Annals of internal medicine
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Review Meta Analysis
Systematic review: prediction of perioperative cardiac complications and mortality by the revised cardiac risk index.
The Revised Cardiac Risk Index (RCRI) is widely used to predict perioperative cardiac complications. ⋯ The RCRI discriminated moderately well between patients at low versus high risk for cardiac events after mixed noncardiac surgery. It did not perform well at predicting cardiac events after vascular noncardiac surgery or at predicting death. High-quality research is needed in this area of perioperative medicine.
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Meta Analysis
Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury.
Trials have provided conflicting results regarding the effect of different ventilatory strategies on the outcomes of patients with the acute respiratory distress syndrome (ARDS) and acute lung injury. ⋯ Available evidence from a limited number of RCTs shows better outcomes with routine use of low Vt but not high PEEP ventilation in unselected patients with ARDS or acute lung injury. High PEEP may help to prevent life-threatening hypoxemia in selected patients.
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Multicenter Study Meta Analysis
Collaborative meta-analysis: associations of 150 candidate genes with osteoporosis and osteoporotic fracture.
Osteoporosis is a highly heritable trait. Many candidate genes have been proposed as being involved in regulating bone mineral density (BMD). Few of these findings have been replicated in independent studies. ⋯ In this large-scale collaborative genome-wide meta-analysis, 9 of 150 candidate genes were associated with regulation of BMD, 4 of which also significantly affected risk for fracture. However, most candidate genes had no consistent association with BMD.
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Review Meta Analysis
C-reactive protein as a risk factor for coronary heart disease: a systematic review and meta-analyses for the U.S. Preventive Services Task Force.
C-reactive protein (CRP) may help to refine global risk assessment for coronary heart disease (CHD), particularly among persons who are at intermediate risk on the basis of traditional risk factors alone. ⋯ Strong evidence indicates that CRP is associated with CHD events. Moderate, consistent evidence suggests that adding CRP to risk prediction models among initially intermediate-risk persons improves risk stratification. However, sufficient evidence that reducing CRP levels prevents CHD events is lacking.
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Review Meta Analysis
Systematic review: glucose control and cardiovascular disease in type 2 diabetes.
Results from clinical trials examining the effect of intensive glucose control on cardiovascular disease have been conflicting. ⋯ Intensive glucose control reduced the risk for some cardiovascular disease outcomes (such as nonfatal myocardial infarction), did not reduce the risk for cardiovascular death or all-cause mortality, and increased the risk for severe hypoglycemia.