International journal of clinical practice
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Int. J. Clin. Pract. · Aug 2021
Meta AnalysisRegional anesthetics versus analgesia for stopping the persistent post-surgical pain: A meta-analysis.
Regional anesthesia might moderate the risk of persistent postsurgical pain, but its effect compared to systemic analgesia is still conflicting. This meta-analysis study was performed to assess the relationship between the efficiency of regional anesthesia versus systemic analgesia in reducing pain persisting longer than 3 months after surgery. ⋯ Regional anesthesia might have an independent relationship with lower pain persisting longer than 3 months after thoracotomy, breast surgery, and cesarean section. Further studies are required to validate these findings.
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Int. J. Clin. Pract. · Aug 2021
Meta AnalysisEffect of reflectance confocal microscopy compared to dermoscopy in the diagnostic accuracy of lentigo maligna: a meta-analysis.
Many concerns were raised about the sensitivity and specificity outcome of reflectance confocal microscopy compared to dermoscopy for the diagnosis of lentigo maligna. However, the reported relationships between their sensitivity and specificity were variable. Our meta-analysis was performed to clarify this relationship. ⋯ Based on this meta-analysis, the reflectance confocal microscopy compared to dermoscopy in lentigo maligna diagnosis had a significantly higher specificity and relatively higher sensitivity. This relationship forces us to recommend reflectance confocal microscopy in lentigo maligna diagnosis for better outcomes and to avoid any possible false-negative results. Further studies are required.
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Int. J. Clin. Pract. · Aug 2021
Review Meta AnalysisD-dimer levels is associated with severe COVID-19 infections: A meta-analysis.
The ongoing pandemic of COVID-19 caused by the novel coronavirus Syndrome-Coronavirus-2 (SARS-CoV-2) is an emerging, rapidly evolving situation. Excluded typical manifestation of pneumonia and acute respiratory symptoms, COVID-19 patients also have abnormal D-dimer concentration in the serum, but the results are controversial. ⋯ Our meta-analysis showed that the severity of patients with COVID-19 significance related to D-dimer concentrations. This may be helpful for the clinic COVID-19 patients.
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Int. J. Clin. Pract. · Aug 2021
Meta AnalysisComparative risk of new-onset hyperkalemia for antihypertensive drugs in patients with diabetic nephropathy: A Bayesian network meta-analysis.
Several randomised controlled trials (RCTs) have evaluated the risk of hyperkalemia of antihypertensive drugs on diabetic nephropathy, yet the results are conflicting. We searched MEDLINE, Embase, The Cochrane Library, and Web of Science for RCTs investigating the risk of antihypertensive drugs on hyperkalemia in diabetic nephropathy from inception to May 31, 2020. Direct comparative meta-analysis showed that the proportion of patients with hyperkalemia was significantly higher in the ARB, aldosterone antagonist, renin inhibitor group than in the placebo group. ⋯ Network meta-analysis showed the risk of hyperkalemia in the ARB, aldosterone antagonist, and renin inhibitor group was higher than in the placebo group, but there was no statistical difference between the CCB, ACEI, β blocker, endothelin inhibitor, and diuretic groups than in the placebo group. The possibility of antihypertensive drugs in risk of hyperkalemia being the worst treatment was aldosterone antagonist (98.8%), followed by ARB (73.8%), renin inhibitor (63.8%), diuretic (53.1%), ACEI (46.9%), β blocker (36.8%), endothelin inhibitor (35.2%), placebo (27.1%), and finally CCB (14.3.1%). Therefore, aldosterone antagonist seems worse than other antihypertensive drugs in the risk of hyperkalemia in patients with diabetic nephropathy.