Tag: pubmed

Cureus. 2025 Jan 24;17(1):e77935. doi: 10.7759/cureus.77935. eCollection 2025 Jan.

ABSTRACT

Introduction Many medical students do not have access to hands-on surgical experience throughout the pre-clinical curriculum. To address this issue, we developed a low-cost abdominal surgery simulator for use during instructive years and tested its efficacy through a proof-of-concept, randomized controlled trial. Our goal is to help medical students integrate foundational anatomy with surgical pathology, enhancing their understanding and translating to academic success on board-relevant topics. Methods Second-year students at Edward Via College of Osteopathic Medicine-Carolinas Campus (VCOM-CC) were split into two groups. The control group utilized the traditional curriculum, while the experimental group used the curriculum along with the simulator in instructive and integrative sessions. We created pre- and post-assessments comprised of gastrointestinal anatomy relevant to United States Medical Licensing Examination (USMLE) Step 1 and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 1 medical licensing examinations and compared the groups’ outcomes using statistical analysis. Results Statistical analysis was performed on the average change between the pre-assessment and post-assessment scores. This trial revealed an average change of -0.267, a standard deviation of 3.90 for the experimental group (n = 15), and an average change of -1.375, a standard deviation of 2.93 for the control group (n = 16). A two-sample t-test at 95% confidence interval yielded a p-value of 0.3246. Conclusion Although this trial did not demonstrate a statistically significant difference in the average score change, the increased exposure to both surgical and anatomical concepts provides a relevant learning experience for students before their clinical curriculum. In the future, we aim to integrate our simulator into pre-clinical medical education. Furthermore, we plan to evaluate the impact of our simulator on the performance of the two groups during surgical rotations as part of our ongoing research.

PMID:39996231 | PMC:PMC11848221 | DOI:10.7759/cureus.77935

Cureus. 2025 Jan 25;17(1):e77949. doi: 10.7759/cureus.77949. eCollection 2025 Jan.

ABSTRACT

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the world’s most serious healthcare issues, causing morbidity, mortality, and high healthcare costs, making effective treatment strategies essential. This meta-analysis assessed the comparative effectiveness and safety of ceftaroline, linezolid, and vancomycin in treating MRSA infections. Searches were undertaken across major electronic databases, including PubMed, Cochrane CENTRAL, Embase, and Web of Science, from 2000 to 2024. A total of 24 studies (17 randomized controlled trials (RCTs) and seven observational studies) involving 11,332 patients met the inclusion criteria. Patients on vancomycin treatment were more likely to have lower odds of being cured than controls (OR 0.68; 95% CI (0.58, 0.81), p < 0.0001), especially when compared to linezolid (OR 0.61; 95% CI (0.49, 0.74), p < 0.00001). Furthermore, mortality rates were significantly higher in vancomycin-treated patients than in controls (OR 1.25; 95% CI (1.00, 1.56), p = 0.05) and more precisely than in linezolid (OR 1.29; 95% CI (1.03, 1.62), p = 0.03). Microbiological eradication rates were not statistically different between vancomycin and the comparators (OR, 0.82; 95% CI (0.63, 1.07), p = 0.14). Safety analysis demonstrated comparable adverse event profiles between vancomycin and linezolid for thrombocytopenia, anemia, and hepatotoxicity. Although vancomycin remains a viable option owing to its accessibility and cost-effectiveness, our findings suggest that newer alternatives, particularly linezolid, may offer superior clinical outcomes in specific MRSA infections, especially in cases of pneumonia or high-risk patients. These results have important implications for clinical practice and antimicrobial stewardship programs and support a more nuanced approach to MRSA treatment based on patient-specific factors, infection characteristics, and local resources.

PMID:39996230 | PMC:PMC11848488 | DOI:10.7759/cureus.77949

Cureus. 2025 Jan 24;17(1):e77936. doi: 10.7759/cureus.77936. eCollection 2025 Jan.

ABSTRACT

BACKGROUND: Long-term prescribing of benzodiazepine receptor agonists (BZRAs) is a problem worldwide, but there are no detailed reports on the effects or side effects of reducing or discontinuing the dose. We retrospectively investigated the efficacy and safety of discontinuing or reducing the dose of BZRAs hypnotics after long-term use.

METHODS: Between April 2018 and May 2019, patients with insomnia after long-term use of BZRA hypnotics had BZRA hypnotics discontinued or their dose reduced, and their sleep conditions and anxiety symptoms were assessed. Insomnia severity (primary endpoint) was assessed as the change from baseline after discontinuation or reduction of BZRA hypnotics using the Insomnia Severity Index Japanese version (ISI-J). Changes from baseline in sleep quality and anxiety symptoms (secondary endpoint) from baseline were assessed using the Pittsburgh Sleep Quality Index Japanese version (PSQI-J) and Generalized Anxiety Disorder-7 (GAD-7), respectively. The adverse events were recorded during the study period. Statistical analysis was performed using the Wilcoxon matched-pairs signed rank test for changes in BZRA and concomitant medication dose, PSQI-J and GAD-7, and the paired t-test for changes in ISI-J.

RESULTS: The changes in ISI-J (discontinuation group: p = 0.07, reduction group: p = 0.91), PSQI-J (discontinuation group: p = 0.19, reduction group: p = 0.19), and GAD-7 scores (discontinuation group, p = 0.27; reduction group, p = 0.81) were not significant after the BZRA hypnotics were discontinued or reduced. Concomitant medications (antipsychotics and antidepressants) did not change from the baseline. The incidence of each adverse event did not change during the study period.

CONCLUSION: BZRA hypnotics can be discontinued or their dose reduced after long-term use without worsening sleep conditions and anxiety symptoms. Our results may provide a basis for the safe and effective discontinuation or dose reduction of long-term benzodiazepine hypnotics use.

PMID:39996227 | PMC:PMC11847632 | DOI:10.7759/cureus.77936

Cureus. 2025 Jan 24;17(1):e77904. doi: 10.7759/cureus.77904. eCollection 2025 Jan.

ABSTRACT

BACKGROUND: The use of peripherally inserted central catheters (PICC) in neonates has been established for numerous years, with significant advancements and enhancements observed in PICC technology over time. The objective of this study is to investigate the application trend of PICC over a 10-year period in a single-center neonatal intensive care unit (NICU).

METHODOLOGY: A retrospective analysis was conducted on the infants admitted between January 2012 and October 2021 who underwent PICC catheterization. Data pertaining to gestational age, birth weight, catheter weight, placement site, and indwelling time, as well as the occurrence of infection and complications, were collected. The data was collated, and statistical analysis was performed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States).

RESULTS: Out of the 1928 enrolled infants who underwent PICC catheterization, 1033 (53.58%) were males, and 895 (46.42%) were females. On the day of placement, their mean gestational age was 30.49±0.70 weeks, and their mean weight was 1398.26±14.05 g. Over the past 10 years, the number of PICC has consistently increased. The majority of cases were due to lower and right limb catheterization, with 1749 (90.72%) lower limb cases and 1477 (76.61%) right limb cases. The duration of catheter indwelling was 19.35±0.27 days. There were 297 cases (15.40%) of catheter-related complications, which included 107 cases (5.55%) of phlebitis, 71 cases (3.68%) of catheter obstruction, and 51 cases (2.65%) of catheter-related bloodstream infection (CRBSI). The binary logistic regression analysis revealed that the catheter site (upper extremity/lower extremity) (OR=0.612; 95% CI: 0.414-0.905; p=0.014) and catheter tip position (OR=1.903; 95% CI: 1.200-3.017; p=0.006) were associated with catheter complications.

CONCLUSIONS: During neonatal PICC catheterization in the NICU, the preferred approach is to perform venous catheterization of the lower extremities and ensure that the catheter tip remains positioned within the vena cava. This technique is associated with a reduction in catheter-related complications.

PMID:39996223 | PMC:PMC11848227 | DOI:10.7759/cureus.77904

Cureus. 2025 Jan 25;17(1):e77963. doi: 10.7759/cureus.77963. eCollection 2025 Jan.

ABSTRACT

BACKGROUND: Anemia is a significant public health issue in rural India, with a very big impact on health and productivity. This study investigates the prevalence and severity of anemia stratified by age and gender in a village in Southern India, using different guidelines.

METHODS: Retrospective data (n=3523) from a 2023 anemia survey done in the field area at Chirravuru under the Centre for Rural Health AIIMS (CRHA), Primary Health Centre (PHC), Nutakki (a peripheral unit of All India Institute of Medical Sciences {AIIMS}, Mangalagiri) covering 90% of the estimated population of the village was taken for the study. The hemoglobin levels were estimated from capillary blood, from where anemia severity was determined. Analysis was carried out to evaluate variations by age and gender to obtain statistical inferences. Results: Prevalence of anemia in the whole population was 79.3% (n=2792) with 32.9% (n=1159) of it being mild, 41.07% (n=1447) moderate, and 5.3% (n=186) severely anemic. Men had higher anemia of milder forms (43.3%) (n=746) than women (23.0%) (n=413), whereas women presented with a more severe form (7.8%) (n=140) compared to men (2.7%) (n=46). Moderate anemia tended to be similar in prevalence across both genders and was commoner among children under five (60%) (n=12) and adolescents (46.6%) (n=41) in comparison with adults (40.7%) (n=1350). Severe anemia was more frequent in adults (5.4%) (n=184).

CONCLUSIONS: Our findings revealed a relatively higher burden of anemia among women and children in Chirravuru. Similar areas of our country need targeted interventions to improve the hemoglobin status of adults and children through nutritional supplementation and health education.

PMID:39996221 | PMC:PMC11849579 | DOI:10.7759/cureus.77963

Cureus. 2025 Jan 22;17(1):e77856. doi: 10.7759/cureus.77856. eCollection 2025 Jan.

ABSTRACT

The choice of treatment of two modalities, open surgical or endovascular, in posterior cerebral artery (PCA) intracranial aneurysms must be taken based on their special characteristics. The objective of this study is to assess the potential superiority in outcomes, operative mortality, and clinical improvement after microsurgical and endovascular management repair in PCA intracranial aneurysms. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we created this study, performing a systematic investigation on the PubMed database, with the last search carried out on June 12, 2016. The eligibility limitations were that only full text was used in the English language, and double-checking was applied. Extracted data was organized on a standard table form, including first author, publication year, general number of patients and patients at follow-up, mortality rate (with 30 days from the selecting treatment), improvement (showing postoperatively at the clinical progress (muscle strength, thinking ability, and disorientation, due to ischemic infarctions following parent vessel occlusion) for the patients of both modalities. There were eight articles that matched our study criteria. The total study population included 8,863 patients with an aneurysm, 184 (2.07%) of which had an aneurysm at the different segments of the PCA. The pooled results revealed no statistically significant difference between the two groups, in terms of mortality, but with substantial statistical results concerning clinical improvement. We concluded that the aneurysmal site and size do not influence the treatment outcome. However, clinical improvement was a statistically significant factor, demonstrating the superiority of open surgical management over endovascular treatment (EVT) for PCA aneurysms. The selection of the appropriate procedure for every case must be done based on its special characteristics.

PMID:39996215 | PMC:PMC11848699 | DOI:10.7759/cureus.77856

Cureus. 2025 Jan 25;17(1):e77960. doi: 10.7759/cureus.77960. eCollection 2025 Jan.

ABSTRACT

Spontaneous intracranial hypotension (SIH) is a rare condition typically caused by a CSF leak at the level of the spine, leading to a reduction in intracranial pressure (ICP). This case describes a 55-year-old man who presented with visual disturbance, intermittent occipital headaches, nausea, altered hearing, and unsteady gait. The initial MRI of the head showed shallow bilateral subdural hematomas, which were believed to be secondary to the stretching of subdural veins. A diagnosis of probable intracranial hypotension was made and further radiological imaging of the spine was carried out to look for the presence of a CSF leak. A CT myelogram identified a CSF leak in the anterior part of the dura at the T1/T2 level, which was believed to be secondary to a bony spur. There are no well-defined statistics on the incidence of the causes of SIH. After a multidisciplinary discussion, a targeted CT-guided epidural blood patch was planned; however, the patient reported improvement in symptoms, so the procedure was abandoned, with serial follow-ups advised.

PMID:39996213 | PMC:PMC11849439 | DOI:10.7759/cureus.77960

Cureus. 2025 Jan 24;17(1):e77903. doi: 10.7759/cureus.77903. eCollection 2025 Jan.

ABSTRACT

INTRODUCTION: Mental health is an integral component of overall health and well-being, encompassing emotional, psychological, and social well-being. It influences cognition, perception, and behavior, and it determines how individuals handle stress, relate to others, and make choices. Mental health is essential at every stage of life, from childhood and adolescence through adulthood. The primary components of mental health include emotional well-being and psychological well-being. Emotional well-being refers to managing and expressing emotions effectively. It encompasses happiness, life satisfaction, and the ability to experience a range of emotions in a balanced manner. Whereas psychological well-being involves self-acceptance, personal growth, purpose in life, environmental mastery, autonomy, and other components. This research study examines the effectiveness of psychoeducation on the mental health status of students pursuing non-medical professional courses in colleges situated in Sangli city.

OBJECTIVES: The study aimed to evaluate the mental health levels of students enrolled in non-medical professional programs before and after receiving psychoeducation and compare these levels after the psychoeducational intervention.

METHODOLOGY: This study employed a pre-experimental pre-test and post-test research design. A purposive sampling technique was used to select the sample from the population, and 60 student participants of non-medical courses were included in this study. A pre-test was conducted followed by a psychoeducation session. A post-test was conducted after seven days to assess the effectiveness of psychoeducation sessions. Evaluations were included based on a standardized Mental Health Continuum-Short Form (MHC-SF) scale. The institutional ethical committee approved the study, and all guidelines, including consent and confidentiality, were strictly followed throughout the research. Results: The pre-test mean score was 33.55 with a standard deviation of 11.3726, while the post-test mean score increased to 57.93 with a standard deviation of 7.0153. The p-value of 0.00001, significantly lower than the 0.05 threshold, indicated a highly significant difference between the pre-test and post-test scores. This suggested that the intervention had a substantial positive effect on the participants, with the results showing clear improvement in the measured variable. The findings’ significance underscored the intervention’s effectiveness in achieving meaningful changes in the participants’ mental health status.

CONCLUSION: The results of the study indicate a statistically significant difference, with a p-value of 0.00001 at a 5% significance level. This supports the acceptance of the alternative hypothesis, demonstrating that there is a notable difference between the pre-test and post-test mean scores of mental health following the provision of psychoeducation to non-medical students. These findings suggest that psychoeducation has a meaningful positive impact, leading to significant improvement in the mental health of non-medical students in the post-test. Overall, this highlights the effectiveness of psychoeducation in enhancing the mental health status of students pursuing non-medical courses.

PMID:39996212 | PMC:PMC11848240 | DOI:10.7759/cureus.77903

Cureus. 2025 Jan 25;17(1):e77975. doi: 10.7759/cureus.77975. eCollection 2025 Jan.

ABSTRACT

Background The present study aimed to assess the efficacy of a heat-treated, FlexiCON nickel-titanium (Ni-Ti) rotary instrumentation system and compare it with existing commonly used instrumentation systems (hand file, ProTaper Universal, and WaveOne) using the EndoVac irrigation system. Methodology A total of 210 single-rooted, human permanent anterior teeth were equally divided into four groups of 50 teeth each (Group I for step-back, group II for ProTaper rotary, Group III for WaveOne reciprocating, and Group IV for FlexiCON rotary instrumentation system), and 10 teeth were used as controls. Canals were irrigated with EndoVac irrigation in each group. Extruded debris, irrigating solution, and Enterococcus faecalis were quantified and statistically analyzed. Results Group IV exhibited the least amount of debris, irrigating solution, and microorganisms than other groups, while Group I presented the most. FlexiCON with EndoVac irrigation demonstrated the least amount of microbe extrusion (14 colony-forming units (CFUs)) among the four instrumentation systems, whereas step-back instrumentation with EndoVac irrigation demonstrated the most (39 CFUs). The control group showed no debris, irrigating solution, or microorganisms. Conclusions FlexiCON Ni-Ti rotary instrumentation showed the least debris, irrigating solution, and bacterial extrusion compared with hand, ProTaper Universal, and WaveOne reciprocating instrumentation systems when EndoVac irrigation methods were used.

PMID:39996211 | PMC:PMC11849799 | DOI:10.7759/cureus.77975

BMC Med Imaging. 2025 Feb 24;25(1):58. doi: 10.1186/s12880-025-01598-0.

ABSTRACT

BACKGROUND: Recently, pediatric hip joint diseases have received increasing attention, however, most researches focus on conventional ultrasound. The aim of our study is to explore the application of real-time shear wave elastography (SWE) technology in different tissue structures of healthy pediatric hip joints to distinguish between the normal and pathological states, and provide a normal reference range for shear wave Young’s moduli for clinical practices and subsequent scientific researches.

METHODS: According to the selection criteria, 189 healthy full-term infants with 378 hip joints were enrolled, including 102 males and 87 females aged 2-90 days. They were divided into three groups based on age: 0-30 days (61 patients), 31-60 days (63 patients), and 61-90 days (65 patients). All the subjects underwent routine ultrasound examination to perform Graf typing, and then subjected to the SWE. The Young’s moduli of the femoral head, acetabular lip, acetabular cartilage apex, gluteus medius, gluteus minimus, and iliacus were recorded. The differences in various parts among the three groups, between the left and right sides, and between males and females were compared. The 95% medical reference value range for each part was obtained and consistency test was conducted.

RESULTS: There was no statistically significant difference in various parts between the left and right hip joints (P > 0.05) or between males and females (P > 0.05). There were significant differences in the femoral head, acetabular lip, and acetabular cartilage apex among the three groups (P < 0.05). The Young’s moduli of the femoral head, acetabular lip, and acetabular cartilage apex were positively correlated with age (r₁ = 0.56, P < 0.05; r₂ = 0.51, P < 0.05; r₃ = 0.58, P < 0.05). The Young’s moduli of the gluteus medius, gluteus minimus, and iliacus were not correlated with age (P > 0.05). The intra- and inter-observer evaluation results both had a high correlation, and the 95% Confidence Interval (95% CI) of both were relatively concentrated.

CONCLUSION: Real-time SWE technology can be used to obtain the Young’s moduli of healthy pediatric hip joints and surrounding tissues, and distinguish between healthy and pathological states. This can provide a normal reference range for shear wave Young’s moduli for clinical practices and subsequent scientific researches.

PMID:39994684 | DOI:10.1186/s12880-025-01598-0