Articles: prospective-studies.
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Prior studies have reported conflicting results regarding the utility of ultrasound in the diagnosis of traumatic pneumothorax (PTX) because they have used sonologists with extensive experience. This study evaluates the characteristics of ultrasound for PTX for a large cohort of trauma and emergency physicians. ⋯ In a large heterogenous group of clinicians who typically care for trauma patients, the sonographic evaluation for pneumothorax was as accurate as supine chest radiography. Thoracic ultrasound may be helpful in the initial evaluation of patients with truncal trauma.
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Anterior interbody fusion has previously been demonstrated to increase neuroforaminal height in a cadaveric model using cages. No prior study has prospectively assessed the relative change in magnetic resonance imaging (MRI) demonstrated neuroforaminal dimensions at the index and supradjacent levels, after anterior interbody fusion with a corticocancellous allograft in a series of patients without posterior decompression. The objective of this study was to determine how much foraminal dimension can be increased with indirect foraminal decompression alone via anterior interbody fusion, and to determine the effect of anterior lumbar interbody fusion on the dimensions of the supradjacent neuroforamina. ⋯ Anterior interbody fusion with a coriticocancellous allograft can significantly increase neuroforaminal dimension even in the absence of formal posterior distraction or foraminotomy; anterior interbody fusion with a coriticocancellous allograft has little effect on supradjacent neuroforaminal dimensions.
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Ther Hypothermia Temp Manag · Mar 2013
Therapeutic hypothermia for brain injury from near hanging: review of the literature.
Hanging, strangulation, and suffocation constitute the second most common cause of death by suicide in the United States after firearms. Near hanging is defined as an unsuccessful attempt at hanging. Victims of near hanging suffer from strangulation with cerebral ischemia and resultant reperfusion injury, irrespective of whether they had cardiac arrest or not. ⋯ Even though some studies showed that near-hanging victims who present comatose to the hospital can have good neurologic outcomes after supportive therapy alone, some patients are still left with a poor neurologic outcome, especially if they sustained cardiac arrest. Prospective studies are warranted to test the potential benefit of TH on neurologic outcome and survival in this patient population. Although it would be difficult to conduct such studies, we feel that the compelling case studies, anecdotal evidence, and extrapolated data support its use until more evidence can be obtained.
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In this article we provide an overview of the different study designs commonly utilized in carrying out clinical and public health research and of the points to consider in reviewing these study designs. The design and conduct of cross-sectional health surveys, case-control, prospective, and case-crossover observational studies, and randomized controlled trials, are discussed in this review article. It is hoped that careful attention to the concerns we have raised will lead to the design and conduct of high-quality research projects and their write-up.
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An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented. ⋯ Application of the risk assessment score and use of the risk strata system may be beneficial in future studies and may be considered as a valuable tool to assess return-to-work following injuries; however, further studies are needed.