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severe trauma

Shira Maguen, Yongmei Li, Erin Madden, Karen H Seal, Thomas C Neylan, Olga V Patterson, Scott L DuVall, Callan Lujan, Brian Shiner
Little is known about predictors of initiation and completion of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD), with most data coming from small cohort studies and post-hoc analyses of clinical trials. We examined patient and treatment factors associated with initiation and completion of EBP for PTSD in a large longitudinal cohort. We conducted a national, retrospective cohort study of all Iraq and Afghanistan War veterans who had a post-deployment PTSD diagnosis from 10/01-9/15 at a Veterans Health Administration facility and had at least one coded post-deployment psychotherapy visit...
February 11, 2019: Psychiatry Research
James M Cottom, Steven M Douthett, Kelly K McConnell
Fractures of the calcaneus are detrimental injuries, often caused by high-energy trauma. To best restore the functionality of a limb and allow normal ambulation, it is recommended to repair displaced intra-articular calcaneus fractures surgically. This article presents several methods of reduction and repair of the calcaneus. Traditionally, calcaneal fractures have been repaired through a lateral extensile incision that has been shown to have a high percentage of wound healing complications. In recent times, there has been a shift toward minimally invasive and sinus tarsi incisional approaches in the repair of calcaneus fractures...
April 2019: Clinics in Podiatric Medicine and Surgery
Alexander E St John, Jason C Newton, Erika J Martin, Bassem M Mohammed, Daniel Contaifer, Jessica L Saunders, Gretchen M Brophy, Bruce D Spiess, Kevin R Ward, Donald F Brophy, José A López, Nathan J White
BACKGROUND: Trauma-induced coagulopathy (TIC) is a common and deadly bleeding disorder. Platelet dysfunction is present during TIC, but its mechanisms remain unclear. Platelets are currently thought to become "exhausted", a state in which they have released their granule contents and can no longer aggregate or contract. METHODS: This prospective observational cohort study tested the hypothesis that platelet exhaustion is present during TIC and characterized the early time course of platelet dysfunction...
February 19, 2019: Journal of Thrombosis and Haemostasis: JTH
Jan Oliver Voß, Nadine Thieme, Sven Märdian, Christian Doll, Stefan Hartwig, Max Heiland, Jan-Dirk Raguse, Nicolai Adolphs
INTRODUCTION: The treatment of facial fractures is an integral part of the oral and maxillofacial surgical treatment spectrum. In the case of complex fractures that involve multiple levels of the facial skeleton associated with severe concomitant injuries, an individual and interdisciplinary treatment approach is needed, which requires the infrastructure of a national trauma center. OBJECTIVE: The aim of this study was to analyze the incidence and management of patients with complex facial fractures and considering the concomitant injury pattern...
February 19, 2019: Der Unfallchirurg
Kalaiarasi Raja, Sithananda-Kumar Venkatesan, Sivaraman Ganesan, Arun Alexander
Introduction:  Penetration injury to the neck constitutes 5-10% of all trauma cases. Penetration of a foreign body into the trachea with subsequent impaction into the tracheoesophageal party wall is extremely rare. We present a patient with an unusual penetrating injury of the neck caused by a metallic foreign body embedded into the tracheoesophageal party wall, and its management. Case Report: A 35-year-old male presented to the emergency department with a history of accidental penetrating injury on his neck, with severe pain and bleeding from the wound entry site...
January 2019: Iranian Journal of Otorhinolaryngology
Kasim L Qureshi, Rachel Upthegrove, Emma Toman, Vijay Sawlani, David James Davies, Antonio Belli
OBJECTIVES: To estimate the prevalence of post-traumatic stress disorder (PTSD) in a large civilian population with traumatic brain injury (TBI), and to assess whether brain injury severity is correlated with PTSD symptoms. DESIGN: Observational, cross-sectional study. SETTING AND PARTICIPANTS: Outpatient clinic in a major UK trauma centre and secondary care hospital. Estimates of PTSD prevalence are based on 171 sampled individuals attending TBI clinic within an 18-month period...
February 19, 2019: BMJ Open
Lauren H Mangum, Joshua J Avila, Brady J Hurtgen, Alicia L Lofgren, Joseph C Wenke
BACKGROUND: Singular traumatic insults, such as bone fracture, typically initiate an appropriate immune response necessary to restore the host to pre-insult homeostasis with limited damage to self. However, multiple concurrent insults, such as a combination of fracture, blunt force trauma, and burns (polytrauma), are clinically perceived to result in abnormal immune response leading to inadequate healing and resolution. To investigate this phenomenon, we created a model rat model of polytrauma...
February 19, 2019: Journal of Orthopaedic Surgery and Research
J Kosola, T Brinck, A Leppäniemi, L Handolin
BACKGROUND AND AIMS: Blunt abdominal trauma can lead to substantial organ injury and hemorrhage necessitating open abdominal surgery. Currently, the trend in surgeon training is shifting away from general surgery and the surgical treatment of blunt abdominal trauma patients is often done by sub-specialized surgeons. The aim of this study was to identify what emergency procedures are needed after blunt abdominal trauma and whether they can be performed with the skill set of a general surgeon...
February 20, 2019: Scandinavian Journal of Surgery: SJS
Effrosyni D Kokaliari, Ann W Roy, Joyce Taylor
BACKGROUND: African American children are overrepresented in foster care at twice to three times the rate of white children. Scholars argue that racism and oppression underlie disproportionality (Križ & Skivenes, 2011). OBJECTIVE: This study explored disproportionality as seen through the eyes of African American parents in the child welfare system. The aim was to understand why African American families are over-represented in child custody statistics and to improve family and parenting support for African American communities...
February 16, 2019: Child Abuse & Neglect
Massimo Petazzoni, Michela Buiatti
CASE DESCRIPTION A 12-year-old obese spayed female American Staffordshire Terrier was admitted for evaluation of acute non-weight-bearing lameness of the right pelvic limb attributed to motor vehicle-related trauma that occurred 2 hours previously. The owners reported a chronic, progressive weight-bearing lameness of the right pelvic limb secondary to a complete cranial cruciate ligament (CrCL) rupture that was diagnosed 6 months previously. They had declined surgery for CrCL repair because of the advanced age of the dog...
March 1, 2019: Journal of the American Veterinary Medical Association
Enzo Guzzo, Fernando Taragano, Silvina Heisecke, Hugo Krupitzki, Leonardo Tondo
The objective of the study was to assess the emotional impact on healthcare professionals and changes in their behavior as a result of patients' suicide in Argentina. An anonymous survey was e-mailed to healthcare professionals registered in CEMIC University Institute Department of Psychiatry database. A total of 250 responses were obtained. Among respondents, 50.6% had provided treatment to patients that committed suicide. The rate rose to 62.5% among psychiatrists. The professionals that gave an affirmative response were assessed with Horowitz Impact of Event Scale to determine the severity of trauma...
May 2018: Vertex: Revista Argentina de Psiquiatriá
Luc A A Janssens, Ivo K A Verheijen, Jordi Serangeli, Thijs van Kolfschoten
Evaluation of a right ventral scapula fragment from a mature Homotherium latidens from Schöningen, Germany (337-300 ka before present - MIS 9) revealed lesions consisting of an osteophyte at the caudal border of the glenoid cavity, and a large, multilobular, cystic feature in the medio-caudal glenoid cavity. Based on the type of lesions, their localization, their severity, and exclusion of several nutritional and other etiologies such as immune mediated disease, joint infection (septic arthritis), and joint tumors, we conclude that the lesion was caused by trauma or age-related shoulder osteoarthritis (or possibly both)...
March 2019: International Journal of Paleopathology
James A Fauerbach, Amanda K Gehrke, Shawn T Mason, Neda F Gould, Stephen M Milner, Julie Caffrey
OBJECTIVE: (1) To evaluate the feasibility of conducting a randomized controlled trial (RCT) of the Safety, Meaning, Activation and Resilience Training (SMART) intervention versus Non-Directive Supportive Psychotherapy (NDSP) in an acutely hospitalized adult burn survivor sample; (2) To assess the preliminary impact of SMART on Acute Stress Disorder (ASD)/Posttraumatic Stress Disorder (PTSD) and Major Depress Disorder (MDD) symptom reduction as secondary prevention. DESIGN: Proof-of-concept, parallel group, RCT design...
February 15, 2019: Archives of Physical Medicine and Rehabilitation
Sravisht Iyer, Han Jo Kim, Alexander Theologis, Venu M Nemani, Todd J Albert, Lawrence G Lenke, Shane Burch, Oheneba Boachie-Adjei, Vedat Deviren, Themistocles S Protopsaltis, Justin S Smith, Justin K Scheer, Jun Mizutani, Eric O Kleinberg, Christopher P Ames
Study Design: Retrospective cohort study. Objective: Determine the indications, complications, and clinical outcomes in patients requiring fusions from the cervical spine to the pelvis. Several investigators have examined fusions from the thoracic spine to the sacrum, but no similar study has been performed for cervical-to-pelvis fusions. Methods: Patients from 2003 to 2014 with an upper instrumented vertebrae (UIV) in the cervical spine (any level) and a lower instrumented vertebrae (LIV) in the sacrum or pelvis were included in the study...
February 2019: Global Spine Journal
Chon-Fu Lio, Hou-Hon Cheong, Chon-Hou Un, Iek-Long Lo, Shin-Yi Tsai
Objective: Correlation analysis and multiple linear regression analysis were conducted to estimate the influence of meteorological factors on road traffic injuries stratified by severity. Crash rate was defined as mean monthly road traffic accidents per 1,000 vectors. Design: Ecological time-series study. Setting: Macao traffic accident registry database between January 1st, 2001 and November 31st, 2016. Participants: In total, 393,176 traffic accidents and 72,501 cases of road traffic injuries (RTIs) were enrolled; patients' severity was divided into mild injury, required hospitalisation, and death...
2019: PeerJ
Sungwoo Park, Gyeong-Won Lee, Eun-Ha Koh, Hyun-Young Kim
The 5q35.2-q35.3 duplication phenotype is characterized by growth delay, microcephaly, mental retardation and delayed bone aging. However, there has been no reports on the occurrence of pancytopenia as a consequence of 5q35.2-q35.3 duplication. A 42-year-old male visited the emergency room due to multiple trauma. He had been diagnosed with mental retardation in the past. No previous history of severe bleeding symptom was also reported. Complete blood cell counts were leukocyte 3.51×109 /L, neutrophil 0.19×109 /L, hemoglobin 8...
October 1, 2018: International Journal of Hematology-oncology and Stem Cell Research
Fernando Brandão Andrade-Silva, Renan Lyuji Takemura, Renato Tavares Bellato, Marcos de Camargo Leonhardt, Kodi Edson Kojima, Jorge Dos Santos Silva
Objectives: To describe the clinical utility of the Manchester triage scale adapted for orthopedic emergency departments and to evaluate its validity in identifying patients with the need for hospital care and its reliability when reproduced by different professionals. Methods: Five triage flowcharts were developed based on the Manchester scale for the following orthopedic disorders: traumatic injuries, joint pain, vertebral pain, postoperative disorders, and musculoskeletal infections...
January 2019: Acta Ortopedica Brasileira
Julina A Rattel, Stephan F Miedl, Laila K Franke, Lisa M Grünberger, Jens Blechert, Martin Kronbichler, Victor I Spoormaker, Frank H Wilhelm
BACKGROUND: Pathological peritraumatic encoding is proposed as a proximal risk factor for the development of posttraumatic stress disorder (PTSD), with trauma-analog studies linking increased neural processing of trauma films to intrusive trauma recollections, a core symptom of PTSD. Cumulative lifetime adversity is proposed as a more distal risk factor, with research indicating a tipping point at about five events with regard to PTSD development following re-exposure to trauma. Thus, within a diathesis × stress framework, increased peritraumatic neural processing may constitute a specific risk factor for PTSD, particularly in individuals with several lifetime adversities...
January 4, 2019: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
Remmelt R Schür, Dick Schijven, Marco P Boks, Bart P F Rutten, Murray B Stein, Jan H Veldink, Marian Joëls, Elbert Geuze, Eric Vermetten, Jurjen J Luykx, Christiaan H Vinkers
Exposure to trauma strongly increases the risk to develop stress-related psychopathology, such as post-traumatic stress disorder (PTSD) or major depressive disorder (MDD). In addition, liability to develop these moderately heritable disorders is partly determined by common genetic variance, which is starting to be uncovered by genome-wide association studies (GWASs). However, it is currently unknown to what extent genetic vulnerability and trauma interact. We investigated whether genetic risk based on summary statistics of large GWASs for PTSD and MDD predisposed individuals to report an increase in MDD and PTSD symptoms in a prospective military cohort (N = 516) at five time points after deployment to Afghanistan: one month, six months and one, two and five years...
February 14, 2019: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
F M Weinberg, C M Speksnijder, T Forouzanfar, A J W P Rosenberg
The majority of studies debating the optimization of treatment for condylar mandibular fractures focus on the bony aspect first. However, fractures of the mandibular condyle may go together with soft tissue injury of the temporomandibular joint. An electronic literature search for this topic was undertaken. Assessment of quality was carried out using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Sixteen articles were included in this review. The reviewed literature showed that intracapsular fractures and dislocated condylar fractures result in more severe injuries...
February 14, 2019: International Journal of Oral and Maxillofacial Surgery
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