Plos One
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Multicenter Study
Predicting early mortality in adult trauma patients admitted to three public university hospitals in urban India: a prospective multicentre cohort study.
In India alone, more than one million people die yearly due to trauma. Identification of patients at risk of early mortality is crucial to guide clinical management and explain prognosis. Prediction models can support clinical judgement, but existing models have methodological limitations. The aim of this study was to derive a vital sign based prediction model for early mortality among adult trauma patients admitted to three public university hospitals in urban India. ⋯ This study showed that routinely recorded systolic blood pressure, heart rate, and Glasgow coma scale predicted early hospital mortality in trauma patients admitted to three public university hospitals in urban India. Our model needs to be externally validated before it can be applied in the clinical setting.
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Comparative Study
Neuro-intensive treatment targeting intracranial hypertension improves outcome in severe bacterial meningitis: an intervention-control study.
To evaluate the efficacy of early intracranial pressure (ICP)-targeted treatment, compared to standard intensive care, in adults with community acquired acute bacterial meningitis (ABM) and severely impaired consciousness. ⋯ Early neuro-intensive care using ICP-targeted therapy, mainly cerebrospinal fluid drainage, reduces mortality and improves the overall outcome in adult patients with ABM and severely impaired mental status on admission.
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Despite increasing numbers of RCTs done in Japan, existing international databases fail to capture them, and detailed information on the quality of Japanese RCTs is still missing. This study assessed the characteristics and quality of Japanese RCTs and analyzed factors related to their quality. ⋯ Despite a considerable number of RCTs conducted in Japan, their quality is not satisfactory in some domains. On the other hand, there are high-quality, non-indexed RCTs. The full disclosure of trial information and quality control of clinical trials are urgently needed in Japan.
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Meta Analysis
Lower intensified target LDL-c level of statin therapy results in a higher risk of incident diabetes: a meta-analysis.
A recent meta-analysis has reported that intensive-dose statin drug increases the risk of incident diabetes. However, doubling of the statin dose generates only a further 6% decrease in low-density lipoprotein cholesterol (LDL-c) on average. This study aimed to determine whether statin therapy with lower intensive-target LDL-c level contributes to higher risk of new-onset diabetes. ⋯ A lower intensified target LDL-c level of statin therapy resulted in a higher risk of incident diabetes.
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Community-acquired pneumonia (CAP) is one of the most important causes of morbidity and mortality worldwide. Etiological data for Cambodia is scarce. We aimed to describe the main etiological agents causing CAP, and their resistance patterns in Cambodia and the greater Mekong region. ⋯ Based on this analysis, CAP data in Cambodia seems to present etiological and resistance profiles comparable to those of neighboring countries. Findings have been shared with the national authorities upon the revision of the national therapeutic guidelines and were disseminated using a specially created website.