scholarly journals Efficacy of probiotics in the prevention of diarrhea in ventilated critically ill ICU patients: meta-analysis of randomized control trials

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kentaro Shimizu ◽  
Tomoya Hirose ◽  
Hiroshi Ogura

AbstractWe comment on the study by Batra et al. on the efficacy of probiotics in the prevention of ventilator-associated pneumonia in critically ill ICU patients. They also reported that probiotics administration was not associated with a statistically significant reduction in the incidence of diarrhea (OR 0.59; CI 0.34, 1.03; P = 0.06; I2 = 38%). However, their meta-analysis missed one RCT, and when we repeated the analysis including this RCT, we found that probiotics administration significantly reduced the incidence of diarrhea (OR 0.51; CI 0.28, 0.92; P = 0.02; I2 = 45.6%). We thus believe that probiotics administration is effective in reducing the incidence of diarrhea in ventilated critically ill ICU patients.

2021 ◽  
pp. 174749302110132
Author(s):  
Ahmed Mohamed ◽  
Nida Fatima ◽  
Ashfaq Shuaib ◽  
Maher Saqqur

Introduction There is controversy if direct to comprehensive center “mothership” (MS) or stopping at primary center for thrombolysis before transfer to comprehensive center “drip-and- ship” (DS) are best models of treatment of acute stroke. In this study, we compare MS and DS models to evaluate the best option of functional outcome. Methods Studies between 1990 and 2020 were extracted from online electronic databases. We compared the clinical outcomes, critical time measurements, functional independence and mortality were then compared. Results A total of 7,824 patients’ data were retrieved from 13 publications (3 randomized control trials and 10 retrospective ones). 4,639 (59.3%) patients were treated under MS model and 3,185 (40.7%) followed the DS model with mean age of 70.01±3.58 vs. 69.03±3.36; p< 0 .001, respectively. The National Institute Health Stroke Scale was 15.57±3.83 for the MS and 15.72±2.99 for the DS model (p=<0.001). The mean symptoms onset-to-puncture time was significantly shorter in the MS group compared to the DS (159.69 min vs. 223.89 min; p=<0.001, respectively). Moreover, the collected data indicated no significant difference between symptom’s onset to intravenous (IV) thrombolysis time and stroke onset-to-successful recanalization time (p=0.205 and p=<0.001, respectively). Patients had significantly worse functional outcome [modified rankin score (mRS)] (3-6) at 90-days in the DS model [Odds Ratio (OR): 1.47, 95% Confidence Interval (CI): 1.13-1.92, p<0.004] and 1.49-folds higher likelihood of symptomatic intracerebral hemorrhage (OR: 1.49, 95%CI: 1.22-1.81, p<0.0001) compared to MS. However, there were no statistically significant difference in terms of mortality (OR: 1.16, 95%CI: 0.87-1.55, p=0.32) and successful recanalization (OR: 1.12, 95%CI: 0.76-1.65, p=0.56) between the two models of care. Conclusion Patients in the MS model have significantly improved functional independence and recovery. Further studies are needed as the data from prospectively randomized studies is not of sufficient quality to make definite recommendations.


Pain ◽  
1987 ◽  
Vol 30 ◽  
pp. S51 ◽  
Author(s):  
A. AntczakBouckoms ◽  
F. Tung ◽  
T. C. Chalmers ◽  
A. Bouckoms

Author(s):  
Ashleigh Kysar-Moon ◽  
Matthew Vasquez ◽  
Tierra Luppen

Abstract Research shows that most people experience at least one traumatic event in their lifetimes, and between 6% and 8% of those with a history of trauma will develop posttraumatic stress disorder (PTSD) and/or related mental health conditions. Women face a greater threat of trauma exposure and have a higher risk of PTSD and depression than men. Trauma-Sensitive Yoga (TSY), a body-based adjunctive therapy, has shown potential in several studies as an effective method for reducing PTSD and depression symptoms. However, existing research and systematic reviews vary widely in their methodological rigor and comparison samples. Thus, in this systematic review we examined the effectiveness of TSY among women with a history of trauma and depression who had participated in randomized control trials with clear control and experimental groups. Findings in fixed- and mixed-effects meta-analysis models suggest marginally significant to no effects of TSY on PTSD and depression outcomes. Our systematic review highlights critical questions and significant gaps in the existing literature about the rationale and best practices of TSY intervention duration.


2014 ◽  
Vol 34 (4) ◽  
pp. 392-400 ◽  
Author(s):  
Jun Xiong ◽  
Zhongyong Liu ◽  
Rixin Chen ◽  
Dingyi Xie ◽  
Zhenhai Chi ◽  
...  

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