"Taposh P Dutta Roy","doi":"10.7759/cureus.80494","DOIUrl":"10.7759/cureus.80494","url":null,"abstract":"<p><p>Healthcare professionals face complex ethical dilemmas in clinical settings in cases involving end-of-life care, informed consent, and surrogate decision-making. These nuanced situations often lead to moral distress among care providers. This paper introduces the Bioethics Artificial Intelligence Advisory (BAIA) framework, a novel and innovative approach that leverages artificial intelligence (AI) to support clinical ethical decision-making. The BAIA framework integrates multiple bioethical approaches, including principlism, casuistry, and narrative ethics, with advanced AI capabilities to provide comprehensive decision support. The framework employs a structured methodology that includes data collection, paradigmatic case review, analysis through \"mattering maps,\" and scenario-based decision reasoning. A detailed analysis of two challenging cases, an end-of-life care decision and a complex conjoined twins case, demonstrates BAIA's potential to harmonize diverse ethical perspectives while reducing the moral burden on healthcare providers. The framework's agentic architecture additionally allows integration with any new and existing ethical AI systems like METHAD, Delphi, and EAIFT, enabling multiframework collaboration. This work also acknowledges limitations related to data quality, bias, and complexity of ethical decisions and proposes mitigation strategies, including standardized databases, fairness algorithms, and maintaining human oversight. Thus, this work represents a significant step toward combining technological advancement in agentic AI with established bioethical principles to improve the quality and consistency of clinical ethical decision-making, thus reducing moral distress for clinicians.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80494"},"PeriodicalIF":1.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627050","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":"Tricuspid Annuloplasty Using a Handmade Gore-Tex Band: A Retrospective Study, Case Series, and Literature Review.","authors":"Selman Dumani, Laureta Dibra, Ermal Likaj, Alessia Mehmeti, Alfred Ibrahimi, Edlira Rruci, Stavri Llazo, Aferdita Veseli, Vera Beca, Ali Refatllari, Altin Veshti","doi":"10.7759/cureus.80474","DOIUrl":"10.7759/cureus.80474","url":null,"abstract":"<p><p>Background Tricuspid valve regurgitation is frequently overlooked by cardiologists and cardiac surgeons alike; consequently, the tricuspid valve is often referred to as \"the forgotten\" valve. It is the most common complication of left heart valve disease. Ring annuloplasty and suture (De Vega) annuloplasty represent two common surgical treatment techniques. We developed a technique to stabilize the tricuspid annulus using a simple handmade Gore-Tex vascular prosthesis. Our literature review did not reveal any publications describing an identical approach. Objectives In this article, we report the results of our technique for repairing the tricuspid valve, particularly emphasizing both the short- and long-term echocardiographic outcomes, along with a review of current tricuspid valve repair surgical techniques. Methods This retrospective study investigated the outcomes of 10 patients who underwent tricuspid valve repair via the tailoring of a simple Gore-Tex vascular graft and implanting it in the tricuspid annulus. Transthoracic echocardiography was used for the preoperative and postoperative evaluation of tricuspid regurgitation (TR). The minimum postoperative follow-up time was three months, compared with a maximum follow-up period of five years. Echocardiographic follow-up was employed to assess the patency of the tricuspid valve repairs. Data are presented as percentages, means, and standard deviations. Statistical analyses were conducted using SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). The primary outcome measures were in-hospital and long-term tricuspid valve competence. We reviewed the literature on tricuspid valve repair to provide a brief overview of this topic. Results The study group comprised 10 patients (8 women and 2 men) with a mean age of 62.3 ± 14.46 years. At hospital admission, all patients were categorized as either NYHA (New York Heart Association) functional class III (80%) or IV (20%). Preoperative TR was severe in 70% of patients and moderate in 30%. The mean pulmonary artery pressure was 57.6 ± 14.98 mmHg. In most patients, the primary indication for surgery was mitral valve pathology in 70% of patients, followed by interatrial septal defect in 30% of patients. Immediately after surgery, nine patients exhibited 1+ TR and one patient had 2+ TR. After long-term follow-up, 77.7% of patients had 1+ TR and 22.3% had 2+ TR. Conclusions Tricuspid valve repair using handmade Gore-Tex band annuloplasty can be an effective method, yielding excellent early and long-term outcomes regarding repair patency, as assessed by echocardiography. This technique is simple, reproducible, and cost-effective.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80474"},"PeriodicalIF":1.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618061","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":"Ultrasound-Guided Rectus Sheath Block With Monitored Anesthesia Care for Necrotic Umbilical Hernia Repair in a Patient With Severe Liver Failure and Refractory Ascites: A Case Report.","authors":"Keisuke Nakazawa, Risyun Ishikawa, Takahiro Suzuki","doi":"10.7759/cureus.80433","DOIUrl":"10.7759/cureus.80433","url":null,"abstract":"<p><p>Patients with severe liver dysfunction present significant perioperative challenges, including the risk of postoperative cognitive dysfunction (POCD) and hepatic encephalopathy (HE), after general anesthesia. While avoiding general anesthesia and deep sedation is crucial for early recovery in this patient population, neuraxial block techniques are often contraindicated due to coagulation disorders. A 73-year-old male patient (190 cm tall, weighing 77 kg) with Child-Pugh C cirrhosis (score 10), coagulopathy (platelets 90,000/μL, prothrombin time (PT) activity 47%), and complex medical history, including treated hepatocellular carcinoma, renal cancer, and bladder cancer, underwent necrotic umbilical hernia repair. The patient, classified as American Society of Anesthesiologists (ASA) physical status IV with a Model for End-Stage Liver Disease (MELD) score of 19, had been hospitalized for two months due to an umbilical hernia infection refractory to antibiotic therapy. After careful preoperative assessment, we selected monitored anesthesia care (MAC) as the preferred anesthetic approach due to the patient's high surgical risk. We performed a bilateral rectus sheath block (RSB) using diluted ropivacaine (0.15%, total 80 mL) with epinephrine (15 μg). Sedation was achieved using dexmedetomidine without a loading dose, supplemented with midazolam and low-dose remifentanil. This approach allowed us to maintain spontaneous breathing while providing adequate analgesia and patient comfort. The surgery was completed successfully with stable hemodynamics and respiratory functions. Throughout the procedure, hemodynamic parameters remained within 20% of baseline values, and bispectral index (BIS) values were maintained between 65 and 80, indicating appropriate sedation depth without excessive anesthetic administration. Ultrasound-guided RSB combined with carefully titrated MAC provides safe and effective anesthesia for umbilical hernia repair in patients with severe liver dysfunction. This approach maintains spontaneous breathing, delivers effective analgesia for somatic and visceral pain, and facilitates clearer differentiation between residual anesthetic effects and worsening HE postoperatively. When coagulopathy precludes neuraxial techniques, this pharmacokinetically informed strategy offers a valuable alternative for high-risk abdominal wall procedures.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80433"},"PeriodicalIF":1.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627121","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":"Artificial Intelligence and Machine Learning: An Updated Systematic Review of Their Role in Obstetrics and Midwifery.","authors":"Paraskevi Giaxi, Victoria Vivilaki, Angeliki Sarella, Vikentia Harizopoulou, Kleanthi Gourounti","doi":"10.7759/cureus.80394","DOIUrl":"10.7759/cureus.80394","url":null,"abstract":"<p><p>Artificial intelligence (AI) and machine learning (ML) are rapidly evolving technologies with significant implications in obstetrics and midwifery. This systematic review aims to evaluate the latest advancements in AI and ML applications in obstetrics and midwifery. A search was conducted in three electronic databases (PubMed, Scopus, and Web of Science) for studies published between January 1, 2022, and February 20, 2025, using keywords related to AI, ML, obstetrics, and midwifery. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for updated systematic reviews. Studies were selected based on their focus on AI/ML applications in obstetrics and midwifery, while non-English publications and review studies were excluded. The review included 64 studies, highlighting significant advancements in AI and ML applications across various domains in obstetrics and midwifery. Findings indicate that AI and ML models and systems achieved high accuracy in areas, such as assisted reproduction, diagnosis (e.g., 3D/4D ultrasound and MRI), pregnancy risk assessment (e.g., preeclampsia, gestational diabetes, preterm birth), fetal monitoring, mode of birth, and perinatal outcomes (e.g., mortality rates, postpartum hemorrhage, hypertensive disorders, neonatal respiratory distress). AI and ML have significant potential in transforming obstetric and midwifery care. The great number of studies reporting significant improvements suggests that the widespread adoption of AI and ML in these fields is imminent. Interdisciplinary collaboration between clinicians, data scientists, and policymakers will be crucial in shaping the future of maternal and neonatal healthcare.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80394"},"PeriodicalIF":1.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607544","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":"Prevalence of Chronic Kidney Disease Among Elderly Patients in the Northeastern Region of Romania: A Descriptive, Cross-Sectional, Retrospective Analysis.","authors":"Ionut Nistor, Ana-Maria Turcu, Anca Elena Stefan, Alexandra Covic, Bogdan Agavriloaei, Gheorghe Mahu, Ioana Alexa, Adrian Covic","doi":"10.7759/cureus.80412","DOIUrl":"10.7759/cureus.80412","url":null,"abstract":"<p><p>In Romania, data pertaining to the incidence and prevalence of chronic kidney disease (CKD) are scant, with an even more limited understanding of the elderly demographic. In this study, we used a descriptive cross-sectional retrospective approach, drawing data from the Geriatrics and Gerontology Clinic at Dr. C.I. Parhon Clinical Hospital in Iași, Romania. We assessed renal function through creatinine measurements and estimated glomerular filtration rate (eGFR) computed using the CKD-Epidemiology Collaboration (EPI) 2021 equation. The final analysis incorporates 1080 patients, categorized based on their eGFR. The average age was 79.76 years. CKD stages 3a-5 prevalence was 25.03% (n=780) and CKD stages 1-5 was 34.6% (n=1080). The most prevalent stage was stage 3a with a frequency of 45% (n=486). Regarding age distribution, 26.2% (n=283) were young elderly, 52.1% (n=563) were elderly, and 21.6% (n=234) were old elderly, with CKD stage 3a prevalent in all age groups. This is the first study in Romania conducted exclusively on elderly patients with CKD. This study was conducted in a university center serving a population of 4.5 million patients, featuring a dedicated nephrology clinic. This study delves into the prevalence of CKD within the elderly demographic, examining its correlation with essential biomarkers of malnutrition. This study spans a decade, from 2012 to 2022, focusing on Romania's northeastern region, specifically Moldova. This is the second substantial analysis carried out in Romania and Eastern Europe, with a unique emphasis on patients aged 65 years and older.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80412"},"PeriodicalIF":1.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607561","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 Safety of Intravenous-to-Oral Lascufloxacin Switch Therapy in Community-Onset Pneumonia: A Single-Arm, Open-Label Clinical Trial.","authors":"Naoki Iwanaga, Naoki Hosogaya, Takahiro Takazono, Yusei Tsukamoto, Ryosuke Morio, Satoshi Irifune, Takuto Miyamura, Yosuke Harada, Yohsuke Nagayoshi, Akira Kondo, Tomo Mihara, Yoshihisa Kohno, Yuichi Fukuda, Tsutomu Kobayashi, Eisuke Sasaki, Toyomitsu Sawai, Yoshifumi Imamura, Toru Morikawa, Kohji Hashiguchi, Yoji Futsuki, Yuichi Inoue, Kiyoyasu Fukushima, Naofumi Suyama, Hiroaki Senju, Hikaru Tanaka, Yurika Kawazoe, Shimpei Morimoto, Yuya Ito, Masataka Yoshida, Kazuaki Takeda, Shotaro Ide, Noriho Sakamoto, Koichi Izumikawa, Katsunori Yanagihara, Hiroshi Mukae","doi":"10.7759/cureus.80404","DOIUrl":"10.7759/cureus.80404","url":null,"abstract":"<p><strong>Background and objective: </strong>For treating community-acquired pneumonia (CAP) in adults, early switching from injectable to oral antimicrobials (switch therapy) is accepted once the clinical course is favorable. Lascufloxacin (LSFX) is a quinolone antibacterial agent, available in intravenous and oral formulations, demonstrating antibacterial activity against a relatively broad spectrum of community-onset pneumonia (COP). No switch therapy using the same drug from injectable to oral antimicrobials has been reported; therefore, we conducted the study to confirm the efficacy and safety of the switch therapy using LSFX.</p><p><strong>Method: </strong>We conducted an open-label, uncontrolled, multicenter study across 16 hospitals from April 2023 to February 2024 to evaluate the efficacy and safety of LSFX switch therapy against mild-to-moderate COP. Once the switch criteria were fulfilled on days 3-5, switch therapy was initiated. The primary endpoint was the cure rate at the time of test of cure (TOC). Secondary endpoints included the proportion of patients receiving switch therapy, clinical efficacy at the end of treatment (EOT), early clinical response, microbiological response at the EOT, and adverse events. The adverse events were collected from the population for the safety analysis set.</p><p><strong>Results: </strong>The median age of the participants was 73 years, and the overall switch therapy implementation rate was 114/120 (95%), aligned with approximately 99/104 (95%) of the switch therapy performed by day three after initiating the therapy. The cure or effective rate was 100/104 (96.2%, 95% confidence interval (CI): 90.44-98.94) at TOC, 101/104 (97.1%, 95% CI: 91.80-99.40) at the early clinical efficacy testing, and 103/104 (99.0%, 95% CI: 94.76-99.98) at EOT. Adverse events related to the study drug were reported in 10.0% of the patients, with hepatic dysfunction as the most common adverse effect. Severe LSFX-induced adverse events were not observed, excluding worsening pneumonia.</p><p><strong>Conclusion: </strong>Switch therapy using LSFX presented high efficacy and acceptable safety profiles against mild-to-moderate severity of COP. This strategy of using the same drug in both intravenous and oral formulations is quite innovative. LSFX may potentially emerge as one of the preferred options for treating COP.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80404"},"PeriodicalIF":1.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617961","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":"Multidisciplinary Management of Single Organism Emphysematous Splenitis Without Splenectomy: A Case Report.","authors":"Suanne C MacConnell, Anand Trivedi","doi":"10.7759/cureus.80389","DOIUrl":"10.7759/cureus.80389","url":null,"abstract":"<p><p>Emphysematous splenitis traditionally requires a splenectomy, resulting in life-long consequences for the patient. <i>Clostridium perfringens</i> is often seen in an immunocompromised population. This case demonstrates a multidisciplinary team approach consisting of percutaneous drainage and a prolonged intravenous and oral antibiotic regime, including ceftriaxone and metronidazole, as well as amoxicillin and clavulanic acid, to provide a successful outcome in an elderly immunocompetent female. This negated the need to proceed to the traditional operative management of splenectomy and validates an equitable conservative approach to treat a <i>C. perfringens</i>-induced emphysematous splenic infection. This approach was undertaken and was likely successful secondary to the haemodynamic stability and immunocompetent baseline of the patient. Her immunocompetency could be maintained due to the non-operative management and should therefore be considered if the clinical situation allows.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80389"},"PeriodicalIF":1.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607555","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}