Cureus最新文献

{"title":"A Case Report and Literature Review on the Management of Foreign Body-Related Duodenal Perforation: Can We Avoid the Scalpel?","authors":"Samuel Ho Ting Poon, Lok Hin K Law, Tat Ming D Chung","doi":"10.7759/cureus.81534","DOIUrl":"10.7759/cureus.81534","url":null,"abstract":"<p><p>Gastrointestinal perforation remains one of the most commonly encountered surgical emergencies. Despite the advancement in surgical techniques and treatment modalities, retroperitoneal duodenal perforation remains a lethal surgical emergency. While perforations of the gastrointestinal tract are typically managed with laparotomy for repair and decontamination, the advancement in endoscopic technique and equipment shed a light on non-operative management for intestinal perforation. We present here a case of duodenal perforation successfully treated by endoscopic approach.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81534"},"PeriodicalIF":1.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765758","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: Glycemic Control in Adult Patients With Type 2 Diabetes Mellitus Receiving Care Through a Nurse-Led Diabetic Follow-Up Clinic Versus Conventional Care: A Randomized Controlled Trial.","authors":"Kalpana Thakur, Suresh K Sharma, Ravi Kant, Vasantha Kalyani","doi":"10.7759/cureus.c215","DOIUrl":"https://doi.org/10.7759/cureus.c215","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.79659.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"c215"},"PeriodicalIF":1.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766188","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":"Medial Tibial Stress Syndrome: A Scoping Review of Epidemiology, Biomechanics, and Risk Factors.","authors":"Mohamed A Saad, Jamal M Jamal, Abdulrazzaq T Aldhafiri, Salem A Alkandari","doi":"10.7759/cureus.81463","DOIUrl":"10.7759/cureus.81463","url":null,"abstract":"<p><p>Regular physical activity confers numerous health and social benefits; however, activity-related lower-limb overuse injuries are prevalent. Medial tibial stress syndrome (MTSS) is a common overuse injury of the lower extremity. It is frequently observed in athletes and in military personnel. It involves exercise-induced pain over the anterior tibia and is an early stress injury in the continuum of tibial stress fractures (TSF). This scoping review aims to synthesize and characterize the literature on MTSS, identify knowledge gaps, and propose future research directions. We conducted a scoping review of the literature, which was informed by the Joanna Briggs Institute and the Arksey and O'Malley methodology, by searching four databases until December 31, 2023. The references were screened by two authors based on their titles, abstracts, and full texts to ensure that they met the inclusion criteria. Data related to the research objectives were extracted, analyzed, and reported numerically and descriptively. Thirty-seven studies were included in the current review, most of which recruited athletes as the study participants (67.6%). This was followed by articles about military members (16.2%). The highest prevalence of MTSS has been reported among recreational marathon runners in India (69.5%). The highest incidence of MTSS was reported in a German study (35.7%). Two studies reported that participants with MTSS had a higher body mass index (BMI) than those without MTSS, and one study found a significant correlation between BMI and the time required for complete recovery. Two studies reported that individuals with greater experience in athletic activities were at a lower risk of developing MTSS later in their careers. In contrast, another study reported that ultramarathon running increases the incidence of MTSS overuse injuries. Traction theory as a cause of MTSS was examined in five studies, and the mean navicular drop test (NDT) score was assessed in three studies. Biomechanical evaluation of ankle disorders and MTSS was performed in five articles and hip abnormalities in four articles. This review identifies research areas on the influence of epidemiological, risk, and biomechanical factors on MTSS development. Such research could inform counseling for patients concerned about MTSS risk factors and curative measures, as well as optimize surveillance and subsequent management of MTSS outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81463"},"PeriodicalIF":1.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766108","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":"Barotrauma-Related Pneumoperitoneum in a Ventilated Child: Distinguishing Air Leak From Bowel Perforation.","authors":"Avinash Hiremath, Mohammed Alblooshi, Ghadir Jaber, Mamoun AlMarzouqi","doi":"10.7759/cureus.81456","DOIUrl":"10.7759/cureus.81456","url":null,"abstract":"<p><p>Pneumoperitoneum in a mechanically ventilated neonate often raises the suspicion of an acute surgical abdomen. However, barotrauma-related pneumoperitoneum resulting from alveolar rupture and air dissection into the peritoneal cavity can mimic gastrointestinal perforation. Differentiating this rare complication of positive-pressure ventilation from a true viscus perforation is essential to prevent unnecessary surgical intervention. We report a two-month-old infant born prematurely with a history of intraventricular hemorrhage and patent ductus arteriosus who presented with frequent apneic episodes, requiring mechanical ventilation at high airway pressures. Serial chest and abdominal radiographs revealed free air under the diaphragm, suggesting pneumoperitoneum. Despite radiographic evidence of potential bowel perforation, the infant remained hemodynamically stable with a soft, non-tender abdomen. A percutaneous peritoneal drain was placed for decompression, but subsequent imaging showed a right-sided pneumothorax requiring chest tube placement. An upper gastrointestinal contrast study confirmed normal bowel continuity with no evidence of perforation, supporting a diagnosis of ventilator-induced pneumoperitoneum. Conservative management-adjusting ventilator settings to reduce peak pressures and maintaining peritoneal drainage-achieved complete resolution of the pneumoperitoneum without surgical exploration. Barotrauma-induced pneumoperitoneum is an important consideration in ventilated infants who develop free intraperitoneal air. Timely recognition and a conservative approach are often sufficient when clinical and radiological findings exclude gastrointestinal perforation. Prompt diagnosis and careful ventilator management can prevent unnecessary laparotomies and optimize outcomes for these vulnerable patients.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81456"},"PeriodicalIF":1.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756658","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 Study to Assess the Association Between Sleep and Migraine.","authors":"Amrit Bansod, Sushant Meshram, Sanjay Ramteke","doi":"10.7759/cureus.81453","DOIUrl":"10.7759/cureus.81453","url":null,"abstract":"<p><p>Introduction Migraines and sleep disturbances affect the majority of people globally. The underlying pathophysiological basis for the role of sleep disturbances in the causation of migraine remains poorly understood due to the complexity of brain functions. As studies assessing the association between sleep disorders and migraine are scarce, the present study was conducted. Materials and methods This study was conducted after obtaining approval from the Institutional Ethics Committee. A total of 60 patients with migraine and 60 age- and gender-matched controls were included after obtaining voluntary, written, and informed consent, provided they met the inclusion and exclusion criteria. Demographic details and relevant histories were noted. Severity of migraine and sleep disturbances was assessed by self-reported questionnaires. Results In the present study, it was noted that both groups were similar in terms of demographic details and personal histories. The global Pittsburgh sleep quality index (PSQI) was significantly higher in cases as compared to controls. Strong positive correlations were noted between global PSQI and numerical pain rating (NPR), headache impact test (HIT-6), and migraine disability assessment (MIDAS) scores. Conclusion Patients with migraine have poor sleep quality and disturbed sleep. The sleep quality also worsens with an increase in the severity of the migraine. Therefore, it is recommended that sleep quality should be evaluated in the initial assessment, and treatment should be instituted accordingly.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81453"},"PeriodicalIF":1.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756653","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 Case of Chronic Expanding Pericardial Hematoma Treated Surgically.","authors":"Kazuki Mori, Satoshi Takebayashi, Masato Morita, Masazumi Kume, Yuichi Nakazono","doi":"10.7759/cureus.81439","DOIUrl":"10.7759/cureus.81439","url":null,"abstract":"<p><p>Chronic expanding hematoma (CEH) is a rare condition characterized by a slowly enlarging hematoma. While chronic expanding hematomas can occur following trauma or surgery, their idiopathic presentation is exceedingly rare. An expanding hematoma can silently lead to diastolic cardiac dysfunction. A 69-year-old woman without a history of thoracic surgery or chest trauma presented with an incidentally discovered pericardial mass measuring 90 × 60 × 45 mm. Imaging revealed a mass with a calcified capsule that compressed the right heart in the anterior mediastinum. Despite initial attempts at off-pump resection, the procedure was converted to on-pump resection because of cardiac injury caused by extensive adhesions. The excised specimen was encapsulated and filled with an old hematoma. Histopathological examination results confirmed the diagnosis of chronic expanding hematoma with no evidence of malignancy. Despite being asymptomatic, the mass was significantly compressing the heart, necessitating surgical resection for diagnostic and therapeutic purposes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81439"},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756703","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":"Recurrent Achilles Tendon Rupture Following Open Surgical Repair, Treated Nonoperatively, and Enhanced With Biological Platelet-Rich Plasma (PRP) Therapy: A Case Report.","authors":"Andrei Visoianu, Gabriela Soare, Constantin Cosmin Baciu, Razvan Ene","doi":"10.7759/cureus.81441","DOIUrl":"10.7759/cureus.81441","url":null,"abstract":"<p><p>Achilles tendon ruptures are common injuries, often occurring in active individuals, with surgical repair being a standard approach for complete ruptures. Cases of open re-rupture of the Achilles tendon represent a rare complication after open surgical repair of that tendon. Literature offers only one or two cases from every author without a consensus on how to deal with this pathology, so each patient should be treated according to the particularities of the case. This case report highlights the management and challenges associated with an open re-rupture of the Achilles tendon in a 35-year-old male patient following primary surgical repair. The patient, a smoker with a BMI of 28.6, initially presented with a complete mid-substance rupture sustained during recreational football. Surgical repair was performed using the Krackow suture technique, followed by structured postoperative rehabilitation. Despite favorable initial recovery, the patient experienced a traumatic open re-rupture of the tendon 14 weeks postoperatively during a sudden jumping motion. Emergency management involved wound closure and non-operative treatment of the incomplete re-rupture, including immobilization and gradual rehabilitation, enhanced with platelet-rich plasma (PRP) injected locally. The patient's subsequent recovery was favorable, allowing him to resume recreational sports six months post-treatment. This case underscores the importance of tailored rehabilitation combined with biological treatment (PRP) that enhances the healing process, the impact of modifiable risk factors, and the need for vigilance in post-repair activity to minimize re-rupture risk.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81441"},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756808","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":"Optimal Surgical Strategies for Posterior Malleolar Ankle Fractures: A Morphology-Based Approach.","authors":"Ting-Yu Chang, Chih-Wei Chang, Yen-Nien Chen","doi":"10.7759/cureus.81325","DOIUrl":"10.7759/cureus.81325","url":null,"abstract":"<p><p>Background Surgical fixation of posterior malleolar fractures (PMFs) has traditionally been guided by fragment size. Recent studies have proposed fragment morphology as a more effective determinant for optimal fixation. To determine the optimal strategy for PMFs, we conducted a radiographic review of our patients. Methods Between January 2016 and December 2019, all adult patients with ankle fractures who underwent surgical fixation at our institution were reviewed (n=648). The exclusion criteria included pilon fractures, tumors, or infections causing neuromuscular dysfunction, insufficient follow-up, bilateral involvement, and prior injuries. After applying these criteria, 110 eligible patients remained for the study. They were further categorized on the basis of treatment type (non-fixation, screw, and plating) and fracture classification system (Haraguchi, Lauge-Hansen, and Weber classifications). The fracture fragment involvement was further classified as large (>25% of the articular surface) or small (<25%). The outcomes were evaluated via the modified Kellgren-Lawrence grade and the final malleolar step-off to assess osteoarthritis severity and fixation stability. Results Compared to non-fixation treatment, surgical intervention was associated with better outcomes in the Haraguchi type 1, supination-external rotation (SER), and pronation-external rotation (PER) groups. Additionally, surgical fixation using plates resulted in a lower step-off rate compared to screws. Notably, patients with small-fragment fractures who underwent surgical fixation exhibited outcomes comparable to or more favorable than those with larger fragments. These findings suggest that fracture morphology with size may have greater prognostic significance than fragment size alone. Conclusion This study on PMFs highlights that fracture morphology, rather than fragment size alone, should guide surgical decision-making for PMFs. Different PMF patterns call for personalized surgical strategies. Compared with screw fixation and non-fixation treatment, plate fixation yields superior outcomes, particularly in terms of joint space narrowing and stability. This study advocates for a morphology-based approach to managing PMFs, prioritizing plate fixation to achieve better results.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81325"},"PeriodicalIF":1.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756800","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":"Successful Treatment of Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Bilateral Ovarian Teratomas Through Three Surgeries Without Loss of Fertility.","authors":"Kazuma Iwata, Daisuke Hamaguchi, Takamitsu Mizota, Yuki Matsuoka, Kiyonori Miura","doi":"10.7759/cureus.81381","DOIUrl":"10.7759/cureus.81381","url":null,"abstract":"<p><p>Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is associated with ovarian teratomas in approximately half of all cases. Surgical removal of these teratomas, combined with immunotherapy, results in rapid improvement in about half of patients. However, the remaining patients exhibit slower improvement and are at risk of severe complications. Additional surgeries may be considered for these patients. Since even microscopic teratomas can contribute to treatment resistance, complete removal of the remaining ovaries is often selected as a surgical approach. However, this approach results in loss of fertility. We report the case of a 28-year-old woman with bilateral ovarian teratomas and a refractory clinical course after initial treatment, including left salpingo-oophorectomy and right cystectomy. She underwent two additional surgeries, one for a residual teratoma and the other for a recurrent teratoma, both involving cystectomies aimed at preserving fertility. She was discharged home a year after admission and gave birth to a baby two years later. Our case is unique in that three surgeries were performed for an anti-NMDA receptor encephalitis patient with teratomas without loss of fertility, and it documents the reproductive outcome of the patient.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81381"},"PeriodicalIF":1.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756824","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":"Retroperitoneal Mass, Abdominal Pain, and Bilateral Hydronephrosis Caused by Testicular Seminoma: A Case Report and Review of the Literature.","authors":"Olaniyi Fadeyi, Saviz Saghari, Ali Esmaeili, Apoorva Cherukuri, Yunfei Wei","doi":"10.7759/cureus.81391","DOIUrl":"10.7759/cureus.81391","url":null,"abstract":"<p><p>Testicular germ cell tumors are very common among young men. Most cases are diagnosed at early stages. However, in some instances, the patient may present with metastasis along with associated symptoms. Complaints after testicular cancer metastasis are diverse and vague. Consequently, it is important for clinicians to be familiar with various forms of presentation seen in testicular cancers. Here, we report a case of a 44-year-old patient who presented to the hospital with complaints of abdominal pain, testicular swelling, and bilateral lower extremity edema. This patient was subsequently diagnosed with testicular seminoma and severe bilateral hydronephrosis. Oncology and Urology were consulted for further management. In this report, we review this rare case and discuss different ways testicular seminoma cases could present clinically.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e81391"},"PeriodicalIF":1.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756813","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}