Saudi Medical Journal最新文献

{"title":"Ethnic Background as a Determinant of Thyroid Cancer Risk: A Decade-Long National Cohort Study Reveals Divergent Epidemics in Saudi Arabia.","authors":"Nizar A Khamjan","doi":"10.15537/1658-3175.8770","DOIUrl":"10.15537/1658-3175.8770","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze and compare temporal trends, demographic characteristics, and stage at diagnosis for thyroid cancer (TC) between Saudi and non-Saudi populations in order to identify potential population-specific etiological drivers.</p><p><strong>Methods: </strong>We conducted a national retrospective cohort study of TC cases in Saudi Arabia from 2013-2022. To assess population-level trends, we computed age-standardized incidence rates (ASIRs) and multivariable Poisson regression alongside piecewise regression models for comparative analysis.</p><p><strong>Results: </strong>Among 14,159 total cases, TC incidence increased disproportionately in Saudi nationals, rising from 884 to 1,677 (90%), significantly outpacing the 184 to 275 (49%) increase observed in non-Saudis. The incidence rate ratio for Saudis versus non-Saudis was 5.67 (95% CI [5.41, 5.94]). Saudis presented with a significantly younger median age at diagnosis (5-10 years earlier, <i>p</i> < 0.001) and demonstrated a steeper annual increase in ASIRs (Interaction <i>β</i> = 0.0307, <i>p</i> < 0.001). A marked stage migration was concurrently observed among Saudi nationals, with localized diagnoses increasing from 55% to 71%. The recent period of the study (post-pandemic) revealed an acceleration in the Saudi cohort (+316.50 cases annually), a pattern absent in non-Saudis.</p><p><strong>Conclusion: </strong>The profound divergence in incidence trends provides compelling evidence consistent with distinct, population-specific etiological drivers. This suggests a need to investigate genetic and environmental factors unique to the Saudi population. However, the heterogeneity of the non-Saudi comparator group necessitates cautious interpretation of the observed incidence rates.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"859-868"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Nanotherapy Applications in Cancer Treatment: <i>A Comprehensive Review</i>.","authors":"Waleed H Mahallawi","doi":"10.15537/1658-3175.8761","DOIUrl":"10.15537/1658-3175.8761","url":null,"abstract":"<p><p>This comprehensive review synthesizes recent advances in cancer nanotherapy, focusing on 6 emerging categories: immunomodulation, gene/RNA delivery, theranostics, radiosensitization, biomimetic carriers, and artificial intelligence (AI)-guided formulations. These innovative platforms demonstrate transformative potential by overcoming key limitations of conventional cancer treatments. Immunomodulatory nanoparticles reprogram tumor microenvironments and convert immunologically \"cold\" tumors to \"hot\" responsive states. Gene delivery systems enable precise editing with >50% efficiency, while theranostic platforms integrate real-time imaging with targeted therapy. Radiosensitizers amplify local radiation dose by twofold, and biomimetic carriers achieve prolonged circulation through immune evasion. An AI-driven approaches optimize personalized formulations based on patient-specific biomarkers. Clinical evidence shows promising safety profiles with predominantly mild-to-moderate adverse events across multiple Phase I-III trials. While nanotherapy represents a paradigm shift in precision oncology, addressing manufacturing reproducibility, long-term safety, and regulatory harmonization remains essential for full clinical translation.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"780-786"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Health-Care Efficiency: <i>A Call for a Multi-Dimensional Framework for Assessing Healthcare System Efficiency</i>.","authors":"Yasser K Alotaibi, Ali N Alharbi","doi":"10.15537/1658-3175.8773","DOIUrl":"10.15537/1658-3175.8773","url":null,"abstract":"","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"900-902"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Middle East Bifurcation Club Consensus Document on Percutaneous Revascularization of Bifurcation Lesions in Association with the National Heart Center <i>- Saudi Health Council</i>.","authors":"Khaled Al-Shaibi, Mirvat Alasnag, Haitham Amin, Ali Nazmi Calik, Ali AlMasood, Abdullah Alenezi, Nouf Alanazi, Abdulrahman AlMoghairi, Hadi Abu-Hantash, Khaled AlMerri","doi":"10.15537/1658-3175.8774","DOIUrl":"10.15537/1658-3175.8774","url":null,"abstract":"<p><p>Bifurcation lesions are among the most challenging in percutaneous coronary intervention (PCI), with outcomes affected by anatomy, side-branch disease, and procedural variability. Existing European definitions and strategies require adaptation for Middle Eastern populations, where diabetes, obesity, and hypertension are highly prevalent and present earlier. The Middle East Bifurcation Club (MEBC), with the National Heart Center, used the Nominal Group Technique to standardize bifurcation PCI terminology, techniques, and treatment pathways tailored to regional demographics. The consensus provides evidence-based recommendations on imaging, provisional and 2-stent strategies, POT, and left main versus non-left main bifurcations, alongside practical algorithms and heart team guidance, highlighting the need for regional outcome data to optimize care.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"903-919"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to \"Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, and Emerging Interventions for Prevention and Management\" [Saudi Medical Journal 2026; 47(2):183-194].","authors":"Fahad H Baali","doi":"10.15537/1658-3175.8777","DOIUrl":"10.15537/1658-3175.8777","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.15537/1658-3175.1001.].</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"971"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Odontogenic Sinusitis With Oroantral Communication and Fistula: <i>A Systematic Review and Meta-Analysis</i>.","authors":"Rana R Alharbi, Omar F Alnajar, Reham E Almahdi, Salman A Alrougi, Remas A Alshehri, Ruyuf A Alotaibi, Shahad S Alharbi, Manal A Eltahir, Yahya A Fageeh","doi":"10.15537/1658-3175.8760","DOIUrl":"10.15537/1658-3175.8760","url":null,"abstract":"<p><strong>Objective: </strong>To assess the available data regarding medicinal, surgical, and combination therapy approaches for odontogenic sinusitis linked to OAC and OAF. Oroantral communication (OAC), an atypical connection between the oral cavity and maxillary sinus, commonly arises following upper jaw procedures, trauma, or infection. Chronic odontogenic maxillary sinusitis may result from OAC developing into an oroantral fistula (OAF) if treatment is not received. Recurrent infections and functional difficulties can be avoided by managing these illnesses effectively.</p><p><strong>Methods: </strong>A systematic search was conducted in National Library of Medicine's (PubMed [MEDLINE]) and Google Scholar for studies published between 2000 and 2024. A total of 174 articles were initially identified. After applying inclusion and exclusion criteria and performing full-text screening, 5 observational studies were included. Data extraction followed a standardized template, meta-analysis was conducted to compare success, failure, and adverse event rates across treatment modalities.</p><p><strong>Results: </strong>Five observational studies, including 459 patients were analyzed. The surgical and medical groups' treatment outcomes did not differ statistically significantly (OR = 3.24; 95% CI: 0.23, 46.18), with initial heterogeneity resolved through sensitivity analysis (I² reduced from 82% to 1%). Similarly, failure rates did not differ significantly between groups (OR = 0.60; 95% CI: 0.01, 486.7), though high heterogeneity remained (I² = 92%). Adverse events were minimal and comparable across groups (Risk Difference = 0; 95% CI: -0.08, 0.08), with no observed heterogeneity (I² = 0%). Overall, both treatment approaches demonstrated similar efficacy and safety profiles.</p><p><strong>Conclusion: </strong>Both medical and surgical interventions appear effective in managing odontogenic sinusitis related to OAC and OAF. To create standardized treatment regimens and evaluate long-term results, more controlled research is required.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"769-779"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of BRCA1 and BRCA2 Germline Mutations in Western Saudi Patients with Epithelial Tubo-Ovarian Carcinoma.","authors":"Wala Mehros, Faisal Aldaheri, Anas Alqarni, Saif Aljehani, Abdulrahman Alnamlah, Alaa Althubaiti, Safaa Huneef, Hatim Jifree","doi":"10.15537/1658-3175.8779","DOIUrl":"10.15537/1658-3175.8779","url":null,"abstract":"<p><strong>Objective: </strong>Ovarian cancer represents the most lethal gynecologic malignancy, the epithelial type (EOC) being the most common. <i>BRCA</i> gene mutations are associated with ovarian cancer, younger age at presentation, strong family history of EOC, and multiple malignancies in a single patient. This study calculated the rate of <i>BRCA</i>-positive EOC and compared <i>BRCA</i>-mutated vs non-mutated EOC cases.</p><p><strong>Methods: </strong>This retrospective cohort study, conducted at Princess Noura Oncology Center between May 2016 and December 2023, explored outcomes in <i>BRCA</i>-positive EOC patients. The inclusion criteria covered all EOC cases. A total of 70 patients were selected.</p><p><strong>Results: </strong>Of the 70 patients, 27 (38.6%) exhibited <i>BRCA</i> gene mutations. <i>BRCA</i>-positive patients demonstrated significant associations with familial history of cancer (<i>p</i> < 0.001) and lower diabetes mellitus rates (<i>p</i> = 0.02). However, our findings revealed no significant differences in treatments, prognosis, or outcomes between <i>BRCA</i>-positive and <i>BRCA</i>-negative patients. Subgroup analyses of different <i>BRCA</i> mutation types yielded no significant differences. Intriguingly, we found no significant variations in recurrence rates, comorbid cancers, or therapy duration between <i>BRCA</i>-positive and <i>BRCA</i>-negative cases (p > 0.01). Contrary to previous studies, we identified no differences in prognosis and survival rates between the cohorts.</p><p><strong>Conclusion: </strong>We identified <i>BRCA</i> gene mutations in 38.6% of our patients. Most comparisons revealed no significant differences between <i>BRCA</i>-positive and <i>BRCA</i>-negative patients, highlighting the need for additional studies to determine the prognostic and clinical value of gene testing in EOC.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"891-899"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Role of Hematologic Inflammatory Markers in the Diagnosis of Missed Abortion.","authors":"Mustafa Bakırcı, Çağlayan Ateş, Ethem S Yalvaç","doi":"10.15537/1658-3175.8767","DOIUrl":"10.15537/1658-3175.8767","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic value of hematological and biochemical inflammatory markers in distinguishing missed abortions from healthy pregnancies during the first trimester.</p><p><strong>Methods: </strong>This retrospective case-control study was conducted between May 2022 and May 2024, included 61 women diagnosed with missed abortion by ultrasound and 100 healthy pregnant women who acted as controls. The following inflammatory markers were calculated from routine blood and biochemistry results: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and C-reactive protein-albumin ratio (CAR). Intergroup comparisons and receiver operating characteristic (ROC) curve analyses were performed.</p><p><strong>Results: </strong>The platelet count was significantly lower in the missed abortion group than in the control group (<i>p</i> = 0.049). No significant differences were found in NLR, PLR, LMR, SII and CAR levels. Only the MLR value was close to the threshold of statistical significance (<i>p</i> = 0.054).</p><p><strong>Conclusion: </strong>In our study, most systemic inflammation markers showed limited diagnostic utility for diagnosing missed abortions. These findings suggest that inflammation in the pathophysiology of missed abortion may be localised or time-dependent rather than systemic. Further prospective studies with larger cohorts are required to confirm these findings.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"833-839"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Predictive Value of Serum NGAL, CysC, Urinary NAG, and eGFR for Sepsis-Associated Acute Kidney Injury in Patients in ICU.","authors":"Yu Han, Wenna Ning, Jian Lu, Jinwei Zhu, ZhiLiang Qin, Xiao Wang","doi":"10.15537/1658-3175.8772","DOIUrl":"10.15537/1658-3175.8772","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate critically ill patients who had sepsis and how various kidney-related measurements, including eGFR, NGAL, CysC, and the urinary enzyme NAG, predict the onset of sepsis-induced renal damage.</p><p><strong>Methods: </strong>The 135 individuals who were admitted to our sepsis intensive care within 2 years to the end of early 2024 were recruited on a prospective basis and were enrolled based on the predefined criteria. Upon admission, they were dichotomized into 2 groups of participants who developed septic-associated kidney injury (82) and without (53). A comparison of baseline laboratory analyses and blood and urine baseline examinations in the groups was done. Single-variable and multi-variable logistic models were used to determine aspects associated with the development of kidney dysfunction. Receiver-operating characteristic curves were used to determine predictive performance of each biomarker and each combination of biomarkers.</p><p><strong>Results: </strong>The SA-AKI group, as compared to the patients with no renal involvement, had significantly greater values in a number of different clinical indices, such as inflammatory cell count, serum levels of procalcitonin, neutrophils: lymphocyte ratio, platelet counts, serum levels of NGAL, serum levels of CysC, and urinary NAG as well as changed eGFR. In the meantime, their SOFA and APACHE II evaluations were also less inclined (all comparisons were statistically significant). The preliminary regression models implied that there were many variables that were linked to SA-AKI. Nevertheless, it is only 4 measures of NGAL in blood, CysC in serum, NAG in urine and eGFR that were not confounded and correlated with the condition. Their values of AUROC were 0.875, 0.889, 0.797 and 0.864 respectively; the combined model of these indicators yielded a higher value of 0.946.</p><p><strong>Conclusion: </strong>The early signs of inevitability of sepsis-associated kidney injury are abnormal eGFR, NAG, CysC, and NGAL among septic ICU patients, and the combination of all these 4 markers offers the most potent predictive power.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"877-883"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-Associated Neutrophils in Advanced Non-Small Cell Lung Cancer Patients Predicted by Clinicopathologic Characteristics and Peripheral Blood Markers.","authors":"Weiwei Hong, Xie Xiong, Chen Fang, Chuanhong Luo, Xiaoying Qian, Xinyuan Yao, Xin Ye, Biao Yu, Bingbiao Zhou, Dengying Chen, Chengsi Shu, Yong Wang, Yong Li","doi":"10.15537/1658-3175.8768","DOIUrl":"10.15537/1658-3175.8768","url":null,"abstract":"<p><strong>Objectives: </strong>The process of analyzing tumor-associated neutrophils (TANs) types is complex. This study explored the relationships among clinicopathological characteristics, peripheral blood markers, and TANs.</p><p><strong>Methods: </strong>Clinical information was retrospective gathered for 115 patients in our hospital from May 2019 to May 2021, and multiplex immunofluorescence staining was utilized to access the expression of TANs and analyze the potential relationship between TANs and clinicopathological features or peripheral blood markers.</p><p><strong>Results: </strong>Among the 115 patients, the proportion of female patients within the neutrophils (N1)-low group was notably greater compared to the N1-high group (87.5% vs. 12.5%, <i>p</i> = 0.022). In nonsmoking patients, the proportions in the N1-low and the N2-high groups were 73.9% and 60.9%, respectively, which were greater than those in the N1-high and the N2-low groups (<i>p</i> = 0.028, <i>p</i> = 0.048). Platelets (PLTs) were negatively correlated with N2 neutrophils (<i>p</i> = 0.027). The CRP levels in the N1-low group and N1-high group were 26.2 and 53.6, respectively (<i>p</i> = 0.040). The N1⁺-high group had higher PLT and AISI compared to the N1⁺-low group (241.4 vs. 286.7, <i>p</i> = 0.014; 525.6 vs. 1230.5, <i>p</i> = 0.040). N1 neutrophils were positively correlated with LDL (<i>p</i> = 0.048). The count of N2⁺ neutrophils and the N⁺/N ratio exhibited a negative correlated with ApoA1 (<i>p</i> = 0.049, <i>p</i> = 0.035). The N⁺/N-high group had higher CYFRA21-1 values (<i>p</i> = 0.021).</p><p><strong>Conclusion: </strong>Our findings indicate that we can utilize simple and readily available clinical information to forecast the expression of TANs within the tumor immune microenvironment.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 5","pages":"840-851"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}