Cureus最新文献

{"title":"Progress to Date on Cranial Electromagnetic Field Stimulation to Modulate Brain Activity.","authors":"Alice S Wang, Paras Savla, James Brazdzionis, Katherine Ko, Dan E Miulli","doi":"10.7759/cureus.84653","DOIUrl":"10.7759/cureus.84653","url":null,"abstract":"<p><strong>Background: </strong>The electromagnetic field (EMF) of the brain can be modulated through EMF stimulation. The authors investigate whether longer duration of continuous EMF stimulation using a novel method to identify and provide feedback and adjustment of EMF recording would translate into sustained improvement in EMF patterns, such as higher amplitude with correlating improvement in clinical symptoms or deficits.</p><p><strong>Methods: </strong>From January 2025 to February 2025, a prospective study enrolled patients greater than 18 years old diagnosed with atraumatic and traumatic brain injury who underwent EMF stimulation within 24 hours of presentation. EMF data were collected using DAQami software (Dataq Instruments, Akron, Ohio) and analyzed using fast Fourier transformation (FFT) with Igor Pro 8 software (Wavemetrics Inc., Lake Oswego, Oregon). Based on each patient's clinical presentations and/or radiographic findings, localization of brain injuries, frequency selection, and optimal voltage stimulation were determined in real-time followed by delivery of incremental increase in duration of stimulation from 3, 5, 8, and 10 minutes until improvement in clinical symptoms and/or neurological deficits and sustained EMF change was achieved.</p><p><strong>Results: </strong>Ten patients were included in this study, with a mean age of 47.1 years. Mechanisms of injury included spontaneous hypertensive intracranial hemorrhage (1 patient) and head trauma after motor vehicle collision, dirt bike accident, and ground-level fall (9 patients). Radiographic findings included spontaneous basal ganglia hemorrhage (1 patient), isolated traumatic subdural hematoma (1 patient), traumatic subarachnoid hemorrhage (1 patient), and no intracranial abnormalities (7 patients). Clinical resolution of their neurological symptoms or remaining asymptomatic was achieved in five patients after three minutes of continuous EMF stimulation, two patients after five minutes of continuous EMF stimulation, and one patient after 10 minutes of continuous EMF stimulation (Table 1). Patient 8 declined to continue with the study after three minutes of continuous EMF stimulation, and patient 9 declined to continue with the study after five minutes of continuous EMF stimulation.</p><p><strong>Conclusions: </strong>This study reveals the progress made to date utilizing a novel technology of EMF measurement at a distance, in real-time, using the non-invasive, lightweight portable helmet, and continuous feedback. The range of brain EMF can be stimulated at the optimal frequency and voltage with or without longer duration of stimulation in a precise and prescribed manner to produce sustained genetic and neuronal changes to improve, recover, and enhance the brain function in a sample of patients with atraumatic and traumatic brain injury and improve or resolve their neurological symptoms or deficits. It illustrates the necessity of real-time evaluation and adjustment of brain E","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84653"},"PeriodicalIF":1.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145126","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":"Anesthesia for Urgent Gastroscopy in Cold Agglutinin Disease: A Case Report and Literature Review.","authors":"Addison H Zhang, Cassie L Dow, Jack Bellamy","doi":"10.7759/cureus.84607","DOIUrl":"10.7759/cureus.84607","url":null,"abstract":"<p><p>We present the case of a 76-year-old lady who underwent an emergency gastroscopy for suspected upper gastrointestinal bleeding on a background of cold agglutinin disease, a rare autoimmune haemolytic anaemia triggered by cold temperatures. Several pre-operative and intra-operative precautions were taken to minimise the risk of hypothermia. Sedation anaesthesia was used with midazolam and gradual titration of propofol with high-flow nasal cannulae to maintain oxygenation. The anaesthetic proceeded safely and without complications, and we compared our technique to the literature.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84607"},"PeriodicalIF":1.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129521","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":"Urosepsis From Nephrolithiasis Caused by Candida glabrata: A Rare Etiology of Urinary Sepsis in an Immunocompetent Patient.","authors":"Jonathan Van Name, Krunal Shukla","doi":"10.7759/cureus.84600","DOIUrl":"10.7759/cureus.84600","url":null,"abstract":"<p><p>Nephrolithiasis can often serve as an infection nidus, as it is typically associated with urease-producing bacteria and can obstruct the urinary tract, leading to pyelonephritis. While most urinary tract infections from septic stones are bacterial in etiology, fungal causes are less commonly reported in immunocompetent patients and rarely manifest as fungemia. Among fungal causes, <i>Candida albicans</i> is the most common. We describe the case of a 41-year-old immunocompetent patient with a history of recurrent kidney stones and percutaneous nephrostomy tube placement, who developed sepsis from a urinary source secondary to a nephrolithiasis. Blood culture isolates grew <i>Candida glabrata</i>. Following identification of the fungus, the patient received a two-week intravenous micafungin course and outpatient stone removal per urological surgery.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84600"},"PeriodicalIF":1.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129732","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: Association Between Body Mass Index and the Efficacy of Calcium Channel Blockers for Hypertension in Cardiovascular Disease Patients.","authors":"Bassel Abdallah, Ahmed Jamal Chaudhary, Muhammad Waqas Javed, Marium Nadeem Khan, Ayesha Bibi, Muhammad Fayyaz Zafar, Muhammad Noor, Usman Tariq, Farzana Salman","doi":"10.7759/cureus.c225","DOIUrl":"https://doi.org/10.7759/cureus.c225","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.81985.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"c225"},"PeriodicalIF":1.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145184","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 Rare Case of Disseminated Varicella Zoster Virus (VZV) Infection Complicated by VZV Pneumonia.","authors":"Suhel A Sabunwala, Tuhina Cornelius","doi":"10.7759/cureus.84630","DOIUrl":"10.7759/cureus.84630","url":null,"abstract":"<p><p>Disseminated varicella zoster virus (VZV) infection is rare in older adults. It is usually seen in immunocompromised adults. It usually manifests as generalized skin lesions, and most patients respond to Acyclovir treatment. Very few cases have been reported where the infection progresses to involve the lungs. Here we present a case of a young female with a history of uncontrolled human immunodeficiency virus (HIV) infection who presented with diffuse skin lesions that were tested positive for VZV. Despite starting on an appropriate regimen with Intravenous Acyclovir, the patient progressed to develop severe pneumonia and respiratory failure.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84630"},"PeriodicalIF":1.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217879","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 Knowledge, Attitude, and Practice Study on Trauma-Informed Care Among Nurses Working in a Hospital in Lucknow District.","authors":"Rajeev Misra, Akanksha Mishra, Rajgopal Reddy, Divyanshi Singh","doi":"10.7759/cureus.84652","DOIUrl":"10.7759/cureus.84652","url":null,"abstract":"<p><p>Background Trauma-informed care (TIC) is a framework that acknowledges the widespread impact of trauma and integrates knowledge about its effects into healthcare practices. As frontline caregivers, nurses frequently encounter patients with trauma histories. Their knowledge, attitude, and practice (KAP) regarding TIC are crucial in ensuring compassionate, effective, and patient-centered care. However, there is limited research assessing the understanding and implementation of TIC among nurses in Indian healthcare settings, particularly in Lucknow District. Materials and methods A cross-sectional, web-based survey was conducted from March 2024 to July 2024, using a random sampling method to assess nurses' KAP regarding TIC at Chandan and Fatima Hospitals. Results Among 208 nurses, 52.88% had 1-5 years of experience. No significant association was found between age and trauma-related perceptions (<i>p</i>> 0.05). Education (<i>p</i> = 0.049) and gender (<i>p</i> = 0.004) significantly influenced TIC techniques, with general nursing and midwifery (GNM) nurses and females predominantly using a broader range of therapeutic approaches. Conclusions This study is significant because it will provide evidence-based insights into the preparedness of nurses in Lucknow District regarding TIC. The findings can contribute to improved nursing education, hospital policies, and patient outcomes by promoting a more trauma-sensitive healthcare environment.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84652"},"PeriodicalIF":1.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145159","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":"Biologic Therapies in the Management of Sports-Related Tendon and Ligament Injuries: A Narrative Review.","authors":"David Koshy, Daniel I Koshy, Emma Ooi","doi":"10.7759/cureus.84556","DOIUrl":"10.7759/cureus.84556","url":null,"abstract":"<p><p>Sports-related tendon and ligament injuries are common among athletes and active individuals, often resulting in prolonged recovery and compromised performance. Traditional management strategies, including physiotherapy and surgical repair, may not yield optimal outcomes, prompting growing interest in biologic therapies such as platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and other regenerative modalities. This targeted narrative review synthesizes current evidence on the application of biologic therapies in treating tendon and ligament injuries, emphasizing their mechanisms of action, clinical efficacy, and limitations. Relevant studies were identified through a focused search of PubMed and Google Scholar from 2010 to 2024. PRP demonstrates sustained pain and function improvement in chronic tendinopathies, whereas MSCs show promise in enhancing graft integrity in ligament reconstruction; however, variability in preparation protocols and limited long-term randomized controlled trials constrain firm conclusions. Emerging approaches, including exosomes and scaffold-based delivery systems, offer new avenues for enhancing tissue healing. Biologic interventions hold considerable promise in augmenting soft tissue injury treatment, but standardized protocols and further high-quality trials are needed to support widespread adoption.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84556"},"PeriodicalIF":1.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145178","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 a Continuous Intravenous Insulin Protocol Modified for East Asians in Postoperative Glycemic Management Following Pancreatectomy.","authors":"Hironobu Sasaki, Kazuma Yagi, Ryota Kogure, Masayuki Honda, Dal Ho Kim","doi":"10.7759/cureus.84527","DOIUrl":"10.7759/cureus.84527","url":null,"abstract":"<p><p>Introduction Glycemic control following pancreatectomy presents challenges, especially in patients with diabetes due to a lack of endogenous insulin, however, optimal management remains unclear. This study evaluated the efficacy and safety of a continuous intravenous insulin infusion protocol employed at our institution, in comparison with conventional glycemic control in patients with pancreatectomy. Materials and methods Sixty-one patients with preoperative glycosylated hemoglobin (HbA1c) of 6.5% or higher, on diabetes medications, or who underwent total pancreatectomy were included. Patients were categorized into three groups: insulin protocol (IP group, <i>n</i> = 24), subcutaneous injection (SI group, <i>n</i> = 15), and continuous intravenous insulin infusion based on the empirical control (EC group, <i>n</i> = 22). The primary outcomes were average blood glucose levels and the proportion of achievement within the target blood glucose range (140-180 mg/dl). Additionally, factors associated with the insulin dose in the IP group were analyzed. Results At predefined time points, the IP group achieved a significantly higher proportion of the target blood glucose range than the SI group (46.2% vs. 31.6%, <i>p</i> = 0.01), with no significant difference in average blood glucose levels (164.1 ± 41.8 vs. 169.1 ± 51.0 mg/dl, <i>p</i> = 0.50). During the 60-hour period following the initiation of frequent blood glucose measurements, the IP group demonstrated significantly reduced average blood glucose levels than the EC group (170.1 ± 56.0 vs. 175.5 ± 43.5 mg/dl, <i>p</i> <0.001), despite significantly longer measurement intervals (1.5 ± 0.7 vs. 1.2 ± 0.7 hours, <i>p</i> <0.001). However, there was no significant difference in the proportion of the target blood glucose range between the IP and EC groups (37.2% vs. 41.0%, <i>p</i> = 0.11). Aspartate transaminase and alanine transferase levels on postoperative day one were positively correlated with the average insulin dose in the IP group (both <i>R</i> = 0.45, <i>p</i> = 0.03). Conclusions This IP helped stabilize blood glucose levels compared to subcutaneous injections and improved glycemic control more effectively than empirically administered continuous intravenous insulin infusion. Postoperative elevations in liver enzymes may serve as predictors of increased insulin requirements.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84527"},"PeriodicalIF":1.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121864","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: Comparison of Assisted Reproductive Technology (ART) Outcomes in Two Controlled Ovarian Stimulation Protocols Using Follitropin Delta, a Recombinant Follicle-Stimulating Hormone (rFSH) Injection.","authors":"Shoji Kokeguchi, Eri Okamoto, Hiroaki Shibahara, Kazuki Yamagami, Kohyu Furuhashi, Noritoshi Enatsu, Masahide Shiotani","doi":"10.7759/cureus.c224","DOIUrl":"https://doi.org/10.7759/cureus.c224","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.81281.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"c224"},"PeriodicalIF":1.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129577","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":"Prescription Digital Therapeutics Research Across Clinical, Engagement, Regulatory, and Implementation Domains: A Bibliometric and Thematic Study.","authors":"Shaheen E Lakhan","doi":"10.7759/cureus.84528","DOIUrl":"10.7759/cureus.84528","url":null,"abstract":"<p><p>Prescription digital therapeutics (PDTs) are Food and Drug Administration (FDA)-authorized software-based treatments designed to treat a range of conditions on the smartphone. Their development and deployment rely on four foundational scientific domains: clinical, engagement, regulatory, and implementation. However, the relative representation of these domains in the PDT literature has not been systematically characterized. We conducted a bibliometric and thematic analysis of PubMed-indexed articles published between 2020 and 2025 containing the term \"prescription digital therapeutic(s).\" Metadata and abstracts were extracted, cleaned, and analyzed using natural language processing for this review. Topic modeling was performed to identify key thematic areas, and each abstract was classified into one or more of the four foundational domains using a structured keyword heuristic framework. Trends in publication volume, authorship, domain co-occurrence, and thematic focus were visualized. Sixty-one unique articles met the inclusion criteria. Publication activity increased over time, peaking in 2022 and 2024. Most first authors were based in the United States, with industry-affiliated authorships predominating. The most frequently publishing journals were Frontiers in Psychiatry and Health Affairs (Millwood). Clinical science was referenced in 45 (74%) papers, followed by engagement science in 35 (58%), regulatory science in 28 (46%), and implementation science in 18 (29%). Only seven (12%) articles addressed all four domains. Topic modeling identified five major themes: substance use and cost modeling, regulatory frameworks, insomnia treatment, engagement strategies, and gamified pediatric interventions. Co-occurrence analysis revealed strong overlap between clinical and engagement domains, while regulatory and implementation science appeared less frequently in combination. The literature on PDTs remains concentrated in clinical and engagement domains, with limited attention to regulatory strategy and real-world implementation. Greater integration across all four scientific domains is needed to ensure that PDTs are not only effective but also scalable, fundable, and embedded into routine care.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 5","pages":"e84528"},"PeriodicalIF":1.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121665","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}