Postgraduate medical journal
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Temporal trends and risk factors of perioperative cardiac events (PCEs) in patients over 80 years old with coronary artery disease (CAD) undergoing noncardiac surgery are still unclear. ⋯ The incidence and independent risk factors of PCEs in patients over 80 years old with CAD undergoing noncardiac surgery showed significant rising trends over the last 9-year period.
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Junior doctors make clinical decisions regularly; therefore, they need to adequately interpret the evidence supporting these decisions. Patients can be harmed if clinical treatments are supported by biased or unreliable evidence. Systematic reviews that contain meta-analyses of randomized controlled trials are a relatively low-biased type of evidence to support clinical interventions. ⋯ In this article, doctors are informed about potential methodological and ethical issues in systematic reviews that contain a meta-analysis that are sometimes not easily identified or even overlooked by the current tools developed to assess their methodological quality or risk of bias. The article presents a discussion of topics related to data extraction, accuracy in reporting, reproducibility, heterogeneity, quality assessment of primary studies included in the systematic review, sponsorship, and conflict of interest. It is expected that the information reported will be useful for junior doctors when they are reading and interpreting evidence from systematic reviews containing meta-analyses of therapeutic interventions, mainly those doctors unfamiliar with methodological principles.
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This article reviews the correlation between presepsin and sepsis and the resulting acute respiratory distress syndrome (ARDS). ARDS is a severe complication of sepsis. Despite the successful application of protective mechanical ventilation, restrictive fluid therapy, and neuromuscular blockade, which have effectively reduced the morbidity and mortality associated with ARDS, the mortality rate among patients with sepsis-associated ARDS remains notably high. ⋯ Recent studies have demonstrated significant variations in presepsin (PSEP) levels between patients with sepsis and those without, particularly in the context of ARDS. Moreover, these studies have revealed substantially elevated PSEP levels in patients with sepsis-associated ARDS compared to those with nonsepsis-associated ARDS. Consequently, PSEP emerges as a valuable biomarker for identifying patients with an increased risk of sepsis-associated ARDS and to predict in-hospital mortality.