Cureus Journal of Medical ScienceCureus 医学科学杂志
Cureus Journal of Medical Science(英文缩写 CUREUS J MED SCIENCE),ISSN 2168-8184,eISSN 2168-8184,中文译名:Cureus 医学科学杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
Cureus Journal of Medical Science 最新收录文献
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1. The Psychological Impact of Hospital Admission on the Elderly: A Prospective Comparative Clinical Audit and Service Evaluation.
1. 住院对老年人的心理影响：一项前瞻性比较临床审计与服务评估PMID:日期:2026-10-04Introduction Hospital admission in older adults can be associated with functional decline, loss of independence, delirium, disruption of routine, and psychological deterioration. Virtual Wards, also described as Hospital-at-Home models, provide acute clinical care in a patient's usual place of residence and may reduce some harms associated with inpatient admission. Although Virtual Wards are commonly evaluated in terms of bed capacity, admission avoidance, and clinical safety, their psychological impact remains less well explored. This audit compared depressive symptoms and self-rated mood in older adults managed in hospital with those treated through a Virtual Ward service. Methods A prospective comparative clinical audit and service evaluation was conducted within the Care of the Elderly directorate at East Cheshire NHS Trust. The audit included 100 patients aged ≥70 years: 50 hospital inpatients and 50 patients managed through Virtual Ward pathways. Eligible patients had received at least five days of inpatient or Virtual Ward care and had broadly comparable medical diagnoses. Patients with severe acute or life-threatening illness, those lacking capacity to participate, and those with communication barriers preventing completion of the assessment tools were excluded. Baseline age, sex, primary diagnosis, and Clinical Frailty Scale (CFS) characteristics were compared descriptively between cohorts. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15), and self-rated mood was assessed using a five-point mood scale. Exploratory unadjusted between-group comparisons were performed for selected patient-level outcomes. Results Hospital inpatients demonstrated a greater depressive symptom burden than Virtual Ward patients. A GDS-15 score of ≥5 was recorded in 36 (72%) hospital inpatients compared with 15 (30%) Virtual Ward patients, corresponding to an unadjusted odds ratio of 6.00 (95% CI, 2.53-14.24; Fisher's exact p<0.001). Low self-rated mood, defined as a score of 1 or 2, was reported by 19 (38%) hospital inpatients compared with three (6%) Virtual Ward patients, with an unadjusted odds ratio of 9.60 (95% CI, 2.62-35.21; Fisher's exact p<0.001). Conversely, positive mood scores of 4 or 5 were reported by 32 (64%) Virtual Ward patients compared with 16 (32%) hospital inpatients. Baseline age and frailty distributions showed substantial descriptive overlap, although some variation in sex and primary diagnosis was present between cohorts. Conclusion Older adults receiving inpatient care demonstrated a greater burden of depressive symptoms and less positive self-rated mood than those managed through the Virtual Ward service. However, the non-randomised design, potential selection bias, and absence of adjustment for important baseline factors such as cognitive status, functional status, social support, and baseline psychological wellbeing mean that causation cannot be established. The findings should therefore be interpreted as an association between care setting and psychological wellbeing rather than evidence that Virtual Ward care itself improves mood. Further prospective evaluation using comprehensive baseline assessment, adjusted analyses, and post-discharge follow-up is required. Older adults who require hospital admission may also benefit from routine mood assessment and targeted measures to support psychological wellbeing.
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2. Structural Barriers Underlying Kidney and Liver Transplant Inequity in Hispanic Americans.
PMID:日期:2026-10-04Hispanic patients in the United States experience a disproportionate burden of end-stage kidney and liver disease, yet they continue to encounter disparities across multiple stages of the transplantation pathway. This narrative review synthesizes evidence on transplant referral, evaluation, waitlisting, organ allocation, living and deceased donation, structural barriers, interventions, and posttransplant outcomes among Hispanic patients. National and regional studies demonstrate persistent inequities whose magnitude varies by organ, stage of care, geographic region, and policy era, with reduced access to both deceased-donor and living-donor kidney transplantation reported among Hispanic adults and children relative to their White counterparts. Linguistic isolation, geographic variation in organ availability and transplant infrastructure, socioeconomic disadvantage, insurance limitations, medical distrust, and organ-procurement practices may contribute to these disparities. Culturally and linguistically concordant programs have improved transplant knowledge, waitlist access, and living-donor transplantation in selected settings. Despite reduced access, Hispanic kidney and liver transplant recipients frequently demonstrate outcomes comparable with or better than non-Hispanic White recipients, although the mechanisms underlying this pattern remain uncertain. Because several major studies use overlapping national registry populations, their findings are best interpreted as convergent rather than fully independent evidence. Structural interventions across referral, evaluation, language access, geography, financial support, organ procurement, and transplant-center practice may improve transplantation equity.
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3. Solitary Rectal Ulcer Syndrome Mimicking Ulcerative Colitis: A Case Report.
PMID:日期:2026-10-03Solitary rectal ulcer syndrome (SRUS) is a benign rectal disorder associated with abnormal defecation and mucosal prolapse. Its clinical and endoscopic features may mimic inflammatory bowel disease (IBD). We report the case of a 28-year-old woman with longstanding obstructed defecation who presented with recurrent bloody mucus discharge and severe iron-deficiency anemia (hemoglobin 6.6 g/dL), which was treated with intravenous iron infusions. C-reactive protein was normal, whereas fecal calprotectin was markedly elevated. Initial colonoscopy showed erythematous and congested mucosa extending from the anal verge to 20 cm, with a large ulcer, raising suspicion of ulcerative colitis. However, the initial biopsies were inconclusive. Following clinical worsening, repeat colonoscopy revealed a 5-cm elevated rectal lesion with central ulceration. Histological examination demonstrated epithelial loss, granulation tissue, villiform crypt changes, and characteristic fibromuscular hyperplasia of the lamina propria, establishing the diagnosis of SRUS. Magnetic resonance defecography revealed an anterior rectocele and internal rectal prolapse, while anorectal manometry demonstrated dyssynergic defecation. Conservative measures and biofeedback provided incomplete improvement, with persistent rectal bleeding. Given the documented internal rectal prolapse and refractory symptoms, laparoscopic ventral rectopexy was performed, resulting in a favorable postoperative clinical course with marked symptomatic improvement and normalization of hemoglobin to 13.7 g/dL. SRUS should be considered when inflammatory-appearing rectal lesions are not supported by histological evidence of IBD, particularly in patients with obstructed defecation.
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4. When Hypercapnia Misleads: A Case of Respiratory-Onset Motor Neuron Disease.
PMID:日期:2026-10-03Motor neuron disease (MND) most commonly presents with limb or bulbar weakness; however, a minority of patients present with respiratory-onset disease, posing significant diagnostic challenges. We report the case of a 78-year-old woman with a background of small airways disease and rheumatoid arthritis not requiring treatment for many years, who presented with a two-year history of progressive exertional dyspnoea, unintentional weight loss, and functional decline. Before diagnosis, she underwent extensive investigation across primary and secondary care, including chest radiography, spirometry, computed tomography imaging, and ear, nose, and throat specialist assessment, without a unifying diagnosis being established. On admission, venous blood gas demonstrated compensated hypercapnia, which was attributed to obstructive airways disease. She subsequently developed hypercapnic respiratory failure, and a clinical diagnosis of MND was made on the basis of generalised muscle wasting, fasciculations, brisk lower-limb reflexes, and electromyography findings. Non-invasive ventilation was initiated with significant clinical improvement. This case highlights the diagnostic challenges of respiratory-onset MND, the risk of anchoring bias in the interpretation of biochemical markers, and the importance of considering neuromuscular causes when respiratory symptoms are disproportionate to radiological and biochemical findings.
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5. Digital Skincare Marketing, Self-Experimentation, and Treatment Adherence in Acne Vulgaris: A Psychodermatological Review.
PMID:日期:2026-10-02Acne vulgaris requires sustained treatment, yet adherence may weaken before meaningful improvement occurs, particularly when topical therapy causes xerosis, peeling, erythema, or stinging. Digital acne content can expand access to education and patient perspectives, but it also places clinical advice beside commercial claims, transformation narratives, and complex skincare routines without a consistent hierarchy of evidence. This narrative review examined evidence relevant to how psychodermatological vulnerability and digital skincare exposure may contribute to cosmetic self-experimentation, cutaneous irritation, and treatment non-adherence, while distinguishing observed associations from untested mechanistic links. This digital exposure includes exposure to online acne/skincare recommendations, social media advice, influencer content, transformation narratives, and algorithmically reinforced skincare-routine content. PubMed, Embase, and Google Scholar were searched through July 22, 2026, for English-language literature published since 2016. Across the reviewed literature, acne-related stigma, depressive symptoms, body dysmorphic symptoms, and treatment expectations were associated with psychological burden, treatment satisfaction, and intention to adhere. Separate studies also described patient uptake of online acne recommendations, clinician-observed dermatoses associated with multi-step cosmetic routines, and associations between cutaneous adverse effects and poorer medication adherence. Together, these findings support a conceptual model in which psychodermatological distress, delayed improvement, online product exposure, cutaneous symptoms, and adherence difficulties may interact, but the available evidence does not establish this sequence causally or longitudinally. No longitudinal study measured digital exposure, product additions, objective barrier change, symptom attribution, and medication persistence in the same patients. Acne care should therefore emphasize realistic treatment timelines, application demonstration, regimen simplification, early follow-up, and detailed review of prescribed and non-prescribed products. These findings do not justify treating all digital content or non-prescription skincare as harmful. Clinician-produced content may support patient education, and selected dermocosmetics may have a role as adjuncts to structured acne care.
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6. Chylothorax Secondary to Behçet's Disease: A Case Report.
6. 继发于白塞病的乳糜胸：一例病例报告PMID:日期:2026-09-04Chylothorax is an uncommon cause of pleural effusion and is most frequently associated with trauma or malignancy. Its occurrence in Behçet's disease (BD) is exceptionally rare and is usually related to extensive central venous thrombosis causing obstruction of the thoracic duct. We report the case of a 35-year-old woman with a five-year history of BD who presented with progressive dyspnea, dry cough, and mild hemoptysis. Chest computed tomography (CT) revealed extensive thrombosis of the superior vena cava extending to both brachiocephalic veins and the right subclavian vein, associated with large bilateral pleural effusions. Diagnostic thoracentesis yielded milky pleural fluid with elevated triglyceride levels, confirming bilateral chylothorax. Other potential causes, including pulmonary embolism, pulmonary artery aneurysm, malignancy, chylopericardium, and chyloperitoneum, were excluded. The patient was treated with therapeutic anticoagulation, high-dose corticosteroids, intravenous cyclophosphamide, repeated therapeutic thoracentesis, and nutritional support with dietary fat restriction. Clinical and radiological outcomes were favorable, with complete resolution of dyspnea and marked regression of the pleural effusions. Chylothorax is a rare but important thoracic manifestation of BD. In patients presenting with unexplained pleural effusion and central venous thrombosis, BD should be considered among the differential diagnoses. Early recognition and prompt immunosuppressive therapy, combined with appropriate management of the pleural effusion, are essential to achieve favorable outcomes.
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7. Differentiating Persistent Sepsis From Pembrolizumab-Induced Secondary Hemophagocytic Lymphohistiocytosis and Concurrent Immune-Mediated Nephritis: A Diagnostic and Therapeutic Challenge.
7. 区分持续性脓毒症与帕博利珠单抗诱导的继发性噬血细胞性淋巴组织细胞增多症及并发免疫介导性肾炎：诊断与治疗的挑战PMID:日期:2026-09-04Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome that can occur as an immune-related adverse event following immune checkpoint inhibitor therapy. Early diagnosis is challenging because its clinical features frequently overlap with severe sepsis, particularly in oncology patients who have recently received marrow-suppressing cytotoxic regimens. We report the case of a 39-year-old woman with triple-negative breast cancer who underwent neoadjuvant chemo-immunotherapy with carboplatin, paclitaxel, epirubicin, cyclophosphamide, and pembrolizumab. Two weeks after her last cycle, she presented with fever, a generalized rash, and purulent discharge from a peripherally inserted central catheter site, with blood cultures initially positive for Gram-positive bacteria. Despite prompt microbiological clearance with broad-spectrum antimicrobials, she developed persistent daily pyrexia, progressive liver function derangement, severe anemia, bilateral pleural effusions, and stage 3 acute kidney injury requiring continuous renal replacement therapy. Serial assessments revealed marked hyperferritinemia, hypertriglyceridemia, elevated aspartate aminotransferase, and an increasing HScore. Bone marrow biopsy showed treatment-related dyspoiesis without overt hemophagocytosis, which did not preclude the diagnosis of pembrolizumab-associated secondary HLH and concurrent immune-mediated nephritis. Targeted treatment with high-dose methylprednisolone, anakinra, and subsequently mycophenolate mofetil led to clinical recovery. The patient was successfully liberated from continuous renal replacement therapy; her cytopenias and kidney function improved, and her hyperinflammatory markers and HScore normalized. Anakinra was discontinued, and she was discharged on oral mycophenolate mofetil and prednisolone. This case underscores the complexity of distinguishing checkpoint inhibitor-associated HLH from persistent infection. Serial clinical scoring, multidisciplinary input, and substituting conventional cytotoxic HLH protocols with targeted biological therapies and organ-preserving immunosuppressants are essential to resolve the hyperinflammatory cascade while preserving renal function.
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8. Cerebral Aspergillosis in a Patient on Ibrutinib: A Case of Diagnostic Ambiguity and Multidisciplinary Care.
8. 伊布替尼治疗患者中的脑曲霉病：一例诊断模糊与多学科诊疗的病例PMID:日期:2026-09-04This case report describes the challenging diagnosis and management of cerebral aspergillosis in a patient with chronic lymphocytic leukaemia undergoing treatment with a BTK inhibitor. The initial presentation was deceptively unspecific, comprising cognitive changes, receptive aphasia, gait instability and mild neurological deficits without fever or significant systemic inflammation. The combination of a muted and non-indicative clinical picture and a broad differential diagnosis reflects the evolving complexity of CNS infections in patients treated with targeted haematological therapies. Neuroimaging played a central role in directing attention toward an intracranial pathological process but did not resolve the ambiguity. CT suggested a space-occupying lesion, while MRI revealed multiple enhancing foci with mixed signal characteristics that could represent fungal, bacterial or neoplastic processes. Diagnosis was only established after neurosurgical intervention, when resection of the dominant lesion provided tissue for definitive identification of . Once the diagnosis was confirmed, long-term voriconazole therapy was initiated and adjusted with therapeutic drug monitoring, while ibrutinib was discontinued to prevent interactions and further immunosuppression. The patient's clinical trajectory gradually stabilised, with radiological follow-up showing resolution of lesions and no recurrence. Overall, this case illustrates the importance of maintaining a high index of suspicion for fungal CNS infections in patients receiving modern immunomodulatory treatments. The interplay between subtle and non-specific neurological clinical signs, atypical imaging and altered immune responses can delay diagnosis unless the clinical team actively integrates therapeutic background and invasive modalities into its reasoning. The favourable outcome achieved here underscores the value of early multidisciplinary involvement, timely pursuit of tissue diagnosis and careful coordination of antifungal therapy.
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9. Sustained Regression of Parotid Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma After Nutritional and Nutraceutical Intervention Without Chemoimmunotherapy: A Case Report.
PMID:日期:2026-09-04Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) in the setting of Sjögren's syndrome (SS) is a well-recognized complication of chronic autoimmune salivary gland inflammation. Standard management options include radiotherapy, immunotherapy, and combination chemoimmunotherapy, with active surveillance reserved for stable, low-burden disease. The potential role of structured nutritional and nutraceutical intervention in this setting has not been previously described. We report the case of a woman who presented at age 52 with SS-associated bilateral parotid MALT lymphoma that progressed substantially over 28 months of active observation, with palpable bilateral parotid enlargement reaching 10 x 5 cm on the left and 6 x 6 cm on the right. Proposed chemoimmunotherapy was deferred by the patient, and she independently initiated a structured multicomponent protocol comprising a strict vegan diet restricted in methionine and cysteine, urinary alkalization, and orally administered nutraceuticals including therapeutic-dose slow-releasing sodium selenite (32 mg/day), B6 pyridoxal-5'-phosphate (P5P), iron, zinc, copper, and manganese, with adjunctive rectal ozone therapy started at approximately Month 3. Serial clinical examinations and ultrasonography documented progressive bilateral parotid regression from approximately Month 7. At Month 20, repeat ultrasonography confirmed substantial radiographic reduction: the right parotid lesion decreased to 1.5 × 0.8 cm and the left to 2.7 × 0.8 cm, with both parotid glands returning to normal overall size with residual hypoechoic lesions and no cervical lymphadenopathy. At approximately Month 19, the hematologist documented no significant lymphadenopathy or splenomegaly on serial physical examination. Prednisone dosing, prescribed for concurrent autoimmune hemolytic anemia (AIHA), fluctuated independently of parotid gland changes throughout, making a corticosteroid-mediated response unlikely. This case documents a rapid and durable regression of progressive bilateral parotid MALT lymphoma after a dietary and nutraceutical protocol targeting tumor redox biology, without chemoimmunotherapy. Although spontaneous regression cannot be excluded, the response timing and proposed mechanism of glutathione and thioredoxin antioxidant pathway disruption merit further clinical study.
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10. Public Awareness and Perceptions of Stem Cell Therapy for Stroke: A Cross-Sectional Survey Study.
PMID:日期:2026-09-04Background Stroke remains a leading cause of death and long-term disability. Although stem cell-based approaches are being investigated as possible regenerative strategies for stroke, public perceptions of their potential benefits, risks, mechanisms, and clinical use are not well-characterized. This exploratory survey described responses to an investigator-developed questionnaire about stem cell therapy for stroke. Methods A 10-item cross-sectional questionnaire was distributed electronically through Google Forms (Google, Inc., Mountain View, CA) to 36 individuals in a convenience sample; 26 completed questionnaires were received (response rate: 72.2%). The questionnaire was investigator-developed and was not validated as a measure of factual knowledge, clinical efficacy, or safety. Responses were categorized as "yes," "no," or "maybe"; one item used time-based response categories. Counts and percentages were calculated using the total number of completed questionnaires as the denominator. The survey was independently conducted as a student-led summer academic project and did not undergo review by an institutional review board, school ethics committee, or independent ethics authority. Results Twenty-six responses were analyzed. For the item asking whether embryonic stem cells are effective in stroke treatment, eight respondents (30.77%) selected "yes," 16 (61.54%) selected "maybe," and two (7.69%) selected "no." For the item asking whether stem cell treatment has advantages for stroke, 21 respondents (80.77%) selected "yes," four (15.38%) selected "maybe," and one (3.85%) selected "no." "Maybe" was the majority or joint-most-frequent response for six of 10 items, including items about animal testing, adverse effects, alternative regenerative treatments, and use during pregnancy. Conclusions In this small convenience sample, responses to an investigator-developed questionnaire suggested favorable perceptions of possible benefits of stem cell therapy for stroke, alongside frequent uncertainty about safety, mechanisms, the timing of improvement, and use in special populations. Because the questionnaire was not validated as a factual-knowledge instrument, findings should be interpreted strictly as descriptive perceptions rather than as evidence of respondents' medical knowledge, treatment confidence, or the clinical efficacy or safety of stem cell therapy. Larger studies using validated instruments and representative sampling are needed.