Digital Commons Network^™

Transjugular Intrahepatic Portosystemic Shunt (Tips) Outcomes For Variceal Hemorrhage During And After Covid-19: Racial, Payer, And Income Disparities - A National Retrospective Cohort Study With Stratified Sensitivity Analyses, Nakul Ganju, Shubham Gupta, Sahak Hovsepian, Samay Shah, Shaunak Ganju, Farshad Aduli

Student Papers, Posters & Projects

BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) reduces mortality in esophageal variceal hemorrhage. Whether the COVID-19 pandemic worsened existing disparities in outcomes among patients undergoing TIPS remains unclear. We aimed to characterize racial, payer-based, and income-based disparities in post-TIPS outcomes before and after the COVID-19 pandemic.

METHODS: Using the 2016-2022 National Inpatient Sample, we conducted a retrospective cohort analysis of 31,860 weighted hospitalizations of adults with cirrhosis and esophageal variceal hemorrhage who underwent TIPS. Admissions were stratified as pre-COVID (2016-2019) and post-COVID (2020-2022). Primary outcomes were in-hospital mortality, length of stay, and total hospital charges. Multivariable regression models with …

Healthcare Provider's Perceptions Of Family Values When Making End-Of-Life Care Decisions For Their Children: Developing And Implementing A Survey Tool., Nithya Sivakumar, Stephanie Kukora, Cherie Ginwalla, Satyan Lakshminrusimha, Jennifer Rosenthal

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Healthcare providers help families navigate end-of-life care decisions in the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU); however, limited studies exist regarding what values providers perceive families utilize when in these situations.

OBJECTIVE: To evaluate providers' perceptions of values that families considered when making end-of-life care decisions for their child.

DESIGN: Develop a novel survey tool to understand providers' perceptions of values families considered when making end-of-life care decisions for their children and distribute the survey tool to providers in a single quaternary care children's hospital within a university hospital.

METHODS: The novel survey tool …

Impact Of Middle Meningeal Artery Embolization Timing On Chronic Subdural Hematoma Resolution And Functional Outcomes, Bluyé Demessie, Muhammed Amir Essibayi, Hamza Adel Salim, Alireza Karandish, Nathan Farkas, Deepak Khatri, Neil Haranhalli, Amanda Baker, Richard Zampolin, Allan L Brook, Seon-Kyu Lee, Nimer Adeeb, James Grist, Fulvio Zaccagna, Yan-Lin Li, Davide Simonato, Diego Alejandro Ortega, Nicole Cancelliere, Jose Danilo Diestro, Dhairya Lakhani, Joseph Carnevale, Craig Schreiber, Atakan Orscelik, Zachary Abecassis, Spencer Raub, Georgios Sioutas, Giancarlo Salsano, Svetlana Kvint, Andrew Falzon, Vance Cantrell, Brian Holliday, Jefferson Abaricia, Pedram Maleknia, Leonardo Cruz-Criollo, Samantha Schimmel, Basel Musmar, Matthew Alexander, Jorge Rios Zermeno, Koul Prateeka, Ahmed Aljuboori, Dominik Vollherbst, Domagoj Gajski, Jared Cooper, Rahim Abo Kasem, Sami Al Kasab, Alejandro Spiotta, Fawaz Al-Mufti, Vladimir Kalousek, Markus Möhlenbruch, Luca Scarcia, Clemens Schirmer, Thien Huynh, Rabih Tawk, Fabio Settecase, Stavropoula Tjoumakaris, Pascal Jabbour, Kunal Vakharia, Mario Zanaty, Santiago Ortega-Gutierrez, Jesse Jones, Marco Colasurdo, Hussein Nasser, Sri Hari Sundararajan, Pascal Mosimann, Erez Nossek, Eytan Raz, Lucio Castellan, Bruno Del Sette, Caterina Michelozzi, Davide Saraceno, Pietro Panni, Visish Srinivasan, Jan-Karl Burkhardt, Gaultier Marnat, Pietro Mario Santini, Michael Levitt, Giuseppe Lanzino, Waleed Brinjikji, Jared Knopman, Tareq Kass-Hout, Julian Spears, Thomas Marotta, Max Wintermark, Vitor Mendes Pereira, Maurizio Fuschi, Adam Dmytriw, David Altschul

Department of Neurosurgery Faculty Papers

BACKGROUND AND PURPOSE: Chronic subdural hematoma (cSDH) affects approximately 20 per 100,000 individuals annually, with surgical recurrence rates of 10-20%. Middle meningeal artery embolization (MMAE) has emerged as a promising minimally invasive treatment, but the optimal timing remains unclear. We evaluated the association between MMAE timing and radiological and functional outcomes in cSDH.

METHODS: We conducted a retrospective multicenter international cohort study across 33 centres, including patients who underwent MMAE for cSDH between January 2018 and December 2024. Patients were stratified by timing from diagnosis: Q1 (≤1 day), Q2 (2 days), Q3 (3-6 days), and Q4 (>6 days). The …

Dosimetric Impact Of Replacing An Anterior Field With A 3d Conformal Anterior Partial Arc In Thoracic Spine Palliative Radiotherapy, Camri Garretson

Masters Projects

Purpose: Palliative radiotherapy is commonly used for the treatment of thoracic spine metastases; however, conventional beam arrangements can expose nearby organs at risk (OAR), including the heart, to unnecessary radiation dose. This study evaluated whether replacing a static anterior beam with a conformal anterior arc could reduce cardiac dose while maintaining adequate target coverage.

Methods: Fifteen thoracic spine treatment plans were retrospectively replanned using an experimental technique in which the static anterior beam from the original plans was replaced with a 3D anterior conformal arc. All other planning parameters, including beam geometry, wedges, and multi-leaf collimator margins (MLC), were kept …

Drivers Of Professional Satisfaction In Emergency Medicine Residency Training In The Us, Arvin Radfar Akhavan, Kirstin Woody Scott, Patrick Hewes, Erin Kinney, Boris Pavic, Josh Simmons, Michelle Lall, Michael Gottlieb, Yvette Calderon, Dave Lu

Department of Emergency Medicine Faculty Papers

BACKGROUND: Physician wellness discussions often center on burnout and negative aspects of clinical practice. Less is known about what brings professional satisfaction to physicians, particularly among emergency medicine (EM) residents. Understanding drivers of professional satisfaction is important for the future of the specialty as they may influence residents' career decisions. This study aimed to identify drivers of professional satisfaction among a national cohort of EM residents.

METHODS: We conducted a mixed methods study using a survey administered following the 2024 ABEM In-Training Examination to EM residents in ACGME-accredited programs. The single-item, free-text survey question asked: "List the top 3 drivers …

Efficacy Of Sirolimus Versus Paclitaxel-Coated Balloons For Coronary Revascularization: An Updated Meta-Analysis With Grade Assessment, Matthew Aldo Wijayanto, Christopher Daniel Tristan, Erlangga Masykur Kynaya, Annisa Aghnia Rahma, Putri Saskia Harimurti, Arwin Saleh Mangkuanom, Amir Aziz Alkatiri, Doni Firman, Bambang Budi Siswanto

Journal of the Saudi Heart Association

Drug-coated balloons are an emerging strategy for coronary revascularization. Despite their increasing use, the comparative efficacy of sirolimus- versus paclitaxel-coated balloons (SCB vs PCB) remains uncertain. This updated meta-analysis evaluated clinical and angiographic outcomes of SCB and PCB in percutaneous coronary intervention (PCI). A comprehensive search of PubMed, Scopus, and ScienceDirect was performed on August 28, 2025. Studies directly comparing SCB and PCB were included. The primary endpoint was target lesion failure (TLF), which was defined as cardiac death, target vessel myocardial infarction (TVMI), or target lesion revascularization (TLR). On follow-up angiography, secondary endpoints consisted of minimal lumen diameter (MLD), …

Association Between Trainee Involvement During Pediatric And Congenital Cardiac Catheterization And Procedural Outcomes., Natalie Jayaram, John A. Spertus, Kevin F. Kennedy, Andrew C. Glatz

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Participation in the cardiac catheterization laboratory is a requirement of cardiology fellowship training. We sought to determine whether trainee presence is associated with outcomes during pediatric and congenital cardiac catheterization.

METHODS: We identified catheterizations between January 2011 and September 2020 within the IMPACT (Improving Pediatric and Adult Congenital Treatment) Registry. Multivariable multilevel regression was used to determine the association between trainee presence and procedural outcomes.

RESULTS: Of 122 760 catheterizations at 107 academic hospitals, a trainee was present in 71 651 (58.4%) cases. Rates of major adverse events were similar between trainee and nontrainee cases (9.0% versus 8.0%). Contrast …

Serial Drilling Technique For Sequential Subtrochanteric Femur Fracture Fixation In Pediatric Osteopetrosis: A Technical Report., Adam Mansour, Josiah J Wolf, Ivan Slyepkan, Morgan Turnow, Michael Anderson, Anthony Wing, Jack Iandoli, Craig Goubeaux, Craig Smith, Allen Kadado

Surgery Articles

Pediatric osteopetrosis presents a significant technical challenge for fracture fixation due to the bone's dense yet brittle nature and frequently absent medullary canal. Traditional drilling methods risk excessive torque, drill-bit breakage, and iatrogenic fractures. Here, we describe a serial drilling technique for plate-and-screw fixation in a 5-year-old child with osteopetrosis who sustained sequential subtrochanteric femur fractures 8 months apart. By creating a small pilot hole, sequentially enlarging it with intermediate bits under copious irrigation, and inserting locking screws manually, we achieved stable fixation with no observed instrument failure or intraoperative complications. This method may provide a practical technical strategy for …

Beyond 72 Hours: A Retrospective Evaluation Of Factors Associated With Delayed Surgical Stabilization Of Rib Fractures., Alexis A Schweibinz, Clarisse Solis, Anna Michaud, John Dillis, Katherine A Graham, William B Devoe

OhioHealth Research Institute Articles

BACKGROUND: Surgical stabilization of rib fractures (SSRF) is recognized as a key intervention in reducing morbidity among patients with multiple displaced rib fractures or flail chest. Early SSRF, typically within 72 hours of admission, has been associated with improved outcomes. The factors contributing to delayed stabilization, defined as 72 hours or greater following admission, remain unclear.

METHODS: A retrospective cohort study was performed, evaluating 492 trauma patients who underwent SSRF at a level II trauma center. Patient demographics, injury characteristics, and associated injuries were analyzed to identify factors associated with delayed SSRF. Groups were defined as early (≤72 hours) and …

Pneumococcal Colonization In Pediatric Patients Undergoing Hematopoietic Cell Transplantation, Liset Olarte, Jennifer E Schuster, Ibrahim Ahmed, Kristina G Hulten

Faculty, Staff and Students Publications

Despite the increased risk of invasive pneumococcal disease among pediatric hematopoietic cell transplant (HCT) recipients, pneumococcal colonization has not been evaluated in this population. We prospectively assessed longitudinal pneumococcal colonization in 22 pediatric HCT recipients from conditioning therapy to 100 days post-HCT. A higher likelihood of pneumococcal colonization was observed in the late post-HCT period (weeks 9-14) compared with the early post-HCT period (weeks 1-8), with odds increasing with each additional week after conditioning.IMPORTANCEThis is the first study to longitudinally evaluate pneumococcal colonization in pediatric hematopoietic cell transplant (HCT) recipients from the onset of conditioning therapy to 100 days post-HCT. …

Al Kuwait Hospital Dubai, Emirates Health Services 1st Research Week 2025: Research Abstracts Of Clinical And Scientific Advances, Suad Hannawi, Linda Saf Eldin, Alaa Abuquta, Yusra Abdulrahman, Maryam Yaslam, Sabaa Saleh Al-Hemyari, Maimouneh Qazi, Noor Majed Al Mheiri, Ahmed Alamadi, Alia Aljasmi, Sondos Al Salmi, Maria Al-Salmi, Moza Aljamri, Ahmed Ibrahim Abdulrahman, Sharifa Alamadi, Haifa Hannawi

Saudi Medical Journal

No abstract provided.

The Outcome Of Thrombectomy Can Be Improved By Shortening The Door-To-Needle And The Onset-To-Door Time, Sounira Mehri, Josef Finsterer

Saudi Medical Journal

No abstract provided.

Provider-Reported Readiness Of Chronic Healthcare Services In Saudi Arabia Under The Health Sector Transformation Program, Aseel Aldhwaihi, Saad Alghanim

Saudi Medical Journal

Objective: To assess provider-reported readiness of chronic healthcare services in Saudi Arabia within the context of the Health Sector Transformation Program (HSTP), using a validated, context-specific assessment instrument. Methods: A national cross-sectional survey was conducted between November 2024 and February 2025 among 254 healthcare providers across 5 health regions and both public and private healthcare sectors. A 34-item instrument, informed by the Chronic Care Model (CCM) and adapted to the Saudi context, assessed 7 system readiness dimensions. Descriptive statistics, independent-samples t-tests, one-way analysis of variance, and Pearson correlation analyses were performed. Results: Overall system readiness was moderately positive. Health system …

Seasonal Variation Of Diabetic Ketoacidosis Among Children And Adolescents With Type 1 Diabetes: A Single-Center Tertiary Experience, Nour Gazzaz, Fajr A Saeedi

Saudi Medical Journal

Objectives: Diabetic ketoacidosis (DKA) seasonal variations among children and adolescents with type 1 diabetes mellitus (T1DM) have been widely studied; however, findings remain inconsistent. Although several studies reported a higher incidence during colder months, others showed no consistent patterns. This study investigated whether DKA frequency and severity vary across seasons, particularly in humid cities. Methods: This retrospective cohort analyzed children and adolescents with T1DM admitted to a tertiary hospital with DKA (2015–2025). Data included demographics, seasonal admission trends, clinical severity, and outcomes. Statistical analyses involved the Chi-square and ANOVA tests. Results: A total of 369 DKA cases …

Glp-1 Receptor Agonists And Sglt-2 Inhibitors In Diabetic Nephropathy: A Comparative Study, Sara Ghadeer Alghadeer, Sama Sami Kanfar, Zakiah Dheya Algallaf, Fatimah Mudhar Alfardan, Rana Alshammrany, Maha Farhat, Cyril Cyrus

Saudi Medical Journal

Objective: To investigate the effects of glucagon-like peptide-1 receptor agonist (GLP-1RAs) on renal function in type 2 diabetes mellitus (T2DM) patients and compared their efficacy to sodium-glucose co-transporter-2 inhibitors (SGLT-2i) in managing diabetic nephropathy. Methods: This is a retrospective cohort study conducted at King Fahad University Hospital, including 115 adults (≥ 18 years) with T2DM and baseline estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m², treated with GLP-1RAs or SGLT-2i for over 1 year. Patients on renal replacement therapy, nephrotoxic drugs, or with incomplete records were excluded. Data were analyzed with Jeffrey's Amazing Statistics Program; the significant value …

Investigating Medical Radiation Awareness Of Saudi Arabian Cardiologists In Catheterization Labs: A Survey Study, Abdulmajeed Alotaibi, Raseel Alsallum, Reemas Alotaibi, Ali M. Aldhebaib, Noha Althubaity, Oinam Gokulchandra Singh, Zyad M. Almutlaq, Abdulaziz M. Albaraikan, Winnie Philip, Abrar M. Al-Mutairi, Mostafa Alqarras, Basma Alrowailli, Abdulrahman Alkhulaifi, Dhaifallah Ziyad Alanazi

Saudi Medical Journal

Objectives: To assess the knowledge, attitudes, and practices of interventional cardiologists in Kingdom of Saudi Arabia (KSA) regarding occupational radiation safety. Occupational radiation exposure poses significant long-term health risks for interventional cardiologists. Understanding current safety knowledge and practices is essential for guiding improvement strategies. Methods: A multicenter, cross-sectional survey was administered across several cardiac centers in KSA. The survey evaluated radiation safety awareness, use of dosimetry monitoring, and adherence to protective measures among practicing interventional cardiologists. Results: The study identified notable gaps in radiation safety knowledge and considerable inconsistencies in dosimetry monitoring. Despite these shortcomings, participants demonstrated high compliance …

Awareness Of The Mediterranean Diet And Its Perceived Effect On Cardiovascular Health In The Western Region, Saudi Arabia, Abdullah M. Alharbi, Mohammed S. Alsaedi, Mutaz S. Alharbi, Faisal F. Almutairi, Adeeb M. Aloufi, Azzam M. Alharbi, Rakan D. Alsaedi, Hatim F. Alhejaili, Motasem M. Alyamani

Saudi Medical Journal

Objective: To increase awareness of mediterranean diet (MD) and its perceived effects on cardiovascular health, enhance knowledge and inform public health efforts aimed at improving the population's health outcomes of. The MD comprises heart-healthy eating patterns high in vegetables, legumes, nuts and seeds, and fruits. Methods: This cross-sectional study involved adult participants who were living in the Western region of the Kingdom of Saudi Arabia. The data were collected online through social media platforms, then cleaned, coded, and analyzed using Statistical Package for the Social Sciences, version 21 to generate key insights. Results: A total of 390 participants were included …

Early Initiation And Dual Patterns Of Cigarette And E-Cigarette Use Among Adults In The Eastern Province, Saudi Arabia: A Cross-Sectional Study, Haidar A. Alridha, Nora A. Alafif

Saudi Medical Journal

Objectives: To explore the early initiation of cigarette and e-cigarette use and the dual patterns of usage among adults in the Eastern Province of Saudi Arabia. Methods: A cross-sectional survey was conducted from December 2024 to February 2025 among adults living in the Eastern Province. An online self-administered questionnaire collected data on sociodemographic characteristics, smoking behaviors, age of initiation, dual-use patterns, and quit attempts. Convenience sampling was applied, and a total of 551 participants were included. Descriptive statistics summarized distributions of smoking behavior and initiation age. Pearson's Chi-square tests were used to examine associations between smoking status, age of initiation, …

Multidimensional Predictors Of Disease Severity And Health Outcomes In Patients With Sickle Cell Disease: A Data-Driven Clinical Insight, Hind A. Alzahrani, Ruba Omar Mohammed Almaghrabi, Raed Alharbi, Abdulaziz Saleh Alghamdi, Mohammad A. Albanghali, Hanan E. Alyahyawi, Abdulmohsen M. Alruwetei, Besma Garah, Mohammed Alzahrani, Samar Hassan Hjar, Sana Shaker

Saudi Medical Journal

Objectives: To describe the clinical, hematologic, and therapeutic characteristics of hospitalized adults with sickle cell disease (SCD) in the Al-Baha region and to identify factors that predict hospitalization as well as transfusion frequency. Methods: A retrospective observational analysis was conducted on 117 adults with confirmed SCD who were admitted to King Fahad Hospital-Al-Baha during 2022–2024. Demographic information, hematologic parameters, clinical features, hospitalization rate, transfusion history, and treatment protocols were collected from the electronic medical records. Statistical analyses (ANOVA, Kruskal-Wallis test, Chi-square tests, and Fisher's exact Test) were performed to compare between groups where applicable. Results: The cohort had a mean …

Dietary Fat Intake And Its Influence On The Association Between Liver Fat And Brain Choline Metabolism In Young Saudi Women, Halima S. Hawesa, Mansour E. Shanawani, Haya A. Alshegri, Mahasin G. Hassan, Amal I. Alorainy, Nouf A. Alroqaiba, Shanoo G. A. Sheikh

Saudi Medical Journal

Objective: Fat-rich nutrition may influence the neurochemical consequences of hepatic lipid accumulation. This study examined whether percent energy from fat modifies the association between liver fat and the brain (Cho/Cr) ratio in healthy young women. Methods: A total of 109 healthy Saudi women aged 18–25 years underwent brain magnetic resonance spectroscopy (¹H-MRS) to quantify Cho/Cr ratios. Liver fat was estimated using MRI-based proton density fat fraction (PDFF), and lipid intake was assessed using a validated food frequency questionnaire. Multivariable regression models tested the interaction between liver fat and fat-derived energy intake, followed by simple slopes analysis, regression …

Urinary Incontinence's Prevalence, Risk Factors, And Quality Of Life Impact On Working Women In Saudi Arabia, Ahmed Mansor, Hatim Tagalsir Osman Ali, Maha Ali, Arwa Abd Al Salam Ashry, Ghala Abdullah Alharbi, Khalid Albasheer, Omer Munder, Isam Mohamed Babbiker Ahmed

Saudi Medical Journal

Background: This study aimed to investigate the prevalence and severity of Urinary incontinence (UI) among working women in Saudi Arabia (SA), identify the associated demographic, lifestyle, medical, and obstetric risk factors, and assess its effect on quality of life and work productivity. The UI is a common underreported condition that affects women's daily functioning and life quality, particularly in the workplace. Methods: During 2025, 390 working women in SA who were at least 18 years old and from various work sectors participated in a descriptive cross-sectional survey. Data were gathered using a validated, structured questionnaire; statistical analysis was carried out …

Artificial Intelligence In Pharmaceutical Care: Transforming Drug Discovery, Development, And Patient-Care Delivery, Abdulrahman G. Alharbi, Abdulrahman A. Aljabri

Saudi Medical Journal

The integration of artificial intelligence (AI) into pharmaceutical care represents a paradigm shift in healthcare delivery, offering unprecedented opportunities to revolutionize medication management, accelerate drug development, and enhance patient outcomes. This comprehensive review synthesized evidence from global literature (2021–2025) examining AI applications across drug discovery and development, clinical trials optimization, medication therapy management, and pharmacy operations. The AI demonstrated prediction accuracies of 86–98% in drug discovery, 80% improvement in clinical trial recruitment efficiency, and 32.7% increase in medication adherence over standard care. The global AI drug discovery market, valued at \$1.5 billion (2023), is projected to reach \$11.8 billion by …

Emerging Strategies For Cardio-Renal Protection Beyond Raas Blockade: Emphasis On Non-Diabetic Ckd And Resistant Hypertension, Fahad S. Alrashidi

Saudi Medical Journal

Non-diabetic chronic kidney disease (ND-CKD) complicated by resistant hypertension remains a high-risk phenotype even when renin–angiotensin system blockade is optimized. This review synthesizes contemporary evidence for cardio-renal protection beyond traditional renin-angiotensin-aldosterone system inhibition (RAASi), with emphasis on mechanisms, clinical trial data, and pragmatic sequencing. Sodium–glucose cotransporter 2 inhibitors provide hemodynamic and tubular benefits that translate into renal and heart failure risk reduction in many patients with ND-CKD. Non-steroidal mineralocorticoid receptor antagonism (MRA) like finerenone targets inflammatory and fibrotic signaling and may add incremental benefit when potassium is proactively managed. The GLP-1 receptor agonists offer cardiometabolic advantages with emerging kidney signals, …

The Use Of Platelet-Rich Plasma For De Quervain's Tenosynovitis: A Systematic Review With Limited Meta-Analysis, Abdullah W. Abumadian, Mohanad I. Binibrahim, Abdurrahman H. Sultan, Mohammed A. Addas, Hattan Y. Bamagaus, Sultan K. Alhaddad, Motasem O. Bamabad, Bayan A. Ghalimah

Saudi Medical Journal

Introduction: De Quervain's tenosynovitis (DQT) is a painful wrist condition that impairs daily activities. Corticosteroid (CS) injections are commonly used for symptom relief, but their effects may diminish over time. Platelet-rich plasma (PRP) has emerged as a regenerative alternative that promotes tissue healing rather than merely suppressing inflammation. This systematic review and limited meta-analysis compare the efficacy and safety of PRP versus CS injections in DQT. A limited meta-analysis was chosen due to the high heterogeneity between studies (I² = 98.7%). Methodology: A comprehensive literature search identified six studies comparing PRP and CS injections. Pain and functional outcomes …

Healthcare-Associated Infection Causes And Mitigation Strategies: A Systematic Review, Mohammad Irfan, Nahed Alquwez

Saudi Medical Journal

Objective: To describe the landscape of healthcare-associated infections (HAI) and, in particular, to pay attention to the types of infection that are usually seen, the most common infectious agents involved and the effective prevention strategies. Methods: A detailed search was performed using Google and PubMed, and studies that exclusively addressed healthcare associated infections or their mitigation. Studies published since 2000 were included. Data from individual articles were extracted and categorized by study focus, type of infection, causes and contributing factors, and documented mitigation strategies. Editorials, reviews, case studies, meta-analyses, and systematic reviews were excluded. Results: The analysis showed that infections …

Clinical Outcomes Of Decompression Versus Decompression With Instrumented Fusion For Lumbar Spinal Stenosis Secondary To Degenerative Spondylolisthesis: A Systematic Review And Meta-Analysis, Lama N. Alqahtani, Ahmed K. Alzahrani, Razan A. Almutairi, Abdulaziz M. Salah, Shahad F. Khan, Mohammad G. Sindi, Khalid E. Fassi, Abdulrahman M. Alshami, Ibrahim A. Hakami

Saudi Medical Journal

Objective: To compare decompression alone with decompression with fusion in patients with degenerative lumbar spondylolisthesis. Methods: PubMed, Google Scholar, Ovid, and Web of Science databases were searched up to March 2025 for randomized controlled trials (RCTs). The primary outcomes were the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. The secondary outcomes included operative time, length of hospital stay, intraoperative blood loss, reoperation, complications, and cost. Pooled analysis was performed using a random-effects model in Review Manager following Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The quality of included randomized trials was evaluated using the …

Computed Tomography Findings Of Normal Appendix In Pediatric Population, Thanwarat Koonthong, Teerasak Phewplung*

Chulalongkorn Medical Journal

Background: Appendicitis remains the most common indication for emergency abdominal surgery in children. Computed tomography (CT) plays a vital role in the evaluation of pediatric patients with suspected appendicitis. Yet, there is limited of literature describing the normal appendiceal diameter in the pediatric Asian population.

Objectives: To characterize the normal pediatric appendix and to identify the variables that influence its diameter in pediatric patients aged one day to 18 years who underwent abdominal CT.

Materials and Methods: The study was approved by the IRB. We conducted a retrospective study of 358 children (≤18 years of age) who underwent abdominal CT …

Greater Weekly Exercise Volume Is Associated With Lower Prevalence Of Metabolic Comorbidities, Psychiatric Conditions, And Exertional Symptoms In Youth Athletes Undergoing Pre-Participation Screening: An Observational Study, Grace Qiu, Seong Kyu Kim, Douglas Corsi, Alexander G. Hajduczok, Imran Masood, Daniel Underberg, Brian Osler, Drew Johnson, David Shipon

Division of Cardiology Faculty Papers

INTRODUCTION: Physical activity has been associated with improved cardiovascular health outcomes in adults. However, the specific associations between physical activity volume and cardiovascular outcomes in youth athletes are less defined.

METHODS: This study analyzed data from the HeartBytes National Youth Database, compiled from Simon's Heart. Simon's Heart is a nonprofit organization that includes information from sports pre-participation examinations for adolescents. The dataset encompasses demographics, electrocardiogram (ECG) findings, and exercise-related symptoms. Youth athletes' self-reported weekly physical activity volume was classified into four levels: < 2 h, 2-5 h, 5-10 h, and >10 h, with less than 2 h taken as the reference group. Given the physical diMerences among athletes …

Clinical Outcomes After Ulnar Collateral Ligament Reconstruction With Palmaris Longus Versus Gracilis Autograft In Baseball Players: A Cohort Analysis, Michael C. Ciccotti, Brooks Martino, Frank Cautela, Nathaniel Tchangou, Daniel Kwak, Eric Didomenico, Harrison S. Fellheimer, Christopher C. Dodson, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

BACKGROUND: Ulnar collateral ligament (UCL) reconstruction (UCLR) is a common procedure for overhead athletes, particularly baseball players sustaining partial or full UCL tears. Palmaris longus (PL) and gracilis (GR) autografts are the most frequently used graft sources, yet limited data compare clinical outcomes in baseball athletes.

PURPOSE: To compare patient-reported outcomes after UCLR with PL versus GR autografts in baseball players.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent isolated UCLR with either PL or GR autograft and a minimum of 2 years of follow-up were identified. All reconstructions were performed using the Modified Jobe or …

Tranexamic Acid In High-Risk Shoulder Arthroplasty Patients: Safety Across Thromboembolic, Cardiac, Renal, And Neurologic Risk Profiles, Tarishi Parmar, Akin Adio, Asim Handy, Mohammad Daher, Alec Kellish, Adam Khan, Joseph A. Abboud

Rothman Institute Papers

INTRODUCTION: Tranexamic acid (TXA) effectively reduces blood loss and transfusion requirements in shoulder arthroplasty. However, concerns regarding thromboembolic, neurologic, cardiac, and renal complications have limited its use in medically high-risk patients. This study evaluated temporal trends and the safety of TXA in high-risk patients undergoing total shoulder arthroplasty (TSA).

METHODS: A retrospective cohort study was conducted using TriNetX, identifying patients who underwent shoulder arthroplasty (2012-2025). Patients were stratified by preexisting high-risk conditions, including prior thromboembolism, renal failure, atrial fibrillation, seizure disorders, and visual disturbances. Within each subgroup, patients receiving TXA were propensity score-matched to those who did not. Perioperative TXA …