Latest Articles
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To ascertain the effect of the intravenous administration of magnesium in acute myocardial infarction on the frequency of arrhythmias and mortality, a meta-analysis of randomized controlled trials was performed. ⋯ Intravenous magnesium is a safe and effective method of reducing the frequency of arrhythmias and mortality in acute myocardial infarction.
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Meta Analysis
Short- and long-term efficacy and safety of flecainide acetate for supraventricular arrhythmias.
This report summarizes efficacy and safety data on the use of flecainide acetate for supraventricular arrhythmias. For this purpose, 60 original articles were identified by a literature search representing data from 1,835 treatment courses. In 18 trials, flecainide was administered intravenously; in 19, orally; and in 23, both forms of therapy were applied. ⋯ Ectopic atrial tachycardia responded in 86% and 95% of patients treated with flecainide acutely or chronically. Data concerning drug-related side effects were available for 1,794 of 1,835 treatment courses (98%). Overall, 352 of 1,794 patients (20%) reported at least one non-cardiac or cardiac adverse experience.(ABSTRACT TRUNCATED AT 250 WORDS)
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Since 1977, six clinical trials have been performed on the subject of routine antibiotic prophylaxis in patients requiring tube thoracostomy for trauma. No definitive conclusions have been reached regarding the efficacy of antibiotic use in this setting. The results of these clinical trials were pooled to generate an unbiased estimate of the efficacy of antibiotic prophylaxis for tube thoracostomy using the technique of meta-analysis. ⋯ Meta-analysis allows synthesis of all of the available data on antibiotic prophylaxis for tube thoracostomy to resolve the controversy surrounding this issue generated by different but similar clinical studies with conflicting results. Despite different conclusions of value when taken individually, the combined analysis does not support the null hypothesis (no effect of antibiotics). The statistical method is highly significant despite different mechanisms of injury, pathologic findings, and antibiotics employed.
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Meta Analysis
Prearrest predictors of survival following in-hospital cardiopulmonary resuscitation: a meta-analysis.
The success rate of cardiopulmonary resuscitation (CPR) varies with the patient population studied. Prearrest variables have been used to identify groups of patients with a particularly low rate of survival following CPR. The purpose of this study was to use the technique of meta-analysis to identify prearrest variables associated with a decreased rate of survival to the time of discharge following CPR of hospitalized patients. ⋯ The identification of prearrest variables that are associated with decreased survival following CPR will assist clinicians when they counsel their patients regarding do-not-resuscitate (DNR) orders. In addition, the further refinement of a predictive tool such as the modified Pre-Arrest Morbidity Index can help clinicians to identify patients for whom CPR is futile. Such an instrument must be validated on an independent data set before it can be considered for clinical application.
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Meta Analysis Comparative Study
Efficacy of multidisciplinary pain treatment centers: a meta-analytic review.
Sixty-five studies that evaluated the efficacy of multidisciplinary treatments for chronic back pain were included in a meta-analysis. Within- and between-group effect sizes revealed that multidisciplinary treatments for chronic pain are superior to no treatment, waiting list, as well as single-discipline treatments such as medical treatment or physical therapy. ⋯ These results tend to support the efficacy of multidisciplinary pain treatment; however, these results must be interpreted cautiously as the quality of the study designs and study descriptions is marginal. Suggestions for improvement in research designs as well as appropriate reports of research completed are provided.