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PURPOSE: Cerebral venous sinus thrombosis (CVST) is a potentially serious complication following surgical treatment of vestibular schwannoma, a benign tumor originating from Schwann cells of the vestibulocochlear nerve. This study aimed to determine the prevalence of CVST following surgical treatment of vestibular schwannoma and the factors contributing to its occurrence. METHOD: Two independent researchers searched the global databases of PubMed, Web of Science, Scopus, and the Cochrane Library up to September 01, 2023. We employed a random-effects model for data analysis. Heterogeneity was evaluated using the I2 test. To assess the quality of the studies meeting our inclusion criteria, we employed the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS: We included 23 articles in this meta-analysis. The pooled prevalence of CVST after vestibular schwannoma surgery was 6.4% (95%CI 3.4-11.5%). The pooled prevalence of CVST following the retrosigmoid (RS), translabyrinthine (TL), and middle cranial fossa (MCF) approaches was 4.8% (95%CI 2.0-11.0%), 9.6% (95%CI 4.3-20.3%) and 9.9% (95%CI 1.6-42.2%), respectively, revealing a significant difference between the TL and the RS approaches (Odds ratio = 2.10, 95%CI 1.45-3.04, P < 0.001). The sigmoid sinus exhibited the highest post-operative thrombosis rate (7.9%), surpassing the transverse sinus (3.7%) and involvement of both sigmoid and transverse sinuses (1.6%), respectively. No significant associations were found with demographic or surgical factors. CONCLUSION: In the current meta-analysis, we identified a 6.4% CVST prevalence following vestibular schwannoma surgery, with varying rates depending on the surgical approach. No significant associations with patient or surgical factors were found, emphasizing the need for heightened clinical vigilance and further research in this context. TRAIL REGISTRATION: PROSPERO ID: CRD42023453513.
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The third most frequent reason for hospitalized acute kidney injury is contrast-induced nephropathy (CIN). Percutaneous coronary intervention (PCI) and coronary angiography (CAG) are two interventions that can result in CIN. In this study, we sought to determine how well gamma-glutamyl transferase (GGT) can predict CIN following CAG and PCI. Method: Two researchers searched through PubMed, Scopus, and Web of Science in November 2022 to find articles that examined GGT levels in CIN patients following PCI or CAG. To rate the quality of the studies, the Joanna Briggs Institute Critical Appraisal Checklist was employed. The Cochran test and I2 statistics were utilized to assess study heterogeneity. To calculate the number of participants required to reject the null hypothesis, power analysis was used. We evaluated the epidemiologic strength of the results using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The authors used Comprehensive Meta-analysis Version 3 to summarize the results. Results: GGT was shown to be considerably greater in patients with CIN according to the meta-analysis's findings (odds ratio: 3.21, 95% CI: 1.26-8.15, P=0.014); nevertheless, the findings were accompanied by significant heterogeneity (I2=91.93%, P<0.001). Although the relationship between CIN and GGT was power full regarding power analysis (1- ß =1, number of effect sizes=4, the average number per group=336), very low quality of evidence was observed regarding GRADE criteria. Conclusions: These results suggest the GGT level may be a predictor of contrast-induced nephropathy in patients having cardiac catheterization; however, more research is required to prove the epidemiological validity.
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Background: Smoking poses a significant risk for colorectal cancer (CRC), considered the third leading reason for cancer-related deaths worldwide. However, there has been limited research on the relationship between smoking and CRC in the Eastern Mediterranean Regional Office (EMRO). Therefore, a meta-analysis was conducted to combine available data and gain a comprehensive understanding of the relationship between smoking and CRC in EMRO. Methods: Two independent researchers searched PubMed, Scopus, and Web of Science until December 2022. The included studies were checked for risk of bias administering the Newcastle-Ottawa scale. Heterogeneity was evaluated using I2 statistics and the Cochrane test. Publication bias was determined through funnel plot analysis and Egger's regression test. Additionally, a meta-regression analysis explored the impact of a country's Human Development Index (HDI) on the relationship between smoking and CRC. Results: The final analysis included 26 studies, revealing a significant association between smoking and CRC (OR = 1.40; 95% CI: 1.11 - 1.78; P = 0.004). Moreover, smoking had a more pronounced adverse effect on CRC in countries with higher HDIs compared to those with lower HDIs (OR = 1.30; 95% CI: 0.99 - 1.71; P = 0.054). Conclusions: Our findings underscore the importance of implementing smoking cessation programs and policies in EMRO countries, as they demonstrate a positive relationship between smoking and the risk of CRC. Furthermore, the results suggest that a country's level of human development may influence the association between smoking and CRC. Further research is needed to investigate this potential connection and develop targeted public health interventions.
