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Delong Li Yurong Kou Shaohui Huang Zechen Wang Chunliu Ning Tengfei Zhao 《Journal of cranio-maxillo-facial surgery》2019,47(6):915-921
ObjectiveParotidectomy is the most classic and unequivocal intervention for parotid neoplasm. The operative outcomes and postoperative complications of parotidectomy between harmonic scalpel and electrocautery gained more prominence in physician. In spite of much research work within the past years, there was an obvious lack of randomized controlled trial to resolve this question. Hence, a quantitative and qualitative meta-analysis was essential to evaluate the differences in these two types of hemostasis method.MethodThe major electronic databases, including Pubmed, Embase, Cochrane library, Google Scholar, China National Knowledge Infrastructure and Chinese Scientific and Technological Journal databases were using the key words “electrocautery”, “electrocoagulation”, “harmonic scalpel”, “ultrasonic scalpel”, “ultrasonic dissector”, “parotidectomy” and “parotid surgery”. 9 articles were included in our systematic review and meta-analysis. The operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis were the outcome measures. Odds ratios (ORs) with 95% confidence intervals (CIs) were employed to evaluate the effect size for categorical outcomes and mean differences (MDs) with 95% confidence intervals (CIs) for continuous outcomes.ResultsIn our meta-analysis, there was a significant reduction in operation time [mean difference: ?20.97; 95%CI=(?24.02,?17.92); P < 0.00001], intraoperative blood loss [mean difference: ?20.75, 95%CI=(?22.32,?19.18); P < 0.00001], hospital stay [mean difference: ?0.83; 95%CI=(?1.10,?0.57); P < 0.00001], salivary fistula [ORs: 0.30, 95%CI=(0.08,1.14)] and transient facial nerve paralysis [OR:0.33, 95%CI=(0.19,0.58),P = 0.0001] in harmonic scalpel group compared with electrocautery group.ConclusionThis meta-analysis indicated that compared with electrocautery, harmonic scalpel (HS)was transcendent in the aspects of operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis. The harmonic scalpel, as an efficient and useful instrument, was advocated in parotidectomy. 相似文献
103.
Elizabeth Gatewood Cindy Broholm Jenna Herman Charles Yingling 《Journal of Professional Nursing》2019,35(6):447-451
BackgroundImplicit bias (IB) is a pervasive phenomenon that negatively impacts health outcomes. IB is unconscious bias that operates at a level in which the individual is not aware of its existence. There is no requirement to include IB content in nursing education.PurposeWe sought to raise awareness of IB and its influence on health outcomes and support a discussion on ways to mitigate the impact of IB.MethodsThrough preparatory and interactive activities, students became familiar with IB and its effects on health outcomes, completed a self-assessment using the Implicit Association Test, and engaged in a faculty-facilitated discussion. This activity was implemented at four institutions in the United States and included 110 students at the BSN, MSN and DNP levels.ResultsThe activity received positive evaluations. A majority of students reported the preparatory learning activities were helpful, increased awareness of their biases and felt recognition of their IB would be helpful in managing their nursing care. Student narratives are also described in this report.ConclusionsInclusion of IB content in nursing education is acceptable to students and faculty. The content is best included at multiple points in the course of study. 相似文献
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Mikel Iturrate Rikardo Minguez Guillermo Pradies Eneko Solaberrieta 《The Journal of prosthetic dentistry》2019,121(2):237-241
This article describes a technique for obtaining an accurate complete-arch digital scan for an edentulous patient. To achieve this, an auxiliary polymeric device that simulates a denture is designed, fabricated, and placed in the mouth. This device, having the geometry of a typical dental arch, facilitates the digitalization of the edentulous complete arch. This is because the change in radius of the curvature (change of geometry) enables the scanner to perform a more accurate alignment. Initially, the necessary location of the implants is acquired, and then the soft tissue is added. This technique can achieve accurate complete-arch digital scans. Distances between implants are closer to the gold standard when using this auxiliary geometry piece than those obtained without using it. 相似文献
106.
May Lynn Tan Barbara Laraia Kristine A. Madsen Lauren E. Au Edward A. Frongillo Lorrene D. Ritchie 《Journal of the Academy of Nutrition and Dietetics》2019,119(10):1722-1731.e2
BackgroundFood insecurity is associated with poor diet and obesity among adult women, but evidence among children is mixed, and few studies have examined differences between boys and girls.ObjectiveThis study examined the relationship between self-reported food insecurity and dietary intake among boys and girls.DesignCross-sectional survey data were used from the Children’s PowerPlay! Campaign evaluation.Participants and settingIn all, 3,547 fourth- and fifth-grade students (9 to 11 years old) from 44 San Diego-area elementary schools in 2012 completed diary-assisted 24-hour recalls and a questionnaire that included five questions from the Child Food Security Assessment.Main outcome measuresIndividual dietary components (including total energy, nutrients, and sugar-sweetened beverages), Healthy Eating Index-2010 scores, and meal patterns (such as meal sizes and missed meals) were derived from 24-hour recalls.Statistical analysesMultivariable linear and logistic regression models were used to estimate the relationships between food insecurity and diet characteristics.ResultsGirls with the highest food insecurity consumed 135 total kilocalories (P<0.005) and 60 snack kilocalories (P<0.05) more per day than girls with no food insecurity. These relationships were absent among boys.ConclusionsFood insecurity among girls in grades 4 and 5 was associated with higher energy intake. Findings support the need for further research to better understand the nature of this relationship and its implications for energy balance. 相似文献
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109.
Jonathan T. Unkart Matthew A. Allison Michael H. Criqui Mary M. McDermott Alexis C. Wood Aaron R. Folsom Donald Lloyd-Jones Laura J. Rasmussen-Torvik Norrina Allen Gregory Burke Moyses Szklo Mary Cushman Robyn L. McClelland Christina L. Wassel 《American journal of preventive medicine》2019,56(2):262-270
110.
E B Madsen E Gilpin H Henning S Ahnve M LeWinter J Mazur R Shabetai D Collins J Ross 《Journal of the American College of Cardiology》1984,3(3):681-689
Because previous reports have suggested that digitalis administration may lead to increased mortality after hospital discharge for acute myocardial infarction, the independent importance of digitalis therapy in long-term prognosis after acute myocardial infarction was investigated by analyzing 1,599 patients after definite myocardial infarction. After hospital discharge, mortality rate for the entire group at 4 months was 7.7% and after 1 year 14.2%. At discharge, 36.6% of the patients were taking digitalis. Compared with those not taking digitalis, those taking digitalis had more historical risk factors and a higher incidence of important clinical prognostic variables during the hospitalization. Their cardiac mortality rate after 4 months and 1 year (12.5 and 22.4%, respectively) was significantly higher than that of patients not taking digitalis (5.0 and 9.6%, respectively). Mortality was higher for patients taking digitalis whether or not they had congestive heart failure during hospitalization. However, in a multivariate Cox analysis for 1 year outcome, neither digitalis nor any other medication variable displaced the important clinical variables of age, congestive heart failure during the hospitalization, previous myocardial infarction, maximal heart rate during the hospitalization and previous angina. Quinidine and digitalis at discharge were selected sixth and seventh (not significant) by the analysis. It is concluded that digitalis therapy at discharge after myocardial infarction was not an independent predictor of late mortality in these patients. 相似文献