Introduction: The published studies comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure aortic regurgitation (AR) are conflicting. We conducted this systematic review and meta-analysis to compare TAVI with SAVR in pure AR. Methods: We searched PubMed, Embase, Web of Science (WOS), Scopus, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) from inception until 23 June 2023. Review Manager was used for statistical analysis. The risk ratio (RR) with a 95% confidence interval (CI) was used to compare dichotomous outcomes. Continuous outcomes were compared using the mean difference (MD) and 95% CI. The inconsistency test (I²) assessed the heterogeneity. We used the Newcastle-Ottawa scale to assess the quality of included studies. We evaluated the strength of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale. Results: We included six studies with 5633 patients in the TAVI group and 27,851 in SAVR. In-hospital mortality was comparable between TAVI and SAVR (RR = 0.89, 95% CI [0.56, 1.42], P = 0.63) (I² = 86%, P < 0.001). TAVI was favored over SAVR regarding in-hospital stroke (RR = 0.50; 95% CI [0.39, 0.66], P < 0.001) (I² = 11%, P = 0.34), in-hospital acute kidney injury (RR = 0.56; 95% CI: [0.41, 0.76], P < 0.001) (I² = 91%, P < 0.001), major bleeding (RR = 0.23; 95% CI: [0.17, 0.32], P < 0.001) (I² = 78%, P < 0.001), and shorter hospital say (MD = − 4.76 days; 95% CI: [− 5.27, − 4.25], P < 0.001) (I² = 88%, P < 0.001). In contrast, TAVI was associated with a higher rate of pacemaker implantation (RR = 1.68; 95% CI: [1.50, 1.88], P < 0.001) (I² = 0% P = 0.83). Conclusion: TAVI reduces in-hospital stroke and is associated with better safety outcomes than SAVR in patients with pure AR.

Background: Emergency cholecystectomy is the mainstay in treating acute cholecystitis (AC). In actual practice, perioperative prophylactic antibiotics are used to prevent postoperative infectious complications (PIC), but their effectiveness lacks evidence. We aim to investigate the efficacy of prophylactic antibiotics in emergency cholecystectomy. Methods: We searched PubMed, Embase, Cochrane CENTRAL, Web of Science (WOS), and Scopus up to June 14, 2023. We included randomized controlled trials (RCTs) that involved patients diagnosed with mild to moderate AC according to Tokyo guidelines who were undergoing emergency cholecystectomy and were administered preoperative and/or postoperative antibiotics as an intervention group and compared to a placebo group. For dichotomous data, we applied the risk ratio (RR) and the 95% confidence interval (CI), while for continuous data, we used the mean difference (MD) and 95% CI. Results: We included seven RCTs encompassing a collective sample size of 1747 patients. Our analysis showed no significant differences regarding total PIC (RR = 0.84 with 95% CI (0.63, 1.12), P = 0.23), surgical site infection (RR = 0.79 with 95% CI (0.56, 1.12), P = 0.19), distant infections (RR = 1.01 with 95% CI (0.55, 1.88), P = 0.97), non-infectious complications (RR = 0.84 with 95% CI (0.64, 1.11), P = 0.22), mortality (RR = 0.34 with 95% CI (0.04, 3.23), P = 0.35), and readmission (RR = 0.69 with 95% CI (0.43, 1.11), P = 0.13). Conclusion: Perioperative antibiotics in patients with mild to moderate acute cholecystitis did not show a significant reduction of postoperative infectious complications after emergency cholecystectomy. (PROSPERO registration number: CRD42023438755).

Background: Micro-ultrasound (micro-US; 29-MHz) offers real-time, high-resolution prostate imaging, but its stand-alone diagnostic accuracy remains uncertain. We synthesized prospective evidence to evaluate micro-US for classifying clinically significant prostate cancer (csPCa) using histopathology as the reference standard. Methods: We searched PubMed, Embase, Scopus, and Web of Science (inception–20 May 2025) for prospective studies assessing micro-US as an index test on a diagnostic pathway. Data were pooled using random-effects models on logit-transformed sensitivity and specificity, with an HSROC representation and model diagnostics. Subgroup and meta-regression analyses explored heterogeneity, including threshold (PRI-MUS) and spectrum effects. Clinical utility was appraised using Fagan nomograms and a likelihood-ratio scatter. Small-study effects were evaluated with Deeks’ test. Results: Five prospective studies met criteria. Pooled sensitivity was 0.84 (95% CI 0.65–0.94) and pooled specificity was 0.41 (95% CI 0.25–0.59), indicating moderate discrimination on HSROC. Secondary metrics were concordant (PLR 1.45, 95% CI 1.17–1.80; NLR 0.37, 95% CI 0.23–0.61; DOR 3.95, 95% CI 2.48–6.30). On a 25% pre-test probability, the Fagan nomogram showed modest shifts (~ 33% after a positive test; ~11% after a negative), supporting a triage/rule-out role. Heterogeneity was substantial and strongly influenced by threshold and clinical spectrum differences; subgroup and meta-regression suggested that spectrum-related factors were associated with lower specificity, whereas no covariate robustly altered sensitivity (exploratory given small k). Model checks were acceptable, and Deeks’ test showed no evidence of small-study effects ( p ≈ 0.70). Conclusion: As a stand-alone index test for csPCa classification, micro-US demonstrates high sensitivity but low specificity, yielding modest impact on post-test probability. These findings support micro-US as a complementary/triage (rule-out) adjunct, particularly when mpMRI is unavailable, contraindicated, or delayed, while highlighting the need for standardized PRI-MUS thresholds, reader training, and larger multicenter studies to refine specificity and clarify integration with MRI-based pathways.

Type 1 diabetes mellitus (T1DM) can lead to a severe and life-threatening complication called diabetic ketoacidosis (DKA). It is the leading cause of death in children with T1DM [1,2]. It is implic...