Psoriasis is a chronic immune-mediated inflammatory disease that extends beyond the skin and is increasingly recognized as a systemic disorder associated with multiple cardiometabolic comorbidities. Growing evidence indicates that patients with psoriasis, particularly those with moderate to severe disease, have an increased risk of cardiovascular morbidity and mortality, including myocardial infarction, stroke, atherosclerotic cardiovascular disease, and cardiovascular death. This narrative review summarizes the current evidence linking psoriasis with cardiovascular comorbidity, with emphasis on disease severity, systemic inflammation, psoriatic arthritis, pediatric psoriasis, and cardiovascular risk factors. The available literature suggests that mild psoriasis may not consistently increase cardiovascular event risk, whereas moderate to severe psoriasis is more frequently associated with adverse cardiovascular outcomes. Pediatric psoriasis has also been linked with obesity, hypertension, diabetes, arrhythmia, and other cardiovascular comorbidities. Shared inflammatory pathways, endothelial dysfunction, metabolic disturbances, and traditional cardiovascular risk factors appear to contribute to this association. These findings support the need to approach psoriasis as a systemic inflammatory disease requiring early cardiovascular risk assessment, lifestyle modification, and multidisciplinary management.
Background: Prostate cancer (PCa) is a biologically heterogeneous disease, with a subset of cases driven by hereditary germline alterations. Methods: Targeted germline sequencing using the Twist Fixed Panel was performed in nine high-risk PCa patients (median age 47; range 30–61). Variants were classified based on ClinVar, gnomAD, and in silico prediction tools. Results: Pathogenic and likely pathogenic variants in DNA damage repair (DDR) genes were identified, including BRCA2, BRIP1, PALB2, and BRCA1. A homozygous ATM variant was observed in one patient. Several ultra-rare variants in MLH3 and BARD1 were also detected. Most variants had allele frequencies <10-6. Conclusions: High-risk and early-onset PCa is associated with rare germline DDR alterations. These findings support expanded germline testing in younger patients and suggest potential relevance for precision oncology approaches, although functional validation is required..
Cardiac surgery-associated acute kidney injury (CSA-AKI) remains a frequent and clinically important complication after coronary artery bypass grafting, valve surgery, and complex aortic procedures. Its development reflects the interaction of pre-existing renal vulnerability with perioperative insults, including renal hypoperfusion, ischemia-reperfusion injury, systemic inflammation, oxidative stress, hemolysis, cardiopulmonary bypass-related injury, and nephrotoxic exposure. Conventional diagnostic markers, particularly serum creatinine and urine output, often identify AKI only after functional decline has occurred, limiting opportunities for early intervention. Novel biomarkers such as NGAL, KIM-1, cystatin C, and TIMP-2/IGFBP7 may improve early risk stratification, although their routine clinical implementation remains limited by cost, availability, and uncertainty regarding biomarker-guided treatment pathways. Current prevention and management strategies therefore rely primarily on early risk assessment, hemodynamic optimization, avoidance of nephrotoxins, careful fluid management, and timely renal support. Importantly, CSA-AKI is increasingly recognized as a continuum extending beyond hospitalization, with increased risks of chronic kidney disease, cardiovascular events, and long-term mortality. This review synthesizes current evidence on the mechanisms, diagnosis, prevention, management, and follow-up of CSA-AKI, while highlighting areas where stronger clinical evidence is still needed.
Introduction: Trauma is leading cause of morbidity and mortality worldwide, with major public health burden in Saudi Arabia. Although structured trauma systems improve outcomes internationally, their impact in the Kingdom remains insufficiently evaluated. This study assessed effect of trauma system implementation in the Alahsa Health Cluster. Methods: retrospective study was conducted at King Fahad Hospital, Level I trauma center in Alahsa, Saudi Arabia. Trauma registry data from the pre-implementation (2017–2018) and post-implementation (2022–2023) periods were analyzed. Eligible patients had an Injury Severity Score (ISS) ≥15 and hospital stay >24 hours. Variables included demographics, injury mechanism and site, length of stay, and in-hospital mortality. Comparisons were performed using chi-square and Mann–Whitney U tests. Multivariable logistic regression estimated adjusted odds ratios for mortality after adjustment for age, injury mechanism, and ISS. Results: total of 631 patients were included (mean age 31.8 years; 87.3% male). Crude in-hospital mortality declined from 19.0% (70/368) before implementation to 16.3% (43/263) afterward (p = 0.011). However, study period was not independent predictor of mortality after adjustment (AOR = 0.97, 95% CI: 0.45–2.10; p = 0.945). Independent predictors of mortality were ISS (AOR = 1.22; p < 0.001) and age (AOR = 1.04; p < 0.001). Motor vehicle accidents decreased from 58.4% to 41.6% (p < 0.001), with significant reductions in head, face, and neck injuries. Mortality decreased among adults but not children. Conclusion: Implementation regional trauma system was associated with reduction in mortality and favorable shifts injury patterns. However, multivariable analysis suggests that the observed improvement was primarily driven by variations in patient case-mix and baseline injury severity rather than a standalone systemic effect. These findings emphasize necessity of rigorous case-mix adjustment in trauma research and support integration of trauma registries, pediatric-specific pathways, and enhanced subspecialty coverage to consolidate improvements and guide national expansion under Vision 2030.
Titanium and titanium alloys are widely used in maxillofacial and reconstructive surgery because they combine mechanical strength, corrosion resistance, manufacturability, and long-term biocompatibility. Their applications include dental implants, mandibular reconstruction plates, titanium mesh, patient-specific implants, orbital reconstruction systems, cranial implants, zygomatic implants, and additively manufactured porous scaffolds. Although titanium provides reliable mechanical stability, its biological performance depends strongly on the surface–tissue interface rather than on bulk material properties alone. Surface chemistry, oxide-layer characteristics, roughness, wettability, and micro/nanotopography influence protein adsorption, osteoblast adhesion, macrophage phenotype, angiogenesis, bacterial adhesion, and osseointegration. This narrative review critically synthesizes current knowledge on surface-modified titanium scaffolds and implants for bone healing in maxillofacial and reconstructive surgery, with emphasis on biological mechanisms, clinical relevance, translational limitations, and future directions. The available evidence supports the concept that optimized titanium surfaces can promote osteogenesis, vascularization, osteoimmunomodulation, and antibacterial activity, but clinical translation remains limited by heterogeneous surface characterization, simplified preclinical models, and insufficient long-term clinical data.
