Latest Articles
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In laboratory animals, the consumption of soy protein, rather than animal protein, decreases serum cholesterol concentrations, but studies in humans have been inconclusive. In this meta-analysis of 38 controlled clinical trials, we examined the relation between soy protein consumption and serum lipid concentrations in humans. ⋯ In this meta-analysis we found that the consumption of soy protein rather than animal protein significantly decreased serum concentrations of total cholesterol, LDL cholesterol, and triglycerides without significantly affecting serum HDL cholesterol concentrations.
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Seminars in perinatology · Aug 1995
Meta AnalysisHome visits during pregnancy: consequences on pregnancy outcome, use of health services, and women's situations.
This review of eight randomized controlled trials assessed two different types of home visits during pregnancy: (1) those offering social support to high-risk women; and (2) those providing medical care to women with complications. In both categories, pregnancy outcome was not improved when women received home visits. The summary odds ratio for preterm delivery (< 37 weeks) was 1.0 (95% CI: 0.8 to 1.1). ⋯ A better integration of hospital and home services might allow a more rational use of health services for women with complications. In addition, we need to define more precisely the content of home visits providing social support. For this, further research is required on how emotional support, health education, and advice influence the health of women and infants and mother-child interactions.
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Critical care medicine · Aug 1995
Meta AnalysisCorticosteroid treatment for sepsis: a critical appraisal and meta-analysis of the literature.
To determine the effect of corticosteroid therapy on morbidity and mortality in patients with sepsis. ⋯ Current evidence provides no support for the use of corticosteroids in patients with sepsis or septic shock, and suggests that their use may be harmful. These trials underscore the need for future methodologically rigorous trials evaluating new immune-modulating therapies in well-defined critically ill patients with overwhelming infection.
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Currently there is no agreement on the treatment of patients who develop a peritonsillar abscess (PTA). This lack of consensus results in highly variable and possibly expensive therapeutic regimens that may not provide optimum quality patient care at reasonable cost. The present study evaluates surgical, medical, diagnostic, and cost factors that affect the management of PTA based on the following: 1. a cohort study of 123 patients with PTA treated using needle aspiration as the initial surgical drainage; 2. a national survey of the PTA management practices of otolaryngologists; and 3. meta-analyses of various components of the treatment regimen for PTA. ⋯ Patients should be treated in an outpatient setting, should receive penicillin if they are not allergic to it, and should receive adequate pain medication. The evidence does not suggest that there is any benefit in examining the abscess contents for microorganisms. Approximately 30% of patients with PTA can be expected to exhibit relative indications for a tonsillectomy.(ABSTRACT TRUNCATED AT 400 WORDS)
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Meta Analysis
Meta-analysis of surgical outcome in adolescent idiopathic scoliosis. A 35-year English literature review of 11,000 patients.
Meta-analysis of the English literature on the surgical treatment of adolescent idiopathic scoliosis. ⋯ Patients appear to be more satisfied by the magnitude of curve correction rather than the percent of curve correction. The degree of curvature before surgery did not predict patient satisfaction. Pearsons r' = 0.045. Satisfaction appears to be best predicted by the degree of correction only and not by the percent curve correction, the curve magnitude before surgery, nor the Group type (King, unspecified). Patient satisfaction is subjective. It does not reflect the benefits of surgery with respect to the future preservation of pulmonary function in thoracic curves nor the prevention of osteoarthritis in lumbar curves.