Emergency medicine journal : EMJ
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Review Meta Analysis
Pulmonary embolism rule-out criteria (PERC) in pulmonary embolism--revisited: A systematic review and meta-analysis.
To perform a systematic review and meta-analysis including all the current studies to assess the accuracy of pulmonary embolism rule-out criteria (PERC) in ruling out pulmonary embolism (PE). ⋯ Because of the high sensitivity and low negative likelihood ratio, PERC rule can be used confidently in clinically low probability population settings.
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A short-cut review was carried out to determine whether hydrotherapy is an effective treatment to reduce pain and improve function in patients recovering from an ankle fracture. Although 12 papers were found using the reported search, no studies were relevant to this three-part question. No evidence was found to support this treatment.
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A short-cut review was carried out to determine whether intranasal lorazepam was as effective as intravenous lorazepam in the control of seizures in children. Eighteen papers were found using the reported search, of which one was directly relevant and another compared intranasal lorazepam with intramuscular paraldehyde. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are shown in table 1. It is concluded that intranasal lorazepam appears to be a safe and effective treatment for this condition.
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A short-cut review was carried out to determine whether cerebrospinal fluid (CSF) opening pressure is significantly affected by the patient's leg position during the procedure. A total of 1410 papers was found using the reported search, of which five were considered relevant to the three-part question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are shown in table 3. It is concluded that alternative leg positions may affect the opening pressure by a small margin but this is unlikely to be of clinical significance.
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A short-cut review was carried out to determine whether intranasal lidocaine was an effective treatment for patients with acute cluster headaches. Two hundred and seventy-two papers were found using the reported search, of which four were considered relevant to the three-part question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are shown in table 2. Although the included studies all found some degree of symptomatic relief with this treatment, the methodological weaknesses of the studies compromised the validity of this finding, and the authors concluded that there was insufficient evidence to support this treatment in clinical practice.