Medicine
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Meta Analysis Comparative Study
Comparative efficacy and safety of second-line medications for status epilepticus: A network meta-analysis.
To systematically review the efficacy and safety of second-line medications for status epilepticus (SE). ⋯ PHB continues to be a prominent option for managing SE, although its safety profile warrants careful consideration. Meanwhile, both VPA and LEV offer distinctive advantages in the treatment of SE, with each demonstrating commendable safety profiles.
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Lumbar 5 (L5) selective nerve root block is a common treatment for lumbar 4/5 disc herniation. It is difficult to perform real-time ultrasound-guided targeted L5 nerve root block because of the deep structure of the L5/S1 intervertebral foramen and the occlusion of the sacrum and ilium. Therefore, the safe and efficient implementation of L5 nerve root block is very important for improving the clinical promotion and use of this procedure. ⋯ The innovative puncture approach method may be considered a therapeutic option in patients with chronic pain.
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Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI) with high mortality rates. While mechanical circulatory support devices like intra-aortic balloon pump (IABP) and Impella are used to manage CS, their comparative effectiveness remains unclear. This meta-analysis aims to evaluate the safety and efficacy of Impella in the treatment of AMI-associated CS. ⋯ Impella significantly reduces 6-month all-cause mortality in patients with CS following AMI compared to standard of care. However, this survival benefit is offset by a substantial increase in major bleeding, limb ischemia, and sepsis risks associated with Impella. Future large scale trials are needed to validate these findings and refine clinical guidelines for the optimal use of Impella in treating CS.
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Observational Study
Characteristics of patients leaving the emergency department without being seen by a doctor: The first report from Türkiye.
The presence of patients who leave without being seen (LWBS) by a physician in the emergency department (ED) is an essential indicator of the accessibility and quality of healthcare delivery. A high LWBS rate implies low patient satisfaction. This study aims to analyze the prevalence and characteristics of LWBS patients in Türkiye and their ED readmission rate within 3 days. ⋯ LWBS patients are both a result and a consequence of ED crowding. A zero LWBS rate is crucial for older adults' health as they may fall victim to an invisible accident while avoiding ED traffic. Prioritizing older adults and reorganizing waiting areas can reduce ED crowding and cost burden due to delayed treatments.
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Meta Analysis
Is intralymphatic immunotherapy effective and safe for allergic rhinitis?: A meta-analysis.
As there is much controversy in using intralymphatic immunotherapy (ILIT) as a therapeutic means for allergic rhinitis (AR), its efficacy and safety for AR were investigated based on a systematic review and meta-analysis. ⋯ After the application of the ILIT strategy against AR, the quality of life of patients was improved and the incidence of adverse events associated with nasal symptoms was reduced, but the conclusion needed further verification with more high-quality research.