Articles: mortality.
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To measure the relationship between time spent waiting for health care services and patients' mortality. ⋯ Our findings support the largely assumed association between long wait times for outpatient health care and negative health outcomes, such as mortality. Future research should focus on the causes of long waits for health care (e.g., physician reimbursement levels), the consequences of long waits in other populations, and effective policies to decrease long waits for health care services.
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Social determinants of health, such as inadequate education, contribute greatly to mortality rates. We examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). ⋯ Higher mortality rates among individuals with inadequate education reflect a complex causal pathway and the influence of confounding variables. Formidable efforts at social change would be necessary to eliminate disparities, but the changes would save more lives than would society's current heavy investment in medical advances. Spending large sums of money on such advances at the expense of social change may be jeopardizing public health.
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Ann Burns Fire Disasters · Mar 2007
Heparin reduced mortality and sepsis in severely burned children.
Objectives. In El Salvador, before 1999, morbidity and mortality in severely burned children were high. In 1998, all children with burns of 40% or larger size died and sepsis was found. ⋯ The survivors had notably smooth skin. Conclusions. The use of heparin in this study relieved burn pain, significantly reduced mortality and sepsis with fewer procedures, and discernibly improved cosmetic results.
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Eur. J. Intern. Med. · Mar 2007
A comparative study of an ambulatory blood pressure measuring device and a wrist blood pressure monitor with a position sensor versus a mercury sphygmomanometer.
Self-measurements of blood pressure (BP) and 24-hour BP measurements are better predictors of cardiovascular mortality and morbidity than office BP measurements. The objective of this study was to compare the accuracy and precision of a wrist BP monitor with a position sensor (Omron 637IT) and of an ambulatory BP measuring monitor (ABPM; Nissei DS-250) with a mercury sphygmomanometer. ⋯ The wrist BP monitor produced results consistent with those of the mercury sphygmomanometer when both were compared with the results of the ABPM. As BP measurement with these devices is a practical and repeatable method, they can be used instead of ABPM in the diagnosis and monitoring of hypertension. However, there is a need for further comparative studies.
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Pediatr Crit Care Me · Mar 2007
CommentDo pediatric patients with septic shock benefit from steroid therapy? A critical appraisal of "Low-dose hydrocortisone improves shock reversal and reduces cytokine levels in early hyperdynamic septic shock" by Oppert et al. (Crit Care Med 2005; 33:2457-2464).
To review the findings and discuss the implications of studies on the use of low-dose corticosteroids in septic shock. ⋯ There is some, albeit limited, evidence for the benefit of low-dose steroids in adults with sepsis. No supporting data are available for the pediatric population; therefore, a randomized controlled trial in septic children is needed.