Articles: cations.
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Curr Treat Option Ne · Sep 2009
Current treatment options for depression after mild traumatic brain injury.
Mild traumatic brain injury (MTBI) is the most common neurologic condition in the United States; about 503 of every 100,000 persons visiting the emergency department have this diagnosis. A complex cluster of neurologic signs and symptoms are associated with an acceleration-deceleration mechanism of injury. Unfortunately, many persons do not seek treatment for MTBI. ⋯ Thus, evidence-based treatment of post-MTBI depression is quite limited. Because depressive symptoms can develop as early as 1 week after injury and can be exacerbated by stress, pain, and comorbidities, it seems prudent to begin early interventions focused on managing pain and stress, along with providing psychoeducational and problem-solving therapies. Efficacy studies are needed to determine whether telemedicine approaches, group interventions, or peer counseling may be helpful methods of delivering such interventions during the early months as ways to attenuate the development of a major depressive disorder.
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Total pancreatectomy (TP) is performed for various indications. Historically, morbidity and mortality have been high. Recent series reporting improved peri-operative mortality have renewed interest in TP. We performed a national review of TP including indication, patient/hospital characteristics, complications and peri-operative mortality. ⋯ TP is increasingly performed nationwide with a concomitant decrease in peri-operative mortality. Patient characteristics, rather than hospital volume, predicted increased mortality.
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Wrong-site, wrong-procedure and wrong-patient surgeries are catastrophic events for patients, medical caregivers and institutions. Operating room (OR) briefings are intended to reduce the risk of wrong-site surgeries and promote collaboration among OR personnel. The purpose of our study was to evaluate 2 OR briefing safety initiatives, "07:35 huddles" (preoperative OR briefing) and "surgical time-outs" (perioperative OR briefing), at the Hospital for Sick Children in Toronto, Ont. ⋯ Structured communication tools, such as 07:35 huddles and surgical time-outs briefings, especially for the nursing personnel, change the notion of individual advocacy to one of teamwork and being proactive about patient safety.