» Nervous system and neurologic conditions

Selenium supplementation for critically ill adults

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There is limited evidence to recommend supplementation of critically ill patients with selenium or ebselen.
Selenium is a trace mineral essential to health and has an important role in immunity, defence against tissue damage and thyroid function. Improving selenium status could help …

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Emergency interventions for hyperkalaemia

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Nebulised or inhaled salbutamol, or IV insulin-and-glucose are the first-line therapies for the management of emergency hyperkalaemia that are best supported by the evidence. Their combination may be more effective than either alone, and should be considered when hyperkalaemia is severe. …

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Single, double or multiple-injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery in adults

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There is evidence that multiple injection techniques using nerve stimulation for axillary plexus block produce more effective anaesthesia than either double or single injection techniques. There is insufficient evidence for a significant difference in other outcomes, including safety.
Regional anaesthesia comprising axillary …

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Anaesthesia for hip fracture surgery in adults

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There was insufficient evidence available from trials comparing regional versus general anaesthesia for surgical repair of hip fractures in adults to rule out clinically important differences. Regional anaesthesia may reduce acute postoperative confusion but no conclusions can be drawn for mortality or …

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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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