Abstract:
:Ultrasound guidance has been reported to facilitate the performance of lumbar punctures (LPs). However, the use of ultrasound guidance has not yet received consistent conclusions. We performed a systematic review and meta-analysis to determine the efficacy of ultrasound-guided LPs. PubMed, Embase and the Cochrane Library were searched for randomised controlled trials comparing ultrasound guidance with traditional palpation for LPs in adults. The primary outcome was risk of failed procedures. A random-effects Mantel-Haenzsel model or random-effects inverse variance model was used to calculate relative risks (RRs) or standardised mean differences (SMDs) with 95% CIs. Twenty-eight trials (N=2813) met the inclusion criteria. Ultrasound-guided LPs were associated with a reduced risk of failed procedures (RR=0.58, 95% CI 0.39 to 0.85, p=0.005). No significant heterogeneity was detected (I2=27%) among these trials. It further decreased first attempt to failure (RR=0.43, 95% CI 0.30 to 0.62, p<0.00001), mean attempts to success (SMD=-0.61, 95% CI -0.80 to -0.43, p=0.00001) and incidences of complications of headache and backache (RR=0.63, 95% CI 0.46 to 0.85, p=0.003). Ultrasound guidance is an effective technique for LPs in adults.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Shu L,Huang J,Liu JCdoi
10.1136/postgradmedj-2020-138238subject
Has Abstractpub_date
2021-01-01 00:00:00pages
40-47issue
1143eissn
0032-5473issn
1469-0756pii
postgradmedj-2020-138238journal_volume
97pub_type
杂志文章,评审abstract::A patient who died in asystole less than 18 h after ingestion of 'Clovercide Extra', a combination hormonal weedkiller containing ioxynil and 4-chloro-2-methyl phenoxypropionic acid, is described. Previous reports describe coma as an early event following ingestion of these herbicides. In contrast our patient, althoug...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.755.681
更新日期:1988-09-01 00:00:00
abstract::In order to assess the neurohormonal responses to oral administration of two drugs with different antihypertensive mechanisms, and their implications for long-term efficacy, we studied the changes in plasma renin activity, aldosterone, catecholamines and blood pressure after two cross-over periods of treatment with ca...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-01-01 00:00:00
abstract::The role of prostaglandins in inflammation is still disputed. Some workers have attempted to fit prostaglandins into a simple model, i.e. inflammatory leads to chemical mediator leads to vascular response. Recent work has shown that this approach may be misleading. An alternative model is proposed, involving the inter...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.625.660
更新日期:1977-11-01 00:00:00
abstract::A patient with alcoholic cardiomyopathy is described in whom cardiovascular function capacity and radiological heart size fluctuated widely with periods of heavy drinking and abstinence. On two occasions, cessation of drinking resulted in clinical recovery from severe degrees of congestive failure and in complete reve...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.700.151
更新日期:1984-02-01 00:00:00
abstract::Congenital heart disease is now more prevalent than acquired in pregnancy in the developed world. In pregnancy the fall in systemic vascular resistance and increase in blood volume and cardiac output can cause functional deterioration in certain conditions. A minimally symptomatic woman with good ventricular function,...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.026625
更新日期:2005-05-01 00:00:00
abstract::Although many of the fundamental biological features of toxoplasmosis are today well appreciated, the practical problem of prevention of its most serious consequence--disabling congenital disease, remains unsolved. The reasons vary in different communities, but are concerned with detection of the chief mode of spread,...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.624.614
更新日期:1977-10-01 00:00:00
abstract::A 61-year-old patient with treated Conn's syndrome due to multiple bilateral adrenocortical adenomata developed primary hyperparathyroidism. At operation, a parathyroid adenoma and a thyroid colloid nodule were found. Although adrenocortical adenomata and hyperplasia are common findings in multiple endocrine adenopath...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.651.45
更新日期:1980-01-01 00:00:00
abstract::The characteristics of three combinations of thiopentone and etomidate [in the ratios of thiopentone (mg):etomidate (mg) of 5:1, 13:1 and 25:1] have been compared with the individual agents alone for the induction of anaesthesia. The incidence of pain on injection and abnormal movements was less with the combination c...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.66.777.539
更新日期:1990-07-01 00:00:00
abstract::Cryoglobulinaemia may cause cutaneous vasculitis and glomerulonephritis, potentially leading to end stage renal failure. An important proportion of cryoglobulinaemias are secondary to hepatitis C virus infection. Emerging antiviral treatment options offer a chance for causal therapy of these cases of cryoglobulinaemia...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2006.046078
更新日期:2007-02-01 00:00:00
abstract::A case of eosinophilic leukaemia in association with chromosomal abnormalities including a double Philadelphia chromosome is reported. Comment is also made on the cardiological problems which arise in this condition. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.654.268
更新日期:1980-04-01 00:00:00
abstract::A case is reported where the use of i.v. disopyramide for a supraventricular tachycardia resulted in a more serious ventricular dysrhythmia giving hypotension and this probably contributed to the development of a myocardial infarction. Attention is drawn to the possible risk. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.646.570
更新日期:1979-09-01 00:00:00
abstract::A patient with seven attacks of acute glomerulonephritis is described. Following each attack renal function returned to normal. Investigations strongly suggested immune complex disease as the cause of the nephritis but extensive tests failed to define the antigen. The possibility of an exogenous self-administered anti...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.687.60
更新日期:1983-01-01 00:00:00
abstract::The earliest manifestations of leukaemia often include rheumatic signs and symptoms. Arthritis is a well recognised complication of leukaemia in children, but acute and chronic leukaemia may also cause arthritis in adults. Leukaemic arthritis may occur at any time during the course of leukaemia and may be the presenti...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.885.425
更新日期:1999-07-01 00:00:00
abstract::Important implications for the recognition of iron deficiency anaemia include diagnosis and correction of underlying causes, most of which are identifiable, in the older patient, by means of conventional upper gastrointestinal endoscopy, and by colonoscopy. The aetiological search may, however, have to be widened to i...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.76.894.195
更新日期:2000-04-01 00:00:00
abstract::Episodic muscular weakness, commonly associated with alterations of serum potassium, is the cardinal feature of periodic paralysis. The combination of transient hyperkalaemia and rigors occurring during febrile episodes of malaria is suggested as the underlying cause which precipitated the muscular paralysis. Three pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.667.273
更新日期:1981-05-01 00:00:00
abstract::Two cases of widespread cutaneous vasculitis are described in association with diltiazem, a recently introduced calcium antagonist. In both cases, spontaneous resolution occurred over several weeks following withdrawal of the drug. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.752.467
更新日期:1988-06-01 00:00:00
abstract::The mechanisms, clinical features and management of the various forms of urticaria are discussed. The importance of histamine receptors, complement and the kinin cascade are reviewed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.53.626.732
更新日期:1977-12-01 00:00:00
abstract::A case of primary purulent meningococcal pericarditis presenting with chest pain, hypotension and cardiac tamponade followed by oliguric renal failure is reported. Treatment with antibiotics and surgical drainage was successful. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.722.1067
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:Circulating nitric oxide (NO) and lipid levels are closely associated with coronary artery disease (CAD). It is unclear whether the rs1799983 polymorphism in endothelial nitric oxide synthase (NOS3) gene is associated with plasma levels of NO and lipids. This systematic review and meta-analysis (Preferred Re...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析
doi:10.1136/postgradmedj-2019-136396
更新日期:2019-07-01 00:00:00
abstract::A patient is described in whom the presenting feature of hypopituitarism was the development of palmar xanthomata associated with type III hyperlipoproteinaemia. Treatment of her secondary hypothyroidism with thyroxine caused resolution of the xanthomata and hyperlipidaemia, but the underlying compositional abnormalit...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.746.1099
更新日期:1987-12-01 00:00:00
abstract::A 27 year old woman with hepato-lenticular degeneration (Wilson's disease) was found to have primary hepatocellular carcinoma (PHC) three and a half years after she was started on treatment with D-penicillamine. The tumour was resected since when she has remained well. Her liver function tests were normal throughout t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.714.357
更新日期:1985-04-01 00:00:00
abstract:INTRODUCTION:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been caused the greatest pandemic of our century. Many of the deaths related to it are due to a systemic inflammatory response, which has been called 'cytokine storm'. OBJECTIVES:We developed a comprehensive review of the pathophysiology mec...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2020-138791
更新日期:2020-10-02 00:00:00
abstract::Two cases of coeliac disease associated with thyroid enlargement are presented. One had a large simple adenomatous goitre which was removed surgically and the other had histological confirmation of lymphadenoma (Hashimoto's disease). ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.616.95
更新日期:1977-02-01 00:00:00
abstract::By comparison with other calcium antagonist drugs, amlodipine has unique pharmacokinetic properties that are probably attributable to its chemical structure and positive ionic charge at physiological pH. Thus, amlodipine undergoes gradual absorption from the gastro-intestinal tract and is widely distributed throughout...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::Diuretics are used extensively in hospitals and in community medical practice for the management of cardiovascular diseases. They are used frequently as the first line treatment for mild to moderate hypertension and are an integral part of the management of symptomatic heart failure. Although diuretics have been used ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2003.010835
更新日期:2004-04-01 00:00:00
abstract::A double-blind, randomized clinical trial comparing cefaclor with amoxycillin in the treatment of acute otitis media with effusion (OME) in infants and children is being conducted at Children's Hospital of Pittsburgh. Although the randomization code has not yet been broken, the results of treating the first 55 childre...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-01-01 00:00:00
abstract::Recurrence of adrenal cortical carcinoma 22 years after first presentation is reported in a 54-year-old woman with Cushing's syndrome. This tumour is normally associated with poor prognosis and prolonged survival is rare. Although the patient had remained well with apparent 'cure' in the intervening years, it is sugge...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.648.765
更新日期:1979-10-01 00:00:00
abstract::Spironolactone therapy is a well-known cause of hyperkalaemia, but in susceptible patient, it may also be associated with metabolic acidosis. We report a case of severe renal tubular acidosis (Type IV) with life-threatening hyperkalaemia caused by spironolactone, and discuss the mechanisms by which this may occur. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.817.887
更新日期:1993-11-01 00:00:00
abstract::Repeated pneumonia and hypogammaglobulinaemia was associated with long term low dose steroid therapy. Clinical improvement with restoration of antibody levels followed substitution of aerosol for oral therapy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.716.523
更新日期:1985-06-01 00:00:00
abstract::The relative prevalence of abnormalities of coronary flow reserve and oesophageal function was ascertained in 32 syndrome X patients with typical angina chest pain, a positive exercise test, and normal coronary arteries. Coronary flow reserve in response to a hyperaemic dose of papaverine was measured using an intraco...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.844.99
更新日期:1996-02-01 00:00:00