Cureus最新文献

This report introduces a novel approach to providing nutritional guidance for people dining out, utilizing takeout meals as a practical tool. The method comprises several essential steps: 1) Preparing takeout versions of restaurant dishes and bringing them to the hospital, 2) performing comprehensive nutritional evaluations of these meals and adjusting them as necessary to meet specific dietary needs, and 3) assessing the impact of these modified meals on post-meal blood glucose levels. This assessment is achieved through continuous blood glucose monitoring at crucial time points: before the meal, 60 minutes after beginning the meal, and 120 minutes after eating. Traditional methods of nutritional guidance for dining out, often based on showing textual photos or gathering information on the dining out habits of patients, face challenges in consistency and reliability due to variations in meal composition and nutritional values. This approach focuses on direct interaction with actual meals and real-time blood glucose monitoring, offering a more specific and effective way to provide nutritional advice. Not only is it suitable for hospital settings, but its simplicity and practicality also make it adaptable to a variety of medical facilities. This approach aids in blood glucose control for patients and also provides valuable feedback to educators, thus contributing to the enhancement of their skills.

Hereditary spastic paraplegia (HSP) is a rare neurodegenerative disease caused by retrograde degeneration of the corticospinal tract and posterior columns, which presents with progressive bilateral leg weakness and spasticity. HSP is inherited in an autosomal dominant pattern involving over 80 causative genes. The recently identified causative gene is the ubiquitin-associated protein 1 (UBAP1)gene, which is associated with juvenile-onset pure spastic paraplegia-80 (SPG80). Here, we present a 36-year-old Filipino male with pure-form HSP caused by a nonsense mutation (NM 001171201.1:c.704 >G) in the UBAP1 gene. To our knowledge, this mutation represents a new variant associated with the UBAP1-related HSP. This case report highlights the importance of awareness among individuals and their families affected by HSP and discusses the risks for future generations and available treatment options.

[This retracts the article DOI: 10.7759/cureus.54191.].

Background: Adolescence is critical for developing lifelong health habits, including oral hygiene. While the effects of smoking on oral health are well-documented in adults, research focusing on adolescents remains limited.

Objective: This paper aims to investigate the prevalence of smoking and its relationship with oral health outcomes, socioeconomic variables, and oral hygiene practices among high school students in Madinah.

Methodology: A cross-sectional study was conducted with a sample size of 2,514 high school students (n = 1,249, 49.7% males; n = 1,265, 50.3% females) from 24 schools in Madinah, Saudi Arabia. Participants completed a self-administered questionnaire that collected data on sociodemographic factors, smoking habits, and oral health behaviors. Clinical dental examinations were conducted to assess caries prevalence using the Decayed, Missing, Filled Teeth (DMFT) index. Bivariate analysis and logistic regression were used to examine the associations between smoking status and the study variables.

Results: The prevalence of smoking among participants was 8.6% (n = 216), with a higher proportion of males (n = 132 out of 1,249, 10.6%) than females (n = 84 out of 1,265, 6.6%) reporting tobacco use (P < 0.001). Smokers were more likely to attend public schools compared to nonsmokers (n = 190 out of 216, 88.0%, vs. n = 1,899 out of 2,298, 82.6%; P = 0.04) and had mothers with intermediate education levels (n = 108 out of 216, 50.0%, vs. n = 892 out of 2,298, 38.8%; P = 0.005). No significant differences were observed for the father's education or age. Regarding oral health outcomes, smokers reported significantly poorer self-rated oral health (n = 43, 19.9%, vs. n = 328, 14.3%; P = 0.026), but no significant association was found between smoking status and DMFT scores (P = 0.66). Smokers also reported less frequent toothbrushing (n = 132, 61.1%, brushing regularly vs. n = 1,686, 73.4%, for nonsmokers; P = 0.001).

Conclusions: Smoking prevalence among high school students in Madinah was 8.6%, with higher rates observed among males and students attending public schools. Smoking was associated with poorer self-rated oral health and less frequent brushing habits. These findings highlight the need for targeted oral health education and smoking prevention programs in schools to address modifiable risk factors and promote healthier behaviors.

Guillain-Barré syndrome (GBS) is a complex and potentially life-threatening disease, representing the most common cause of acute neuromuscular paralysis worldwide. Its diagnosis is primarily based on clinical findings, often complemented by electrophysiological studies and laboratory investigations. Therefore, knowledge of the clinical signs and symptoms is essential to make a prompt diagnosis and allow timely initiation of therapeutic interventions. Despite significant advancements in our understanding of this disease, many aspects of its nature are yet to be fully understood. We present a compelling case that initially manifested with the Lhermitte sign, followed by the development of paresthesias and diminished muscle strength originating in the upper extremities and progressing in a cephalocaudal pattern. These initial findings suggest a pathology involving the cervical spinal cord or nerve roots. However, the patient's evolving neurological deficits and subsequent diagnostic studies revealed an unexpected etiology: GBS. This case highlights the importance of maintaining a broad differential diagnosis, even when confronted with seemingly characteristic clinical presentations. It also reveals the complexity of GBS, a disease that can present with potential atypical manifestations that can mimic other neurological disorders.

Introduction Excessive repetitive physical activity most often leads to acute musculoskeletal pain. The management of acute pain is one of the primary concerns. The nociceptive pain has both sensory and affective qualities, patterns, and intensity. In this article, we focus on the effect of a turmeric-Boswellia formulation on that aspect at different locations of the body. Methods This multicentric study with a randomized, double-blind, placebo-controlled design enrolled 232 subjects in a male-to-female ratio of 1:1. The test dosage was 1,000 mg of turmeric-Boswellia extract (TBE) and a similar placebo in a parallel design allocation of 1:1 ratio. Healthy subjects with acute musculoskeletal pain of exercise-related origin with a numerical pain rating score of ≥ 5 were included in the study. The study duration was six hours, and the efficacy was analyzed using the short form of the McGill Pain Questionnaire, having subscales visual analog scale (VAS) and present pain index (PPI). Results There was a significant reduction in pain in the McGill total score (p < 0.001) of the TBE group, with a 98% change from the baseline compared to the placebo. The sensory and affective domains showed a significant reduction of 98% (p < 0.001) and 97% (p < 0.001) in pain in the TBE group from the baseline compared to placebo. The VAS had a 97% (p < 0.001), and PPI had 96% (p < 0.001) pain relief in the TBE group from the baseline compared to placebo. In the sensory domain, the most common pain descriptor reported by the participant was "tender," and in the affective domain, it was "tiring-exhaustive." The descriptor frequency of "tender" reduced from 65% in baseline to 1%, and "tiring-exhaustive" reduced from 61% to 3% at the end of six hours for the TBE group, while the placebo showed negligible change. The mean pain intensity of all pain descriptors in the TBE group showed more than 95% change from baseline. Conclusion It can be concluded that the turmeric-Boswellia formulation was very effective for exercise-induced musculoskeletal pain irrespective of location and had a significant reduction in pain intensity for sensory as well as affective pain sensations.

[This retracts the article DOI: 10.7759/cureus.74161.].

Background Upper gastrointestinal bleeding (UGIB) is one of the most common major medical emergencies. This study sought to determine the epidemiology, clinical characteristics, and outcomes of UGIB in the largest major tertiary care center in Bahrain, compared to regional and international cohorts. Methods We conducted a retrospective cohort study of all patients diagnosed with UGIB between April 2021 and April 2022 in Salmaniya Medical Complex, Bahrain's largest tertiary-level public hospital. The primary outcomes measured included 30-day mortality rates and one-year readmission rates. Other variables collected included demographic factors, baseline characteristics, comorbidities, symptomatology, endoscopic findings, and etiologies of the bleeding. Results A total of 212 patients with UGIB were included. The mean age of the patients was 56.7 ± 19.1 years. More than 50% of patients with UGIB presented with melena and symptoms of anemia. The most common cause of UGIB in Bahrain was duodenal ulcers, which were found in 75 patients (37.7%). One in two patients with UGIB required packed red blood cells, while fresh-frozen plasma and platelet transfusions were reserved for severe cases. The readmission rate within one year of discharge (14.2%) was associated with smoking, cardiac history, melena, gastric malignancy, and rescope during admission. The 30-day mortality (15.6%) was associated with comorbidities of chronic kidney disease, cerebrovascular disease, and hematochezia on presentation. Conclusion Overall, the mortality rate of UGIB in Bahrain is higher than in countries in the region, the UK, and the US, signaling potential gaps in management and a reflection of a more complex patient population.

Objectives: Although several studies have reported the treatment prognosis in squamous cell carcinoma of the head and neck, few studies exist on the prognosis and mortality-related risk factors in untreated cases. This study aimed to determine the outcomes of patients with head and neck squamous cell carcinoma who underwent no treatment and investigate the associated factors.

Methods: This retrospective, single-institution study initially included 718 patients with head and neck cancer who visited our hospital between January 2015 and December 2021; 43 untreated patients were included in the final analysis. This study was conducted in Japan, where universal health insurance ensures access to treatment for all citizens.

Results: The median patient age was 79 years, with a predominance of male patients. The primary reasons for patients being untreated were patient refusal, dementia, and advanced age. The median survival time for untreated patients was 20.5 weeks, with 90% succumbing within one year of their first visit. Univariate analyses showed that an advanced clinical stage (stage IV) was a major determinant of survival. In patients with stage IV disease, living alone or without family support was the sole significant predictor of a poor prognosis.

Conclusions: Our results inform healthcare providers about the consequences of not providing treatment and patients regarding treatment choices.

Infectious myocarditis (IM) and infective endocarditis (IE), sometimes associated with infection of the surrounding mediastinal tissue or embolic complications caused by residual implantable cardioverter defibrillator (ICD) lead material embedded in the ventricle, present a significant challenge for cardiac surgeons due to the difficulty of precisely locating the old intracardiac pacing lead remnants because of the heart's continuous movement. We present the case of successful two-stage elective sternotomy extraction of two residual defibrillator leads, one trapped in the left innominate vein, easily removed after veinotomy without cardiopulmonary bypass (CPB), and the other embedded intramyocardially in the inferior wall of the right ventricle, successfully removed under CPB after fluoroscopic guidance. The patient was discharged four weeks post-operation without complications. In our case, transesophageal echocardiography (TEE) was not performed due to the patient's history of esophageal achalasia.