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Background Liver abscess is a life-threatening condition. Percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) are both minimally invasive techniques used to manage liver abscess. We aim to compare both techniques’ efficacy and safety. Methods We performed a systematic review and meta-analysis involving randomized controlled trials (RCTs) from PubMed, Embase, Scopus, WOS, Cochrane, and Google scholar until July 22 nd , 2022. We pooled dichotomous outcomes using risk ratio (RR) presented with a 95% confidence interval (CI) and continuous outcomes using mean difference (MD) with 95% CI. We registered our protocol with ID: CRD42022348755. Results We included 15 RCTs with 1,626 patients. Pooled RR favored PCD (RR: 1.21 with 95% CI: 1.11, 1.31, P<0.00001) in success rate and recurrence after six months (RR: 0.41 with 95% CI: 0.22, 0.79, P=0.007). We found no difference in adverse events (RR: 2.2 with 95% CI: 0.51, 9.54, P=0.29). Pooled MD favored PCD in time to clinical improvement (MD: −1.78 with 95% CI: −2.50, −1.06, P<0.00001), time to achieve 50% reduction (MD: −2.83 with 95% CI: −3.36, −2.30], P<0.00001) and duration of antibiotic needed (MD: −2.13 with 95% CI: −3.84, −0.42, P=0.01). We found no difference in the duration of hospitalization (MD: −0.72 with 95% CI: −1.48, 0.03, P=0.06). The results were heterogeneous for all the continuous outcomes which were all measured in days. Conclusions Our updated meta-analysis concluded that PCD is more effective than PNA in liver abscess drainage. However, evidence is still uncertain, and more high-quality trials are still required to confirm our results.

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Targeted drug delivery (TDD) systems have several advantages, especially with drugs having toxic side effects such as lornoxicam (LX) which shows high hepatotoxicity and nephrotoxicity, especially with long-term use. This work represents an attempt to control magnetic microspheres encapsulating LX and magnetite nanoparticles (MNPs) for potential targeted drug delivery of LX. Superparamagnetic nanoparticles were fabricated via the co-precipitation method and together with LX were encapsulated into polycaprolactone (PCL) microspheres through an oilin-water (O/W) emulsion solvent evaporation method. The effects of changing the amount of drug, MNPs, and volume of the aqueous phase were investigated by preparing several microsphere formulations. Increasing the amount of encapsulated MNPs increased the magnetization of the microspheres without affecting the morphology. Doubling the volume of the aqueous phase resulted in a higher encapsulation efficiency and drug loading; 83.9% and 10.7%, respectively, while increasing the amount of drug had a negative effect on both drug loading and encapsulation efficiency. Drug release from the microspheres was successfully achieved and showed a biphasic nature. A system of four planar coils was then used to magnetically control the movement of a cluster of capsules in a glycerin medium, as a simulation for the targeting process. The microspheres were successfully controlled to move in a U-turn path with sharp corners demonstrating their potential for TDD applications.

The work was completed while Abdelrahman Mahmoud was pursuing his masters degree at Marmara University under the supervision of Dr. Bulut. This project was funded by Turkish National Science Foundation (Tübitak) under grant number 119E031.