Introduction: Post-tonsillectomy hemorrhage is a serious complication that varies according to the surgical technique used, potentially compromising patient safety and recovery. Even though several techniques were frequently used, including cold steel dissection, coblation, monopolar diathermy, and bipolar diathermy, there were certain discrepancies in hemorrhage rates in the literature. This meta-analysis aims to compare the rates of primary and secondary hemorrhage among these surgical techniques, with a focus on guiding clinical decision-making. Methodology: A total of 12 studies, published between 2005 and 2024, were selected from the PubMed, Web of Science, Scopus, and Cochrane Library databases, comprising 1684 participants from both pediatric and adult groups. Primary and secondary hemorrhage rates, surgical techniques, and study characteristics were extracted as data. Therefore, the aim of performing this meta-analysis with random-effects models was to calculate pooled estimates for hemorrhage rates and the heterogeneity index (I²). The techniques studied included cold steel dissection, coblation, monopolar diathermy, and bipolar diathermy. Results: The pooled primary hemorrhage rate across all techniques was 1.0% (95% Cl: 0.5–1.4%), with insignificant heterogeneity (I² = 0.0%, p < 0.665). By contrast, pooled secondary hemorrhage occurred at a rate of 5.8% (95% CI: 3.9–7.6%). Cold steel tonsillectomy was associated with the lowest secondary hemorrhage rate of 3.7% (95% CI: 0.8–6.6%, I² = 43.558%, p = 0.115), while bipolar diathermy had the highest secondary hemorrhage rate of 8.6% (95% CI: 2.3–15.0%, I² = 86.448%, p < 0.001). Conclusions: This meta-analysis underscores the considerable variability in rates of post-tonsillectomy hemorrhage frequency among various surgical techniques. Cold steel dissection appears to be the safest regarding secondary hemorrhage, while coblation likely minimizes primary bleeding. Bipolar diathermy comes across as the technique with the highest risk for primary hemorrhage and requires special caution during its use. Such results emphasize the need for careful selection of the surgical technique concerning patients’ particular conditions and the need to enhance care periods to reduce the bearing of any hemorrhagic complications.

Introduction: Infective endocarditis (IE) requires 4 to 6 weeks of intravenous antibiotics. Outpatient parenteral antibiotic therapy (OPAT) is increasingly used and guideline endorsed, but IE-specific comparative evidence is limited, as prior meta-analyses pooled single-arm data without an inpatient comparator. We compared the safety and efficacy of OPAT versus continued hospital-based antibiotic therapy. Methods: This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. PubMed/MEDLINE, Embase, Cochrane CENTRAL, and Web of Science were searched to 18 April 2026 for comparative studies of adults with IE. Two reviewers screened using Rayyan and extracted data, and risk of bias was assessed with Risk Of Bias In Non-randomized Studies of Interventions. Random-effects meta-analyses (DerSimonian–Laird) produced risk ratios with 95% confidence intervals (CIs) (RevMan 5.4). Results: Five comparative studies (3497 adults) were included. OPAT was associated with lower all-cause mortality (risk ratio [RR]: 0.40, 95% CI: 0.18–0.90; I ² = 87%, P = 0.03) and with lower acute kidney failure (RR: 0.71, 95% CI: 0.59–0.86, P = 0.0004). No significant differences were seen for readmission (RR: 1.09), relapse (0.73), valve replacement (1.15), arrhythmia, sepsis, stroke, embolic complications, or heart failure. Conclusions: In appropriately selected, stabilized patients, OPAT was associated with lower all-cause mortality and acute kidney failure, with no significant differences in major other adverse events. Protocol: CRD420261410723.

Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease in which pruritus is common, often refractory, and poorly served by current th

Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of heart failure cases and remains difficult to diagnose non-invasively. Artificial intelligence (AI) applied to echocardiography may improve detection, but its aggregate diagnostic accuracy has not been quantified. We performed a diagnostic test accuracy meta-analysis of AI-enabled echocardiography for identifying HFpEF, elevated left ventricular filling pressure, or diastolic dysfunction. MEDLINE/PubMed, Embase, and CENTRAL were searched from inception to June 2026. Studies reporting the accuracy of AI models applied to echocardiography against invasive, guideline-adjudicated, or ASE/EACVI reference standards were included. Sensitivity and specificity were pooled using a bivariate random-effects (Reitsma) model, with a summary receiver operating characteristic (ROC) curve, diagnostic odds ratio, and likelihood ratios. Risk of bias was assessed with QUADAS-2. Eight studies (2770 participants; 1317 [47.5%] with the target condition) were included. Pooled sensitivity was 84.0% (95% CI: 73.0–91.0%) and specificity 83.0% (95% CI: 73.0–89.0%), with an area under the summary ROC curve of 0.875 (95% CI: 0.791–0.930). The diagnostic odds ratio was 24.73 (95% CI: 18.46–33.12); positive and negative likelihood ratios were 4.84 and 0.20. Heterogeneity was high. Performance did not differ by AI architecture but varied significantly by reference standard. No small-study effects were detected. AI-enabled echocardiography shows good pooled accuracy for detecting HFpEF and elevated filling pressures, supporting its diagnostic potential. High heterogeneity and reference-standard dependence warrant larger, prospectively validated studies before routine clinical adoption.

The Myval and Myval Octacor transcatheter heart valves (THVs) are newer-generation balloon-expandable devices for transcatheter aortic valve implantation (TAVI) in severe aortic stenosis (AS), but comprehensive synthesis of 1-year outcomes incorporating recent randomized data remains limited. We searched PubMed/MEDLINE, Embase, and CENTRAL through June 2026 for randomized controlled trials and propensity-matched or adjusted observational studies comparing Myval/Myval Octacor with contemporary THVs in adults undergoing transfemoral TAVI for severe symptomatic AS. The primary outcome was 1-year all-cause mortality; secondary outcomes included cardiovascular death, stroke, new permanent pacemaker implantation (PPI), mean transvalvular gradient, effective orifice area, and moderate-to-severe aortic regurgitation. Random-effects meta-analyses generated pooled risk ratios (RRs) and mean differences with 95% confidence intervals. Five studies (2 randomized trials, 3 propensity-matched/adjusted cohorts; 2327 patients: 1107 Myval, 1220 contemporary THV recipients) were included. At 1 year, Myval showed comparable outcomes to contemporary THVs for all-cause mortality (RR 0.89, 0.66–1.21), cardiovascular death (RR 0.92, 0.55–1.55), and stroke (RR 1.41, 0.91–2.18), with similar new PPI rates (RR 0.82, 0.47–1.42). Among randomized trials, Myval had lower mean transvalvular gradients (MD −1.28 mm Hg, −1.73 to −0.82) and larger effective orifice area (mean difference +0.15 cm ² , 0.09–0.20) than SAPIEN, with no significant difference in moderate-to-severe aortic regurgitation (RR 1.28, 0.19–8.71). Myval demonstrated comparable all-cause mortality, cardiovascular death, stroke, and PPI rates to contemporary THVs at 1 year, along with favorable hemodynamics versus SAPIEN, supporting Myval as an effective contemporary TAVI platform; longer-term studies are needed to confirm durability and clinical outcomes.