Background: We performed a systematic review and meta-analysis to determine the effect of suction with water seal, compared with water seal alone, applied to intra pleural chest tubes on the duration of air leaks in patients undergoing pulmonary surgery. Methods:We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to find randomized controlled trials (RCTs) comparing the effect of the 2 methods on the duration of air leaks. Trials were systematically assessed for eligibility and validity. Data were extracted in duplicate and pooled across studies using a random-effects model. Results:The search yielded 7 RCTs that met the eligibility criteria. No difference was identified between the 2 methods in duration of air leak (weighted mean difference [WMD] 1.15 days, favours water seal; 95% confidence interval [CI] -0.64 to 2.94), time to discharge (WMD 2.19 d, favours water seal; 95% CI -0.63 to 5.01), duration of chest tubes (WMD 0.96 d, favours water seal; 95% CI -0.12 to 2.05) or incidence of prolonged air leaks (absolute risk reduction [ARR] 0.04, favours water seal; 95% CI -0.01 to 0.09). Water seal was associated with a significantly increased incidence of postoperative pneumothorax (ARR -0.14, 95% CI -0.21 to -0.07). Conclusion:No differences were identified in terms of duration of air leak, incidence of prolonged air leak, duration of chest tubes and duration of hospital stay when chest tubes were placed to suction rather than water seal. Chest tube suction appears to be superior to water seal in reducing the incidence of pneumothorax; however, the clinical significance of this finding is unclear.Contexte : Nous avons procédé à une revue systématique et à une méta-analyse dans le but de comparer l'effet de 2 méthodes de drainage thoracique intrapleural (la première, scellée sous eau avec succion et l'autre, scellée sous eau, mais sans succion) sur la durée des fuites d'air chez les patients soumis à une chirurgie pulmonaire. Méthodes : Nous avons interrogé les bases de données MEDLINE, EMBASE et le registre central Cochrane des essais randomisés et contrôlés (ERC) pour recenser lesERC ayant comparé l'effet des 2 méthodes sur la durée des fuites d'air. Nous avons évalué de manière systématique l'admissibilité et la validité des ERC. Nous avons extrait en double les données des essais retenus et nous les avons regroupées selon un modèle à effets aléatoires.Résultats : L'interrogation a permis de recenser 7 ERC qui répondaient aux critères d'admissibilité. Nous n'avons observé aucune différence entre les 2 méthodes quant à la durée des fuites d'air (différence moyenne pondérée [DMP] 1,15 j, favorisant le système scellé sous eau; intervalle de confiance [IC] à 95 % -0,64 à 2,94), durée du séjour hospitalier (DMP 2,19 j, favorisant le système scellé sous eau; IC à 95 % 0,63 à 5,01), la durée du drainage thoracique (DMP 0,96 j, favorisant le système scellé sous eau; IC à 95 % 0,12 à 2,05) ou l'incidence des fuites d'air prolongées (réduction du risque absolu [RRA] 0,04, favorisant le sys...
Considering the involvement of hippocampal mGlu receptors in learning and memory processes as well as in neurotoxicity and seizure production, the reduced expression of these receptors might contribute to ethanol withdrawal-induced seizures and also may play a role in cognitive deficits and brain damage caused by long-term ethanol consumption.
<p>ABSTRACT<br />The impact of using influencers in a product such as a smartphone that can create stronger advertising effectiveness. This strengthens the understanding of advertising in an effort to tell stories, arouse emotions, create fantasy, and impact to provide strong visuals. This study aims to analyze the effect of VIVO brand image. By using quantitative research and processed with SPSS 25.0, the results of this study explain that brand image is partially influenced by factors such as endorser self quality, similarity, and persuasive power displayed. While factors can be trusted, expertise, physical attractiveness, popularity does not affect. Simultaneously the brand image in the VIVO device is influenced by Trustworthy factors, Expertise, Physical Attraction, Quality Appreciated, Similarity, Popularity, and Persuasive Strength.<br /><strong>Keywords:</strong> brand image, device, endorser, influencer</p><p><br />ABSTRAK<br />Dampak dari penggunaan influencer dalam dalam suatu produk seperti gawai yang dapat menciptakan efektivitas iklan yang lebih kuat. Hal ini menguatkan pemahaman iklan dalam upaya untuk menceritakan kisah, membangkitkan emosi, menciptakan fantasi, dan dampak memberikan visual yang kuat. Penelitian ini bertujuan untuk menganalisis pengaruh citra merek gawai VIVO. Dengan menggunakan penelitian kuantitatif dan diolah dengan SPSS 25.0 hasil penelitian ini menjelaskan citra merek secara parsial dipengaruhi oleh faktor-faktor seperti kualitas diri endorser, kesamaan, dan kekuatan persuasif yang ditampilkan. Sedangkan faktor-faktor dapat dipercaya, keahlian, daya tarik fisik, popularitas tidak berpengaruhi. Secara simultan citra merek pada gawai VIVO dipengaruhi oleh faktor-faktor Dapat Dipercaya, Keahlian, Daya Tarik Fisik, Kualitas Dihargai, Kesamaan, Popularitas, dan Kekuatan Persuasif.<br /><strong>Kata kunci:</strong> citra merek, gawai, endorser, influencer</p>
Intravenous fat emulsion (IFE) therapy is a novel treatment that has been used to reverse the acute toxicity of some xenobiotics with varied success. We sought to determine how US Poison Control Centers (PCCs) have incorporated IFE as a treatment strategy for poisoning. A closed-format multiplechoice survey instrument was developed, piloted, revised, and then sent electronically to every medical director of an accredited US PCC in March 2011. Addresses were obtained from the American Association of Poison Control Centers listserv, and participation was voluntary and remained anonymous. Data were analyzed using descriptive statistics. The majority of PCC medical directors completed the survey (45 out of 57; 79 %). Of the 45 respondents, all felt that IFE therapy played a role in the acute overdose setting. Most PCCs (30 out of 45; 67 %) have a protocol for IFE therapy. In a scenario with "cardiac arrest" due to a single xenobiotic, directors stated that their center would "always" or "often" recommend IFE after overdose of bupivacaine (43 out of 45; 96 %), verapamil (36 out of 45; 80 %), amitriptyline (31 out of 45; 69 %), or an unknown xenobiotic (12 out of 45; 27 %). In a scenario with "shock" due to a single xenobiotic, directors stated that their PCC would "always" or "often" recommend IFE after overdose of bupivacaine (40 out of 45; 89 %), verapamil (28 out of 45; 62 %), amitriptyline (25 out of 45; 56 %), or an unknown xenobiotic (8 out of 45; 18 %). IFE therapy is being recommended by US PCCs; protocols and dosing regimens are nearly uniform. Most directors feel that IFE is safe but are more likely to recommend IFE in patients with cardiac arrest than in patients with severe hemodynamic compromise.
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