BMJ : British medical journal
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Review Meta Analysis
Effects of vitamin D supplementation on bone density in healthy children: systematic review and meta-analysis.
To determine the effectiveness of vitamin D supplementation for improving bone mineral density in children and adolescents and if effects vary with factors such as vitamin D dose and vitamin D status. ⋯ It is unlikely that vitamin D supplements are beneficial in children and adolescents with normal vitamin D levels. The planned subgroup analyses by baseline serum vitamin D level suggest that vitamin D supplementation of deficient children and adolescents could result in clinically useful improvements, particularly in lumbar spine bone mineral density and total body bone mineral content, but this requires confirmation.
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Review Meta Analysis
Prevention of pain on injection of propofol: systematic review and meta-analysis.
To systematically determine the most efficacious approach for preventing pain on injection of propofol. ⋯ The two most efficacious interventions to reduce pain on injection of propofol were use of the antecubital vein, or pretreatment using lidocaine in conjunction with venous occlusion when the hand vein was chosen. Under the assumption of independent efficacy a third practical alternative could be pretreatment of the hand vein with lidocaine or ketamine and use of a propofol emulsion containing medium and long chain triglycerides. Although not the most effective intervention on its own, a small dose of opioids before induction halved the risk of pain from the injection and thus can generally be recommended unless contraindicated.
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Review Meta Analysis
Angiotensin receptor blockers and risk of myocardial infarction: meta-analyses and trial sequential analyses of 147 020 patients from randomised trials.
To evaluate the cardiovascular outcomes and other outcomes associated with angiotensin receptor blockers. ⋯ This large and comprehensive analysis produced firm evidence to refute the hypothesis that angiotensin receptor blockers increase the risk of myocardial infarction (ruling out even a 0.3% absolute increase). Compared with controls, angiotensin receptor blockers reduce the risk of stroke, heart failure, and new onset diabetes.
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Meta Analysis
Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials.
To evaluate the effectiveness of comprehensive geriatric assessment in hospital for older adults admitted as an emergency. ⋯ Comprehensive geriatric assessment increases patients' likelihood of being alive and in their own homes after an emergency admission to hospital. This seems to be especially true for trials of wards designated for comprehensive geriatric assessment and is associated with a potential cost reduction compared with general medical care.