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PurposeMethodsResultsConclusionCataract surgery is a common operation, typically carried out on older adults who have many comorbid medical conditions. Many of these patients may be undergoing aspirin therapy for diverse cardiovascular causes. Nevertheless, there is ongoing controversy regarding the administration of aspirin therapy during the perioperative period, as there are concerns regarding the risk of bleeding problems compared to thromboembolic events. Although aspirin is commonly used, there is no agreement on whether to continue or stop taking it before cataract surgery. This systematic review and meta-analysis attempt to assess the safety of continuing or discontinuing aspirin in the setting of cataract surgery.We conducted a systematic review and meta-analysis following PRISMA guidelines. Four databases were searched until January 25, 2024, for studies assessing the safety and efficacy of aspirin continuation or discontinuation before cataract surgery. The risk ratios (RR) of the extracted data and their 95% confidence interval (95% CI) were pooled using RevMan 5.4 software. We registered our protocol in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42024529986).We included nine studies with a total of 65,196 patients comprising various study designs and global populations. The analysis revealed a significant increase in subconjunctival hemorrhage risk with aspirin continuation (RR: 1.74, 95% CI: 1.22, 2.50, p = .002). However, the risk of hyphema, retrobulbar hemorrhage, vitreous hemorrhage, intraocular pressure spike, corneal edema, posterior capsule rupture, and visual acuity changes did not significantly differ between aspirin continuation and discontinuation or aspirin and placebo groups.Although the use of aspirin before cataract surgery raises the likelihood of subconjunctival bleeding, it does not increase the risk of potentially sight-threatening bleeding events. We recommend continuation of aspirin in patients undergoing cataract surgery. [ABSTRACT FROM AUTHOR]

Objectives To investigate dual-energy computed tomography's (DECT) diagnostic performance in detecting neurological complications following endovascular therapy (EVT) of acute ischaemic stroke (AIS). Methods We performed the literature search using Web of Science, Scopus, PubMed, EBSCO, and Science Direct databases for published related studies. The selected studies estimated the validity of DECT in the detection of neurological complications after EVT for AIS. Study quality assessment was performed utilizing the Quality of Diagnostic Accuracy Studies-2 Tool. Our meta-analysis calculated the pooled sensitivity, negative likelihood ratio, specificity, and positive likelihood ratio for each detected complication. The summary receiver operating characteristics (sROC) curve was utilized to estimate the area under the curve (AUC). Results Of 22 studies, 21 were included in the quantitative synthesis. In the detection of intracerebral haemorrhage (ICH), DECT pooled overall sensitivity and specificity were 69.9% (95% CI, 44.5%-86.8%) and 100% (95% CI, 92.1%-100%); whereas, in the detection of ischaemia, they were 85.9% (95% CI, 80.4%-90%) and 90.7% (95% CI, 87%-93.5%), respectively. On the sROC curve, AUC values of 0.954 and 0.952 were recorded for the detection of ICH and ischaemia, respectively. Conclusions DECT demonstrated high accuracy and specificity in the detection of neurological complications post-endovascular treatment of AIS. However, further prospective studies with a standardized reference test and a larger sample size are recommended to support these findings. Advances in knowledge DECT is a rapid and valid imaging tool for the prediction of ICH and cerebral ischaemia after the EVT of AIS. [ABSTRACT FROM AUTHOR]

The international healthcare community has encountered several difficulties because of the COVID-19 pandemic brought on by SARS-CoV-2. COVID-19 can lead to an abnormal immune response that features excessive inflammation, so targeting the vagus nerve through non-invasive vagus nerve stimulation (nVNS) may hold promise as an intervention. This meta-analysis aimed to examine the outcomes of using nVNS on different inflammatory biomarkers in COVID-19 patients. Up until May 2023, we performed a review of online databases. We included randomized controlled trials (RCTs) that discussed how nVNS affected patients with COVID-19's clinical outcomes. Using the Revman 5.4 software (Cochrane, London, United Kingdom), a meta-analysis was carried out to find the pooled mean difference (MD), with 95% confidence intervals (CIs), of nVNS effects on different inflammatory biomarkers, including interleukin-10 (IL-10), C-reactive protein (CRP), IL-6, and cortisol levels. The review included four RCTs involving 180 COVID-19 patients. Following nVNS treatment, there was a significant increase in IL-10 levels (MD = 1.53, 95% CI: 0.77, 2.29; p < 0.001). CRP levels (MD = -2.24, 95% CI: -4.52, 0.05; p = 0.06), IL-6 levels (MD = 4.07, 95% CI: -3.16, 11.32; p = 0.27), cortisol levels (MD = 1.45, 95% CI: -11.67, 14.57; p = 0.83), and D-dimer levels (MD = -0.47, 95% CI: -1.31, 0.38; p = 0.28) did not differ significantly. These findings suggest that nVNS may positively impact certain inflammatory markers in COVID-19 patients, suggesting that nVNS could be a beneficial adjunctive treatment., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Taha et al.)