Medicine
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Observational Study
Associations of race, mechanism of injury, and neighborhood poverty with in-hospital mortality from trauma: A population-based study in the Detroit metropolitan area.
Health disparities based on race and socioeconomic status are a serious problem in the US health care system, but disparities in outcomes related to traumatic injury have received relatively little attention in the research literature. This study uses data from the State Inpatient Database for Michigan including all trauma-related hospital admissions in the period from 2006 to 2014 in the Detroit metropolitan area (N = 407,553) to examine the relationship between race (White N = 232,109; African American N = 86,356, Hispanic N = 2709, Other N = 10,623), socioeconomic background, and in-hospital trauma mortality. Compared with other groups, there was a higher risk of mortality after trauma among African Americans (odds ratio [OR] = 1.20, P < .001), people living in high-poverty neighborhoods (OR = 1.01, P < .001), and those enrolled in public health insurance programs (OR = 1.53, P < .001). ⋯ After controlling for mechanism alone in multiple logistic regression, African American race remained a significant predictor of mortality risk (OR = 1.12, P < .001). After additionally controlling for the socioeconomic factors of insurance status and neighborhood poverty levels, there were no longer any significant differences between racial groups in terms of mortality (OR = 0.99, P = .746). These results suggest that in this population the racial inequalities in mortality outcomes were fully mediated by differences between groups in the pattern of injuries suffered and differences in risk based on socioeconomic factors.
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To evaluate the clinical outcomes of an anterolateral approach for lateral humeral condylar fractures in children. The patients aged < 15 years undergoing surgery with an anterolateral approach for humeral lateral condylar fractures between April 2005 and March 2014 were investigated. Medical records and radiographs from 15 patients were reviewed. ⋯ Based on Flynn criteria, clinical results for both cosmetics and function were excellent in 13 patients, and good in 2. The advantages of the anterolateral approach are combining an optimal view of the anterior articular surface of the trochlea and capitellum and a limited risk of devascularization injury. We strongly recommend an anterolateral approach for these fractures in children to prevent postoperative deformity and to achieve anatomical reduction and reliable fixation.
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Review Meta Analysis
Efficacy of Internet-delivered cognitive-behavioral therapy for the management of chronic pain in children and adolescents: A systematic review and meta-analysis.
Pediatric chronic pain is relatively common in the world. Although cognitive behavior therapy (CBT) has been shown to be efficacious in children and adolescents, it is generally recognized that availability and accessibility of CBT are limited. While Internet-delivered cognitive-behavioral therapy (ICBT) performs better in these areas. ⋯ PROSPERO CRD42017069811.
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Review Meta Analysis
Trends in conjunctivochalasis research from 1986 to 2017: A bibliometric analysis.
With the aging of the population and the use of video terminals, the incidence of Conjunctivochalasis is getting higher, and related research is increasing. So our research aimed to use visualization software to display the research trends of Conjunctivochalasis. ⋯ This research will help relevant clinicians and researchers to accurately and quickly grasp the research trends in the field, and continue to conduct new research on the basis.
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Review Meta Analysis Comparative Study
Effect of high-volume hemofiltration on mortality in critically ill patients: A PRISMA-compliant systematic review and meta-analysis.
High-volume hemofiltration (HVHF) is widely used for blood purification in critically ill patients with systemic inflammatory syndromes. The purpose of this study was to evaluate the effect of HVHF on mortality at different follow-up periods in critically ill patients. ⋯ Our findings suggest HVHF significantly reduced the incidence of 28-day mortality when pooled the study sample size < 100. Further, HVHF had a marginal effect on the incidence of 7-day mortality.