International journal of clinical practice
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Int. J. Clin. Pract. · Jul 2021
Randomized Controlled TrialEffect of propofol-based total intravenous anesthesia on postoperative cognitive function and sleep quality in elderly patients.
This study aimed to observe the effect of propofol-based total intravenous anaesthesia (TIVA) on postoperative cognitive function and sleep quality in elderly patients. ⋯ Propofol-based TIVA has little effect on the cognitive function and sleep quality of elderly patients after surgery, and it is worthy of clinical application.
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Int. J. Clin. Pract. · Jul 2021
Presence of risk factors for thyroid cancer does not improve the performance of ultrasound screening for thyroid nodules in patients with obesity.
It has been suggested, on a theoretical basis, that ultrasound screening of thyroid nodules in obese patients with additional risk factors (family history, chronic autoimmune thyroiditis or high thyrotropin) might be cost-effective for the early detection and treatment of thyroid cancer. The present study evaluates if this approach can be validated in a real clinical setting. ⋯ The presence of known risk factors for thyroid cancer does not improve the performance of a US screening strategy aimed at the detection of thyroid nodules in obese patients. According to current guidelines, screening for thyroid nodules in obese patients is not recommended regardless of the presence of thyroid cancer risk factors.
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Int. J. Clin. Pract. · Jul 2021
Review Meta AnalysisShort-term versus long-term dual antiplatelet therapy after drug-eluting stent implantation in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis.
The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is under controversial. The aim of the present systematic review and meta-analysis was to evaluate the safety and efficacy of short-term (≤6 months) DAPT vs long-term (≥12 months) DAPT after PCI with a drug-eluting stent (DES). ⋯ Compared with long-term DAPT, short-term DAPT did not increase the risk of ischemic complications but did reduce the risks of major bleeding and any bleeding by over 25%. This study showed that short-term DAPT could be considered for most patients after DES implantation.
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Int. J. Clin. Pract. · Jul 2021
Meta AnalysisAcute intracerebral hemorrhage and diffusion-weighted imaging lesions: a meta-analysis.
Diffusion-weighted imaging lesions in intracerebral haemorrhage are related to a higher risk of recurrent intracerebral haemorrhage, cognitive damage, and mortality. However, it has been reported that the relationship between the risk of diffusion-weighted imaging lesions and intracerebral haemorrhage subtype or the risk factors for diffusion-weighted imaging lesions is variable. This meta-analysis was performed to evaluate this relationship. ⋯ Based on this meta-analysis, the history of hypertension may have an independent risk relationship with a higher rate of diffusion-weighted imaging lesions. Also, subjects with diffusion-weighted imaging lesions had a greater decrease in systolic pressure in the acute phase of the intracerebral haemorrhage compared to those without diffusion-weighted imaging lesions. This relationship forces us to recommend that identification of diffusion-weighted imaging lesions might add appreciated evidence to evaluate the progression of the underlying micro-angiopathy especially in subjects with a history of hypertension. Though further studies are needed to define the mechanisms by which these lesions may lead to cognitive damage and stroke reappearance.
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Int. J. Clin. Pract. · Jul 2021
Meta AnalysisLevel of phosphate diets effect on fibroblast growth factor-23 levels in chronic kidney disease subjects: A meta-analysis.
High fibroblast growth factor-23 levels increase cardiovascular disease risk in chronic kidney disease subjects. The effects of dietary phosphate levels on fibroblast growth factor-23 in chronic kidney disease subjects have conflicting results. This meta-analysis was performed to evaluate this relationship. ⋯ Lower dietary phosphate levels had significantly lower 24-hour urinary phosphate excretion, intact fibroblast growth factor-23 level compared with higher dietary phosphate levels in chronic kidney disease subjects. This relationship forces us to recommend low dietary phosphate levels in chronic kidney disease subjects to decrease fibroblast growth factor-23 level to avoid any possible cardiovascular disease risk in such a subject.