Background: Drug-coated balloons (DCB) have emerged as a potential option for treating in-stent restenosis (ISR). We aimed to assess the efficacy and safety of DCB compared to uncoated balloons (UCB) for patients with ISR. Methods: We systematically searched Embase, MEDLINE, and Cochrane Library for randomized controlled trials comparing drug-coated balloons with uncoated balloons for coronary in-stent restenosis (ISR). Dichotomous and continuous outcomes were pooled using Revman 5.4 under a random-effects model. All the outcomes were assessed at a 6-month to 1-year follow-up period. Results: A total of 7 RCTs involving 1407 patients were included in our review. DCBs significantly reduced the rate of target lesion revascularization (TLR) (RR 0.28; 95% CI: 0.16, 0.48), target vessel revascularization (TVR) (RR 0.36; 95% CI: 0.14, 0.90), major adverse cardiovascular events (MACE) (RR 0.39; 95% CI: 0.26, 0.58), and MI (RR 0.56; 95% CI: 0.35, 0.91). However, no significant difference was observed between the two groups regarding all-cause mortality, cardiovascular mortality, and stent thrombosis. DCB significantly improved angiographic outcomes such as binary restenosis (RR 0.23; 95% CI: 0.12, 0.43), late lumen loss (MD −0.44; 95% CI: − 0.55 to −0.33), and percent diameter stenosis (MD −13.91; 95% CI: − 24.15 to −3.67) compared to the UCB group. Conclusion: Our meta-analysis showed that drug-coated balloons have superior efficacy and safety compared to uncoated balloons in coronary in-stent restenosis patients.

Background: Postoperative pain following laparoscopic cholecystectomy remains a major clinical concern, and the optimal method of local anesthetic delivery is unresolved. This systematic review and meta-analysis evaluated the efficacy and safety of laparoscopic-guided transversus abdominis plane (LTAP) block versus port-site local anesthetic infiltration for reducing pain, opioid use, and improving recovery in patients undergoing LC. Methods: This review was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and was prospectively registered on the International Prospective Register of Systematic Reviews (CRD420261344930). PubMed, Embase, and the Cochrane Library were searched from inception to March 2026, without language restriction, for randomized controlled trials (RCTs) comparing LTAP block with standard port-site local anesthetic infiltration in adults undergoing LC. Eligible studies were RCTs reporting at least 1 clinically relevant outcome (postoperative pain, operative time, shoulder pain, rescue analgesia, hospital stay, or discharge within 24 hours); observational studies, non-randomized designs, and reviews were excluded. Risk of bias was assessed independently by 2 reviewers using the Cochrane Risk of Bias 2.0 tool. Data were pooled using a random-effects model (Mantel-Haenszel method with DerSimonian-Laird estimation) in Review Manager version 5.4.1, with heterogeneity quantified using the I-squared statistic (heterogeneity measure). Results: Eight RCTs comprising 711 patients were included (LTAP unilateral in 2 studies, bilateral in 6). LTAP significantly reduced visual analogue scale pain scores at 1, 3, 6, and 24 hours compared with port-site infiltration, although heterogeneity was substantial for some outcomes and was reduced following sensitivity analyses. No significant differences were found between groups in operative time, shoulder pain, rescue analgesia, postoperative nausea and vomiting, or discharge within 24 hours, with a modest reduction in hospital stay favoring LTAP. Grading of Recommendations Assessment, Development and Evaluation certainty of evidence was high for pain at 1 and 3 hours, moderate for most secondary outcomes, and low for pain at 6 and 12 hours. Trial sequential analysis confirmed the reliability of the benefit for early pain relief and hospital stay, while several outcomes remained inconclusive. Conclusion: LTAP block provides superior early postoperative analgesia compared with port-site local anesthetic infiltration after laparoscopic cholecystectomy, with a modest reduction in hospital stay, although evidence for several secondary outcomes remains limited by heterogeneity and inconclusive trial sequential analysis.

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease known for its systemic inflammatory effects and associated comorbidities. Chronic obstructive pulmonary disease (COPD) has been increasingly recognized as a significant comorbidity in RA patients. This meta-analysis aims to quantify the prevalence and relative risk of COPD in patients with RA compared to the general population. Methods: A systematic search of PubMed, Embase, and Google Scholar was conducted until April 30th, 2024. Studies were selected based on predefined inclusion criteria, focusing on those reporting data on COPD in RA patients. Random-effects models were used to estimate pooled prevalence rate and risk ratios, along with 95% confidence intervals (CIs), to report the overall effect size. Statistical significance was set at P < .05. Statistical analyses were conducted using Review Manager and MedCalc software, with results pooled using the Mantel-Haenszel random-effects model. Heterogeneity was assessed using I ² statistics, and publication bias was evaluated using funnel plots, Egger regression, and Begg rank correlation tests. Results: Twenty-four studies with a combined population of 1,710,600 individuals were included. The pooled prevalence of COPD in RA patients was 7.06% (95% CI 4.56–10.13). Subgroup analysis showed a prevalence of 6.36% in Asia and 7.1% in the studies from the rest of the world. RA patients had a significantly higher risk of developing COPD compared to the general population, with an risk ratios of 1.58 (95% CI 1.37–1.82, P < .0001). The relative risk in Asian populations was 1.61 (95% CI, 1.19–2.18, P < .0001) compared to 1.56 (95% CI, 1.24–1.97, P < .0001) in studies from the rest of the world. According to Newcastle–Ottawa Scale, most studies were of high or moderate quality. According to Egger regression and Begg rank correlation tests, all analyses were free of publication bias. Conclusion: This meta-analysis offers strong evidence that individuals with RA are at a significantly higher risk of developing COPD. These findings emphasize the need for regular screening for COPD in RA patients and the implementation of proactive management strategies to reduce this risk. Further research is required to fully understand this relationship.