Introduction. Controversy exists regarding the use of NPWT for wound healing. Objective. This study assessed the effectiveness of NPWT compared with conventional treatment in the management of different wound types, including acute and chronic wounds. Materials and Methods. PubMed, Cochrane Central Register of Controlled Trials, Scopus, EMBASE, EBSCO, Ovid, and Web of Science were searched, from database inception up to October 2021, for relevant studies comparing NPWT with conventional treatment for wound healing. Primary outcomes included time to healing, wound healing rate, and duration of treatment. Secondary outcomes included adverse events, length of hospital stay, and 30-day mortality rate. Pooled analysis of the outcomes data is presented as SMD (95% CI) for continuous data and OR (95% CI) for dichotomous data. Results. Twenty-four studies (3064 patients) were included in the meta-analysis. NPWT was associated with shorter time to healing (SMD, −0.79; 95% CI, −1.22 to −0.37), shorter duration of treatment (SMD, −1.24; 95% CI, −1.92 to −0.56), and higher rate of wound healing (OR, 2.05; 95% CI, 1.49-2.83) compared with control. NPWT was also associated with a lower incidence of adverse events (OR, 0.42; 95% CI, 0.23-0.77) and a lower 30-day mortality rate (OR, 0.25; 95% CI, 0.12-0.56). There were no significant differences between NPWT and control regarding hospital stay (SMD, −0.52; 95% CI, −1.06 to 0.03). Conclusions. NPWT is seemingly associated with better wound healing outcomes compared with conventional therapy. However, the data should be interpreted with substantial caution given limitations such as high heterogeneity between studies and the small sample size of the included studies.

Introduction: Endovascular recanalization therapy has demonstrated considerable efficacy in the treatment of acute ischemic stroke (AIS). However, not all patients appear to benefit on the long term from this therapy. No studies have assessed the role of Cerebrolysin following mechanical thrombectomy (MT). The present study was conducted to evaluate the safety and efficacy of Cerebrolysin as add-on treatment to MT in patients with cardioembolic AIS.Methods: This study evaluated 150 patients admitted to the stroke unit. Data were prospectively collected from 75 patients with cardioembolic AIS and National Institutes of Health Stroke Scale (NIHSS) ≥10, who underwent successful MT ± recombinant tissue plasminogen activator (rt-PA). Patients fulfilling inclusion criteria were consecutively enrolled and treated with Cerebrolysin at a daily dose of 30 ml for 14 days, with treatment initiated within 8 h following MT. Patients were compared with a historical control group of 75 well-matched patients who underwent MT ± rt-PA but did not receive Cerebrolysin. The primary outcome measure was a favorable modified Rankin Scale (mRS = 0–2) at day 90. Secondary parameters included the NIHSS, the Montreal Cognitive Assessment (MoCA), the rate of hemorrhagic transformation, mortality, and adverse events. Propensity score matching was performed to match the variables between the compared groups.Results and discussion: The overall results demonstrated that patients treated with Cerebrolysin exhibited a significantly higher proportion of mRS scores of 0–2 at day 90 (64% vs. 34.7%) in comparison to the control group. This finding was consistent with lower NIHSS and mRS scores at all study visits, and a lower any hemorrhagic transformation rate (20% vs. 57.3%). Furthermore, the logistic regression analysis revealed that patients with favorable mRS scores were less likely to undergo hemorrhagic transformation (odds ratio = 2.75, 95% confidence interval = 1.17, 6.45; p = 0.002). The administration of Cerebrolysin as an add-on treatment resulted in a significant benefit for AIS patients following MT, characterized by an improvement in mRS and NIHSS scores, along with a reduced rate of hemorrhagic transformation. The administration of Cerebrolysin was safe and well tolerated. Further studies are required to confirm these results.

Introduction: Thompson and Austin Moore prostheses have been commonly used in hemiarthroplasties for displaced femoral neck fractures. There has been considerable debate about which of these prostheses is preferred. The purpose of this meta-analysis was to compare historical data for clinical outcomes of cemented Thompson and uncemented Austin Moore hemiarthroplasty in displaced femoral neck fractures. Methods: We searched Medline via PubMed, Cochrane Central, Scopus, Ovid and Web of Science for relevant articles up to February 2019. The included outcomes measured were hip function, hip pain, implant-related complications, surgical complications, reoperation rate and hospital stay. The data were pooled as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI) between the two compared groups in a meta-analysis model. Results: Ten studies (four RCTs and six observational studies) with a total of 4378 patients were included in the final analysis. The pooled RR showed that the Thompson group was associated with a lower incidence of postoperative hip pain (RR = 0.66, 95% CI [0.54, 0.80]), lesser reoperation rate (RR = 0.46, 95% CI [0.24, 0.88]), lesser intraoperative fractures (RR = 0.15, 95% CI [0.09, 0.25]), but a longer operative time (MD = 12.04 min, 95% CI [2.08, 22.00]) in comparison to the Austin Moore group. The effect estimate did not favour either group in terms of hip function, periprosthetic fractures, prosthetic dislocations, wound infection, mortality and hospital stay. Conclusion: Evidence shows that Thompson hemiarthroplasty is better than Austin Moore hemiarthroplasty in terms of hip pain, reoperation rate and intraoperative fractures. Whereas the postoperative hip function is equivalent, these results could be considered when assessing the outcomes in modern hips.

Background: Thrombophilia testing is commonly conducted following an ischemic stroke, especially in cases classified as cryptogenic. However, there is limited evidence linking most thrombophilic conditions to ischemic stroke, and the justification for such testing in many clinical scenarios remains unclear. This study aimed to assess the association between thrombophilia gene polymorphisms and ischemic stroke of undetermined etiology. Methods: This prospective analytical study was conducted over one year and included 45 patients with ischemic stroke of undetermined etiology. Genetic testing for 12 thrombophilia-related gene variants was performed. Data were analyzed using SPSS version 26, with statistical significance set at p < 0.05. Ethical approval and informed consent were obtained from all participants. Results: Thrombophilia-related gene abnormalities were identified in 77.7% of patients, with two or more heterozygous or homozygous variants present. The most common variants were MTHFR C677T (57.8% heterozygous, 8.9% homozygous), MTHFR A1298C (37.8% heterozygous, 8.9% homozygous), and B-Fibrinogen − 455 G ~ A (37.8% heterozygous). Most patients presented with mild stroke severity. HPA-1 a/b, APO B R3500Q, and APO E variants were absent in all cases. Conclusion: This study highlights a high prevalence of thrombophilia gene polymorphisms among patients with ischemic stroke of undetermined etiology. These findings support the potential relevance of thrombophilia in stroke pathogenesis and emphasize the need for further research to clarify its clinical implications for diagnosis, management, and prevention.