Accuracy of Ultrasonography for the Diagnosis of Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis

Objective

To evaluate the accuracy of inlet and outlet ultrasonography measurements for the diagnosis of carpal tunnel syndrome (CTS).

呼出气一氧化氮检测在支气管哮喘和慢性阻塞性肺疾病诊断中的价值

目的:探讨呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)检测在支气管哮喘(哮喘)和慢性阻塞性肺疾病诊断中的价值。方法:选择慢性阻塞性肺疾病患者、哮喘患者各120例以及120名健康志愿者,均测定FeNO值。结果:慢性阻塞性肺疾病患者、哮喘患者、健康志愿者的FeNO测定值分别为(25.8±15.6)ppb、(64.1±51.8)ppb、(18.8±7.3)ppb,慢性阻塞性肺疾病患者和哮喘患者的FeNO值与健康志愿者比较差异均有统计学意义(P0.05),慢性阻塞性肺疾病患者与哮喘患者比较差异有统计学意义(P0.01)。3组研究对象的年龄、身高、体质量等一般资料比较差异均无统计学意义。FeNO测定值与年龄、身高、体质量、体质量指数、第1秒用力呼气容积(FEVI)、第1秒用力呼吸容积与用力肺活量之比(FEVI/FVC)均不存在直线相关性(P0.05)。结论:慢性阻塞性肺疾病及哮喘患者FeNO值均高于健康志愿者,FeNO测定值与FEVI、FEVI/FVC等均不存在直线相关性,其原因可能是研究采用的样本量偏少。     

Diagnostic value of bladder tumor fibronectin in patients with bladder tumor: A systematic review with meta-analysis

Objectives

Bladder tumor fibronectin (BTF) has been related as a promising biomarker for the early diagnosis of bladder tumor. The meta-analysis was used to establish the diagnostic value of bladder tumor fibronectin in diagnosing bladder tumor.

Methods

Relevant literatures evaluating the value of BTF in the diagnosis of bladder tumor were searched in PubMed, Embase, China National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP), and Wan Fang Data. Summary estimates were used to evaluate the value of BTF in the diagnosis of bladder tumor by using the Meta-DiSc and STATA 11.0 statistical software.

Results

The meta-analysis included 5 studies (649 patients, 291 controls). The summary estimates revealed that the pooled sensitivity was 81% (95% confidence interval [CI]: 74%–85.1%) and specificity was 80% (95%CI 74%–84%). In addition, the area under the summary ROC curve (AUC) was 0.86 (95%CI 0.82–0.89).

Conclusion

BTF is a potential marker for the diagnosis of bladder tumor, and more prospective studies are needed in the future.     

Correlation of left ventricular systolic dysfunction determined by low ejection fraction and 30-day mortality in patients with severe sepsis and septic shock: A systematic review and meta-analysis

Introduction

The prognostic implications of myocardial dysfunction in patients with sepsis and its association with mortality are controversial. Several tools have been proposed to evaluate cardiac function in these patients, but their usefulness beyond guiding therapy is unclear. We review the value of echocardiographic estimate of left ventricular ejection fraction (LVEF) in the setting of severe sepsis and/or septic shock and its correlation with 30-day mortality.

Methods

We conducted a systematic review and meta-analysis to evaluate the prognostic functionality of newly diagnosed LV systolic dysfunction by transthoracic echocardiography on critical ill patients admitted to the intensive care unit with severe sepsis or septic shock.

Results

A search of EMBASE and PubMed, Ovide MEDLINE, and Cochrane CENTRAL medical databases yielded 7 studies meeting inclusion criteria reporting on a total of 585 patients. The pooled sensitivity of depressed LVEF for mortality was 52% (95% confidence interval [CI], 29%-73%), and pooled specificity was 63% (95% CI, 53%-71%). Summary receiver operating characteristic curve showed an area under the curve of 0.62 (95% CI, 0.58-0.67). The overall mortality diagnostic odd ratio for septic patients with LV systolic dysfunction was 1.92 (95% CI, 1.27-2.899). Statistical heterogeneity of studies was moderate.

Conclusion

The presence of new LV systolic dysfunction associated with sepsis and defined as low LVEF is neither a sensitive nor a specific predictor of mortality. These findings are limited because of the heterogeneity and underpower of the studies. Further research into this method is warranted.