Articles: cations.
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It became increasingly necessary to rethink the value and clinical implication of traumatic brain injury (TBI) management guided by intracranial pressure (ICP) monitoring. ⋯ There were multiple differences between the ICP monitoring and no ICP monitoring groups regarding patient characteristics, injury severity, characteristics of CT scan, and hospital type. ICP monitoring in conjunction with ICP targeted therapies is significantly associated with lower mortality in some special TBI subgroups.
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The aim of the study was to identify hospital characteristics associated with variation in patient disposition after emergent surgery. ⋯ Nearly half of Medicare beneficiaries are discharged to a nonhome destination after emergent colectomy. Hospital ownership of a skilled nursing facility and low nurse-to-patient ratios are highly associated with nonhome discharges. This may signify the underlying financial incentives to preferentially utilize postacute care facilities under the traditional fee-for-service payment model.
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A porous bioresorbable polymer scaffold has previously been tested in preclinical animal models of spinal cord contusion injury to promote appositional healing, spare white matter, decrease posttraumatic cysts, and normalize intraparenchymal tissue pressure. This is the first report of its human implantation in a spinal cord injury patient during a pilot study testing the safety and feasibility of this technique (ClinicalTrials.gov Identifier: NCT02138110). ⋯ AIS, American Spinal Injury Association Impairment ScaleSCI, spinal cord injurytSCI, traumatic spinal cord injury.
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Venous thromboembolism (VTE) is a common complication of traumatic brain injury (TBI) with an estimated incidence of 25% when chemoprophylaxis is delayed. The timing of initiating prophylaxis is controversial given the concern for hemorrhage expansion. The objective of this study was to determine the safety of initiating VTE chemoprophylaxis in patients with TBI within 24 hours of presentation. ⋯ Early (<24 hours) initiation of VTE chemoprophylaxis in patients with traumatic intracranial hemorrhage appears to be safe. Further prospective studies are needed to validate this finding.