Chest
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Review Meta Analysis
WHAT IS THE ROLE OF TIOTROPIUM IN ASTHMA? A SYSTEMATIC REVIEW WITH META-ANALYSIS.
The role of tiotropium for the treatment of asthma has not yet been clearly defined. The aim of this systematic review was to assess the efficacy and safety of tiotropium in patients with asthma. ⋯ Tiotropium resulted noninferiorly to salmeterol and superiorly to placebo in patients with moderate to severe asthma who were not adequately controlled by ICS or ICS/salmeterol. Major benefits were concentrated in the increase in lung function and in the case of patients with severe asthma, in the reduction of exacerbations.
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Review Meta Analysis
Prognostic value of plasma Heart-type Fatty Acid Binding Protein in patients with acute Pulmonary Embolism: a Meta-analysis.
Several studies have described heart-type fatty acid-binding protein (H-FABP) from early blood samples as a predictor of outcome in acute pulmonary embolism (PE). This systematic review is designed to determine the prognostic value of H-FABP aimed for use in patients with acute PE. ⋯ H-FABP is associated with an increased risk of mortality or complicated clinical events in patients with acute PE across different studies with a high degree of clinical and methodologic diversity. The result suggests that H-FABP has significant prognostic value for acute PE.
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Background: The use of inhaled corticosteroids (ICSs) is associated with an increased risk of pneumonia in patients with COPD. However, the risks of other respiratory infections, such as TB and influenza, remain unclear. Methods: Through a comprehensive literature search of MEDLINE, EMBASE, CINAHL, Cochrane Library, and ClinicalTrials.gov from inception to July 2013, we identified randomized controlled trials of ICS therapy lasting at least 6 months. ⋯ Results were similar with each meta-analytic approach. Furthermore, the number needed to harm to cause one additional TB event was lower for patients with COPD treated with ICSs in endemic areas than for those in nonendemic areas (909 vs 1,667, respectively). Conclusions: This study raises safety concerns about the risk of TB and influenza associated with ICS use in patients with COPD, which deserve further investigation.
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Review Meta Analysis
Chest computed tomography screening for lung cancer in asbestos occupational exposure: a systematic review and meta-analysis.
Lung cancer is the most frequent malignant asbestos-related pathology and remains the most fatal cancer of industrialized countries. In heavy smokers, early detection of lung cancer with chest CT scan leads to a 20% mortality reduction. However, the use of CT scan screening for early detection of lung cancer in asbestos-exposed workers requires further investigation. This study aimed to determine whether CT scan screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer using a systematic review and meta-analysis. ⋯ CT scan screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer. Detection of lung cancer in asbestos-exposed workers using CT scanning is at least equal to the prevalence in heavy smokers (1%; 95% CI, 0.09%-1.1%) and also shared a similar proportion of stage I diagnoses. Screening asbestos-exposed workers could reduce mortality in proportions previously observed among heavy smokers and, thus, should not be neglected, particularly for individuals combining both exposures.
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Review Meta Analysis
Comparative Effectiveness and Safety of Drug Therapy for Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis.
Drug treatment for pulmonary hypertension improved 6-minute walk distance and reduced hospitalisation. Combination is more effective than monotherapy.
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