Cureus最新文献

{"title":"Shorter Night Splinting by a Modified Ponseti Method With Similar Foot-Function and Health-Related Quality of Life.","authors":"Angela Seidel, Severine Tinembart, Nadine Kaiser, Kai Ziebarth","doi":"10.7759/cureus.80260","DOIUrl":"10.7759/cureus.80260","url":null,"abstract":"<p><p>Background The Ponseti method is the most frequent method for clubfoot treatment. It includes a six-year night-splinting period, which is difficult to comply with. The objective of this study is to evaluate the clinical outcomes, recurrence rates, and patient-reported health-related quality of life following a modified Ponseti method with reduced night splinting duration. Methods We analyzed 107 children (77 boys, 30 girls, 152 clubfeet) who were treated for idiopathic clubfoot from January 1994 to January 2015. The initial treatment started at a mean age of 9.2 days. Long-leg Soft Casts TM3 were applied until the desired position of the foot was achieved. At a mean age of 3.2 months, the residual deformity was corrected surgically. We assessed the clinical outcome by chart review and the functional outcome by a questionnaire that included the disease specific instrument (DSI) and the health-related quality of life assessed by the pediatric quality of life inventory (PedsQL™).  Results In 101 patients (92.7%) and 142 feet (93.4%), we had a clinical follow-up at a mean age of 7.39±4.9 years. A Denise Brown splint or a unilateral orthosis was applied for a mean period of 7.8±4.8 months over the whole day and an additional 17.3 ±16.3) nights only. At a mean follow-up of 10.0±SD 6.2 years, 82.2% of patients returned the questionnaires. The mean DSI was 74.8±17.5. The mean overall PedsQL™ was 87.8±12.6. The PedsQL™ functional component score showed a mean of 89.4±5.6, and the PedsQL™ social component score a mean of 86.9±13.5. Ten (9.3%) patients had a bilateral, and 18 (16.8%) patients had a unilateral relapse. Conclusions Achilles tendon lengthening (ATL) and limited posterior release, followed by a reduced period of splinting of 2.1 years, provide similar results compared to the original Ponseti method.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80260"},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589090","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 Narrative Review of Community-Based Epidemiological Studies on Parkinson's Disease in India.","authors":"Sarbjeet Khurana, Mandaville Gourie-Devi","doi":"10.7759/cureus.80248","DOIUrl":"10.7759/cureus.80248","url":null,"abstract":"<p><p>Parkinson's disease (PD) is the second most prevalent neurodegenerative condition, following Alzheimer's disease. Worldwide, the prevalence of PD differs among various populations and geographical areas. In our nation, there is a paucity of population-based epidemiological research that can effectively ascertain the prevalence of PD. In this review article, we have attempted to examine the prevalence rates gathered from the neuro-epidemiological studies in India.  We searched for published articles on the prevalence rate of PD in India from PubMed and Google Scholar, using the keywords \"prevalence\", \"burden\", \"epidemiology\", \"Parkinson's disease\", and \"India\". The review includes all the community-based studies that calculated the prevalence rate of PD. There are few community-based studies on the prevalence rate of PD. The observed prevalence rates vary a lot in urban and rural areas; also, urban areas show higher prevalence rates than rural areas. Some studies suggest that Parkinson's disease is more common among males, while others indicate a higher prevalence among females. Almost all research suggests that the prevalence rate increases with age for both males and females. The study carried out at the senior care facility revealed that the elderly had a limited understanding of Parkinson's disease. Epidemiological studies on PD are crucial to expanding our knowledge about PD. Given the variations in regions, ethnic groups, and cultures, conducting a comprehensive nationwide multi-center study is essential to investigate the prevalence and factors contributing to PD. Initiatives to raise awareness about PD are also the need of the hour.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80248"},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589043","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":"Modified C-V Flap for Nipple Reconstruction.","authors":"Ulises Solis Bermudez, Mariana Gabriela Monroy Velázaquez, Karina Lizbeth Lara Sampayo, Sergio Federico Estrada Tijerina, Jesus Eduardo Trujillo Rodríguez, Moisés Alvir Ruiz Lopez, Erik Ponce Graciano, Oscar Ulises Rosales Martinez","doi":"10.7759/cureus.80256","DOIUrl":"10.7759/cureus.80256","url":null,"abstract":"<p><p>Nipple reconstruction is a crucial aspect of breast reconstruction, focusing on restoring the aesthetic appearance of the nipple-areola complex (NAC). Techniques such as the C-V flap are commonly used, but they often face challenges in maintaining nipple projection over time, requiring overcorrection. The modified C-V flap, incorporating purse-string sutures, improves projection retention and reduces the need for revisions. A 63-year-old woman with a history of failed reconstructions underwent a modified C-V flap, achieving favorable results. This technique, combined with composite grafts and tattooing, addresses complications such as radiotherapy effects and enhances the overall outcome. The approach offers a reliable and personalized solution, optimizing long-term results in nipple reconstruction.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80256"},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607547","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":"Evaluating the Tumor Burden, Histological Changes, and Immune Landscape of Breast Cancer Post-neoadjuvant Chemotherapy: Insights From 50 Cases.","authors":"Arasi Rajesh, Dharma Saranya Gurusamy, Rajalakshmi Manikkam","doi":"10.7759/cureus.80258","DOIUrl":"10.7759/cureus.80258","url":null,"abstract":"<p><p>Breast cancer is a heterogeneous disease with variable responses to neoadjuvant chemotherapy (NACT). Evaluating the histopathological and immune changes in post-NACT breast cancer specimens is crucial for understanding treatment response and guiding further management. This study aims to assess tumor burden using the Residual Cancer Burden (RCB) index, examine histological alterations, evaluate immune activity through tumor-infiltrating lymphocytes (TILs), and analyze proliferative capacity via Ki-67 expression in post-NACT breast cancer specimens. A cross-sectional study of 50 modified radical mastectomy (MRM) specimens post-NACT was conducted. The histopathological analysis included tumor regression changes, stromal and cellular alterations, and nodal involvement. Immune response was assessed by quantifying TILs, and proliferation was measured using the Ki-67 index. Statistical correlations were made between clinicopathological parameters, TILs, and Ki-67 expression. Residual disease was detected in 39 cases (78%), and 11 cases (22%) had no residual disease. Among the 39 cases with residual disease, the majority were classified as RCB II (22 cases, 56%), 16 cases (41%) were classified as RCB III, and one case (3%) was classified as RCB I. Common histological changes post-NACT included fibrosis in 31 cases (62%), necrosis in 19 cases (38%), and infiltration by foamy histiocytes in 16 cases (32%). Malignant epithelial cells more frequently exhibited foamy cytoplasm (16 cases (41%) vs. two cases (5%); p=0.0003), hyperchromatic nucleus (26 cases (67%) vs. six cases (15%); p=0.0001), and prominent nucleoli (26 cases (67%) vs. four cases (10%); p=0.0001) compared to benign cells. Among the 39 cases with residual disease, low TIL and high Ki-67 expression were observed in 20 cases (51%), while 12 cases (32%) showed high TIL and low Ki-67. Residual tumors with high TIL and high Ki-67 (four cases, 10%) and low TIL and low Ki-67 (three cases, 8%) were less common. A significant inverse relationship was found between TIL levels and Ki-67 expression (p=0.0002), as tumors with low TIL were more likely to have high Ki-67 expression (20 cases, 51%), whereas those with high TIL more frequently exhibited low Ki-67 expression (12 cases, 32%). Post-NACT evaluation of tumor burden, immune landscape, and proliferation provides valuable prognostic insights. Integrating RCB, TILs, and Ki-67 into routine pathological assessment may aid patient stratification and guide personalized treatment strategies. Further large-scale studies are needed to validate these findings and improve therapeutic decision-making in breast cancer management.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80258"},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589070","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":"Critical Considerations in Emergency Repair of Giant Bilateral Inguinoscrotal Hernias.","authors":"Panuwat Pornkul, Renae Bertucci, Kate Swift, Chrispen Mushaya","doi":"10.7759/cureus.80242","DOIUrl":"10.7759/cureus.80242","url":null,"abstract":"<p><p>This article examines the emergency surgical management of giant bilateral inguinoscrotal hernias through a representative case report. In this case, surgical intervention was required due to an associated cecal volvulus. While acute complications such as bowel strangulation are rare in hernias of this size, delayed presentation and the lack of timely surgical consultation permit significant inguinoscrotal hernia growth. Furthermore, underlying medical comorbidities in these patients may preclude the safe administration of general anesthesia, further hindering timely surgical repair. In developed countries, both trainees and consultants often have limited exposure to such cases, resulting in minimal experience managing the technical challenges involved. Key factors for successful surgical repair include addressing the loss of domain and managing extensive bilateral anatomical defects. This case report outlines the acute management of a cecal volvulus and the use of an open Rives-Stoppa repair, a technique commonly employed for recurrent, large, or complex inguinal and ventral hernias. By detailing our surgical approach and relevant surgical considerations, this case report provides an educational opportunity to understand the critical challenges of managing giant inguinoscrotal hernias.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80242"},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589052","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 Management of Infective Endocarditis Complicated by Pheochromocytoma: A Case Report.","authors":"Koki Ikemoto, Akiyuki Takahashi, Kazunari Ohkawa, Keisuke Shuntoh, Katsuhiko Oka","doi":"10.7759/cureus.80269","DOIUrl":"10.7759/cureus.80269","url":null,"abstract":"<p><p>Pheochromocytomas present with paroxysmal hypertension due to a sudden release of catecholamines stimulated by radiological contrast media, surgery, or anesthetic agents. This often complicates the maintenance of patient hemodynamics during surgery. A 55-year-old man with a high fever was admitted to a hospital. Laboratory blood tests revealed elevated white blood cell and C-reactive protein levels. Transthoracic and transesophageal echocardiography revealed moderate aortic regurgitation, along with aortic valve vegetation. Magnetic resonance imaging revealed multiple cerebral embolisms, whereas computed tomography showed a left adrenal incidentaloma. Further examinations showed high levels of plasma-free metanephrine, adrenaline, and noradrenaline in the blood and metanephrines in the urine. 123I-metaiodobenzylguanidine scintigraphy revealed ligand accumulation in the tumor at 6 and 24 h after injection. Based on these results, the diagnosis of pheochromocytoma was confirmed. Doxazosin was promptly administered, and its dosage was escalated. Despite ongoing antimicrobial therapy, transesophageal echocardiography did not reveal any reduction in the size of the vegetation. Hence, the patient underwent surgical treatment. A laparoscopic left adrenalectomy was initially performed. The patient's blood pressure increased with insufflation and manipulation around the tumor but dropped immediately after the adrenal tumor was resected. Following the adrenalectomy, a cardiopulmonary bypass was established. The bicuspid aortic valve leaflets along with the vegetation were completely resected. Subsequently, a mechanical aortic valve was implanted. Inotropic agents were completely weaned off within two days after surgery. A pathological examination confirmed the adrenal incidentaloma to be pheochromocytoma. One-stage surgery with adrenalectomy before cardiac surgery using cardiopulmonary bypass may be an effective strategy for patients with pheochromocytomas diagnosed with infective endocarditis. In addition, it can reduce the risk of complications with pheochromocytoma by managing the patient's systemic condition as much as possible before cardiac surgery.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80269"},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598563","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":"Primary Pulmonary Epithelial-Myoepithelial Carcinoma: A Case Report and Comprehensive Literature Review of a Rare Lung Neoplasm.","authors":"Sara Morgado, Ana F Santos, Fernando Nogueira","doi":"10.7759/cureus.80188","DOIUrl":"10.7759/cureus.80188","url":null,"abstract":"<p><p>Primary epithelial-myoepithelial carcinoma (EMC) of the lung is a rare subtype of pulmonary tumors. Originating from bronchial submucosal glands, EMC shares histopathological characteristics with its salivary gland counterparts and typically presents as a low-grade malignancy. Due to its rarity, there is limited literature to guide diagnosis and management. We report the case of a 75-year-old male with a history of smoking and chronic conditions who presented with persistent right-sided back pain. Imaging revealed a para-hilar lesion in the right lung, later confirmed as EMC through bronchoscopy and histopathological analysis. Staging studies excluded local invasion and metastasis, and a multidisciplinary team recommended surgical resection. The patient underwent surgery without complications, and histological analysis of the resected specimen confirmed the diagnosis. At follow-up in the pulmonary oncology clinic, no recurrence or metastasis was observed. This case highlights the importance of a multidisciplinary approach for diagnosing and managing rare pulmonary neoplasms. Bronchoscopy and histopathological analysis played a crucial role in achieving an accurate diagnosis. This case contributes to the limited data on EMC and supports surgical intervention as the primary treatment option for localized disease.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80188"},"PeriodicalIF":1.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589086","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 Prospective, Non-interventional Observational Study to Assess the Efficacy, Safety, and Tolerability of the Casein Hydrolysate-Based Food Supplement in High-Risk Human Papillomavirus-Positive Women.","authors":"Carmen Pingarron, Alfonso Duque, Ana López, Juan Ferragud","doi":"10.7759/cureus.80201","DOIUrl":"10.7759/cureus.80201","url":null,"abstract":"<p><p>Objective The study aimed to assess the efficacy, safety, and tolerability of casein hydrolysate-based food supplement, HuPaVir^®, in high-risk human papillomavirus (HR-HPV)-positive women. Methods A prospective, multicenter, and non-interventional observational study was carried out in Spain. At the end of the study, 118 HR-HPV-positive women (20 to 65 years old) were enrolled and completed the follow-up as required by the protocol. All participants performed HPV-DNA testing, liquid-based cytology, and DNA extraction by multiplex PCR at zero and six months. Upon baseline evaluation, participants were provided with a casein hydrolyzed formula or managed with a wait-and-see approach. Supplementation treatment consisted of daily consumption of one dose of the casein hydrolysate formula for six months. The study population was then divided into four groups based on the baseline cytology result and the supplementation treatment performed during the follow-up period. Treated participants underwent blood tests to determine different immune parameters. Treated participants were also provided with case report forms to register any adverse effect during the study and were asked to complete a voluntary survey to assess product tolerance and acceptability by rating their level of agreement. Results At six months, consumption of the casein hydrolysate formula resulted in total or partial clearance of the HR-HPV type and normalization of cervical cytology in a statistically significant percentage of cases compared to the untreated group (74.6% vs. 35.6%; p<0.01 and 67.4% vs. 41.9%; p<0.05, respectively). Notably, a positive trend in increasing serum levels of innate immunity markers, such as natural killer (NK) cells, and adaptive immunity markers, such as CD8 and CD4 T lymphocytes, was observed in the treated participants. Conclusion The results suggest that daily supplementation with the casein hydrolysate formula is effective in causing significant virus clearance and lesion remission compared to the conventional approach in clinical practice for HR-HPV-positive women. However, a large, multicenter, standardized, and randomized study with longer-term follow-up, 12 months after supplementation treatment, is needed to confirm and strengthen these findings. The formula was found to be safe and well-tolerated.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80201"},"PeriodicalIF":1.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589046","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 Entity in Children: Two Cases of Post-traumatic Priapism With Spontaneous Resolution.","authors":"Mohammed Alblooshi, Masih Abdul Kader, Mustafa Hamchou","doi":"10.7759/cureus.80128","DOIUrl":"10.7759/cureus.80128","url":null,"abstract":"<p><p>This report presents two pediatric cases of post-traumatic high-flow priapism managed using a conservative approach. The first case involved a six-year-old boy who developed a persistent, painful penile erection three days after sustaining perineal trauma from a seesaw incident. Color Doppler ultrasonography revealed an arteriovenous fistula with a localized hematoma. The second case involved a five-year-old boy who presented with a persistent, painless erection following a bicycle-related groin injury; Doppler ultrasonography confirmed a high-flow arteriocavernosal fistula. Both patients were managed with intermittent penile shaft compression administered in two‑hour cycles (compression followed by release, with immediate decompression upon discomfort). Follow-up duplex ultrasonography at two weeks confirmed the resolution of the fistula, and both patients remained asymptomatic for at least three months. These cases illustrate that a conservative management strategy can serve as an effective alternative to invasive interventions in pediatric post-traumatic high-flow priapism.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80128"},"PeriodicalIF":1.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574824","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 a Petersen's Hernia During Pregnancy After Roux-en-Y Gastric Bypass.","authors":"Shalini J Weerasekera, Hasthika Ellepola","doi":"10.7759/cureus.80131","DOIUrl":"10.7759/cureus.80131","url":null,"abstract":"<p><p>Obesity is an escalating problem worldwide and is associated with increased adverse maternal and perinatal outcomes in pregnancy. Bariatric surgery offers women an effective method of sustained weight loss, with patients often less likely to develop obesity-related comorbidities in pregnancy, including hypertension and gestational diabetes. However, despite beneficial effects, previous bariatric surgery can also predispose pregnant patients to developing internal hernias. We present a rare case of a Petersen's hernia diagnosed in a patient with a previous Roux-en-Y gastric bypass procedure during her third trimester.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80131"},"PeriodicalIF":1.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574821","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}