Latest Articles
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Critical care medicine · Jul 1991
Meta Analysis Comparative StudySucralfate versus antacids or H2-antagonists for stress ulcer prophylaxis: a meta-analysis on efficacy and pneumonia rate.
Histamine2 (H2)-receptor antagonists and antacids have been the basic drugs for the prevention of stress bleeding in ICU patients during the past decade. Recently, drugs without major influence on gastric pH have been investigated in stress bleeding prophylaxis. Therefore, a meta-analysis (Mantel-Haenszel test) was undertaken to determine the efficacy of sucralfate in the prevention of macroscopically visible stress bleeding, as well as the influence of sucralfate on the frequency of pulmonary infections. ⋯ Sucralfate is an effective drug for the prevention of stress bleeding that minimizes the risk of nosocomial pneumonia in long-term ventilated ICU patients.
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Revista médica de Chile · Apr 1991
Randomized Controlled Trial Meta Analysis Clinical Trial[Premature rupture of membranes at preterm. Meta-analysis of the effect of steroids on the prevention of respiratory distress syndrome].
The use of steroids in premature rupture of the membranes is controversial. We used meta-analysis of published results to evaluate the effect of steroid treatment to prevent fetal respiratory distress syndrome associated to premature rupture of the membranes and found that a 30% reduction in the rate of this complication was observed in patients receiving steroids. ⋯ However, infectious complication of the mother increased (mean relative risk 1.68, 95% Cl 1.16-2.44) but not those of the neonate. These results support the use of steroids in order to prevent fetal respiratory distress syndrome in pregnant women with premature rupture of membranes.
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To establish whether there is evidence of the efficacy of homoeopathy from controlled trials in humans. ⋯ At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.
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Meta Analysis
The J-curve phenomenon and the treatment of hypertension. Is there a point beyond which pressure reduction is dangerous?
We critically appraised the medical literature to evaluate whether there is a point beyond which blood pressure reduction in hypertensive subjects is no longer beneficial and possibly even deleterious. Thirteen studies that stratified cardiovascular outcomes by level of achieved blood pressure in treated hypertensive subjects who had been followed up for at least 1 year were critiqued by four independent reviewers. ⋯ The beneficial therapeutic threshold point was 85 mm Hg. We conclude that low treated diastolic blood pressure levels, ie, below 85 mm Hg, are associated with increased risk of cardiac events.