Annals of Saudi medicine最新文献

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Outcomes of patients in intensive care units according to COVID-19 status: analysis of 114 854 cases in Saudi Arabia. 基于COVID-19状况的重症监护病房患者结局:沙特114854例病例分析
Annals of Saudi medicine Pub Date : 2025-03-01 Epub Date: 2025-04-03 DOI: 10.5144/0256-4947.2025.86
Sahal Alzahrani, Soukaina Azouz Ennaceur, Turky Arbaein
{"title":"Outcomes of patients in intensive care units according to COVID-19 status: analysis of 114 854 cases in Saudi Arabia.","authors":"Sahal Alzahrani, Soukaina Azouz Ennaceur, Turky Arbaein","doi":"10.5144/0256-4947.2025.86","DOIUrl":"10.5144/0256-4947.2025.86","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has profoundly affected global health systems. Healthcare systems across the globe have been pushed to their limits, with intensive care units (ICUs) witnessing a sharp rise in admissions, putting a strain on resources and personnel.</p><p><strong>Objectives: </strong>Examine ICU health outcomes, including mortality, length of stay (LOS), and discharge rates, among COVID-19 and non-COVID-19 patients.</p><p><strong>Design: </strong>Retrospective, cross-sectional study.</p><p><strong>Setting: </strong>A national cross-sectional dataset provided by the Ministry of Health in Saudi Arabia.</p><p><strong>Patients and methods: </strong>All patients admitted to ICUs across Saudi Arabia between January 1, 2022, and December 31, 2022. Patients were classified as confirmed COVID-19 cases and non-COVID-19 cases. To evaluate the ICU outcomes, the study used multivariate regression models, adjusting for covariates including age, gender, region, citizenship, and comorbidity score.</p><p><strong>Main outcome measures: </strong>ICU outcomes including mortality, LOS and discharge rate.</p><p><strong>Sample size: </strong>114 854 ICU patients.</p><p><strong>Results: </strong>The study population consisted of 114 854 ICU patients across various demographic and clinical categories. Mortality was found to be higher in COVID-19 patients than non-COVID-19 patients, with COVID-19 patients showing a 7% increase in mortality (OR=1.07, 95% CI: 1.02-1.12). Also, COVID-19 patients had 78% higher odds of being discharged home than the non-COVID-19 group (OR=1.78, 95% CI: 1.71-1.84). Moreover, the average LOS in the ICU was significantly shorter for COVID-19 patients than non-COVID-19 patients by 6% on average (Coefficient=-0.06, 95% CI: -0.07 to -0.03).</p><p><strong>Conclusion: </strong>Significant differences were seen in ICU outcomes between patients with and without COVID-19, including mortality rates, discharge rates, and LOS. COVID-19 patients exhibited higher mortality rate and discharge rate, and shorter ICU LOS than those without COVID-19.</p><p><strong>Limitations: </strong>The data used in this study has missing critical information such as laboratory results, socioeconomic variables, and hospitalization characteristics.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797175","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}
引用次数: 0
High-dose statins for the prevention of recurrent ischemic stroke: a systematic review and meta-analysis of randomized controlled trials. 大剂量他汀类药物预防缺血性卒中复发:随机对照试验的系统回顾和荟萃分析。
Annals of Saudi medicine Pub Date : 2025-03-01 Epub Date: 2025-04-03 DOI: 10.5144/0256-4947.2025.112
Muhammed Siddique Shahid, Mariam Safwan Bourgleh, Adel Alharfi, Shahad Albariqi, Lamia Albalawi, Rema Alohali, Turki Albaqami, Moaz Safwan Bourgleh
{"title":"High-dose statins for the prevention of recurrent ischemic stroke: a systematic review and meta-analysis of randomized controlled trials.","authors":"Muhammed Siddique Shahid, Mariam Safwan Bourgleh, Adel Alharfi, Shahad Albariqi, Lamia Albalawi, Rema Alohali, Turki Albaqami, Moaz Safwan Bourgleh","doi":"10.5144/0256-4947.2025.112","DOIUrl":"10.5144/0256-4947.2025.112","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic stroke (IS) is a leading cause of disability and mortality, with fatal outcomes increased with recurrent strokes. This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the safety and efficacy of high-dose statins for secondary IS prevention.</p><p><strong>Methods: </strong>This review was regestered on PROSPERO (registration number: CRD42024574088). Cochrane methodology was followed in this review and comprehensively searched PubMed, Embase, Cochrane Library and clinicaltrial.gov, to include all RCTs conducted from 2004 to 2024, comparing high-dose statins (simvastatin ≥40 mg, atorvastatin ≥40 mg, and rosuvastatin ≥20 mg) with low-dose statins, placebo, or standard care. Outcomes of this review were recurrent IS reduction and adverse events reported in RCTs.</p><p><strong>Results: </strong>Nine RCTs involving 5,503 patients, with male patients ranging from 25.8% to 81.6% were included. Compared to controls, high-dose statins did not significantly reduce risks for secondary IS (OR 0.78, 95% CI [0.61, 1.00], <i>P</i>=.05) and hemorrhagic stroke (OR 0.85, 95% CI [0.56, 1.29], <i>P</i>=.45). Furthermore, no differences were observed in mortality rates and adverse events between groups.</p><p><strong>Conclusion: </strong>Treatment with high dose statins didn't reduce the risk of stroke recurrence or improve mortality, though further research is needed.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"112-128"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The association of metabolic positron emission tomography/computed tomography parameters with survival in small cell lung cancer. 代谢正电子发射断层扫描/计算机断层扫描参数与小细胞肺癌患者生存的关系
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.25
Merve Ayık Türk, Berna Kömürcüoğlu, Nurşin Agüloğlu, Tuğçe Doksöz Çiftçi, Mücahit Fidan, Sinan Çolak, Özgür Batum
{"title":"The association of metabolic positron emission tomography/computed tomography parameters with survival in small cell lung cancer.","authors":"Merve Ayık Türk, Berna Kömürcüoğlu, Nurşin Agüloğlu, Tuğçe Doksöz Çiftçi, Mücahit Fidan, Sinan Çolak, Özgür Batum","doi":"10.5144/0256-4947.2025.25","DOIUrl":"10.5144/0256-4947.2025.25","url":null,"abstract":"<p><strong>Background: </strong>Small cell lung cancer (SCLC) is a lung malignancy with a poor prognosis and metastases at the time of diagnosis. There is limited experience using positron emission tomography/computed tomography (PET/CT) for SCLC diagnosis, staging, and follow-up.</p><p><strong>Objective: </strong>Investigate the survival effect of primary tumor standardized uptake value max (SUVmax), SUV mean, metabolic tumor volume (MTV), total lesion glucose (TLG), bone marrow SUV (BM), and bone marrow to liver ratio (BLR) in SCLC.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>Single center in Turkey.</p><p><strong>Patients and methods: </strong>Patients who were cyto/histologically diagnosed with SCLC and had PET/CT simultaneous with the diagnosis were included in the study.</p><p><strong>Main outcome measures: </strong>The effect of PET/CT parameters on overall survival (OS) and progression-free survival (PFS).</p><p><strong>Sample size: </strong>304.</p><p><strong>Results: </strong>The 5-year OS median value was 14.62 months, and the 5-year PFS was 13.01 months. In Kaplan-Meier analysis, SUVmax, MTV, and TLG were statistically significant variables in OS (<i>P</i>=.03; <i>P</i><.001; <i>P</i><.001, respectively). MTV and TLG were significant in PFS (<i>P</i><.001; <i>P</i>=.0003, respectively). In the multivariate analysis, MTV was an independent PET/CT parameter associated with OS (<i>P</i>=.003), stage of disease (<i>P</i>=.012), SUVmax (<i>P</i>=.003), MTV (<i>P</i>=.016), and TLG (<i>P</i>=.005) were significant variables in PFS.</p><p><strong>Conclusion: </strong>In our study, MTV was an independent parameter that can be used to predict survival in SCLC. Considering the effect of MTV, a metabolic PET/CT parameter on survival, it can be recommended for clinical use as a standard measure of evaluation in PET/CT reports, just like SUVmax.</p><p><strong>Limitations: </strong>The first limitation was the single-center and retrospective design of the study. Due to the retrospective design of the study, weight loss, performance status, and smoking history could not be obtained from every patient. Second, inaccurate registration of PET and CT images due to patient respiratory movements may affect measurements.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392709","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}
引用次数: 0
Endometrial thickness as a predictive value of ectopic pregnancy in in-vitro fertilization/intracytoplasmic sperm injection cycles: a case-control study. 子宫内膜厚度作为体外受精/胞浆内单精子注射周期异位妊娠的预测价值:一项病例对照研究
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.33
Haifa F Alsadhan, Ghadeer L Aljahdali, Samaher S Alfaraj, Nazish Masud, Mutlaq Almutlaq, Lujain Alwasel, Lena H Alfaraj, Salem Abualburak, Hayat Alrabieaa, Fahad Alsalman
{"title":"Endometrial thickness as a predictive value of ectopic pregnancy in in-vitro fertilization/intracytoplasmic sperm injection cycles: a case-control study.","authors":"Haifa F Alsadhan, Ghadeer L Aljahdali, Samaher S Alfaraj, Nazish Masud, Mutlaq Almutlaq, Lujain Alwasel, Lena H Alfaraj, Salem Abualburak, Hayat Alrabieaa, Fahad Alsalman","doi":"10.5144/0256-4947.2025.33","DOIUrl":"10.5144/0256-4947.2025.33","url":null,"abstract":"<p><strong>Background: </strong>The incidence rate of ectopic pregnancy (EP) with assisted reproductive technology (ART) has been reported to be higher than that of spontaneous pregnancy. Endometrial thickness (EMT) is considered an independent risk factor.</p><p><strong>Objectives: </strong>Evaluation of endometrial thickness as a predictor of ectopic pregnancy in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Setting: </strong>Women's Health Specialist Hospital, formerly known as King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.</p><p><strong>Patients and methods: </strong>This study was a 1:2 matched case-control study that enrolled 24 ectopic pregnancy patients and 50 matched intrauterine pregnancy patients. They were matched on maternal age, the presence of tubal factor, and parity. The estimated sample size for patients with ectopic pregnancy was 25-30, whereas that for controls was estimated to be 60 patients. The sampling technique was a purposive (nonprobability).</p><p><strong>Main outcome measures: </strong>Endometrial thickness after IVF/ICSI is a predictor of ectopic pregnancy.</p><p><strong>Sample: </strong>79 patients.</p><p><strong>Results: </strong>Multivariate logistic regression analysis was performed to analyze EP predictors, and a receiver operating characteristic (ROC) curve was used to evaluate the predictors of EP. After adjustment for other factors in the logistic regression model, we found that the tubular factor increased the risk of EP by 7.6 times, whereas the ovarian factor significantly decreased EP by 85%. Other factors, including EMT, did not significantly affect the probability of developing ectopic pregnancy.</p><p><strong>Conclusions: </strong>EMT was not predictive nor protective of EP in women who underwent ART cycles. Nevertheless, the presence of tubular factors has strong predictive value, whereas ovarian factors have significant protective value against EP.</p><p><strong>Limitations: </strong>The study design affects the generalizability and level of evidence provided. The small sample size and single-center inclusion had an impact on the results and statistical tests used.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392678","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}
引用次数: 0
Incidence, outcomes, and mortality risk factors of acute kidney injury in critically ill children: a tertiary care center study in Saudi Arabia. 危重儿童急性肾损伤的发生率、结局和死亡率危险因素:沙特阿拉伯三级保健中心研究
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.62
Tareq Alayed, Abdulaziz Alansary, Mohammed Al-Nahdi, Abdullah Alotaibi, Raghad Alhuthil, Moath Al Abdulsalam, Fahad Aljofan, Abdullah Alturki, Tariq Alofisan
{"title":"Incidence, outcomes, and mortality risk factors of acute kidney injury in critically ill children: a tertiary care center study in Saudi Arabia.","authors":"Tareq Alayed, Abdulaziz Alansary, Mohammed Al-Nahdi, Abdullah Alotaibi, Raghad Alhuthil, Moath Al Abdulsalam, Fahad Aljofan, Abdullah Alturki, Tariq Alofisan","doi":"10.5144/0256-4947.2025.62","DOIUrl":"10.5144/0256-4947.2025.62","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a critical concern in pediatric intensive care units (PICUs) due to its high mortality rate.</p><p><strong>Objectives: </strong>Investigate AKI incidence, outcomes, and mortality-related risk factors among critically ill children.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>A PICU.</p><p><strong>Patients and methods: </strong>The study included children (aged 4 weeks to 14 years) who were admitted to the PICU from (2016 to 2019) and developed AKI at King Faisal Specialist Hopsital and Research Centre.</p><p><strong>Main outcomes measures: </strong>AKI incidence, outcomes, and mortality-related risk factors.</p><p><strong>Sample size: </strong>111 records of patients with AKI.</p><p><strong>Results: </strong>Of 969 PICU admissions, 111 cases developed AKI and were entered in the analysis, with an incidence rate of (11.5%). The median age was 43 months [interquartile range (IQR): 16-120], with hematology/oncology conditions being the most prevalent underlying diseases (56.8%). Septic shock and nephrotoxin medications were the leading causes of AKI, accounting for (46.8%) and (45.0%), respectively. Regarding AKI severity, (37.8%) were classified as stage 1, (25.2%) as stage 2, and (37.0%) as stage 3 AKI. As for PICU interventions, the highest was inotropic support (63.1%), followed by mechanical ventilation (56.8%) and renal replacement therapy (23.4%). The PICU mortality rate was (38.7%) (43/111), with no significant association between AKI stage and mortality. However, the multivariable analysis identified bone marrow transplant (BMT) (<i>P</i>=.042) and inotropic support (<i>P</i>=.001) as significant predictors of mortality.</p><p><strong>Conclusion: </strong>These findings underscore the importance of early recognition and tailored management of AKI in PICU settings. Despite advancements in critical care, AKI remains a significant challenge, contributing to prolonged hospitalization, mortality, and increased health-care resource utilization. Therefore, more investigation is warranted.</p><p><strong>Limitations: </strong>Retrospective study single-center nature.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"62-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392707","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}
引用次数: 0
Impact of renin angiotensin system inhibitors on survival of patients with metastatic non-small cell lung cancer. 肾素血管紧张素系统抑制剂对转移性非小细胞肺癌患者生存的影响。
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.18
Nadiye Sever, Emil Yunusov, Abdussamet Çelebi, Alper Yaşar, Nargiz Majidova, Erkam Kocaaslan, Pınar Erel, Yeşim Ağyol, Ali Kaan Güren, Selver Işık, Rukiye Arıkan, Özlem Ercelep, Osman Köstek, İbrahim Vedat Bayoğlu, Murat Sarıc
{"title":"Impact of renin angiotensin system inhibitors on survival of patients with metastatic non-small cell lung cancer.","authors":"Nadiye Sever, Emil Yunusov, Abdussamet Çelebi, Alper Yaşar, Nargiz Majidova, Erkam Kocaaslan, Pınar Erel, Yeşim Ağyol, Ali Kaan Güren, Selver Işık, Rukiye Arıkan, Özlem Ercelep, Osman Köstek, İbrahim Vedat Bayoğlu, Murat Sarıc","doi":"10.5144/0256-4947.2025.18","DOIUrl":"10.5144/0256-4947.2025.18","url":null,"abstract":"<p><strong>Background: </strong>We aimed to explore the correlation between anti-hypertensive treatment and survival rates in patients with metastatic non-small cell lung cancer (mNSCLC).</p><p><strong>Objective: </strong>In this study, we analyzed the correlation between antihypertensive treatment and survival in 300 patients with mNSCLC.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Settings: </strong>Medical faculty hospital.</p><p><strong>Patients and methods: </strong>We investigated the relationship between antihypertensive treatment and survival in 300 patients who were diagnosed with mNSCLC. We also examined the relationship between histological type, performance status, gender, age and type of antihypertensive medication used and survival.</p><p><strong>Main outcomes and measures: </strong>Survival difference between mNSCLC patients with and without antihypertensive treatment.</p><p><strong>Sample size: </strong>300 patients with mNSCLC.</p><p><strong>Results: </strong>Among patients receiving concomitant antihypertensive treatment, 107 (35.7%) were prescribed angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB), 64 (21.3%) beta-blockers and 36 (11%) calcium channel blockers. The study found that the overall survival rates for all patients at 36 and 60 months were 11.5% and 7%, respectively. However, the ACEi/ARB group had higher survival rates at 18.1% and 12% for 36 and 60 months, respectively, compared to the non-ACEi/ARB group with rates of 8.7% and 5% (<i>P</i><.05).</p><p><strong>Conclusion: </strong>These results strongly suggest that renin-angiotension system (RAS) inhibitors hold great promise as potential adjunctive therapies for mNSCLC due to their significant inhibitory effects on cell proliferation, angiogenesis and tumor progression.</p><p><strong>Limitations: </strong>Retrospective and non-randomized nature. Additionally, the retrospective analysis did not allow for verification of the duration or regularity of drug use, which made it infeasible to examine dose-response relationships with reliability.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392681","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}
引用次数: 0
Nontraumatic headaches in the emergency department: identifying clinical associations and predictive warning signs of intracranial pathologies. 急诊科的非创伤性头痛:识别临床关联和颅内病变的预测性警告信号。
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.50
Abdulaziz M Alghamdi, Abdulkarim M Alghamdi, Yousof Fahad Allarakia, Arwa S Alghamdi, Abdulaziz S Alrashid, Abdulwhab M Alotaibi, Reem Addas, Ahmed I Lary
{"title":"Nontraumatic headaches in the emergency department: identifying clinical associations and predictive warning signs of intracranial pathologies.","authors":"Abdulaziz M Alghamdi, Abdulkarim M Alghamdi, Yousof Fahad Allarakia, Arwa S Alghamdi, Abdulaziz S Alrashid, Abdulwhab M Alotaibi, Reem Addas, Ahmed I Lary","doi":"10.5144/0256-4947.2025.50","DOIUrl":"10.5144/0256-4947.2025.50","url":null,"abstract":"<p><strong>Background: </strong>Although headaches are common, only 3-21% are estimated to be secondary, with their causes ranging from non-alarming to life-threatening conditions.</p><p><strong>Objectives: </strong>Evaluate the associated factors and predictive warning signs of intracranial pathologies in patients presenting with nontraumatic headaches to the emergency document (ED).</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Settings: </strong>Medical center in Jeddah.</p><p><strong>Patients and methods: </strong>Data were collected from all patients who presented to the ED with nontraumatic headaches and underwent brain computed tomography (CT) scans from September 2021 to September 2022.</p><p><strong>Main outcome measures: </strong>The associated factors and predictive warning signs of intracranial pathologies.</p><p><strong>Sample size: </strong>387.</p><p><strong>Results: </strong>Sixty-seven (17.31%) patients had intracranial pathologies. The median (IQR) age of all patients was 49 (23) years and females constituted 61.8%. Patients with intracranial pathologies were significantly more likely to have severe headaches (59.7% vs. 33.7%, <i>P</i><.001), to have compressing or sharp headaches (16.4% vs. 6.2%, P=.003), to have constant headaches (16.4% vs. 7.8%, <i>P</i>=.003), to be on chemo-therapy or radiotherapy (10.5% vs. 2.8%, <i>P</i>=.004), and to be smokers (13.4% vs. 6.2%, <i>P</i>=.042) than the other group. Multiple logistic regression of headache warning signs revealed that significant changes or progression in pattern, frequency, or severity of headache (OR: 3.2, CI: 1.5-6.6, <i>P</i>=.001), motor deficits, including abnormal reflexes (OR: 2.9, CI: 1.2-6.9, <i>P</i>=.011), personality changes, confusion, memory impairment, drowsiness, slurred speech or loss of consciousness (OR: 2.6, CI: 1.4-5.0, <i>P</i>=.002), and sudden onset of headache (OR: 1.9, CI: 1.0-3.6, <i>P</i>=.046) were predictive of intracranial pathologies.</p><p><strong>Conclusions: </strong>Our findings suggest that these four headache warning signs can help physicians predict intracranial pathologies and subsequently decide which patients should undergo brain imaging in non-traumatic headache cases.</p><p><strong>Limitations: </strong>Single-center study and retrospective design.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"50-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392708","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}
引用次数: 0
The therapeutic effect of leucogen in treating alcoholic liver cirrhosis with thrombocytopenia or leukopenia. 白细胞原治疗酒精性肝硬化伴血小板减少或白细胞减少的疗效观察。
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.9
Min Su, Mengwen He, Wu-Cai Yang, Jianjun Wang, Chang Guo, Yi-Ming Fu, Chun-Wang, Shuyao Li, Dong Ji, Hong-Yan Chen
{"title":"The therapeutic effect of leucogen in treating alcoholic liver cirrhosis with thrombocytopenia or leukopenia.","authors":"Min Su, Mengwen He, Wu-Cai Yang, Jianjun Wang, Chang Guo, Yi-Ming Fu, Chun-Wang, Shuyao Li, Dong Ji, Hong-Yan Chen","doi":"10.5144/0256-4947.2025.9","DOIUrl":"10.5144/0256-4947.2025.9","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia and leukopenia are common complications of alcoholic liver cirrhosis (ALC) and are associated with an increased risk of bleeding, infection and mortality.</p><p><strong>Objectives: </strong>Evaluate the effectiveness and safety of leucogen, a cysteine derivative that increases platelet (PLT) and white blood cell (WBC) counts in ALC patients.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>Department of hepatology, general hospital.</p><p><strong>Patients and methods: </strong>Patients with ALC who had thrombocytopenia and/or leukopenia were enrolled between 2022 and 2023 and were divided into two groups based on their treatment: the leucogen group (20 mg, three times per day) and the non-leucogen group.</p><p><strong>Main outcome measures: </strong>The primary endpoint was an increase in PLT or WBC of ≥5% from baseline.</p><p><strong>Sample size: </strong>413 patients (320 patients in the final analysis).</p><p><strong>Results: </strong>In this retrospective study, 320 patients were analyzed post-propensity score matching: 160 patients each in the leucogen and non-leucogen groups. Following 3 months of treatment, the leucogen group experienced a median increase in PLT levels of 1.0×10<sup>9</sup>/L versus a decrease of 3.0×10<sup>9</sup>/L in the non-leucogen group (<i>P</i>=.003), and a median increase in WBC counts of 0.1×10<sup>9</sup>/L compared to a decrease of 0.1×10<sup>9</sup>/L (<i>P</i>=.006). The changes in ALT, AST, and TBIL levels were not significantly different between groups. A higher proportion of patients in the leucogen group experienced increases in both PLT (46.9% vs. 32.5%, <i>P</i>=.012) and WBC counts (50.0% vs. 36.2%, <i>P</i>=.018), and 28.1% of patients in the leucogen group had increases in both parameters, compared to 15.6% in the non-leucogen group (<i>P</i>=.01). The leucogen group also demonstrated greater increases in PLT (OR 1.833; <i>P</i>=.009) and WBC counts (OR 1.759; <i>P</i>=.013) compared to the non-leucogen group. The safety profile of leucogen was favorable, with no significant adverse events reported. Leucogen was particularly beneficial for patients younger than 60 years and those with lower baseline ALT and AST levels, showing significant improvements in both PLT and WBC counts in these subgroups.</p><p><strong>Conclusions: </strong>Leucogen effectively increased PLT and WBC counts in patients with ALC, showing a favorable safety profile.</p><p><strong>Limitations: </strong>Retrospective study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392710","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}
引用次数: 0
Evaluation of intra-abdominal injuries in patients referred to the emergency department as a result of traffic accidents. 对因交通事故被转介到急诊科的病人腹部损伤的评估。
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.1
Ahmet Münir Yılmaz, Enes Kalıntaş, Hatice Eylem Kömürcüler Yılmaz
{"title":"Evaluation of intra-abdominal injuries in patients referred to the emergency department as a result of traffic accidents.","authors":"Ahmet Münir Yılmaz, Enes Kalıntaş, Hatice Eylem Kömürcüler Yılmaz","doi":"10.5144/0256-4947.2025.1","DOIUrl":"10.5144/0256-4947.2025.1","url":null,"abstract":"<p><strong>Background: </strong>Traffic accidents are one of the most important reasons that increase the workload of emergency services all over the world. Especially in developing countries, this problem is difficult to solve due to rapid population growth.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the causes of mortality and morbidity, the organs affected by the injury, and the prognosis of the patients who are referred to the emergency department as a result of traffic accidents and underwent abdominal imaging.</p><p><strong>Design: </strong>Retrospective, cross-sectional study.</p><p><strong>Setting: </strong>A state hospital in Turkey.</p><p><strong>Patients and methods: </strong>1014 patients admitted to Gaziantep Abdulkadir Yüksel State Hospital between 15 July 2022 to 15 July 2023 due to traffic accidents and examined for abdominal trauma were retrospectively evaluated.</p><p><strong>Main outcome measures: </strong>Evaluation of patients admitted due to traffic accidents and examined for abdominal trauma.</p><p><strong>Sample size: </strong>1014 patients.</p><p><strong>Results: </strong>The mean age of the patients was 25.88 years, 79.6% were male, 67.3% were admitted to the hospital by ambulance, 47.4% were admitted as a result of a vehicular traffic accident, 34.3% were admitted as a result of a non-vehicular traffic accident, 18.2% were admitted as a result of a motorcycle accident and 36.4% were drivers, 35.3% were pedestrians and 28.3% were passengers. Intra-abdominal organ injuries were detected in 3.2% of all patients, including urinary system in 1%, hepatobiliary system in 0.9% and spleen in 0.8%. It was determined that 13% of the patients had life-threatening injuries and 40.2% had injuries that could not be treated with simple medical intervention.</p><p><strong>Conclusion: </strong>It was determined that 21% of the patients admitted to the emergency department as a result of traffic accidents required hospitalization or resulted in death. Prevention of traffic accidents, which especially threaten the young population, is of great importance both in reducing the workload in the emergency department and in minimizing labor and financial losses.</p><p><strong>Limitations: </strong>Since the study was based on retrospective file review, files with missing information were not included in the study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392679","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}
引用次数: 0
Timing of discharge of pediatric patients post cardiac catheterization. 儿科患者心导管置入术后的出院时机。
Annals of Saudi medicine Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.5144/0256-4947.2025.40
Ali A Alakhfash, Abdulrahman A Al Mesned, Abdulla M Al Qwaiee, Naser Kolko, Zainab Alnakhli
{"title":"Timing of discharge of pediatric patients post cardiac catheterization.","authors":"Ali A Alakhfash, Abdulrahman A Al Mesned, Abdulla M Al Qwaiee, Naser Kolko, Zainab Alnakhli","doi":"10.5144/0256-4947.2025.40","DOIUrl":"10.5144/0256-4947.2025.40","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Same-day discharge after cardiac catheterization may be safe for some patients. This study aimed to review our experience with same-day discharge after pediatric cardiac catheterization following the implementation of a fast-track protocol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Evaluate the feasibility of same-day discharge after pediatric cardiac catheterization and identify risk factors for prolonged hospital stay.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Pediatric cardiology department.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;Data from patients who underwent cardiac catheterization were recorded over 17 months, from January 2022 to May 2023, focusing on pediatric cardiac catheterization procedures, including demographics, clinical, echocardiographic, catheterization data, and outcomes. Criteria were set to determine the possibility of same-day discharge post-cardiac catheterization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The primary outcome was the length of hospital stay post-cardiac catheterization. Secondary outcomes included identifying risk factors for prolonged hospital stay (more than 12 hours) and any associated complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Sample size: &lt;/strong&gt;300 patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 300 patients, 201 (67%) were discharged on the same day (with less than 12 hours' hospital stay), and 57 patients (19%) stayed overnight. The median length of stay (LOS) after pediatric cardiac catheterization was 8.7 hours (25th percentile: 7.5 hours, 75th percentile: 23.8 hours). No complications were reported in patients discharged on the same day. The majority of procedures were interventional cardiac catheterizations (242 cases, 80.7%), with most patients (166 cases, 55.3%) discharged on the same day of the procedure. The most common age group was between 3 to 6 months (114 patients, 38%). Regression analysis revealed that cardiac catheterization in neonates and infants less than 3 months old, more complex interventions such as patent ductus arteriosus stenting and right ventricular outflow tract stenting, interventions in the aortic valve, and the occurrence of complications were associated with prolonged hospital stay.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Same-day discharge following catheterization is feasible for the majority of pediatric patients and can contribute to reduced healthcare costs and improved patient satisfaction. We developed a fast-track protocol for assessing the timing of discharge after pediatric cardiac catheterization, outlining potential indications and contraindications for same-day discharge. Factors associated with prolonged hospital stays include interventions in the neonatal period and procedure-related complications. Careful patient selection and monitoring impleare essential to ensure optimal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The retrospective nature of the study and the single-center experience","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"40-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392711","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}
引用次数: 0
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