Introduction: Asthma is a chronic respiratory disease affecting approximately 5 million children in the US, but little is known about whether asthma alters children’s attention and memory functions. Most studies on this topic focus on psychiatric and QoL outcomes rather than cognitive functions, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate the attention deficit and memory function outcomes in children with bronchial asthma. Methods: A systematic search was conducted in PubMed, Web of Science, and Cochrane Library from inception to 28 February 2025 for studies evaluating attention deficit and memory function in children with bronchial asthma. Outcomes of interest included attention deficit and memory function. Statistical analysis was performed with R 4.3.1. Heterogeneity was accessed using the I² statistics and Cochrane Q test. The standardized mean difference (SMD) with restricted maximum-likelihood estimator random-effects method was computed for all outcomes. Results: A total of seven studies were included in the final meta-analysis, comprising 104,975 patients, of whom 10,200 (9.7%) had bronchial asthma (mean age ± 8.98 years, mean 45% females). In the pooled analysis, children with asthma had a worsened attention deficit compared to the healthy group (SMD 0.29; 95% CI [0.07; 0.51]; p = 0.01; I² = 92%). However, no statistically significant difference was found in memory function between groups (SMD −0.24; 95% CI [−1.81; 1.33]; p = 0.77; I² = 96%). Conclusions: Children with asthma showed significantly higher attention deficit scores compared to healthy children. No statistically significant differences were observed in memory function between the groups. These findings may have implications for early cognitive screening in pediatric asthma management.

Introduction: Unruptured intracranial aneurysms (UIAs) can induce psychological stress, leading to anxiety, depression, and impaired quality of life (QoL). Most studies on this topic are limited by small sample sizes, cross-sectional designs, and a focus on treated rather than untreated cases, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate mental health and QoL outcomes in patients with untreated UIAs. Methods: A systematic search was conducted up to 30 November 2024 using PubMed, Scopus, and Cochrane Central for studies comparing patients with untreated UIAs to a control group. The outcomes of interest included anxiety, depression, and QoL. Statistical analysis was performed using RevMan 5.1.7 and R 4.3.1. Heterogeneity was assessed using I² statistics and the Cochrane Q test. Risk ratios (RR) and standardized mean differences (SMD) were computed using a frequentist random-effects model. Results: We included five studies with 417,152 patients, of whom 85,668 (20.53%) had untreated UIAs. In the pooled analysis, patients with untreated UIAs had significantly higher anxiety levels (SMD 0.66; 95% CI [0.16; 1.17]; p = 0.01; I² = 76%) and lower QoL (SMD −0.82; 95% CI [−1.12; −0.53]; p = 0.01; I² = 56%) compared to the control group However, no statistically significant differences were found in depression (RR 0.94; 95% CI [0.52; 1.72]; p = 0.84; I² = 88%) between groups. Conclusions: This meta-analysis indicates a potential association between untreated UIAs and increased anxiety levels and reduced QoL. Regarding depression, no significant differences were observed between groups.

Background and Objectives: High-grade gliomas (HGGs) are aggressive primary brain tumors with a poor prognosis despite multimodal treatment. The anesthetic technique used during surgery may influence tumor progression and survival, but its role in HGGs remains unclear. This meta-analysis evaluated the effect of total intravenous anesthesia (TIVA) versus inhalational anesthesia (INHA) on overall survival (OS) and progression-free survival (PFS) in HGG patients. Materials and Methods: A systematic search was conducted in PubMed, Scopus, and Cochrane databases for studies assessing the impact of TIVA versus INHA on OS and PFS in HGG patients. Statistical analysis was performed using R version 4.3.1. Heterogeneity across studies was quantified using the Cochrane Q test alongside the I² statistic. A random-effects model was employed to derive the pooled hazard ratios (HRs). Results: A total of five studies involving 827 participants (mean age 58 years, mean females 38%) were included, of whom 406 (49%) received TIVA. No statistically significant differences were observed in OS (HR 0.77; 95% CI [0.58–1.02]; p = 0.07; I² = 67%) or PFS (HR 0.88; 95% CI [0.70–1.10]; p = 0.27; I² = 51%) between the groups. A subgroup analysis revealed that TIVA was associated with improved OS in patients with grade IV tumors (HR 0.70; 95% CI [0.51–0.96]; p = 0.03), while no significant effect was observed in the mixed grade III–IV subgroup. However, the test for subgroup differences was not statistically significant (p = 0.0669), and this finding should be interpreted with caution. No significant differences were observed in median OS or PFS, or in single-arm meta-analyses. Conclusions: This meta-analysis found no statistically significant differences in overall or progression-free survival between TIVA and INHA in patients undergoing surgery for HGGs. Although a subgroup analysis suggested a possible survival advantage of TIVA in grade IV tumors, the lack of a statistically significant subgroup difference test limits the strength of this finding. Further investigation is needed to determine whether anesthetic technique influences outcomes in this subgroup.

Acute and chronic postoperative low back pain are frequent occurrences after lumbar spine surgery, contributing to long-term disability and increased analgesic use. Neuromodulation techniques-both invasive and non-invasive-have emerged as promising non-pharmacological interventions. However, current evidence remains fragmented. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of neuromodulation in managing acute and chronic postoperative low back pain. We systematically searched PubMed, Scopus, and Cochrane databases from inception up to 30 June 2025 for randomized controlled trials (RCTs) published in English only comparing neuromodulation to sham modulation in patients with postoperative low back pain following lumbar spine surgery. The review protocol was registered in PROSPERO (CRD420251108776). Primary outcomes included pain intensity reduction, analgesic consumption, functional disability, and adverse effects. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) for continuous outcomes were calculated using a frequentist random-effects model. Proportions and 95% CIs for binary outcomes, including adverse events and sex distribution, were computed using the Freeman-Tukey double arcsine transformation to stabilize variance. Heterogeneity was assessed using the I² statistic and Cochrane's Q test. Twelve RCTs involving 413 patients (mean age 53 years; 55 % female) were included, with 207 (50%) receiving neuromodulation. In the pooled analysis, neuromodulation significantly reduced pain intensity (SMD - 0.82; 95 % CI [-1.13, -0.50]; p < 0.00001; I² = 53 %) and analgesic consumption (SMD - 0.91; 95 % CI [-1.63, -0.20]; p = 0.01; I² = 81 %) compared to sham. No significant difference was found in functional disability (SMD - 0.31; 95 % CI [-0.85, 0.24]; p = 0.28; I² = 44 %). The pooled female proportion was 55 % (95 % CI [42.99, 66.95]; I² = 73 %), and the prevalence of adverse effects was 12.48 % (95 % CI [6.13, 20.39]; I² = 0 %). This meta-analysis demonstrates that neuromodulation significantly reduces postoperative pain and opioid consumption after lumbar spine surgery, although it does not improve functional disability. Given the growing need for non-pharmacological pain management strategies, neuromodulation represents a promising evidence-based adjunct in postoperative care. Future high-quality RCTs should refine optimal protocols and evaluate long-term functional outcomes.

Introduction: Sleep disturbances are common in patients with degenerative lumbar disease, yet the effect of surgical treatment on sleep recovery remains insufficiently quantified. This meta-analysis evaluated postoperative changes in sleep quality, pain, disability, and quality of life (QoL) following lumbar spine surgery. Methods: PubMed, Scopus, and the Cochrane Library were searched up to 1 March 2026 for studies reporting pre- and postoperative outcomes in adults undergoing surgery for degenerative lumbar pathologies. A Bayesian random-effects model with vague priors for overall effects and weakly informative priors for between-study heterogeneity were applied. Sensitivity analyses with alternative priors and subgroup analyses by study design, risk of bias, mean age, procedure, and pathology were performed. Posterior probabilities (PP), 95% credible intervals (CrIs), and posterior predictive distributions were estimated. Results: Twenty-five studies comprising 3,546 patients were included. Surgery was associated with improvement in sleep quality (SMD − 1.36; 95% CrI − 2.02 to − 0.71; PP 99%). Significant reductions were observed in back pain (MD − 3.73; 95% CrI − 4.75 to − 2.69; PP 99%), leg pain (MD − 3.44; 95% CrI − 4.47 to − 2.40; PP 99%), disability (MD − 18.95; 95% CrI − 26.41 to − 11.48; PP 99%), and improved QoL (SMD 1.09; 95% CrI 0.23 to 1.95; PP 99%). Meta-regression suggested that pathology and risk of bias contributed to heterogeneity, whereas age, procedure, and study design had limited influence. Conclusion: This Bayesian meta-analysis found that lumbar surgery for degenerative lumbar disease is associated with improvements in sleep quality, pain, disability, and QoL, supporting the inclusion of sleep outcomes in perioperative assessment.

Introduction: Glioblastoma is the most aggressive primary brain tumor in adults, with limited survival despite multimodal therapy. Tumor-treating fields (TTFs) combined with temozolomide (TMZ) have emerged as a therapeutic option for newly diagnosed glioblastoma (nGBM), yet the magnitude, robustness, and generalizability of its benefit remain uncertain. This Bayesian meta-analysis aimed to determine whether the addition of TTFs to TMZ improves survival outcomes and safety profiles in patients with nGBM. Methods: We systematically searched PubMed, Scopus, and the Cochrane Library from inception to 5 April 2026, for studies comparing TTFs + TMZ with TMZ alone in nGBM (PROSPERO “CRD420261374813”). Outcomes included overall survival (OS; hazard ratio [HR]), progression-free survival (PFS; HR), and dermatologic adverse effects (proportions). A Bayesian random-effects model with vague priors for overall effects and informative/weakly informative priors for between-study heterogeneity was applied. Sensitivity analyses with alternative prior specifications were performed, and posterior probabilities (PPs), 95% credible intervals (CrIs), and posterior predictive probabilities (PPPs) were estimated. Results: Twelve studies (one randomized controlled trial and 11 observational studies) comprising 2797 patients were included (TTFs + TMZ: 1228; TMZ: 1569). TTFs + TMZ was associated with improved OS (HR 0.68; 95% CrI 0.57–0.80; 99% PP HR < 1) with a 96% PPP that future studies would also favor TTFs + TMZ. PFS was likewise improved (HR 0.67; 95% CrI 0.58–0.77; 99% PP HR < 1), with a 98% PPP favoring TTFs + TMZ in future studies. Subgroup analyses suggested that risk of bias contributed more to heterogeneity than study design. Among patients receiving TTFs + TMZ, the estimated proportion of dermatologic adverse effects was 57.8% (95% CrI 0.36–0.79), with high PPs of exceeding clinically meaningful thresholds. Conclusions: In this Bayesian meta-analysis, TTFs combined with TMZ was associated with improved OS and PFS in nGBM, although dermatologic toxicity was frequent. These findings support TTFs + TMZ as an effective adjunctive strategy, while emphasizing the importance of patient selection, adherence, and toxicity management.