1. Neprilysin inhibitors-- block neprilysin, an endopetidase that degrades bradykinin, natriuretic peptides, and adrenomedullin. Increase endogenous vasodilation, diuresis, and inhibition of adrenomedullary activity.
2. PARADIGM-HF trial {double-blind RCT, n=8442, NEJM} shows neprilysin inhibitors effective in reducing mortality (20% reduction) and hospitalization for heart failure (20%) in patients with NYHA class II, III, or IV heart failure and EF < 40.
3. DEGRA trial in australia of bifrontal decompressive craniectomy for TBI {RCT, n=150, NEJM} found no benefit (long term death/disability) from the surgical procedure, and in fact more harm than for standard medical care. Importantly, there was a significantly (12% vs 27%) higher rate of people with non-reactive pupils that were randomized to surgery. Post-hoc analysis adjusting for that rendered the difference between surgical and medical care insignificant -- ie surgery was no longer harmful.

4. Prevention of venous thromboembolism in neurosurgery: a metaanalysis, {Chest 2008}

METHODS: We searched the medical literature to identify prospective trials reporting on VTE prevention (either mechanical or pharmacologic). The rates of VTE and bleeding were our primary end points and were pooled using a random-effects model.

RESULTS: We identified 30 studies reporting on 7,779 patients. There were 18 randomized controlled trials and 12 cohort studies. The results of pooled relative risks (RRs) showed LMWH and intermittent compression devices (ICDs) to be effective in reducing the rate of deep vein thrombosis (LMWH: RR, 0.60; 95% confidence interval [CI], 0.44 to 0.81; ICD: RR, 0.41; 95% CI, 0.21 to 0.78). Similar results were seen when pooled rates from all 30 trials were analyzed. In head-to-head trials, there was no statistical difference in the rate of intracranial hemorrhage (ICH) between therapy with LMWH and nonpharmacologic methods (RR, 1.97; 95% CI, 0.64 to 6.09). The pooled rates of ICH and minor bleeding were generally higher with heparin therapy than with non-heparin-based prophylactic modalities.
5. DVT rate overall {from same paper: Chest 2008} lower with chemoprophylaxis than mechanical prophylaxis 

6. ICH rate overall {from same paper: Chest 2008} higher with chemoprophylaxis than mechanical prophylaxis; most of the studies with lovenox are newer than the ones with heparin, I wonder if that impacts the findings at all. 

7. Death rate overall {from same paper: Chest 2008} is actually the same.... interesting. I wonder how robust this data is. It would also be interesting to see neurological morbidity as an outcome. 

(Major and minor referring to bleeds) 

8.  Venous thromboembolism prophylaxis in patients undergoing cranial neurosurgery: a systematic review and meta-analysis {Neurosurgery 2011}

METHODS: We selected RCTs that evaluated LDUH or LMWH prophylaxis of VTE in patients undergoing elective cranial neurosurgery. A meta-analysis assessing heparins vs no heparin (either with or without mechanical methods) was performed.

RESULTS:Eight RCTs were identified. Six RCTs involving 1170 patients evaluated LDUH or LMWH vs a control group. Five of 6 trials found a significant reduction in the risk of symptomatic and asymptomatic VTE with heparin prophylaxis. The pooled risk ratio was 0.58 (95% confidence interval, 0.45-0.75). ICH was more common in those receiving heparin, but not statistically significantly. For every 1000 patients who receive heparin prophylaxis, 91 VTE events will be prevented (approximately 35 of which are proximal deep vein thrombosis or pulmonary embolism and 9 to 18 of which are symptomatic), whereas 7 ICHs and 28 more minor bleeds will occur.

9. Patchell surgery for spinal cord mets study (methods) 
- Inclusion criteria: Age > 18, compressive lesion of spinal cord (not only cauda), at least one neuro deficit (incl pain), only one compressive lesion, no chronic paraplegia (>48 hrs), no radiosensitive tumors (germ cell tumors, lymphoma, multiple myeloma), no neuro-deficit-causing comorbidity (ie brain cancer), no previous radiotherapy such that would preclude further radiation of the dose requrired by the study
-  Cohort: N approx 100, half in control group (radiation only- 30 gy to spine incl 1 level above and below), half in surgery group (immediate circumferential decompression - specific technique was surgeon's choice + radiation)
10. Patchell surgery for spinal cord mets study (results)

Post treatment outcomes All-comers:
- 57% that could walk in rad only group, 84% could walk in surgery + rad group.
- Patients retained ability to walk for 13 (rad only) vs 122 days (surgery + rad), p<0.003
Excluding people who were paraplegic at baseline:
- 74% vs 94% could walk in rad only vs surgery + rad (p=0.02)