Rectal Indomethacin in Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: An Updated Meta-Analysis with Trial Sequential Analysis.

Background: Acute pancreatitis is a significant complication of endoscopic retrograde Cholangiopancreatography (ERCP) with no established prevention strategy. Recent studies suggest that rectal indomethacin may reduce the incidence of post-ERCP pancreatitis (PEP), but its effectiveness varies with patient risk levels and the concurrent use of pancreatic stenting. This updated meta-analysis evaluates the efficacy of rectal indomethacin in preventing PEP.

Comparative Efficacy of Mycophenolate Mofetil vs. Azathioprine in Autoimmune Hepatitis: A Systematic Review and Meta-Analysis.

Background: Azathioprine (AZA) is the standard treatment for both induction and maintenance of response in autoimmune hepatitis (AIH). However, lifelong administration is often required, and the combination therapy of prednisolone and azathioprine raises significant concerns regarding efficacy and tolerability, especially given the high relapse rates following AZA cessation. Consequently, there is a need to explore alternative treatment options.

Cost analysis of robot NICE procedure versus open, laparoscopic, and robotic colorectal surgery: is there an economic benefit to natural orifice resection?

Background: The robotic NICE procedure (Natural Orifice IntraCorporeal Anastomosis with Transrectal Extraction) has emerged as an innovative approach for left-sided colorectal resections. In this procedure, specimen extraction and completion of anastomosis are performed without abdominal wall incision, improving patient outcomes and potentially reducing healthcare costs.

Objective: This study aims to evaluate the cost-effectiveness of the robotic NICE procedure compared to open, laparoscopic, and robotic surgical approaches for left-sided colorectal resections.

PD-1/PD-L1 inhibitors in advanced, unresectable esophageal squamous-cell carcinoma: A meta-analysis of their effects across patient subgroups.

Background: Advanced esophageal cell carcinoma (ESCC) is associated with poor survival outcomes. PD-1/PD-L1 inhibitors have been approved for the treatment of advanced ESCC. We aim to study PD-1/PD-L1 inhibitors across other variables in advanced ESCC, including data presented at the September 2024 FDA Oncologic Drugs Advisory Committee (ODAC) meeting.

Characteristics of early- versus late-onset esophageal adenocarcinoma: insights from the National Inpatient Sample 2016-2020.

Background: The incidence of early-onset esophageal adenocarcinoma (EAC) in adults aged <50 years is rising, yet remains under-investigated. This study compared demographic, clinical and socioeconomic predictors of early- vs. late-onset EAC using national hospitalization data.

ECCO consensus on management of Inflammatory Bowel Disease in low-and middle-income countries.

Background: The incidence and prevalence of inflammatory bowel disease [IBD] have increased significantly in low- and middle-income countries [LMICs] in recent decades. Managing IBD in these settings presents substantial challenges. This consensus aims to describe the epidemiology of IBD in LMICs and to highlight the key challenges in its diagnosis and treatment.

Anti-IL 12/23 versus Anti-Tumor Necrosis Factor-α in Patients with Biologically Naïve Crohn's Disease: A Systematic Review and Meta-analysis.

Introduction: Crohn's disease (CD) is a chronic inflammatory condition of the digestive tract, characterized by a noncontinuous pattern of transmural inflammation, leading to a significant decline in quality of life and productivity. For biologic-naïve patients, anti-tumor necrosis factor (TNF)-α and anti-interleukin (IL)-12/23 therapies are commonly recommended. This study compares anti-IL-12/23 and anti-TNF-α for clinical remission, corticosteroid-free remission, endoscopic remission, and endoscopic response in biologic-naïve patients.

Diagnostic performance of SHOX2 and RASSF1A gene methylation assays in malignant pleural effusion: A systematic review and meta-analysis.

Background: Malignant pleural effusion (MPE) is a common complication of advanced malignancies, requiring differentiation from benign pleural effusion for appropriate management. Cytology and biopsy have limitations, necessitating more sensitive, less invasive diagnostic techniques. The objective of this study was to evaluate the diagnostic accuracy of methylated SHOX2 (short-stature homeobox 2) and RASSF1A (Ras association domain family member 1A) genes in detecting MPE.

Prognosis of Nonagenarian ICU Patients A Bayesian analysis of prospective European studies.

Background: As the population ages, the number of very elderly patients (≥ 90 years, nonagenarians) admitted to intensive care units (ICUs) is increasing. This trend raises concerns about the appropriateness of ICU care for this age group, especially due to the uncertainty surrounding their prognosis. Some studies suggest that elderly ICU patients have outcomes similar to slightly younger patients, but skepticism remains due to clinical judgment, cultural attitudes, and resource allocation concerns.

Assessing the learning curve in robot-assisted intracorporeal colorectal anastomosis and transrectal extraction (NICE) procedure: from Initial Learning to Mastery.

The robotic NICE procedure is a novel minimally invasive approach in colorectal surgery, yet its learning curve remains undefined; this study aimed to define its distinct phases by analyzing operative time trends. A retrospective review of 170 consecutive NICE procedures performed by a single surgeon between May 2018 and August 2019 was undertaken. Skin-to-skin operative time was the learning curve surrogate and plotted with unadjusted and risk-adjusted cumulative sum (CUSUM) analyses.

Outcomes of intended temporary stomas in Crohn's disease (INTESTINE study): international, multicentre, retrospective study.

Background: Patients with ileocolic Crohn's disease often require surgery that can result in temporary stoma formation. Stomas are associated with a morbidity and can negatively impact quality of life. This study aimed to investigate the short-term (6-month) and mid-term (18-month) outcomes of intended temporary stomas in patients with Crohn's disease.

Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage: The Global Burden of Disease Study 2021.

Importance: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure.

Objective: To estimate the worldwide burden of SAH.

TreatmENT of AnastomotiC LeakagE after colon cancer resection: the TENTACLE - Colon study.

Background: Anastomotic leakage (AL) is a common and severe complication after colon cancer resection, but studies investigating various treatment strategies and factors influencing outcomes are scarce.

Objectives: (1) To identify predictive factors associated with 90-day mortality and 90-day Clavien-Dindo grade 4-5 complications amongst patients who developed AL following colon cancer resection with subsequent development and validation of prediction models, and (2) to explore and compare the effectiveness of various treatment strategies for AL following colon cancer resection, adjusting for type of index surgery, different leak entities and patient factors.

Methods: The TENTACLE - Colon is an international multicentre retrospective cohort study.

Efficacy of Semaglutide and Other GLP-1 Agonists in Patients with Heart Failure With Preserved Ejection Fraction and Obesity: A Systemic Review and Meta-Analysis.

Semaglutide, a novel drug, has shown potential benefits for heart failure with preserved ejection fraction (HFpEF) and obesity in early trials. This study aims to evaluate the efficacy and safety of semaglutide and other glucagon-like peptide-1 (GLP-1) agonists in HFpEF patients with obesity. A comprehensive electronic search was conducted on October 18, 2024, using PubMed, Scopus, Web of Science, Embase, and Cochrane.

Comparative diagnostic performance of [68 Ga]Ga-FAPI PET/CT and [18 F]FDGPET/CT in biliary tract cancers: a systematic review and meta-analysis.

Background: Biliary tract cancers (BTCs) are aggressive malignancies with poor prognosis due to late-stage diagnosis. While [18 F]-FDG PET/CT is widely used for detection and staging, its sensitivity for certain BTC subtypes is limited, prompting the evaluation of 68 Ga-FAPI PET/CT as a promising alternative.

Objective: To compare the diagnostic performance of [68 Ga]Ga-FAPI PET/CT and [18 F]FDG PET/CT in detecting BTCs, including primary tumors, lymph node involvement, and distant metastases.

Ventilation practices in acute brain injured patients and association with outcomes: the VENTIBRAIN multicenter observational study.

Purpose: Current mechanical ventilation practices for patients with acute brain injury (ABI) are poorly defined. This study aimed to describe ventilator settings/parameters used in intensive care units (ICUs) and evaluate their association with clinical outcomes in these patients.

Methods: An international, prospective, multicenter, observational study was conducted across 74 ICUs in 26 countries, including adult patients with ABI (e.

Comparative Efficacy and Safety of Low-Dose Direct Oral Anticoagulants Versus Dual Antiplatelet Therapy Following Left Atrial Appendage Occlusion in Patients With Nonvalvular Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Background: Left atrial appendage occlusion (LAAO) is an alternative to chronic oral anticoagulation (OAT) for stroke prevention in nonvalvular atrial fibrillation (NVAF) patients with contraindications to OAT. Postprocedure antithrombotic therapy (ATT) is essential to reduce the risk of device-related thrombosis (DRT), but the optimal regimen remains uncertain.

Aims: This study aims to compare the safety and efficacy of low-dose direct oral anticoagulants (DOACs) versus dual antiplatelet therapy (DAPT) following LAAO.

Essential components and validation of multi-specialty robotic surgical training curricula: a systematic review.

Introduction: The rapid adoption of robotic surgical systems has overtook the development of standardized training and competency assessment for surgeons, resulting in an unmet educational need in this field. This systematic review aims to identify the essential components and evaluate the validity of current robotic training curricula across all surgical specialties.

Methods: A systematic search of MEDLINE, EMBASE, Emcare, and CINAHL databases was conducted to identify the studies reporting on multi-specialty or specialty-specific surgical robotic training curricula, between January 2000 and January 2024.

Mortality, functional outcome and health-related quality of life in patients with necrotizing skin- and soft tissue infections in the ICU: Protocol of a multinational prospective cohort study (SKIN-ICU).

Background: Necrotizing soft tissue infections (NSTI) are rare and life-threatening bacterial infections characterized by necrosis of subcutaneous tissue, fascia, or muscle. Few prospective studies have been conducted. The primary objective is to assess the 90-day mortality rate and to identify prognostic factors in patients with NSTI in an international setting.

Oxygenation improvement and duration of prone positioning are associated with ICU mortality in mechanically ventilated COVID-19 patients.

Background: Prone position has been diffusely applied in mechanically ventilated COVID-19 patients. Our aim is ascertaining the association between the physiologic response and the length of the first cycle of prone position and intensive care unit (ICU) mortality.

Methods: International registry including COVID-19 adult patients who underwent prone positioning.

Comparison of 12- to 24-Hour Versus 72-Hour Intravenous Terlipressin in Patients With Acute Esophageal Variceal Bleeding: A Systematic Review and Meta-analysis.

To compare the efficacy and safety of 12-24 hours versus 72 hours of intravenous terlipressin therapy in patients with acute esophageal variceal bleeding (AVB). A systematic search was conducted using PubMed, Scopus, Cochrane Library, Google Scholar, Web of Science, VHL, and ClinicalTrials.gov for studies published up to February 24, 2024.

Plasma transfusion in the intensive care unit.

Background: Current guidelines discourage prophylactic plasma use in non-bleeding patients. This study assesses global plasma transfusion practices in the intensive care unit (ICU) and their alignment with current guidelines.

Study Design And Methods: This was a sub-study of an international, prospective, observational cohort.

Contemporary assessment of short- and functional 90-days outcome in old intensive care patients suffering from COVID-19.

Purpose: There are limited data about the outcome of old intensive care (ICU) patients suffering from Covid-19 in the post-vaccination era. This study distinguishes the pre- and post-acute illness living conditions of ICU survivors from non-survivors.

Methods: This prospective international multicenter study included 642 old (≥ 70 years) ICU patients, including data ranging from pre-illness condition to functional 90-days follow-up.