BMC research notes
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There is a lack of an instrument to evaluate systematic reviews of non-randomized studies in epidemiological research. The Assessment of Multiple Systematic Reviews (AMSTAR) is widely used to evaluate the scientific quality of systematic reviews, but it has not been validated for SRs of non-randomized studies. The objective of this paper is to report our experience in applying AMSTAR to systematic reviews of non-randomized studies in terms of applicability, reliability and feasibility. Thus, we applied AMSTAR to a recently published review of 32 systematic reviews of non-randomized studies investigating the hospital volume-outcome relationship in surgery. ⋯ AMSTAR showed good psychometric properties, comparable to prior findings in systematic reviews of randomized controlled trials. AMSTAR can be applied to systematic reviews of non-randomized studies, although there are some item specific issues users should be aware of. Revisions and extensions of AMSTAR might be helpful.
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Historical Article
False positives complicate ancient pathogen identifications using high-throughput shotgun sequencing.
Identification of historic pathogens is challenging since false positives and negatives are a serious risk. Environmental non-pathogenic contaminants are ubiquitous. Furthermore, public genetic databases contain limited information regarding these species. High-throughput sequencing may help reliably detect and identify historic pathogens. ⋯ False positives and negatives remain problematic in ancient DNA analyses despite the application of high-throughput sequencing. Our results suggest that several studies claiming the discovery of ancient pathogens may need further verification. Additionally, true single molecule sequencing's short read lengths, inability to sequence through DNA lesions, and limited ancient-DNA-specific technical development hinder its application to palaeopathology.
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Observational Study
Fluid prescription practices of anesthesiologists managing patients undergoing elective colonoscopy: an observational study.
Routine fluid prescription is common practice amongst anesthesiologists caring for patients undergoing colonoscopy. However there is limited information about routine procedural fluid prescription practices of anesthesiologists in this setting. Routine fluid administration may also have important pharmaco-economic implications for the health care budget. Therefore we performed a prospective observational study assessing the fluid prescription practices of anesthesiologists caring for patients undergoing elective colonoscopy. ⋯ Routine fluid prescription by anesthesiologists managing patients undergoing colonoscopy was ineffective with low actual fluid volumes delivered during the procedure. There was no association between volumes of fluid delivered and procedural hypotension, adverse events, or procedure duration. Anesthesiologists should question the clinical and pharmaco-economic value of routine fluid administration for patients undergoing elective endoscopy.
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The lack of a reliable scoring system that predicts the development of septic shock and death precludes comparison of disease and/or treatment outcomes in animal models of sepsis. We developed a murine sepsis score (MSS) that evaluates seven clinical variables, and sought to assess its validity and reliability in an experimental mouse model of polymicrobial sepsis. ⋯ The MSS reliably predicts disease progression and mortality in an animal model of polymicrobial sepsis. More importantly, it may be used to assess and compare outcomes among various experimental models of sepsis, and serve as an ethically acceptable alternative to death as an endpoint.
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Review Case Reports
Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: a case report and review of the literatures.
Post-operative rhabdomyolysis is a well-known complication, especially after bariatric and orthopaedic surgeries. There are few published reports of rhabdomyolysis following cardiac surgery. Acute kidney injury had been distinguished as a serious complication of cardiac surgery. We report a case of 55-years-old male patient who developed rhabdomyolysis precipitated acute kidney injury after coronary artery bypass graft. ⋯ Prolonged duration of surgery is a well-recognized risk factor in the development of rhabdomyolysis. Early recognition of rhabdomyolysis induced acute kidney injury is important in reducing the post-operative morbidity and mortality in patients. A protocol based approach could be applied for early recognition and management.