Medicine
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Meta Analysis Comparative Study
Vonoprazan versus proton pump inhibitors for the management of gastroesophageal reflux disease: A protocol for a systematic review with meta-analysis.
Vonoprazan, a novel potassium-competitive acid blocking agent, is used in the management of gastroesophageal reflux disease (GERD). We aim to perform a systematic review and meta-analysis for the comparison of the effects of vonoprazan and proton pump inhibitors (PPIs) in GERD in randomized controlled trials (RCTs). ⋯ To our knowledge, this systematic review and meta-analysis will be the first to evaluate existing research comparing Vonoprazan and PPIs in GERD. Our study will provide information about the effect of vonoprazan and PPIs in GERD in RCTs. The review will benefit patients, healthcare providers, and policymakers.
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Randomized Controlled Trial Observational Study
Effects of different doses of intranasal dexmedetomidine on preoperative sedation and postoperative agitation in pediatric with total intravenous anesthesia undergoing adenoidectomy with or without tonsillectomy.
Dexmedetomidine is a highly selective α2 receptor agonist, this study aimed to investigate the effects of different doses of intranasal dexmedetomidine on the preoperative sedation and postoperative agitation in pediatric with total intravenous anesthesia (TIVA) for adenoidectomy with or without tonsillectomy. This is a double-blind placebo-controlled randomized trial. Pediatric were randomly divided into the D1, D2, and S groups, each group contained 30 patients. ⋯ The Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) in the D2 group was significantly lower than the S group (P = .013). The intranasal dexmedetomidine of 1 or 2 μg kg 25 to 40 minute before induction of anesthesia both could deliver effective preoperative sedation, reducing the children's distress of separation from parents. Moreover, intranasal dexmedetomidine of 2 μg kg could deliver more effective postoperative analgesia and reduce postoperative agitation, without prolonging postoperative recovery or causing severe adverse events.
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Enhanced recovery after surgery (ERAS) is acknowledged to reduce perioperative stress in several surgical diseases. Here, we investigated whether modified ERAS is associated with beneficial effects in the setting of emergency colorectal surgery. We retrospectively evaluated the medical records of 839 consecutive patients with obstructive colorectal cancer undergoing surgical intervention at 4 institutes. ⋯ Median (interquartile range) postoperative hospital stay in the modified ERAS group was 6 (3-22) days versus 9 (7-27) days in the traditional care group (P < .001). Furthermore, the interval from operation to postoperative chemotherapy (d) was significantly shorter in the modified ERAS group (35.6 ± 11.5 vs 47.6 ± 23.8, P < .001). The modified ERAS was safe and associated with clinical benefits, including fast recovery of bowel function, reduced postoperative complications, and shorter hospital stay for patients with obstructive colorectal cancer.
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Comparative Study
Hope as a behavior and cognitive process: A new clinical strategy about mental health's prevention.
Given the aging population, it is necessary to develop strategies for the prevention and promotion of mental health in the elderly. Hope as the ability to trace and maintain paths can be used as a key construct for these strategies, promoting cognitive health if stimulated. ⋯ Hope in addition to cognitive stimulation shows more significant results in elderly people at initial stimulation (0.18), mainly at the permanence and troubleshooting on the paths concerned; this corresponds with the results obtained for hope (0.18). Depressive symptomatology showed significant differences among the 2 groups (0.39 and 0.02). In the between-groups comparisons, only GDS showed significance (0.46).Hope training has an impact on the remission of depressive symptoms and, despite increased hope levels, training was effective for the reduction of depression symptoms for up to 6 months, thereafter only playing a maintenance role. Broadly, hope has been shown to promote elderly people's mental health.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of the UEScope videolaryngoscope with the Macintosh laryngoscope during simulated cardiopulmonary resuscitation: A randomized, cross-over, multi-center manikin study.
Endotracheal intubation (ETI) can be challenging, especially in life-threatening situations such as cardiopulmonary resuscitation (CPR). Videolaryngoscopes aim to ease ETI, but effort is still widely discussed. This study intended to investigate 2 different airway devices regarding the success rate of ETI during ongoing chest compressions. ⋯ In simulated CPR scenarios, intubation with the UEScope resulted in a better glottis visualization, a higher intubation success, and a shorter intubation time compared to Macintosh laryngoscope (MAC). Moreover, in situations where the airway is difficult for ETI especially by the paramedic, the UEScope would be a better choice than the MAC. Further studies are needed to confirm these results in real-life patients.