Difference between revisions of "Sun"

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<span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"="">The addition of hyperbaric oxygen to management of acute spinal cord injured patients resulted in improved functional ability and reduced signs of neuro-inflammation</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:">The addition of hyperbaric oxygen to management of acute spinal cord injured patients resulted in improved functional ability and reduced signs of neuro-inflammation</span></span>'''</span>
  
 
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. The addition of hyperbaric oxygen improved motor scores and an impairment scale in acute spinal injury<br/> 2. There were accompanying signs of reduced neuro-inflammation with hyperbaric oxygen</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">1. The addition of hyperbaric oxygen improved motor scores and an impairment scale in acute spinal injury<br/> 2. There were accompanying signs of reduced neuro-inflammation with hyperbaric oxygen</span></span>'''</span>
  
 
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Citation/s:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1.Sun L, Zhao L, Li P, Liu X, Liang F, Jiang Y, Kang N, Gao C, Yang J. Effect of hyperbaric oxygen therapy on HMGB/NF-kB expression and prognosis of acute spinal cord injury: a randomized clinical trial. Neuroscience Letters 2019, Jan23;692:47-52.<br/> '''Lead author's name and fax: '''Lei Sun: leisun-neurology@foxmail.com</span></span></span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Citation/s:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:">1.Sun L, Zhao L, Li P, Liu X, Liang F, Jiang Y, Kang N, Gao C, Yang J. Effect of hyperbaric oxygen therapy on HMGB/NF-kB expression and prognosis of acute spinal cord injury: a randomized clinical trial. Neuroscience Letters 2019, Jan23;692:47-52.<br/> '''Lead author's name and fax: '''Lei Sun: leisun-neurology@foxmail.com</span></span></span>
  
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Three-part Clinical Question:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">For patients with acute spinal injury, does the administration of hyperbaric oxygen along with usual standard measures, compared to standard measures alone, lead to any effects on secondary inflammatory responses and electromyographic changes?<br/> '''Search Terms:''' Spinal cord injury; inflammatory markers, DNA binding protein</span></span></span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Three-part Clinical Question:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:">For patients with acute spinal injury, does the administration of hyperbaric oxygen along with usual standard measures, compared to standard measures alone, lead to any effects on secondary inflammatory responses and electromyographic changes?<br/> '''Search Terms:''' Spinal cord injury; inflammatory markers, DNA binding protein</span></span></span>
  
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">The Study:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Non-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Adult patients with traumatic spinal cord injury and admitted to the relevant hospital within 72 hours.<br/> '''Control group''' (N = 38; 38 analysed): Conventional medical and surgical management with mannitol, methylprednisolone, ganglioside and vitamin B12.<br/> '''Experimental group''' (N = 41; 41 analysed): As above plus 100% oxygen breathing at 1 ATA for 60 minutes daily for 30 days.</span></span></span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">The Study:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:">Non-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Adult patients with traumatic spinal cord injury and admitted to the relevant hospital within 72 hours.<br/> '''Control group''' (N = 38; 38 analysed): Conventional medical and surgical management with mannitol, methylprednisolone, ganglioside and vitamin B12.<br/> '''Experimental group''' (N = 41; 41 analysed): As above plus 100% oxygen breathing at 1 ATA for 60 minutes daily for 30 days.</span></span></span>
  
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">The Evidence:</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">The Evidence:</span></span>'''</span>
  
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| style="width:96.65pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Outcome</span>'''</span></p>  
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| style="width:96.65pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Outcome</span></span>'''</span></p>  
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| style="width:55.15pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Time to Outcome</span>'''</span></p>  
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| style="width:55.15pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Time to Outcome</span></span>'''</span></p>  
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| style="width:41.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Control group</span>'''</span></p>  
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| style="width:41.0pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control group</span></span>'''</span></p>  
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| style="width:57.4pt" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Hyperbaric group</span>'''</span></p>  
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| style="width:57.4pt; border:solid windowtext 1.0pt" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Hyperbaric group</span></span>'''</span></p>  
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| style="width:67.2pt" width="92" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Relative risk reduction</span>'''</span></p>  
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| style="width:67.2pt; border:solid windowtext 1.0pt" width="92" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Relative risk reduction</span></span>'''</span></p>  
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| style="width:69.35pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Absolute risk reduction</span>'''</span></p>  
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| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Absolute risk reduction</span></span>'''</span></p>  
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| style="width:51.75pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">NNT</span>'''</span></p>  
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| style="width:51.75pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">NNT</span></span>'''</span></p>  
 
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| rowspan="2" style="width:96.65pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Improved at least one level in American Spinal Injury Impairment Scale</span>'''</span></p>  
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| rowspan="2" style="width:96.65pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Improved at least one level in American Spinal Injury Impairment Scale</span></span>'''</span></p>  
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| style="width:55.15pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">30 days</span>'''</span></p>  
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| style="width:55.15pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">30 days</span></span>'''</span></p>  
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| style="width:41.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">.71</span>'''</span></p>  
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| style="width:41.0pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">.71</span></span>'''</span></p>  
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| style="width:57.4pt" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">.93</span>'''</span></p>  
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| style="width:57.4pt; border:solid windowtext 1.0pt" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">.93</span></span>'''</span></p>  
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| style="width:67.2pt" width="92" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">30%</span>'''</span></p>  
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| style="width:67.2pt; border:solid windowtext 1.0pt" width="92" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">30%</span></span>'''</span></p>  
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| style="width:69.35pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">0.22</span>'''</span></p>  
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| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">0.22</span></span>'''</span></p>  
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| style="width:51.75pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">5</span>'''</span></p>  
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| style="width:51.75pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">5</span></span>'''</span></p>  
 
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| colspan="3" style="width:156.55pt" width="215" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">95% CIs:</span></span></p>  
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| colspan="3" style="width:156.55pt; border:solid windowtext 1.0pt" width="217" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p>  
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| style="width:67.2pt" width="92" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">7% to 54%</span></span></p>  
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| style="width:67.2pt; border:solid windowtext 1.0pt" width="92" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">7% to 54%</span></span></span></p>  
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| style="width:69.35pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.05 to 0.38</span></span></p>  
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| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.05 to 0.38</span></span></span></p>  
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| style="width:51.75pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">3 to 19</span></span></p>  
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| style="width:51.75pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">3 to 19</span></span></span></p>  
 
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| rowspan="2" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Measure</span>'''</span></p>  
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| rowspan="2" style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Measure</span></span>'''</span></p>  
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| colspan="2" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Control Group</span>'''</span></p>  
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| colspan="2" style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control Group</span></span>'''</span></p>  
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| colspan="2" style="width:67.2pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Experimental Group</span>'''</span></p>  
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| colspan="2" style="width:67.2pt; border:solid windowtext 1.0pt" width="97" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Experimental Group</span></span>'''</span></p>  
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| rowspan="2" style="width:55.1pt" width="75" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Difference</span>'''</span></p>  
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| rowspan="2" style="width:55.1pt; border:solid windowtext 1.0pt" width="77" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Difference</span></span>'''</span></p>  
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| rowspan="2" style="width:73.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">95% CI</span>'''</span></p>  
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| rowspan="2" style="width:73.0pt; border:solid windowtext 1.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">95% CI</span></span>'''</span></p>  
 
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| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Mean</span>'''</span></p>  
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| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p>  
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| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">SD</span>'''</span></p>  
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| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p>  
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| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Mean</span>'''</span></p>  
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| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p>  
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| style="width:28.05pt" width="43" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">SD</span>'''</span></p>  
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| style="width:28.05pt; border:solid windowtext 1.0pt" width="44" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p>  
 
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<span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">High mobility group box 1 (HMGB1) in plasma at 30 days (ng/ml)</span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">High mobility group box 1 (HMGB1) in plasma at 30 days (ng/ml)</span></span>'''</span>
  
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| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">4.48</span></span></p>  
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| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">4.48</span></span></span></p>  
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| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">2.08</span></span></p>  
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| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.08</span></span></span></p>  
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| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">3.65</span></span></p>  
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| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">3.65</span></span></span></p>  
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| style="width:28.05pt" width="43" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">1.30</span></span></p>  
+
| style="width:28.05pt; border:solid windowtext 1.0pt" width="44" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.30</span></span></span></p>  
−
| style="width:55.1pt" width="75" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.83</span></span></p>  
+
| style="width:55.1pt; border:solid windowtext 1.0pt" width="77" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.83</span></span></span></p>  
−
| style="width:73.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.06 to 1.60</span></span></p>  
+
| style="width:73.0pt; border:solid windowtext 1.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.06 to 1.60</span></span></span></p>  
 
|-
 
|-
−
|  
+
| style="border:solid windowtext 1.0pt" |  
−
<span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">F-wave persistence (% of discernible F-waves) at 30 days</span>'''</span>
+
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">F-wave persistence (% of discernible F-waves) at 30 days</span></span>'''</span>
  
−
| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.52</span></span></p>  
+
| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.52</span></span></span></p>  
−
| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.24</span></span></p>  
+
| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.24</span></span></span></p>  
−
| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.73</span></span></p>  
+
| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.73</span></span></span></p>  
−
| style="width:28.05pt" width="43" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.15</span></span></p>  
+
| style="width:28.05pt; border:solid windowtext 1.0pt" width="44" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.15</span></span></span></p>  
−
| style="width:55.1pt" width="75" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.21</span></span></p>  
+
| style="width:55.1pt; border:solid windowtext 1.0pt" width="77" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.21</span></span></span></p>  
−
| style="width:73.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.12 to 0.30</span></span></p>  
+
| style="width:73.0pt; border:solid windowtext 1.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.12 to 0.30</span></span></span></p>  
 
|-
 
|-
−
|  
+
| style="border:solid windowtext 1.0pt" |  
−
<span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Mean American Spinal Injury Motor Score at 30 days</span>'''</span>
+
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean American Spinal Injury Motor Score at 30 days</span></span>'''</span>
  
−
| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">53</span></span></p>  
+
| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">53</span></span></span></p>  
−
| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">20</span></span></p>  
+
| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">20</span></span></span></p>  
−
| <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">77</span></span></p>  
+
| style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">77</span></span></span></p>  
−
| style="width:28.05pt" width="43" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">10</span></span></p>  
+
| style="width:28.05pt; border:solid windowtext 1.0pt" width="44" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">10</span></span></span></p>  
−
| style="width:55.1pt" width="75" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">24</span></span></p>  
+
| style="width:55.1pt; border:solid windowtext 1.0pt" width="77" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">24</span></span></span></p>  
−
| style="width:73.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">16.8 to 31.2</span></span></p>  
+
| style="width:73.0pt; border:solid windowtext 1.0pt" width="100" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">16.8 to 31.2</span></span></span></p>  
 
|}
 
|}
  
−
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Comments:</span></span>'''<br/> <span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. A ganglioside is a glycoshpingolipid derived from a cell plasma membrane and has immunological activity . Has been used in neurodegenerative disorders.<br/> 2. HMGB1 is a DNA binding protein that is a pro-inflammatory marker.<br/> 3. Poor methodological reporting. Method of randomization and any blinding unclear.<br/> 4. Clinical outcomes are poorly presented. ASIA scores read from graph.</span></span></span>
+
<br/> '''<span style="font-size:12.0pt">Comments:</span>'''
  
−
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Appraised by:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 30 June 2020<br/> '''Kill or Update By:''' June 2024</span></span></span>
+
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1. A ganglioside is a glycoshpingolipid derived from a cell plasma membrane and has immunological activity . Has been used in neurodegenerative disorders.<br/> 2. HMGB1 is a DNA binding protein that is a pro-inflammatory marker.<br/> 3. Poor methodological reporting. Method of randomization and any blinding unclear.<br/> 4. Clinical outcomes are poorly presented. ASIA scores read from graph.</span></span></span>
  
−
&nbsp;
+
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Appraised by:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 30 June 2020<br/> '''Kill or Update By:''' June 2024</span></span></span>
 +
<p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:x-large;">[[Neuro_-_miscellaneous|BACK]]</span></p>

Latest revision as of 03:05, 1 July 2020

The addition of hyperbaric oxygen to management of acute spinal cord injured patients resulted in improved functional ability and reduced signs of neuro-inflammation

1. The addition of hyperbaric oxygen improved motor scores and an impairment scale in acute spinal injury
2. There were accompanying signs of reduced neuro-inflammation with hyperbaric oxygen

Citation/s:1.Sun L, Zhao L, Li P, Liu X, Liang F, Jiang Y, Kang N, Gao C, Yang J. Effect of hyperbaric oxygen therapy on HMGB/NF-kB expression and prognosis of acute spinal cord injury: a randomized clinical trial. Neuroscience Letters 2019, Jan23;692:47-52.
Lead author's name and fax: Lei Sun: leisun-neurology@foxmail.com

Three-part Clinical Question:For patients with acute spinal injury, does the administration of hyperbaric oxygen along with usual standard measures, compared to standard measures alone, lead to any effects on secondary inflammatory responses and electromyographic changes?
Search Terms: Spinal cord injury; inflammatory markers, DNA binding protein

The Study:Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Adult patients with traumatic spinal cord injury and admitted to the relevant hospital within 72 hours.
Control group (N = 38; 38 analysed): Conventional medical and surgical management with mannitol, methylprednisolone, ganglioside and vitamin B12.
Experimental group (N = 41; 41 analysed): As above plus 100% oxygen breathing at 1 ATA for 60 minutes daily for 30 days.

The Evidence:

Outcome

Time to Outcome

Control group

Hyperbaric group

Relative risk reduction

Absolute risk reduction

NNT

Improved at least one level in American Spinal Injury Impairment Scale

30 days

.71

.93

30%

0.22

5

95% CIs:

7% to 54%

0.05 to 0.38

3 to 19

 

Measure

Control Group

Experimental Group

Difference

95% CI

Mean

SD

Mean

SD

High mobility group box 1 (HMGB1) in plasma at 30 days (ng/ml)

4.48

2.08

3.65

1.30

0.83

0.06 to 1.60

F-wave persistence (% of discernible F-waves) at 30 days

0.52

0.24

0.73

0.15

0.21

0.12 to 0.30

Mean American Spinal Injury Motor Score at 30 days

53

20

77

10

24

16.8 to 31.2


Comments:

1. A ganglioside is a glycoshpingolipid derived from a cell plasma membrane and has immunological activity . Has been used in neurodegenerative disorders.
2. HMGB1 is a DNA binding protein that is a pro-inflammatory marker.
3. Poor methodological reporting. Method of randomization and any blinding unclear.
4. Clinical outcomes are poorly presented. ASIA scores read from graph.

Appraised by:Mike Bennett m.bennett@unsw.edu.au; Tuesday, 30 June 2020
Kill or Update By: June 2024

Sumhorsa.gif

BACK

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