Background: Endovascular thrombectomy (EVT) improves functional outcomes at 90 days in patients with acute ischemic stroke (AIS) with large vessel occlusion (LVO). However, its long-term efficacy and safety beyond 90 days remain unclear. Objective: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of EVT plus best medical treatment (BMT) versus BMT alone beyond 90 days in patients with AIS and LVO. Methods: PubMed, Embase, and Cochrane Central databases were searched to identify randomized controlled trials (RCTs) comparing EVT plus BMT versus BMT alone in AIS patients with LVO. Primary outcomes included functional independence (mRS ≤2), independent ambulation (mRS ≤3), death or dependency (mRS 4–6), and all-cause mortality beyond 90 days. We applied a random-effects model and pooled risk ratios (RRs) along with 95% confidence intervals (CIs) using the Cochrane RoB2 tool for assessing risk of bias in randomized trials. Results: Seven RCTs with 2358 patients (56% males) were included. The mean age of the patients was 69.5 years and mean follow-up duration was 1.2 years. The results showed that EVT combined with BMT improved functional independence (mRS ≤2) (RR 2.08, CI: 1.55–2.80; P < 0.00001), independent ambulation (mRS ≤3) (RR 1.71, CI: 1.36–2.15; P < 0.00001), and quality of life (SMD 0.36; CI: 0.19–0.54; P < 0.00001) beyond 90 days compared to BMT alone. Moreover, the EVT plus BMT group also had a significantly reduced death or dependency (mRS 4–6) (RR 0.78, CI: 0.73–0.84; P < 0.00001) and all-cause mortality (RR 0.83, CI: 0.76–0.90; P < 0.0001) beyond 90 days than the BMT group. All RCTs were rated as having a low risk of bias. Conclusion: EVT combined with BMT significantly improves long-term functional outcomes and quality of life and reduces mortality in AIS patients with LVO compared to BMT alone.

Background and Objectives: Neonatal respiratory distress syndrome (NRDS), resulting from a deficiency of pulmonary surfactant (PS), can cause alveoli to collapse. Glucocorticoids reduce inflammation and are effective in reducing pulmonary swelling. This study aims to assess the effectiveness of the combination of PS and budesonide in the management of NRDS. Materials and Methods: Publications between 21 May and 24 November were screened through PubMed, Cochrane and Embase. Data analysis was performed on RevMan 5.3 software. Subgroup analysis was performed to evaluate the routes of administrations. Results: The use of budesonide along with pulmonary surfactant for treating NRDS revealed the following results: (1) a reduced duration of invasive mechanical ventilation (standardized mean difference (SMD) = −1.06, 95% confidence interval (CI) = −1.55 to −0.56, p < 0.0001); (2) reduced rate of bronchopulmonary dysplasia (BPD) occurrence (relative risk (RR) = 0.72, 95% CI = 0.60 to 0.86, p = 0.0003); (3) reduced duration for hospital admittance (SMD = −0.38, 95% CI = −0.64 to −0.11, p = 0.005). The occurrence of complications, i.e., sepsis, pneumothorax, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), rate of mortality, hyperglycemia and intraventricular hemorrhage (IVH), was not significantly different among the intervention and comparison group except for patent ductus arteriosus (PDA) and pulmonary hemorrhage, with their incidence being higher in the control group (p = 0.002 and p = 0.05, respectively). Conclusions: The combination of pulmonary surfactant and budesonide decreases the occurrence of BPD, duration of mechanical ventilation, length of hospital stay and risk of pulmonary hemorrhage and PDA. It does not increase the risk of complications and death and is clinically safe.

Background: Immune thrombocytopenia (ITP) is an autoimmune condition often managed with corticosteroids, intravenous immunoglobulins, or thrombopoietin receptor agonists. In settings where these therapies are inaccessible or contraindicated, dapsone an older antimicrobial agent with immunomodulatory effects has been proposed as an alternative, though its comparative effectiveness and safety profile remain inadequately defined. Objectives: This study systematically reviews and synthesizes existing data to assess the efficacy and tolerability of dapsone in adult patients with ITP. Methods: Following PRISMA guidelines, a literature search across PubMed, Embase, and Cochrane databases identified observational studies and interventional trials evaluating dapsone in ITP, including comparisons with standard treatments. Primary outcomes included complete and overall response rates, hemoglobin variation, relapse frequency, and adverse effects. Risk of bias was evaluated using the Newcastle–Ottawa Scale and Cochrane tools. Meta-analysis was conducted using RevMan and R (meta/metafor). Results: Four eligible studies encompassing over 270 patients were analyzed. The pooled complete response rate was 28%, while the overall response rate reached 47%. Dapsone use was associated with a modest decline in hemoglobin levels with a mean decrease of 1.74 g/dL, and relapse occurred in approximately 21% of patients. Adverse effects most commonly hemolytic anemia and methemoglobinemia were reported in 18% of patients, though generally not severe. Heterogeneity was explored through leave-one-out sensitivity analyses. Conclusions: Dapsone demonstrates moderate efficacy and an acceptable safety profile in adult ITP patients, especially in resource-limited contexts. While it may not match thrombopoietin agonists in preventing relapse, its low cost and oral administration offer practical advantages. Further large-scale randomized trials are warranted to clarify its role in ITP management.