Acknowledgments |
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xiii | |
Preface |
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xv | |
Foreword |
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xvii | |
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1 | (6) |
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2 In Comparison to Prior Wars, More Troops Are Surviving |
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7 | (4) |
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11 | (48) |
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What Happens During an Explosion? |
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11 | (1) |
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Sequence of Events in an IED Explosion |
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11 | (3) |
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Idealized Blast Pressure Waveform |
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14 | (1) |
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There Are Four Mechanisms of Blast Injury |
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15 | (1) |
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Armored Vehicle Capsized by a Roadside IED Explosion |
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16 | (1) |
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17 | (1) |
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18 | (1) |
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How Do Shock Waves Injure Tissue? |
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18 | (2) |
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Several Theories Have Been Advanced to Explain Primary Blast-Induced Neurotrauma (BINT) |
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20 | (3) |
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"Here Edema, There Edema, Everywhere Edema, Edema!" |
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23 | (2) |
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Hyperemic Cerebral Swelling and Scalp Edema (IED Blast Injury) |
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25 | (1) |
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Cerebral Edema and Scalp Swelling Are Common in Blast Trauma |
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26 | (1) |
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Soft Tissue Edema Is Common in Blast Trauma |
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27 | (1) |
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Blast Lung and Foreign Body Embolus |
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28 | (1) |
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Cerebral Edema and Hyperemia Are Common in Blast Brain Injury |
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29 | (1) |
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Cerebral Edema and Hyperemia Are Common in Blast Brain Injury |
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30 | (1) |
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31 | (1) |
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Secondary Blast Injury (Typical Fragmentation Wounds) |
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32 | (1) |
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Secondary Blast Brain Injury |
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33 | (1) |
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34 | (1) |
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35 | (1) |
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35 | (1) |
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Tertiary Blast Trauma (Crush Injury) |
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36 | (1) |
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Tertiary Blast Trauma (Enlarging Contusions) |
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37 | (1) |
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Tertiary Blast Trauma (Crush Injury) |
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38 | (1) |
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Tertiary Blast Trauma (Remote Traumatic Axonal Injury) |
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39 | (1) |
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39 | (1) |
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Quaternary Blast Trauma (Thermal and Toxic Inhalation Injury) |
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40 | (1) |
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What Determines the Severity of a Blast Injury? |
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41 | (1) |
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42 | (5) |
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How Common Is Blast Brain Injury? |
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47 | (1) |
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48 | (2) |
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Serum and Cerebrospinal Fluid Biomarkers of Brain Injury Have Been Shown to Correlate with Patient Outcome |
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50 | (1) |
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Biomarkers of BINT, in Particular, Remain Elusive |
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51 | (8) |
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4 The Weapons of War and Terrorism |
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59 | (90) |
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"Homemade" Improvised Explosive Device (IED) |
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60 | (1) |
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Typical IED and Ballistic Fragment |
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61 | (1) |
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Vehicle-Borne IED ("Car Bomb" Injury) |
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62 | (1) |
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Vehicle-Borne IED ("Car Bomb" Injury) |
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63 | (2) |
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Explosively Formed Projectile (EFP) |
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65 | (2) |
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67 | (1) |
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Rocket-Propelled Grenade (RPG) Injury |
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68 | (2) |
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70 | (3) |
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Bullet Behavior in Tissue |
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73 | (1) |
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74 | (1) |
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The Entry Site of a Gunshot Wound Is Always Smaller Than the Exit Site |
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75 | (1) |
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76 | (1) |
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77 | (2) |
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Bullet Deformity and Fragmentation Increase the Injury |
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79 | (2) |
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Ballistic Brain Injury Analogy |
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81 | (1) |
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Behavior of a Bullet through the Brain |
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82 | (2) |
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Fatal Gunshot Wound Showing Typical Poor Prognostic Imaging Findings |
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84 | (2) |
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86 | (1) |
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Type II Shotgun Injury to the Face (Acute) |
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87 | (1) |
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Type III Shotgun Injury to the Occiput (Chronic) |
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88 | (2) |
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Dual-Energy CT Decreases Artifacts from Metallic Foreign Bodies |
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90 | (3) |
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Superficial Gunshot Wound |
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93 | (1) |
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Penetrating Gunshot Wound |
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94 | (2) |
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Gunshot Wound Ricochet Injury |
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96 | (1) |
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Gunshot Wound Ricochet Injury |
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97 | (1) |
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Gunshot Wound Ricochet Injury |
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98 | (1) |
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99 | (1) |
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100 | (4) |
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Unihemispheric, Nonlethal, Penetrating Gunshot Wound |
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104 | (1) |
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Unihemispheric, Nonlethal, Perforating Gunshot Wound (Cerebral Vasopasm + External Herniation) |
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105 | (2) |
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Bihemispheric, Nonlethal, Perforating Gunshot Wound |
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107 | (1) |
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Bihemispheric, Nonlethal, Perforating Gunshot Wound |
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108 | (1) |
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Bihemispheric, Lethal, AK-47 Sniper Rifle, Penetrating Gunshot Wound (Full Metal Jacket Bullet) |
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109 | (1) |
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Skull Fractures in Gunshot Wounds |
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109 | (1) |
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Lethal Gunshot Wounds (Penetrating versus Perforating) |
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110 | (2) |
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Typical Perforating Gunshot Wound Exit Site |
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112 | (1) |
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Concentric Heaving Skull Fracture in Gunshot Wounds |
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113 | (1) |
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Concentric Heaving Skull Fracture in Gunshot Wounds |
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114 | (2) |
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Orbital Roof Blow-Down Fracture in Gunshot Wounds |
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116 | (1) |
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117 | (2) |
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Gunshot Wound Fracture Patterns: Keyhole Fracture |
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119 | (5) |
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Nonballistic Penetrating Injury |
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124 | (1) |
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Nonballistic Penetrating TBI (Rebar Impalement) |
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125 | (1) |
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Nonballistic Penetrating TBI (Accidental Nail Gun Injury) |
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126 | (1) |
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Nonballistic Penetrating TBI (Accidental Nail Gun Injury) |
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127 | (2) |
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Nonballistic Penetrating TBI (Lawn Dart Injury) |
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129 | (2) |
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Penetrating TBI (Non-Accidental Nail Gun Injury) |
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131 | (1) |
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Penetrating Craniocervical Injury (Chopstick) |
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132 | (6) |
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Nonballistic Penetrating TBI (Phillips Screwdriver) |
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138 | (2) |
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Nonballistic Penetrating TBI (Typical Knife Wound to the Head) |
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140 | (1) |
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Nonballistic Penetrating TBI (Surfboard to Head) |
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141 | (2) |
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Remote Nonballistic Penetrating TBI (Traumatic Pseudoaneurysm) |
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143 | (1) |
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Stab Wound to Neck (Embolic Infarction) |
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144 | (5) |
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5 How Does Combat TBI Differ from Civilian TBI? 12 Lessons |
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149 | (166) |
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Lesson 1 Military Patients Are More Homogenous Than Civilian Patients |
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149 | (1) |
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Lesson 2 Patient Triage and Transport are Different |
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150 | (3) |
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Patient Transport in War (Five Levels) |
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153 | (7) |
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Level 2 Forward Surgical Team (FST) |
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154 | (2) |
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Level 3 Combat Support Hospital (CSH) |
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156 | (4) |
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Combat Casualty Communication |
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160 | (1) |
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Transport from Level 3 to Level 4 |
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161 | (2) |
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Lesson 3 The Imaging Approach Is Different in War and Terrorism |
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163 | (1) |
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164 | (1) |
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Typical IED Blast Injuries to the Extremities |
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165 | (2) |
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167 | (3) |
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Role of MRI in Combat (and Concussion) |
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170 | (2) |
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Wooden Foreign Body (Tree Branch) Mimicking a Pseudoaneurysm on MRI |
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172 | (1) |
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Lesson 4 Blast-Related Trauma Is the Most Common Mechanism of Injury in War and Terrorist Attacks |
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173 | (1) |
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Decompressive Hemicraniectomy Performed in a Combat Field Hospital |
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174 | (1) |
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"Blast-Plus" Brain Injury |
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175 | (2) |
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"Blast-Plus" Brain Injury |
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177 | (2) |
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"Blast-Plus" Brain Injury |
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179 | (1) |
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"Blast-Plus" Brain Injury |
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179 | (2) |
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"Blast-Plus" Brain Injury (Traumatic Axonal Injury) |
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181 | (1) |
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"Blast-Plus" Brain Injury (Bus Explosion/Suicide Bomb) |
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181 | (2) |
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Cerebral Vasospasm (IED Blast) |
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183 | (1) |
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"Blast-Plus" Brain Injury (Subacute Traumatic Axonal Injury) |
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184 | (1) |
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"Blast-Plus" Brain Injury (Interval Cerebral Atrophy) |
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185 | (1) |
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"Blast-Plus" Brain Injury (Chronic) |
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186 | (2) |
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Advanced Neuroimaging Techniques in Blast TBI |
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188 | (2) |
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Multimodality Imaging (including DTI) in TBI |
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190 | (5) |
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Functional Magnetic Resonance Imaging (fMRI) in Repetitive Head Injury |
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195 | (2) |
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Magnetoencephalography (MEG) and Magnetic Source Imaging (MSI) in TBI |
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197 | (2) |
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Magnetic Resonance Spectroscopy (MRS) in TBI |
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199 | (3) |
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Single Photon Emission Computed Tomography (SPECT) in TBI |
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202 | (1) |
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Positron Emission Tomography (PET) Imaging in TBI |
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203 | (3) |
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Magnetoencephalography (MEG) and Diffusion Tensor Imaging (DTI) of "Blast-Plus" Brain Injury |
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206 | (1) |
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Blast-Induced Neurotrauma (BINT) |
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207 | (2) |
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Diffusion Tensor Imaging (DTI) in Blast-Induced Neurotrauma (BINT) |
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209 | (1) |
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Primary Blast Brain Injury (Blast-Induced Neurotrauma [ BINT]) |
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210 | (3) |
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"Blast-Plus" Brain Injury (Diffusion Tensor Imaging) |
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213 | (2) |
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Lesson 5 Polytrauma Is More Common |
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215 | (1) |
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Combat, Terrorism, and Natural Disaster Polytrauma |
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216 | (1) |
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Combat, Terrorism, and Natural Disaster Polytrauma |
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217 | (1) |
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218 | (1) |
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219 | (1) |
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Pulmonary Laceration (Helicopter Crash) |
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220 | (2) |
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222 | (1) |
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Spinal Trauma (Humvee IED Blast Injury) |
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223 | (2) |
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Spinal Trauma (IED Blast Injury) |
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225 | (1) |
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Spine Trauma (IED Blast Injury) |
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226 | (1) |
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227 | (2) |
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Multimodality Imaging in TBI |
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229 | (1) |
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Multimodality Imaging in TBI |
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230 | (1) |
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Lesson 6 Life-Threatening Hemorrhage Is More Common |
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231 | (2) |
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Lesson 7 Hyperthermia and Burns Are More Common |
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233 | (2) |
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235 | (2) |
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237 | (1) |
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Lesson 8 Assessment of the True Extent of Injury in the Acute Setting Is More Difficult |
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238 | (7) |
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"Blast-Plus" TBI (Second Impact Syndrome) |
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245 | (1) |
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Lesson 9 Facial Injuries Are More Common and More Complex |
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246 | (1) |
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Complex Maxillofacial Trauma (AK-47 Gunshot Wound) |
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247 | (1) |
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Complex Maxillofacial Injury (Blast Trauma) |
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248 | (1) |
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Complex Maxillofacial Injury (Blast Trauma) |
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249 | (2) |
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251 | (1) |
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Complex Maxillofacial Injury (Blast Trauma) |
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252 | (1) |
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"Blast-Plus" TBI (Post-traumatic Anosmia) |
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253 | (3) |
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The Orbits Are the Main Entry Site to the Brain in Blast Trauma |
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256 | (1) |
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Bilateral Penetrating Ocular Injury (IED Explosion) |
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257 | (1) |
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Unilateral Blunt Orbital and Ocular Trauma |
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257 | (1) |
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Orbital and Ocular Trauma (Orbital Hematocyst) |
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258 | (1) |
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Ocular Trauma (Globe Rupture) |
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259 | (1) |
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Orbital Trauma (Orbital Emphysema) |
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260 | (1) |
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Orbital Trauma (Optic Canal Fracture) |
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260 | (1) |
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Carotid-Cavernous Fistula (Blast Injury) |
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261 | (1) |
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Importance of Protective Eyewear in Combat |
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262 | (1) |
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Importance of Protective Eyewear in the Garden |
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262 | (2) |
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Lesson 10 Stroke and Cerebrovascular Injuries Are More Common |
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264 | (2) |
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Blast-Induced Cerebral Vasospasm |
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266 | (1) |
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Multivessel Injury (IED Blast Trauma) |
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267 | (1) |
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Vascular Laceration and Middle Cerebral Artery Infarction (IED Explosion) |
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268 | (1) |
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Ischemic Infarction and Traumatic Vascular Dissection |
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268 | (1) |
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Vascular Dissection (Ischemia without Infarction) |
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269 | (2) |
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Vascular Dissection (Preserved Luminal Caliber) |
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271 | (1) |
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Pseudoaneurysm and Delayed Migration of a Foreign Body |
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272 | (3) |
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Dissection/Pseudoaneurysm (Hand Grenade Injury) |
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275 | (2) |
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277 | (1) |
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Foreign Body Embolus (IED Blast Injury) |
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278 | (1) |
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Intraluminal Thrombus (IED Explosion) |
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279 | (1) |
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Foreign Body Embolus (IED Blast Injury) |
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280 | (1) |
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Hypoxic-Ischemic Encephalopathy (IED Explosion) |
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281 | (1) |
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Drowning (Prolonged Extrication from Humvee Rollover into the Tigris River) |
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282 | (1) |
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Cerebral Fat Embolism (Humvee Rollover with Femoral Fractures) |
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283 | (1) |
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Lesson 11 Combat TBI Patients Are Particularly Vulnerable to Secondary TBI |
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284 | (1) |
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Lesson 12 Post-traumatic Stress Disorder (PTSD) Is More Common Following Combat Than following Civilian Trauma |
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285 | (1) |
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285 | (1) |
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285 | (1) |
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286 | (1) |
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How Common Is PTSD in Combat? |
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287 | (1) |
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PTSD Also Occurs in Civilian Trauma |
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288 | (1) |
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The Symptoms of PTSD Overlap with TBI |
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288 | (1) |
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Imaging Applications Are in Their Infancy in Psychiatry, in General, and PTSD in Particular |
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289 | (1) |
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Advanced Neuroimaging in PTSD |
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289 | (2) |
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Functional MRI in a Memory Suppression |
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291 | (24) |
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6 Transferring Lessons to the Home Front |
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315 | |
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Lessons That Should Be Applied to Civilian Trauma |
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315 | (1) |
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Combat and Terrorist Injuries Are Different from Civilian Injuries |
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315 | (1) |
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Combat and Terrorist Injuries Are More Severe Than Civilian Injuries |
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316 | (1) |
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Blast Brain Injuries and Post-traumatic Stress Disorder (PTSD) Are More Common than Previously Thought |
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316 | (1) |
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One of the Rare Benefits of War Is the Advancement in Neurotrauma Care that Occurs |
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317 | (2) |
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Every Physician (and Department) Needs to Plan in Advance |
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319 | |