Maimonides Medical Center is a non-profit, non-sectarian hospital located in Borough Park, in the New York City borough of Brooklyn, in the U.S. state of New York. Maimonides is both a treatment facility and academic medical center with 711 beds, and more than 70 primary care and sub-specialty programs. As of August 1, 2016, Maimonides Medical Center was an adult and pediatric trauma center, and Brooklyn's only pediatric trauma center.
Platelet-rich plasma (PRP) is increasingly used in orthopedic and spine surgery for its regenerative and anti-inflammatory effects, yet its clinical efficacy as an adjunct to percutaneous endoscopic lumbar discectomy (PELD) remains uncertain. A systematic search was performed in PubMed, Scopus, Cochrane Library, and Google Scholar through September 2025. Five comparative studies involving 479 patients met the inclusion criteria. Extracted outcomes included postoperative pain (VAS for low back and leg pain), functional recovery (ODI and JOA scores), MRI-based structural measurements obtained both preoperatively and postoperatively (Pfirrmann grading, intervertebral disc height, and spinal canal cross-sectional area), as well as recurrence rates. PRP demonstrated significant benefits in early postoperative pain control, with lower VAS scores for low back pain (p < 0.001) and leg pain (p < 0.001) at 3 months. Improvements in low back pain persisted at 6 months (p = 0.003), while leg pain became borderline and no longer statistically significant (p = 0.05). Functional recovery also favored PRP, with higher clinician-assessed JOA scores at 3 and 6 months (p = 0.02 and p < 0.001) and improved patient-reported ODI scores at both time points (p < 0.001). MRI-based outcomes indicated greater postoperative spinal canal expansion (p < 0.001), better preservation of intervertebral disc height (p = 0.002), and less progression in Pfirrmann degenerative grading (p < 0.001). PRP was additionally associated with a significantly reduced rate of recurrent lumbar disc herniation (p = 0.007). PRP appears to enhance both clinical and structural outcomes when used as an adjunct to PELD, contributing to improved pain relief, functional recovery, and postoperative disc integrity. While promising, these findings highlight the need for larger high-quality studies to refine PRP protocols and confirm long-term effectiveness.
The purpose of this study was to compare perioperative outcomes between dialysis-dependent and non-dialysis patients undergoing multilevel lumbar fusion. The National Inpatient Sample (2016–2022) was queried for adults undergoing elective multilevel lumbar fusion. Dialysis dependence was identified using ICD-10-CM codes. Demographic, clinical, and hospital characteristics were compared between groups using survey-weighted analyses. Multivariable logistic regression examined the independent association between dialysis status and complications, non-routine discharge, and inpatient mortality. Significance was set at the P < 0.05 level. Among 459,360 weighted admissions, 840 (0.18
Gastric cancer remains a significant health burden, especially in Asia. Potassium-competitive acid blockers (P-CABs) provide stronger acid suppression than proton pump inhibitors (PPIs), but their long-term impact on metachronous gastric cancer (MGC) remains unclear. This study evaluated the incidence and duration-dependent risk of MGC in P-CAB/PPI users. This multicenter retrospective cohort study included patients from 15 institutions in Japan who underwent endoscopic or surgical resection for gastric cancer between 2014 and 2022. After exclusions, 7172 patients who had received H. pylori eradication were analyzed. Chronic use of P-CAB/PPI was defined as administration for more than 3 months. The primary outcome was the incidence of MGC. Cox regression models were used, along with subgroup analyses based on duration and initial treatment type (endoscopy versus surgery). During a median follow-up of 5.8 years, MGC developed in 342 patients. The incidence was highest among P-CAB users (20.9 per 1,000 person-years), followed by PPI users (13.5) and non-users (7.1). Both P-CAB and PPI use were independently associated with increased MGC risk (hazard ratio 3.89 and 1.75, respectively). The association between P-CAB use and MGC was stronger with longer durations of use (hazard ratio 3.44 for < 1 year, 3.95 for 1–3 years, and 9.36 for > 3 years) and was particularly evident in the post-endoscopic group (hazard ratio 4.22) in subgroup analyses. Chronic use of P-CAB/PPI were associated with MGC. Longer duration may be associated with increased risk of MGC. Further studies are warranted to validate these findings.
Very early onset inflammatory bowel disease (VEO-IBD) is a rare, severe condition with over 80 monogenic causes. These often resist conventional therapies, necessitating targeted treatments such as biologics and hematopoietic stem cell transplantation (HSCT). This study aimed to systematically review therapeutic outcomes. This systematic review followed PRISMA guidelines. We searched MEDLINE/PubMed, Web of Science, and Scopus (up to July 25, 2025) for studies on outcomes of targeted therapies in genetically confirmed monogenic VEO-IBD. Eligible studies included case reports, case series, and observational studies reporting remission, exacerbation, or mortality, with quality assessed using Joanna Briggs Institute checklists. Of 447 records, 62 studies (31 case reports, 21 observational studies, 10 case series) involving 355 patients were included. HSCT (4 studies) achieved survival rates of 64
Mediastinal radiation potentiates aortic stenosis and complicates its treatment. We compared the short and midterm-outcomes with transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with prior mediastinal radiation. Electronic databases were searched from inception through December 2024. Dichotomous outcomes were pooled as risk ratios (RRs), and continuous outcomes were pooled as mean differences (MDs) with respective 95% confidence intervals (CIs). Six observational studies were identified, including 2458 TAVR patients and 1873 SAVR patients. In the short-term, TAVR was associated with lower rate of mortality (RR: 0.54; 95% CI: 0.34-0.88), atrial fibrillation (RR: 0.31; 95% CI: 0.15-0.65), acute kidney injury (RR: 0.75; 95% CI: 0.59-0.95), bleeding (RR: 0.37, 95% CI: 0.33-0.42), and shorter length of hospital stay (MD: -4.30; 95% CI: -5.45 to -3.15). One-year mortality was comparable between the 2 groups (RR: 1.04; 95% CI: 0.50-2.13). This meta-analysis of observational studies of patients with prior mediastinal radiation demonstrated that TAVR was associated with better short-term outcomes compared to SAVR. While 1-year mortality appeared similar between the 2 interventions, this finding should be interpreted with caution. However, randomized controlled trials are needed to validate these findings.
