Background: Dry needling (DN) has emerged as a potential treatment for mechanical neck pain, but the evidence remains inconclusive. This study aimed to assess the efficacy of DN in improving pain and functionality in patients with chronic mechanical neck pain. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Databases, including PubMed, Cochrane Library, Scopus, and Google Scholar, were searched from December 2013 to January 2024. Studies involving adult participants with chronic mechanical neck pain treated with DN were included in the study. The primary outcomes were pain pressure threshold (PPT), Neck Disability Index (NDI), and cervical range of motion. Statistical analysis used a random-effect model. Results: Nine RCTs with a total of 540 participants were included in the study. DN significantly improved the PPT with an MD of 0.52 (95% confidence interval [CI], 0.39–0.65; P < 0.001). NDI also showed a significant improvement, with an MD of −0.68 (95% CI, −1.32–−0.05; P = 0.04). In terms of cervical range of motion, DN improved flexion (MD 4.07, 95% CI, 0.39–7.75; P = 0.03) and right rotation (MD 8.20, 95% CI, 3.05–13.35; P = 0.002), but no significant differences were observed in extension, left rotation, or lateral flexions (P > 0.05). Conclusion: DN appears effective in short-term pain relief and functional outcomes for patients with mechanical neck pain but shows limited impact on the cervical range of motion.

Background: Aggressive brain tumors like glioblastoma multiforme (GBM) pose a poor prognosis. While magnetic resonance imaging (MRI) is crucial for GBM management, distinguishing it from other lesions using conventional methods can be difficult. This study explores advanced MRI techniques better to understand GBM properties and their link to patient outcomes. Methods: We studied MRI scans of 157 GBM surgery patients from January 2020 to March 2024 to extract radiomic features and analyze the impact of fluid-attenuated inversion recovery (FLAIR) resection on survival using statistical methods, proportional hazards regression, and Kaplan–Meier survival analysis. Results: Predictive models achieved high accuracy (area under the curve of 0.902) for glioma-grade prediction. FLAIR abnormality resection significantly improved survival, while diffusion-weighted image best-depicted tumor infiltration. Glioblastoma infiltration was best seen with advanced MRI compared to metastasis. Glioblastomas showed distinct features, including irregular shape, margins, and enhancement compared to metastases, which were oval or round, with clear edges and even contrast, and extensive peritumoral changes. Conclusion: Advanced radiomic and machine learning analysis of MRI can provide noninvasive glioma grading and characterization of tumor properties with clinical relevance. Combining advanced neuroimaging with histopathology may better integrate oncology and radiology for optimized glioblastoma management. However, further studies are needed to validate these findings with larger datasets and assess additional MRI sequences and radiomic features.

Background: Proton beam radiation therapy (PBRT) is an advanced cancer treatment modality that utilizes the distinctive physical properties of protons to precisely deliver radiation to tumor targets while sparing healthy tissue. This cannot be obtained with photon radiation. In this systematic review and meta-analysis, we aimed to comprehensively assess the risk of brainstem toxicity in pediatric brain tumor patients undergoing PBRT. Methods: With adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a predetermined search strategy was used to identify eligible articles from PubMed, Web of Science, Scopus, and Cochrane Library through July 2024. Results: The current study included a total of 11 eligible articles. The pooled prevalence of patients who suffered from brainstem toxicity was 1.8% (95% CI: 1%, 2.6%). The pooled prevalences of patients with Grade 1 to Grade 5 brainstem toxicity were found to be 10.6% (95% CI: 8.8%, 30%), 1.5% (95% CI: 0.6%, 2.5%), 0.7% (95% CI: 0.3%, 1.1%), 0.4% (95% CI: 0.1%, 0.7%), and 0.4% (95% CI: 0.1%, 0.8%), respectively, with an overall pooled prevalence of 0.7% (95% CI: 0.4%, 1%). Conclusions: This study revealed a relatively low incidence of symptomatic brainstem toxicity and its related mortality in the pediatric population undergoing PBRT. However, further research is encouraged to study the broader effects of PBRT and to explore various factors that may influence the risk of brainstem toxicity in patients treated with PBRT.

Background: Traumatic brain injury (TBI) is an injury resulting from external force exerted directly or indirectly on the skull. This is presently the major cause of mortality and disability among youth globally. Repetitive transcranial magnetic stimulation (rTMS) was proposed for the treatment of various neurological disorders such as TBI. We conducted the current systematic review and meta-analysis to investigate the efficacy of rTMS in TBI patients. Methods: We conducted our database searching on PubMed, Scopus, and Web of Science from inception till August 2024 to look for articles that fulfil our aim. The search strategy was based on two main keywords: “Transcranial magnetic stimulation” AND “Traumatic brain injury.” We conducted the pooled analysis of continuous variables using standardized mean difference (SMD) due to difference in measurement scales. Results: Seven randomized controlled trials were included. A statistically significant improvement in cognitive function was observed after rTMS compared to control group with SMD of 0.7 (95% confidence interval [CI]: 0.25, 1.14, P = 0.002) with non-significant heterogeneity, and pain with SMD of −0.57 (95% CI: −1.02, −0.11, P = 0.01), I² = 64%, P = 0.04. However, no difference was observed between the two groups regarding depression with SMD of −0.1 (95% CI: −0.54, 0.35, P = 0.67). Conclusion: The use of rTMS is associated with improved cognitive functions and reduction in pain. No effect was observed regarding depression but future studies are still warranted in this important clinical field.

Background The practice of preoperative hair removal has been debated regarding its role in Surgical Site Infection (SSI) prevention. This study aimed to compare the different hair removing modalities and investigate the effect of preoperative hair removal on SSI rates. Methods A systematic review and meta-analysis were conducted according to PRISMA guidelines. Three databases—PubMed, Web of Science, and Cochrane Library—were searched for relevant studies comparing preoperative hair removal to no hair removal. Studies eligible for inclusion were randomized controlled trials (RCTs) and cohort studies reporting SSI rates. Odds ratios, mean differences, and p-values were analyzed using a random effect model. Results Seventeen studies involving 5,407 patients were included. No statistically significant difference in SSI rates was found between the hair removal and no removal groups (OR = 1.066, 95% CI 0.646–1.758, p = 0.803). When comparing clipping to no hair removal, there was no significant difference (OR = 0.967, 95% CI 0.642–1.455, p = 0.870). Razor shaving was associated with higher skin damage and slightly increased SSI risk compared to clipping but not statistically significant (OR = 0.749, 95% CI 0.346–1.623, p = 0.464). Depilatory creams, however, were favored over razor shaving (OR = 3.235, 95% CI 1.543–6.785, p = 0.002), as they were linked to less skin damage and easier application. Conclusion Preoperative hair removal does not significantly impact SSI rates. Clipping appears to be a safer alternative to shaving, while depilatory creams show promise as an effective, less damaging option.

Background: Brain metastasis has a negative influence on the morbidity and mortality of cancer patients. Conventionally, whole-brain radiotherapy (WBRT) was favored as the standard treatment for brain metastases. However, it has been linked to a significant decline in neuro-cognitive function and poor quality of life. Stereotactic radiosurgery (SRS) has recently gained prominence as an alternative modality, considering that it provides targeted high-dose radiation while minimizing adverse effects. This study evaluates the efficacy and safety of SRS versus WBRT in patients with intracranial metastases. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, through July 2024, we searched PubMed, Scopus, and Web of Science for articles comparing WBRT and SRS in patients with intracranial metastases. Outcomes included local and distant recurrence, leptomeningeal disease (LMD), and survival. We also used a random-effect model to perform a meta-analysis. Results: The findings revealed no significant differences in local (risk ratio [RR] = 0.70, 95% confidence interval [CI] [0.46, 1.06]) or distant recurrence rates (RR = 0.83, 95% CI [0.54, 1.28], P = 0.41) between WBRT and SRS. However, SRS was associated with a greater risk of post-radiation LMD (hazard ratio [HR] = 3.09, 95% CI [1.47, 6.49], P = 0.003). Survival rates at 1 year (RR = 1.03, 95% CI [0.83, 1.29], P = 0.76) and 5 years (RR = 0.89, 95% CI [0.39, 2.04], P = 0.78) demonstrated no significant differences. Conclusion: SRS and WBRT exhibited similar recurrence rates and overall survival (OS) at 1 and 5 years, with WBRT being more effective in managing post-radiation LMD. SRS patients, on the other hand, had longer OS when measured in months.