Aortic valve stenosis in patients with chronic liver diseases, particularly liver cirrhosis and End-Stage Liver Disease, poses significant management challenges due to the interplay between cardiovascular and hepatic dysfunction. This systematic review and meta-analysis compared the safety and efficacy of Transcatheter Aortic Valve Replacement (TAVR) and Surgical Aortic Valve Replacement in this high-risk population. An extensive search of PubMed, Embase, and Web of Science (inception to January 5, 2025) identified 11 retrospective studies comprising 19,097 patients. Risk ratios for dichotomous outcomes and mean differences (MD) for continuous outcomes, each with 95% confidence intervals, were calculated using random-effects models. The analysis revealed that TAVR significantly reduced hospital mortality (RR 0.36, 95 % CI: 0.30-0.42; I² = 7.6 %), acute kidney injury (RR 0.51, 95 % CI: 0.33-0.78; I² = 57.2 %), bleeding (RR 0.33, 95 % CI: 0.28-0.39; I² = 0.0 %), stroke (RR 0.35, 95 % CI: 0.23-0.51; I² = 6.1 %), and blood transfusion (RR 0.48, 95 % CI: 0.40-0.57; I² = 7.6 %). TAVR was also associated with shorter hospital stays (MD -6.77 days, 95 % CI: -9.17 to -4.38; I² = 97.5 %). No significant differences were observed in vascular complications requiring surgery or hospital charges and post-operative infections. These findings suggest TAVR offers significant advantages over SAVR in reducing complications such as mortality, acute kidney injury, and bleeding in patients with liver disease. However, further randomized trials are necessary to confirm long-term outcomes and establish optimal treatment strategies for this high-risk population.

Cannabidiol (CBD) has gained significant attention for its potential therapeutic benefits, but its safety profile in healthy populations remains underexplored. This systematic review and meta-analysis aim to evaluate the safety of CBD compared to placebo in healthy adults. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov identified four randomized controlled trials (RCTs) involving 269 healthy adults. The primary outcome was headache, with secondary outcomes including fatigue, abdominal pain, diarrhea, upper respiratory tract infection (URTI), and dizziness. The results revealed that CBD use was associated with a significantly higher risk of diarrhea (RR = 5.85; 95% CI = 1.14–30.02; P = 0.03). While there was a trend toward increased abdominal pain and headache, these results were not statistically significant. Fatigue, dizziness, and URTI showed no significant differences between the CBD and placebo groups. These findings suggest that while CBD appears safe for short-term use in healthy adults, gastrointestinal side effects, particularly diarrhea, should be monitored. Further large-scale studies with longer follow-up periods are warranted to confirm these results and explore long-term safety.

Kawasaki disease is the leading cause of acquired heart disease in children, with coronary artery lesions (CALs) as its most serious complication. Although intravenous immunoglobulin (IVIG) is the standard first-line treatment, some patients develop IVIG resistance or persistent inflammation, increasing the risk of adverse outcomes. This systematic review and meta-analysis evaluated the efficacy and safety of adjunctive corticosteroid therapy in children with Kawasaki disease. PubMed, Embase, and Cochrane CENTRAL were searched through May 2026 for randomized controlled trials comparing IVIG plus corticosteroids with IVIG alone. Outcomes included CAL at approximately 4 weeks, need for additional IVIG therapy, duration of fever, and treatment-related adverse events. Six trials involving 3904 children were included. Compared with IVIG alone, adjunctive corticosteroid therapy significantly shortened fever duration and reduced the need for additional IVIG treatment. However, no significant differences were observed in the incidence of CAL or adverse events. Trial sequential analysis indicated that the available evidence for coronary outcomes remains insufficient, as the required information size has not yet been reached. These findings suggest that corticosteroids improve early clinical response and reduce treatment resistance in Kawasaki disease, but their role in preventing CALs remains uncertain and requires further large-scale randomized trials.