Annals of Saudi medicine最新文献

{"title":"Predictors of medication regimen complexity and its impact on hemoglobin a1c in type 2 diabetes patients: a retrospective analysis in ambulatory care in Makkah City.","authors":"Sarah M Khayyat, Ruba S Azfr Ali, Hanadi H Alrammaal, Salwa M S Khayyat, Wafaa A Alqurashi, Reemaz Alsaedi, Wejdan Alotaibi, Aseel Alahmadi","doi":"10.5144/0256-4947.2024.296","DOIUrl":"10.5144/0256-4947.2024.296","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a widespread chronic disease that poses a significant management challenge due to the complexity of the associated medication regimens, which can have a considerable impact on patient outcomes.</p><p><strong>Objectives: </strong>Explore the complexity level of diabetes medications among patients with T2DM and to identify the predictors of medication regimen complexity (MRC) and its correlation with hemoglobin A1C (HbA1c) levels.</p><p><strong>Design: </strong>Retrospective, cross-sectional study.</p><p><strong>Setting: </strong>An ambulatory care setting of a tertiary hospital in Makkah City, Saudi Arabia.</p><p><strong>Patients and methods: </strong>Patients with T2DM referred to the diabetic clinic were identified and assessed for eligibility. The data were collected from patient electronic medical records between October 2022 and September 2023. The MRC Index was used to evaluate the complexity of the patients' medication regimens.</p><p><strong>Main outcomes measures: </strong>MRC index scores and HbA1c levels.</p><p><strong>Sample size: </strong>353 records of patients with T2DM.</p><p><strong>Results: </strong>The analysis revealed that 61.8% (n=218) of patients had high MRC, with the dosing frequency contributing significantly to their MRC (mean=3.9, SD=1.9). Having polypharmacy and longstanding T2DM were predictors of high MRC (odds ratios=4.9 and 2.6, respectively; <i>P</i>≤.01). Additionally, there was an inverse association between the patients' diabetes-specific MRC index scores and their glycemic control (odds ratios=0.2, <i>P</i><.001).</p><p><strong>Conclusion: </strong>The study findings highlight the importance of considering MRC in managing T2DM. Simplifying medication regimens and optimizing medication management strategies can improve patient outcomes. Further research is needed to explore interventions to reduce MRC and enhance diabetes management in this population.</p><p><strong>Limitations: </strong>Retrospective study design measuring the MRC at a diabetes-specific level.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 5","pages":"296-305"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11454975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378693","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":"Evaluating the effect of histopathological parameters of prostate adenocarcinoma on prognosis in radical prostatectomy specimens.","authors":"Ergün Tercan, O Uzcan Erbatu, Oktay Üçer, Sefa Metin, Nalan Ne E","doi":"10.5144/0256-4947.2024.234","DOIUrl":"10.5144/0256-4947.2024.234","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, significant updates have been made regarding the classification and grading of prostate adenocarcinoma in radical prostatectomy specimens, following decisions reached in international conferences and through impactful publications. These alterations are closely linked to patient prognosis.</p><p><strong>Objectives: </strong>Observe the incidence of these changes and their impact on patient prognosis. Additionally, investigate the relationship between histopathological and clinical parameters to assist in multidisciplinary treatment planning.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary university hospital.</p><p><strong>Methods: </strong>Hematoxylin and eosin, along with immunohistochemistry stained sections, were reevaluated, and clinical information, including patient demographics, preoperative PSA levels, and patient follow-up were collected from patients who underwent radical prostatectomy at our center.</p><p><strong>Sample size: </strong>182 patients.</p><p><strong>Main outcome measures: </strong>Biochemical recurrence.</p><p><strong>Results: </strong>The study highlighted the negative prognostic effects of factors such as Gleason grade group, lymphovascular invasion, intraductal carcinoma, positive surgical margins, extraprostatic extension, pathological T stage, and seminal vesicle invasion. These factors are important determinants of recurrence-free survival in prostate adenocarcinoma patients.</p><p><strong>Conclusion: </strong>This study identified comedonecrosis and intraductal carcinoma as independent negative prognostic factors. A 3-mm cutoff for positive surgical margins was supported, while the current cutoff for extraprostatic extension may require reevaluation. The impact of cribriform pattern and ductal carcinoma appears to be influenced by the grade group. No independent relationship was found between the Gleason score/pattern on positive surgical margins or extraprostatic extension and prognosis. Further, large-scale studies with long-term follow-up are needed.</p><p><strong>Limitations: </strong>The study is limited by the relatively small number of patients for certain parameters.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"234-248"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914840","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":"Assessing risk factors for complications in computer tomography-guided lung biopsy: quantitative analysis for predicting pneumothorax.","authors":"Jie Zhang, Jianli An, Xiuxiu Jing, Jingpeng Wu, Xioxia Zhang, Hongzhi Lu, Ye Tian","doi":"10.5144/0256-4947.2024.228","DOIUrl":"10.5144/0256-4947.2024.228","url":null,"abstract":"<p><strong>Background: </strong>Computer tomography (CT)-guided lung biopsy carries the risk of pneumothorax. A variety of other risk factors affect the occurrence of pneumothorax.</p><p><strong>Objective: </strong>Assess the incidence and risk factors associated with pneumothorax complications in CT-guided lung biopsy, and to conduct a quantitative analysis of the variables among the significant risk factors to identify more effective indicators for predicting pneumothorax complications.</p><p><strong>Design: </strong>Retrospective logistic.</p><p><strong>Setting: </strong>Single center in China.</p><p><strong>Patients and methods: </strong>From June 2017 to May 2021, consecutive patients who underwent CT-guided lung biopsy were identified from the medical record system. Binary logistic regression analysis was used to identify potential risk factors for pneumothorax. Receiver operating characteristic (ROC) curves were constructed for continuous variables to determine cutoff values that optimized sensitivity and specificity.</p><p><strong>Main outcome measures: </strong>The incidence and risk factors of pneumothorax in CT-guided lung biopsy.</p><p><strong>Sample size: </strong>132 patients.</p><p><strong>Results: </strong>The incidence of pneumothorax was 28.9% (38/132), with 6.8% (9/132) of patients requiring chest tube insertion. Results indicated that smaller lesion size (OR 0.724; 95% CI 0.619-0.848; <i>P</i>=.0001), longer needle tract length (OR 1.320; 95% CI 1.145-1.521; <i>P</i>=.001), multiple passes through the pleura (OR 4.618; 95% CI 1.378-15.467; <i>P</i>=.013), and needle tract length/lesion diameter (L/D) ratio (OR 0.028; 95% CI 0.002-0.732; <i>P</i>=.007) were independent risk factors for pneumothorax. ROC curve analysis determined a cut-off value of 0.81 for the L/D ratio (sensitivity=89.5%, specificity=71.3%). The area under the ROC curve (AUC) values of maximum diameter, needle tract length, and L/D ratio for pneumothorax were 0.749, 0.812, and 0.850, respectively.</p><p><strong>Conclusions: </strong>The L/D ratio, multiple passes through the pleura, longer needle tract length, and smaller lesions were independent risk factors for pneumothorax. A L/D ratio of less than 0.81 may indicate a pneumothorax. It may be necessary to use the proper sealing procedure for this patient group.</p><p><strong>Limitations: </strong>Due to its retrospective nature, there may be inherent selection bias.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"228-233"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914836","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":"Comparisons of the oncological results of transoral laser surgery and radiotherapy for early stage laryngeal squamous cell cancer: single-center long-term results.","authors":"Sumeyra Doluoglu, Omer Bayir, Bulent Ocal, Emel Cadalli Tatar, Mehmet Hakan Korkmaz, Guleser Saylam","doi":"10.5144/0256-4947.2024.213","DOIUrl":"10.5144/0256-4947.2024.213","url":null,"abstract":"<p><strong>Background: </strong>In the treatment of early stage laryngeal cancers, surgery (transoral laryngeal surgery (TOLS), open partial laryngeal surgery (OPLS) and radiotherapy (RT) are used.</p><p><strong>Objectives: </strong>Compare the oncological results of patients with early stage laryngeal squamous cell carcinoma (LSCC) treated with TOLS or RT.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Settings: </strong>Tertiary training and research hospital.</p><p><strong>Patients and methods: </strong>The participants were divided into patients who underwent TOLS and RT treatment. The groups were compared with each other in terms of local recurrence, regional recurrence, distant metastasis, 3 and 5-year overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS) and laryngectomy-free survival rates (LFS).</p><p><strong>Main outcome measures: </strong>The effects of TOLS and RT treatment on local control, regional control, OS, DFS, DDS and LFS in early stage laryngeal cancers.</p><p><strong>Sample size: </strong>261.</p><p><strong>Results: </strong>The mean follow-up time was 48 (26) months. There were 186 patients who underwent TOLS and 75 patients who underwent RT treatment. Gender, cigarette/alcohol consumption, tumor localization, anterior commissure involvement, tumor grades, recurrence rates and recurrence localizations of the groups were similar. The 5-year overall, disease specific, disease free and laryngectomy-free survival rates were 85.9%, 88%, 79.4%, 96.3% in the TOLS group and 74.3%, 76.7%, 72.3%, 85.2% in the RT group (<i>P</i>=.034, .065, .269, .060, respectively).</p><p><strong>Conclusions: </strong>TOLS had equal and good oncological outcomes on OS and DFS compared to RT. Anterior commissure involvement was statistically significant independent prognostic risk factor for DFS in both groups. The 5-year OS rate was greater in the TOLS groups (<i>P</i>=.034).</p><p><strong>Limitations: </strong>Retrospective, but to the best our knowledge, this is the first study in Turkey with a high patient volume and a long follow-up time.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914837","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":"Efficacy and safety of autologous platelet-rich plasma in anal fistula: a systematic review and meta-analysis.","authors":"Yuanhui Xu, Lin Ma, Keliang Jia, Xiaoling Wu, Chang Ge","doi":"10.5144/0256-4947.2024.264","DOIUrl":"10.5144/0256-4947.2024.264","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the efficacy and safety of autologous PRP in anal fistula.</p><p><strong>Methods: </strong>The search was done in electronic databases such as; PubMed, Scopus, Google Scholar, Embase, and Cochrane Library. The outcomes investigated in this study were the rate of improvement, the rate of recurrence, and the rate of fecal incontinence.</p><p><strong>Results: </strong>Cure, incontinence, and recurrence rates were 68% (95% CI, .60-.76), 27% (95% CI, .12-.46), and 18% (95% CI, .12-.26), respectively. The pooled improvement ratio in patients treated with PRP compared to control group was 1.35 times, which was statistically significant (pooled OR=1.35, 95% CI, 1.14-1.60, <i>P</i><001). The pooled recurrence ratio in patients treated with PRP compared to control group was 1.17, which was not statistically significant (pooled OR=1.17, 95% CI, 0.44-3.11).</p><p><strong>Discussion: </strong>Platelet-rich plasma is an effective method of healing people with anal fistula.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"264-271"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914839","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 role of endocervical curettage in the diagnosis of cervical intraepithelial neoplasia in human papillomavirus positive patients.","authors":"Ibrahim Gulhan, Raziye Özdemir, Alper İleri, Hande İleri, Sena Özcan, Ayse Betül Öztürk, Mehmet Gökçü, Mehmet Özeren","doi":"10.5144/0256-4947.2024.220","DOIUrl":"10.5144/0256-4947.2024.220","url":null,"abstract":"<p><strong>Background: </strong>The role of endocervical curettage (ECC) in the diagnosis of cervical intraepithelial neoplasia (CIN) is a controversial topic.</p><p><strong>Objectives: </strong>Investigate the role of ECC in the diagnosis of CIN in human papillomavirus (HPV) positive patients.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>A tertiary training and research hospital.</p><p><strong>Patients and methods: </strong>This study included patients who were referred for colposcopy between 2018-2022 because of abnormal screening results. ECC results, age, cytology, HPV status, and colposcopic impression of the patients were extracted from the medical records. Multinomial logistic regression analyses were performed to identify factors that could predict CIN on ECC.</p><p><strong>Main outcome and measures: </strong>The likelihood of high-grade squamous intraepithelial lesions (HSIL) in ECC in patients with cervical biopsy results of normal and low-grade squamous intraepithelial lesion (LSIL).</p><p><strong>Sample size: </strong>2895 women.</p><p><strong>Results: </strong>In patients with normal and LSIL cervical biopsy results, HSILs were detected in 6.7% of ECC results. There was no difference in the detection rates of CIN in ECC among groups with smear results negative for intraepithelial lesions or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US), and LSIL. The likelihood of HSIL being observed in ECC was 2.2 times higher in patients with HPV16. The probability of LSIL disanois was 2.3 times higher in women aged 50-59 years and 2.8 times higher in women ≥ 60 years compared to the reference group of <30 years. The probability of LSIL was 2.3 and HSIL by ECC was 2.2 times higher in both age categories (<i>P</i><.012 and <i>P</i>=.032, respectively) than the reference group of <30 years.</p><p><strong>Conclusion: </strong>Regardless of colposcopic findings, ECC should be performed in patients with smear results of NILM who are positive for HPV16, in patients with smear results of ASC-US and LSIL who are positive for any oncogenic type of HPV and in patients 50 and above with any result of smear or any oncogenic HPV type.</p><p><strong>Limitations: </strong>We did not have the components of the HPV types in mixed groups.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"220-227"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914842","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":"Diabetes mellitus and the risk of spontaneous bacterial peritonitis in patients with liver cirrhosis: a systematic review and meta-analysis.","authors":"Raghad Alhajaji, Mayada Mohammad Samkari, Mona A Althobaiti, Bashaer Ruddah Al-Ahmadi, Alaa Mohammed Bugis, Amjad Mohammed Bugis, Fatimah Yaseen Sabbagh, Somaya A Althobaiti, Amro S Bukari, Safenaz Meshal Alqurashi, Hana Abdullah Mshrai, Omar Ahmed Abdelwahab","doi":"10.5144/0256-4947.2024.272","DOIUrl":"10.5144/0256-4947.2024.272","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous bacterial peritonitis (SBP) represents a critical and potentially lethal condition that typically develops in individuals with liver cirrhosis. This meta-analysis aimed to assess diabetes mellitus (DM) as a risk factor for SBP in liver cirrhotic patients.</p><p><strong>Methods: </strong>Following PRISMA guidelines, fifteen studies were included, for a total of 76 815 patients. The risk of bias was assessed using the Newcastle-Ottawa scale (NOS). We represented the results as risk ratios (RR) with the corresponding 95% confidence intervals (CI) using RevMan software. Additionally, we pooled the hazard ratios (HR) for developing SBP in patients with DM from the included studies.</p><p><strong>Results: </strong>The meta-analysis shows a significantly increased risk of SBP in cirrhotic patients with DM (HR: 1.26; 95% CI [1.05-1.51], <i>P</i>=.01; HR: 1.70; 95% CI [1.32-2.18], <i>P</i><.001).</p><p><strong>Conclusions: </strong>The study signifies that DM is an independent risk factor for SBP, emphasizing the need for targeted preventive measures in this specific population.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"272-287"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914838","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":"Appendiceal neoplasms in Saudi Arabia: prevalence and clinicopathological profile.","authors":"Mohammed Nabil AlAli, Ahmad Zubaidi, Thamer A Bin Traiki, Khayal Alkhayal, Mohammed Sbaih, Saud Khalid Aldeghaither, Farah F Almugrin, Sulaiman Abdullah Alshammari, Mohammed Alswayyed, Maha Abdullah","doi":"10.5144/0256-4947.2024.255","DOIUrl":"10.5144/0256-4947.2024.255","url":null,"abstract":"<p><strong>Background: </strong>The appendix is a small organ with no particular known function. Primary appendiceal neoplasms (ANs) are rare. While the prevalence is increasing worldwide over the past two decades, no apparent increase in the prevalence of ANs has been reported in the Arabian Gulf States. Recently, a significant decline in the age at diagnosis of some types of ANs has been reported worldwide, with a female predominance.</p><p><strong>Objectives: </strong>Evaluate the prevalence and clinicopathological characteristics of ANs within our institution in Saudi Arabia and compare them to limited existing studies from different regions as well as the Arabian Gulf States.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Tertiary care center in Riyadh.</p><p><strong>Patients and methods: </strong>All patients who underwent appendectomy and had the appendix submitted for histopathological evaluation between May 2015 and June 2020 were included to allow for a follow-up of 5 years or more at the time of data collection.</p><p><strong>Main outcome measures: </strong>Demographics, clinical presentations, surgical interventions, histopathological findings, complications, and recurrence rates.</p><p><strong>Sample size: </strong>25 AN patients.</p><p><strong>Results: </strong>Of 1110 patients, 25 had ANs (13 female and 12 male participants) with a mean (standard deviation) age of 54.6 (14.1) years. Only 40% presented with acute appendicitis, 64% had comorbidities, and less than 50% underwent laparoscopic appendectomy. Histopathologically, 72% were low-grade appendiceal mucinous neoplasms (LAMNs). Complications were minimal grades (Clavien-Dindo classification), with 80% experiencing none. The mean hospital stay was 9.96 days. Local recurrence occurred in 8% of cases, and distant metastasis was documented in one adenocarcinoma case. However, the 5-year overall and disease-free survival rates were 88% and 80%, respectively.</p><p><strong>Conclusions: </strong>The incidence of ANs is increasing in Saudi Arabia with the higher prevalence of LAMNs. The pathological examination of the resected appendix played a pivotal role in the diagnosis of ANs.</p><p><strong>Limitations: </strong>Data collected retrospectively, a single institution, and a small population.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"255-263"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914835","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":"Prevalence of discordance between femoral and lumbar bone mineral density among older adults in a community-based setting.","authors":"Muath A Alkhunizan, Nouf AlMasoud, Majd Munia Abdulmowla, Zoha Khalid, Mohammed Alshaker, Yaser Abdullah Alendijani","doi":"10.5144/0256-4947.2024.249","DOIUrl":"10.5144/0256-4947.2024.249","url":null,"abstract":"<p><strong>Background: </strong>T-score measurement via dual-energy X-ray absorptiometry (DXA) is the gold standard for assessing and classifying the bone mineral density status of patients as normal, osteopenic, or osteoporotic according to the World Health Organization criteria. However, the diagnostic accuracy may be affected by the skeletal site selected for DXA.</p><p><strong>Objectives: </strong>Estimate the prevalence of femoral and lumbar BMD discordance in a community-based setting in Riyadh, Saudi Arabia.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Polyclinics at a tertiary care center.</p><p><strong>Patients and methods: </strong>This study included all patients aged ≥60 years who visited the Department of Family Medicine and underwent DXA screening between 2016 and 2022.</p><p><strong>Main outcome measures: </strong>Discordance was defined as a difference in BMD status between two skeletal sites. Minor discordance occurs when adjacent sites have different diagnoses; i.e., one site exhibits osteoporosis and the other exhibits osteopenia. In contrast, major discordance occurs when one site exhibits osteoporosis and the other exhibits normal BMD.</p><p><strong>Sample size: </strong>1429 older adults.</p><p><strong>Results: </strong>The study patients had a median age of 66 years (60-99, minimum-maximum). The prevalence of discordance was 41.6%, with major discordance present in 2.2% of patients and minor discordance in 39.4%. The distribution of discordance did not differ significantly among the sociodemographic factors.</p><p><strong>Conclusion: </strong>Discordance is prevalent among the Saudi geriatric population. During the analysis of DXA results, physicians should account for discordance when diagnosing and ruling out osteoporosis in high-risk patients.</p><p><strong>Limitations: </strong>All factors influencing discordance were not explored thoroughly; this study mainly focused on older adults. Furthermore, diverse age groups need to be investigated for a more comprehensive understanding of the analyzed factors.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"249-254"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914841","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":"Clinical outcomes of corticosteroid administration for acute respiratory distress syndrome in adults based on meta-analyses and trial sequential analysis.","authors":"Di Wu, Yue Li, Shao-Hua Dong, Yue Gao","doi":"10.5144/0256-4947.2024.167","DOIUrl":"10.5144/0256-4947.2024.167","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS), which results in lung injury as a consequence of sepsis and septic shock, is associated with severe systemic inflammation and is responsible for a high worldwide mortality rate.</p><p><strong>Objective: </strong>Investigate whether corticosteroids could benefit clinical outcomes in adult with ARDS.</p><p><strong>Methods: </strong>A comprehensive search of electronic databases Ovid MEDLINE, Ovid EMbase, and Cochrane Library from their inception to 7 May 2023 was conducted to identify studies that met the eligibility criteria, including only randomized controlled trials. The study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the methods of trial sequential analysis.</p><p><strong>Main outcome measures: </strong>Mortality rates, including including the 14-, 28-, 45-, and 60-day mortality, hospital mortality, and intensive care unit (ICU) mortality.</p><p><strong>Sample size: </strong>17 studies with 2508 patients.</p><p><strong>Results: </strong>Data relating to mortality at 14, 28, 45, and 60 days were not significantly different when treatments with corticosteroids and placebo were compared. In terms of hospital and ICU mortality, the mortality of those who had received corticosteroids was significantly lower than that of those who had not. ARDS patients who received assisted ventilation benefited from corticosteroid therapy, as revealed by the significant difference in outcome days between those who received assisted ventilation and those who did not. Corticosteroid had significantly more days free from mechanical ventilation, ICU-free days, and MODS-free days during the first 28 days, but not more organ support-free days up to day 28.</p><p><strong>Conclusion: </strong>Although corticosteroid therapy did not reduce mortality rates at different observation periods, it significantly reduced hospital and ICU mortality. Administering corticosteroids to ARDS patients significantly decreased the days of assisted ventilation and time cost consumption. This study confirmed that long-term use of low-dose glucocorticoids may have a positive effect on early ARDS.</p><p><strong>Limitation: </strong>Risk of bias due to the differences in patient characteristics.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 3","pages":"167-182"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297571","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}