Emergency medicine journal : EMJ
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Review Meta Analysis
Pulmonary embolism rule-out criteria (PERC) in pulmonary embolism--revisited: A systematic review and meta-analysis.
To perform a systematic review and meta-analysis including all the current studies to assess the accuracy of pulmonary embolism rule-out criteria (PERC) in ruling out pulmonary embolism (PE). ⋯ Because of the high sensitivity and low negative likelihood ratio, PERC rule can be used confidently in clinically low probability population settings.
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Review Meta Analysis Comparative Study
Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis.
Establishing intravenous access is often vital in an acute hospital setting but can be difficult. Ultrasound-guided cannulation increases success rates in prospective studies. However, these studies have often lacked a comparative group. This systematic review and meta-analysis aimed to determine the clinical effectiveness of Ultrasound-guided peripheral intravenous cannulation compared with the standard technique in patients known to have difficult access. ⋯ Ultrasound guidance increases the likelihood of successful peripheral cannulation in difficult access patients. We recommend its use in patients who have difficult venous access, and have failed venous cannulation by standard methods. Further randomised controlled trials (RCTs) with larger sample sizes would be of benefit to investigate if Ultrasound has any additional advantages in terms of reducing the procedure time and the number of skin punctures required for successful venous cannulation.
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Review Meta Analysis
Heart-type fatty acid binding protein as an early marker for myocardial infarction: systematic review and meta-analysis.
Heart-type fatty acid binding protein (H-FABP) has been proposed as an early biomarker of myocardial infarction (MI). The authors aimed to undertake a systematic review and meta-analysis to estimate the early sensitivity and specificity of quantitative and qualitative H-FABP assays. ⋯ H-FABP has modest sensitivity and specificity for MI at presentation but estimates are subject to substantial uncertainty and primary data are subject to substantial heterogeneity. H-FABP may have a role alongside troponin in improving early sensitivity but comparison with high sensitivity troponin assays is required.
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Review Meta Analysis
Safety profile and outcome of mild therapeutic hypothermia in patients following cardiac arrest: systematic review and meta-analysis.
Evidence has shown that mild therapeutic hypothermia (MTH) could improve survival and neurological outcome in patients following cardiac arrest. But this therapy may cause some adverse effects. The authors sought to take a systematic approach to describe the safety aspects and outcome of MTH following cardiac arrest to help clinical practice. ⋯ Evidence about the safety of MTH in children has been limited. These results suggest that while it may result in some adverse events, MTH is generally safe in patients following cardiac arrest and could improve the short-term and long-term survival of comatose patients after cardiac arrest. But awareness of these adverse events should be kept in mind in clinical practice.
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Review Meta Analysis
Meta-analysis of controlled studies on immunotherapy in severe scorpion envenomation.
Despite conflicting evidence, specific serotherapy is recommended for scorpion envenomation. ⋯ SAV should not be administered in Old World scorpion envenomation until its efficacy is established by an appropriately designed RCT. In the Arizona scorpion sting, SAV hastens the recovery process.