Over the past few decades, researchers have attempted to overcome the disadvantages of metallic stents. This led to the birth of the first “Bioresorbable Scaffold” (BRS) model, the Absorb Bioresorbable Vascular Scaffold (BVS), in 1999 by Abbott. A stent that spontaneously resorbs shows a promising theoretical minimal risk of long-term stent thrombosis and omits the need for long-term antiplatelet therapy. However, only one year after its Food and Drug Administration (FDA) approval in 2016, it was voluntarily withdrawn owing to concerns regarding its safety because of the higher risk of target lesion failure. Although long-term follow-up data from the ABSORB IV trial were released in 2023 and showed a comparable long-term safety profile for BRS compared to conventional metallic stents, with only a slightly higher target lesion failure in the first three years, concerns remain regarding their use. Therefore, in this study, we discuss the different adverse events associated with different BRS models. We also discuss various approaches to optimizing the use of BRS, new BRS manufacturing techniques (e.g., 3D printing), and novel BRS models yet to be approved (e.g., DREAM 3G magnesium-based BRS). We suggest carefully selecting patients who could obtain the maximum benefit from BRS through the discussed selection criteria, which could reduce the risk of target lesion failure and BRS complications. Using newer technologies, such as 3D printing, also has excellent potential for making BRS more cost- and market-friendly, owing to their fast output and ability to form individually curated scaffolds.

Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting 5%–10% of reproductive-aged women. Its diverse clinical spectrum includes reproductive, metabolic, and dermatological abnormalities, with cutaneous manifestations often serving as visible indicators of underlying hormonal and metabolic imbalances. Objective: This review explores the pathophysiology, diagnosis, management, and psychosocial impact of the cutaneous manifestations of PCOS, providing an integrated understanding of their clinical significance. Methods: A comprehensive analysis was conducted based on existing literature to elucidate the underlying mechanisms, diagnostic approaches, and treatment options for dermatological features associated with PCOS, including acne, hirsutism, acanthosis nigricans, seborrheic dermatitis, and androgenic alopecia. Results: The pathophysiology of cutaneous manifestations in PCOS is driven by hyperandrogenism, insulin resistance, and local androgenic effects on the pilosebaceous unit. Acne and hirsutism are among the most common skin findings, followed by androgenic alopecia and acanthosis nigricans. Diagnostic strategies combine clinical evaluation with hormonal assays and imaging. Management requires a multidisciplinary approach encompassing hormonal therapies, lifestyle modifications, and targeted dermatological treatments. Additionally, these manifestations significantly impair psychosocial well-being, necessitating holistic care. Conclusion: Cutaneous manifestations are a cosmetic concern and an essential diagnostic and therapeutic focus in PCOS. Addressing these features can enhance patient outcomes by mitigating physical symptoms and improving quality of life. Future research should emphasize personalized treatments and the psychosocial aspects of care to provide comprehensive management for women with PCOS.

Background: While traditional open discectomy is the standard surgical treatment for lumbar disc herniation (LDH), minimally invasive endoscopic techniques have emerged as potential alternatives. This systematic review and meta-analysis evaluated the comparative effectiveness of endoscopic discectomy (ED) and conventional surgical techniques (CT). Methods: A comprehensive search of the PubMed, Scopus, Cochrane Library, and Web of Science databases was conducted through January 2025. Randomized controlled trials and high-quality observational studies comparing ED and CT for LDH were included. Primary outcomes included Visual Analog Scale scores for back and leg pain (VAS-Back and VAS-Leg) and the Oswestry Disability Index (ODI). The secondary outcomes included complication rates, reoperation rates, and length of hospital stay. Results: Fourteen studies (1795 participants) met the inclusion criteria. Meta-analysis revealed no significant differences between ED and CT in terms of VAS-Back [standardized mean difference (SMD): 0.02; 95% CI: −0.15 to 0.19], VAS-Leg (SMD: −0.02; 95% CI: −0.19 to 0.16), or ODI scores (SMD: −0.09; 95% CI: −0.27 to 0.08). The complication rates (RR: 0.85; 95% CI: 0.55–1.31) and reoperation rates (RR: 1.00; 95% CI: 0.75–1.33) were comparable between the groups. ED was associated with a significantly shorter hospital stay (SMD: −2.40; 95% CI: −4.31 to −0.49). Conclusion: Minimally invasive ED is comparable to CTs in terms of pain relief, functional improvement, and safety profiles, while potentially offering the advantage of a shorter hospital stay. These findings support the viability of endoscopic approaches as effective alternatives to traditional surgery for LDH, although the surgical technique selection should be individualized based on patient characteristics, surgeon expertise, and available resources.

Background: Fibromyalgia is a chronic disorder characterized by pain and psychological symptoms in adults. Several randomized controlled trials (RCTs) have shown the effectiveness and safety of low-dose naltrexone (LDN) in the treatment of fibromyalgia in variable small settings. Hence the need to conducted a meta-analysis to evaluate the overall effect and the strength of evidence. Methodology: PUBMED, CENTRAL, and ClinicalTrials.gov were searched to retrieve RCTs comparing naltrexone with placebo in fibromyalgia patients for systematic review and meta-analysis. We conducted pairwise meta-analyses using DerSimonian and Laird random-effects model via RevMan 5.4. We reported dichotomous outcomes as relative risk (RR) and continuous outcomes as standardized mean difference (SMD) with 95% confidence intervals (CIs). Quality of included RCTs was assessed using revised Cochrane Risk of Bias Tool for RCTs (RoB 2.0). Heterogeneity was detected by Chi ² and I ² values for each meta-analysis and if significant, sensitivity analysis was performed. Results: We included five RCTs in meta-analysis. Our results estimated that LDN is superior to placebo in alleviating pain both in primary (SMD −0.61; 95% CI −1.14, −0.08) and sensitivity analysis (SMD −0.87; 95% CI −1.28, −0.46) but not in raising mechanical pain threshold (SMD 0.24; 95% CI −0.09, 0.56) in fibromyalgia patients. Neither the primary (RR 1.68; 95% CI 0.84, 3.36) nor sensitivity analysis (RR 0.98; 95% CI 0.72, 1.34) could associate LDN use with the incidence of headache. The incidence of vivid dreams (RR 2.41; 95% CI 1.77, 3.28) was significantly higher in treatment group as compared to placebo. Conclusion: LDN is considered to be effective in the treatment of fibromyalgia. No serious adverse effects were reported in treatment group. There is need for more RCTs to support the evidence.

Objectives: This systematic review and meta-analysis evaluated the effectiveness of gastric electrical stimulation (GES) in alleviating symptoms of gastroparesis (GP) compared to alternative medical therapies. Methods: We conducted a comprehensive search of PubMed, Cochrane Library, and Embase from January 2004 to October 2024 using MeSH terms and keywords related to GP and GES. The search included randomized controlled trials (RCTs) and observational studies published in English. Data extraction followed PRISMA and AMSTAR guidelines. The primary outcome was symptom control, measured using the weighted mean difference and a 95% confidence interval (CI). Statistical analysis was performed using RevMan software, and the certainty of evidence was assessed using the GRADE tool. Results: A total of 1918 articles were screened, with 4 studies included in the final analysis. The mean difference in symptom control was −0.16 (95% CI: −0.57, 0.26). Heterogeneity was assessed using the chi-square Test, and inconsistency was quantified using the I ² index. Conclusions: GES provides some symptomatic relief in GP, particularly for nausea and vomiting, though the improvements were not statistically significant. Future research should focus on non-crossover RCTs to minimize bias and further explore GES efficacy in idiopathic and postsurgical gastroparesis cases.

Rationale: Adaptive deep brain stimulation (aDBS) represents a notable advancement in treating Parkinson’s disease (PD), as it offers enhanced therapeutic outcomes and personalized management by adjusting stimulation parameters in real-time according to individual neural signals. This approach minimizes adverse effects commonly associated with standard continuous deep brain stimulation (cDBS). This case report describes the progress of a 62-year-old man with severe PD who demonstrated notable enhancement in motor symptoms and quality of life throughout a 3-month trial period using aDBS. Patient concerns: A 62-year-old man who has been suffering from Parkinson’s disease. Diagnoses: The patient had been diagnosed with PD for 10 years. The patient’s motor symptoms, including dyskinesia during the on-state and akinesia during the off-state, progressively worsened over time. Interventions: The patient underwent bilateral subthalamic nuclei DBS surgery with cDBS. Following progressive worsening of motor symptoms, he was transitioned to aDBS. Outcomes: The aDBS system adaptively modified stimulation parameters by utilizing real-time neural feedback from beta band activity detected in the subthalamic nucleus, resulting in decreased dyskinesia and reduced reliance on medication. The customized strategy led to a significant improvement in motor symptoms, a reduction in dyskinesia, and an overall enhancement in quality of life during the 3-month trial period. Lessons: Existing evidence highlights the ability of aDBS to improve motor control and reduce problems associated with DBS, such as speech and gait abnormalities. Research findings have demonstrated significant improvements in motor scores and a reduction in stimulation time, highlighting the effectiveness of aDBS and its ability to prolong the lifespan of devices.