Journal Club - 2007-06-05

1. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis.

Tang BM, Eslick GD, Craig JC, McLean AS.
Lancet Infect Dis 2007;7(3):210-7. PMID: 17317602
PubMed: Abstract - Related articles
Fulltext options: Lancet Infect Dis - CrossRef - DOI - EBSCO - OVID

Summary: " Procalcitonin cannot reliably differentiate sepsis from other non-infectious causes of systemic inflammatory response syndrome in critically ill adult patients. The findings from this study do not lend support to the widespread use of the procalcitonin test in critical care settings."

2. Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study.

Dellinger EP, Tellado JM, Soto NE, Ashley SW, Barie PS, Dugernier T, Imrie CW, Johnson CD, Knaebel HP, Laterre PF, Maravi-Poma E, Kissler JJ, Sanchez-Garcia M, Utzolino S.
Ann Surg 2007;245(5):674-83. PMID: 17457158
PubMed: Abstract - Related articles
Fulltext options: Ann Surg - CrossRef - DOI - EBSCO - OVID

Summary: "This study demonstrated no statistically significant difference between the treatment groups for pancreatic or peripancreatic infection, mortality, or requirement for surgical intervention, and did not support early prophylactic antimicrobial use in patients with severe acute necrotizing pancreatitis." Comment: Compare this article to PMID 8480272 and PMID 9834279</a>.

3. Medical observation, compared with parathyroidectomy, for asymptomatic primary hyperparathyroidism: a prospective, randomized trial.

Bollerslev J, Jansson S, Mollerup CL, Nordenström J, Lundgren E, Tørring O, Varhaug JE, Baranowski M, Aanderud S, Franco C, Freyschuss B, Isaksen GA, Ueland T, Rosen T.
J Clin Endocrinol Metab 2007;92(5):1687-92. PMID: 17284629
PubMed: Abstract - Related articles
Fulltext options: J Clin Endocrinol Metab - CrossRef - DOI - EBSCO - OVID

Summary: "Asymptomatic patients with mild pHPT have decreased QoL and more psychological symptoms than normal controls. No benefit of operative treatment, compared with medical observation, was found on these measures so far."

4. Surgery versus prolonged conservative treatment for sciatica.

Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JA, Tans JT, Thomeer RT, Koes BW, Leiden-The Hague Spine Intervention Prognostic Study Group.
N Engl J Med 2007;356(22):2245-56. PMID: 17538084
PubMed: Abstract - Related articles
Fulltext options: N Engl J Med - CrossRef - DOI - EBSCO - OVID

Summary: "The 1-year outcomes were similar for patients assigned to early surgery and those assigned to conservative treatment with eventual surgery if needed, but the rates of pain relief and of perceived recovery were faster for those assigned to early surgery. (Current Controlled Trials number, ISRCTN26872154 [controlled-trials.com].).Copyright 2007 Massachusetts Medical Society."