Digital Commons Network^™

When Probiotics Guidelines Differ: A Practical Guide For Clinicians And Researchers, Geoffrey A Preidis, Hania Szajewska, Marla Cunningham, Howard Bauchner, Daniel J Merenstein

Faculty, Staff and Students Publications

Many professional organizations publish clinical practice guidelines for the use of probiotics in gastrointestinal disorders. Generally, no two guidelines align perfectly, and some differ markedly. These discrepancies occur because clinical practice guidelines are not purely mechanical outputs of data synthesis. They are shaped by structured interpretation, value judgments, and predefined thresholds for uncertainty. These elements become particularly visible when effect sizes are small, heterogeneity is high, and outcomes vary in clinical relevance-as is the case with probiotic research. This article examines why discordance among probiotic guidelines is predictable and provides practical guidance for clinicians who must decide among conflicting recommendations …

Using Randomization To Compare Ai And Expert-Generated Formative Assessment Questions In Medical Education, Akshat Kumar, Katie Stinson, Litao Wang, Elizabeth Nugent, Yongsu Lee, Mark Hormann, Latanya Jones Love, Toufeeq Ahmed Syed

Faculty, Staff and Student Publications

Background: AI-generated content is being used across the education spectrum and is beneficial for creating complex multiple-choice questions, such as those used in medical education. However, evaluating AI-generated content is challenging, and existing testing and evaluation methods are falling short. This study uses randomization to compare medical students' performance on and subjective evaluation of AI versus expert-generated questions. We hypothesized that there would be no difference in student performance or subjective evaluation of AI vs expert-generated questions.

Methods: We designed a single-center, randomized study where medical student participants received either one AI- or expert-generated question per day over four weeks. …

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Micah D Forshee, Erika J Nachman, Esha R Shenoy, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …

Is Your Cyst Really A Ganglion Cyst? A Case Report Of Angioleiomyoma Mimicking A Plantar Fascia Cystic Lesion, Christopher Anjorin Ms Dpmc, Joseph Bender Dpm

School of Podiatric Medicine - Student Research

Ganglion cysts are among the most common benign soft tissue masses encountered in podiatric clinical practice, and their diagnosis is often presumed based on location, clinical observation, and transillumination. However, this case highlights a diagnostic idiosyncrasy: a lesion clinically presumed to be a ganglion cyst within the plantar fascia was ultimately identified as an angioleiomyoma following surgical excision and histopathological evaluation. This finding underscores the importance of maintaining a broad differential diagnosis when assessing cystic lesions, particularly those that transilluminate, as benign vascular tumors may closely mimic more common entities in both clinical presentation and imaging. More importantly, what if …

Ambulatory Blood Pressure Variability In Prediction Of Target Organ Injury: The Ship Ahoy Study, Coral D Hanevold, Jang Dong Seo, Stephen R Daniels, Bonita E Falkner, Michael A Ferguson, Joseph T Flynn, Julie R Ingelfinger, Philip R Khoury, Marc B Lande, Kevin E Meyers, Mark Mitsnefes, Joshua Samuels, Elaine M Urbina

Faculty, Staff and Student Publications

Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD) over mean BP measures is not known.

Methods: We assessed clinic and ambulatory BP (ABP), anthropometrics, and TOD in 397 adolescents. ABP means standard deviation (SD), BP, and heart rate (HR) dipping were calculated; coefficients of variability (CV) were calculated (SD/mean) to assess ABP variabilities. Measures of TOD included LVMI, left ventricular hypertrophy (LVH), LV systolic shortening, LV diastolic function (e'/a'), and …

Discriminative Performance Of Externally Validated Dementia Risk Prediction Models: A Systematic Review And Meta-Analysis, Blossom C.M. Stephan, Jacob Brain, Kaarin J. Anstey, Tanya Buchanan, Claire V. Burley, Elissa Burton, Jennifer Dunne, Linda Errington, Matthew Gorringe, Zhongyang Guan, Bronwyn Myers, Serena Sabatini, Marc Sim, William Stephan, Eugene Yee Hing Tang, Narelle Warren, Mario Siervo

Research outputs 2022 to 2026

Background: Data on the external validation of current dementia risk prediction models has not yet been systematically synthesised. This systematic review and meta-analysis collated results from three previous reviews to evaluate the predictive discriminative performance of dementia risk models when validated in population-based settings. Methods: Embase (via Ovid), Medline (via Ovid), Scopus, and Web of Science were searched from inception to June 2022 with an updated search conducted up to November 2024. Included studies (1) had a population-based cohort design; (2) assessed incident late-life (i.e. ≥ 60 years) dementia; and (3) reported predictive performance of at least one dementia risk …

A Genomic Approach For Accurate Identification Of Closely Related Species With Next-Generation Sequencing Samples, Nour Al Dain Marzouka, Amira Al-Aamri, Fatima Alshamsi, Mariam Khalili, Sarah El Hajj Chehadeh, Meera S. Mohamed, Yassir Mohammed Eltahir, Rafeek Koliyan, Mohamed Moustafa Abdelhalim, Assem Attia, Mira Mousa, Guan Tay, Habiba Alsafar

Research outputs 2022 to 2026

Accurate species identification from Whole Genome Sequencing (WGS) data remains challenging, particularly for closely related species such as sheep (Ovis aries) and goats (Capra hircus). Through analysis of mapping quality metrics and Kraken2 taxonomic classification of 40 WGS sheep and goat samples, we demonstrate that conventional approaches yield ambiguous results, with overlapping alignment rates and inconclusive taxonomic assignments. We present a robust comparative genomic approach that uses species-specific genomic regions to distinguish these species in WGS samples. We define species-specific regions as those exhibiting distinctive coverage patterns: average coverage when samples are aligned to their matching reference genome but absent/low …

In-Hospital Mortality Patterns And Readmissions In Patients With Chronic Obstructive Pulmonary Disease: An Analysis Of The Role Of Pulmonary Hypertension, Saad Afzal Khan, Trishna Parikh, Adishwar Rao, Akriti Agrawal, Aarohi Parikh, Farah Kazzaz, Sarah Shin, Harry Karmouty-Quintana, Maulin Patel, Kha Dinh, Bela Patel, Bindu Akkanti

Faculty, Staff and Student Publications

Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017-2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline …

Genetic Drivers Of Progression In Alzheimer’S Disease Are Distinct From Disease Risk, Celeste E. Cohen, Shane Fernandez, Umran Yaman, Ahmad R. Ehyaei, Eleftheria Kodosaki, Aydan Askarova, Tenielle Porter, Eleanor O’Brien, Paul Maruff, Alexi Nott, John A. Hardy, Simon M. Laws, Dervis A. Salih, Maryam Shoai

Research outputs 2022 to 2026

Background: Recent trials in Alzheimer’s disease (AD) demonstrate encouraging outcomes. These trials target risk mechanisms identified through genetic analysis whilst directly aiming to reduce progression rates. Evidence from other neurodegenerative diseases suggests the genetics of progression is distinct from risk of disease. To expand these initial successes and improve clinical outcomes further we need to understand genetics of progression of disease. These can be deduced through rigorous analysis of meticulously phenotyped longitudinal cohorts. In this study we first looked at known genetic drivers of risk, namely polygenic risk scores for AD and APOE‑ε4, to assess their role in progression. This …

The Relationship Between Dietary Sodium Intake And Cognitive Function: A Narrative Review, Samantha L. Gardener, M. Fu, L. Morini, T. Schwartzkopff, G. Savage, R. N. Martins, S. R. Rainey-Smith

Research outputs 2022 to 2026

Purpose of Review: This narrative review provides discussion on current evidence regarding the relationship between sodium intake and cognitive function in animal and human studies, as well as potential mechanisms underlying this relationship. Recent Findings: Recent evidence suggests high sodium intake is associated with development of cognitive impairment and neural dysfunction. Additionally, studies have proposed that high sodium intake is associated with increased aggregation of Aβ-amyloid and that hypertension (for which high sodium intake is a risk factor) modulates the relationship between Aβ-amyloid and development of cognitive impairment and Alzheimer’s disease. However, while animal studies demonstrate a consistent relationship between …

Murine Typhus In Georgia: Historical Context And A Probable Case Of Resurgence Where Previously-Thought Eradicated, Giovanni Mella-Velazquez, Christopher He, Bolanle Akinsola, Judson Miller

Journal of the Georgia Public Health Association

Background: Murine typhus, caused by Rickettsia typhi, is a flea-borne illness historically endemic to the southeastern United States, with initial cases reported in Atlanta, Georgia in 1913. Following vector control efforts, incidence declined significantly, and the disease was removed from the nationally notifiable disease list in 1987. While recent cases have been reported in select regions, murine typhus has not been documented in Georgia for decades. We present a pediatric case in Atlanta that may represent the first reported instance in nearly 40 years, suggesting possible reemergence in the Southeast.

Methods: We conducted a case report analysis of a pediatric …

Physician-Assisted Suicide And Euthanasia: A Discussion, Adam Omelianchuk Phd, Ma, Clinical Ethicist,

History of Medicine Seminar

No abstract provided.

The Lateral Recovery Position In Medical Vs Dental Emergencies, John Regis, Steven Saxe, Jason Ciccotelli, Saskia Richter, Jessica Immonen

The Journal of Integrative Physiology

The lateral recovery position is widely used in prehospital and clinical settings to help maintain airway patency in unconscious patients who are breathing spontaneously. Tracheal anatomy and asymmetries in respiratory structures, along with gravitational effects on soft tissues, may influence the efficacy and safety of this positioning. Clinical nuances related to the setting and secondary health concerns interestingly create disagreement on preferred side for lateral placement. This article explores the anatomical and physiological considerations that support the lateral recovery position—focusing on tracheal asymmetry and its implications for airway patency—along with emergency medical practices in medical versus dental emergencies. It also …

Ribosomal Biogenesis In Acute Myeloid Leukemia: A Less-Attended Process With Profound Implications For Oncogenesis And Therapeutic Vulnerability, Muhammad-Redha Abdullah-Zawawi, Nadiah Abu, Nurul Syakima Ab Mutalib, Farah Azima Abdul Muttlib, Hafiza Alauddin

Saudi Medical Journal

No abstract provided.

Drooling In Children With Cerebral Palsy: A Retrospective Observational Study Of Clinical Characteristics, Severity, And Treatment, Kamel Awadh Alenazi, Lama Dakhakhni, Nancy Hassan, Wejdan Almuhraj

Saudi Medical Journal

Objectives: To report the characteristics, severity, and treatment of drooling in cerebral palsy (CP) children.
Methods: This retrospective observational study included CP children with active complaints of drooling from the Drooling Clinic, Sultan Bin Abdulaziz Humanitarian City (Riyadh, Saudi Arabia). Drooling severity was assessed via the Modified Drooling Questionnaire (MDQ). The functional motor and manual ability levels were classified via the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS).
Results: In total, 122 patients were identified. Mean age was 6.28 ± 2.71 years, and 67/122 (54.9%) were boys. Gastroesophageal reflux disease was noted in 23/122 (18.9%). …

Sinonasal Inverted Papilloma: Demographics, Recurrence Predictors, And Surgical Outcomes — A 10-Year Retrospective Review At A Tertiary Center In Saudi Arabia, Ali J. Asiry, Majed A. Alali, Nasir A. Magboul, Salem A. Alrasheed, Ibraheem M. Alkanhal, Mohammed A. Alabduljabbar, Raid H. Almadi, Abdullah S. Aldughaither, Faisal S. Alfawaz, Ali Majrashi, Saud Alromaih, Ghassan Alokby, Tamadar Al Doheyan

Saudi Medical Journal

Objectives: To characterize the demographic, clinical, and radiological profile of patients with sinonasal inverted papilloma (IP) managed at a tertiary center in Saudi Arabia, to determine recurrence rates in primary versus revision cases, and to identify factors associated with recurrence.
Methods: This retrospective observational study included 59 adult patients with histopathologically confirmed sinonasal inverted papilloma (IP). Demographic, clinical, radiological, and surgical data were extracted from medical records. Tumors were staged using the Krouse system. Patients were stratified into primary or revision cases, and associations with recurrence were evaluated.
Results: Most patients were men (72.9%) and older than 45 (79.7%) years …

Incidence Rate And Factors Predicting The Recurrent Cerebral Ischemic Events After The First-Ever Ischemic Stroke: A Single-Center Exploratory Study From The Eastern Region Of Saudi Arabia, Azra Zafar, Mustafa Al-Qarni

Saudi Medical Journal

Objective: First-ever ischemic stroke (FIS) patients carry a higher risk of recurrent ischemic strokes (RIS). This study reports the incidence rate and describes the factors predicting recurrences in FIS patients.
Methods: This retrospective study, enrolling patients with FIS, was carried out at the King Fahd Hospital. Association between different variables and RIS was determined by estimating the 95% confidence intervals (95% CI) and odds ratio (OR).
Results: The majority of patients were Saudi (74.1%) and male (72.9%). Over a 5-year follow-up study, the incidence rate was 26.1% (95% confidence interval [CI] = 22.2-30.1) for all recurrences and 22.7% (95% CI …

Beyond Chronological Age: Performance Status And Clinical Frailty Predict Survival In Saudi Geriatric Lymphoma Patients: A Competing Risk Analysis, Musa Fares Alzahrani, Ghazi S. Alotaibi, Sarah S. Sewaralthahab, Fatima A. Alshalati, Ibrahim N. Alrumaih, Badraa A. Muharib, Kazi Nur Asfina, Saleh Ahmed Alkholaif, Shaden A. Albassam, Saleh Abdullah Aljanah, Shahad A. Al Hemidin, Ahmed Y. Jamal, Fadi S. Alakeel, Walid A. Alkeridy, Farjah H. Algahtani, Aamer Aleem

Saudi Medical Journal

Objective: To evaluate the prognostic impact of performance status, frailty, and treatment intensity on survival outcomes in a geriatric lymphoma cohort using a competing risk framework. In Saudi Arabia, despite a growing aging population, there is a lack of literature detailing frailty or survival dynamics for geriatric lymphoma patients.
Methods: We conducted retrospective cohort study in Tertiary center in Riyadh, Saudi Arabia. Geriatric patients (≥ 60 years) diagnosed with lymphoma during 2011–2024 were analyzed. Baseline demographics, laboratory parameters, pathology, and frailty status were extracted. Survival dynamics were modeled using cumulative incidence functions to isolate lymphoma-related mortality (LRM) from age-related competing …

Growth, Methodological Evolution, And Clinical Maturity Of Artificial Intelligence Research In Major Medical Journals, 2018–2025: A Longitudinal Bibliometric Study, Abdulraoof Alsaeedi, Norah Alqarni, Ibrahim Rozi, Mohamed Ibrahim

Saudi Medical Journal

Objectives: To quantify changes in the volume, methods, and clinical maturity of artificial intelligence (AI) and machine learning (ML) research in major medical journals from 2018 through 2025.
Methods: We conducted a longitudinal bibliometric study of PubMed-indexed records from 99 leading clinical and general medical journals. The search was conducted on July 2026. Records were deduplicated and classified as empirical AI/ML research, evidence synthesis, AI discourse, or unclassified. Empirical studies were categorized by model family and clinical maturity. Journal-year Poisson generalized estimating equations used total substantive publications as an offset and clustered observations by journal.
Results: Among 6,891 unique publications, …

Barriers To And Needs For The Implementation Of Artificial Intelligence In Radiation Therapy Planning In Saudi Arabia. A Cross-Sectional Survey, Abdulaziz Alshaikh, Ghadah Alqarni, Abdulaziz Alghamdi, Khalid Alrabiah, Nasser Al-Rajhi, Mohammed Aldehaim

Saudi Medical Journal

Objectives: To assess radiation oncology physicians' perceptions of artificial intelligence (AI) in radiation therapy planning in Saudi Arabia and identify barriers to and support needs for its implementation.
Methods: A cross-sectional online survey was distributed through the Saudi Association of Radiation Oncology email list to 142 physicians from April to May 2026. We analyzed responses using descriptive statistics and exploratory 2-sided Fisher exact tests comparing residents with nonresidents.
Results: Forty-three complete responses were analyzed (response rate: 30.3%). A total of 33 (76.7%) respondents agreed or strongly agreed that AI would improve planning accuracy and efficiency. Nineteen (44.2%) reported no workplace …

Artificial Intelligence Readiness Among Paramedics At The Saudi Red Crescent Authority: A Cross-Sectional Study, Mohammed Jamaan Alsahli

Saudi Medical Journal

Objective: To evaluate AI readiness among paramedics working within the Saudi Red Crescent Authority (SRCA) and examine demographic and professional characteristics related to their readiness.
Methods: This cross-sectional study was conducted among SRCA paramedics. Data were collected through a structured online questionnaire covering demographic and professional features and the validated Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS), which assesses four dimensions: Cognition, Ability, Vision, and Ethics. Comparisons between groups were performed with the Mann-Whitney U and Kruskal-Wallis tests, while correlations were assessed using Spearman's rank correlation, and a multiple linear regression model examined factors independently related to AI …

Artificial Intelligence In Gastrointestinal Precision Medicine: A Critical Appraisal Through The Lens Of Inflammatory Bowel Disease, Abdulrahman G. Alharbi, Abdulrahman A. Aljabri

Saudi Medical Journal

Artificial intelligence (AI) now supports many facets of gastrointestinal and hepatic care, from lesion recognition during endoscopy to the interpretation of large molecular datasets. This review first outlines AI's broader role across gastroenterology and hepatology, and then uses inflammatory bowel disease (IBD) as a case study for AI-assisted multiomics integration. The review applies a consistent evidentiary framework that distinguishes exploratory, retrospective, and prospective study designs. Retrospective genomic and image-based studies report promising discriminative performance for risk classification and lesion detection, but this evidence remains largely exploratory or retrospective, whereas prospective randomized evidence is currently strongest for AI-assisted endoscopic polyp detection. …

Efficacy And Safety Of Botulinum Toxin For The Treatment Of Psoriasis: A Systematic Review And Meta-Analysis, Rahaf A. Alothman, Hussein M. Alshamrani, Mishari T. Alrubaiaan, Ruba M. Alghanmi, Reshale A. Johar, Lina K. Almutairi, Mohammed H. Abduljabbar, Ahmed M. Baabdullah, Sultan S. Alfaer

Saudi Medical Journal

Objective: To evaluate the current literature on Botulinum toxin (BoNT) use in psoriasis treatment, focusing on efficacy and safety. Botulinum toxin, known for its neuroprotective effects, is a promising therapeutic agent for inflammatory skin diseases.
Methods: We searched electronic databases, including MEDLINE, Web of Science, and Google Scholar, from inception until March 2025 to identify randomized controlled trials and cohort studies in English that enrolled patients with psoriasis treated with BoNT injections over their lesions, reported outcomes related to the clinical question, and included raw numbers of outcomes.
Results: Of the 342 retrieved articles, 166 duplicates were removed. Screening of …

Association Of Kirsten Rat Sarcoma Viral Oncogene Homolog Mutation With The Prognosis Of Colorectal Cancer In Arab Countries And Saudi Arabia: A Systematic Review And Meta-Analysis, Mohammed Ageeli Hakami, Hassan Abdullah Albargy

Saudi Medical Journal

Objectives: To quantify the potential impact of Kirsten rat sarcoma (KRAS) mutation on survival outcomes in colorectal cancer (CRC) patients from Arab countries, particularly in Saudi Arabia. As a chief cause of cancer-associated mortality worldwide, CRC shows a rising incidence across Arab countries. Among molecular drivers, KRAS mutation plays a pivotal role in tumor initiation, resistance to therapies, and disease progression. Nonetheless, the prognostic influence of KRAS mutation in Arab populations remains inconclusive.
Methods: Key databases were searched to find appropriate publications. Eligible studies evaluated KRAS mutation’s association with overall survival (OS) in CRC patients from Arab nations. Hazard ratios …

Evaluating The Diagnostic Performance And Clinical Interpretability Of Explainable Ai (Xai) In Digital Histopathology: A Meta-Analysis Of Diagnostic Performance, Bandar S. Alshreef, Yousif A. Kariri

Saudi Medical Journal

Objective: To explore peer-reviewed research on the application of Explainable Artificial Intelligence (XAI) techniques for histopathology-driven cancer risk evaluation, and to address the limitations delaying its transition into routine clinical pathology practice (such as model reliability, clinical interpretability, and governance oversight).
Methods: We conducted a systematic review with quantitative meta-analysis of studies evaluating explainable artificial intelligence (XAI) in histopathology. Searches were performed in Web of Science, Scopus, PubMed, and Google Scholar through November 2025. Eligible studies were assessed for diagnostic performance, explainability approaches, and methodological quality. Of the 47 included studies, 9 provided sufficient quantitative data for meta-analysis. Post-hoc visual …

Machine Learning And Large Language Model Decision Support For Medication-Error Prevention Across The Medication-Use Process: A Systematic Review With Implications For Saudi Arabia, Emad A. Alsaleh, Maram J. Alnemer, Yousef H. A. Alhassan, Asaad A. A. Khalil, Mohammed A. Kaddoura, Azfar Athar Ishaqui, Muhammad B. Maqsood, Adnan Iqbal

Saudi Medical Journal

Objectives: Medication errors are a major source of preventable harm. We systematically reviewed workflow integrated artificial intelligence (AI) decision support (machine learning [ML], natural language processing, computer vision, and large language models [LLMs]) aimed at detecting, intercepting, or preventing medication errors, and considered implications for Saudi Arabia.
Methods: We searched MEDLINE (PubMed), Embase, Scopus, Web of Science Core Collection, IEEE Xplore, and the Cochrane Library for English language studies published from January 2010 to February 2026. Eligible studies used real clinical/pharmacy data and evaluated an AI component designed to prevent or detect medication errors across prescribing/order verification, dispensing, …

Baseline 18f-Fdg Pet/Ct-Derived Metabolic Parameters And Intratumoral Heterogeneity In Relation To Survival In Bone Sarcomas ​, Hali̇m Özçevi̇k, Müge Öner Tamam, Meryem Eslem Bi̇çen Altin, Cüneyt Tamam, Merve Nur Acar Tayyar, Mehmet Mesut Sönmez

Turkish Journal of Medical Sciences

Background/aim: This study assessed correlations between intratumoral heterogeneity, survival outcomes, and baseline 18F-FDG PET/ CT-derived semiquantitative metabolic parameters and histological subtype in patients with bone sarcomas.

Materials and methods: We retrospectively analyzed 44 patients with biopsy-proven bone sarcomas who underwent baseline 18F-FDG PET/CT before treatment. Total lesion glycolysis, metabolic tumor volume, heterogeneity indices (HI1, HI2, HI3), and semiquantitative standardized uptake parameters (SUVmax, SUVmean, SUVpeak, and SUVmin), all derived from the primary tumor, were examined. SUVmin and SUVmax AUCs were compared using the DeLong test. Kaplan–Meier survival analysis, Cox regression, correlation analysis, and ROC analysis were used to assess associations with …

Lactulose Hydrogen Breath Test Findings In Children And Adolescents With Duodenogastric Reflux And Suspected Small Intestinal Bacterial Overgrowth: A Pilot Study ​, Hati̇ce Yilmaz Dağli, Zafer Şahi̇n, Dudu Duygu Ci̇van, Reha Artan, Aygen Yilmaz

Turkish Journal of Medical Sciences

Background/aim: This study aimed to identify small intestinal bacterial overgrowth (SIBO) in children and adolescents with persistent symptoms of duodenogastric reflux disease (DGRD).

Materials and methods: Patients aged 5–18 years who were diagnosed with DGRD between 2021 and 2023 were identified. Patients with two or more of 10 symptoms suggestive of SIBO (nausea, vomiting, weight loss, diarrhea, fatigue, joint pain, bloating, depression, acne rosacea, malnutrition) underwent lactulose hydrogen breath testing (LHBT).

Results: A total of 112 patients with DGRD were identified. Seven patients who could not be reached via the telemedicine method were excluded from the study. LHBT was not …

Is The 2d:4d Ratio Different In Patients With Dupuytren’S Disease Compared With The Normal Population? ​, Mustafa Yasi̇n Hati̇poğlu, Tevfi̇k Onur Özdemi̇r

Turkish Journal of Medical Sciences

Background/aim: The second-to-fourth digit (2D:4D) ratio is commonly used as an indirect marker of prenatal androgen exposure, although its biological validity is limited. Evidence of its relationship with Dupuytren disease is scarce. This study compared the radiographic 2D:4D ratios of patients with Dupuytren disease with those of a control group and examined whether the association differed by sex.

Materials and methods: Included in this retrospective observational study were 81 patients with Dupuytren disease and 82 age-comparable controls who contributed 101 and 122 hand measurements, respectively. The phalangeal lengths of the second and fourth digits were measured from hand radiographs and …

Delta Lactate-To-Albumin Ratio Predicts Major Complications In Patients With Cytoreductive Surgery And Hyperthermic Intraperitoneal Chemotherapy ​, Aytaç Polat, Selcuk Gulmez, Deni̇z Avan, Azi̇z Serkan Senger, Orhan Uzun, Mursi̇t Di̇ncer, Nuri̇ Havan, Erdal Polat, Mustafa Duman

Turkish Journal of Medical Sciences

Background/aim: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) imposes substantial physiological stress and carries a high risk of major postoperative complications. This study aimed to evaluate the predictive value of the delta lactate-to-albumin ratio (ΔLAR) for major complications following CRS/HIPEC.

Materials and methods: This retrospective cohort study evaluated 150 consecutive adult patients undergoing CRS/HIPEC. Δ-Lactate was calculated as the difference between arterial lactate levels measured before general anesthesia induction and at the end of surgery. ΔLAR was calculated by dividing Δ-lactate by serum albumin measured at 6–9 h postoperatively. Major postoperative complications were defined as Clavien–Dindo grade ≥III complications within …