Articles: function.
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Little is known about the contribution of placebo effects and changes observed with no treatment in interventions for nonspecific low back pain (NSLBP). This systematic review assessed the proportions of the overall treatment effect that may be attributable to specific treatment effects, placebo effects, and changes observed with no treatment in randomized controlled trials (RCTs) in patients with NSLBP. Trials published before 2019 were identified from a published systematic review, and the search was updated in MEDLINE, Embase, and Cochrane Central for trials published between January 2019 and March 2023. ⋯ For physical function (11 studies) and HRQoL (6 studies), these proportions were 34%, 13%, and 53%, and 11%, 41%, and 48%, respectively. These results show that approximately half of the overall treatment effect of conservative and mainly passive interventions for patients with chronic NSLBP is attributable to changes observed with no treatment, rather than specific or placebo effects of treatments. However, the certainty of evidence was very low to low, suggesting that the true effects might be markedly different from the effect sizes underlying these estimates.
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Minerva anestesiologica · Jun 2024
Meta Analysis Comparative StudyEfficacy and safety of extrafascial injection versus intrafascial injection for interscalene brachial plexus block: a systematic review and meta-analysis.
This systematic review and meta-analysis aimed to assess the efficacy and safety of interscalene brachial plexus block (ISB) techniques in upper limb and shoulder surgeries. ⋯ Our findings favor extrafascial ISB techniques because they reduce hemidiaphragmatic paresis, preserve respiratory function, and lower block-related complications. However, further research is necessary to establish their safety and efficacy in specific patient populations.
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Critical care medicine · Jun 2024
Randomized Controlled TrialEffects of Vibration Therapy on the Physical Function of Critically Ill Adults Trial: A Randomized Controlled Trial.
Vibration therapy uses vibration to rehabilitate physical functions. Recently, it has been demonstrated to be safe for critically ill patients. However, its effects on physical functions are unclear. ⋯ Vibration therapy did not improve the total FSS-ICU. However, the supine-to-sit ability in the FSS-ICU improved without any adverse event.
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Critical care medicine · Jun 2024
ReviewToward Equitable Kidney Function Estimation in Critical Care Practice. Guidance From the Society of Critical Care Medicine's Diversity, Equity, and Inclusion in Renal Clinical Practice Task Force.
Accurate glomerular filtration rate (GFR) assessment is essential in critically ill patients. GFR is often estimated using creatinine-based equations, which require surrogates for muscle mass such as age and sex. Race has also been included in GFR equations, based on the assumption that Black individuals have genetically determined higher muscle mass. However, race-based GFR estimation has been questioned with the recognition that race is a poor surrogate for genetic ancestry, and racial health disparities are driven largely by socioeconomic factors. The American Society of Nephrology and the National Kidney Foundation (ASN/NKF) recommend widespread adoption of new "race-free" creatinine equations, and increased use of cystatin C as a race-agnostic GFR biomarker. ⋯ The lack of direct evidence in critically ill patients is a key barrier to broad implementation of newly developed "race-free" GFR equations. Additional research evaluating GFR equations in critically ill patients and novel approaches to dynamic kidney function estimation is required to advance equitable GFR assessment in this vulnerable population.