Impact of local anesthesia block on pain medication use and length of hospital stay in elderly indigenous patients in Alaska hospitalized for fragility fracture.

Introduction: Fragility fractures (low-energy, minimal-trauma fractures) are common in the aging population and can lead to decreased function, increased mortality, and long-lasting pain. Although opioids are helpful in reducing acute postoperative pain, they present risks that may lead to increased morbidity and mortality. Materials and Methods: This was a retrospective review of medical records of all Alaska Native and American Indian people older than 50 years, who received surgery for hip fracture repair between January 2018 and June 2019 (n = 128). Results: We found that receipt of a peripheral nerve block (PNB) is a predictor for decreased length of hospital stay. However, receipt of PNB did not predict a reduction in postoperative morphine milligram equivalents opioid doses. Discussion: Further study is required to determine whether one PNB method is superior to others based on individual-level characteristics.

Geographic, Subject, and Authorship Trends among LMIC-based Scientific Publications in High-impact Global Health and General Medicine Journals: A 30-Month Bibliometric Analysis.

The globalization of medical research and global health's increasing popularity worldwide have resulted in greater geographic, ethnic, and socioeconomic diversity of studies published in the scientific literature. Yet the geographic distribution, authorship representation, and subject trends among Low-/Low-Middle-Income Country (LIC/LMIC)-based scientific publications remain largely unknown. This analysis assesses these gaps in knowledge. We performed a comprehensive bibliometric analysis of all scientific articles published between January 2014 and June 2016 in the four most prominent general medicine and five most prominent general global health journals based on impact factor. The African region, containing 24% of the global LIC/LMIC population, accounted for 49.9% of all publications. Corresponding authors with either exclusive or joint appointment to a LIC/LMIC institution were present in 26.2% of all included articles. Over one-quarter (28.8%) of all publications did not list a local author. Nearly two-thirds (62.1%) of articles published in global health journals and roughly half (52.4%) in general medicine journals involved infectious diseases. Non-HIV infectious disease studies were by far the most frequent subject areas across all journals. The trends identified in this study may help to inform the evolution and prioritization of future research efforts, thereby allowing global health to remain truly global.