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The purpose of this study was to assess the efficacy of continuous renal replacement therapies in patients with severe sepsis or septic shock, with or without acute kidney injury. We performed a systematic search in Medline, Embase, Web of Knowledge, Cochrane Library and Clinicaltrials.gov and a hand search of the retrieved studies. We included both randomised controlled clinical trials and subgroups of randomised trials that assessed the effect of continuous renal replacement therapies (at traditional or high doses) and reported clinical outcomes in adult patients with severe sepsis or septic shock. The study selection and data extraction were performed by duplicate. Analysis of heterogeneity and meta-analysis was performed according to the Cochrane Collaboration guidelines for conducting systematic reviews of interventions. Twelve studies (1895 patients) met the inclusion criteria. Pooling of all studies resulted in a mortality risk ratio of 0.96 (95% confidence interval 0.83 to 1.12). The studies showed moderate statistical heterogeneity (I2 statistic 52%, P = 0.02). The effect on mortality was not modified (interaction P values non significant) by the dose of continuous renal replacement therapies, the severity of illness or the risk of bias. The available evidence suggests that these therapies in patients with severe sepsis or septic shock are not associated with an improvement in other outcomes such as haemodynamics, pulmonary gas exchange, multiple organ dysfunction syndrome or length of stay. The best available evidence does not support the routine use of continuous renal replacement therapies (at traditional or high doses) in patients with severe sepsis or septic shock. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study which examines the effectiveness of continuous renal replacement therapies in the management of patients with severe sepsis and septic shock, in the absence or presence of acute kidney injury. According to the authors, continuous renal replacement therapies did not improve clinical outcomes such as hemodynamics, pulmonary gas exchange, length of stay, or multiple organ dysfunction syndrome. They indicate the ineffeciency of the therapy both at traditional and high doses.

Background: Male alcohol consumption is one of the accepted risk factors for intimate partner violence. The aim of this study is to assess the magnitude of the association between male alcohol consumption and intimate partner violence against women and the quality of the evidence of published papers exploring this relationship empirically. Methods: Systematic review and meta-analysis of quantitative studies (1966-2004). Eight databases from Social and Behavioural Sciences, Clinical Medicine, and Life Sciences were reviewed. Studies with available 2 x 2 table or odds ratio were analysed using meta-analytic techniques. Results: A total of 22 studies fulfilled the inclusion criteria for the systematic review: 14 (63.6%) were cross-sectional studies, 6 (27.3%) case-series, 2 (9.1%) case-control studies. Ten studies analysed the relationship between alcohol and violence as their primary hypothesis and only two used a direct measure of alcohol consumption. Of them, 11 papers were included in the meta-analysis. The overall pooled odds ratio was 4.57 (95% confidence limits 3.30-6.35), but a high degree of heterogeneity was observed. The magnitude of the effect was inversely associated with the year of publication. The biggest odds ratios were obtained in the studies with the smallest sample sizes. Conclusions: The evidence about the relationship between alcohol consumption and intimate partner violence is of low quality in the study designs and maybe biased by publication of positive results. Currently there is not enough empirical evidence to support preventive policies based on male alcohol consumption as a risk factor in the particular case of intimate partner violence. [ABSTRACT FROM AUTHOR]