Revista Colombiana de Anestesiología
01 Jan 2016-Vol. 40, Iss: 3, pp 240-244
TL;DR: The high frequency of inadvertent hypothermia requires action guidelines for prevention and management, especially in high-risk patients who, in this study, were patients ≥ 65 years of age and females.
Abstract: a b s t r a c t Introduction: Randomized clinical trials (RCT) are one of the most reliable methods of scien- tific investigation in health sciences. It is a corner stone of evidence based medicine and the backbone of high standard knowledge. Several types of errors can compromise the results and affect its validity. Objectives: To assess the risk of bias of the clinical trials published in the Revista Colombiana de Anestesiologia (RCA) medical journal by applying the "risk of bias detection" tool of the Cochrane Collaboration. Methods: All the clinical trials in the RCA journal were found by carrying out a systematic research. These trials were randomly distributed among 6 evaluators trained in the use of the "risk of bias detection" tool of the Cochrane Collaboration. Results were presented descriptively, graphically and chronologically to each of the 6 parameters that conform the "risk of bias detection" tool. Results: The RCA journal has published 40 volumes as of 1973. The searching process identi- fied a total 75 RCT up until 2009. The frequency of RCT publication has risen with time. The cities with most publications were Bogota DC and Medellin, and most trials were related to the management of acute and chronic pain. The greatest risk of bias (29% of all RCT) was found in the concealing of randomization sequences (parameter 2). 30% of the studies showed four or more parameter values of low risk of bias. A trend of decreasing proportion of high risk values was observed as time passed.
01 Jan 2011
TL;DR: This paper identified four point mutations in the U4atac snRNA component of the minor spliceosome in patients with brain and bone malformations and unexplained postnatal death [microcephalic osteodysplastic primordial dwarfism type 1 (MOPD 1) or Taybi-Linder syndrome (TALS); Mendelian Inheritance in Man ID no. 210710].
Abstract: Mutation in a small nuclear RNA hinders splicing of pre–messenger RNAs and causes the severe malformations of Taybi-Linder syndrome. The spliceosome, a ribonucleoprotein complex that includes proteins and small nuclear RNAs (snRNAs), catalyzes RNA splicing through intron excision and exon ligation to produce mature messenger RNAs, which, in turn serve as templates for protein translation. We identified four point mutations in the U4atac snRNA component of the minor spliceosome in patients with brain and bone malformations and unexplained postnatal death [microcephalic osteodysplastic primordial dwarfism type 1 (MOPD 1) or Taybi-Linder syndrome (TALS); Mendelian Inheritance in Man ID no. 210710]. Expression of a subgroup of genes, possibly linked to the disease phenotype, and minor intron splicing were affected in cell lines derived from TALS patients. Our findings demonstrate a crucial role of the minor spliceosome component U4atac snRNA in early human development and postnatal survival.
TL;DR: In this paper, the intramedullary canal during fixation of femoral shaft fractures may contribute to pulmonary morbidity in patients with trauma, and a study was conducted to compare acute and late pulmonary complications after reamed or non-reamed nailing of femur fractures.
Abstract: Reaming the intramedullary canal during fixation of femoral shaft fractures may contribute to pulmonary morbidity in patients with trauma The purpose of our study was to compare acute and late pulmonary complications after reamed or nonreamed nailing of femur fractures Patients who had femoral shaft fractures were randomized prospectively to a reamed (n = 41) or nonreamed (n = 41) femoral nailing group Arterial blood gases were measured before and after femur fixation Ratios of PaO 2 /FiO 2 and alveolar arterial gradients were calculated Pulmonary complications (acute respiratory distress syndrome) (ARDS), pneumonia, and respiratory failure) were monitored Age, gender, fracture site, fracture type, time to nailing, length of operation, Injury Severity Score, and Abbreviated Injury Scale-thorax were similar for the two groups No significant differences were observed in the ratio of PaO 2 /FiO 2 ratios or alveolar arterial (A-a) gradients before and after nailing The overall incidence of pulmonary complications was 146% (eight patients who had reamed nailing and four patients who had nonreamed nailing), and given the sample size, definitive conclusions could not be reached because of inadequate statistical power We were unable to document differences in pulmonary physiologic response or clinical outcome between patients having reamed and nonreamed femoral nailing This study may serve as a pilot investigation for other clinical investigations
01 Jan 2002
TL;DR: Compared with patient‐controlled intravenous opioid analgesia, intrapartum epidural analgesia did not significantly increase the cesarean delivery rate in women with severe preeclampsia at the authors' level III center, and it provided superior pain relief.
Abstract: OBJECTIVE: To estimate whether the cesarean delivery rate differs between women with severe preeclampsia who receive intrapartum epidural analgesia versus patient-controlled intravenous opioid analgesia. METHODS: Women with severe preeclampsia at at least 24 weeks' gestation were randomly assigned to receive either intrapartum epidural (n = 56) versus patient-controlled intravenous opioid analgesia (n = 60), and each was administered by a standardized protocol. The sample size was selected to have 80% power to detect at least a 50% difference in the predicted intergroup cesarean delivery rates. Data were analyzed by intent to treat. RESULTS: Selected maternal characteristics and neonatal outcomes were similar in the two groups. The cesarean delivery rates in the epidural group (18%) and the patient-controlled analgesia group (12%) were similar (P = .35). Women who received epidural analgesia were more likely to require ephedrine for the treatment of hypotension (9% versus 0%, P = .02), but their infants were less likely to require naloxone at delivery (9% versus 54%, P <.001). Epidural analgesia provided significantly better pain relief as determined by a visual analogue intrapartum pain score (P <.001) and a postpartum pain management survey (P =.002). CONCLUSION: Compared with patient-controlled intravenous opioid analgesia, intrapartum epidural analgesia did not significantly increase the cesarean delivery rate in women with severe preeclampsia at our level III center, and it provided superior pain relief.
30 Jul 2008
TL;DR: La capacite du BIS a mesurer la profondeur de the sedation en reanimation, notamment dans les situations of sedation profonde, chez le patient curarise ou sous pentobarbital, reste a etre demontree.
Abstract: Resume La sedation est une therapeutique dont les effets tant benefiques que deleteres necessitent une evaluation adaptee aux besoins du patient et ce, a toutes les etapes de son evolution clinique. L’objectif a cibler dans la majorite des cas que sont les sedations legeres, est un patient calme, cooperant et non douloureux, adapte au ventilateur. Durant ces sept dernieres annees, faute de developpement d’autres outils permettant une evaluation objective, huit nouvelles echelles ont ete developpees et majoritairement testees pour leurs qualites metrologiques. Le choix d’une echelle, a ce jour, peut se discuter entre le score de Ramsay, de par sa simplicite, l’echelle de vigilance–agitation de Richmond (RASS) traduite et partiellement validee en francais et l’echelle Adaptation to The Intensive Care Environment-ATICE d’origine francophone, pour une echelle incluant le niveau de conscience. L’echelle Behavioral Pain Scale (BPS) de Grenoble evalue la douleur et le confort. Deux echelles sont methodologiquement valides et robustes : ATICE, RASS. Les criteres de choix des echelles par le personnel soignant semblent etre : le niveau de reproductibilite, la clarte, la representativite des niveaux de sedation et d’agitation, la convivialite et la rapidite. In fine, le choix entre une echelle globale, facile d’utilisation et une echelle precise, plus complexe est a determiner au sein de chaque service, dans l’attente d’etudes randomisees comparatives prouvant la superiorite d’une echelle. Le BIS est moins performant que l’application d’une echelle pour evaluer l’etat d’eveil dans les sedations legeres. L’enregistrement concomitant de l’electromyogramme induit une surestimation des valeurs de BIS. En revanche, dans les quelques situations ou une sedation profonde est requise, les echelles ne permettent pas d’eliminer une sedation excessive. La capacite du BIS a mesurer la profondeur de la sedation en reanimation, notamment dans les situations de sedation profonde, chez le patient curarise ou sous pentobarbital, reste a etre demontree. Les etudes pharmacoeconomiques manquent.
TL;DR: An Explanation and Elaboration of the PRISMA Statement is presented and updated guidelines for the reporting of systematic reviews and meta-analyses are presented.
Abstract: Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
TL;DR: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is introduced, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses.
Abstract: Moher and colleagues introduce PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses. Us...
TL;DR: The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate.
Abstract: Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
•23 Sep 2019
TL;DR: The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
Abstract: The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
TL;DR: The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
Abstract: Background. Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. Objective. To develop a checklist for explicit and comprehensive reporting of qualitative studies (indepth interviews and focus groups). Methods. We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Results. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Conclusions. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.