BioMed research international
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To compare the efficacy and safety of vonoprazan-based versus proton pump inhibitor (PPI)-based triple therapy in the eradication of Helicobacter pylori. ⋯ Efficacy of vonoprazan-based triple therapy is superior to that of PPI-based triple therapy for first-line H. pylori eradication. Additionally, vonoprazan-based triple therapy is better tolerated than PPI-based triple therapy.
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Meta Analysis
Pulmonary Rehabilitation for Exercise Tolerance and Quality of Life in IPF Patients: A Systematic Review and Meta-Analysis.
The aim of this study is to evaluate the efficacy and safety of pulmonary rehabilitation (PR) in patients with idiopathic pulmonary fibrosis (IPF). Methods. Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wanfang Data, and Chinese Biomedical Literature Database (SinoMed) were comprehensively searched. Randomized controlled trials (RCTs) that investigated the effects of PR for IPF patients were included. Literature selection and data extraction were conducted by two review authors independently. The Cochrane Collaboration's Risk of Bias tool and RevMan software (version 5.3) were used to evaluate the quality of studies and conduct statistical analysis, respectively. Results. Seven studies (190 participants) were included. PR had a significant effect on six-minute walk distance (6MWD) (MD:48.60; 95%CI: 29.03 to 68.18; Z=4.87, P<0.00001), and 6MWD was improved more in subgroup analysis including studies conducted in Asia (MD: 53.62; 95%CI: 30.48 to 76.66; Z=4.54, P<0.00001) and Europe (MD:54.10; 95% CI: 26.65 to 101.56; Z=2.23, P=0.03). Forced vital capacity (FVC%) was higher (MD: 3.69; 95%CI: 0.16 to 7.23; Z=2.05, P=0.04). St. George's Respiratory Questionnaire (SGRQ)/IPF-specific SGRQ (SGRQ-I) total score was lower (MD: -7.87; 95% CI: -11.44 to -4.30; Z=4.32, P<0.0001). No significant effects were found for lung diffusing capacity determined by the single-breath technique (DLCO%) (MD: 3.02; 95%CI: -0.38 to 6.42; Z=1.74, P=0.08). ⋯ This study suggests that PR may enhance exercise capacity and improve quality of life in IPF patients. Besides, PR may also delay the decline of lung function of patients with IPF. However, further research should more fully assess the efficacy and safety of PR for IPF.
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Patient characteristics and predictive factors for outcomes were analysed in 202 cases undergoing simple decompression, primary subcutaneous transposition, or secondary subcutaneous transposition for ulnar nerve compression at the elbow at a tertiary referral hospital. Data from medical charts and a survey were evaluated. The mean patient age was 49 years with revision surgery cases being significantly younger. ⋯ We suggest simple decompression as the procedure of first choice. Transposition can be used in selected cases or when simple decompression fails. All patients should be strongly recommended to stop smoking considering the remarkably increased risk for complications among smokers.
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Multicenter Study Comparative Study Clinical Trial
Comparative Evaluation of a New Depth of Anesthesia Index in ConView® System and the Bispectral Index during Total Intravenous Anesthesia: A Multicenter Clinical Trial.
The performance of a new monitor for the depth of anesthesia (DOA), the Depth of Anesthesia Index (Ai) based on sample entropy (SampEn), 95% spectral edge frequency (95%SEF), and burst suppression ratio (BSR) was evaluated compared to Bispectral Index (BIS) during total intravenous anesthesia (TIVA). 144 patients in six medical centers were enrolled. General anesthesia was induced with stepwise-increased target-controlled infusion (TCI) of propofol until loss of consciousness (LOC). During surgery propofol was titrated according to BIS. ⋯ A decrease or an increase of Ai was significantly greater than that of BIS when consciousness changes (during LOC: -9.13±10.20 versus -5.83±9.63, p<0.001; during ROC: 10.88±11.51 versus 5.32±7.53, p<0.001). The conclusion is that Ai has similar characteristic of BIS as a DOA monitor and revealed the advantage of SampEn for indicating conscious level. This trial is registered at Chinese Clinical Trial Registry with ChiCTR-IOR-16009471.
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This meta-analysis with trial sequential analysis (TSA) compared the clinical efficacy of extracorporeal cardiopulmonary resuscitation (ECPR) with conventional CPR (CCPR) for adult patients who experienced in-hospital cardiac arrest (IHCA) or out-of-hospital CA (OHCA). ⋯ Relative to CCPR, ECPR improved the survival and neurological outcome of patients who had IHCA. Compared to IHCA patients, TSA could not confirm better survival and neurologic outcome of ECPR in OHCA patients, suggesting that further studies are needed.