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Ivan I, Budiman F, Ruby R, Wendi IP, Ridjab DA. Current evidence of survival benefit between chest-compression only versus standard cardiopulmonary resuscitation in out-of-hospital cardiac arrest : Updated systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. Herz 2020; 46:198-208. [PMID: 32975628 DOI: 10.1007/s00059-020-04982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/11/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Evidence to support a better cardiopulmonary resuscitation method between standard vs. continuous chest compression (STD-CPR vs. CCC-CPR) is lacking. MATERIALS AND METHODS Our systematic review followed PRISMA guidelines. We searched PubMed, ScienceDirect, EBSCOhost, and ProQuest database from 1985 to 26 September 2019 restricted to randomized controlled trial, human study, and English articles. Quality assessment of between-study heterogeneity and a trial sequential analysis (TSA) were conducted. We estimated overall significance with 80% power and adjusted Z values thresholds using O'Brien-Fleming α‑spending function. Required information size with 21% relative risk using the estimation between-group incidences provided from the median rate across trials was determined. Inconclusive TSA result will lead to size estimation of future RCT. Quality of evidence was analyzed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) Handbook and TSA. RESULTS Based on three trials in OHCA with dispatcher-guided and bystander-initiated CPR, our meta-analysis favors CCC-CPR for survival to hospital discharge, compared to STD-CPR (RR [Risk Ratio] = 1.21[1.01-1.46], 95% CI, p = 0.68, I2 = 0). However, current meta-analyses with 3031 patients appeared to be inconclusive. There is a significant risk of type 1 error and therefore, results are potentially false positive. It is estimated that a minimal of 4331 patients needed to deem a conclusive result and a total of 5894 patients with similar risk profile required to stabilize statistic results in future trials. Quality of evidence is downgraded to moderate due to serious imprecision based on TSA. CONCLUSION Based on these analyses, evidence is inadequate to conclude the superiority of one CPR method over the other. Further trials with larger numbers of patients are needed to deem a conclusive and stable meta-analysis.
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Affiliation(s)
- I Ivan
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - F Budiman
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - R Ruby
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - I P Wendi
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - D A Ridjab
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Humbert F, Bohnert M, Mooijman K, Schulten S, Veld PI, Rollier P, Leuschner R, Capps K, Agin J, Allaert C, Asmundson R, Asperger H, Bohnert M, Bound A, Dixon L, Donda S, Espersen M, Foster K, Gangar V, Hammack T, Humbert F, Humes L, in’t Veld P, James L, Jost-Keating K, Kalinowski R, Kwan J, Lamb J, Leung S, Lienau A, Littell A, Mooijman K, Mui L, Ott M, Qvist S, Roberts D, Ruby R, Rude R, Santos C, Schulten S, Sellers R, Smith M, Solis D, Stecchini ML, Stegeman H, Steneryd A, Suktankar V, Wiberg C, Young V. Detection of Salmonella in Fresh Cheese, Poultry Products, and Dried Egg Products by the ISO 6579 Salmonella Culture Procedure and the AOAC Official Method: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.2.275] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Three food types were analyzed for the presence of Salmonella by the AOAC culture method and by the International Organization for Standardization (ISO 6579:2002) culture method. Paired test portions of each food type were simultaneously analyzed by both methods. A total of 21 laboratories representing federal government agencies and private industry, in the United States and Europe, participated in this interlaboratory study. Foods were artificially contaminated with Salmonella and competing microflora if naturally contaminated sources were not available. No statistical differences (p < 0.05) were observed between the AOAC and ISO culture methods for fresh cheese and dried egg products. A statistically significant difference was observed for one of the 2 lots of poultry from the first trial. The poultry meat used in this run was radiation sterilized, artificially contaminated with Salmonella and competitive flora, and then lyophilized. A second trial was conducted with 2 separate lots of raw ground chicken that were naturally contaminated. The results from the second trial showed no statistical difference between the 2 culture methods. A third trial involving 4 laboratories was conducted on 2 separate lots of naturally contaminated raw poultry. Again, no statistically significant differences occurred. It is recommended that ISO 6579:2002 culture method for Salmonella be adopted Official First Action for the analysis of fresh cheese, fresh chilled and frozen poultry, and dried egg products.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Florence Humbert
- Agence Française de Sécurité Sanitaire des Aliments, Laboratoire d'Étude et de Recherches Avicoles et Porcines, BP 53, 22440, Ploufragan, France
| | - Marylène Bohnert
- Agence Française de Sécurité Sanitaire des Aliments, Laboratoire d'Étude et de Recherches Avicoles et Porcines, BP 53, 22440, Ploufragan, France
| | - Kirsten Mooijman
- National Institut of Public Health and Environment, Microbiological Laboratory for Health Protection, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Saskia Schulten
- National Institut of Public Health and Environment, Microbiological Laboratory for Health Protection, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Paul In’t Veld
- Regional Inspectorate South, PO Box 2280, 5202 CG's-Hertogenbosch, Rijzertlaan 19, 's-Hertogenbosch, The Netherlands
| | - Patricia Rollier
- Centre d'Étude et de Controle des Analyses en Industrie Laitière, BP 89, 39801 Poligny, France
| | - Renata Leuschner
- Ministry of Agriculture, Fisheries, and Food, Control Science Laboratory, Sand Hutton, Y041 1LZ York, United Kingdom
| | - Katherine Capps
- Ministry of Agriculture, Fisheries, and Food, Control Science Laboratory, Sand Hutton, Y041 1LZ York, United Kingdom
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Armato J, Ruby R, Reaven G. Plasma triglyceride determination can identify increased risk of statin-induced type 2 diabetes: a hypothesis. Atherosclerosis 2015; 239:401-4. [PMID: 25682039 DOI: 10.1016/j.atherosclerosis.2015.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 02/05/2015] [Accepted: 02/05/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the ability of plasma triglyceride (TG) measurements to identify statin-treated persons at accentuated risk of statin-induced type 2 diabetes (T2DM). METHODS The experimental population consisted of nondiabetic, statin-treated patients (n = 469), classified as being at high risk for T2DM, subdivided on the basis of a plasma TG concentration of 1.7 mmol/L. Comparisons were made of demographic characteristics, concentrations of fasting glucose, insulin, HbA1c, and hs-CRP, oral glucose tolerance tests, estimates of insulin action and secretion, and lipid/lipoprotein profiles. RESULTS Despite similar fasting glucose and HbA1c concentrations, patients with elevated TG concentrations displayed markers of increased risk of T2DM (insulin resistance and compensatory hyperinsulinemia), more adverse lipid/lipoprotein profiles, and increased prevalence of abnormal hs-CRP values. CONCLUSION These findings demonstrate that plasma TG concentrations ≥ 1.7 mmol/L identified a subset of individuals at enhanced risk of developing statin-induced diabetes within a population classified prior to statin treatment as being at high risk of T2DM.
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Affiliation(s)
- J Armato
- Providence Little Company of Mary Cardiometabolic Center, Torrance, CA 90503, USA.
| | - R Ruby
- Providence Little Company of Mary Cardiometabolic Center, Torrance, CA 90503, USA
| | - G Reaven
- Division of Cardiovascular Medicine Falk CVRC, Stanford Medical Center 300 Pasteur Drive Stanford, CA 94305, USA
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Webster AC, Morley-Forster PK, Dain S, Ganapathy S, Ruby R, Au A, Cook MJ. Anaesthesia for adenotonsillectomy: a comparison between tracheal intubation and the armoured laryngeal mask airway. Can J Anaesth 1993; 40:1171-7. [PMID: 8281594 DOI: 10.1007/bf03009607] [Citation(s) in RCA: 101] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A prototype armoured laryngeal mask airway (LMA) was compared with tracheal intubation (ETT) for anaesthesia for adenotonsillectomy. Fifty-five children were randomised into the LMA group and 54 into the ETT group. During insertion of the LMA, peripheral oxyhaemoglobin desaturation (SpO2) < 94% occurred in ten patients (18.2%) and in seven patients (13%) during tracheal intubation (NS). After opening the Boyle-Davis gag, airway obstruction occurred in ten patients (18.2%) in the LMA group and in three patients (6%) in the ETT group (P = 0.07). In five patients (9%) the LMA was abandoned in favour of tracheal intubation. In all others (91%), when the need for adequate depth of anaesthesia was realized, a satisfactory airway was achieved more rapidly than with tracheal intubation (P < 0.001), and maintained throughout surgery. Manually assisted ventilation was required in all patients in the ETT group, mean duration 373 +/- 385 sec, and in 26 patients (52%) in the LMA group, mean duration 134 +/- 110 sec, P < 0.001. Mean end-tidal CO2 (PetCO2) was 45.5 +/- 6.21 mmHg in the ETT group and 46.6 +/- 6.09 in the LMA group (NS). The LMA did not limit surgical access. Heart rate, MAP and blood loss in the LMA group were 110 +/- 21, 74 +/- 9 mmHg and 1.92 +/- 1.22 ml.kg-1 respectively, compared with 143 +/- 13 (P < 0.001), 85 +/- 12 mmHg (P < 0.001) and 2.62 +/- 1.36 ml.kg-1 (P < 0.05) with tracheal intubation. Fibreoptic laryngoscopy at the end of surgery in 19 patients in the LMA group revealed no blood in the larynx.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A C Webster
- Department of Anaesthesia, University of Western Ontario, St. Joseph's Health Centre, London
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Ruby R, Gullane PJ, Mintz D. Chemodectomas of the head and neck. J Otolaryngol 1981; 10:126-36. [PMID: 6264093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The authors' experience in dealing with 10 cases of chemodectomas occurring in head and neck is outlined. The symptomatology of these tumors is discussed with their investigation and management. Analysis of this series suggests that polytomography is the most valuable tool in diagnosing lesions within the confines of the temporal bone, whereas angiography is the most rewarding method of investigating cervical lesions. Surgical resection is the preferred method of treatment, and the most definitive. However, in those cases where the patient's general medical condition or the size and location of the tumor create unacceptable risk factors, radiotherapy may be employed as a palliative measure.
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