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Surgical versus non-surgical treatment for acute anterior shoulder dislocation

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Limited evidence supports primary surgery for young people engaged in highly demanding physical activities who have sustained their first acute traumatic shoulder dislocation. There is no evidence available to determine which treatment is better for other patient groups.
Acute anterior shoulder dislocation …

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Interventions for treating acute elbow dislocations in adults

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Overall, there is a lack of evidence to inform clinical decisions for treating acute simple elbow dislocations in adults. Nonetheless, it should be noted that, while weak and inconclusive, the available evidence from a trial comparing surgery versus conservative treatment did …

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Psychological treatment for anxiety in people with traumatic brain injury

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There is some evidence for the effectiveness of cognitive behavioural therapy (CBT) for treating acute stress disorder following mild traumatic brain injury (TBI) and of CBT combined with neurorehabilitation for targeting general anxiety symptomatology in people with mild-to-moderate TBI.
Psychological treatments are …

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Corticosteroids for acute traumatic brain injury

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The increase in mortality with steroids in one trial suggest that steroids should no longer be routinely used in people with traumatic head injury (TBI).
TBI is a leading cause of death and disability. Corticosteroids have been widely used in treating people …

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Hypothermia for traumatic head injury

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There is no evidence that hypothermia is beneficial in the treatment of head injury. Hypothermia should not be used except in the context of a high-quality randomised controlled trial with good allocation concealment.
Hypothermia has been used in the treatment of head …

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Mannitol for acute traumatic brain injury

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Mannitol therapy for raised intracranial pressure (ICP) may have a beneficial effect on mortality when compared with pentobarbital treatment, but it may have a detrimental effect on mortality compared with hypertonic saline. ICP-directed treatment shows a small beneficial effect compared to …

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Gangliosides for acute spinal cord injury

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The evidence available does not support the use of ganglioside treatment to reduce the death rate in spinal cord injury (SCI) patients. No evidence has yet emerged that ganglioside treatment improves recovery or quality of life in survivors.
SCI results in loss …

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Steroids for acute spinal cord injury

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Methylprednisolone has been shown to enhance sustained neurologic recovery in a phase III randomised trial; findings replicated in a second trial. Therapy must be started within 8 hours of injury using an initial bolus of 30 mg/kg by IV for 15 …

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Antifibrinolytic drugs for acute traumatic injury

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Tranexamic acid safely reduces mortality in bleeding trauma patients without increasing the risk of adverse events.  Tranexamic acid should be given as early as possible and within three hours of injury, as treatment later than this is unlikely to be effective.
Uncontrolled …

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Colloids versus crystalloids for fluid resuscitation in critically ill patients

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There is no evidence that resuscitation with colloids reduces the risk of death, compared to resuscitation with crystalloids, in patients with trauma, burns or following surgery. Furthermore, the use of hydroxyethyl starch might increase mortality. As colloids are not associated with …

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