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Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis / Santiago León Atehortúa Muñoz
Título : Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis Tipo de documento : documento electrónico Autores : Santiago León Atehortúa Muñoz, Fecha de publicación : 2022 Títulos uniformes : eClinicalMedicine Idioma : Inglés (eng) Palabras clave : CNS infection Diagnostic accuracy Encephalitis Film array Meningitis Meta-analysis Multiplex PCR Resumen : Background: The FilmArray Meningitis/Encephalitis(FA/ME) panel brings benefits in clinical practice, but its diagnostic test accuracy (DTA) remains unclear. We aimed to determine the DTA of FA/ME for the aetiological diagnostic in patients with suspected central nervous system(CNS) infection. Methods: We performed a systematic review with DTA meta-analysis (PROSPERO: CRD42020139285). We searched Embase, Medline (Ovid), and Web of Science from inception until September 1st, 2021. We assessed the study-level risk of bias with the QUADAS-2 tool and applied the GRADE approach to assess the certainty of the synthesised evidence. We included studies that simultaneously measured the reference test (CSF/blood culture for bacteria, and specific polymerase chain reaction for viruses) and the FA/ME in patients with suspected CNS infection. We performed random-effects bivariate meta-analysis models of combined sensitivity and specificity using CSF/blood cultures(reference test 1) and a final diagnosis adjudication based on clinical/laboratory criteria (reference test 2). Findings: We included 19 studies (11,351 participants). For all bacteria with reference test 1 (16 studies/6183 patients) sensitivity was estimated at 89·5% (95%CI 81·1-94·4), and specificity at 97·4% (95%CI 94-98·9). With reference test 2 (15 studies/5,524 patients), sensitivity was estimated at 92·1%(95%CI 86·8-95·3) and specificity at 99.2(95%CI 98·3-99·6) For herpes simplex virus-2(HSV-2), enteroviruses, and Varicella-Zoster virus (VZV), we obtained sensitivities between 75·5 and 93·8%, and specificities above 99% (reference test 1). Certainty of the evidence was low. Interpretation: FA/ME may have acceptable-to-high sensitivities and high specificities for identifying bacteria, especially for S.pneumoniae, and viruses, especially for HSV-2, and enteroviruses. Sensitivities for L.monocytogenes, H.influenzae, E.coli, and HSV-1 were suboptimal. Mención de responsabilidad : Juliana Trujillo-Gomez, Sofia Tsokani, Catalina Arango-Ferreira, Santiago Atehortua-Muñoz, Maria José Jimenez-Villegas, Carolina Serrano-Tabares, Areti-Angeliki Veroniki, and Ivan D. Florez Referencia : EClinicalMedicine. 2022 Feb 14;44:101275. DOI (Digital Object Identifier) : 10.1016/j.eclinm.2022.101275 PMID : 35198914 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589537022000050 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6011 Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis [documento electrónico] / Santiago León Atehortúa Muñoz, . - 2022.
Obra : eClinicalMedicine
Idioma : Inglés (eng)
Palabras clave : CNS infection Diagnostic accuracy Encephalitis Film array Meningitis Meta-analysis Multiplex PCR Resumen : Background: The FilmArray Meningitis/Encephalitis(FA/ME) panel brings benefits in clinical practice, but its diagnostic test accuracy (DTA) remains unclear. We aimed to determine the DTA of FA/ME for the aetiological diagnostic in patients with suspected central nervous system(CNS) infection. Methods: We performed a systematic review with DTA meta-analysis (PROSPERO: CRD42020139285). We searched Embase, Medline (Ovid), and Web of Science from inception until September 1st, 2021. We assessed the study-level risk of bias with the QUADAS-2 tool and applied the GRADE approach to assess the certainty of the synthesised evidence. We included studies that simultaneously measured the reference test (CSF/blood culture for bacteria, and specific polymerase chain reaction for viruses) and the FA/ME in patients with suspected CNS infection. We performed random-effects bivariate meta-analysis models of combined sensitivity and specificity using CSF/blood cultures(reference test 1) and a final diagnosis adjudication based on clinical/laboratory criteria (reference test 2). Findings: We included 19 studies (11,351 participants). For all bacteria with reference test 1 (16 studies/6183 patients) sensitivity was estimated at 89·5% (95%CI 81·1-94·4), and specificity at 97·4% (95%CI 94-98·9). With reference test 2 (15 studies/5,524 patients), sensitivity was estimated at 92·1%(95%CI 86·8-95·3) and specificity at 99.2(95%CI 98·3-99·6) For herpes simplex virus-2(HSV-2), enteroviruses, and Varicella-Zoster virus (VZV), we obtained sensitivities between 75·5 and 93·8%, and specificities above 99% (reference test 1). Certainty of the evidence was low. Interpretation: FA/ME may have acceptable-to-high sensitivities and high specificities for identifying bacteria, especially for S.pneumoniae, and viruses, especially for HSV-2, and enteroviruses. Sensitivities for L.monocytogenes, H.influenzae, E.coli, and HSV-1 were suboptimal. Mención de responsabilidad : Juliana Trujillo-Gomez, Sofia Tsokani, Catalina Arango-Ferreira, Santiago Atehortua-Muñoz, Maria José Jimenez-Villegas, Carolina Serrano-Tabares, Areti-Angeliki Veroniki, and Ivan D. Florez Referencia : EClinicalMedicine. 2022 Feb 14;44:101275. DOI (Digital Object Identifier) : 10.1016/j.eclinm.2022.101275 PMID : 35198914 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589537022000050 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6011 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001847 AC-2022-017 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-017Adobe Acrobat PDF Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis / Laura Fernanda Niño Serna
Título : Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis Tipo de documento : documento electrónico Autores : Laura Fernanda Niño Serna, Fecha de publicación : 2020 Títulos uniformes : Archives of Disease in Childhood Idioma : Inglés (eng) Palabras clave : Children diarrhoea gastroenteritis gelatin meta-analysis systematic review tannate Resumen : Objective: To determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children. Design: Systematic review and meta-analysis. Data sources: MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions. Eligibility criteria for selecting studies: Randomised controlled trials in children with ADG, comparing GT with placebo. Results: Of 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=−15.85 hours; 95% CI −42.24 to 14.82, I2=92%; three studies), stool frequency at day 2 (MD=0.11 stools/day; 95% CI −0.39 to 0.62: I2=26%; two studies), diarrhoea at day 3 (risk ratio [RR]=0.46; 95% CI 0.06 to 3.47: I2=73%; two studies), vomiting (RR=1.31; 95% CI 0.95 to 1.80: I2=0%; two studies) or adverse events (RR=0.86; 95% CI 0.27 to 2.66: I2=0%; two studies). Most common adverse events included abdominal pain and nausea. Conclusion: The effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty). Mención de responsabilidad : Ivan D Florez, Javier M Sierra, Laura F Niño-Serna Referencia : Arch Dis Child. 2020 Feb;105(2):141-146. DOI (Digital Object Identifier) : 10.1136/archdischild-2018-316385 PMID : 31272969 En línea : https://adc.bmj.com/content/early/2019/07/04/archdischild-2018-316385 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4241 Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis [documento electrónico] / Laura Fernanda Niño Serna, . - 2020.
Obra : Archives of Disease in Childhood
Idioma : Inglés (eng)
Palabras clave : Children diarrhoea gastroenteritis gelatin meta-analysis systematic review tannate Resumen : Objective: To determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children. Design: Systematic review and meta-analysis. Data sources: MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions. Eligibility criteria for selecting studies: Randomised controlled trials in children with ADG, comparing GT with placebo. Results: Of 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=−15.85 hours; 95% CI −42.24 to 14.82, I2=92%; three studies), stool frequency at day 2 (MD=0.11 stools/day; 95% CI −0.39 to 0.62: I2=26%; two studies), diarrhoea at day 3 (risk ratio [RR]=0.46; 95% CI 0.06 to 3.47: I2=73%; two studies), vomiting (RR=1.31; 95% CI 0.95 to 1.80: I2=0%; two studies) or adverse events (RR=0.86; 95% CI 0.27 to 2.66: I2=0%; two studies). Most common adverse events included abdominal pain and nausea. Conclusion: The effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty). Mención de responsabilidad : Ivan D Florez, Javier M Sierra, Laura F Niño-Serna Referencia : Arch Dis Child. 2020 Feb;105(2):141-146. DOI (Digital Object Identifier) : 10.1136/archdischild-2018-316385 PMID : 31272969 En línea : https://adc.bmj.com/content/early/2019/07/04/archdischild-2018-316385 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4241 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001221 AC-2019-010 Archivo digital Producción Científica Artículos científicos Disponible Economic analysis of routine neuromonitoring of recurrent laryngeal nerve in total thyroidectomy / Álvaro Enrique Sanabria Quiroga
Título : Economic analysis of routine neuromonitoring of recurrent laryngeal nerve in total thyroidectomy Tipo de documento : documento electrónico Autores : Álvaro Enrique Sanabria Quiroga, Fecha de publicación : 2015 Títulos uniformes : Biomédica Idioma : Inglés (eng) Palabras clave : Thyroid gland thyroidectomy cost-benefit analysis meta-analysis Resumen : Introduction: Thyroidectomy is a common surgery. Routine searching of the recurrent laryngeal nerve is the most important strategy to avoid palsy. Neuromonitoring has been recommended to decrease recurrent laryngeal nerve palsy. Objective: To assess if neuromonitoring of recurrent laryngeal nerve during thyroidectomy is cost-effective in a developing country. Materials and methods: We designed a decision analysis to assess the cost-effectiveness of recurrent laryngeal nerve neuromonitoring. For probabilities, we used data from a meta-analysis. Utility was measured using preference values. We considered direct costs. We conducted a deterministic and a probabilistic analysis. Results: We did not find differences in utility between arms. The frequency of recurrent laryngeal nerve injury was 1% in the neuromonitor group and 1.6% for the standard group. Thyroidectomy without monitoring was the less expensive alternative. The incremental cost-effectiveness ratio was COP$ 9,112,065. Conclusion: Routine neuromonitoring in total thyroidectomy with low risk of recurrent laryngeal nerve injury is neither cost-useful nor cost-effective in the Colombian health system. Mención de responsabilidad : Álvaro Sanabria, Adonis Ramírez Referencia : Biomedica. 2015 Jul-Sep;35(3):363-71. DOI (Digital Object Identifier) : 10.7705/biomedica.v35i3.2371 PMID : 26849698 En línea : https://www.revistabiomedica.org/index.php/biomedica/article/view/2371 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3929 Economic analysis of routine neuromonitoring of recurrent laryngeal nerve in total thyroidectomy [documento electrónico] / Álvaro Enrique Sanabria Quiroga, . - 2015.
Obra : Biomédica
Idioma : Inglés (eng)
Palabras clave : Thyroid gland thyroidectomy cost-benefit analysis meta-analysis Resumen : Introduction: Thyroidectomy is a common surgery. Routine searching of the recurrent laryngeal nerve is the most important strategy to avoid palsy. Neuromonitoring has been recommended to decrease recurrent laryngeal nerve palsy. Objective: To assess if neuromonitoring of recurrent laryngeal nerve during thyroidectomy is cost-effective in a developing country. Materials and methods: We designed a decision analysis to assess the cost-effectiveness of recurrent laryngeal nerve neuromonitoring. For probabilities, we used data from a meta-analysis. Utility was measured using preference values. We considered direct costs. We conducted a deterministic and a probabilistic analysis. Results: We did not find differences in utility between arms. The frequency of recurrent laryngeal nerve injury was 1% in the neuromonitor group and 1.6% for the standard group. Thyroidectomy without monitoring was the less expensive alternative. The incremental cost-effectiveness ratio was COP$ 9,112,065. Conclusion: Routine neuromonitoring in total thyroidectomy with low risk of recurrent laryngeal nerve injury is neither cost-useful nor cost-effective in the Colombian health system. Mención de responsabilidad : Álvaro Sanabria, Adonis Ramírez Referencia : Biomedica. 2015 Jul-Sep;35(3):363-71. DOI (Digital Object Identifier) : 10.7705/biomedica.v35i3.2371 PMID : 26849698 En línea : https://www.revistabiomedica.org/index.php/biomedica/article/view/2371 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3929 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000513 AC-2015-066 Archivo digital Producción Científica Artículos científicos Disponible The evolution of laparoscopy in abdominal surgery: A meta-analysis of the effect on infectious outcomes / Álvaro Enrique Sanabria Quiroga
Título : The evolution of laparoscopy in abdominal surgery: A meta-analysis of the effect on infectious outcomes Tipo de documento : documento electrónico Autores : Álvaro Enrique Sanabria Quiroga, Fecha de publicación : 2014 Títulos uniformes : Minimally Invasive Therapy & Allied Technologies Idioma : Inglés (eng) Palabras clave : Surgical wound infection laparoscopy meta-analysis abdominal abscess Resumen : Background: Laparoscopic surgery has been recommended as an effective strategy because of its advantages in decreasing abdominal surgical site infections (SSIs). The aim of this study was to assess the effect of laparoscopy on superficial and organ/space SSIs compared with open surgery in hollow-viscus procedures over time. Study design: Data on SSIs from randomized-controlled trials (RCTs) evaluating open versus laparoscopic abdominal surgeries were extracted from the Cochrane Database Reviews. Re-analysis of these data was performed to assess infections. Heterogeneity was also explored. A subgroup analysis was performed according to elective/emergency surgery status. Results: Data from 72 RCTs including 8218 patients were collected (4116 patients in the laparoscopic group and 4102 patients in the open group). For superficial SSI, the pooled RD was -4.4% (95% CI: -5.4% to -3.3%), which indicated a lower risk in the laparoscopic group. For organ/space SSI, the pooled RD was 0.5% (95% CI: -0.1% to 1%), which indicated similar rates between the groups. Changes in SSI frequency had occurred over time. Conclusion: Laparoscopic surgery significantly decreases the risk of superficial SSI but does not affect the risk of organ/space SSI. Experience with technique improves outcomes. Mención de responsabilidad : Alvaro Sanabria, Valentin Vega, Luis C Dominguez, Erick Espitia, Adriana Serna, Camilo Osorio Referencia : Minim Invasive Ther Allied Technol. 2014 Mar;23(2):74-86. DOI (Digital Object Identifier) : 10.3109/13645706.2013.854808 PMID : 24236695 En línea : https://www.tandfonline.com/doi/full/10.3109/13645706.2013.854808 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4570 The evolution of laparoscopy in abdominal surgery: A meta-analysis of the effect on infectious outcomes [documento electrónico] / Álvaro Enrique Sanabria Quiroga, . - 2014.
Obra : Minimally Invasive Therapy & Allied Technologies
Idioma : Inglés (eng)
Palabras clave : Surgical wound infection laparoscopy meta-analysis abdominal abscess Resumen : Background: Laparoscopic surgery has been recommended as an effective strategy because of its advantages in decreasing abdominal surgical site infections (SSIs). The aim of this study was to assess the effect of laparoscopy on superficial and organ/space SSIs compared with open surgery in hollow-viscus procedures over time. Study design: Data on SSIs from randomized-controlled trials (RCTs) evaluating open versus laparoscopic abdominal surgeries were extracted from the Cochrane Database Reviews. Re-analysis of these data was performed to assess infections. Heterogeneity was also explored. A subgroup analysis was performed according to elective/emergency surgery status. Results: Data from 72 RCTs including 8218 patients were collected (4116 patients in the laparoscopic group and 4102 patients in the open group). For superficial SSI, the pooled RD was -4.4% (95% CI: -5.4% to -3.3%), which indicated a lower risk in the laparoscopic group. For organ/space SSI, the pooled RD was 0.5% (95% CI: -0.1% to 1%), which indicated similar rates between the groups. Changes in SSI frequency had occurred over time. Conclusion: Laparoscopic surgery significantly decreases the risk of superficial SSI but does not affect the risk of organ/space SSI. Experience with technique improves outcomes. Mención de responsabilidad : Alvaro Sanabria, Valentin Vega, Luis C Dominguez, Erick Espitia, Adriana Serna, Camilo Osorio Referencia : Minim Invasive Ther Allied Technol. 2014 Mar;23(2):74-86. DOI (Digital Object Identifier) : 10.3109/13645706.2013.854808 PMID : 24236695 En línea : https://www.tandfonline.com/doi/full/10.3109/13645706.2013.854808 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4570 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001069 AC-2014-143 Archivo digital Producción Científica Artículos científicos Disponible Which percutaneous tracheostomy method is better? A systematic review / Álvaro Enrique Sanabria Quiroga
Título : Which percutaneous tracheostomy method is better? A systematic review Tipo de documento : documento electrónico Autores : Álvaro Enrique Sanabria Quiroga, Fecha de publicación : 2014 Títulos uniformes : Respiratory Care Idioma : Inglés (eng) Palabras clave : Tracheostomy meta-analysis intensive care surgery minimally invasive surgical procedures Resumen : Background: The aim of this study was to assess the different methods of percutaneous tracheostomy in terms of successful performance of the tracheostomy as well as safety. Tracheostomy is the most common procedure performed on the airway for patients in ICUs. Lately, several methods of percutaneous tracheostomy (multiple dilator, progressive dilator, forceps dilation, screw-like dilation, balloon dilation, and translaryngeal) have been described, with theoretical advantages, but there is no consensus about which is better. Methods: A systematic review with critical appraisal of the literature was done. Literature in multiple databases was searched. Randomized controlled trials comparing different tracheostomy methods were selected. Clinical and methodological characteristics were assessed. A meta-analysis using fixed effect models was planned for statistically homogeneous outcomes. Results: Fourteen randomized controlled trials were included, most of them with small sample sizes and with comparisons of multiple methods. Blue Rhino methods were less difficult for surgeons (risk difference of 14.7% [95% CI 8–21.5]) and had more minor bleeding events (risk difference of −6.3% [95% CI −13.58 to 0.8]). There were no differences in major bleeding events. Statistically, heterogeneity and lack of data impede comparison with other outcomes. Conclusion: The Blue Rhino method is less difficult and has more minor bleeding events, but physicians also have more experience with this technique. However, trials are underpowered to define the best method. Mención de responsabilidad : Alvaro Sanabria Referencia : Respir Care. 2014 Nov;59(11):1660-70. DOI (Digital Object Identifier) : 10.4187/respcare.03050 PMID : 25185145 En línea : http://rc.rcjournal.com/content/59/11 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3760 Which percutaneous tracheostomy method is better? A systematic review [documento electrónico] / Álvaro Enrique Sanabria Quiroga, . - 2014.
Obra : Respiratory Care
Idioma : Inglés (eng)
Palabras clave : Tracheostomy meta-analysis intensive care surgery minimally invasive surgical procedures Resumen : Background: The aim of this study was to assess the different methods of percutaneous tracheostomy in terms of successful performance of the tracheostomy as well as safety. Tracheostomy is the most common procedure performed on the airway for patients in ICUs. Lately, several methods of percutaneous tracheostomy (multiple dilator, progressive dilator, forceps dilation, screw-like dilation, balloon dilation, and translaryngeal) have been described, with theoretical advantages, but there is no consensus about which is better. Methods: A systematic review with critical appraisal of the literature was done. Literature in multiple databases was searched. Randomized controlled trials comparing different tracheostomy methods were selected. Clinical and methodological characteristics were assessed. A meta-analysis using fixed effect models was planned for statistically homogeneous outcomes. Results: Fourteen randomized controlled trials were included, most of them with small sample sizes and with comparisons of multiple methods. Blue Rhino methods were less difficult for surgeons (risk difference of 14.7% [95% CI 8–21.5]) and had more minor bleeding events (risk difference of −6.3% [95% CI −13.58 to 0.8]). There were no differences in major bleeding events. Statistically, heterogeneity and lack of data impede comparison with other outcomes. Conclusion: The Blue Rhino method is less difficult and has more minor bleeding events, but physicians also have more experience with this technique. However, trials are underpowered to define the best method. Mención de responsabilidad : Alvaro Sanabria Referencia : Respir Care. 2014 Nov;59(11):1660-70. DOI (Digital Object Identifier) : 10.4187/respcare.03050 PMID : 25185145 En línea : http://rc.rcjournal.com/content/59/11 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3760 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000335 AC-2014-001 Archivo digital Producción Científica Artículos científicos Disponible Neuromonitoring in thyroidectomy: a meta-analysis of effectiveness from randomized controlled trials / Álvaro Enrique Sanabria QuirogaPermalink