Approximately 25% of patients with chronic rhinosinusitis (CRS) have recurrence after endoscopic sinus surgery (ESS). The goal is to analyze and integrate research on individual and genetic factors of recurrence in CRS patients following ESS. A systematic review and meta-analysis were performed using PRISMA criteria. Various databases were searched from January 2008 to May 2025. ESS studies with adults with CRS reported results based on clinical or genetic factors. The Newcastle–Ottawa Scale and five dimensions of bias were examined study quality. Pooled odds ratios with 95% confidence intervals were estimated using a random-effects DerSimonian–Laird model. Heterogeneity was assessed using I 2 , publication bias using funnel plots and Egger test, and evidentiary certainty using GRADE. A total of 17 trials with 40,059 individuals were examined. Asthma, non-steroidal antiinflammatory drug (NSAID) intolerance, allergy, and higher Lund–Mackay scores (LMSs) were significant clinical predictors of recurrence. TAS2R38 polymorphisms had poorer outcomes, but only 4 trials were included. Asthma, NSAID intolerance, allergy, higher LMS, and TAS2R38 polymorphisms are significant predictors of recurrence in CRS following ESS. These results support the use of comorbidities, radiologic severity, and genetic biomarkers in preoperative risk classification, emphasizing the need for larger, standardized, and multi-ethnic research.

PURPOSE: Firefighters are exposed to high levels of occupational risk factors, such as safety risks, chemical, ergonomic, and physical hazards that may jeopardize their lives. To overcome these hazards, firefighters must be physically, mentally, and personally fit to work. This study aimed to explore the criteria and factors affecting firefighters' resilience based on stakeholders' experiences. METHODS: This qualitative study was carried out using conventional content analysis. In total, 21 face-to-face interviews were conducted by firefighters who were experienced in the field. The interviews were carried out from July 2019 to January 2020. The data were collected using 3 unstructured interviews and then resumed by 18 semi-structured interviews. Data analysis was done using Graneheim method. RESULTS: The participants had more than 5 years of experience in the field of search and rescue. The extracted codes through data analysis were classified into 3 main categories (individual, organizational, and social factors), 9 sub-categories (mental, physical, occupational, managerial, colleagues-related, equipment-related, environmental, community-related, and family-related factors), as well as 19 sub-sub-categories and 570 codes. CONCLUSION Firefighters' personality, physical condition, behavior and psychological characteristics can affect their resilience along with organizational and management factors that play significant role in people's safety. Developing a tool for assessing resilience can help decision makers to have a real depict of firefighters' job qualifications.
Firefighters/psychology* ; Humans ; Qualitative Research

PURPOSE: Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. RESULTS: The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. CONCLUSIONS: It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection.
Anesthesia, General ; Coma ; Hemiplegia ; Humans ; Iran ; Medical Records ; Nephrostomy, Percutaneous ; Neurologic Manifestations ; Paraplegia ; Prone Position ; Retrospective Studies