Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis.

BACKGROUND: Superior vena cava (SVC) syndrome is caused by the obstruction of the SVC and can result in significant morbidity and mortality. In contemporary practice, endovascular therapy (ET) has become the standard of care for a majority of these patients. This study is a systematic review and meta-analysis of the available literature to assess technical success, restenosis, and recurrence of SVC syndrome following endovascular intervention. METHODS: For this meta-analysis, we conducted a systematic literature review of PubMed, Cochrane Library, and Embase databases from inception to April 14, 2021 for studies on ET for SVC syndrome. Studies included full-length journal articles on the use of ET among adults with SVC syndrome. Case reports or case series with fewer than 20 patients were excluded. We evaluated the endpoints of technical success rate, restenosis rate, and recurrence rates in SVC syndrome patients after endovascular stenting. The results of this study were calculated using random-effects models. FINDINGS: We identified 6,012 reports, of which 39 studies met our inclusion criteria and were included for analysis. A total of 2200 patients received ET for SVC syndrome. The weighted technical success rate was 98.8% (95% CI 98.2-99.3) with low heterogeneity (I2=17.4%, p = 0.185), restenosis rate was 10.5% (95% CI 8.4-12.6) with moderate heterogeneity (I2=53.5%, p<0.001), and recurrence rate was 10.8% (95% CI 8.1-13.5) with high heterogeneity (I2=75.8%, p<0.001). Total complication rate was 8.6% (95% CI 7.3%-9.9%) with a mean complication rate of 7.5% (95% CI 4.7%-10.3%). INTERPRETATION: Our systematic review revealed high technical success, low restenosis, and low recurrence rates following ET. Collectively, these results support the paradigm of ET as an effective and safe treatment for patients with SVC syndrome. FUNDING: None.

What is genomic medicine?

Genomic medicine is rapidly changing the future of medicine. Medical librarians need to understand this field of research and keep current with its latest advancements. Even if they are not directly involved in genomic medicine, librarians can play an integral role by helping health care consumers and practitioners who may also need to expand their knowledge in this area. This article provides a basic introduction to genomic medicine, gives a brief overview of its recent advancements, and briefly describes some of the ethical, legal, and social implications of this emerging area of research and practice.

Transforming the systematic review service: a team-based model to support the educational needs of researchers.

To meet the current needs of researchers who perform systematic reviews in health care settings, libraries need to provide high-quality educational services for researchers as part of their systematic review services. A team of librarians with diverse skills is also important for ensuring the growth and sustainability of systematic review services. This commentary describes a new team-based systematic review service model that can transform systematic review services by providing a pathway for librarians to offer a comprehensive educational service for systematic review research in a variety of health sciences library settings.