Search Results (14,774)

Background: Perioperative fluid management plays a critical role in optimizing recovery after radical cystectomy. Various strategies, such as restrictive fluid therapy, goal-directed fluid therapy (GDFT), and warmed fluids, have been studied for their impact on complications and outcomes. However, the optimal approach remains uncertain. Methods: We conducted a systematic review in accordance with PRISMA 2020 guidelines. A PubMed search was performed in January 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies published in English that assessed perioperative fluid strategies in radical cystectomy. Two reviewers independently selected studies, with a third resolving discrepancies. Data were extracted on study characteristics, interventions, and outcomes. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Due to heterogeneity, narrative synthesis was used. Results: Seventeen studies (eight RCTs, nine observational; total n = 3519) were included. Three publications based on a single RCT (n = 167) showed that restrictive fluid therapy with norepinephrine significantly reduced blood loss (p < 0.0001), transfusions (p = 0.0006), complications (p = 0.006), and hospital stay (p = 0.02), with a trend toward fewer 90-day complications (p = 0.12). Six studies (four RCTs, two observational) evaluated GDFT. Doppler- and SVV-based GDFT reduced ileus, nausea, wound infections, and blood loss, although findings on renal function and length of stay were mixed. One RCT showed that warmed fluids reduced transfusion needs (p = 0.028) and hospital stay (p = 0.05). VBFI (Vascular Bed Filling Index)- and aVBFI (adjusted Vascular Bed Filling Index)-guided strategies may lower complications in ileal conduit patients, but evidence remains limited. Conclusions: Restrictive fluid therapy with norepinephrine appears to improve outcomes after radical cystectomy. GDFT and warmed fluids show potential benefits, but findings are inconsistent. Further high-quality trials are needed to define the optimal strategy. Full article

Background/Objectives: Youth mental health significantly impacts future well-being, with nearly half of mental health disorders emerging during adolescence. Civic engagement is defined as active participation in the community to improve conditions for others or to help shape the community’s future. It offers a unique opportunity to enhance youth mental well-being, acting as a protective factor against mental health struggles. In this line, Relational Developmental Systems Theory posits that positive youth development is positively linked to civic engagement. The main objective of this literature-based paper is to identify, select, assess, and synthesize the existing literature on interventions promoting mental health in the youth through civic engagement, resulting in an up-to-date review. Methods: Following PRISMA guidelines, a search was conducted using PsycInfo, Scopus, and Web of Science to gather studies published between 2018 and 2023, based on the combination of key terms: (“civic engagement” OR “social participation”) AND (“mental health” OR “psychological adjustment” OR “well-being”) AND (adolescen* OR teen* OR youth OR “young people”) AND (program* OR intervention OR training OR education). Data extraction and risk-of-bias assessments were performed. Results: Ten studies were included in this review which suggest that civic engagement programs improve youth mental health outcomes, including reduced anxiety, reduced sadness, and increased resilience. These programs foster empowerment, sense of belonging, and social connections, while also enhancing interpersonal skills and career aspirations. Youth also gain valuable skills such as leadership, communication, and problem-solving, contributing to educational and vocational growth. However, challenges such as socio-economic barriers and attendance issues can impact some outcomes, with variations in effectiveness across programs. Conclusions: Youth civic engagement programs should integrate mental health support to mitigate the emotional costs of activism, ensuring greater participation and well-being. It is important to adapt these programs to local contexts and provide flexibility to strengthen participation and community impact. Future research should explore the role of cultural, gender, and socio-economic factors in shaping program outcomes and utilize randomized controlled trials to improve the validity and generalizability of findings. Full article

Background: Pelvic floor muscle (PFM) dysfunctions, such as urinary incontinence (UI), significantly impact women’s quality of life. The abdominal hypopressive technique (AHT), a breathing and posture-based intervention, has emerged as a promising approach to improve PFM function. Despite growing evidence on its efficacy, limited research explores its effect on PFM contractility. Objective: This study aimed to evaluate the effects of an 8-week AHT program on pelvic floor muscle (PFM) strength in adult women with no prior experience with AHT. Methods: A randomized controlled trial was conducted with 42 females (mean age 43 ± 9 years) assigned to an experimental group (EG, n = 21) or a control group (CG, n = 21). The EG completed 24 AHT sessions (30 min/session, 3 sessions/week) over 8 weeks. PFM strength, measured via maximum voluntary contraction (MVC), was assessed pre- and post-intervention using the Phenix Biofeedback Kit. Secondary outcomes included load absorption and muscle efficiency. Muscle efficiency and load absorption were also registered. Results: After the 8-week intervention, significant improvements were observed in the EG for maximal voluntary contraction (MVC1 (from 672.2 ± 344.1 g/cm² to 890.3 ± 435.8 g/cm², p = 0.002) and load absorption (from 83.9 ± 36.8 to 103.1 ± 37.3, p = 0.001), with no significant changes in the CG. Between-group differences for MVC1 (p = 0.001), MVC2 (p = 0.016), and load absorption (p = 0.008) were statistically significant. High adherence (96%) and no adverse events were recorded. Conclusions: An 8-week AHT program significantly improved PFM strength, load absorption, and muscle efficiency in women from the present study comparing with the CG. AHT could be considered a safe, non-invasive, and effective intervention for pelvic floor rehabilitation, with potential benefits for addressing UI and enhancing pelvic floor functionality. Future research should focus on long-term outcomes and comparisons with alternative therapies. Full article

Background and Objectives: Percutaneous cardiovascular interventions (PCIs) have become a cornerstone in the management of cardiovascular diseases. However, patients often experience significant anxiety and pain during these procedures, which can negatively impact their overall experience and clinical outcomes. Virtual reality (VR) is an emerging non-pharmacological intervention designed to alleviate procedural anxiety and pain through immersive distraction techniques. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) identified from PubMed, CENTRAL, Scopus, Google Scholar, and Web of Science up to November 2024. Primary outcomes were peri-procedural anxiety and pain; secondary outcomes included vital signs, procedure duration, and safety (e.g., delirium). Continuous data were pooled using a random-effect model and reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs) in Stata MP v.17. Certainty of evidence was assessed using the GRADE approach. Results: Ten RCTs involving 890 patients were included. VR distraction significantly reduced peri-procedural anxiety (SMD: –0.70; 95% CI: –1.15 to –0.26; p < 0.001). However, no significant differences were observed between groups for peri-procedural pain (SMD: –0.64; 95% CI: –1.45 to 0.16; p = 0.12), systolic blood pressure (SMD: –0.31; 95% CI: –1.23 to 0.61; p = 0.50), diastolic blood pressure (SMD: –0.25; 95% CI: –1.07 to 0.56; p = 0.54), heart rate (SMD: –0.44; 95% CI: –0.93 to 0.05; p = 0.08), respiratory rate (SMD: –0.93; 95% CI: –2.18 to 0.31; p = 0.14), or procedure duration (SMD: 0.07; 95% CI: –1.14 to 0.28; p = 0.49). Conclusions: VR significantly ameliorated peri-procedure anxiety in patients undergoing PCIs; however, it had no effect on peri-procedure pain or vital signs. This is based on uncertain evidence from heterogeneous studies, warranting further confirmation through large-scale RCTs. Full article

Background: Psoriasis is a persistent, inflammatory skin disease with autoimmune characteristics. Beyond the obvious signs of skin lesions, it has negative systemic repercussions that impair the patient’s quality of life. This study aimed to determine the effectiveness of N-acetylcysteine (NAC) alone or in combination with Vitamin E in the treatment of mild to moderate active psoriasis vulgaris. Methods: This study was an open-label, prospective, randomized, controlled interventional clinical trial conducted at Cairo Hospital for Dermatology and Venereology (Al-Haud Al-Marsoud). In total, 45 patients with mild to moderate symptoms were randomly assigned to three groups, with fifteen patients each, as follows: the control group received the standard psoriatic treatment of topical steroids and salicylic acid; the acetylcysteine group received standard psoriatic treatment in addition to NAC 600 mg per day 30 min prior to breakfast for 8 weeks; and the acetylcysteine and Vitamin E group received standard psoriatic treatment in addition to NAC 600 mg per day, in a similar way of dosing like the previous group, and Vitamin E 1000 mg per day. All participants performed a comprehensive assessment including hematological parameters, the Psoriasis Area and Severity Index (PASI), the Dermatology Life Quality Index (DLQI), malondialdehyde (MDA), and interleukin-36 gamma (IL-36γ). Results: The treatment strategy involving the use of NAC alone and in combination with Vitamin E showed significant improvement in the assessed parameters compared to the control group receiving conventional therapy. The acetylcysteine group showed improvements of 41% in PASI and 49.4% in DLQI, a decrease of 34.3% in MDA, and a decrease of 31% in IL-36γ. Similarly, the acetylcysteine and Vitamin E group showed improvements of 52% in PASI and 42% in DLQI, a decrease of 37% in MDA, and a decrease of 35% in IL-36γ. There were no significant differences found between the N-acetylcysteine and N-acetylcysteine and Vitamin E groups. Moreover, significant positive correlations were found between MDA, IL-36γ, and PASI at baseline and after the third follow-up. Conclusions: This study found promising therapeutic benefits in the addition of NAC to the conventional therapy in psoriatic patients with mild to moderate symptoms, as it significantly improved psoriasis disease outcomes and improved the patient’s quality of life. However, the addition of Vitamin E to the NAC regimen did not show additional benefits. Full article

Coronary artery disease and vitamin D deficiency are both widespread conditions with a high incidence worldwide. Coronary artery disease is a complex illness with variable manifestation and pathogenesis. It often involves the development of atherosclerosis, and it frequently has serious or even fatal consequences for the patient. Vitamin D receptor expression is found in many tissues throughout the body, which results in a broad effect of the vitamin. Studies have found correlations between vitamin D deficiency and the development of coronary artery disease as well as other cardiovascular diseases, such as hypertension. This review will discuss randomized controlled trials conducted from 2020 forward, aiming to elucidate whether vitamin D supplements have the potential to be used as an add-on treatment for coronary artery disease. The randomized controlled trials all used vitamin D as intervention and tested a population suffering from coronary artery disease or the risk of developing it. Even though animal studies found evidence that vitamin D can regulate inflammation, lipid profile, foam cell formation, vessel reactivity, and blood pressure, which are all mediators in the development of atherosclerosis, the results from the randomized controlled trials were ambiguous. The general older population did not seem to benefit from the treatment, but different subgroups such as patients with type 2 diabetes and patients with more developed coronary artery disease exhibited some positive effects from the treatment. Furthermore, vitamin D showed cardioprotective effects following coronary artery bypass surgery, which make it a possible add-on treatment before invasive coronary intervention. The question in focus still needs further research and a more focused approach on subgroups that may benefit from treatment. Full article

Background and Objectives: The development of non-dairy probiotic products is a challenge for the food industry, while cereals, as probiotic carriers, provide the means to incorporate probiotics, prebiotics, and fiber into the human diet. The present study investigated the effects of Lactococcus cremoris spp. immobilized on oat flakes on blood and urine biomarkers in a randomized placebo-controlled single-blind clinical trial. Materials and Methods: Fifty-four eligible participants were randomized into a placebo or probiotic group that consumed 5 g of oat flakes daily for 12 weeks. Blood and urine samples were collected at the baseline, 6 weeks, and 12 weeks to assess the glycemic, lipemic, inflammatory, immunological, and antioxidant biomarkers, as well as the vitamin levels. Results: The intervention group exhibited a significant reduction in their hs-CRP levels (p = 0.002) and a trend toward decreased IL-6 levels (p = 0.035) at week 12 compared to the control group, suggesting a potential anti-inflammatory effect. Additionally, a significant reduction in insulin levels was observed in the probiotic group at week 6, with a clinical trend toward differentiation despite the absence of statistically significant differences between the groups. Furthermore, there were promising results regarding certain biomarkers, such as vitamin B12 and cortisol levels, in the probiotic group. Conclusions: The twelve-week consumption of Lactococcus cremoris spp. immobilized on oat flakes resulted in improvements in inflammatory, metabolic, and stress-related biomarkers. These results support the examined concept of non-dairy probiotic products, though further research is needed to confirm their efficacy and clarify their underlying mechanisms. Full article

Background: Pre-eclampsia (PE) is a common and serious pregnancy complication, contributing significantly to maternal and neonatal morbidity and mortality. Emerging evidence suggests a potential link between vitamin D deficiency (VDD) and an increased risk of PE. However, the data remain inconclusive, and the precise role of vitamin D supplementation in preventing PE is still uncertain. This systematic review and meta-analysis aims to evaluate the association between maternal VDD and the risk of pre-eclampsia, specifically focusing on randomized controlled trials (RCTs) to assess the potential preventive effect of vitamin D supplementation during pregnancy. Methods: A systematic review and meta-analysis were conducted by reviewing RCTs that investigated the link between maternal VDD and the incidence of pre-eclampsia. The studies were sourced from major databases such as PubMed, Scopus, and Web of Science, with studies published from 2016 to 2025. A random-effects model was employed to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Results: A total of 2461 participants were included from the five RCTs. The meta-analysis revealed a significant reduction in the risk of pre-eclampsia among pregnant women receiving vitamin D supplementation (RR = 0.61, 95% CI: [0.50–0.75], p < 0.001), supporting its protective role. Subgroup analysis revealed that the association was particularly strong in women with serum vitamin D levels < 20 ng/mL. Additionally, supplementation with vitamin D showed a trend towards reducing the risk of pre-eclampsia, although the studies showed some heterogeneity regarding supplementation dosages and timing. Conclusions: This systematic review and meta-analysis provides robust evidence that maternal VDD is associated with an increased risk of pre-eclampsia. The findings suggest that correcting VDD through supplementation during pregnancy may be an effective preventive strategy to reduce the incidence of pre-eclampsia. However, further well-designed RCTs are required to determine the optimal timing, dosage, and long-term effects of vitamin D supplementation on maternal and neonatal health outcomes. Full article

Background/Objectives: Duodenal stump fistula (DSF) is one of the most feared postoperative complications in gastric cancer surgery. It has a 1.6–5% incidence rate and correlates with potentially high rates of morbidity (75%) and mortality (16–20%). The absence of duodenal stump reinforcement is considered one of the main risk factors. Our meta-analysis aimed to provide updated evidence by comparing DSF rates among patients who underwent distal or total gastrectomy for malignant gastric disease with or without reinforcement of the duodenal stump. Methods: We performed a systematic review following the PRISMA guidelines. PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library databases were used to identify articles of interest. Meta-analysis was performed by using RevMan Version 5.4. Results: The six included comparative studies (19,527 patients: 11,545 reinforcement group versus 7982 control group) covered an approximately 20-year study period (2005–2023). All the studies included were observational in nature. Meta-analysis of pooled results showed that, compared to the control group, the reinforcement group recorded a statistically significant lower DSF rate (OR: 0.32, 95% CI: 0.17, 0.60, p = 0.0004). Considering secondary outcomes, no statistically significant differences were identified between the two groups in terms of operative time, EBL, overall postoperative complications, and length of hospital stay. Just major postoperative complications were considerably lower in the reinforcement group compared to the control group (OR: 0.66, 95% CI: 0.43, 0.99, p = 0.04). Conclusions: Duodenal stump reinforcement appears to reduce the rate of DSF after distal or total gastrectomy for malignant gastric disease. Given the significant biases among meta-analyzed studies, our results require careful interpretation. Further randomized, possibly multicenter trials may turn out to be of paramount importance in confirming our results. Full article

Background: Alcohol Use Disorder (AUD) is highly prevalent among substance use disorders worldwide and is characterized by a multifactorial pathophysiology. AUD treatment is mostly based on combined pharmacotherapy and multidisciplinary clinical approaches. Nonetheless, meta-analytical studies assessing the efficacy of combination therapy are scarcely available. Methods: We searched for randomized clinical trials through PubMed, ClinicalTrials.gov, Cochrane Library, SciELO, Biblioteca Virtual em Saúde, and Google Scholar databases. Original clinical trials published in English and Portuguese were selected. Data collection followed the PRISMA and MOOSE guidelines and was assessed using the Risk of Bias Tool (RoB 2). Heterogeneity was assessed using the Q test. Meta-regression was conducted using Egger’s regression method. Twelve articles were finally included in the analysis, and random-effects models were applied on aggregate trial results. Results: The meta-analysis found that combination therapies led to an average 4.045% increase in abstinence rates (95% CI: 0.415% to 7.675%) compared to monotherapies. Meta-regression showed a strong positive association between the use of naltrexone, acamprosate, and sertraline—either alone or in combination—and treatment success in AUD. The meta-regression also highlighted the impact of patients’ variables, such as gender, age, country, and psychiatric comorbidities, on their treatment outcomes. These findings may identify a potential therapeutic pathway promoting alcohol abstinence, further supported by a Number Needed to Treat (NNT) of 25, as an acceptable value for substance use disorder treatments. Conclusions: Combined pharmacotherapies are more effective than monotherapy in enhancing abstinence rates in AUD treatment, with naltrexone, acamprosate, and sertraline emerging as key adjunctive agents promoting these outcomes. These findings underscore the complexity of AUD as a multifactorial psychiatric condition and highlight the potential of combined pharmacotherapy as a promising strategy for achieving better treatment outcomes, particularly in terms of abstinence rates. Full article

Venous thromboembolic events (VTEs), especially in the form of portal vein thrombosis (PVT), are common complications of cirrhosis and are associated with significant morbidity. These patients can also be easily tipped toward bleeding because of deficiencies in procoagulant factors and pharmacokinetic and pharmacodynamic changes that occur during disease progression. Therefore, the understanding of how to use pharmacotherapy to treat VTE is a key to success in achieving VTE resolution without potentiating adverse bleeding events (AEs). Based on a review of the literature and the authors’ clinical experience, it was determined that unfractionated heparin (UFH), low molecular weight heparin (LMWH), fondaparinux, argatroban, warfarin, and direct oral anticoagulants all have evidence of use in patients with cirrhosis and VTE. However, the available literature is mostly limited to retrospective studies and case reports. There appears to be a paucity of prospective, randomized trials that compare the available pharmacotherapy at typical and adjusted doses. Overall, the decision as to the choice of agent and dose prescribed for anticoagulant therapy should include assessment on clot burden, bleeding risk, drug-drug/disease interactions, and the risk of presence of AEs. Full article

This study aimed to evaluate prosthetic complications, implant survival rates, and marginal bone loss in implant-supported monolithic restorations compared to metal-ceramic restorations. The study was registered in PROSPERO (CRD420251022336) and conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. A systematic search was conducted in the electronic databases MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to December 2024. The inclusion criteria comprised studies evaluating only randomized clinical trials that evaluated implant-supported monolithic restorations directly compared to metal-ceramic restorations, considering any type of ceramic material and regardless of the fixation system (screw-retained or cemented), with a minimum follow-up of one year. A meta-analysis was performed using RevMan 5.4 software, and the risk of bias and certainty of evidence were assessed using the RoB 2.0 and GRADE tools, respectively. A total of six studies were included, all of which exclusively evaluated monolithic zirconia single crowns over follow-up periods ranging from 1 to 3 years. None of the included studies evaluated fixed partial dentures or restorative materials other than monolithic zirconia. In total, 267 patients (mean age range: 18–57 years) were analyzed, with a total of 174 implant-supported monolithic zirconia crowns and 165 metal-ceramic single crowns in the posterior region (premolars and molars). The meta-analysis revealed that implant-supported monolithic zirconia single crowns exhibited significantly fewer prosthetic complications compared to metal-ceramic single crowns (p < 0.0001; Risk Ratio [RR]: 0.26; Confidence Interval [CI]: 0.14–0.47). However, no statistically significant differences were observed between implant-supported monolithic zirconia and metal-ceramic single crowns regarding implant survival rates (p = 0.36; RR: 1.66; CI: 0.56–4.94) or marginal bone loss (p = 0.15; Mean Difference [MD]: −0.05; CI: −0.11–0.02). The risk of bias assessment indicated that four studies had a low risk of bias. However, the certainty of evidence was classified as low for prosthetic complications and implant survival rates and very low for marginal bone loss. Within the limitations of this review, it can be concluded that implant-supported monolithic zirconia single crowns can be considered a favorable treatment option as they show comparable implant survival and bone stability to metal-ceramic crowns, with a potential reduction in short-term prosthetic complications such as screw loosening and ceramic chipping. However, due to the limited number of studies included and low certainty of evidence, further long-term research is still needed to confirm their clinical performance over time. Full article

Background/Objectives: Cochlear implantation (CI) significantly enhances speech perception and quality of life in patients with severe-to-profound sensorineural hearing loss, yet outcomes vary substantially. Accurate preoperative prediction of CI outcomes remains challenging. This study aimed to develop and validate a machine learning model predicting postoperative speech recognition using a large, single-center dataset. Additionally, we compared model performance with expert clinical predictions to evaluate potential clinical utility. Methods: We retrospectively analyzed data from 2571 adult patients with postlingual hearing loss who received their cochlear implant between 2000 and 2022 at Hannover Medical School, Germany. A decision tree regression model was trained to predict monosyllabic (MS) word recognition score one to two years post-implantation using preoperative clinical variables (age, duration of deafness, preoperative MS score, pure tone average, onset type, and contralateral implantation status). Model evaluation was performed using a random data split (10%), a chronological future cohort (patients implanted after 2020), and a subset where experienced audiologists predicted outcomes for comparison. Results: The model achieved a mean absolute error (MAE) of 17.3% on the random test set and 17.8% on the chronological test set, demonstrating robust predictive performance over time. Compared to expert audiologist predictions, the model showed similar accuracy (MAE: 19.1% for the model vs. 18.9% for experts), suggesting comparable effectiveness. Conclusions: Our machine learning model reliably predicts postoperative speech outcomes and matches expert clinical predictions, highlighting its potential for supporting clinical decision-making. Future research should include external validation and prospective trials to further confirm clinical applicability. Full article

Background: Pelvic organ prolapse (POP) and stress incontinence (SUI) are very common medical conditions, affecting women’s quality of life worldwide. Current surgical and conservative therapies often yield variable outcomes and carry risks of complications or recurrence. Platelet-rich plasma (PRP) has emerged as a promising regenerative approach in various medical disciplines. Its application in urogynecology remains relatively new and emerging. The objective of this study was to review and consolidate existing evidence regarding the application of PRP injections for treating POP and/or SUI. Methods: This scoping review was conducted in accordance with the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR). The search strategy included MEDLINE (PubMed), Web of Science, and Scopus databases, covering articles published up to February 2025, with no restrictions on publication date. Results: We included in our review a total of 13 manuscripts and 320 patients at the end of the screening process. A total of ten SUI studies, comprising 273 patients, and three POP studies, involving 47 patients, satisfied all the review criteria. Both clinical entities reported high subjective improvement following PRP treatment. Moreover, PRP appeared to have no significant adverse effects. Conclusions: Our scoping review suggests that PRP may have potential benefits in the treatment of POP and SUI. Nevertheless, the current evidence on its application in this area remains limited. Therefore, well-designed, large-scale randomized controlled trials (RCTs) with extended follow-up periods are urgently needed, in the era of personalized medicine. Full article

Background: Endotracheal tube (ETT) intubation during general anesthesia (GA) is commonly associated with postoperative sore throat. This study aimed to evaluate whether thermal-softened ETTs reduce the postoperative sore throat incidence in patients undergoing elective surgery under GA. Methods: We conducted a comprehensive search of the literature across PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials (RCTs) evaluating the effect of thermal-softened ETTs on postoperative sore throat in patients undergoing elective surgeries under GA. The primary outcome was postoperative sore throat incidence, while secondary outcomes included hoarseness, vocal cord lesions, and time to intubation. Data were extracted independently by two authors, and the risk of bias was assessed using the Revised Cochrane risk of bias tool (version 2.0). A meta-analysis was then performed using the random-effects model, with the results expressed as risk ratios (RRs) and mean difference (MDs). Results: Eight studies, with a total of 970 participants, were included. Thermal-softened ETTs significantly reduced postoperative sore throat incidence (RR: 0.60, 95% CI: 0.44 to 0.82, p = 0.001). Subgroup analysis showed no difference for single-lumen tubes (RR: 0.76, 95% CI: 0.45 to 1.26, p = 0.28), but remained significant for double-lumen tubes (RR: 0.5, 95% CI: 0.39 to 0.65, p < 0.00001). No significant difference was found in hoarseness (RR: 0.86, 95% CI: 0.64 to 1.17, p = 0.34), but a lower incidence of vocal cord lesions (RR: 0.52, 95% CI: 0.40 to 0.68, p < 0.00001) was observed. No difference was found in the time to intubation (MD: −6.51, 95% CI: −20.04 to 7.02, p = 0.35). Conclusions: Thermal-softened ETTs may reduce the incidence of postoperative sore throat and vocal cord lesions but have no significant effect on hoarseness or intubation time. Full article