Galen Medical Journal最新文献

{"title":"Evaluation of The Effect of Acute-normovolemic Hemodilution on Blood Transfusion Rate in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A Prospective Randomized and Controlled Trial : Short title: Acute-normovolemic Hemodilution in CABG.","authors":"Ali Jabbari, Shabnam Tabasi, Marjan Kazemi Nia, Mansour Deylami","doi":"10.31661/gmj.v15i.3740","DOIUrl":"10.31661/gmj.v15i.3740","url":null,"abstract":"<p><strong>Background: </strong>Perioperative use of allogeneic blood products is associated with increased mortality, morbidity, and postcardic therapy. The effectiveness of blood preservation strategies such as acute isovolemic hemodilution (ANH) has been demonstrated with varying degrees of success. This study presents an analysis of the effects of isovolemic hemodilution on blood transfusion in patients undergoing cardiopulmonary bypass.</p><p><strong>Material and methods: </strong>We tested the efficacy of ANH in reducing cardiac morbidity during anesthesia prior to cardiopulmonary bypass using a randomized trial. They were divided into two groups: ANH (88 patients) and standard control (88 patients), both selected as CS. The ANH group aimed to achieve a hematocrit level of 28% by performing full blood exchange with colloids. Patients underwent myocardial protection procedures, including cold blood cardioplegia and anesthesia preconditioning. Outcomes were evaluated by measuring cardiac enzymes, including serum troponin I and creatinine phosphokinase. Changes in demand for cardiovascular and cerebrovascular drugs were also taken into account.</p><p><strong>Results: </strong>Intraoperative fluid balance (crystalloids, colloids, and urine), postoperative fluid balance (crystalloids plus colloids, urine, and chest tube fluid), and RBC concentrate were not statistically different between the two groups (P0.05). However, the results showed that the hematocrit level was more stable in the ANH group than in the control group.</p><p><strong>Conclusion: </strong>Preoperative ANH provides better hematocrit stability and better cardio protection in patients receiving a myocardial perfusion pump; but does not affect water and urine treatment.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e3740"},"PeriodicalIF":0.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Synbiotic Supplementation and Postoperative Outcomes in Elective GI Surgery: A Double-blinded, Placebo-controlled Trial : Short title: Synbiotics and Elective GI Surgery.","authors":"Pourya Adibi, Ahmad Reza Karimi, Mehrdad Sayadinia","doi":"10.31661/gmj.v15i.3580","DOIUrl":"10.31661/gmj.v15i.3580","url":null,"abstract":"<p><strong>Background: </strong>Surgery harms the gastrointestinal (GI) tract barrier and changes intestinal microbiota composition, disrupting the balance of gut flora. Synbiotics, which are mixtures of beneficial bacteria and chemicals that promote gut flora growth, are particularly important for recovery after GI surgery. We aimed to assess the effect of consumption of synbiotics prior to the gastrointestinal surgeries on complications.</p><p><strong>Materials and methods: </strong>40 patients who planned to undergo elective gastrointestinal surgery randomized in a double-blinded, placebo-controlled, phase 3 trial to a single dose perioperative and seven-day postoperative intervention with a synbiotic, LactoCare®, or placebo provided by knowledge-based spin-off company, Zist Takhmir. Randomisation was performed by a computer algorithm.</p><p><strong>Results: </strong>42.5% of participants were men. Nausea and vomiting occurred in eight patients in the placebo group, and seven patients in the synbiotic group, and the two groups were not statistically significant (P0.99). Other complications, such as (surgical site infection, fever, surgical site infection, pneumonia, and anastomosis site leakage) were not observed in the placebo or synbiotic groups. In assessing variables dependent on time, the mean time to start oral feeding in the synbiotic group was 32.35±28.84 hours after surgery, and in the placebo group was 28.45±24.91 hours (P=0.796). The first gas passing time was 13.00±15.81 hours in the synbiotic group and 9.65±13.90 hours in the placebo group after surgery(P=0.406). The hospitalisation length of patients in the synbiotic group was 2.6±1.27 days, and for patients in the placebo group was 2.35±1.08 days(P=0.42).</p><p><strong>Conclusion: </strong>Administration of synbiotics as a single dose before surgery and seven days postoperatively did not have a significant effect on infectious complications and time-dependent variables in patients with abdominal surgery.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e3580"},"PeriodicalIF":0.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Antithrombotics in Geriatric PCI for STEMI: Balancing Ischemic Protection with Bleeding Risk: Short title: Novel Antithrombotics in Geriatric PCI for STEMI.","authors":"Ibrahim Pakizeh, Bahram Sohrabi","doi":"10.31661/gmj.v15i.4032","DOIUrl":"10.31661/gmj.v15i.4032","url":null,"abstract":"","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e4032"},"PeriodicalIF":0.7,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused Echocardiography to Guide Management in Acute Decompensated Heart Failure: From Rapid Phenotyping to Therapeutic Precision : Short title: Focused Echocardiography in the Management of Acute Decompensated Heart Failure.","authors":"Zakieh Amiraslanzadeh, Elnaz Javanshir","doi":"10.31661/gmj.v15i.4224","DOIUrl":"10.31661/gmj.v15i.4224","url":null,"abstract":"","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e4224"},"PeriodicalIF":0.7,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular Imaging-Guided Percutaneous Coronary Intervention: A Critical Appraisal of Evidence and Clinical Practice : Short title:Intravascular Imaging-Guided Percutaneous Coronary Intervention.","authors":"Mohammad Rostamzadeh, Negar Jafari, Abdolmohammad Ranjbar, Hamid Biglary, Shirin Alord","doi":"10.31661/gmj.v15i.4274","DOIUrl":"10.31661/gmj.v15i.4274","url":null,"abstract":"<p><p>Intravascular imaging has emerged as a critical adjunct to percutaneous coronary intervention (PCI), providing detailed insights into coronary anatomy, plaque morphology, and stent optimization beyond conventional angiography. Despite advances in PCI, adverse outcomes such as stent thrombosis and restenosis persist, often related to suboptimal lesion assessment and stent deployment. This review critically evaluates contemporary evidence from randomized controlled trials, large registries, and meta-analyses comparing intravascular imaging-guided and angiography-guided PCI. Current data consistently demonstrate that imaging guidance, particularly with intravascular ultrasound (IVUS), improves procedural optimization and reduces adverse cardiovascular events, with the greatest benefit observed in complex coronary lesions. Optical coherence tomography (OCT) provides superior spatial resolution and enhances detection of stent-related complications, although its impact on clinical outcomes appears more context-dependent. While recent guidelines strongly endorse intravascular imaging in complex PCI, real-world adoption remains limited due to economic, procedural, and training-related barriers. Variation in study design and variability in imaging protocols further complicate interpretation of existing evidence. Intravascular imaging-guided PCI represents a transition toward precision-guided coronary revascularization. Future research should focus on standardized imaging strategies, long-term outcomes, and integration with emerging technologies to optimize patient selection and procedural outcomes.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e4274"},"PeriodicalIF":0.7,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Hemodialysis Efficacy for Serum and Salivary Clearance of Urea, Creatinine, and Uric Acid in Chronic Kidney Disease Patients : Short title: Evaluation of Hemodialysis Efficacy in CKD Patients.","authors":"Azam Hosseini, Farid Abbasi, Iraj Mirzaii-Dizgah, Reza Afshar","doi":"10.31661/gmj.v15i.4098","DOIUrl":"10.31661/gmj.v15i.4098","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a progressive and irreversible loss of kidney function that may progress to end-stage renal disease requiring hemodialysis. While hemodialysis is an established life-saving therapy, simple methods to assess its adequacy are needed. Saliva analysis is a non-invasive alternative to serum testing. This study evaluated changes in urea, creatinine, and uric acid levels in serum before and after hemodialysis and compared them with salivary levels to assess the adequacy of hemodialysis.</p><p><strong>Materials and methods: </strong>A case-control study was conducted on 32 patients undergoing hemodialysis and 30 healthy controls. Blood and saliva samples were collected immediately before and after dialysis from patients and controls. Serum and salivary levels of markers were analyzed by biochemical methods. Serum and salivary levels of markers were compared between the patient group (before and after dialysis) and the control group by t-test and the diagnostic accuracy of salivary markers compared to serum markers was evaluated by the receiver-operating characteristic (ROC) curve and area under the curve (AUC).</p><p><strong>Results: </strong>There were significant differences between the serum and salivary levels of urea, creatinine, and uric acid in patients before and after hemodialysis, and also with the control group (P0.05). There was a positive correlation between the serum and salivary levels of urea, creatinine and uric acid before hemodialysis, and creatinine after hemodialysis. The AUC for salivary urea and creatinine was 0.87 and 0.88, respectively, and the cut-off point for urea and creatinine was 55 mg/dL and 0.5 mg/dL, respectively. The ROC analysis for uric acid was not significant.</p><p><strong>Conclusion: </strong>This study showed that before hemodialysis, the changes in salivary urea, creatinine, and uric acid in CKD patients (in the fasting state) were similar to serum. Additionally, after hemodialysis, changes in salivary creatinine levels were similar to serum. Therefore, saliva analysis is suggested as a non-invasive alternative to serum analysis for assessment of the efficacy of hemodialysis.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e4098"},"PeriodicalIF":0.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surface Topography and Pushout Bond Strength of Glass Fiber Posts with Different Surface Treatments to Root Dentin Following Cementation by Precuring and Co-Curing Methods : Short title: Surface Topography and Pushout Bond Strength of Glass Fiber Posts to Root Dentin Following Cementation.","authors":"Azita Kaviani, Pardis Khoshnood, Faramarz Zakavi","doi":"10.31661/gmj.v15i.3865","DOIUrl":"10.31661/gmj.v15i.3865","url":null,"abstract":"<p><strong>Background: </strong>This study assessed the surface topography and pushout bond strength (PBS) of glass fiber posts (GFPs) with different surface treatments to root dentin following cementation by precuring and co-curing methods.</p><p><strong>Materials and methods: </strong>In this in vitro study, 80 extracted single-rooted premolars were decoronated and randomly assigned to 4 groups (n=20) for surface treatment of GFPs with 20% H2O2, Er,Cr:YSGG laser (2780 nm, 90 mJ, 4.5 W, 50 Hz, 60 seconds) and sandblasting (50 µm aluminum oxide particles, 2.8 bar pressure, 10 mm distance, 20 seconds). No surface treatment was performed in group 4. Each group was randomly divided into two subgroups (n=10) for cementation of GFPs with precuring and co-curing methods. The PBS was measured, the mode of failure was determined, and the surface topography of the posts was assessed under a scanning electron microscope (SEM). Data were analyzed by ANOVA, Tukey, and Dunnett tests (alpha=0.05).</p><p><strong>Results: </strong>The mean PBS of H2O2-treated GFPs was significantly higher in co-curing than precuring method (P=0.04). No significant difference was found between the precuring and co-curing in PBS of GFPs with other surface treatments (P0.05). The mean PBS of sandblasted, laser-treated, and H2O2-treated GFPs was not significantly different in precuring method. In co-curing cementation, sandblasting significantly decreased the PBS (P=0.04) while laser and H2O2 surface treatments had no significant effect on PBS (P0.05).</p><p><strong>Conclusion: </strong>The co-curing cementation method yielded a significantly higher PBS than the precuring method in H2O2-treated GFPs. Sandblasting significantly decreased the PBS of GFPs cemented by the co-curing method.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e3865"},"PeriodicalIF":0.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Periodic Electrocardiograms in Individuals with Metabolic Disorders: A Policy Brief : Short title:Periodic ECG Monitoring in Metabolic Disorders.","authors":"Seyed Rasool Nazemi Fard, Babak Pezeshki, Mojtaba Farjam","doi":"10.31661/gmj.v15i.4206","DOIUrl":"10.31661/gmj.v15i.4206","url":null,"abstract":"<p><p>Metabolic disorders, including obesity, type 2 diabetes, metabolic dysfunction-associated fatty liver disease (MAFLD), anemia, and insulin resistance, are increasingly prevalent and represent a major contributor to cardiovascular morbidity and mortality. Emerging evidence indicates that these conditions are associated with prolongation of the corrected QT (QTc) interval, a well-established marker of ventricular arrhythmias and sudden cardiac death. Individuals with metabolic disorders have a significantly higher risk of life-threatening arrhythmias, even in the absence of known cardiovascular disease. Insulin resistance, a central component of cardiometabolic dysfunction, has also been linked to QT interval prolongation. Despite this growing body of evidence, QTc monitoring is not currently included in routine clinical guidelines for the management of metabolic disorders. Electrocardiography (ECG) is a low-cost and widely accessible diagnostic tool that enables early identification of high-risk individuals and supports timely preventive interventions. Routine implementation of baseline and annual ECG-based QTc monitoring has the potential to reduce sudden cardiac death, improve cardiovascular risk stratification, and decrease healthcare costs associated with acute cardiac events. This policy brief advocates for the adoption of a national QTc monitoring strategy as a scalable and cost-effective approach to improving cardiovascular outcomes in patients with metabolic disorders.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e4206"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Laser Versus Cryotherapy in the Treatment of Lentigines: A Systematic Review and Meta-analysis of Randomized Controlled Trials : Short title: Safety and Efficacy of Laser Versus Cryotherapy in the Treatment of Lentigines.","authors":"Mohammad Almohideb","doi":"10.31661/gmj.v15i.4137","DOIUrl":"10.31661/gmj.v15i.4137","url":null,"abstract":"<p><strong>Background: </strong>Lentignies is one of the pigmentary skin lesions causing abnormal skin color in sun-exposed areas in particular the hands and the face. In this systematic review and meta-analysis, we aimed to study the safety and efficacy of cryotherapy versus laser in lentigines treatment.</p><p><strong>Materials and methods: </strong>Beginning from inception and up to 19th May 2023, we did a comprehensive search strategy including five databases (Web of Science=33, Scopus=79, PubMed=28, Virtual Health Library=30 and Scholar=622). The search strategy was performed according to the search term \"(\"solar lentigines\" OR \"solar lentigo\" OR \"lentigines\" OR \"lentigo\") AND (\"laser\") AND (\"cryotherapy\")\".</p><p><strong>Results: </strong>total of 5 studies (n=13-120, mean age 39-60) comparing lasers (Q-switched Nd:YAG, PDL, argon, CO2, etc.) vs cryotherapy for solar lentigines, mostly using intrapatient randomization, were included. Meta-analysis revealed no significant difference in marked (OR=1.15, 95% CI [-0.42, 2.73], P=0.151, I²=0.6%) or moderate improvement (OR=0.63, 95% CI [-0.01, 1.26], P=0.055, I²=0%), but lasers yielded significantly higher ≥50% improvement in patients (OR=1.36, 95% CI [0.5, 2.21], P=0.002, I²=0.3%), lower mild (OR=-0.96, 95% CI [-1.65, -0.26], P=0.007, I²=0%) and poor response in lesions (OR=-1.72, 95% CI [-3.2, -0.24], P=0.023, I²=0%). Side effects were comparable; heterogeneity remained very low (I²≤0.9%). Four studies showed high risk of bias. One trial demonstrated fractional CO2 or cryotherapy plus 4% pidobenzone significantly outperformed monotherapy.</p><p><strong>Conclusion: </strong>Laser may be superior to cryotherapy in the treatment of lentigines with comparable side effects among the two groups. However, we recommend further RCTs comparing the two modalities to confirm our findings which had many limitations.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e4137"},"PeriodicalIF":0.7,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance and Radio-Pathologic Correlation of Image-Guided Biopsy in Head and Neck Lesions: A Systematic Review : Short title: Diagnostic Performance and Radio-Pathologic Correlation of Image-Guided Biopsy in Head and Neck Lesions.","authors":"Hadi Al-Hakami","doi":"10.31661/gmj.v15i.4145","DOIUrl":"10.31661/gmj.v15i.4145","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis of head and neck lesions relies heavily on image-guided biopsy techniques, which facilitate targeted sampling and enable radiologic-pathologic correlation. Increasing use of CT-guided fine-needle aspiration cytology (FNAC) and core-needle biopsy (CNB) necessitates updated evaluation of their diagnostic performance and safety. To systematically identify, appraise, and synthesize published evidence on the diagnostic accuracy, tissue adequacy, and radio-pathologic concordance of image-guided biopsy for head and neck lesions.</p><p><strong>Materials and methods: </strong>This review followed PRISMA 2020 guidelines and a protocol registered in PROSPERO (CRD420251181567). Searches were conducted across PubMed/MEDLINE, Scopus, Cochrane Library, Web of Science, and Google Scholar (January 2018-September 2025). Eligible studies included human subjects undergoing image-guided FNAC or CNB with reported diagnostic outcomes. Two reviewers independently screened, extracted data, and assessed quality using QUADAS-2. Due to methodological and clinical heterogeneity, meta-analysis was not performed.</p><p><strong>Results: </strong>From 345 records, eight studies met inclusion criteria. Most were retrospective (8/10), evaluating CT-guided FNAC, CNB, or percutaneous needle biopsy across cervical, suprahyoid, salivary, lymphatic, thyroid, and skull base lesions. Diagnostic sensitivities ranged from 85-95%, specificities from 92-97%, and overall accuracies from 90-96%. Diagnostic yield was high (85-100%), and radio-pathologic concordance consistently exceeded 87%. Complications were uncommon and generally minor, except for hilar lymph node biopsies, which showed higher pneumothorax rates.</p><p><strong>Conclusion: </strong>Image-guided biopsy of head and neck lesions demonstrates high diagnostic accuracy and excellent radio-pathologic concordance across diverse anatomic regions, supporting its role as a reliable, minimally invasive diagnostic tool. Despite strong performance in deep and complex spaces, procedure-specific complication risks-particularly in hilar lymph node sampling-should inform clinical decision-making.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"15 ","pages":"e4145"},"PeriodicalIF":0.7,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}