Change is sometimes difficult to detect, especially if it happens gradually. Psychologists call it creeping normalcy. With slow change, we become conditioned with each incremental step and do not appreciate the overall change. Then, sometimes, when we stop and look back, we are struck with the contrast.
World-wide, ectopic pregnancy occurs in approximately 1-2% of pregnant women. Although it likely is underreported, according to CDC data covering 1970-1989, there was nearly a four-fold increase in the incidence of ectopic pregnancy, from 4.5/1000 to 16.0/1000 of all reported pregnancies.
This issue is the second part of a discussion about severe traumatic brain injury (TBI).
This is the first of a two-part series on severe traumatic brain injury, focusing on the evidence for optimal care.
The Advanced Trauma Life Support (ATLS) course for doctors was introduced in Nebraska in 1978 and given nationally for the first time in 1980 by the American College of Surgeons. The goal of ATLS is to serve as a safe and reliable method for managing patients with traumatic injury and provide a "common baseline for the continued innovation and challenge of existing paradigms in trauma care."
Remember the principle of homeostasis from first-year physiology the idea that the human body has self-regulating processes to maintain a desirable internal state? What were we taught to do when disease disrupted the self-regulating processes, and physiologic parameters were abnormal? Use medical treatments to restore them to normal values. Well, now we know that this may not be the best way to enhance survival.
