ObjectivesCurrently ketamine is not used often as an analgesic in the emergency department (ED). Nonetheless, it can increase the efficiency of opioids and decrease their side effects. The purpose of this systematic review and meta-analysis was to evaluate whether low-dose ketamine in the ED provides better analgesia with fewer adverse effects.MethodsThe PubMed, EMBASE, and Cochrane Library databases were searched by two reviewers independently (last search performed on January 2016). Data were also extracted independently.ResultsA total of 6 trials involving 438 patients were included in the current analysis. Our subgroup analysis of pain reduction indicates that the favorable effects of ketamine were similar or superior to those of placebo or opioids, although these effects were heterogeneous. However, low-dose ketamine was associated with a higher risk of neurological (relative risk [RR] = 2.17, 95% confidence interval [CI] = 1.37–3.42, P < 0.001) and psychological events (RR = 13.86, 95% CI = 4.85–39.58, P < 0.001). In contrast, the opioid group had a higher risk of major cardiopulmonary events (RR = 0.22, 95% CI = 0.05–1.01, P = 0.05).ConclusionsThe efficiency of ketamine varies depending on the pain site, but low-dose ketamine may be a key agent for pain control in the ED, as it has no side effects. It may also help to reduce the side effects of opioids.

BackgroundThe BRAFV600E mutation, which accounts for about 60–80% papillary thyroid carcinoma(PTC), has been identifiedas a prognostic marker for risk stratification of PTC patients. However, the BRAFV600E mutation as a prognostic marker in papillary thyroid microcarcinoma (PTMC) is unclear.MethodsWe performed a retrospective review of 101 patients who underwent surgery for PTMC. We studied the prevalence of the BRAFV600E mutation. The associations between the BRAFV600E mutation and clinicopathologic characteristics were analyzed.ResultsThe BRAFV600E mutation was observed in 72 patients (71.3%). There was no statistically significant correlation in age, gender, multifocality, extrathyroidal extension, presence of Hashimoto thyroiditis, and lymph node metastasis between the BRAFV600E mutant group and wild group.ConclusionsThe BRAFV600E mutation is not significantly associated with prognostic factors in PTMC.

These results suggest that a 6-week Tai Chi program can be utilized as an effective nursing program to reduce blood pressure for hypertensive patients.

The evidence for tai chi in reducing BP in the elderly individuals is limited. Whether tai chi has benefits over exercise is still unclear. The number of trials and the total sample size are too small to draw any firm conclusions. Further rigorous RCTs are warranted.

We investigated the effects of tai chi on disease activity, flexibility and depression in patients with ankylosing spondylitis (AS). We allocated 40 patients to either a tai chi treatment group or a no-treatment control group. The tai chi group performed 60 min of tai chi twice weekly for eight consecutive weeks and 8 weeks of home-based tai chi, after which the group showed significant improvement in disease activity and flexibility compared to the control group. All outcome measures were significantly lower in the tai chi group than they were during pre-treatment, while they did not change in the control group. These findings suggest that tai chi can improve disease activity and flexibility for patients with AS. Tai chi is an easily accessible therapy for patients and, as such, may be an effective intervention for AS. However, we cannot completely discount the possibility that the placebo effect was responsible for the improvement.

Purpose: Pulmonary rehabilitation (PR) programs are important in the treatment of patients with chronic obstructive pulmonary disease (COPD) but vary widely in type, duration, and efficacy. This metaanalysis investigated the effect of PR programs on respiratory muscle strength in patients with COPD. Methods: PubMed, Embase, and CINAHL were searched. The primary outcome variables were maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP). The secondary outcome variables were the modified Borg score after the 6-min walking test, percent predicted forced expiratory volume in 1 second (FEV 1 %pred), and percent FEV 1 /forced volume capacity (FVC). Comprehensive Meta-Analysis, version 3.0, was used to analyze the data. The effect size was calculated using the standardized mean difference (SMD) and 95% confidence interval (CI). Results: Twenty randomized controlled trials (with 992 participants) were included in the analysis. The PR programs had a significant effect on the MEP (SMD, 0.87; 95% CI, 0.42e1.32; p < .001), MIP (SMD, 0.53; 95% CI, 0.13e0.93; p ¼ .009), and modified Borg score (SMD, À0.37; 95% CI, À0.52 to À0.22; p < .001) in patients with COPD. There was no effect on FEV 1 %pred (SMD, 0.09; 95% CI, À0.12 to 0.30; p ¼ .406) or FEV 1 /FVC% (SMD, 0.04; 95% CI, À0.17 to 0.26; p ¼ .702). Conclusion: PR programs improve respiratory muscle strength in patients with COPD. Strategies for selecting a suitable PR program need to be developed, and future studies should evaluate the long-term effects of such programs on pulmonary function.

Tai chi has been claimed to generate beneficial effects with respect to a wide range of diseases. The purpose of this systematic review was to evaluate evidence from randomised clinical trials (RCTs) testing the effectiveness of tai chi for increasing aerobic capacity. Systematic searches were conducted on 14 electronic databases without restrictions on population characteristics or the language of publication. The outcome measures considered for inclusion were changes in maximal oxygen consumption as a test for aerobic capacity. Five RCTs met all inclusion criteria. Three RCTs compared the effects of tai chi with no treatment. The meta-analysis failed to show an effect of tai chi on aerobic capacity compared with sedentary controls (n = 151, weight mean difference, ml/kg/min, 0.50, 95% CI -1.14 to 2.15, p = 0.55). Two RCTs compared tai chi with conventional physical exercise including brisk, low intensity and moderate intensity walking, and aerobic exercise. The results show that tai chi was not statistically significantly superior to physical exercise. In conclusion, the existing evidence does not suggest that regular tai chi is an effective way of increasing aerobic capacity.

Tai chi exercise has been recommended as suitable for the improvement of health in the elderly. The purpose of this study was to investigate the effects of tai chi on lower urinary tract symptoms (LUTSs), quality of life (QoL), and sex hormone levels in patients with benign prostate hypertrophy (BPH). The elderly patients with BPH were randomized to receive tai chi or usual care. Fifty-six participants were randomized into either the tai chi group (n = 28) or the control group (n = 28). After 12 weeks of treatment, the tai chi group showed significant improvement in LUTS and QoL. There was a significant effect of tai chi on testosterone but no significant effect on insulin or glucose. No serious adverse events were observed during the study period. In conclusion, our results suggest that 12 weeks of tai chi may improve LUTS and QoL in elderly patients with BPH.