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1.
Cureus ; 15(11): e48727, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38094516

RESUMO

Psychoneuroimmunology (PNI) offers a deep dive into the nexus between emotional stress, immunity, and surgical outcomes. In this narrative review, we first trace PNI's historical roots, providing a foundational understanding of its evolution. We then dissect its significance across the surgical journey, from the preoperative phase through to postoperative recovery. It becomes evident through our exploration that emotional stress has profound implications for surgery, notably influencing wound healing rates, susceptibility to infections, and overall postoperative well-being. Among the arsenal to combat these challenges, interventions such as cognitive-behavioral therapy, mindfulness, and complementary practices such as meditation and yoga have emerged as potent tools. They not only mitigate stress but also play a pivotal role in enhancing immune function. However, the journey to optimizing surgical outcomes is not just about identifying effective interventions. A resounding theme is the importance of holistic care, ensuring that all patients have equitable access to these tools. As PNI continues to evolve, we stand at the precipice of a healthcare revolution, one that promises a blend of personalized care, anchored in a deep understanding of the mind-body connection in surgical contexts.

2.
Cureus ; 15(11): e49082, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38125253

RESUMO

This comprehensive exploration unveils the transformative potential of Artificial Intelligence (AI) within medicine and surgery. Through a meticulous journey, we examine AI's current applications in healthcare, including medical diagnostics, surgical procedures, and advanced therapeutics. Delving into the theoretical foundations of AI, encompassing machine learning, deep learning, and Natural Language Processing (NLP), we illuminate the critical underpinnings supporting AI's integration into healthcare. Highlighting the symbiotic relationship between humans and machines, we emphasize how AI augments clinical capabilities without supplanting the irreplaceable human touch in healthcare delivery. Also, we'd like to briefly mention critical findings and takeaways they can expect to encounter in the article. A thoughtful analysis of the economic, societal, and ethical implications of AI's integration into healthcare underscores our commitment to addressing critical issues, such as data privacy, algorithmic transparency, and equitable access to AI-driven healthcare services. As we contemplate the future landscape, we project an exciting vista where more sophisticated AI algorithms and real-time surgical visualizations redefine the boundaries of medical achievement. While acknowledging the limitations of the present research, we shed light on AI's pivotal role in enhancing patient engagement, education, and data security within the burgeoning realm of AI-driven healthcare.

3.
Cureus ; 15(10): e46998, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37965396

RESUMO

This article provides an in-depth review of the current state of management for diabetes, hypertension, and cardiovascular disease, focusing on advancements from genomics to robotics. It explores the role of genomic markers in personalized medicine, offering tailored treatment options for these chronic conditions. The article also examines the efficacy of various pharmacological and surgical interventions, including bariatric surgery for diabetes and device-based treatments for hypertension. A comparative analysis is presented to evaluate the cost-effectiveness and patient outcomes between medical and surgical approaches. The review concludes that while personalized medicine and minimally invasive surgical techniques show promise, more high-quality comparative research is needed. The ultimate goal is to integrate these emerging technologies within a framework of evidence-based medicine to improve patient outcomes and health equity.

4.
Cureus ; 15(9): e45996, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37900524

RESUMO

Focal cortical dysplasia (FCD) is a prominent neurological disorder characterized by disruptions in localized brain cell organization and development. This narrative review delineates the multi-faceted nature of FCD, emphasizing its correlation with drug-resistant epilepsy, predominantly in children and young adults. We explore the historical context of FCD, highlighting its indispensable role in shaping our comprehension of epilepsy and cortical anomalies. The clinical spectrum of FCD is broad, encompassing diverse seizure patterns, cognitive impairments, and associated neuropsychiatric disorders. We underscore the importance of differential diagnosis, with techniques ranging from electroencephalogram (EEG) interpretations to microscopic evaluations, and discuss advanced diagnostic modalities, such as the 3T magnetic resonance imaging (MRI) epilepsy protocols. Therapeutically, while anti-seizure medications are often first-line interventions, surgically refractory cases necessitate more invasive procedures, underscoring the importance of individualized treatment. Furthermore, the review touches upon the prognostic aspects of FCD, highlighting the importance of personalized care regimens, and provides insights into emerging therapeutic avenues, including the potential of the mammalian target of rapamycin (mTOR) pathway. Conclusively, this review accentuates the complex relationship between brain development and epileptogenicity inherent to FCD and underscores the promise of future research in enhancing patient outcomes.

5.
Cureus ; 15(9): e44694, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37674761

RESUMO

Soft tissue sarcomas (STSs) are a heterogeneous group of malignancies that have long posed challenges in terms of diagnosis, treatment, and management. This narrative review provides a comprehensive exploration into the multifaceted realm of STS, spanning from its historical origins to the latest advancements in research and clinical care. We delve into the molecular intricacies of STS, highlighting the genetic and epigenetic aberrations that drive these tumors. The review emphasizes the neurological implications of STS, a relatively underexplored area, shedding light on the interplay between tumor biology and neural processes. The evolving therapeutic landscape is discussed, with a focus on the promise of targeted therapies, immunotherapy, and precision medicine. A significant portion is dedicated to the patient-centric approach, underscoring the importance of holistic care that addresses both the physical and psychological needs of STS patients. Furthermore, we highlight the gaps in current research and clinical practices, offering insights into potential avenues for future exploration. This review serves as a valuable resource for clinicians, researchers, and the broader scientific community, encapsulating the current state of STS knowledge and pointing toward future directions in this dynamic field.

6.
Cureus ; 15(7): e41509, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37551252

RESUMO

Gastrointestinal neuroectodermal tumors (GNETs) are extremely rare and intriguing malignancies originating from neural crest cells in the digestive tract. The digestive tract's neural crest cells can give rise to incredibly unusual and interesting gastrointestinal neuroectodermal tumors (GNETs). GNETs present considerable hurdles in diagnosis and management because of their rarity and varied expression. In this case report, a 45-year-old male patient is described who had signs of GNET, such as exhaustion, weight loss, and abdominal pain. A 7-cm jejunum tumor and related thickening of the gut wall were discovered using imaging investigations. The diagnosis of malignant GNET was confirmed by surgical resection, and adjuvant treatment was given. A recurring tumor required a second surgical procedure despite an initial disease-free period. The report emphasizes the difficulties involved in the diagnosis, treatment, and long-term effects of GNETs. The rarity of GNETs necessitates the development of standardized treatment protocols as well as additional research to enhance diagnostic precision and explore novel therapeutic approaches for this aggressive malignancy.

7.
Cureus ; 15(7): e42504, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37637651

RESUMO

Acute myeloid leukemia (AML) is a hematologic cancer that is characterized by unchecked myeloid precursor cell growth in the bone marrow and peripheral circulation, which results in an overabundance of immature myeloid cells. The 22-year-old man featured in this case report had a fever, tiredness, and easy bruising. Pancytopenia was discovered through laboratory testing, and an AML diagnosis was confirmed by a bone marrow biopsy, with myeloid blasts making up 85% of the nucleated cells. FLT3-ITD and NPM1 mutations were found by genetic testing. After receiving induction chemotherapy using the drugs daunorubicin and cytarabine, the patient experienced complete remission after just one cycle of treatment. He then had an allogeneic stem cell transplant and was still in remission during follow-up. This example highlights the significance of early AML diagnosis and detection, as well as the function of molecular profiling and risk stratification in directing treatment choices. It emphasizes the requirement for continued study to produce novel treatments and enhance results for AML patients. In general, this case study advances knowledge of AML and its management techniques. For AML patients to experience the best results, early diagnosis, risk assessment, and individualized therapy plans based on molecular profiling are essential. AML patients' prognosis and quality of life can be improved by the development of targeted medicines, which require ongoing study to better understand the disease.

8.
Cureus ; 15(7): e42658, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37521593

RESUMO

Soft-tissue sarcomas (STS) comprise a heterogeneous category of malignant tumors originating from mesenchymal tissue. Spindle cell sarcoma, characterized by its infrequent occurrence, poses diagnostic and therapeutic complexities owing to its rarity. We present a case of an 80-year-old male with a diagnosis of spindle cell sarcoma in the retroperitoneal space. The patient underwent midline exploratory laparotomy for tumor excision and was planned for postoperative chemotherapy. Unfortunately, the tumor recurred aggressively, leading to a fatal outcome. This case highlights the uncommon occurrence of retroperitoneal spindle cell sarcoma (RPSCS) and the importance of accurate diagnosis, appropriate surgical management, and adjuvant therapy.

9.
Cureus ; 15(5): e39612, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37384071

RESUMO

Brain metastasis from Ewing sarcoma is rare and can present with various symptoms. We present a 21-year-old female who underwent surgery for Ewing sarcoma of the knee joint and, after six months, was reported with complaints of headache and vomiting. Considering recommended investigations, metastatic Ewing sarcoma of the brain was diagnosed, and a treatment protocol, such as a combination of surgery, chemotherapy, and radiation, was given. Our observation shows this is the first case reported with a solitary metastatic brain lesion associated with Ewing sarcoma.

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