Trending Articles
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The bone & joint journal · Feb 2017
Review Meta AnalysisMeta-analysis of gap balancing versus measured resection techniques in total knee arthroplasty.
There are two techniques widely used to determine the rotational alignment of the components in total knee arthroplasty (TKA); gap balancing (GB) and measured resection (MR). Which technique is the best remains controversial. We aimed to investigate this in a systematic review and meta-analysis. ⋯ This study suggests that GB may provide better radiographic and clinical outcomes than MR when used to determine mechanical rotation in TKAs. Cite this article: Bone Joint J 2017;99-B:151-8.
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J. Huazhong Univ. Sci. Technol. Med. Sci. · Aug 2017
Meta Analysis Comparative StudyTIPS versus endoscopic therapy for variceal rebleeding in cirrhosis: A meta-analysis update.
Endoscopic therapy (ET) is most common method for preventing variceal bleeding in cirrhosis, but the outcomes are not perfect. Recently, transjugular intrahepatic portosystemic shunt (TIPS) is introduced into clinical practice. However, the beneficial effects of TIPS compared to ET on cirrhotic patients is unknown. ⋯ Although there was no significant difference in survival and PTE, TIPS was superior to ET in decreasing the incidence of VRB (OR=0.27; 95% CI, 0.19-0.39, P<0.00001), and decreasing the incidence of bleeding-related death (OR=0.21; 95% CI, 0.13-0.32, P<0.00001). Subgroup analysis found a lower mortality (OR=0.48; 95% CI, 0.23-0.97; P=0.04) without any increased incidence of PTE (OR=1.37; 95% CI, 0.75-2.50; P=0.31) in the studies of a greater proportion (≥40%) of patients with Child-Pugh class C cirrhosis receiving TIPS, and TIPS with covered stent did not increase the risk of PTE compared to ET (OR=1.52, 95% CI =0.82-2.80, P=0.18). It was concluded that TIPS with covered stent might be considered the preferred choice of therapy in patients with severe liver disease for secondary prophylaxis.
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Meta Analysis
Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and meta-analysis.
Primary prevention of coronary heart disease is most appropriate for patients at relatively high risk. Measurement of coronary artery calcium has been proposed as a way to improve risk assessment, but it is unknown whether it adds predictive information to standard risk factor assessment. ⋯ The coronary artery calcium score is an independent predictor of coronary heart disease events.
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Meta Analysis
Therapeutic targets for the anemia of predialysis chronic kidney disease: a meta-analysis of randomized, controlled trials.
Anemia is one of the major complications in predialysis patients with chronic kidney disease (CKD). A clearer cognition of the prognostic impact of hemoglobin (Hb) or hematocrit (Hct) target on the outcomes of predialysis patients with CKD is significant. This article aims to establish the suitable hemoglobin target to provide clinical guidance. ⋯ However, no significant difference was found in all-cause mortality (RR 1.10, 95% CI 0.98 to 1.23; p=0.11), stroke (RR 1.32, 95% CI 0.82 to 2.10; p=0.25) and treatment of renal replacement including hemodialysis, peritoneal dialysis and renal transplant (RR 1.08, 95% CI 0.95 to 1.22; p= 0.23) between the higher hemoglobin group and the lower one. The results favor the higher hemoglobin target. To target the higher hemoglobin when treating predialysis patients with CKD may decrease the risk of transfusion without increasing the risk of death, stoke, and treatment of renal replacement.
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To investigate the effect of physician gender on consultation length in UK hospital outpatient clinics and compare this, through meta-analysis, with previous studies outside the UK. ⋯ Findings from this analysis of clinic consultations in the UK National Health Service do not support previous studies, which were undertaken predominantly in North America and primary care settings. Overall, meta-analysis suggests doctors' gender may influence consultation length. Gender differences in communication should be considered in training clinicians and in overall clinical practice.