Chinese Med J Peking
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Chinese Med J Peking · Jan 2013
Meta AnalysisTelithromycin versus clarithromycin for the treatment of community-acquired respiratory tract infections: a meta-analysis of randomized controlled trials.
The emergence of bacterial resistance to commonly used antibiotics, such as macrolides, is complicating the management of respiratory tract infections (RTIs). Telithromycin, a ketolide antimicrobial structurally related to macrolides, is approved for the treatment of community-acquired RTIs, and shows lower pathogen resistance rates. The purpose of this study was to compare the efficacy and safety of telithromycin with clarithromycin, a macrolide routinely used as therapy for RTIs. ⋯ Our findings indicate that oral telithromycin and clarithromycin have similar treatment efficacy and adverse effect. The advantages of lower antimicrobial resistance rates, once-daily short-duration dosing and reported lower health-care costs make oral telithromycin a useful option for the empiric management of mild-to-moderate RTIs.
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Chinese Med J Peking · Jan 2013
Meta AnalysisEffect of noninvasive, positive pressure ventilation on patients with severe, stable chronic obstructive pulmonary disease: a meta-analysis.
This meta-analysis evaluated the effect of noninvasive, positive pressure ventilation on severe, stable chronic obstructive pulmonary disease (COPD). ⋯ Noninvasive positive pressure ventilation improves the arterial carbon dioxide tension but does not improve the mortality, pulmonary function, or exercise tolerance and should be cautiously used in severe stable chronic obstructive pulmonary disease.
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Chinese Med J Peking · Jan 2013
Meta AnalysisEffects of glucocorticoids on traumatic brain injury related critical illness-related corticosteroid insufficiency.
Traumatic brain injury (TBI) is a heterogeneous condition that can lead to critical LLLness-related corticosteroid insufficiency (CIRCI) causing a high mortality and morbidity. Glucocorticoids were widely used in the clinical management of TBI, but their benefit has been challenged in some studies and their efficacy, especially for treating CIRCI in TBI patients, remains unclear. ⋯ This meta-analysis suggests an increased risk of death for TBI patients on a high dose and short term of glucocorticoids compared with those on a low dose and long term, for whom a trend towards clinical improvement is evident. In addition, stress-does of GCs further decrease the pneumonia incidence in TBI patients suffering from CIRCI. A large-scale multicenter randomized controlled trial is warranted for testing (1) the efficacy of stress-dose GCs treatment in the sub-acute phase of TBI (4-21 days after initial trauma), when CIRCI is most likely to occur; (2) the hypothesis that stress-dose GCs could boost patients' stress function and ensure survival.
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We review the targets of the deep brain and the responsive neurostimulation system (RNS) to identify the best optimal stimulation parameters and the best mode of stimulation, whether cyclical, continuous, or smarter. ⋯ Although statistically significant reductions in seizures have been observed using several different stimulation techniques, including vagus nerve stimulation, DBS, and RNS, these effects are currently only palliative and do not approach the efficacy comparable with that seen in resection in appropriately selected patients. More research is needed to determine optimal stimulation targets and techniques as well as to determine which epilepsy patients will benefit most from this technology.
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Chinese Med J Peking · Jan 2013
Randomized Controlled TrialEfficacy evaluation for the treatment of unstable lumbar disc herniation by traditional and modified lamina osteotomy replantation.
The traditional lamina osteotomy replantation method is prone to nerve root injury and low back pain recurrence. Our team has proposed a modified approach that improves the osteotomy site and its fixation procedure. The aim of this study was to evaluate the clinical efficacy of traditional and modified lamina replantation methods in treating unstable lumbar disc herniation. ⋯ Compared to the traditional approach, the modified technique for lamina replantation showed lower rates of dural and nerve damage, a higher lamina healing rate, a lower back pain recurrence rate, and better clinical scores. It is a safe and effective operation for lumbar spine surgery.