Cureus最新文献

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition of the nasal passages and sinuses, often characterized by nasal congestion, loss of smell, facial pressure, and nasal discharge. Conventional treatments, such as corticosteroids and endoscopic sinus surgery (ESS), often provide only temporary relief, with frequent recurrence of symptoms. For patients with severe, refractory CRSwNP, biologic therapies have emerged as a promising treatment option. This review evaluates the efficacy and safety of biologic treatments for CRSwNP, including dupilumab, mepolizumab, and omalizumab. We analyze clinical trial data, patient-reported outcomes, and the latest research on the use of biologics in CRSwNP management. Our findings confirm the efficacy of biologics in treating CRSwNP, showing consistent improvements in both clinical and patient-reported outcomes. The use of biologics resulted in a significant reduction in nasal polyp size, improved nasal congestion, and reduced the need for further surgery or systemic corticosteroids. Moreover, patients experienced an improved sense of smell and a better quality of life. This review also includes a comparative analysis of the three biologics, highlighting their efficiency and potential risks. The findings suggest that dupilumab may be the most effective biologic therapy for CRSwNP, showing superior efficacy compared to mepolizumab and omalizumab in reducing nasal polyp size and improving nasal congestion. The article provides valuable insights for healthcare providers and patients considering biologic therapy for CRSwNP, emphasizing the importance of personalized treatment decisions based on individual patient factors, including disease severity, comorbidities, and preferences.

Background Social media (SM) platforms are commonly used in Saudi Arabia, even for health information. SM platforms allow users to have conversations, share information, and create web content. Given the growing dependence on social media for health-related concerns, it is critical to understand how Saudis use these platforms to get health information. This study aimed to determine the Saudi population's attitude and awareness regarding health information sought on SM. Subject and methods This cross-sectional study was conducted among adults in Riyadh, Kingdom of Saudi Arabia, from September to October 2024. A self-administered questionnaire was distributed randomly in the Medical City King Saud University family medicine clinic. The questionnaire includes socio-demographic data (i.e., age, gender, marital status, etc.), the most commonly used type of SM, and various questions to assess the knowledge and influence of SM on health information.  Results Among the 330 participants, 117 (63%) were female respondents, and 126 (38.2%) were between 31 and 40 years old. WhatsApp was the most prominent type of SM used at 192 (58.2%). Disease or medical problems were the most notable health information being seen online at 172 (52.1%), and "to be informed" was the most common reason for seeking health information online at 237 (72.4%). The perception of unemployed female respondents that health information obtained from SM is reliable was significantly higher than that of unemployed male respondents (p<0.05). Surprisingly, male participants usually do believe SM can enhance awareness (p = 0.015). Conclusion The findings of this study suggest that SM influences the behavior of the adult population seeking health information in Saudi Arabia. Female participants tended to believe that the health information obtained from SM was credible. To be more informed was the primary reason for seeking health information online. There is a need to educate patients visiting family medicine clinics about the reliability of health information obtained online.

In this case study, an all-ceramic (Emax) crown and a post and core restoration are used to successfully treat external inflammatory root resorption (EIRR) in a mandibular molar. A 21-year-old male patient was diagnosed with EIRR and hypercementosis after presenting with pain and significant damage to his lower right first molar. The patient chose a post and core restoration over extraction and implant placement due to budgetary constraints. Endodontic retreatment, fiber post cementation, core buildup, and Emax crown placement were all part of the treatment. At the one-year follow-up, the patient had a healed periapical region, healthy gingiva, and sound tooth structure. In managing EIRR cases, this case study emphasizes the importance of meticulous treatment planning and execution, focusing on selecting the best course of action for the long-term stability and health of the affected tooth. Both the patient's overall dental health and the expertly crafted restoration contributed to the favorable outcome.

Introduction: Organ donation is the transplantation of tissues or organs from one person to another, and it is considered a method to save lives when a patient has end-stage organ failure. Community willingness to engage in organ donation programs is imperative in promoting successful organ transplantation.

Methods: This research employed a cross-sectional study design involving 420 adult participants from the Qassim Region, Saudi Arabia. An online questionnaire was used to collect data and later analyzed using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York, United States).

Results: The results reveal that only six (1.4%) participants had donated an organ before. One hundred sixty-eight (40.0%) participants believed that a person could donate their organ during their lifetime, with 225 (53.6%) aware that kidneys could be donated. A total of 198 (47.1%) participants supported the practice of organ donation. Religious motivation was the primary reason for the majority of participants willing to donate their organs (128, 64.7%). Conversely, among those unwilling to donate, 86 individuals (38.7%) cited a lack of knowledge about the practice as their reason. Two hundred sixty-six (63.3%) respondents expressed willingness to donate organs if laws and religion encouraged the practice. One hundred fifteen (27.4%) had a low knowledge level, 203 (48.3%) had a moderate knowledge level, and 102 (24.3%) had a high knowledge level. Age, education level, and occupation showed a statistically significant relationship with the knowledge score on organ donation (p < 0.05).

Conclusion: The study revealed that the general population exhibited a moderate understanding of and favorable attitude toward organ donation. Age, education level, and occupation significantly influenced knowledge scores related to organ donation. Additionally, religious beliefs emerged as the primary driver for organ donation. There is a need to raise public knowledge about the importance of organ donation in saving lives, improving quality of life, and establishing sustainable and ethical organ transplantation systems in Saudi Arabia.

Introduction: 5-aminolevulinic acid (5-ALA) fluorescence used in glioma surgery has different intensities within tumors and among different patients, some molecular and external factors have been implicated, but there is no clear evidence analyzing the difference of fluorescence according to glioma molecular characteristics. This study aimed to compare molecular factors of glioma samples with fluorescence intensity to identify potential cofounders and associations with clinically relevant tumor features.

Methods: Tumor samples of high-grade glioma patients operated using 5-ALA for guided resection were included for comparative analysis of fluorescence intensity and molecular features. All the samples were processed under the same conditions. The power for fluorescent stimulation and acquisition time was the same between samples. An inverted fluorescence microscope compared the mean fluorescence for each molecular variation. p53, ATRX and Ki67 expression and IDH1 mutation were assessed by immunohistochemistry. Follow-up of the patients for progression-free survival and overall survival was made.

Results: We found that the fluorescence intensity for each specific tumor was independent of the methylation of the methylguanine-DNA-methyltransferase (MGMT) promoter region assessed by pyrosequencing, there was no association of fluorescence with p53, ATRX, IDH1 mutation as assessed by immunochemistry. Also, fluorescence intensity has no relation with time of tumor recurrence or overall survival.

Conclusion: With the results, we argue that many factors are involved in fluorescence intensity that may be related to the specific metabolic status of the glioma cells analyzed, which is more likely to be responsible for the variation of fluorescence.

[This corrects the article DOI: 10.7759/cureus.56561.].

Background Communication and teamwork are essential in medicine. Established standards emphasise the importance of collaboration and access to support. Some departments divide doctors into teams; however, inter-team communication is not always efficient. This quality improvement project aimed to improve teamwork and communication between resident-doctor teams at the Medicine for Older People (MOP) department at University Hospital Southampton using a messaging application. Secondary objectives were to assess the management of workload, resident doctor well-being, and patient safety. Materials and methods A WhatsApp (Meta Platforms, Inc., Menlo Park, California, United States) communication group was created to involve all eight MOP teams (no patient information was discussed). Anonymous questionnaires were used pre-implementation and two months post-implementation to assess the impact on communication, teamwork, overtime hours, doctor well-being, and patient safety. Data analysis was carried out using the IBM SPSS Statistics for Windows, Version 30 (Released 2024; IBM Corp., Armonk, New York, United States). We calculated 95% confidence intervals (CIs) and p-values using the Wilcoxon signed-rank test. Results All 24 resident doctors (Foundation/Senior House Officers) participated, and 19 completed both questionnaires. Significant improvements were seen in communication (very good/good ratings: pre-implementation 5%; post-implementation 100%, 95% CI 1.62-2.58, p<0.001), teamwork (pre-implementation 26%; post-intervention 84%, 95% CI 1.12-2.15, p<0.001), and workplace well-being (pre-intervention 47%; post-intervention 84%, 95% CI 0.47-1.21, p=0.001). Mean days worked overtime per week were reduced from 1.89 to 1.31 (95% CI (-0.91) - (-0.25), p=0.005) and the mean time worked overtime was reduced from 29.7 minutes/week to 19.9 minutes/week (95% CI (-14.61) - (-4.92), p=0.003). All the doctors (100%) strongly agreed/agreed the intervention helped distribute tasks more evenly and facilitated the timely completion of work. Around 90% felt this very positively/positively impacted patient safety. All doctors recommended this intervention for future residents. Conclusion Group messaging applications, such as WhatsApp, can enhance communication between resident-doctor teams, leading to improvements in supportive teamwork, patient care, and doctor well-being.

The natural product MGN-3 (Biobran) is a defatted, partially hydrolysed rice bran-derived hemicellulose enzymatically modified with an extract of Lentinus edodes. It has a high proportion of arabinoxylan. It has a protective action against intracerebroventricular streptozotocin-induced murine sporadic Alzheimer's disease and reverses spatial memory deficit in this disease model. The aim was to test the hypothesis that MGN-3 increases glutamatergic burst activity in human neuronal and glial cells by conducting an in vitro multielectrode array-based micro-electrophysiological study in a cultured mixture of human glutamatergic neurones, GABAergic neurones and astrocytes. The effects of MGN-3 at two concentrations, 0.750 g L^-1 and 0.375 g L^-1, and vehicle (control), on glutamatergic burst activity in a triculture of human-induced pluripotent stem cell (hiPSC)-derived GABAergic neurones, glutamatergic neurones and astrocytes were studied. The change in the number of glutamatergic bursts normalised to the vehicle control was analysed using a normal or Gaussian generalised linear model. This statistical model was highly significant (p = 1.468 × 10^-17). Both MGN-3 concentrations were associated with highly significant main effects. These results provide strong evidence to reject the null hypothesis that MGN-3 does not affect glutamatergic burst activity in human neuronal and astrocytic cells. The study's strengths include the novel use of hiPSC-derived neurones and astrocytes and the robust statistical significance of the findings. Limitations include in vitro conditions that may not fully replicate in vivo conditions, potential variability in hiPSC-derived cell preparations, and the need to test other neuronal subtypes or additional doses to assess dose-dependent effects. These should be addressed in future studies.

Introduction Intraventricular hemorrhage is a severe condition caused by bleeding within the brain ventricles. It is often due to trauma, tumors, vascular malformation, aneurysm, oxygen deprivation, or idiopathic. A common complication associated with intraventricular hemorrhage is hydrocephalus, which is the accumulation of cerebrospinal fluid in the ventricles. Hydrocephalus can be classified as communicating or non-communicating. This study aimed to evaluate the incidence of communicating hydrocephalus after intraventricular hemorrhage. Methods This retrospective study was conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, and included 52 adult patients treated between 2012-2022 who met the eligibility criteria. We examined the relationships among age, sex, length of hospitalization, presenting symptoms, co-morbidities, Evans index, Graeb score, Glasgow Coma Score, survival, and ventriculoperitoneal shunt complications through univariate and bivariate analyses. The Shapiro-Wilk test was used to evaluate data distribution. Differences between groups were analyzed using the chi-square test for categorical variables and the Mann-Whitney U test for non-parametric variables. Results The median age of the participants was 54 years, with a male predominance (57.7%). Motor dysfunction was the most frequently reported symptom at presentation (48.1%). Among the 30 patients who developed hydrocephalus after intraventricular hemorrhage, 70% had communicating hydrocephalus. There was a substantial correlation between mortality and hydrocephalus type (P =0.020). Conclusion Intraventricular bleeding is associated with an increased risk of communicating hydrocephalus, with an incidence rate of 3% per person-year.

Objective More patients visit oral surgery outpatient clinics from evening to night to treat persistent gingival bleeding (PGB) related to periodontal disease (PD) (PD-PGB). Since there are few reports on PD-PGB, the present study performed a detailed characterisation of this disease. Materials and methods Patients who visited our oral surgery clinic between 1 January 2014 and 31 December 2022 to treat PD-PGB without trauma. Demographic data, systemic diseases and bleeding tooth characteristics were retrieved. The occurrence of systemic diseases was compared with that of the control group (patients consisting of temporomandibular joint dislocation and minor trauma). Results Among 295 patients with gingival bleeding (GB) unrelated to trauma, 193 patients (65.4%) showed postoperative bleeding, and 91 patients (30.1%) showed PD-PGB; 93.4% of patients over 60 years old showed PD-PGB. Patients in the PGB-RPD group showed a significantly higher percentage (57.1%) of taking anticoagulants and/or antiplatelets than the control group (24.2%) (P < 0.001) Significantly higher percentage of patients in the PGB-RPD group showed a significantly higher incidence of hypertension (68.1%) than the control group (34.1%) (P < 0.001). Bleeding is the most frequently observed in molars, with a depth of the pockets exceeding 4 mm. Conclusion PD-PGB accompanied by deep pockets was more common in older patients and aggravated by taking anticoagulants and/or antiplatelets and antihypertensives. PD-PGB is not rare, and periodontal maintenance, such as regular dental checks, is an important preventive measure.