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[This corrects the article DOI: 10.7759/cureus.34400.].

Left ventricular (LV) thrombosis usually occurs as a complication of acute anterior myocardial infarction (MI) and dilated cardiomyopathy. It also occurs in patients with a hypercoagulable state. However, in the setting of normal systolic function, LV thrombi are extremely rare. We present a case of a healthy woman who had LV thrombus despite normal LV systolic function that presented as an acute aortoiliac embolism.

Radiotherapy is the cornerstone of brain metastasis management. With the advancement of therapies, patients are living longer, exposing them to the long-term effects of radiotherapy. Using concurrent or sequential chemotherapy, targeted agents, and immune checkpoint inhibitors may increase the incidence and severity of radiation-induced toxicity. Recurrent metastasis and radiation necrosis (RN) appear indistinguishable on neuroimaging, making it a diagnostic dilemma for clinicians. Here, we present a case of RN in a 65-year-old male patient who previously had brain metastasis (BM) from primary lung cancer, misdiagnosed initially as recurrent BM.

Diagnosis and treatment of subsegmental pulmonary embolism (SSPE) are challenging. Contrary to segmental pulmonary emboli (PE), little is known about the accuracy of the diagnosis of SSPE. We aimed to assess the accuracy of SSPE in our retrospective cohort study. Patients with isolated SSPE were included. Concurrent segmental PE or deep venous thrombosis (DVT) were considered an exclusion criteria. Another radiologist reviewed each CTA. A total of 43 patients with SSPE were identified. Forty patients (93%) received therapeutic anticoagulation. The average duration of anticoagulation therapy was four months. Another radiologist's review of the CTA on admission revealed a discordant diagnosis: 13 out of 43 (30% | cases were reported negative for SSPE. One case was reported for segmental PE. As a conclusion, the accuracy of the diagnosis of SSPE is low as the discordance rate by different radiologists is high. More studies are needed to establish the diagnosis and guide treatment of SSPE.

Methaemoglobinaemia is defined as elevated methaemoglobin in the blood which is characterised by conversion of some of the reduced ferrous iron elements [Fe2+] to the oxidised ferric [Fe3+] form which does not have capacity to bind and transport oxygen resulting in functional anaemia. Causes can be genetic mutations or acquired by medications such as dapsone, nitrates or benzocaine. Benzocaine is currently being used as a topical anaesthetic agent before certain procedures. We report a case of benzocaine spray–induced methaemoglobinaemia in a patient who underwent oesophagogastroduodenoscopy for evaluation of upper gastrointestinal bleeding.

We report a case of emphysematous endometritis in a 65-year-old patient who has stage III, high-grade, poorly differentiated endometrial cancer; she was on chemotherapy. The patient developed pyogenic emphysematous endometritis complicated by hypovolemic shock and sepsis. She was admitted to the intensive care unit for treatment with vasopressors and antibiotics. The shock was successfully managed and her hospital course was otherwise unremarkable.

This research explores the perception of patient protection culture among emergency nurses at King Saud Medical City. The study examines key dimensions of safety culture, including teamwork, communication, error reporting, and leadership support. Utilizing a descriptive and analytical approach, data were collected via the Hospital Survey on Patient Safety Culture (HSOPSC), involving 210 nurses across pediatric, maternity, and general emergency departments. Findings indicate that 46.7% of nurses rated the safety culture as “acceptable,” with 40% assessing it as “very good.” Critical strengths include teamwork within units (74%) and leadership acknowledgment of safety adherence (76.67%). However, challenges persist, such as inadequate staffing levels (65.33%) and fear of punitive repercussions for errors (76%), which hinder open reporting. Additionally, communication breakdowns between hospital units (76.67%) were identified as a major issue. Demographic analysis revealed that younger nurses and expatriates face unique challenges, including lower perceptions of communication effectiveness. The research underscores the importance of fostering a non-punitive culture, improving interdepartmental communication, and implementing structured safety protocols. The study concludes that while a foundational understanding of safety culture exists, targeted interventions are needed to enhance communication, leadership engagement, and error reporting. These findings offer actionable insights for healthcare administrators to strengthen patient safety and improve the overall quality of care in emergency settings

Traumatic brain injury is a leading cause of morbidity and mortality worldwide. The relationship between hyperoxia and outcomes in patients with TBI remains controversial. We assessed the effect of persistent hyperoxia on the neurological outcomes and survival of critically ill patients with moderate-severe TBI.This was a retrospective cohort study of all adults with moderate-severe TBI admitted to the ICU between 1st January 2016 and 31st December 2019 and who required invasive mechanical ventilation. Arterial blood gas data was recorded within the first 3 hours of intubation and then after 6-12 hours and 24-48 hours. The patients were divided into two categories: Group I had a PaO2 < 120mmHg on at least two ABGs undertaken in the first twelve hours post intubation and Group II had a PaO2 ≥ 120mmHg on at least two ABGs in the same period. Multivariable logistic regression was performed to assess predictors of hospital mortality and good neurologic outcome (Glasgow outcome score ≥ 4).The study included 309 patients: 54.7% (n=169) in Group I and 45.3% (n=140) in Group II. Hyperoxia was not associated with increased mortality in the ICU (20.1% vs. 17.9%, p=0.62) or hospital (20.7% vs. 17.9%, p=0.53), moreover, the hospital discharge mean (SD) Glasgow Coma Scale (11.0(5.1) vs. 11.2(4.9), p=0.70) and mean (SD) Glasgow Outcome Score (3.1(1.3) vs. 3.1(1.2), p=0.47) were similar. In multivariable logistic regression analysis, persistent hyperoxia was not associated with increased mortality (adjusted odds ratio [aOR] 0.71, 95% CI 0.34-1.35, p=0.29). PaO2 within the first 3 hours was also not associated with mortality: 121-200mmHg: aOR 0.58, 95% CI 0.23-1.49, p=0.26; 201-300mmHg: aOR 0.66, 95% CI 0.27-1.59, p=0.35; 301-400mmHg: aOR 0.85, 95% CI 0.31-2.35, p=0.75 and >400mmHg: aOR 0.51, 95% CI 0.18-1.44, p=0.20; reference: PaO2 60-120mmHg within 3 hours. However, hyperoxia >400mmHg was associated with being less likely to have good neurological (GOS ≥4) outcome on hospital discharge (aOR 0.36, 95% CI 0.13-0.98, p=0.046; reference: PaO2 60-120mmHg within 3 hours.In intubated patients with moderate-severe TBI, hyperoxia in the first 48 hours was not independently associated with hospital mortality. However, PaO2 >400mmHg may be associated with a worse neurological outcome on hospital discharge.