Cureus最新文献

{"title":"Exploring Non-antibiotic Interventions for Preventing Urinary Tract Infections During Pregnancy: A Systematic Review.","authors":"Shivani Srivastava, Shreekar Roddam, Deepshikha Srivastava, Abdulmumini Shehu, Khyathi Krishna Gogineni, Ruchit Singla, Ahmed Owolabi, Basma Alleelwa, Aliyu O Olaniyi, Olabisi P Lawal","doi":"10.7759/cureus.93874","DOIUrl":"10.7759/cureus.93874","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are a common health concern in pregnancy and often require antibiotic therapy. Antimicrobial resistance (AMR) resulting from antibiotic misuse is a major public health challenge, and non-antibiotic interventions (NAIs) may provide a safer means of prevention. This systematic review evaluated non-antibiotic strategies for preventing UTIs during pregnancy as a way to reduce antibiotic prescribing and combat AMR. The review aims to evaluate the role of NAIs in preventing UTIs during pregnancy, with a focus on their potential to reduce antibiotic prescribing and AMR within the NHS care system. A systematic search of Ovid Medline, Web of Science, and Scopus identified studies that compared NAIs to a placebo, usual treatment, or no intervention. Eligible studies included randomised controlled trials, cohort studies, and other relevant designs. Study quality was assessed using established appraisal tools, and a narrative synthesis was conducted due to intervention heterogeneity. Eight studies met the inclusion criteria, examining cranberry products, Mediterranean diet, OM-89 (an oral immunostimulant also known as Uro-Vaxom), ascorbic acid, and knowledge-based interventions. Evidence from seven studies suggests that NAIs may reduce UTI incidence, but the findings are limited, and further research is needed to confirm their effectiveness during pregnancy. The review concludes that NAIs, particularly cranberry products and the Mediterranean diet, may reduce UTI incidence during pregnancy and offer a promising strategy to limit antibiotic use and AMR. However, given the methodological limitations and low quality of available evidence, further high-quality research is required to establish the safety, efficacy, and cost-effectiveness of these therapies in pregnant women.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93874"},"PeriodicalIF":1.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240643","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":"Serum Vitamin D Level and Disease Activity in Patients With Systemic Lupus Erythematosus.","authors":"Aye Thin Zar Oo, Wint Thandar Oo, Kyaw L Tun, Aung K Myint, May Thu Zar Aye, Nandar E Khin, Khin Pyae Sone, Pyae Sonn","doi":"10.7759/cureus.93853","DOIUrl":"10.7759/cureus.93853","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with variable clinical manifestations and disease activity. Emerging evidence suggests that vitamin D may play a role in immune regulation and disease pathogenesis. This study aimed to investigate the association between serum vitamin D levels and disease activity in patients with SLE at Mandalay General Hospital.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 60 patients diagnosed with SLE. Disease activity was assessed using the Systemic Lupus Activity Measure (SLAM) score. Serum vitamin D levels were measured using the enzyme-linked immunosorbent assay (ELISA) at the National Health Laboratory, Mandalay. Patients were categorized into active and inactive disease groups based on SLAM scores, and intergroup comparisons were made.</p><p><strong>Results: </strong>Among the 60 patients, the majority (43.3%) were aged 21-30 years, with a mean ± SD age of 25.77 ± 7.98 years. Female patients predominated (98.3%; female-to-male ratio 59:1). The mean SLAM score was 9.25 ± 2.94. Common clinical features included anaemia (56.7%), skin rash (33.3%), mucosal ulcers (16.7%), arthritis (16.7%), serositis (11.7%), vasculitis (11.7%), and neuropsychiatric lupus (5%). Patients with active disease had significantly lower serum vitamin D levels (12.2 ± 1.36 ng/mL) compared to those with inactive disease (26.1 ± 10.22 ng/mL; t = 5.55, p < 0.0001). A moderate inverse correlation was observed between SLAM scores and vitamin D levels (Pearson's r = -0.51, p < 0.0001), suggesting a clinically meaningful association between lower vitamin D levels and higher disease activity.</p><p><strong>Conclusion: </strong>This study demonstrates a moderate inverse relationship between serum vitamin D levels and SLE disease activity. These findings suggest that vitamin D may serve as a potential biomarker for disease monitoring. However, due to the cross-sectional design and relatively small sample size, causality cannot be established. Further longitudinal studies are recommended.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93853"},"PeriodicalIF":1.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240698","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":"Ultrasonographic Predictors of Difficult Laparoscopic Cholecystectomy.","authors":"Ibrahim Asim, Ahmed Taymour Algahiny, Omar HeshamEldin Abouelella, Malak Mohamed Refaat Shehab El Din, Omar Samir Mohamed Megahed Saleh Elmitwalli, Mohamed Bakr Elnagar, Haya Khaled Ali Abdulla AlKhalifa, Ahmed Mostafa Abdalla Mohamed, Hosam Alazazzi","doi":"10.7759/cureus.93870","DOIUrl":"10.7759/cureus.93870","url":null,"abstract":"<p><p>Laparoscopic cholecystectomy (LC) is the gold-standard treatment for gallstone disease, but some procedures become technically challenging, resulting in longer operative times, higher conversion rates, and increased complications. Accurate preoperative prediction is essential for safe surgical planning. This review summarizes current evidence on ultrasonographic predictors of difficult LC (DLC) and evaluates validated ultrasound-based scoring systems for preoperative risk stratification. Ultrasound remains the first-line modality for gallbladder assessment and provides several key predictors of surgical difficulty: gallbladder wall thickness (GBWT) consistently demonstrates the strongest independent association with DLC, correlating with conversion and postoperative complications. Pericholecystic fluid, though less frequent, is highly specific for severe inflammation and complex cases. Gallstone impaction at the neck or Hartmann's pouch is a stronger predictor than stone multiplicity. Abnormal gallbladder size, whether contracted or distended, complicates dissection, while common bile duct dilatation serves as a secondary predictor. Several scoring systems combine these sonographic features with clinical variables such as age, sex, obesity, and prior inflammation, helping achieve stronger predictive accuracy.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93870"},"PeriodicalIF":1.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246136","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":"Esketamine in a Patient With Major Depressive Disorder and Polysubstance Use: A Case Report.","authors":"Abdelazim Ali, Nahida Ahmed, Sona Varghese","doi":"10.7759/cureus.93876","DOIUrl":"10.7759/cureus.93876","url":null,"abstract":"<p><p>Major depressive disorder (MDD) frequently co-occurs with substance use disorders (SUDs), leading to poorer outcomes and limited options. Esketamine is approved for treatment-resistant depression (TRD); its effects on craving and abstinence in SUD are less explored. A 41-year-old man with recurrent MDD (suicidal ideation) and polysubstance use (daily morphine/prescription opioids; intermittent methamphetamine) failed multiple antidepressants and engaged in opioid-seeking behavior. Intranasal esketamine was initiated adjunctive to the ongoing oral antidepressant. At one month, depressive symptoms and craving markedly improved. At two months, he achieved abstinence from opioids and methamphetamine. At four months, he returned to work and started a business. At six months, he remained euthymic and abstinent. The Patient Health Questionnaire-9 (PHQ-9) scores dropped progressively from 24 at baseline to 4 at six months. Tolerability was good (transient dizziness, mild dissociation). Beyond rapid antidepressant effects, esketamine may reduce craving via glutamatergic modulation and synaptic plasticity. In conclusion, esketamine may offer dual benefits in TRD with comorbid SUD; however, controlled studies are needed.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93876"},"PeriodicalIF":1.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245979","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":"Unmasking the Masked: A Case Report of Atypical Methotrexate Toxicity Leading to Severe Bone Marrow Suppression.","authors":"Dipesh Karki, Roshna Shrestha, Asmi Pandey, Prashant Neupane","doi":"10.7759/cureus.93828","DOIUrl":"10.7759/cureus.93828","url":null,"abstract":"<p><p>Methotrexate (MTX), a cornerstone in the management of rheumatic diseases, can induce severe adverse effects if not monitored meticulously. This report details a rare case of MTX-induced severe bone marrow suppression in a 65-year-old female, highlighting the critical importance of dosing accuracy, especially in the elderly. The patient, diagnosed with rheumatoid arthritis, experienced an acute episode of toxicity due to a dosing error. This case underscores the necessity for stringent monitoring and patient education to prevent similar incidents.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93828"},"PeriodicalIF":1.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234756","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":"Anemia in Pregnancy: Incidence, Risk Factors, and Outcomes.","authors":"Lateefa O Aldakhil, Saleh Alobaid, Adnan T Almogbel, Saad M Alfouzan","doi":"10.7759/cureus.93807","DOIUrl":"10.7759/cureus.93807","url":null,"abstract":"<p><strong>Background: </strong>In Saudi Arabia, the reported prevalence of anemia in pregnancy varies considerably, reflecting differences in sociodemographic characteristics and nutritional status across study populations.</p><p><strong>Objectives: </strong>This study aimed to (i) determine the prevalence of anemia at the first antenatal visit; (ii) assess prevalence across pregnancy trimesters; (iii) identify risk factors, including compliance with iron and multivitamin supplementation; and (iv) evaluate maternal and neonatal outcomes associated with anemia.</p><p><strong>Methods: </strong>We conducted a prospective cohort study at the antenatal clinic of King Khalid University Hospital, Riyadh, Saudi Arabia, between January 2020 and December 2022. Pregnant women attending their first antenatal visit were consecutively recruited and followed throughout pregnancy. Hemoglobin (Hb) was measured in each trimester, and anemia was defined according to the World Health Organization (WHO) criteria. Outcomes included postpartum hemorrhage (PPH, transfusion, preterm birth, low birth weight (LBW), and neonatal intensive care unit (NICU) admission. Notably, Hb data were available for 220 women (21.9%) in the first trimester, primarily due to late booking. This limitation was acknowledged to ensure transparency regarding potential selection bias.</p><p><strong>Results: </strong>A total of 1003 women were included. The prevalence of anemia increased with gestational age: 26 women (11.8%) at the first visit, 105 women (14.4%) in the second trimester, and 289 women (28.8%) in the third trimester. Advancing gestational age was an independent predictor of anemia (adjusted OR 1.03, 95% CI 1.01-1.05, p = 0.007). Anemia was significantly associated with PPH (18 women (6.3%) vs. 23 women (3.6%), p = 0.047), but not with LBW or NICU admission. Iron supplementation increased progressively during pregnancy, but postpartum continuation was significantly lower among anemic women compared with non-anemic women (195 (67.5%) vs. 528 (83.4%), p = 0.035).</p><p><strong>Conclusion: </strong> Anemia in pregnancy is common among Saudi women and is associated with maternal complications and suboptimal adherence to supplementation. Early screening, strategies to improve compliance, and culturally tailored nutritional counseling are essential to reduce risks.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93807"},"PeriodicalIF":1.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240657","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":"Turning the Tide on Falls: A Narrative Review Toward Safer Aging.","authors":"Ramakant Yadav, Ajay Emani, Roopesh Kirar, Midhun Mohan","doi":"10.7759/cureus.93845","DOIUrl":"10.7759/cureus.93845","url":null,"abstract":"<p><p>Falls are a significant source of morbidity and mortality in the elderly, contributing to functional decline, loss of independence, and increased healthcare burden. Falls are an important public health problem that has a great effect on the quality of life of an individual. Peer-reviewed original and systematic review articles were sourced, which were published from January 2000 until January 2025 in the PubMed/Medline, Embase, and Cochrane Library databases using keywords and Boolean operators like AND, or OR, such as \"falls\", \"elderly\", \"definition\", \"management\", \"aetiology\", \"neurodegenerative diseases\", \"epilepsy and fall\", \"dementia and fall\", and prevention and diagnostic tests for postural instability and falls. This article integrates current guidelines and research to present a comprehensive review on falls in older adults, addressing epidemiology, pathophysiology, risk factors, consequences, and multifaceted prevention strategies to guide clinicians and researchers.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93845"},"PeriodicalIF":1.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Exenatide, a Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist, in Idiopathic Intracranial Hypertension and Polycystic Ovary Syndrome: A Case Report.","authors":"Despina Nicolaou, Nicolas Nicolaou, Lisa M Douglas, Savvas Christou","doi":"10.7759/cureus.93846","DOIUrl":"10.7759/cureus.93846","url":null,"abstract":"<p><p>Idiopathic intracranial hypertension (IIH) and polycystic ovary syndrome (PCOS) are strongly associated with obesity in women of reproductive age. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been extensively reported to facilitate weight loss through central satiety. Emerging evidence demonstrates additional benefits of GLP-1 RAs. Exenatide exerts direct effects on choroid plexus receptors, reducing cerebrospinal fluid (CSF) secretion and intracranial pressure (ICP), and on the ovary, enhancing follicular maturation, restoring ovulation, and improving fertility outcomes in PCOS. A 29-year-old woman with PCOS was referred from gynecology for assessment of intermittent visual blurring and chronic headaches. Ophthalmic examination revealed normal monocular visual acuity of 6/5 in each eye but reduced binocular vision of 6/12, associated with double vision. She also reported a weight gain of 15 kg over eight months. Fundoscopy was unremarkable, with no optic disc swelling. IIH without papilledema (IIHWOP) was diagnosed based on magnetic resonance imaging showing an enlarged pituitary fossa, partial empty sella, and optic nerve sheath dilatation, with lumbar puncture confirming a raised opening pressure of 280 mmH₂O and normal CSF. Initial treatment with acetazolamide was discontinued due to intolerance. Exenatide was subsequently initiated, leading to early improvement in headache frequency and diplopia, independent of weight loss. Menstrual cycles, hormonal profile, and insulin resistance also improved beyond the effect of metformin alone. This case highlights the potential of exenatide to provide dual therapeutic benefits in IIH and PCOS, acting through direct receptor-mediated pathways to reduce ICP, improve headaches, and restore ovulatory cycles, and indirectly through the reduction of central obesity. Further studies are warranted to establish its role in the combined management of these conditions.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93846"},"PeriodicalIF":1.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240635","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":"An Uncommon Confluence: Splenic Lymphangioma and Appendiceal Mucinous Neoplasm.","authors":"İlkay Çinar, Ilker Sengul, Ali Muhtaroğlu, Demet Sengul","doi":"10.7759/cureus.93804","DOIUrl":"10.7759/cureus.93804","url":null,"abstract":"<p><p>Splenic lymphangiomas, per se, are exceedingly rare, benign congenital malformations of lymphatic vessels, typically diagnosed in childhood or incidentally in adulthood. Appendiceal mucinous neoplasms (AMNs) are also infrequent, often asymptomatic, and usually discovered incidentally. To date, the co-occurrence of these two distinct primary lesions in the same patient has not been previously reported. We present the case of an 83-year-old Turkish female who underwent emergent abdominal surgery for an acute abdomen secondary to a strangulated left diaphragmatic herniation. Multiple perforations were identified in the transverse colon, accompanied by widespread ischemia involving the terminal ileum, cecum, and right colon. Upon laparotomy, a diaphragmatic defect measuring approximately 10 cm in diameter was identified in the left hemidiaphragm. The herniated abdominal viscera were meticulously reduced and examined, and multiple perforations were identified in the transverse colon, accompanied by widespread ischemia involving the terminal ileum, cecum, and right colon. An emergent splenectomy was performed due to severe ischemia and irreparable structural damage observed within the compromised hernia sac, with the resection of the terminal ileum, the ascending, and transverse colon. During the operative intervention, both a splenic lymphangioma and a low-grade AMN were incidentally discovered. The histological diagnosis was confirmed with factor VIII-related antigen (factor VIII-R antigen) immunohistochemical positivity. The patient, unfortunately, succumbed on the fifth postoperative day due to progressive multi-organ failure. This report documents the first known instance of the simultaneous identification of splenic lymphangioma and AMN as primary lesions in a single patient. This unique case underscores the critical importance for surgeons to remain vigilant for unexpected pathologies and highlights the necessity of a multidisciplinary approach in evaluating rare incidental findings for appropriate classification and follow-up.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93804"},"PeriodicalIF":1.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240671","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":"Preoperative Prediction of Chronic Post-surgical Pain Risk After Total Knee Arthroplasty: Insights From a Single-Center Case-Control Study.","authors":"Bhavesh Santani, Shubhabrata De, Diego Vergara-Jalandoni, Abhina George, Venancio Manipol, Ulfat Sardar, Rakshya Upreti, Ashwin Unnithan","doi":"10.7759/cureus.93815","DOIUrl":"10.7759/cureus.93815","url":null,"abstract":"<p><p>Background Chronic post-surgical pain (CPSP) is a common and distressing complication following total knee arthroplasty (TKA). Despite advancements, CPSP remains a significant challenge, necessitating the development of a predictive model to identify at-risk patients. Materials and methods This level III case-control study analyzed 869 patients who underwent TKA between 2019 and 2021 at a single center. Data on demographics, comorbidities, mental health conditions, pre-existing pain, opioid use, substance abuse, and surgical factors were collected. Univariate and multivariate logistic regression analyses were conducted to identify significant preoperative risk factors. Independent predictors from multivariate analysis were assigned weighted scores proportional to their odds ratios, which were then adjusted according to previous literature and investigator consensus to create a clinically usable tool. Receiver operating characteristic (ROC) curve analysis was performed, and cutoffs were identified to optimize sensitivity and specificity. Results Out of 869 patients who underwent TKA, 15.7% (n = 136) developed CPSP. Out of these 136 patients, 22% (29) were referred to specialist pain management clinics. Univariate analysis identified seven significant predictors: diabetes mellitus, coronary artery disease (CAD), heart failure, mental health conditions, pre-existing pain, and preoperative opioid use. The multivariate analysis excluded heart failure (p = 0.098). The strongest association was found with CAD (OR = 2.98). A scoring system was developed, and an ROC analysis yielded an area under the curve of 0.616 (95% CI: 0.562-0.671, p = 0.001). Conclusions Identifying preoperative risk factors and using this score as a predictive model, pending further prospective validation, can help stratify patients and enable targeted interventions, potentially minimizing the impact and financial burden of CPSP after TKA.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93815"},"PeriodicalIF":1.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234768","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}