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  • BMJ  (6)
  • 1
    Online Resource
    Online Resource
    Selenium and bone health: a protocol for a systematic review and meta-analysis
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 10 ( 2020-10), p. e036612-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 10 ( 2020-10), p. e036612-
    Abstract: Bone health affects the ability of human body to stay active, and its degradation can cause considerable morbidity and mortality. The factors related to bone health play an important role in preventing osteoporosis and its adverse consequences. However, the risk factors for osteoporosis have not been fully elucidated. Deficiency in the trace element selenium may be one of the risk factors for the development of osteoporosis. Previous studies have investigated the effects of selenium on osteoporosis; however, the results are inconclusive. Therefore, the present study aimed to systematically examine the existing literature on the associations between dietary or serum selenium and bone mineral density (BMD), osteoporosis or osteoporotic fractures, and to quantify such associations through meta-analysis. Methods and analysis PubMed, Embase and Cochrane Library will be searched using a specified search strategy to identify relevant studies up to October 2019. Both interventional and observational studies in humans will be included. The outcomes will include BMD and the prevalence or incidence of osteoporosis and osteoporotic fractures. For dietary or serum selenium and BMD, osteoporosis or osteoporotic fractures pooled analyses, estimates will be expressed as the mean difference, and the pooled OR, relative risk, HR or beta coefficient, and corresponding 95% CIs. Heterogeneity of the studies and publication bias will be investigated accordingly. To assess the quality and the risk of bias of the included studies, the Newcastle-Ottawa Quality Scale or the Cochrane risk of bias assessment tool will be used where appropriate. Ethics and dissemination Since no private and confidential patient data will be included in the reporting, approval from an ethics committee is not required. The results will be published in a peer-reviewed journal. The study raises no ethical issues. PROSPERO registration number CRD42019147188.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2019-036612
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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  • 2
    Online Resource
    Online Resource
    Analgesic efficacy and safety of ketamine after total knee or hip arthroplasty: a meta-analysis of randomised placebo-controlled studies
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 9 ( 2019-09), p. e028337-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 9 ( 2019-09), p. e028337-
    Abstract: To examine the analgesic efficacy and safety of ketamine after total knee or hip arthroplasty. Design Systematic review and meta-analysis. Data sources PubMed, EMBASE and Cochrane Library from inception to 22 May 2019. Eligibility criteria for selecting studies Randomised controlled trials comparing the efficacy and safety of ketamine with placebo for postoperative pain relief in patients undergoing total knee or hip arthroplasty. Data extraction and synthesis Data (ie, pain intensity, morphine consumption, gastrointestinal and psychotic adverse effects) were extracted by two reviewers independently. The Cochrane Collaboration’s recommended tool was used to determine the methodological quality of included studies. Results A total of 10 studies were included. One of them was rated as low quality. Compared with placebo, intravenous ketamine was effective for pain relief during 0–8-hour (weighted mean difference (WMD) −1.21, 95% CI −1.45 to −0.98, p 〈 0.001; three studies, 149 participants) but not during 8–24-hour postoperative periods, and effective for reduction of cumulative morphine consumption during both 0–24-hour (WMD −17.76, 95% CI −31.25 to −4.27, p=0.01; five studies, 366 participants) and 0–48-hour (WMD −21.79, 95% CI −25.46 to −18.11, p 〈 0.001; four studies, 252 participants) postoperative periods, without increasing risks of gastrointestinal or psychotic adverse effects. The limited data available for intra-articular (WMD −0.49, 95% CI −0.70 to −0.29, p 〈 0.001; two studies, 83 participants) and epidural (WMD −2.10, 95% CI −3.30 to −0.90, p 〈 0.001; one study, 20 participants) ketamine pointed to a significant reduction in pain intensity during 8–24-hour postoperative period. Conclusions Intravenous administration of ketamine is effective and safe for postoperative pain relief in patients undergoing total knee or hip arthroplasty. Nevertheless, the analgesic efficacy and safety of ketamine in such patients seem to vary by different administration routes and still warrant further studies to explore.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-028337
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 3
    Online Resource
    Online Resource
    Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis
    BMJ ; 2018
    In:  BMJ Open Vol. 8, No. 12 ( 2018-12), p. e022879-
    Details
    In: BMJ Open, BMJ, Vol. 8, No. 12 ( 2018-12), p. e022879-
    Abstract: To investigate the efficacy and safety of the pulsed electromagnetic field (PEMF) therapy in treating osteoarthritis (OA). Design Meta-analysis. Data sources PubMed, Embase, the Cochrane Library and Web of Science were searched through 13 October 2017. Eligibility criteria for selecting studies Randomised controlled trials compared the efficacy of PEMF therapy with sham control in patients with OA. Data extraction and synthesis Pain, function, adverse effects and characteristics of participants were extracted. RevMan V.5.2 was used to perform statistical analyses. Results Twelve trials were included, among which ten trials involved knee OA, two involved cervical OA and one involved hand OA. The PEMF group showed more significant pain alleviation than the sham group in knee OA (standardised mean differences (SMD)=−0.54, 95% CI −1.04 to –0.04, p=0.03) and hand OA (SMD=−2.85, 95% CI −3.65 to –2.04, p 〈 0.00001), but not in cervical OA. Similarly, comparing with the sham–control treatment, significant function improvement was observed in the PEMF group in both knee and hand OA patients (SMD=−0.34, 95% CI −0.53 to –0.14, p=0.0006, and SMD=−1.49, 95% CI −2.12 to –0.86, p 〈 0.00001, respectively), but not in patients with cervical OA. Sensitivity analyses suggested that the exposure duration 〈 =30 min per session exhibited better effects compared with the exposure duration 〉 30 min per session. Three trials reported adverse events, and the combined results showed that there was no significant difference between PEMF and the sham group. Conclusions PEMF could alleviate pain and improve physical function for patients with knee and hand OA, but not for patients with cervical OA. Meanwhile, a short PEMF treatment duration (within 30 min) may achieve more favourable efficacy. However, given the limited number of study available in hand and cervical OA, the implication of this conclusion should be cautious for hand and cervical OA.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2018-022879
    DOI: 10.1136/bmjopen-2018-022879.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2018
    detail.hit.zdb_id: 2599832-8
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  • 4
    Online Resource
    Online Resource
    A subset of metastatic pancreatic ductal adenocarcinomas depends quantitatively on oncogenic Kras/Mek/Erk-induced hyperactive mTOR signalling
    BMJ ; 2016
    In:  Gut Vol. 65, No. 4 ( 2016-04), p. 647-657
    Details
    In: Gut, BMJ, Vol. 65, No. 4 ( 2016-04), p. 647-657
    Type of Medium: Online Resource
    ISSN: 0017-5749 , 1468-3288
    URL: Article
    DOI: 10.1136/gutjnl-2014-307616
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2016
    detail.hit.zdb_id: 1492637-4
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  • 5
    Online Resource
    Online Resource
    Association between egg consumption and metabolic syndrome in Chinese population: a cross-sectional study
    BMJ ; 2021
    In:  BMJ Open Vol. 11, No. 12 ( 2021-12), p. e050317-
    Details
    In: BMJ Open, BMJ, Vol. 11, No. 12 ( 2021-12), p. e050317-
    Abstract: Metabolic syndrome (MS) comprises a constellation of symptoms that include abdominal obesity, hypertension, hyperglycaemia and dyslipidaemia. Dietary intake is a crucial environmental risk factor for MS, but the exact association between MS and egg consumption, which accounts for more than half of the daily total cholesterol intake in Chinese population, has not been previously studied. The aim of this study was to examine the correlation between dietary egg consumption and the prevalence of MS in the context of a large population. Design A cross-sectional study. Settings Our study was conducted in a health examination centre in China. Participants Participants who aged ≥40 years and received routine physical examinations were included for analyses. Main outcome measures MS was diagnosed in accordance with the clinical diagnosis criteria specified in the American Heart Association Guidelines. Egg consumption was assessed by a validated semi-quantitative food frequency questionnaire. Results A total of 11 529 participants (46.2% women) were included in the present study. On the basis of multivariable logistic regression analysis, egg consumption was negatively associated with the prevalence of MS after adjusting for dietary energy intake (OR=0.84, 95% CI 0.76 to 0.93, p value for trend=0.001). The above findings did not change with further adjustment for other potential confounders: model 2 was further adjusted for age, body mass index and sex (based on model 1) and model 3 was further adjusted for education level, physical activity level, smoking status, alcohol use status, dietary fat intake, dietary fibre intake and nutritional supplementation (based on model 2). Consistent results were obtained from the analysis in the female subgroup but not in male subjects. Conclusions A higher level of egg consumption was associated with a lower prevalence of MS in our study participants, and particularly in female subjects.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-050317
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2599832-8
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  • 6
    Online Resource
    Online Resource
    Recommendation about the perioperative prevention of infection to healthcare workers and the anesthesia management of children with SARS-CoV-2 infection
    BMJ ; 2020
    In:  World Journal of Pediatric Surgery Vol. 3, No. 1 ( 2020-03), p. e000126-
    Details
    In: World Journal of Pediatric Surgery, BMJ, Vol. 3, No. 1 ( 2020-03), p. e000126-
    Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread widely and persistently over 100 countries. New challenges have occurred in the perioperative management of airway and anesthesia in children diagnosed with SARS-CoV-2 infection. According to current publications and to our own experiences in anesthesia management for cases with SARS-CoV-2 suspected, we reviewed concerns about the perioperative prevention of SARS-CoV-2 to medical staff and the anesthesia strategy to the patient.
    Type of Medium: Online Resource
    ISSN: 2516-5410
    URL: Article
    DOI: 10.1136/wjps-2020-000126
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2934437-2
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