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Related Concept Videos

Critical Region, Critical Values and Significance Level01:16

Critical Region, Critical Values and Significance Level

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The critical region, critical value, and significance level are interdependent concepts crucial in hypothesis testing.
In hypothesis testing, a sample statistic is converted to a test statistic using z, t, or chi-square distribution. A critical region is an area under the curve in  probability distributions demarcated by the critical value. When the test statistic falls in this region, it suggests that the null hypothesis must be rejected. As this region contains all those values of the...
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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
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Prostanoids for critical limb ischaemia.

Valeria Vietto1, Juan Va Franco, Victoria Saenz

  • 1Family and Community Medicine Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

The Cochrane Database of Systematic Reviews
|January 11, 2018
PubMed
Summary
This summary is machine-generated.

Prostanoids do not prevent amputations in critical limb ischaemia (CLI) but may offer modest relief from rest pain and aid ulcer healing. However, they increase adverse events, making their overall benefit uncertain for CLI patients.

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Area of Science:

  • Vascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Peripheral arterial occlusive disease (PAOD) is a significant cause of cardiovascular morbidity and mortality.
  • Critical limb ischaemia (CLI) poses a treatment challenge, often leaving amputation as the only option for non-reconstructive cases.
  • Prostanoids are explored for CLI due to vasodilatory, antithrombotic, and anti-inflammatory properties.

Purpose of the Study:

  • To evaluate the efficacy and safety of prostanoids in CLI patients unsuitable for surgical intervention.
  • This review is an update of a previous assessment first published in 2010.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched multiple databases and trial registries up to January 2017.
  • Included 33 RCTs with 4477 participants comparing prostanoids with placebo, other agents, or head-to-head.

Main Results:

  • High-quality evidence shows prostanoids do not reduce amputation rates compared to placebo.
  • Moderate-quality evidence suggests prostanoids may offer small benefits in rest pain relief and ulcer healing.
  • Adverse events were more frequent with prostanoids (moderate-quality evidence).
  • Low-quality evidence indicates no clear difference in cardiovascular mortality.

Conclusions:

  • Prostanoids do not impact amputation rates in CLI patients.
  • While offering potential benefits for pain and ulcers, prostanoids are associated with increased adverse events.
  • The overall benefit-harm balance for prostanoids in CLI remains uncertain, necessitating careful consideration of alternatives.