Cureus最新文献

{"title":"Full-Mouth Disinfection Using Oral Sitafloxacin for Stage III and IV Grade C Periodontitis With High Bacterial Load: A Case Series.","authors":"Satoru Morikawa, Takazumi Yasui, Taneaki Nakagawa","doi":"10.7759/cureus.78531","DOIUrl":"10.7759/cureus.78531","url":null,"abstract":"<p><p>This case series presents a novel treatment approach for severe periodontitis with high bacterial loads in four patients (aged 32-47 years), including three cases of stage III and one case of stage IV, grade C periodontitis. After conventional scaling and root planing failed in one case, we developed a protocol combining full-mouth disinfection (FMD) with oral sitafloxacin (STFX) for cases with high levels of subgingival periodontal pathogens. FMD involved thorough debridement within 1 week, with STFX (100 mg/day) administered for 7 days. Clinical and microbiological parameters were evaluated before and after treatment. The results showed marked improvements in probing pocket depth, bleeding on probing, and inflamed periodontal surface area, with substantial reductions in red complex bacteria. This approach often eliminates the need for periodontal surgery, even in deep pockets, suggesting FMD with STFX as an effective nonsurgical alternative for severe periodontitis with significant bacterial load.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78531"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384440","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":"Safety of Compounded Medications.","authors":"Rohini Garg, Harmit Singh","doi":"10.7759/cureus.78541","DOIUrl":"10.7759/cureus.78541","url":null,"abstract":"<p><p>Compounded medications are medications that are prepared by compounding pharmacies to meet individual patients' needs that cannot be met by FDA-approved brand name or generic medications. This may be the case when a patient needs a different dose or route of administration or if a patient is allergic to a certain ingredient in an FDA-approved medication. While compounded medications help to fill a necessary gap, they can have significant safety issues. Due to lesser regulatory oversight, patient safety may be compromised due to contamination or inaccurate potency of compounded medications. Compounded medications should be prescribed only when an FDA-approved medication cannot be used, and the benefits outweigh the risks. Enforcement of adequate oversight by regulatory agencies and maintenance of strict safety precautions at the compounding facilities are needed to ensure patient safety.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78541"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256488","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":"Two Cases of Prurigo Nodularis in Hematologic Malignancies: Hodgkin Lymphoma and Waldenström Macroglobulinemia.","authors":"Filipa Reis, Francisca Sarmento, Sara Sarmento, Marta Freixa","doi":"10.7759/cureus.78540","DOIUrl":"10.7759/cureus.78540","url":null,"abstract":"<p><p>Prurigo nodularis (PN) is a chronic inflammatory skin disorder marked by intense itching and firm, pruritic nodules, often linked to dermatologic, autoimmune, or systemic conditions, including malignancies such as hematologic cancers. We present two cases illustrating PN as a potential cutaneous manifestation of hematologic malignancies: a 48-year-old male with a history of psoriasis and persistent pruritus misdiagnosed as scabies, later found to have Hodgkin lymphoma, and an 86-year-old female with fatigue, anemia, and erythematous lesions diagnosed with Waldenström macroglobulinemia. These cases underscore the importance of recognizing PN as a symptom of underlying malignancy, enabling earlier diagnosis and treatment to improve outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78540"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257277","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":"Disseminated Histoplasmosis as a Presentation of Advanced HIV-1 Infection in a Non-endemic Country.","authors":"Débora A Alves, João Trêpa, José Sousa-Baptista, João Pereira-Vaz, Rui Tomé","doi":"10.7759/cureus.78581","DOIUrl":"10.7759/cureus.78581","url":null,"abstract":"<p><p>Disseminated histoplasmosis is an opportunistic fungal infection considered an AIDS-defining illness, sometimes with a fatal outcome. We report a case of disseminated histoplasmosis as the initial presentation of advanced HIV-1 infection in a migrant living in a non-endemic area. Histoplasmosis was suspected based on the clinical presentation, epidemiological factors, and observation in the peripheral blood smear of neutrophils and monocytes with yeast-like forms. The diagnosis was confirmed through a positive peripheral blood smear and subsequent culture of <i>Histoplasma capsulatum</i> from a bronchoalveolar lavage sample. The patient was treated with 14 days of liposomal amphotericin B plus oral itraconazole for two years, with a good response. Direct examination of peripheral blood has been considered a valuable diagnostic method, specifically in severely immunocompromised patients, as our case report. The presented case highlights the importance of considering disseminated histoplasmosis in the differential diagnosis of HIV-infected patients, even in non-endemic regions. Hence, the need for a high index of suspicion to ensure early diagnosis and treatment is crucial as the influx of migrants increases globally.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78581"},"PeriodicalIF":1.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366981","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":"Interactions Between Anesthesia and Sleep: Optimizing Perioperative Care to Improve Sleep Quality and Surgical Recovery Outcomes.","authors":"Sahil Patel, Raymond Ownby","doi":"10.7759/cureus.78505","DOIUrl":"10.7759/cureus.78505","url":null,"abstract":"<p><p>Sleep is a fundamental physiological process that supports immunity, cognition, memory, and metabolism, making it essential for overall health and well-being. Poor-quality sleep is associated with the onset of many diseases, including cardiovascular and mental health disorders. When using anesthesia, it is essential to have a thorough understanding of the metabolic dysfunction and immunosuppression linked to sleep loss to ensure appropriate perioperative management. Commonly used agents like propofol, sevoflurane, and ketamine affect consciousness, pain levels, and autonomic responses. Inhaled anesthetics (e.g., sevoflurane and isoflurane) and intravenous anesthetics (propofol) act on gamma-aminobutyric acid (GABA) receptors and influence stages of sleep and circadian rhythms. Ketamine may uniquely preserve some aspects of restorative sleep, while most anesthetics affect rapid eye movement (REM) and slow wave sleep (SWS), altering cognitive and physical recovery. Modifying anesthetic regimes depending on the patient's sleep history and risk factors can maximize sleep health and postoperative patient outcomes. The physiological effects of anesthesia on the central nervous system persist beyond the perioperative period by influencing sleep quality, circadian regulation, and postoperative outcomes. Effective pain management is a significant component in addressing sleep quality. Opioids, while effective for pain relief, disrupt sleep architecture by reducing REM and SWS, increasing awakening frequency, and potentially causing respiratory depression. Multimodal pain therapy, including non-opioid analgesics, can reduce dependence, improve sleep quality, and lower adverse effects. Anesthetic agents can influence the body's internal clock, leading to mood changes, fatigue, and cognitive deficits. This review exploits the relationship between sleep and anesthesia, detailing the effect of anesthetic agents on the quality, architecture, and recovery of sleep patterns post-surgery. It also explores how these agents influence sleep stages, such as REM and non-REM sleep, and their implications for patient outcomes. Incorporating sleep optimization techniques can enhance recovery timelines and patient well-being. Researching anesthetic techniques that support postoperative sleep health is essential for further improving patient outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78505"},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191343","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: Differences Between Medication-Related Osteonecrosis of the Jaw Caused by Bisphosphonates and Denosumab: Histological, Molecular Biological, and Clinical Studies.","authors":"Taro Miyoshi, Mitsunobu Otsuru, Kota Morishita, Keisuke Omori, Kei-Ichiro Miura, Saki Hayashida, Satoshi Rokutanda, Yuki Matsushita, Masahiro Umeda, Tomohiro Yamada","doi":"10.7759/cureus.c210","DOIUrl":"https://doi.org/10.7759/cureus.c210","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7759/cureus.62855.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"c210"},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256087","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":"Functional Recovery After 18 Sessions of Radio Electric Asymmetric Conveyor Tissue Optimization Reparative Protocol for Hill-Sachs Lesion in a Post-traumatic Shoulder Dislocation.","authors":"Alessandro Castagna, Enrico Castagna, Vania Fontani, Salvatore Rinaldi","doi":"10.7759/cureus.78495","DOIUrl":"10.7759/cureus.78495","url":null,"abstract":"<p><p>This case report describes the clinical progress of a 22-year-old male patient diagnosed with a consolidating Hill-Sachs lesion, treated with 18 sessions of Tissue Optimization Reparative (TO-Rpr) protocol, specific to Radio Electric Asymmetric Conveyor (REAC) technology. At baseline, the patient reported persistent pain with a numeric rating scale (NRS) score of 7 out of 10 and significant functional limitations of the shoulder (flexion 90°, abduction 70°, external rotation 20°), accompanied by bone marrow edema, tendinous alterations, and significant inflammation. The therapeutic protocol aimed to modulate tissue bioelectric activity to promote reparative processes and reduce inflammation. Follow-up MRI, performed four months after treatment, revealed complete resolution of bone marrow edema, normalization of tendinous structures, and reduced cortical irregularities. Clinically, flexion improved to 160°, abduction to 150°, and external rotation to 70°, with muscle strength restored to 5/5 and pain reduced to 0/10 on the NRS. This case highlights the role of REAC TO-Rpr treatment in managing complex joint lesions, showcasing its potential to significantly improve clinical and radiological parameters within a short timeframe.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78495"},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256090","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":"Global Awareness and Response to Early Symptoms of Acute Stroke: A Systematic Literature Review.","authors":"Theodoros Vatsalis, Dimitrios Papadopoulos, Vasiliki Georgousopoulou, Prodromos Bostantzis, Jobst Rudolf","doi":"10.7759/cureus.78420","DOIUrl":"10.7759/cureus.78420","url":null,"abstract":"<p><p>Stroke is a condition that leaves persistent disability and causes high mortality worldwide. Knowledge of recognizing early symptoms along with awareness of immediate response to acute stroke among the general population has proven insufficient. Pre-attendance delays adversely affect the time window from symptoms onset to needle time, therefore the effect of recanalization treatments. Although 35% of patients are potentially eligible for these treatments such as intravenous thrombolysis only about about 8-10% of them manage to receive. The study aimed to investigate the association between knowledge of early symptoms in the general population and proper response to acute stroke through prompt activation of emergency medical services (EMS) independently of sociodemographic factors. A systematic review was conducted to identify relevant studies that assessed the general population's knowledge of early symptom recognition and awareness of immediate response to acute stroke. Two investigators reviewed articles published in the PubMed database, from December 1, 2023, to February 29, 2024. The search yielded a total of 340 articles. After the 340 articles were screened, 293 reports were excluded due to title and abstract, irrelevant studies, or when the full text was not available. Finally, a total of 10 articles were included in this systematic review. Out of ten studies included in this review, seven studies were conducted in Asia, in one study the origin continent is Oceania, while the remaining two studies come from America. All studies were designed and conducted as cross-sectional studies. The most commonly recognizable early symptoms of a stroke were found to be difficulty in speaking or understanding speech, weakness on one side of the body including the face, plus sudden dizziness. Regarding responding to early stroke symptoms, the EMS call option gathered the most preferences of the respondents by 80%. Enlightenment campaigns are needed to highlight acute stroke symptoms unknown to the general public such as facial asymmetry.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78420"},"PeriodicalIF":1.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366992","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":"Comparative Efficacy and Safety of Netarsudil-Containing Interventions for Intraocular Pressure Control: A Systematic Review and Network Meta-Analysis.","authors":"Bakhtawar Awan, Mohamed Elsaigh, Areej Tariq, Mohammed Badee","doi":"10.7759/cureus.78432","DOIUrl":"10.7759/cureus.78432","url":null,"abstract":"<p><p>Netarsudil has been approved for lowering elevated intraocular pressure (IOP), showing effectiveness through two distinct mechanisms. It is also effective when used in combination with other therapies to enhance outcomes. This study aims to compare the drug's effectiveness with other treatments, both as a standalone and in combination therapies, while also assessing potential adverse effects to evaluate its overall safety and suitability. We systematically searched PubMed, Cochrane, Web of Science, and Scopus till the 7th of October. Data from eligible studies were extracted and combined using a frequentist network meta-analysis, presented as mean differences (MDs) for continuous outcomes and risk ratios (RRs) along with their 95% confidence intervals (CIs). We used the Cochrane risk-of-bias (ROB) tool to assess the quality of the included RCTs. Netarsudil 0.02%/latanoprost 0.005% fixed-dose combination (FDC) q.d. was the most effective in reducing IOP in one-, two-, and six-week follow-ups in addition to the three-month follow-up. The netarsudil-containing medication was associated with higher adverse events compared to other arms. Netarsudil 0.02%/latanoprost 0.005% FDC q.d. and bimatoprost 0.03%/timolol 0.5% FDC emerged as the most effective therapies for lowering IOP, with each showing significant advantages at different follow-up points. Both FDCs achieved substantial reductions in IOP and a high proportion of patients reaching target IOPs. However, safety profiles indicate that traditional therapies like latanoprost 0.005% and timolol 0.5% may have fewer side effects, including lower incidences of blurred vision, conjunctival hemorrhage, and conjunctival hyperemia.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78432"},"PeriodicalIF":1.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124264","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":"Severe Thrombocytopenia in Pregnancy Secondary to Influenza A.","authors":"Donya T Sabet, Luke Prior, Lilantha Wedisinghe","doi":"10.7759/cureus.78449","DOIUrl":"10.7759/cureus.78449","url":null,"abstract":"<p><p>Thrombocytopenia is a common finding in pregnancy, with the majority due to gestational thrombocytopenia. Gestational thrombocytopenia is an innocuous condition that rarely requires treatment. Immune thrombocytopenia accounts for only a minority of thrombocytopenia in pregnancy and can have serious implications, especially in the peripartum period, including restrictions on birth plans and complications such as postpartum haemorrhage and neonatal thrombocytopenia. We present a case of possible immune thrombocytopenia secondary to influenza A infection. The case involves a 19-year-old, gravida-2, para-1, who developed severe thrombocytopenia shortly after influenza A, with a nadir platelet count of 31 × 10⁹/L. The platelet count returned to normal levels after six days of oral prednisolone 25 mg. This case highlights the importance of a thorough workup to identify more serious conditions causing thrombocytopenia.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 2","pages":"e78449"},"PeriodicalIF":1.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256561","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}