Trauma

Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic...

PURPOSE: The proximal radioulnar joint (PRUJ) and the radiocapitellar joint may be destabilized after trauma. Different techniques for stabilization of PRUJ have been proposed, but none of them can stabilize the radiocapitellar joint at the same time. We propose a ligamentoplasty to stabilize the radial head at these two joints by reconstructing the radial head annular ligament and the lateral collateral ulnar ligament (LCUL) with a single graft (palmaris longus or gracilis tendon of the knee)...

Skull surgery, also known as craniectomy, is done to treat trauma or brain diseases and may require the use of an implant to reestablish skull integrity. This study investigates the performance of 3D printed bone implants in a mouse model of craniectomy with the aim of making biodegradable porous implants that can ultimately be fitted to a patient's anatomy. A non-polymeric thermoplastic bioink composed of fatty acids and β-tricalcium phosphate was used to 3D print the skull implants. Some of these were sintered to yield pure β-tricalcium phosphate implants...

BACKGROUND: Neurodegeneration is a complex cellular process linked to prompt changes in myelin integrity and gradual neuron loss. Current imaging techniques offer estimations of myelin volumes in lesions/remyelinated areas but are limited to detect subtle injury. PURPOSE: To investigate whether measurements detected by a signal hierarchically isolated as a function of time-to-echo (SHIFT) MRI technique can determine changes in myelin integrity and fiber axolemma...

Trauma exposure can lead to poor psychological health not only for those directly affected, but also for their children. Additional research is needed to understand mechanisms in the intergenerational sequelae of traumatic stress. The current study examined parenting stress as a moderator of the association between parents' lifetime trauma exposure and school-aged children's internalizing symptoms (N = 139 dyads). Results of multiple regression analyses showed that the relationships between parental trauma exposure and child separation anxiety and harm avoidance were significant when parenting stress was moderate to high, but not when parenting stress was low...

PURPOSE: Limb amputation and death are devastating sequelae of acute compartment syndrome (ACS), and have been posited to result either from the initial injury burden or from pathophysiologic sequelae, such as rhabdomyolysis leading to acute renal failure. We aimed to test the hypothesis that severity of trauma is associated with limb amputation and death in patients with traumatic leg ACS. METHODS: We retrospectively reviewed 302 patients with ACS of 302 legs treated with fasciotomies from 2000 to 2015 at two tertiary trauma centers...

Ankle arthritis is a useful clinical signpost to differential diagnosis in rheumatic disease. Biomechanical features and differences in cartilage physiology compared with the knee may confer protection of the ankle joint from factors predisposing to certain arthritides. The prevalence of ankle OA is low, and usually secondary to trauma. Primary OA of the ankle should be investigated for underlying causes, especially haemochromatosis. New presentations of inflammatory mono/oligo arthritis involving the ankle are more likely due to undifferentiated arthritis or spondyloarthritis than RA, and gout over CPPD...

Author's correction note: Clinical article Br Dent J 2020; 229: 169-175.When this article was initially published, panels B and C of were duplicates. The correct figure is presented here.The authors apologise for any convenience caused.

Stress hyperglycemia and insulin resistance are evolutionarily conserved metabolic adaptations to severe injury including major trauma, burns, or hemorrhagic shock (HS). In response to injury, the neuroendocrine system increases secretion of counterregulatory hormones that promote rapid mobilization of nutrient stores, impair insulin action, and ultimately cause hyperglycemia, a condition known to impair recovery from injury in the clinical setting. We investigated the contributions of adipocyte lipolysis to the metabolic response to acute stress...

INTRODUCTION: Trauma resuscitation is a complex and time-sensitive endeavour with significant risk for error. These errors can manifest from sequential system, team and knowledge-based failures, defined as latent safety threats (LSTs). In situ simulation (ISS) provides a novel prospective approach to recreate clinical situations that may manifest LSTs. Using ISS coupled with a human factors-based video review and modified framework analysis, we sought to identify and quantify LSTs within trauma resuscitation scenarios...

BACKGROUND: Pedicle screw fixation is commonly used in the treatment of spinal pathologies. While the biomechanical factors that affect bone fixation have been frequently described, questions remain as to which imaging modality is the ideal medium for preoperative planning. Due to its perceived superiority in assessing bony changes, computed tomography (CT) scan is assumed to be the gold standard for preparative planning, and we hypothesize that magnetic resonance imaging (MRI) is sufficiently accurate to predict screw length and diameter compared to CT...

BACKGROUND: Ankle fractures are the most common traumatic bone injuries of the lower limb. Over 50% of ankle fractures occur at the syndesmosis level (type AO B). The goal of treatment is to achieve an anatomical reduction and appropriate stabilization. The present study aimed to evaluate the clinical-functional and radiological results, and complications of minimally invasive reduction and fixation technique for ankle fractures type AO B. The surgical technique also is detailed. MATERIAL AND METHODS: A prospective analysis of 451 patients undergoing surgery for type AO B displaced ankle fracture was performed...

This study sought to compare point-of-care ultrasound (POCUS) and conventional X-rays for detecting fractures in children. This was a prospective, non-randomized, convenience-sample study conducted in five medical centers. It evaluated pediatric patients with trauma. POCUS and X-ray examination results were treated as dichotomous variables with fracture either present or absent. Descriptive statistics were calculated in addition to prevalence, sensitivity, specificity, positive predictive value and negative predictive value, including 95% confidence intervals (CIs)...

OBJECTIVE: To assess the relationship between metaphyseal callus formation and preservation of distal tibial alignment in pilon fractures treated with internal plate fixation. DESIGN: Retrospective Review SETTING: Academic Level I Trauma Center PATIENTS: Forty-two patients with AO/OTA type C2 or C3 pilon fractures treated with plate fixation. INTERVENTION: Internal fixation with anterolateral plating, medial plating, or both. Modified Radiographic Union Score in Tibial fracture (mRUST) scores were determined from six-month radiographs...

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Past studies have indicated that mothers who are victims of intimate partner violence (IPV) have a greater risk of developing depression symptoms. Furthermore, existing literature provides evidence that children's mental health can be affected by their mother's mental health well past infancy and early childhood. Given this, children of IPV victims are particularly at risk of developing depression symptoms. Guided by trauma theory, the ecobiodevelopmental (EBD) framework, and social learning theory, this study investigates the long-term relationship between maternal IPV victimization during pregnancy and teen depression symptoms...

Cumulative lifetime trauma has a profound impact on the development of schizophrenia spectrum disorders. However, few studies have determined participants' most distressing (i.e., "worst") life event in childhood or adulthood or examined whether this event contributes to poorer clinical outcomes. The present study aimed to (a) determine the associations between the worst life event and demographic/clinical variables and (b) examine the associations between the worst life event and psychiatric symptoms (i...

Viscoelastic whole blood tests are increasingly used to guide hemostatic therapy in bleeding patients in the perioperative, trauma, and obstetric settings. Compared with standard laboratory tests of hemostasis, they have a shorter turnaround time and provide simultaneous information on various aspects of clot formation and lysis. The two available brands TEG (thromboelastography) and ROTEM (rotational thromboelastometry) provide devices that are either manually operated or fully automated. The automation allows for the assays to be used as point-of-care tests increasing their usefulness in massively bleeding patients with rapidly changing hemostatic profiles...

PURPOSE: The aim of this study was to determine whether virtual monochromatic dual-energy CT imaging improves the evaluation of suspected non-union of the appendicular skeleton treated with titanium or stainless steel intramedullary nails and plates. METHOD: Forty-one patients with a clinical suspected non-union with hardware in place were included and scanned on a dual-source CT-scanner using 100/Sn150kVp. Images including titanium hardware were extracted at 130 keV...

OBJECTIVES: Failure to diagnose non-accidental trauma (NAT) leaves the victim at risk of further injury or even death. It is incumbent upon physicians and other health care personnel to identify trauma patterns that have a high likelihood of being caused by NAT. The objective of this study is to discuss the presentation of nasal septal hematoma (NSH) or nasal septal abscess (NSA) as a sign of NAT. METHODS: This is a retrospective case series of patients presenting with nasal septal hematoma or abscess between 2010 and 2019...