Neutrophil to Lymphocyte Ratio as a Biomarker for Predicting the Coronary Artery Abnormality in Kawasaki Disease: A Meta-Analysis.

We conducted a systematic review and meta-analysis on the relationship between the neutrophil to lymphocyte ratio (NLR) and coronary artery abnormalities (CAA) in patients with Kawasaki disease (KD), according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. We searched PubMed, Scopus, Web of Science, Embase, TRIP, Google Scholar, and ProQuest up to the 8th of August 2022. This was done to retrieve eligible studies. No date or language limitations were considered in this study. Methodology quality assessment was conducted according to the Newcastle-Ottawa scale (NOS). Standard mean difference (SMD) and its 95% confidence interval (CI) were used to depict the pooled continuous variables. Finally, 17 articles with 6334 KD patients, of whom 1328 developed CAA, were enrolled in this meta-analysis. NLR level was significantly higher in KD patients with CAA compared to those without CAA (SMD =0.81; 95% CI =0.05-1.57, P = 0.03). In addition, NLR level was significantly higher in patients with coronary artery aneurysms than those without coronary artery aneurysms (SMD =2.29; 95% CI =0.18-4.41, P = 0.03). However, no significant association between NLR and coronary artery dilation was observed in this meta-analysis (SMD =0.56; 95% CI = -0.86-1.99). There was no publication bias for the pooled SMD of NLR for coronary artery abnormality in KD (Egger's test P = 0.82; Begg's test P = 0.32). The NLR may be useful in monitoring CAA development in these patients and may further imply a mechanistic role in potential inflammation that mediates this process.

Evaluating the rate of post-surgical complications between three surgical methods in management of pulmonary hydatid disease.

INTRODUCTION: Hydatid disease is a zoonotic disease caused by Echinococcus. Surgery remains the gold standard approach of treatment. AIM: This study reports on 10 years of experience on surgical management of 78 cases of pulmonary hydatid disease and compares the rates of post-surgical complications between three approaches. MATERIAL AND METHODS: Three different surgical approaches - the Ugon method, cystectomy and lobectomy - were performed for pulmonary hydatid disease treatment during a 1-year follow-up program. The relationships between patient's age, sex, cyst location and surgical approach and occurrence of post-surgical complications were first assessed. Then post-surgical complications between these three methods were compared. RESULTS: From 78 patients, 51.5% were female and 48.5% were male (whose average age was 36.1). Hydatid cysts were found in the right (43.58%) and left (37.17%) lung while 19.23% of patients had bilateral cysts. Patient's age, sex and cyst location did not have any significant effect on the occurrence of complications. Post-surgical complications were only dependent on the surgical approach. 23% of the patients had post-surgical complications (including air leak, fistula, empyema, seroma and wound infection) and air leak was the most frequent one. CONCLUSIONS: Since complications were only dependent on the surgical method, the rate of post-surgical complications were compared between the three approaches. Cystectomy and lobectomy had similar rates of complications, which were lower than that of the Ugon method. It can be concluded that cystectomy is the method of choice for management of pulmonary hydatid disease, with the lowest rate of complications.