The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jan 2014
More harm than good: antiseizure prophylaxis after traumatic brain injury does not decrease seizure rates but may inhibit functional recovery.
The purposes of this study were to examine the current Brain Trauma Foundation recommendation for antiseizure prophylaxis with phenytoin during the first 7 days after traumatic brain injury (TBI) in preventing seizures and to determine if this medication affects functional recovery at discharge. ⋯ Therapeutic study, level IV; epidemiologic study, level III.
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J Trauma Acute Care Surg · Jan 2014
Observational StudyActivity of factor VII in patients with isolated blunt traumatic brain injury: association with coagulopathy and progressive hemorrhagic injury.
Given the importance of factor VII (FVII) in extrinsic pathway of coagulation cascade, we sought to elucidate the relationship between FVII and traumatic brain injury-induced coagulopathy and progressive hemorrhagic injury (PHI). ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Jan 2014
Observational StudyTracheostomy timing in traumatic brain injury: a propensity-matched cohort study.
The optimal timing of tracheostomy in patients with severe traumatic brain injury (TBI) is controversial; observational studies have been challenged through confounding by indication, and interventional studies have rarely enrolled patients with isolated TBI. ⋯ Therapeutic study, level II.
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J Trauma Acute Care Surg · Jan 2014
Outpatient laparoscopic appendectomy should be the standard of care for uncomplicated appendicitis.
In 2012, a protocol for routine outpatient laparoscopic appendectomy for uncomplicated appendicitis was published reflecting high success, low morbidity, and significant cost savings. Despite this, national data reflect that the majority of laparoscopic appendectomies are performed with overnight admission. This study updates our experience with outpatient appendectomy since our initial report, confirming the efficacy of this approach. ⋯ Therapeutic study, level V.