Medicine
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Review Meta Analysis
The safety of concomitant transcatheter aortic valve replacement and percutaneous coronary intervention: A systematic review and meta-analysis.
TAVR is a rapidly spreading treatment option for severe aortic valve stenosis. Significant coronary artery disease (CAD) is present in 40% to 75% of patients undergoing TAVR. However, when to treat the concomitant coronary artery lesions is controversial. ⋯ These data did not show a significant difference in short-term outcomes between concomitant PCI and TAVR versus staged PCI and TAVR.
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Review Meta Analysis
Is hemoglobin A1c and perioperative hyperglycemia predictive of periprosthetic joint infection following total joint arthroplasty?: A systematic review and meta-analysis.
This meta-analysis aims to determine whether hemoglobin A1c (HbA1c) and perioperative hyperglycemia are associated with the increased risk of periprosthetic joint infection following total knee and hip arthroplasty. ⋯ The present meta-analysis shows that high HbA1c and perioperative hyperglycemia are associated with a higher risk of periprosthetic joint infection following total joint arthroplasty. Screening of HbA1c and perioperative blood glucose is therefore an effective method to predict deep infection.
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Review Meta Analysis
The associations of stroke, transient ischemic attack, and/or stroke-related recurrent vascular events with Lipoprotein-associated phospholipase A2: A systematic review and meta-analysis.
Studies on stroke and lipoprotein-associated phospholipase A2 (Lp-PLA2) have produced conflicting results. ⋯ In patients with TIA and first ischemic stroke, elevated Lp-PLA2 activity levels were associated with recurrent vascular events. And in the general population elevated Lp-PLA2 levels were associated with the risk of stroke, although the association between Lp-PLA2 activity levels and the risk of stroke was less profound compared with the corresponding association of stroke risk with the Lp-PLA2 mass levels.
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Review Meta Analysis
A systematic review and meta-analysis of the impact of mineralocorticoid receptor antagonists on glucose homeostasis.
Spironolactone, a nonselective mineralocorticoid receptor antagonist (MRA), may have a deleterious effect on glycemia. The objective of this review was to assess current knowledge on MRAs' influence (spironolactone, eplerenone, and canrenone) on glucose homeostasis and the risk of diabetes. ⋯ Spironolactone may induce disease-specific and modest alterations on glycemia. It is uncertain whether these effects are transient or not. Data from the most extensively studied population, individuals with diabetes, do not support a long-term glycemic impact in these patients. Further prospective studies are necessary to establish spironolactone's true biological effects and their clinical implications.
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Randomized Controlled Trial
Efficacy of pudendal nerve block for alleviation of catheter-related bladder discomfort in male patients undergoing lower urinary tract surgeries: A randomized, controlled, double-blind trial.
Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle. Based on this theoretical knowledge, we formed a hypothesis that CRBD could be prevented by pudendal nerve block. ⋯ General anesthesia along with bilateral pudendal nerve block decreased the incidence and severity of CRBD for the first 12 hours postoperatively.