Background and Objectives: Femoral neck fractures are common among elderly patients and are typically managed surgically to restore mobility and reduce complications. Total Hip Replacement (THR) and Hemiarthroplasty (HA) are standard interventions. While both procedures are widely used, the comparative risks of thromboembolic complications remain unclear. This study aimed to systematically compare the risk of Venous Thromboembolism (VTE), including Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), and Arterial Thromboembolic events in patients undergoing THR versus hemiarthroplasty for femoral neck fractures. Materials and Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Google Scholar, and OVID-Medline for studies published between 2000 and 2024. Eligible studies included patients aged ≥50 years with femoral neck fractures treated with THR or Hemiarthroplasty and reported thromboembolic outcomes. Risk of bias was assessed using the Newcastle–Ottawa Scale and the RoB 2 tools. Meta-analysis was performed using RevMan software (Version 5.4). Results: Twelve studies were included in the systematic review, and ten in the meta-analysis, encompassing over 160,000 patients. THR was associated with a significantly increased risk of DVT (RR = 1.53; 95% CI: 1.40–1.68, p = 0.00001) and combined VTE (RR = 1.48; 95% CI: 1.36–1.61, p = 0.00001) compared to HA. No significant difference was observed in PE risk. Interestingly, THR was linked to a lower risk of Arterial Thromboembolic events, such as Ischemic Stroke. Conclusions: Compared with Hemiarthroplasty, THR increases the risk of VTE, including DVT, with no increased risk of PE. Surgical decisions should be guided by individual patients’ risk factors for thrombotic and cardiovascular events.

Obstructive sleep apnea syndrome (OSAS) in children is a prevalent pediatric illness, marked by partial or complete upper airway obstruction during sleep that significantly impacts quality of life. Adenotonsillectomy is the initial surgical treatment for kids with adenotonsillar hypertrophy. Nonetheless, AT's comparative effectiveness versus other therapies in terms of QoL improvement is contentious. This study systematically compares the effects of AT vs. WWST on QoL, cognition, and behavior in pediatric OSAS patients. A PRISMA-compliant systematic review and meta-analysis were conducted. The search was conducted across PubMed, Web of Science, Ovid Medline, Google Scholar, and ClinicalTrials.gov, encompassing studies published between 2000 and 2024. Studies were included if they reported QoL outcomes in pediatric OSAS patients comparing AT with WWST. Risk of bias was assessed using ROB 2 for randomized controlled trials (RCTs), and statistical analyses were performed using RevMan. Four RCTs (N=1436) met the inclusion criteria. AT significantly improved QoL, as measured by OSA-18 (pooled mean difference: -14.16[-25.40, -2.93]; P < 0.00001, I² = 79%) and PedsQL (pooled mean difference: 4.92 [3.37, 6.47]; P < 0.00001, I² = 0%). However, AT did not significantly improve cognitive and executive functions (BRIEF mean difference: -2.44 [-18.32, 13.44], P = 0.05, I² = 77%). Risk of bias showed variability in blinding and attrition rates. AT greatly enhances QoL in children with OSAS compared to WWST, while its effect on cognition and executive function remains uncertain. Long-term outcomes and cost-effectiveness should be addressed by future studies to inform clinical decision-making.

Purpose: This study aimed to evaluate the effects of active transcranial direct current stimulation (tDCS) compared with sham stimulation on circulating brain-derived neurotrophic factor (BDNF), pain-related outcomes, working memory, and inflammatory and neuroplasticity biomarkers. Methods: PubMed/MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched from inception to May 2026. Randomized and controlled clinical trials comparing active with sham tDCS in adults were included. The primary outcome was post-treatment BDNF concentration. Secondary outcomes included pain intensity, pain catastrophizing, pain-related disability and functional interference, working memory, and circulating inflammatory or neuroplasticity biomarkers. Risk of bias was assessed using the revised Cochrane risk-of-bias tool. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled using random-effects models. Serum and plasma BDNF were analyzed separately. Results: Twenty-one studies were included in the systematic review, of which 15 contributed to at least one quantitative synthesis and 12 study comparisons contributed to the primary BDNF analyses. Active tDCS did not significantly affect serum BDNF (MD = −0.01 [−0.15, 0.13], p = 0.890) or plasma BDNF (MD = 0.02 [−0.25, 0.29], p = 0.870) compared with sham stimulation. In contrast, active tDCS was associated with lower pain intensity (MD = −1.79 [−2.34, −1.23], p < 0.00001). No statistically significant difference was observed in the PCS total score or in the helplessness, magnification, or rumination subscales, although the point estimates generally favored active tDCS. For pain-related disability and functional interference, active tDCS was associated with lower PCP:S total scores and lower emotional interference, whereas no significant differences were observed for interference with daily activities or pain frequency. No significant differences were observed for working memory, interleukins, tumor necrosis factor-alpha, glial cell line-derived neurotrophic factor, interleukin-18, or soluble tumor necrosis factor receptors. Substantial heterogeneity was present in several pain-related and inflammatory biomarker analyses. Conclusions: Active tDCS was not associated with consistent differences in circulating serum or plasma BDNF or in the assessed peripheral inflammatory and neuroplasticity biomarkers compared with sham stimulation; however, these null peripheral findings should not be interpreted as evidence of absent central neuroplastic effects, because circulating measures may not adequately capture localized or transient biological changes within the central nervous system. Active tDCS was associated with improvements in some pain-related outcomes; however, the limited number of studies, substantial heterogeneity, and low certainty of the available evidence preclude firm conclusions regarding its clinical effectiveness for pain management.