Cureus Journal of Medical Science

Cureus Journal of Medical Science The Open Access medical journal for a new generation of doctors, researchers and patients. Cureus currently recognizes the following medical specialties.
(2)

Don’t see your specialty listed? Contact us at support@cureus.com. A
Allergy and Immunology
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Cardiac/Thoracic/Vascular Surgery
Cardiology
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Dentistry
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Emergency Medicine
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Family Medicine
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Gastroenterology
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Health Policy
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Infectious Disease
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Medical Education and Simulation
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Nephrology
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Obstetrics and Gynecology
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Pain Management
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R
Radiation Oncology
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S
Substance Use and Addiction
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T
Therapeutics
Trauma
U
Urology

A 45-year-old woman with sickle cell anemia presented with fever, severe headache, and reduced consciousness. Her initia...
01/05/2026

A 45-year-old woman with sickle cell anemia presented with fever, severe headache, and reduced consciousness. Her initial CT scan was normal.

But lumbar puncture revealed a rare and alarming finding: Frankly purulent cerebrospinal fluid, with profound neutrophilic pleocytosis, undetectable glucose, and confirmed Streptococcus pneumoniae.

Despite prompt empiric therapy and aggressive neurocritical care, within 72 hours she developed:

Multifocal cerebral infarcts
Basal ganglia hemorrhage
Malignant cerebral edema

She ultimately progressed to brain death.

The takeaway:

In adults with sickle cell anemia, pneumococcal meningitis can evolve catastrophically, and fast. A normal early CT does not exclude severe CNS infection, and this population may be especially vulnerable to early cerebrovascular complications.

This case reinforces the need for:

A low threshold for lumbar puncture
Early escalation of neurocritical monitoring
Strict adherence to pneumococcal vaccination in high-risk patients

Would this case lower your threshold for LP in high-risk patients with headache and fever?
Should adults with sickle cell disease be monitored more aggressively for early CNS complications of meningitis?

Share how this would influence your clinical approach.

Read more here: https://hubs.la/Q03ZgLp80

01/05/2026

What links digital autoamputation, heavy smoking, and a massive pulmonary embolism?

A 45-year-old man with a 20+ pack-year smoking history and COPD presents with:
Dyspnea and hemoptysis
Severe thigh pain
Raynaud phenomenon
Necrotic fingertips with prior digital autoamputation

Imaging reveals:
📌 Extensive bilateral DVT
📌 Acute pulmonary embolism with right heart strain

What’s the most likely underlying diagnosis?

👇 Drop your answer in the comments BEFORE checking the explanation here: https://hubs.la/Q03Zsb2q0
👇 What single clinical clue made you choose it?

01/05/2026

Is va**ng really safer or are we repeating old mistakes with new devices? 🚭

Since their introduction in the mid-2000s, e-ci******es (ENDS) have been widely marketed as a safer alternative to smoking and even as a smoking-cessation tool.

But what do we actually know about their effects on the human body?

This review breaks down:
How va**ng devices work
What’s inside the aerosol
How these components interact with human physiology
And why adolescents may be particularly vulnerable

The evidence shows that va**ng is not risk-free.

Multiple device components and chemicals are linked to adverse health effects, raising concerns about long-term exposure, regulation, and public awareness.

The takeaway:
E-ci******es are not just a personal choice, they’re a public health issue.
Education, ingredient standards, and marketing restrictions comparable to to***co may be essential to reduce harm, especially among young users.

Read the full review here: https://hubs.la/Q03ZrTlP0

💬 Do you think va**ng should be regulated the same way as traditional ci******es?
💬 Is the public being adequately inform about the potential health risks of va**ng?

Share your perspective especially if you work in healthcare, education, or policy.

**ng ******es

Fear is meant to keep us alive. But when fear lingers, resurfaces, or refuses to switch off, it can become the foundatio...
01/04/2026

Fear is meant to keep us alive. But when fear lingers, resurfaces, or refuses to switch off, it can become the foundation of disorders like PTSD, anxiety, and schizophrenia.

This systematic review explored the neural conversation between the basolateral amygdala (BLA) and the medial prefrontal cortex (mPFC), the brain circuit that decides when fear is expressed and when it’s extinguished.

What the evidence shows:

The BLA and mPFC communicate bidirectionally, but not uniformly
Prelimbic cortex pathways tend to promote fear expression
Infralimbic cortex pathways help suppress and extinguish fear
Astrocytes and NMDA receptor signaling play key roles in both forming and erasing fear memories

When these circuits are dysregulated, fear can become maladaptive, contributing to psychiatric illness.

The takeaway:

Fear isn’t controlled by a single “fear center.” It’s regulated by precise circuits, specific cell types, and timing-dependent signaling, and understanding this complexity may unlock better, more targeted treatments.

Do you think future psychiatric treatments should target specific fear circuits rather than symptoms alone?
Which do you see as more promising: circuit-level neuromodulation or pharmacologic approaches?

Share your perspective; neuroscience thrives on dialogue.

Read more here: https://hubs.la/Q03ZgHDb0

Influenza isn’t just a respiratory illness, especially in older adults.For patients with hypertension, diabetes, or exis...
01/03/2026

Influenza isn’t just a respiratory illness, especially in older adults.
For patients with hypertension, diabetes, or existing cardiovascular disease, influenza can act as a trigger for serious cardiac events, including myocardial infarction.

This systematic review examined whether influenza vaccination reduces the risk of heart attacks, and the signal is compelling:

Vaccination appears to lower cardiovascular risk
Annual vaccination may offer the greatest protective effect
The benefit is most relevant for older, high-risk adults

The takeaway:

Influenza vaccination may be an underused cardiovascular prevention strategy, not just an infection-control measure. In aging populations, protecting against the flu could also mean protecting the heart.

Do you routinely frame the flu vaccine as a cardiovascular preventive tool for high-risk patients?
Should cardiology and primary care be more proactive in prescribing annual flu vaccination?

Weigh in; is this a missed opportunity in preventive care?

Read more here: https://hubs.la/Q03ZgCjH0

Navigation technology has transformed spine surgery, yet how it’s used still varies widely from surgeon to surgeon.Guide...
01/02/2026

Navigation technology has transformed spine surgery, yet how it’s used still varies widely from surgeon to surgeon.

Guidewires first? Screws first? Cage first? This variability can slow workflow and blunt the real advantages of 3D navigation.

This study evaluated a fully navigated, stepwise MISS-TLIF workflow, starting with a single preoperative 3D O-arm spin, followed by navigation at every critical step, all through a single small incision.

What did this standardized approach achieve?

100% successful navigated screw and cage placement
Low blood loss (≈100 mL)
Accurate pedicle screw placement (93%)
Low facet joint violation rate (7%)
Significant long-term improvement in Oswestry Disability Index
Improved medial screw convergence and disc parameters

The takeaway:

Navigation works best when it’s systematic, not selective. A standardized, fully navigated workflow may reduce errors, streamline surgery, and limit radiation, while improving precision and outcomes.

Do you follow a fixed navigation sequence in MISS-TLIF, or tailor it case by case?
Would a standardized navigation-first workflow improve efficiency in your OR, or limit flexibility?

Curious to hear how others are integrating navigation into daily spine practice.

Read more here: https://hubs.la/Q03ZgBvV0

Immune checkpoint inhibitors save lives, but they can also trigger rare, devastating neurological complications. This ca...
01/01/2026

Immune checkpoint inhibitors save lives, but they can also trigger rare, devastating neurological complications. This case report describes a melanoma patient treated with PD-1 blockade who developed progressive, fatal immune-mediated neuropathy. Extensive workup ruled out metastatic, infectious, metabolic, and paraneoplastic causes.

What stood out was timing.

Worsening neuropathic symptoms and functional decline followed irregular, late-afternoon infusions
Earlier-day infusions were associated with fewer symptoms
Inflammatory markers (NLR, PLR, SII) peaked shortly after late infusions

While causality cannot be proven from a single case, the pattern raises a provocative possibility: Circadian desynchronization may amplify immune activation and neurotoxicity.

The authors propose the concept of “Chrono-Immune Neuropathy”, suggesting that when immunotherapy is administered may influence the severity of immune-related adverse events.

The takeaway:
Immunotherapy dosing may not be time-neutral.
Consistency and circadian awareness could matter, especially for neurologic toxicity.

Do you think time-of-day scheduling should be considered in immunotherapy protocols?
Have you observed differences in toxicity based on infusion timing in your patients?

This challenges how we think about precision medicine, weigh in.

Read more here: https://hubs.la/Q03ZgHbn0

Heart failure doesn’t appear overnight. In many patients, damage begins silently, long before symptoms or a reduced ejec...
12/31/2025

Heart failure doesn’t appear overnight. In many patients, damage begins silently, long before symptoms or a reduced ejection fraction show up.

In this real-world cardiology cohort from a resource-limited setting, most patients had: Normal conventional echocardiography but borderline or abnormal left ventricular global longitudinal strain (LVGLS)

And what predicted impaired strain?
Everyday risk factors we see daily:

Higher BMI
Elevated systolic & diastolic blood pressure
Increased LV mass
Abnormal diastolic indices (e’, E/e’)
Even LVEF within the “normal” range

The takeaway: LVGLS reveals subclinical myocardial dysfunction that routine echo can miss, especially in patients with obesity and hypertension. In settings where heart failure is often diagnosed late, strain imaging may shift care from reaction to prevention.

Should LVGLS be used more routinely for risk stratification, even when LVEF is normal?
In low-resource settings, is strain imaging a priority tool or a luxury we can’t afford?

Share how you currently assess early heart failure risk in your practice.

Read more here: https://hubs.la/Q03ZgwWX0

12/31/2025

In this episode of the Why I Chose Cureus: Author Spotlight Series, Dr. Tibor Bakacs, Medical Doctor at the Rényi Mathematical Research Institute and Chief Scientific Officer of HepC Therapeutics in Budapest, Hungary, shares his experience publishing four articles with Cureus including his widely read autobiographical case report on severe herpes zoster ophthalmicus.

During his emergency episode, Dr. Bakacs supplemented standard acyclovir therapy with an experimental viral therapy developed by his company using infectious bursal disease virus (IBDV), a double-stranded RNA avian vaccine virus and potent interferon inducer. His case demonstrated rapid clinical improvement, drawing global attention.

Dr. Bakacs highlights the strengths of publishing with Cureus:
Fast, thoughtful peer review
Quick publication timelines
Open access visibility with 16,000+ global readers on his case report
Low article processing fees compared to standard open-access journals
Authors retain full copyright
A supportive, transparent editorial experience

Dr. Bakacs’ Cureus publications span virology, clinical immunology, biotech innovation, and autobiographical case reporting reflecting Cureus’ mission to elevate diverse and meaningful medical science.

Explore Dr. Bakacs’ publications on his Cureus author profile: https://hubs.la/Q03Zgb930

Submit your video using our recording guide: https://hubs.la/Q03Zgb4v0

12/28/2025

At Cureus, peer review is built for speed, transparency, and scientific integrity without the barriers of traditional publishing.

Structured, bias-aware review
Inline feedback (no PDFs, no clunky uploads)
Median review time under 10 days
Median publication time: 26 days

Because reviewers aren’t gatekeepers, they’re partners in advancing science.

Click here to learn more about how Cureus peer review works: https://hubs.la/Q03Z57Gq0

Vesicostomy is often performed to reduce bladder pressure and prevent kidney damage in children with vesicoureteral refl...
12/27/2025

Vesicostomy is often performed to reduce bladder pressure and prevent kidney damage in children with vesicoureteral reflux (VUR) or neurogenic bladder. But for some patients, febrile urinary tract infections (fUTIs) keep coming back.

This study looked closely at 27 children after vesicostomy and found one clear signal:

VUR during the bladder filling phase, seen on preoperative VCUG, was strongly linked to recurrent infections.
75% of children with filling-phase VUR developed fUTIs
The odds of infection were 7.5 times higher compared to those without it
Other factors like bladder compliance or detrusor overactivity did not show a significant association

The takeaway?
Not all reflux behaves the same, and when reflux occurs may matter just as much as whether it exists. Identifying filling-phase VUR before surgery could help guide closer follow-up and additional preventive strategies.

Read more here: https://hubs.la/Q03YfCMG0

New technology is changing how we look at the fetal heart.Using fetal heart quantification (HQ), a form of ultrasound tr...
12/26/2025

New technology is changing how we look at the fetal heart.
Using fetal heart quantification (HQ), a form of ultrasound tracking heart motion, researchers followed heart development throughout pregnancy in healthy fetuses.

They found that just four measurements may be especially meaningful:

Tricuspid valve width
Tricuspid valve length
Four-chamber heart area
Right ventricular end-diastolic area

In a high-risk pregnancy complicated by fetal growth restriction and complex heart defects, these same tools detected abnormal heart loading and reduced contractility, changes not always obvious on routine scans.

This study suggests the fetal heart isn’t just something we see, it’s something we can measure, track, and understand earlier than ever before.

Early detection could change monitoring, counseling, and outcomes in high-risk pregnancies.

Read more here: https://hubs.la/Q03Yfxpw0

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