Articles: patients.
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Meta Analysis
In hospitalized patients with influenza, oseltamivir or peramivir may reduce hospital length of stay (low-certainty evidence).
Gao Y, Guyatt G, Uyeki TM, et al. Antivirals for treatment of severe influenza: a systematic review and network meta-analysis of randomised controlled trials. Lancet. 2024;404:753-763. 39181595.
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Meta Analysis Comparative Study
High-flow nasal cannula oxygen therapy versus noninvasive ventilation in acute respiratory failure related to suspected or confirmed acute heart failure: a systematic review with meta-analysis.
The objective of this review is to compare high-flow nasal cannula (HFNC) oxygen (High flow oxygen) and noninvasive ventilation (NIV) for the management of acute respiratory failure secondary to suspected or confirmed acute heart failure (AHF). A comprehensive and relevant literature search of MEDLINE, Web of Science, and the Cochrane Library was conducted using Medical Subject Heading and Free text terms from January 2010 to March 2024. All randomized clinical trials and observational retrospective and prospective studies reporting adult patients with acute respiratory failure due to suspected or confirmed AHF and comparing HFNC to NIV were included. ⋯ Tracheal intubation requirement was 7% and 5% of patients in the HFNC and NIV groups, respectively (OR: 1.4, 95% CI: 0.5-3.5) in randomized studies, and 20% and 9% in the high flow oxygen and NIV group, respectively (OR: 2.1, 95% CI: 0.5-9.4) in observational studies. Mortality was 13% and 8% in the high flow oxygen and the NIV groups, respectively (OR: 1.8, 95% CI: 0.8-1.1) in randomized studies and 14% and 9% in the high flow oxygen and the NIV groups, respectively (OR: 1.4, 95% CI: 0.5-3.7) in observational studies. Compared with NIV, high flow oxygen was not associated with a higher risk of treatment failure during initial management of patients with acute respiratory failure related to suspected or confirmed AHF.
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Minerva anestesiologica · Dec 2024
Meta AnalysisMagnesium sulfate infusion for emergence agitation in adult patients after general anesthesia: a systematic review and meta-analysis of randomized controlled trials.
Emergence agitation following general anesthesia poses significant risks to both patients and medical staff. While extensive research has explored the efficacy of magnesium sulfate (MgSO
4 ) in managing pediatric emergence agitation, its effectiveness in adults remains uncertain. Therefore, this meta-analysis seeks to evaluate the efficacy of MgSO4 in mitigating emergence agitation following general anesthesia in adult populations. ⋯ Magnesium sulfate infusion during general anesthesia was associated with lower incidence of emergence agitation in adults. However, no significant differences were observed regarding emergence agitation severity scores, PONV, or extubation time. -
Pol. Arch. Med. Wewn. · Nov 2024
Meta AnalysisNeuropsychiatric adverse events in tenofovir disoproxil fumarate- and tenofovir alafenamide-based HIV therapy and prophylaxis: a systematic review and meta-analysis.
Tenofovir is integral to antiretroviral therapy (ART) and pre‑exposure prophylaxis (PrEP) for HIV; however, neuropsychiatric adverse events (NPAEs) associated with its use have not been systematically investigated. ⋯ Common occurrence of NPAEs in tenofovir‑based HIV multidrug regimens highlights the need to screen HIV patients for neuropsychiatric complications. The lack of effect of tenofovir, as compared with placebo, for most analyzable NPAEs suggests its favorable safety profile. However, a possible increase in the dizziness risk on tenofovir, and a potentially elevated risk of headache on tenofovir alafenamide- as compared with tenofovir disoproxil fumarate-based regimens in HIV therapy merit further investigation.
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Background: Hemodynamic support using vasoactive agents is a mainstay in the management of patients with pediatric fluid-refractory septic shock (FRSS). However, evidence supporting the appropriate choice of vasoactive agent is limited. This study aimed to perform a systematic review and meta-analysis on the effect of different first-line vasoactive strategies on mortality in pediatric FRSS. ⋯ Interpretation: Among children with FRSS receiving a single vasoactive agent, norepinephrine was associated with the lowest mortality rate. Comparing dopamine and epinephrine, patients receiving epinephrine needed less mechanical ventilation and showed a trend for lower mortality rate. Further research is needed to better delineate the first-line vasoactive agent in this population.