Background/Objectives: Glucagon-like peptide-1 receptor agonists are increasingly used worldwide for weight and hyperglycemia management. There is an ongoing debate on the presence of increased gastric residue, leading to complications such as aspiration and overall safety in patients receiving upper gastrointestinal endoscopy. We aimed to study the effect of GLP-RAs on endoscopy outcomes. Methods: We conducted a detailed search of online databases to select the studies which provided details of the effects of GLP-RAs on patients undergoing endoscopy. The outcomes of interest were odds of retained gastric content (RGC), aspiration risk, and aborted and repeated procedures. A random effect model was used to calculate the pooled odds of outcomes with a 95% CI. We further calculated the pooled odds of predictive factors associated with an increased rate of retained gastric residues in the study population. Results: We included 12 studies with a total of 105,515 patients, of which 32,144 were on GLP-1 RAs and 73,273 were in the control group. A total of 234 (0.73%) aspiration events in GLP-RA users were noted compared to 257 (0.35%) events in the control group. No increased odds (1.26, 95% CI 0.86–1.87, I² 34%) of aspiration were found in GLP-1 users compared to the non-GLP-1 group. Patients on GLP-1 RA had increased RGC compared to the control group (OR 6.30, 95% CI 5.30–7.49, I² 0%). The pooled odds of aborted (OR 5.50, 95% CI 3.25–9.32, I² 0%) and repeated procedures (OR 2.19, 95% CI 1.42–3.38, I² 0%) were significantly higher in GLP-1 RA users. Patients taking Tirazepatide had the highest percentage of RGC (18.9%), while exenatide users had the lowest rate (6.2%) of food retention. Patients undergoing concomitant colonoscopy were found to have significantly low pooled odds of RGC (OR 0.26, 95% CI 0.04–0.48). GLP-1 RAs use was independently associated with increased odds of RGC (3.91, 95% CI 3.21–4.62, I² 0%). The results were homogenous and stayed consistent in the sensitivity analysis. Conclusions: Although the odds of RGC and aborted procedures are high in the GLP-1 RAs group compared to the control, no significant difference in the odds of aspiration was found between the two groups. Simple measures such as a clear liquid diet for 24 h, as routinely set for patients undergoing colonoscopy, may reduce the risk of retaining gastric residue in these patient populations.

Obstructive sleep apnea (OSA), characterised by apnea or hypopnea, often presents with symptoms such as gasping or snoring. However, these symptoms can be nonspecific and are frequently overlooked, particularly in pregnant women, where they are often attributed to normal physiological adaptations, leading to underdiagnosis and negative maternal and fetal outcomes. This narrative review examines the implications of OSA during pregnancy, highlighting the importance of early screening and evaluating available treatment options. We reviewed various articles on PubMed and Google Scholar about the impact of OSA during pregnancy, screening methodologies, and treatment effectiveness. OSA often increases sympathetic activity along with immune dysfunction, resulting in adverse outcomes like gestational hypertension, preeclampsia, gestational diabetes, cardiomyopathy, depression, and higher rates of cesarean deliveries, while the fetus suffers from intrauterine growth restriction (IUGR), preterm births, and perinatal mortality. Various screening tools, such as the Berlin Questionnaire, Epworth Sleepiness Scale (ESS), STOP-BANG, and Wisconsin questionnaires, aid in early diagnosis. Treatment options include lifestyle modifications, positive airway pressure (PAP) therapy, either continuous (CPAP) or bilevel (BiPAP), hypoglossal nerve stimulation (HGNS), mandibular advancement devices (MAD), and maxillomandibular advancement (MMA) surgery, with CPAP being identified as the preferred treatment. To reduce adverse outcomes for both the mother and the fetus, early detection and treatment of OSA in pregnant women are essential. Increased awareness among expectant mothers, routine screening using validated questionnaires, and appropriate treatment selection can not only decrease fetal complications but also reduce the risk of long-term adverse effects of OSA on maternal health.

Objective: To examine the association between colorectal cancer (CRC) and cardiovascular disease (CVD), evaluating shared risk factors, treatment-related cardiac complications, and the need for multidisciplinary care approaches.Methods: This narrative review was based on a structured literature search of PubMed/MEDLINE, Embase, Scopus, and Google Scholar for articles published from database through March 2025. The search combined the keywords “colorectal cancer,” “colon cancer,” “cardiovascular disease,” “cardiotoxicity,” “atherosclerosis,” “gut dysbiosis,” “NF-κB,” “obesity,” and “cardio-oncology” using the Boolean operators “AND” and “OR.” Original studies, systematic reviews, meta-analyses, and relevant narrative reviews addressing shared risk factors, pathophysiological mechanisms, or treatment-related cardiac effects linking colorectal cancer and cardiovascular disease were eligible for inclusion. Titles and abstracts were screened for relevance, and the full texts of potentially eligible articles were then assessed against these criteria. Articles were excluded if they were not available in English, were conference abstracts without an accompanying full text, or did not directly address the colorectal cancer–cardiovascular disease relationship. The reference lists of retrieved articles were hand-searched to identify additional relevant studies. Given the narrative design of this review, a formal quality appraisal and quantitative (meta-analytic) synthesis were not undertaken.Results: Patients with colorectal cancer demonstrated significantly elevated cardiovascular disease risk compared to non-cancer populations, with prevalence increasing over recent decades. Key contributing factors included aging demographics, shared lifestyle risk factors (obesity, hypertension, insulin resistance), and overlapping pathophysiological mechanisms between both conditions. Chemotherapy-induced cardiotoxicity emerged as a major clinical challenge, frequently necessitating treatment modifications or interruptions. The presence of concurrent cardiac conditions complicated cancer treatment protocols, requiring careful balance between oncological efficacy and cardiovascular safety. Treatment delays due to cardiac complications were associated with suboptimal cancer outcomes.Conclusion: The bidirectional relationship between colorectal cancer and cardiovascular disease necessitates integrated care approaches. The rising prevalence of CVD in CRC patients, combined with treatment-related cardiac complications, underscores the critical need for multidisciplinary teams incorporating both cardiology and oncology expertise. Early cardiovascular risk assessment, proactive cardiac monitoring during cancer treatment, and collaborative care protocols are essential for optimizing patient outcomes. This cardio-oncology approach ensures comprehensive management of both conditions while minimizing treatment interruptions and maximizing therapeutic efficacy for improved patient survival and quality of life.

Background/Aims: Although endoscopic glue injection is the conventional first-line treatment for gastric variceal (GV) bleeding, a large body of evidence supports the safety and effectiveness of endoscopic ultrasound (EUS)-guided coil and glue injections. We compared the safety and efficacy of these two modalities.Methods: A random-effects model was used for the pooled estimates. The outcomes of interest were the odds of technical success, GV obliteration, adverse events, rebleeding, reintervention, and pulmonary embolization (PE).Results: Eight studies involving 659 patients (EUS-guided coil+glue, n=200; endoscopic glue, n=459) were included in the meta-analysis. The rebleeding (odds ratio [OR], 0.28, 95% confidence interval [CI], 0.16–0.51; I2=0%) and reintervention (OR, 0.28; 95% CI, 0.15–0.52; I2=0%) rates were significantly lower in the EUS-guided coil+glue. EUS-guided coil+glue group had higher rates (OR, 4.56; 95% CI, 2.04 –10.19; I2=30%) of GV obliteration after the first session. No difference in the odds of technical success (OR, 2.03; 95% CI, 0.50–8.22; I2=0%), adverse events (OR, 1.19; 95% CI, 0.44–3.20; I2=45%), abdominal pain (OR, 1.17; 95% CI, 0.36–3.82; I2=44%) fever (OR, 1.09; 95% CI, 0.41–2.92; I2=0%), PE (OR, 0.52; 95% CI, 0.19–1.47; I2=0%) and all-cause mortality (OR, 0.67; 95% CI, 0.32–1.40; I2=0%) was identified.Conclusions: EUS-guided coil and glue injections are safe and effective for the treatment of gastric varices.