Medicine
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Meta Analysis Comparative Study
Oral vs intravenous tranexamic acid in total-knee arthroplasty and total hip arthroplasty: A systematic review and meta-analysis.
This study aimed to compare the efficacy and safety of oral tranexamic acid (TXA) with intravenous (IV) TXA in reducing perioperative blood loss in total-knee arthroplasty (TKA) and total-hip arthroplasty (THA). ⋯ Oral TXA is equivalent to IV TXA in reducing perioperative blood loss and should be recommended in TKA and THA. More high-quality studies are needed to elucidate this issue.
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An adductor canal block (ACB) provides recognized analgesia following total knee arthroplasty (TKA). This meta-analysis compared the single-injection ACB (SACB) with the continuous-injection ACB (CACB). ⋯ The SACB technique provides similar analgesia in the 24 hours following TKA compared with CACB, while the CACB method was better over 48 hours.
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A network meta-analysis was conducted to regard the effects of available immunosuppressive medications in pediatric frequently-relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome (SDNS). ⋯ No significant differences in acceptability were found. Our results suggest that cyclophosphamide may be preferred initially in children with FRSN/SDNS, chlorambucil, and rituximab may be acceptable medications for patients with FRSN/SDNS. Long-term follow-up trials focused on gonadal toxicity and limitation of maximum dosage of cyclophosphamide should been carried out.
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Observational Study
Prediction of acute kidney injury: the ratio of renal resistive index to semiquantitative power Doppler ultrasound score-a better predictor?: A prospective observational study.
This study aimed to explore the diagnostic performance of the ratio of renal resistive index (RRI) to semiquantitative power Doppler ultrasound (PDU) score in predicting acute kidney injury (AKI) 3 in critically ill patients. This study was a prospective, observational study that included 101 critically ill patients. RRI and semiquantitative PDU score were measured within 6 hours following admission to the intensive care unit (ICU). ⋯ In 93 patients, except for 8 patients with a PDU score of 0, the AUC of RRI/PDU [0.938 (95% CI: 0.868-0.977)] was superior to the PDU score (0.905 [95% CI: 0.826-0.956], P = .133), RRI [0.782 (95% CI: 0.684-0.861), P = .016], serum creatinine [0.801 (95% CI: 0.705-0.877), P = .017], or 6 hours AKI stage (0.876 [95% CI: 0.791-0.935], P = .110) in predicting AKI 3 on D5. In our study, RRI, PDU score, RRI/PDU, and 6 hours AKI stage were useful in predicting AKI 3. Furthermore, RRI/PDU may be a better predictor of AKI 3.
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Constipation is one of the most common diseases in children and it is also a significant healthcare burden, more than many other common childhood diseases. For some children, 1st-line treatment cannot relieve their constipation and their constipation symptoms maybe continue to adolescence. So, alternative treatment options such as lactobacilli are needed. However, the effectiveness and safety of lactobacilli is still unclear. To investigate this question, we conduct a systematic review and meta-analysis. ⋯ CRD42019125913.