Background: ChatGPT, a powerful AI language model, has gained increasing prominence in medicine, offering potential applications in healthcare, clinical decision support, patient communication, and medical research. This systematic review aims to comprehensively assess the applications of ChatGPT in healthcare education, research, writing, patient communication, and practice while also delineating potential limitations and areas for improvement. Method: Our comprehensive database search retrieved relevant papers from PubMed, Medline and Scopus. After the screening process, 83 studies met the inclusion criteria. This review includes original studies comprising case reports, analytical studies, and editorials with original findings. Result: ChatGPT is useful for scientific research and academic writing, and assists with grammar, clarity, and coherence. This helps non-English speakers and improves accessibility by breaking down linguistic barriers. However, its limitations include probable inaccuracy and ethical issues, such as bias and plagiarism. ChatGPT streamlines workflows and offers diagnostic and educational potential in healthcare but exhibits biases and lacks emotional sensitivity. It is useful in inpatient communication, but requires up-to-date data and faces concerns about the accuracy of information and hallucinatory responses. Conclusion: Given the potential for ChatGPT to transform healthcare education, research, and practice, it is essential to approach its adoption in these areas with caution due to its inherent limitations.

Introduction: Diabetes Mellitus (DM) is a significant global health concern, with Type 2 DM (T2DM) being highly prevalent. Glucagon-Like Peptide 1 receptor agonists (GLP-1RA), such as Danuglipron, offer potential benefits in T2DM management. This meta-analysis examines the safety and efficacy of Danuglipron, focusing on adverse outcomes and glycemic parameters. Methods: A systematic search was conducted in PubMed, Scopus, and Cochrane Library for RCTs involving Danuglipron till August 2023, following PRISMA guidelines. The Cochrane risk-of-bias tool was used for quality assessment. Adverse outcomes (diarrhea, nausea, vomiting, headache, decreased appetite, dyspepsia, dizziness) and glycemic parameters like changes in HbA1C, fasting plasma glucose (FPG), and body weight were analyzed. Results: Four RCTs published from 2021 to 2023 were included. Both doses of Danuglipron were associated with diarrhea (RR=2.66, 90% CI: 1.32 to 5.35, p=0.02), nausea (RR=5.5, 90% CI: 3.4 to 8.88, p< 0.00001), and vomiting (RR=5.98, 90% CI: 2.93 to 12.23, p=0.0001). The 120mg dose showed decreased appetite (RR=3.46, 90% CI: 1.57 to 7.62, p=0.01), dyspepsia (RR=4.04, 90% CI: 1.93 to 8.43, p=0.002), and dizziness (RR=5.08, 90% CI: 1.45 to 17.82, p=0.03). Reductions in HbA1C (SMD − 1.09, 90% CI − 1.39 to − 0.8, p < 0.00001), FPG (SMD − 1.10, 90% CI − 1.46 to − 0.75, p < 0.00001), and body weight (SMD − 1.08, 90% CI − 1.42 to − 0.74, p < 0.00001) were observed for both doses. Conclusion: Danuglipron demonstrates potential for glycemic control and weight reduction in T2DM. Adverse outcomes include diarrhea, nausea, vomiting, and decreased appetite, with dose-related effects. Clinicians must weigh benefits against side effects when considering Danuglipron for T2DM management.

Background: Kidney transplantation is a superior treatment for end-stage renal disease (ESRD), compared with hemodialysis, offering better quality of life and birth outcomes in women with ESRD and lower fertility rates. Objectives: To investigate the pregnancy, maternal, fetal, and graft outcomes following kidney transplantation in women with ESRD and evaluate the improvements in quality of life and associated risks. Design: A systematic review and meta-analysis performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology guidelines. Data Sources and Methods: A thorough search of multiple databases, including PubMed, Embase, Scopus, ATC abstracts, and Cochrane Central Register of Controlled Trials, was conducted to identify studies that analyzed pregnancy outcomes in kidney transplant patients. The search was conducted from the inception of each database to January 2023. Results: The study reviewed 109 studies that evaluated 7708 pregnancies in 5107 women who had undergone renal transplantation. Of these, 78.48% resulted in live births, 9.68% had induced abortion, and 68.67% had a cesarean section. Miscarriage occurred in 12.54%, preeclampsia in 20.87%, pregnancy-induced hypertension in 24.30%, gestational diabetes in 5.08%, and preterm delivery in 45.30% of cases. Of the 853 recipients, 123 had graft loss after pregnancy and 8.06% suffered acute rejection. Conclusion: Pregnancy after kidney transplantation is associated with risks for mother and fetus; however, live births are still possible. In addition, there are reduced overall risks of stillbirths, miscarriages, neonatal deaths, and gestational diabetes. Registration: PROSPERO (CRD42024541659).

Introduction: Malignant neoplasms of bone and articular cartilage, although rare, are associated with substantial morbidity and mortality, posing a serious health burden. Understanding the trends in mortality related to these cancers is crucial for developing targeted interventions and improving patient outcomes. This study aims to analyze long-term mortality trends, identify demographic and geographic disparities, and uncover potential factors driving changes in mortality rates. Methods: This retrospective study analyzed mortality rates among individuals aged 65 and older from 1999 to 2020 using CDC WONDER death certificate data, abstracting demographics, geographic factors, and urban/rural status. Results: From 1999 to 2020, 18,205 adults aged 65 and older died from malignant neoplasms of bone and cartilage. The age-adjusted mortality rate (AAMR) started at 20 per 100,000 in 1999 and steadily declined until 2012 (APC: −1.12). However, from 2012 onwards, there was a notable reversal, with the AAMR rising sharply to 23.8 by 2020 (APC: 4.73). Men had higher mortality rates than women, with NH Black individuals showing the highest rates among races. Southern states and nonmetropolitan areas had elevated AAMRs, suggesting targeted interventions for better outcomes and lower death rates. Conclusion: The findings highlight significant inequities, with Southern states and nonmetropolitan areas showing elevated age-adjusted mortality rates (AAMRs). These geographic disparities underscore the urgent need for targeted public health interventions in these regions to improve cancer outcomes and reduce mortality. Addressing these gaps is essential for achieving more equitable health outcomes, particularly in high-risk populations.

Background: Small vessel coronary artery disease presents challenges in percutaneous coronary intervention due to higher restenosis rates with traditional treatments. Drug-coated balloons (DCBs) offer a potential alternative, but their efficacy compared to drug-eluting stents (DES) remains debated. This meta-analysis aims to provide updated insights into the comparative outcomes of DCBs versus DES in small coronary artery disease. Main text: Following PRISMA guidelines, a systematic review identified seven randomized controlled trials (RCTs) comparing DCBs with DES for small vessel CAD. Data were extracted and pooled for analysis, assessing outcomes including target lesion revascularization (TLR), target vessel revascularization (TVR), mortality, myocardial infarction (MI), stent/vessel thrombosis, and major adverse cardiovascular events (MACE). Statistical analysis was performed using RevMan version 5.4, employing random-effects models and forest plots with odds ratios (OR) and 95% confidence intervals (CI). Among 1,808 patients across seven RCTs, no significant difference was found in TVR between DCB and DES over 3 years (OR = 0.95, 95% CI [0.58, 1.54], p = 0.82). While initial analyses favoured higher TLR incidence in DES, the trend shifted towards DCB over time, with a non-significant association favouring DCB at 3 years (OR = 0.51, 95% CI [0.26, 1.00], p = 0.05). DCB use was associated with significantly higher rates of MACE and MI at the 3-year mark (MACE: OR = 0.55, 95% CI [0.38, 0.79], p = 0.001; MI: OR = 0.35, 95% CI [0.17, 0.7], p = 0.003), while mortality rates converged between the two interventions over time. Vessel thrombosis rates were similar between DCB and DES. Conclusions: While DCBs may offer comparable efficacy to DES in terms of TVR and TLR over shorter durations, there is a concerning trend towards higher rates of MACE and MI associated with DCB use at the 3-year mark. Further research with larger sample sizes, longer follow-up durations, and consistent inclusion criteria is needed to elucidate the optimal treatment strategy for small vessel CAD. Until then, DES may be considered a safer option for managing small vessel CAD.