JAMA : the journal of the American Medical Association
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Review
Prolonged therapeutic hypothermia after traumatic brain injury in adults: a systematic review.
The benefits of therapeutic hypothermia as a treatment for traumatic brain injury (TBI) remain unclear. ⋯ Therapeutic hypothermia may reduce the risks of mortality and poor neurologic outcome in adults with TBI. Outcomes were influenced, however, by depth and duration of hypothermia as well as rate of rewarming (
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial.
Faster magnetic resonance imaging (MRI) scanning has made MRI a potential cost-effective replacement for radiographs for patients with low back pain. However, whether rapid MRI scanning results in better patient outcomes than radiographic evaluation or a cost-effective alternative is unknown. ⋯ Rapid MRIs and radiographs resulted in nearly identical outcomes for primary care patients with low back pain. Although physicians and patients preferred the rapid MRI, substituting rapid MRI for radiographic evaluations in the primary care setting may offer little additional benefit to patients, and it may increase the costs of care because of the increased number of spine operations that patients are likely to undergo.
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Substantial discrepanies exist between clinical diagnoses and findings at autopsy. Autopsy may be used as a tool for quality management to analyze diagnostic discrepanies. ⋯ The possibility that a given autopsy will reveal important unsuspected diagnoses has decreased over time, but remains sufficiently high that encouraging ongoing use of the autopsy appears warranted.