Incisional hernia is the most common postoperative complication of abdominal wall surgery that significantly increases morbidity. We aimed to evaluate recurrence rates and perioperative outcomes associated with Laparoscopic and open repair for Incisional hernia recurrence. A comprehensive and systematic literature search was conducted across PubMed, Embase, CINAHL Ultimate, Medline, Scopus, and the Cochrane Controlled Trials Register. Studies published between July 2013, and November 2024 were screened for inclusion. The data extracted included recurrence rates, surgical complications, bowel injury, and outcomes. Pooled risk ratios (RR) were calculated to compare the outcomes of Laparoscopic repair and Open repair. Statistical analysis was performed using STATA V17 using a random-effects model. A total of 15 randomized controlled trials (RCTs), encompassing 1502 patients from nine countries, met the eligibility criteria. The analysis revealed no significant difference in recurrence rates between LR and OR. However, LR was associated with a significantly lower likelihood of wound drainage (RR=0.07, 95% CI: 0.04-0.15) and a reduced risk of postoperative infection (RR=0.31, 95% CI: 0.17-0.55) compared to OR. Conversely, the risk of bowel injury (RR=2.80, 95% CI: 1.15-6.80, p=0.02), indicating that patients undergoing LR were nearly three times more likely to experience bowel injury than those undergoing OR. Laparoscopic repair of incisional hernias offers several advantages over open repair, including lower rates of wound infection. However, it is associated with a higher risk of bowel injury, necessitating careful patient selection and surgical expertise.

The MTHFR C677T polymorphism and protection against Legg-Calvé-Perthes disease in children: an updated systematic review and meta-analysis.

This is an update of a Cochrane review published in 2012 of initiation of antihypertensive monotherapy or step-up therapy in people with untreated mild hypertension (systolic blood pressure 140 to 159 mmHg or diastolic blood pressure 90 to 99 mmHg, or both) and no pre-existing cardiovascular disease. The original review demonstrated no difference in the incidence of all-cause mortality, total cardiovascular events (stroke, myocardial infarction, and congestive heart failure), stroke incidence, coronary heart disease, or withdrawal due to adverse effects (WDAEs). Evidence for antihypertensive pharmacotherapy in people with mild hypertension for primary prevention remains uncertain in the literature with conflicting studies. We therefore performed an update of the original Cochrane review to reassess whether initiation of antihypertensive pharmacotherapy compared to placebo or no treatment in people with untreated mild hypertension and no pre-existing cardiovascular disease reduces the risk of all-cause mortality, total cardiovascular events, stroke, coronary heart disease, or WDAEs. To reassess the efficacy and risks of initiating antihypertensive pharmacotherapy in adults with untreated mild hypertension and no pre-existing cardiovascular disease. The primary objective was to reassess the risk of all-cause mortality and total cardiovascular events (defined as fatal and non-fatal strokes, myocardial infarction, and congestive heart failure). The secondary objectives were to reassess the risk of stroke (fatal and non-fatal), coronary heart disease (fatal and non-fatal myocardial infarction and sudden cardiac death), and WDAEs. We searched the Cochrane Hypertension Specialised Register, CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform from inception to June 2024. We included randomized controlled trials (RCTs) of at least one-year duration comparing initiation on antihypertensive monotherapy or step-up therapy, or both, versus placebo or no treatment in participants with mild hypertension and no pre-existing cardiovascular disease. Our critical outcomes were all-cause mortality and total cardiovascular events. Important outcomes were stroke, coronary heart disease (fatal and non-fatal myocardial infarction and sudden cardiac death), and WDAEs. Two review authors assessed risk of bias independently and in duplicate using Cochrane's RoB 1 tool. Two review authors performed title and abstract screening, full-text review, and data extraction independently and in duplicate. We calculated risk ratio (RR) along with 95% confidence interval (CI) for all-cause mortality, total cardiovascular events, stroke events, coronary heart disease events, and WDAEs with the Mantel-Haenszel test and a fixed-effect model. We assessed the certainty of the evidence using the GRADE approach. We included individual patient data from five trials involving a total of 9124 participants, of whom 4593 received antihypertensives and 4531 received placebo or no treatment. All five trials reported all-cause mortality; four trials reported total cardiovascular events and strokes; three trials reported coronary heart disease; and one trial reported WDAEs. There may be little to no reduction in all-cause mortality (RR 0.85, 95% CI 0.64 to 1.14; 5 trials, 9124 participants; low-certainty evidence), total cardiovascular events (RR 0.93, 95% CI 0.69 to 1.24; 4 trials, 7292 participants; low-certainty evidence), or coronary heart disease (RR 1.12, 95% CI 0.80 to 1.57; 3 trials, 7080 participants; low-certainty evidence). There may be a decreased risk of stroke (RR 0.41, 95% CI 0.20 to 0.84; 4 trials, 7292 participants; low-certainty evidence) and an increase in WDAEs (RR 4.80, 95% CI 4.14 to 5.57; 1 trial, 17,354 participants [aggregate trial-level data; individual patient data unavailable]; low-certainty evidence) with antihypertensives. We downgraded the certainty of evidence for all outcomes due to imprecision, indirectness, and risk of bias. In people with untreated mild hypertension and no pre-existing cardiovascular disease, initiation of antihypertensive monotherapy or step-up therapy may not reduce all-cause mortality, total cardiovascular events, or coronary heart disease compared to those who received placebo or no treatment. There may be a reduction in stroke, but possibly also an increase in WDAEs. CIHR Grant to the Hypertension Review Group and British Columbia Ministry of Health Grant to the Therapeutics Initiative. Protocol (2007): doi.org/10.1002/14651858.CD006742. Original review (2012): doi.org/10.1002/14651858.CD006742.pub2.

The use of research biobanks and databases often involves prolonged storage of data, meaning that an increasing amount of deceased participants' data is being used in research. Research participants are not always informed of the intent to continue using their data post-mortem, and using such data affects the privacy of decedents and their surviving relatives. It is therefore important to assess the perspectives of interest-holders in this respect, considering the rapid progress of big-data technologies, new privacy regulations in the EU and unprecedented data sharing during the COVID-19 pandemic. This paper aimed to update a systematic review by Bak etal., to investigate the views of interest-holders on post-mortem data sharing in research. This systematic review followed the same search strategy and inclusion criteria as the previous review, focusing on new empirical evidence on the views of interest-holders regarding the post-mortem sharing or re-use of genetic or health data of research participants, from studies published in 2019-2025. It is reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRIMSA) statement. Findings of included studies were narratively synthesized. The updated systematic review identified seven studies involving 2151 participants, which were of high quality. The main themes of these studies related to perceived acceptability of post-mortem data sharing, aspects of consent (including broad consent), sharing clinical findings with relatives, and barriers and facilitators to data sharing. The findings illustrate that post-mortem genetic and health-related data use remains a relatively under-explored subject, with evident gaps in legislation and guidance.

Many survivors of childhood brain tumors face long-term adverse health outcomes like obesity. Uncertainties surround the effect of interventions to manage obesity-related outcomes in survivors of childhood brain tumors. The goal of this updated systematic review and meta-analysis was to provide the best estimate of the treatment efficacy of pharmacotherapy intervention on anthropometric outcomes in this pediatric population. We searched CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, PubMed, ClinicalTrials.gov, and ProQuest for articles published from January 1, 2015, to January 31, 2025. A meta-analysis was performed using the generic inverse-variance method in RevMan 5.4. Heterogeneity was assessed using the Cochrane Q test and the I2 statistic. We used the GRADE approach to determine the certainty of evidence. A total of six studies met the inclusion criteria: four newly identified studies published after January 1, 2015 (125 participants), and two from the previously published review (23 participants). The pooled estimate showed no significant change in body mass index z-score after intervention (mean difference = -0.02; 95% CI: -0.06 to 0.02, I2 = 0%; 4 studies, 94 participants; low certainty of evidence). Similar pooled effects were observed across other outcomes; however, individual studies reported significant changes in some outcomes within the treatment groups after the intervention. Pharmacological agents showed no significant change in anthropometric outcomes for survivors of childhood brain tumors. Further trials are needed to assess the efficacy of pharmacological agents and to identify subgroups most likely to benefit.

The optimal anesthetic technique during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) remains uncertain. General anesthesia (GA) provides airway protection and procedural stability, whereas conscious sedation (CS) offers faster workflow and the ability to monitor neurological status. This updated systematic review and meta-analysis (SRMA) aims to summarize and update the existing literature from randomized controlled trials (RCTs) to guide the selection of the most appropriate anesthetic technique during EVT for AIS. We searched the electronic databases of PubMed, ProQuest, and Scopus from their inception to October 17, 2025. No time or language restrictions were applied. Only RCTs were included. The SRMA protocol was registered with PROSPERO (ID: CRD420251170612) on 18th October 2025. Statistical analysis was performed using Review Manager software. Risk of bias (RoB) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were assessed. Of the 348 records screened, ten eligible RCTs were included. GA was associated with a significantly higher rate of successful reperfusion, but there was no difference in 90-day functional independence on modified Rankin scale (mRS) score, or mortality compared with CS. GA increased the risk of hypotension and prolonged the door-to-puncture time, but not other complications or process times. The RoB was low for most included studies. The certainty of evidence for study outcomes was moderate on GRADE. To conclude, GA has superior recanalization rates than CS, but functional outcomes and mortality are similar. Conversely, hypotension occurs more frequently with GA, while CS provides a faster workflow.

Transcranial magnetic stimulation (TMS) is a non-invasive technique to stimulate the brain, while electroencephalography (EEG) is a non-invasive technique to record its electrical activity. Their combined use (TMS-EEG) has been established only relatively recently, after successful development of TMS-compatible EEG amplifiers. TMS-EEG offers the unparalleled opportunity to directly perturb the brain with TMS and simultaneously record its response with EEG. This allows inferences on causal input-output relationships, therefore going critically beyond purely observational techniques, such as resting-state EEG or functional MRI, in the study of brain dynamics. This consensus review updates the work of Tremblay and coworkers [Clin Neurophysiol 2019; 130: 802-844]. Since then, substantial advances have been made in understanding contamination of TMS-EEG signals by physiological and non-physiological artifacts, as well as in developing strategies to avoid or control them. In parallel, new insights have emerged regarding the physiological mechanisms underlying TMS-EEG responses and their diagnostic and prognostic utility in a broad range of psychiatric and neurological disorders. As such, TMS-EEG is rapidly shaping a dynamic new field in clinical neurophysiology and neuroscience. This review provides a critical and comprehensive synthesis of current knowledge, including practical guidance for implementing TMS-EEG in the clinical setting.

Photodynamic therapy-induced inflammation and adverse effects: An updated review.

Zero- or minimal-fluoroscopy vs conventional fluoroscopy in catheter ablation of supraventricular tachycardias: An updated systematic review and meta-analysis.

Comparative efficacy and safety of clozapine and olanzapine in schizophrenia and related disorders: An updated systematic review.

Risk factors for urethrocutaneous fistula following primary hypospadias repair in children: A systematic review and meta-analysis.

Safety of paclitaxel-coated devices in patients with peripheral artery disease: an updated systematic review and meta-analysis of randomized controlled trials.

A histo-clinical score to predict evolution to radioactive iodine-refractory of the follicular cell-derived thyroid carcinoma (PREDIRAIR): a single-centre, prospective, cohort study.

Esophageal papillomas and human papillomavirus infection: A case series, scoping review and analysis.

Identifying cancer in the French National Health Data System (SNDS): an updated scoping review of algorithms, validation and applications.

Copper, cuproptosis and male reproductive health: An updated and narrative review.

Composite allotransplantation has become a viable reconstructive option for selected patients, but preservation remains a major barrier to broader clinical application. Static cold storage is the current gold standard, yet ischemia reperfusion injury and limited preservation times restrict its effectiveness. Recent advances in machine perfusion and subzero nonfreezing storage (or supercooling) have prompted renewed interest in optimizing graft viability. Following PRISMA guidelines, we systematically searched PubMed, EMBASE, and Cochrane, covering studies published from June 2022 to August 2025 for studies on ex vivo preservation of vascularized composite allotransplantations. Eligible articles included original studies in English evaluating postharvest, pretransplant preservation strategies. Data extracted were study design, preservation methods, perfusates, and primary outcomes. Risk of bias was assessed using SYRCLE for animal studies and Joanna Briggs Institute for human/cadaver studies. Seventeen studies met the inclusion criteria: 1 on static cold storage, 13 on machine perfusion, and 3 on supercooling. Static cold storage research has declined, with the only recent study investigating subnormothermic machine perfusion as a recovery adjunct. Machine perfusion studies focused on the optimization of perfusion parameters, perfusate composition, and circuit design. Red blood cell-based perfusates remained common, but alternative oxygen carriers such as polymerized hemoglobin-based oxygen carrier-201 and dextran oxygen microcarriers showed promise despite edema-related challenges. Supercooling studies demonstrated the feasibility of multiday preservation in rodent and porcine models. Overall, risk of bias was high or unclear across animal studies, mainly due to selection and performance bias, whereas the single human ex vivo study showed low risk of bias. The field of vascularized composite allograft preservation is expanding rapidly, with a combination of static and dynamic techniques emerging as a promising option to extend graft viability beyond the current limits. However, translation to clinical setting remains limited by small preclinical studies, methodological heterogeneity, and the paucity of functional endpoints. Standardized protocols, robust large-animal models, and eventual human feasibility trials are needed to establish clinically applicable preservation strategies.

Acupuncture for Parkinson's disease constipation: Updated meta-analysis and systematic review

Stable isotope measurement of in vivo nitric oxide production in health and disease: an updated systematic review and meta-analysis.

To analyze the safety and effectiveness of covered balloon-expandable (CBE) stent grafts for treatment of aortoiliac occlusive disease (AIOD) from publications between 2000 and 2024. A PubMed systematic literature review search was conducted to expand a previous review (2000-2019) and include publications between 2020 and 2024. Terms included balloon-expandable/expanding, iliac, and specific stent graft names. Study eligibility criteria included ≥5 patients with AIOD treated with CBE stents and reports of patency or freedom from target lesion revascularization (fTLR). Primary, primary-assisted, and secondary patency and fTLR rates at 1, 6, 9, 12, 24, 36, 48, and 60 months were analyzed. The search identified 252 records; 25 studies (29 publications) met eligibility, resulting in 1,983 patients included in the meta-analysis. The stent grafts included Advanta V12 Balloon Expandable Covered Stent/iCast Covered Stent System (Advanta V12/iCast; Getinge Maquet, Rastatt, Germany), GORE VIABAHN VBX Balloon Expandable Endoprosthesis (VBX Stent Graft; W. L. Gore & Associates, Inc. Flagstaff, Arizona), BeGraft Peripheral Stent Graft System and/or BeGraft Peripheral Plus Stent Graft (Bentley InnoMed GmbH, Hechingen, Germany), LifeStream Balloon Expandable Vascular Covered Stent (Becton Dickenson, Tempe, Arizona), iCover Stent Graft (iVascular, Barcelona, Spain), and mixed-device cohorts. Pooled stent graft primary patency rates at 12, 24, 36, 48, and 60 months were 91%, 85%, 81%, 79%, and 80%, respectively, and fTLR rates were 94%, 91%, 87%, 84%, and 85%, respectively. Primary patency was higher (P ≤ .05) for VBX Stent Graft than that for V12/iCast Stent Graft at 6 months (odds ratio [OR], 3.1), 12 months (OR, 2.2), and 24 months (OR, 2.8). The fTLR was also higher for VBX Stent Graft at 24 months (OR, 1.8; P = .042). This updated systematic review and meta-analysis and findings, although observational and not confirmatory, add to the body of evidence supporting the clinical utility of CBE stents in managing AIOD.