Latest Articles
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Abdominal aortic aneurysm surgery is a major vascular procedure with a considerable risk of (mainly cardiac) mortality. ⋯ A readily applicable clinical prediction rule can be based on the combination of literature data and individual patient data. The risk estimates may be useful for clinical decision making in individual patients.
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To evaluate the effect of cytotoxic chemotherapy on survival in patients with non-small cell lung cancer. ⋯ At the outset of this meta-analysis there was considerable pessimism about the role of chemotherapy in non-small cell lung cancer. These results offer hope of progress and suggest that chemotherapy may have a role in treating this disease.
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Meta Analysis
Is senile dementia "age-related" or "ageing-related"?--evidence from meta-analysis of dementia prevalence in the oldest old.
The observation of an exponential increase in senile dementia prevalence with age has led to the conclusion that this disease may be inevitable in those who live long enough. The alternative view is that at very high ages the prevalence rate levels off. Studies conducted to date have not included sufficient numbers of very old people to resolve this difference of opinion. ⋯ The rate of increase in senile dementia prevalence was found to fall in the age range 80-84, and at around the age of 95 prevalence was seen to level off to about 40%. It seems that senile dementia is better conceptualised as an "age-related" (ie, occurring within a specific age range) rather than as an "ageing-related" disorder (that is, caused by the ageing process itself). Very elderly survivors may be at diminishing risk of dementia and this has implications for public health policy.
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To determine the risk of elevated total homocysteine (tHcy) levels for arteriosclerotic vascular disease, estimate the reduction of tHcy by folic acid, and calculate the potential reduction of coronary artery disease (CAD) mortality by increasing folic acid intake. ⋯ A 5-mumol/L tHcy increment elevates CAD risk by as much as cholesterol increases of 0.5 mmol/L (20 mg/dL). Higher folic acid intake by reducing tHcy levels promises to prevent arteriosclerotic vascular disease. Clinical trials are urgently needed. Concerns about masking cobalamin deficiency by folic acid could be lessened by adding 1 mg of cobalamin to folic acid supplements.
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Anaesth Intensive Care · Oct 1995
Meta AnalysisA meta-analysis on the efficacy of epidural corticosteroids in the treatment of sciatica.
The efficacy of epidural corticosteroids in the treatment of sciatica was investigated by meta-analysis of all randomized controlled trials. Eleven suitable trials of good quality were identified involving a total of 907 patients. The use of epidural (caudal or lumbar) steroid in the short-term (up to 60 days) increased the odds ratio (OR) of pain relief ( > 75% improvement) to 2.61 (95% CI 1.90-3.77) when compared with placebo. ⋯ Adverse events included dural tap (2.5%), transient headache (2.3%) and a transient increase in pain (1.9%). There were no reported longterm adverse events. In conclusion we present quantitative evidence from meta-analysis of pooled data from randomized trials that epidural administration of corticosteroids is effective in the management of lumbosacral radicular pain.