Adv Clin Exp Med
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Review Meta Analysis
Meta-analysis of the diagnostic value of procalcitonin in adult burn sepsis.
Sepsis is one of the main causes of death in burn patients, and many studies have suggested that procalcitonin (PCT) is a biomarker for the early diagnosis of sepsis, but the results are controversial. The aim of this study was to evaluate the diagnostic value of serum PCT in adult burn sepsis by conducting a meta-analysis of published studies. The PubMed, Embase, Web of Science, CNKI and China Wanfang databases were searched, and studies on PCT as a marker for the diagnosis of adult burn sepsis from the establishment of the database, to February 1, 2020 were screened. ⋯ The combined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) were 0.67 (95% CI: 0.48-0.81), 0.87 (95% CI: 0.72-0.95), 5.20 (95% CI: 2.49-10.84), 0.38 (95% CI: 0.24-0.61) and 13.70 (95% CI: 5.72-32.82), respectively. The area under the summary receiver operating characteristic curve (SROC) was 0.85 (95% CI: 0.82-0.88), and the diagnostic threshold was the main source of heterogeneity. Results demonstrate that serum PCT may be used as a useful biomarker for the early diagnosis of burn sepsis in adults, and may be combined with other diagnostic indexes to further improve the sensitivity and specificity.
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The COVID-19 pandemic forced dental professionals to cope with an unexpected challenge and caused an abrupt cessation of conventional care practices. The high degree of contagiousness as well as the diffusion of the virus through the air and droplets via respiratory transmission placed dental professionals at top-level risk of contracting and spreading the disease. General recommendations were announced in different countries, including patient distancing, air ventilation, surface and instrument sanitization, and the wearing of suitable masks and shields. ⋯ In the categories that involve low energy, the beneficial effects of lasers are available and sometimes preferable during this pandemic because only conventional precautions are required. Lasers maintain the potential to add benefits to dental practice even in the COVID-19 era, but it is necessary to know how lasers work to utilize these advantages. The great potential of laser light, with undiscovered limits, may provide a different path to face the severe health challenges of this pandemic.
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Iatrogenic anemia caused by diagnostic blood sampling is a common problem in the intensive care unit, where continuous monitoring of blood parameters is very often required. Cumulative blood loss associated with phlebotomy along with other factors render this group of patients particularly susceptible to anemia. ⋯ Iatrogenic blood loss has also gained particular attention in neonatal care, where cumulative blood loss due to samples taken during the first week of life could easily equal or exceed circulating blood volume. This review summarizes the current knowledge on the causes of iatrogenic anemia and discusses the most common preventive measures taken to reduce diagnostic blood loss and the requirement for blood component transfusions in the aforementioned clinical situations.
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Pain management originated at the turn of the 1960s and 70s in the United States, and spread to Western Europe almost a decade later. It is estimated today that a lack of adequate pain management affects 80% of the global population, and is a serious problem in over 150 countries. At the national level, the greatest burden of inadequate pain management is borne by the elderly, pregnant and breastfeeding women, children, people coping with addictions to harmful substances, and the mentally ill. ⋯ Pain management should be considered a priority. It is an interdisciplinary task requiring the cooperation of the whole medical staff. The current review of literature revealed a number of factors limiting the possibility of achieving effective pain management, related to healthcare systems, medical staff and patients.