São Paulo medical journal = Revista paulista de medicina
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Review Meta Analysis
Diagnostic accuracy of sonography for pleural effusion: systematic review.
The initial method for evaluating the presence of pleural effusion was chest radiography. Isolated studies have shown that sonography has greater accuracy than radiography for this diagnosis; however, no systematic reviews on this matter are available in the literature. Thus, the aim of this study was to evaluate the accuracy of sonography in detecting pleural effusion, by means of a systematic review of the literature. ⋯ In different populations and clinical settings, sonography showed consistently high sensitivity, specificity and accuracy for detecting fluid in the pleural space.
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Review Meta Analysis
Regular treatment with formoterol and an inhaled corticosteroid versus regular treatment with salmeterol and an inhaled corticosteroid for chronic asthma: serious adverse events.
an increase in serious adverse events with both regular formoterol and regular salmeterol in chronic asthma has been demonstrated in comparison with placebo in previous Cochrane reviews. This increase was significant in trials that did not randomise participants to an inhaled corticosteroid, but less certain in the smaller numbers of participants in trials that included an inhaled corticosteroid in the randomised treatment regimen. ⋯ the seven identified studies in adults did not show any significant difference in safety between formoterol and budesonide in comparison with salmeterol and fluticasone. Asthma-related serious adverse events were rare, and there were no reported asthma-related deaths. There was a single small study comparing formoterol and beclomethasone to salmeterol and fluticasone in adults, but no serious adverse events occurred in this study. No studies were found in children. Overall there is insufficient evidence to decide whether regular formoterol and budesonide or beclomethasone have equivalent or different safety profiles from salmeterol and fluticasone.
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Review Meta Analysis
Specific immunotherapy using Hymenoptera venom: systematic review.
The only effective treatment for patients who have severe reactions after Hymenoptera stings is venom immunotherapy. The aim of this study was to review the literature to assess the effects of venom immunotherapy among patients presenting severe reactions after Hymenoptera stings. ⋯ Specific immunotherapy should be recommended for adults and children with moderate to severe reactions, but there is no need to prescribe it for children with skin reactions alone, especially if the exposure is very sporadic. On the other hand, the risk-benefit relation should always be assessed in each case.