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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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of the UEScope videolaryngoscope with the Macintosh laryngoscope during simulated cardiopulmonary resuscitation: A randomized, cross-over, multi-center manikin study.
Endotracheal intubation (ETI) can be challenging, especially in life-threatening situations such as cardiopulmonary resuscitation (CPR). Videolaryngoscopes aim to ease ETI, but effort is still widely discussed. This study intended to investigate 2 different airway devices regarding the success rate of ETI during ongoing chest compressions. ⋯ In simulated CPR scenarios, intubation with the UEScope resulted in a better glottis visualization, a higher intubation success, and a shorter intubation time compared to Macintosh laryngoscope (MAC). Moreover, in situations where the airway is difficult for ETI especially by the paramedic, the UEScope would be a better choice than the MAC. Further studies are needed to confirm these results in real-life patients.
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Review Meta Analysis Comparative Study
The comparison of propofol and midazolam for bronchoscopy: A meta-analysis of randomized controlled studies.
Propofol and midazolam are widely used for the sedation of bronchoscopy. This systematic review and meta-analysis is conducted to compare the efficacy of propofol and midazolam for bronchoscopy. ⋯ Propofol sedation is able to reduce recovery time and shows similar safety compared with midazolam sedation during bronchoscopy.
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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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Meta Analysis Comparative Study
Vonoprazan versus proton pump inhibitors for the management of gastroesophageal reflux disease: A protocol for a systematic review with meta-analysis.
Vonoprazan, a novel potassium-competitive acid blocking agent, is used in the management of gastroesophageal reflux disease (GERD). We aim to perform a systematic review and meta-analysis for the comparison of the effects of vonoprazan and proton pump inhibitors (PPIs) in GERD in randomized controlled trials (RCTs). ⋯ To our knowledge, this systematic review and meta-analysis will be the first to evaluate existing research comparing Vonoprazan and PPIs in GERD. Our study will provide information about the effect of vonoprazan and PPIs in GERD in RCTs. The review will benefit patients, healthcare providers, and policymakers.