JAMA : the journal of the American Medical Association
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Meta Analysis
The relationship between methodological quality and conclusions in reviews of spinal manipulation.
To study the relationship between the methodological quality and other characteristics of reviews of spinal manipulation for low back pain on the one hand and the reviewers' conclusions on the effectiveness of manipulation on the other hand. ⋯ The majority of the reviews concluded that spinal manipulation is an effective treatment for low back pain. Although, in particular, the reviews with a relatively high methodological quality had a positive conclusion, strong conclusions were precluded by the overall low quality of the reviews. More empirical research on the review methods applied to other therapies in other professional fields is needed to further explore our findings about the factors related to a positive reviewers' conclusion.
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Multicenter Study
Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease.
To describe outcomes and identify variables associated with hospital and 1-year survival for patients admitted to an intensive care unit (ICU) with an acute exacerbation of chronic obstructive pulmonary disease (COPD). ⋯ Patients with COPD admitted to an ICU for an acute exacerbation have a substantial hospital mortality (24%). For patients aged 65 years or older, mortality doubles in 1 year from 30% to 59%. Hospital and longer-term mortality is closely associated with development of nonrespiratory organ system dysfunction; severity of the underlying respiratory function substantially influences mortality following hospital discharge. The need for mechanical ventilation at ICU admission did not influence either short- or long-term outcomes. Physicians should be aware of these relationships when making treatment decisions or evaluating new therapies.
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Comparative Study
Ethnic differences in the use of peritoneal dialysis as initial treatment for end-stage renal disease.
To evaluate the influence of ethnicity on the use of peritoneal dialysis (PD) as initial treatment for end-stage renal disease (ESRD) after controlling for other patient characteristics. ⋯ Ethnic differences in initial PD use cannot be explained by many demographic, socioeconomic, and comorbid factors associated with the use of PD as initial treatment for ESRD.
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To assess the long-term relationship of midlife blood pressure levels to late-life cognitive function. ⋯ Midlife SBP is a significant predictor of reduced cognitive function in later life. Early control of SBP levels may reduce the risk for cognitive impairment in old age.