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Sample records for brain trauma foundation

  1. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... Cancer Foundation joins the PBTF Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  2. Predicting 14-day mortality after severe traumatic brain injury: application of the IMPACT models in the brain trauma foundation TBI-trac® New York State database.

    Science.gov (United States)

    Roozenbeek, Bob; Chiu, Ya-Lin; Lingsma, Hester F; Gerber, Linda M; Steyerberg, Ewout W; Ghajar, Jamshid; Maas, Andrew I R

    2012-05-01

    Prognostic models for outcome prediction in patients with traumatic brain injury (TBI) are important instruments in both clinical practice and research. To remain current a continuous process of model validation is necessary. We aimed to investigate the performance of the International Mission on Prognosis and Analysis of Clinical Trials in TBI (IMPACT) prognostic models in predicting mortality in a contemporary New York State TBI registry developed and maintained by the Brain Trauma Foundation. The Brain Trauma Foundation (BTF) TBI-trac® database contains data on 3125 patients who sustained severe TBI (Glasgow Coma Scale [GCS] score ≤ 8) in New York State between 2000 and 2009. The outcome measure was 14-day mortality. To predict 14-day mortality with admission data, we adapted the IMPACT Core and Extended models. Performance of the models was assessed by determining calibration (agreement between observed and predicted outcomes), and discrimination (separation of those patients who die from those who survive). Calibration was explored graphically with calibration plots. Discrimination was expressed by the area under the receiver operating characteristic (ROC) curve (AUC). A total of 2513 out of 3125 patients in the BTF database met the inclusion criteria. The 14-day mortality rate was 23%. The models showed excellent calibration. Mean predicted probabilities were 20% for the Core model and 24% for the Extended model. Both models showed good discrimination with AUCs of 0.79 (Core) and 0.83 (Extended). We conclude that the IMPACT models validly predict 14-day mortality in the BTF database, confirming generalizability of these models for outcome prediction in TBI patients.

  3. Brain and Behavior Research Foundation.

    Science.gov (United States)

    ... Stress Disorder View All > Donate DONATE TODAY! > The Brain & Behavior Research Foundation is committed to alleviating the suffering caused ... and breakthroughs in scientific research. Copyright © 2016 the brain & behavior research foundation Privacy Policy Legal Notices and Disclaimers

  4. Operation Brain Trauma Therapy

    Science.gov (United States)

    2014-10-01

    positive reports. However, recent reviews from the field of cancer suggest that often the literature on pre-clinical work is over-inflated –even when...in microglia cells in the brain, although it is also present in macrophages in the peripheral compartments. Importantly Iba-1 is highly up- regulated... ultrastructural analyses were performed. These studies confirmed the diffuse nature of the axonal injury while also confirming that the brain regions assessed

  5. Operation Brain Trauma Therapy

    Science.gov (United States)

    2013-10-01

    investigators. This included resveratrol , N-acetylcysteine, necrostatin, INO-1001, glibenclamide, AER 271, edaravone, melatonin, fluoxetine, amphetamine...significantly ameliorates cortical damage following traumatic brain injury. Exp Neurol. 2000;161:631-637. 34. Sullivan PG, Rabchevsky AG , Hicks RR, et al...Berges L. Dependency of cyclosporine tissue distribution and metabolism on the age and gender of rats after a single intravenous dose. Internat J

  6. Operation Brain Trauma Therapy

    Science.gov (United States)

    2012-10-01

    kg rH  Male Wistar rat  Hemodilution did not  Hemodilution did  HCT to 60 in  2008 (Chopp  group)  IP d1,  d2  and  d3 ; +/‐  isovolemic  hemodilution...Nicotinamide Vitamin B3 has shown dramatic beneficial effects on all aspects of outcome evaluated including function, neuropathology, and blood-brain...with a promising 4 h time window (1). Nicotinamide is commercially available as vitamin B3. It represents an example of an agent that could be readily

  7. Imaging brain plasticity after trauma

    Institute of Scientific and Technical Information of China (English)

    Zhifeng Kou; Armin Iraji

    2014-01-01

    The brain is highly plastic after stroke or epilepsy;however, there is a paucity of brain plasticity investigation after traumatic brain injury (TBI). This mini review summarizes the most recent evidence of brain plasticity in human TBI patients from the perspective of advanced magnetic resonance imaging. Similar to other forms of acquired brain injury, TBI patients also demonstrat-ed both structural reorganization as well as functional compensation by the recruitment of other brain regions. However, the large scale brain network alterations after TBI are still unknown, and the ifeld is still short of proper means on how to guide the choice of TBI rehabilitation or treat-ment plan to promote brain plasticity. The authors also point out the new direction of brain plas-ticity investigation.

  8. Fetal trauma: brain imaging in four neonates

    Energy Technology Data Exchange (ETDEWEB)

    Breysem, Luc; Mussen, E.; Demaerel, P.; Smet, M. [Department of Radiology, University Hospitals, Herestraat 49, 3000, Leuven (Belgium); Cossey, V. [Department of Pediatrics, University Hospitals, Leuven (Belgium); Voorde, W. van de [Department of Forensic Medicine, University Hospitals, Leuven (Belgium)

    2004-09-01

    The purpose of this paper is to describe brain pathology in neonates after major traffic trauma in utero during the third trimester. Our patient cohort consisted of four neonates born by emergency cesarean section after car accident in the third trimester of pregnancy. The median gestational age (n=4) was 36 weeks (range: 30-38). Immediate post-natal and follow-up brain imaging consisted of cranial ultrasound (n=4), computed tomography (CT) (n=1) and post-mortem magnetic resonance imaging (MRI) (n=1). Pathology findings were correlated with the imaging findings (n=3). Cranial ultrasound demonstrated a huge subarachnoidal hemorrhage (n=1), subdural hematoma (n=1), brain edema with inversion of the diastolic flow (n=1) and severe ischemic changes (n=1). In one case, CT demonstrated the presence and extension of the subarachnoidal hemorrhage, a parietal fracture and a limited intraventricular hemorrhage. Cerebellar hemorrhage and a small cerebral frontal contusion were seen on post-mortem MRI in a child with a major subarachnoidal hemorrhage on ultrasound. None of these four children survived (three children died within 2 days and one child died after 1 month). Blunt abdominal trauma during pregnancy can cause fetal cranial injury. In our cases, skull fracture, intracranial hemorrhage and hypoxic-ischemic encephalopathy were encountered. (orig.)

  9. Modeling Pediatric Brain Trauma: Piglet Model of Controlled Cortical Impact.

    Science.gov (United States)

    Pareja, Jennifer C Munoz; Keeley, Kristen; Duhaime, Ann-Christine; Dodge, Carter P

    2016-01-01

    The brain has different responses to traumatic injury as a function of its developmental stage. As a model of injury to the immature brain, the piglet shares numerous similarities in regards to morphology and neurodevelopmental sequence compared to humans. This chapter describes a piglet scaled focal contusion model of traumatic brain injury that accounts for the changes in mass and morphology of the brain as it matures, facilitating the study of age-dependent differences in response to a comparable mechanical trauma.

  10. Can Brain 'Pacemaker' Improve Lives of Head Trauma Patients?

    Science.gov (United States)

    ... 161109.html Can Brain 'Pacemaker' Improve Lives of Head Trauma Patients? Deep brain stimulation appears to boost function and quality of life, small study finds To use the sharing ... that's implanted from the head, under the skin, through the neck and shoulders ...

  11. A review of neuroimaging findings in repetitive brain trauma.

    Science.gov (United States)

    Koerte, Inga K; Lin, Alexander P; Willems, Anna; Muehlmann, Marc; Hufschmidt, Jakob; Coleman, Michael J; Green, Isobel; Liao, Huijun; Tate, David F; Wilde, Elisabeth A; Pasternak, Ofer; Bouix, Sylvain; Rathi, Yogesh; Bigler, Erin D; Stern, Robert A; Shenton, Martha E

    2015-05-01

    Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease confirmed at postmortem. Those at highest risk are professional athletes who participate in contact sports and military personnel who are exposed to repetitive blast events. All neuropathologically confirmed CTE cases, to date, have had a history of repetitive head impacts. This suggests that repetitive head impacts may be necessary for the initiation of the pathogenetic cascade that, in some cases, leads to CTE. Importantly, while all CTE appears to result from repetitive brain trauma, not all repetitive brain trauma results in CTE. Magnetic resonance imaging has great potential for understanding better the underlying mechanisms of repetitive brain trauma. In this review, we provide an overview of advanced imaging techniques currently used to investigate brain anomalies. We also provide an overview of neuroimaging findings in those exposed to repetitive head impacts in the acute/subacute and chronic phase of injury and in more neurodegenerative phases of injury, as well as in military personnel exposed to repetitive head impacts. Finally, we discuss future directions for research that will likely lead to a better understanding of the underlying mechanisms separating those who recover from repetitive brain trauma vs. those who go on to develop CTE.

  12. Brain Metabolic Changes in Rats following Acoustic Trauma

    Science.gov (United States)

    He, Jun; Zhu, Yejin; Aa, Jiye; Smith, Paul F.; De Ridder, Dirk; Wang, Guangji; Zheng, Yiwen

    2017-01-01

    Acoustic trauma is the most common cause of hearing loss and tinnitus in humans. However, the impact of acoustic trauma on system biology is not fully understood. It has been increasingly recognized that tinnitus caused by acoustic trauma is unlikely to be generated by a single pathological source, but rather a complex network of changes involving not only the auditory system but also systems related to memory, emotion and stress. One obvious and significant gap in tinnitus research is a lack of biomarkers that reflect the consequences of this interactive “tinnitus-causing” network. In this study, we made the first attempt to analyse brain metabolic changes in rats following acoustic trauma using metabolomics, as a pilot study prior to directly linking metabolic changes to tinnitus. Metabolites in 12 different brain regions collected from either sham or acoustic trauma animals were profiled using a gas chromatography mass spectrometry (GC/MS)-based metabolomics platform. After deconvolution of mass spectra and identification of the molecules, the metabolomic data were processed using multivariate statistical analysis. Principal component analysis showed that metabolic patterns varied among different brain regions; however, brain regions with similar functions had a similar metabolite composition. Acoustic trauma did not change the metabolite clusters in these regions. When analyzed within each brain region using the orthogonal projection to latent structures discriminant analysis sub-model, 17 molecules showed distinct separation between control and acoustic trauma groups in the auditory cortex, inferior colliculus, superior colliculus, vestibular nucleus complex (VNC), and cerebellum. Further metabolic pathway impact analysis and the enrichment overview with network analysis suggested the primary involvement of amino acid metabolism, including the alanine, aspartate and glutamate metabolic pathways, the arginine and proline metabolic pathways and the purine

  13. The Impact of Childhood Trauma on Brain Development: A Literature Review and Supporting Handouts

    Science.gov (United States)

    Kirouac, Samantha; McBride, Dawn Lorraine

    2009-01-01

    This project provides a comprehensive overview of the research literature on the brain and how trauma impacts brain development, structures, and functioning. A basic exploration of childhood trauma is outlined in this project, as it is essential in making associations and connections to brain development. Childhood trauma is processed in the…

  14. Quantifying Discretization Effects on Brain Trauma Simulations

    Science.gov (United States)

    2016-01-01

    as an official Department of the Army position unless so designated by other authorized documents. Citation of manufacturer’s or trade names does...consisted of software development and production for ARL shadowgraph range data collection. Her primary career and research goals lie in the fields of...human-centered computing with a focus on assisting patients with brain disorders or injuries, including the elderly . Approved for public release

  15. Autopsy Findings of Brainstem in Head Trauma in Comparison with CT Scan Findings in Brain Trauma Ward in Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Shakeri Bavil Moslem

    2009-10-01

    Full Text Available Computed tomography (CT is now the primary diagnostic method for head trauma because of its ability to demonstrate the nature, extent, sites, and multiplicity of brain injuries. Although there have been numerous reports on the CT findings of most types of intracranial injury, the findings in brainstem injury have not been well described. This study aimed at comparing the autopsy findings of brainstem in head trauma in comparison with CT scan results. Two hundred patients with head trauma, who expired after a period of time of hospitalization, were assessed in a diagnostic value study. Brain stem involvement was determined by autopsy as well as CT scanning of the brain during their hospitalization. The results of the two methods were compared with each other, emphasizing on the type and location of probable lesions in the brain stem. Considering the autopsy as the method of the choice, sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of CT scan in brain stem lesions of patients with head trauma were calculated. The effect of primary cause of head trauma, survival time and Glasgow Coma Scale (GCS were evaluated, as well. Brain stem lesions were detected in 39 (19.5% patients in autopsy. However, CT scan revealed brain stem lesions in 23(11.5% cases. The sensitivity, specificity, PPV and NPV of CT scan was 59%, 100%, 100% and 91% respectively. The most common lesions of the brain stem region were as contusion of pons (8.5%, medulla (5% and midbrain (4.5%. There were 6 (3% cases of ponto-medullary junction tearing and 1 (0.5% case of cervico-medullary junction tearing. CT scan is a specific method of evaluating patients with probable brain stem injuries after head trauma, but low sensitivity limits its efficacy. Our results are in conformity with the reports in the literature.

  16. Subacute posttraumatic complaints and psychological distress in trauma patients with or without mild traumatic brain injury

    NARCIS (Netherlands)

    de Koning, M. E.; Gareb, Barzi; El Moumni, M.; Scheenen, M. E.; van der Horn, H. J.; Timmerman, M. E.; Spikman, J. M.; van der Naalt, J.

    2016-01-01

    Objective: To identify the frequency, nature and profile of complaints for trauma patients with and without mild traumatic brain injury (mTBI), and to assess their relation to anxiety and depression. Methods: A prospective cohort study in a level-one trauma centre was conducted. Mild traumatic brain

  17. Lactate storm marks cerebral metabolism following brain trauma.

    Science.gov (United States)

    Lama, Sanju; Auer, Roland N; Tyson, Randy; Gallagher, Clare N; Tomanek, Boguslaw; Sutherland, Garnette R

    2014-07-18

    Brain metabolism is thought to be maintained by neuronal-glial metabolic coupling. Glia take up glutamate from the synaptic cleft for conversion into glutamine, triggering glial glycolysis and lactate production. This lactate is shuttled into neurons and further metabolized. The origin and role of lactate in severe traumatic brain injury (TBI) remains controversial. Using a modified weight drop model of severe TBI and magnetic resonance (MR) spectroscopy with infusion of (13)C-labeled glucose, lactate, and acetate, the present study investigated the possibility that neuronal-glial metabolism is uncoupled following severe TBI. Histopathology of the model showed severe brain injury with subarachnoid and hemorrhage together with glial cell activation and positive staining for Tau at 90 min post-trauma. High resolution MR spectroscopy of brain metabolites revealed significant labeling of lactate at C-3 and C-2 irrespective of the infused substrates. Increased (13)C-labeled lactate in all study groups in the absence of ischemia implied activated astrocytic glycolysis and production of lactate with failure of neuronal uptake (i.e. a loss of glial sensing for glutamate). The early increase in extracellular lactate in severe TBI with the injured neurons rendered unable to pick it up probably contributes to a rapid progression toward irreversible injury and pan-necrosis. Hence, a method to detect and scavenge the excess extracellular lactate on site or early following severe TBI may be a potential primary therapeutic measure.

  18. Foundational perspectives on causality in large-scale brain networks.

    Science.gov (United States)

    Mannino, Michael; Bressler, Steven L

    2015-12-01

    likelihood that a change in the activity of one neuronal population affects the activity in another. We argue that these measures access the inherently probabilistic nature of causal influences in the brain, and are thus better suited for large-scale brain network analysis than are DC-based measures. Our work is consistent with recent advances in the philosophical study of probabilistic causality, which originated from inherent conceptual problems with deterministic regularity theories. It also resonates with concepts of stochasticity that were involved in establishing modern physics. In summary, we argue that probabilistic causality is a conceptually appropriate foundation for describing neural causality in the brain.

  19. Foundational perspectives on causality in large-scale brain networks

    Science.gov (United States)

    Mannino, Michael; Bressler, Steven L.

    2015-12-01

    likelihood that a change in the activity of one neuronal population affects the activity in another. We argue that these measures access the inherently probabilistic nature of causal influences in the brain, and are thus better suited for large-scale brain network analysis than are DC-based measures. Our work is consistent with recent advances in the philosophical study of probabilistic causality, which originated from inherent conceptual problems with deterministic regularity theories. It also resonates with concepts of stochasticity that were involved in establishing modern physics. In summary, we argue that probabilistic causality is a conceptually appropriate foundation for describing neural causality in the brain.

  20. Standard large trauma craniotomy for severe traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    L(U) Li-quan 吕立权; JIANG Ji-yao 江基尧; YU Ming-kun 于明琨; HOU Li-jun 侯立军; CHEN Zhi-gang 陈志刚; ZHANG Guang-ji 张光霁; ZHU Cheng 朱诚

    2003-01-01

    Objective: To study the effect of standard large trauma craniotomy(SLTC) on outcomes of patients with severe traumatic brain injury (TBI) (GCS≤8).Methods: 230 patients with severe TBI were randomly divided into two groups.115 patients underwent SLTC (10 cm×12 cm) as an SLTC group, and other 115 patients underwent temporo-parietal or fronto-temporal craniotomy (6 cm×8 cm) according to the position of hematomas as a routine craniotomy (RC) group.Other treatments were identical in two groups.According to Glasgow outcome scale (GOS), the prognosis of the patients was evaluated and the complications were compared between two groups.Results: 27 patients got good outcome and moderate disability (23.5%), 40 severe disability and vegetative survival (34.8%), and 48 died (41.7%) in SLTC group.21 patients got good outcome and moderate disability (18.3%), 28 severe disability and vegetative survival (24.3%), and 66 died (57.4%) in RC group.The incidence of incision hernia was lower in SLTC group than in RC group.However, the incidence of operative encephalocele, traumatic epilepsy and intracranial infection were not different in two groups.Conclusions: Standard large trauma craniotomy significantly reduces the mortality of patients with severe TBI without serious complications, but does not improve the life quality of the patients.

  1. Early maladaptive schemas in adult survivors of interpersonal trauma: foundations for a cognitive theory of psychopathology

    OpenAIRE

    Karatzias,Thanos; Jowett, Sally; Begley, Amelie; Deas, Suzanne

    2016-01-01

    Background Although the association between psychological trauma and early maladaptive schemas (EMS) is well established in the literature, no study to date has examined the relationship of EMS to PTSD and psychopathologies beyond depression and anxiety in a sample of adult survivors of interpersonal trauma. This information may be useful in helping our understanding on how to best treat interpersonal trauma. Objective We set out to investigate the association between EMS and common forms of ...

  2. Early maladaptive schemas in adult survivors of interpersonal trauma: foundations for a cognitive theory of psychopathology

    Science.gov (United States)

    Karatzias, Thanos; Jowett, Sally; Begley, Amelie; Deas, Suzanne

    2016-01-01

    Background Although the association between psychological trauma and early maladaptive schemas (EMS) is well established in the literature, no study to date has examined the relationship of EMS to PTSD and psychopathologies beyond depression and anxiety in a sample of adult survivors of interpersonal trauma. This information may be useful in helping our understanding on how to best treat interpersonal trauma. Objective We set out to investigate the association between EMS and common forms of psychopathology in a sample of women with a history of interpersonal trauma (n=82). We have hypothesised that survivors of interpersonal trauma will present with elevated EMS scores compared to a non-clinical control group (n=78). We have also hypothesised that unique schemas will be associated with unique psychopathological entities and that subgroups of interpersonal trauma survivors would be present in our sample, with subgroups displaying different profiles of schema severity elevations. Method Participants completed measures of trauma, psychopathology, dissociation, self-esteem, and the Young Schema Questionnaire. Results It was found that survivors of interpersonal trauma displayed elevated EMS scores across all 15 schemas compared to controls. Although the pattern of associations between different psychopathological features and schemas appears to be rather complex, schemas in the domains of Disconnection and Impaired Autonomy formed significant associations with all psychopathological features in this study. Conclusions Our findings support the usefulness of cognitive behavioural interventions that target schemas in the domains of Disconnection and Impaired Autonomy in an effort to modify existing core beliefs and decrease subsequent symptomatology in adult survivors of interpersonal trauma. Highlights of the article Interpersonal trauma survivors are distinguished primarily by a generalised elevation of their maladaptive schemas, rather than a unique schema profile

  3. Interpersonal violence in posttraumatic women: brain networks triggered by trauma-related pictures.

    Science.gov (United States)

    Neumeister, Paula; Feldker, Katharina; Heitmann, Carina Y; Helmich, Ruth; Gathmann, Bettina; Becker, Michael P I; Straube, Thomas

    2016-12-20

    Interpersonal violence (IPV) is one of the most frequent causes for the development of posttraumatic stress disorder (PTSD) in women. Trauma-related triggers have been proposed to evoke automatic emotional responses in PTSD. The present functional magnetic resonance study investigated the neural basis of trauma-related picture processing in women with IPV-PTSD (n = 18) relative to healthy controls (n = 18) using a newly standardized trauma-related picture set and a non-emotional vigilance task. We aimed to identify brain activation and connectivity evoked by trauma-related pictures, and associations with PTSD symptom severity. We found hyperactivation during trauma-related vs neutral picture processing in both subcortical [basolateral amygdala (BLA), thalamus, brainstem] and cortical [anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), insula, occipital cortex] regions in IPV-PTSD. In patients, brain activation in amygdala, ACC, insula, occipital cortex and brainstem correlated positively with symptom severity. Furthermore, connectivity analyses revealed hyperconnectivity between BLA and dorsal ACC/mPFC. Results show symptom severity-dependent brain activation and hyperconnectivity in response to trauma-related pictures in brain regions related to fear and visual processing in women suffering from IPV-PTSD. These brain mechanisms appear to be associated with immediate responses to trauma-related triggers presented in a non-emotional context in this PTSD subgroup.

  4. Early maladaptive schemas in adult survivors of interpersonal trauma: foundations for a cognitive theory of psychopathology

    Directory of Open Access Journals (Sweden)

    Thanos Karatzias

    2016-09-01

    Full Text Available Background: Although the association between psychological trauma and early maladaptive schemas (EMS is well established in the literature, no study to date has examined the relationship of EMS to PTSD and psychopathologies beyond depression and anxiety in a sample of adult survivors of interpersonal trauma. This information may be useful in helping our understanding on how to best treat interpersonal trauma. Objective: We set out to investigate the association between EMS and common forms of psychopathology in a sample of women with a history of interpersonal trauma (n=82. We have hypothesised that survivors of interpersonal trauma will present with elevated EMS scores compared to a non-clinical control group (n=78. We have also hypothesised that unique schemas will be associated with unique psychopathological entities and that subgroups of interpersonal trauma survivors would be present in our sample, with subgroups displaying different profiles of schema severity elevations. Method: Participants completed measures of trauma, psychopathology, dissociation, self-esteem, and the Young Schema Questionnaire. Results: It was found that survivors of interpersonal trauma displayed elevated EMS scores across all 15 schemas compared to controls. Although the pattern of associations between different psychopathological features and schemas appears to be rather complex, schemas in the domains of Disconnection and Impaired Autonomy formed significant associations with all psychopathological features in this study. Conclusions: Our findings support the usefulness of cognitive behavioural interventions that target schemas in the domains of Disconnection and Impaired Autonomy in an effort to modify existing core beliefs and decrease subsequent symptomatology in adult survivors of interpersonal trauma.

  5. Influence of age on brain edema formation, secondary brain damage and inflammatory response after brain trauma in mice.

    Directory of Open Access Journals (Sweden)

    Ralph Timaru-Kast

    Full Text Available After traumatic brain injury (TBI elderly patients suffer from higher mortality rate and worse functional outcome compared to young patients. However, experimental TBI research is primarily performed in young animals. Aim of the present study was to clarify whether age affects functional outcome, neuroinflammation and secondary brain damage after brain trauma in mice. Young (2 months and old (21 months male C57Bl6N mice were anesthetized and subjected to a controlled cortical impact injury (CCI on the right parietal cortex. Animals of both ages were randomly assigned to 15 min, 24 h, and 72 h survival. At the end of the observation periods, contusion volume, brain water content, neurologic function, cerebral and systemic inflammation (CD3+ T cell migration, inflammatory cytokine expression in brain and lung, blood differential cell count were determined. Old animals showed worse neurological function 72 h after CCI and a high mortality rate (19.2% compared to young (0%. This did not correlate with histopathological damage, as contusion volumes were equal in both age groups. Although a more pronounced brain edema formation was detected in old mice 24 hours after TBI, lack of correlation between brain water content and neurological deficit indicated that brain edema formation is not solely responsible for age-dependent differences in neurological outcome. Brains of old naïve mice were about 8% smaller compared to young naïve brains, suggesting age-related brain atrophy with possible decline in plasticity. Onset of cerebral inflammation started earlier and primarily ipsilateral to damage in old mice, whereas in young mice inflammation was delayed and present in both hemispheres with a characteristic T cell migration pattern. Pulmonary interleukin 1β expression was up-regulated after cerebral injury only in young, not aged mice. The results therefore indicate that old animals are prone to functional deficits and strong ipsilateral cerebral

  6. A case report of diffuse pneumocephalus induced by sneezing after brain trauma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yun-xu; LIU long-xi; QIU Xiao-zhong

    2013-01-01

    Pneumocephalus is the presence of air in the cranial vault.The common etiologies of pneumocephalus are brain trauma and cranial surgery.We report a case of a 26-year-old man with brain trauma who developed diffuse pneumocephalus after sneezing.CT scan was performed on arrival,and the image showed subarachnoid hemorrhage without pneumocephalus.On the seventh day after a big sneeze brain CT scan was re-performed,which showed pneumocephalus.After another ten days of treatment,the patient was discharged without any symptoms.

  7. Targeting Epigenetic Mechanisms in Pain Due to Trauma and Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2015-10-01

    Pain  ( nociceptive ) sensitization was followed using the von Frey method. Those measures were continued until  the resolution of sensitization. We...AWARD NUMBER: W81XWH-14-1-0579 TITLE: Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury (TBI) PRINCIPAL...SUBTITLE Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury (TBI) 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0579 5c

  8. Rebooting the Brain: Using Early Childhood Education to Heal Trauma from Abuse and Neglect

    Science.gov (United States)

    McLintock, Ben

    2011-01-01

    Abused and neglected children live in a world that usually includes some sort of violence, chaos, and tremendous physical and mental stress. This toxic environment wreaks havoc on a child's developing brain. This article discusses how to use early childhood education to heal trauma from abuse and neglect. It shares the story of two children, Bryce…

  9. Micronized progesterone as a neuroprotector in pregnant women with post-trauma brain syndrome

    OpenAIRE

    2014-01-01

    The present article is concerned with the study of glial fibrillary acidic protein (GFAP) level in the blood serum of pregnant women  with post–trauma brain injury syndrome (post-TBI syndrome) as the marker of  hematoencephalic barrier status and predictor of obstetric and perinatal complications development.

  10. Micronized progesterone as a neuroprotector in pregnant women with post-trauma brain syndrome

    Directory of Open Access Journals (Sweden)

    Irina Vasilivna Tsyganenko

    2014-05-01

    Full Text Available The present article is concerned with the study of glial fibrillary acidic protein (GFAP level in the blood serum of pregnant women  with post–trauma brain injury syndrome (post-TBI syndrome as the marker of  hematoencephalic barrier status and predictor of obstetric and perinatal complications development.

  11. Foundation for PSP/CBD and Related Brain Diseases

    Science.gov (United States)

    Donate I want to learn Overview Progressive Supranuclear Palsy (PSP) Prime of life brain diseases FAQ About Our Research Research Initiatives Investigator Resources Healthcare Professional Resources I need Support Overview Personal ...

  12. Paradoxical effects of brain death and associated trauma on rat mesenteric microcirculation: an intravital microscopic study

    Directory of Open Access Journals (Sweden)

    Rafael Simas

    2012-01-01

    Full Text Available OBJECTIVE: Experimental findings support clinical evidence that brain death impairs the viability of organs for transplantation, triggering hemodynamic, hormonal, and inflammatory responses. However, several of these events could be consequences of brain death-associated trauma. This study investigated microcirculatory alterations and systemic inflammatory markers in brain-dead rats and the influence of the associated trauma. METHOD: Brain death was induced using intracranial balloon inflation; sham-operated rats were trepanned only. After 30 or 180 min, the mesenteric microcirculation was observed using intravital microscopy. The expression of Pselectin and ICAM-1 on the endothelium was evaluated using immunohistochemistry. The serum cytokine, chemokine, and corticosterone levels were quantified using enzyme-linked immunosorbent assays. White blood cell counts were also determined. RESULTS: Brain death resulted in a decrease in the mesenteric perfusion to 30%, a 2.6-fold increase in the expression of ICAM-1 and leukocyte migration at the mesentery, a 70% reduction in the serum corticosterone level and pronounced leukopenia. Similar increases in the cytokine and chemokine levels were seen in the both the experimental and control animals. CONCLUSION: The data presented in this study suggest that brain death itself induces hypoperfusion in the mesenteric microcirculation that is associated with a pronounced reduction in the endogenous corticosterone level, thereby leading to increased local inflammation and organ dysfunction. These events are paradoxically associated with induced leukopenia after brain damage

  13. Long-Term Attention Problems After Brain Trauma

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-07-01

    Full Text Available Parent ratings of attention problems were obtained at long-term follow-up (average 4 years after traumatic brain injury (TBI and compared with ratings of premorbid attention problems shortly after injury, in a study of 132 children (ages 6-12 years at the Ohio State University and Columbus Children's Research Institute and other centers.

  14. Curing "moral disability": brain trauma and self-control in Victorian science and fiction.

    Science.gov (United States)

    Schillace, Brandy L

    2013-12-01

    While, historically, the disabled body has appeared in literature as "monstrous," burgeoning psychological theories of the Victorian period predicated an unusual shift. In a culture of sexual anxiety and fears of devolution and moral decay, the physically disabled and "weak" are portrayed as strangely free from moral corruption. Unlike the cultural link between deviance and disability witnessed in the medical literature and eugenic approach to generation, authors of narrative fiction-particularly Charles Dickens, but Wilkie Collins, Charlotte Yonge, and others as well-portray disabled characters as "purified," and trauma itself as potentially sanitizing. This present paper argues that such constructions were made possible by developments in the treatment of insanity. "Curing 'Moral Disability': Brain Trauma and Self-Control in Victorian Fiction," examines the concept of trauma-as-cure. Throughout the Victorian period, case studies on brain trauma appeared in widely circulated journals like the Lancet, concurrently with burgeoning theories about psychological disturbance and "moral insanity." While not widely practiced until the early twentieth century, attempts at surgical "cures" aroused curiosity and speculation-the traumatic event that could free sufferers from deviance. This work provides a unique perspective on representations of disability as cure in the nineteenth century as a means of giving voice to the marginalized, disabled, and disempowered.

  15. Objective and Personalized Longitudinal Assessment of a Pregnant Patient with Post Severe Brain Trauma

    Directory of Open Access Journals (Sweden)

    Elizabeth B Torres

    2015-03-01

    Full Text Available Background: Following severe trauma to the brain (whether internally generated by seizures, tumors or externally caused by collision with or penetration of objects individuals may experience initial coma state followed by slow recovery and rehabilitation treatment. At present there is no objective biometric to track the daily progression of the person for extended periods of time.Objective: We introduce new analytical techniques to process data from physically wearable sensors and help track the longitudinal progression of motions and physiological states upon the brain trauma. Settings and Participant: The data used to illustrate the methods were collected at the hospital settings from a pregnant patient in coma state. The patient had brain trauma from a large debilitating seizure due to a large tumor in the right pre-frontal lobe.Main Measures: We registered the wrist motions and the surface-skin-temperature across several daily sessions in four consecutive months. A new statistical technique is introduced for personalized analyses of the rates of change of the stochastic signatures of these patterns.Results: We detected asymmetries in the wrists’ data that identified in the dominant limb critical points of change in physiological and motor control states. These patterns could blindly identify the time preceding the baby’s delivery by C-section when the patient systematically brought her dominant hand to her abdominal area. Changes in temperature were sharp and accompanied by systematic changes in the statistics of the motions that rendered her dominant wrist’s micro-movements more systematically reliable and predictable than those of the non-dominant wrist.Conclusions: The new analytics paired with wearable sensing technology may help track the day-by-day individual progression of a patient with post brain trauma in clinical settings and in the home environment.

  16. MR tomography after head and brain trauma: Comparison with CT, EEG and neurological examination

    Energy Technology Data Exchange (ETDEWEB)

    Dewes, W.; Moskopp, D.; Kurthen, M.; Solymosi, L.; Harder, T.; Kersting, G.

    1989-03-01

    56 patients with head and brain trauma and in coma were studied prospectively by means of MRT, CT, EEG and neurological examination. All patients had initial CT and EEG admission. MRT showed that in our patients morphological return to normal was the exception. Patients with head and brain injuries should be examined by MRT during the course of their illness. The use of special sequences, such as gradient-echo sequences for the diagnosis of haemorrhagic contusions, is indicated. CT should be retained for evaluating bone injury and cerebral damage during the acute stage.

  17. Effects of HIV and childhood trauma on brain morphometry and neurocognitive function.

    Science.gov (United States)

    Spies, Georgina; Ahmed-Leitao, Fatima; Fennema-Notestine, Christine; Cherner, Mariana; Seedat, Soraya

    2016-04-01

    A wide spectrum of neurocognitive deficits characterises HIV infection in adults. HIV infection is additionally associated with morphological brain abnormalities affecting neural substrates that subserve neurocognitive function. Early life stress (ELS) also has a direct influence on brain morphology. However, the combined impact of ELS and HIV on brain structure and neurocognitive function has not been examined in an all-female sample with advanced HIV disease. The present study examined the effects of HIV and childhood trauma on brain morphometry and neurocognitive function. Structural data were acquired using a 3T Magnetom MRI scanner, and a battery of neurocognitive tests was administered to 124 women: HIV-positive with ELS (n = 32), HIV-positive without ELS (n = 30), HIV-negative with ELS (n = 31) and HIV-negative without ELS (n = 31). Results revealed significant group volumetric differences for right anterior cingulate cortex (ACC), bilateral hippocampi, corpus callosum, left and right caudate and left and right putamen. Mean regional volumes were lowest in HIV-positive women with ELS compared to all other groups. Although causality cannot be inferred, findings also suggest that alterations in the left frontal lobe, right ACC, left hippocampus, corpus callosum, left and right amygdala and left caudate may be associated with poorer neurocognitive performance in the domains of processing speed, attention/working memory, abstraction/executive functions, motor skills, learning and language/fluency with these effects more pronounced in women living with both HIV and childhood trauma. This study highlights the potential contributory role of childhood trauma to brain alterations and neurocognitive decline in HIV-infected individuals.

  18. Oral Administration of Sitagliptin Activates CREB and Is Neuroprotective in Murine Model of Brain Trauma

    DEFF Research Database (Denmark)

    DellaValle, Brian; Brix, Gitte S; Brock, Birgitte

    2016-01-01

    for immunoblotting for assessment of selected biomarkers for pathology and protection. Results: Sitagliptin treatment reduced lesion size at day 2 post-injury by ~28% (p ... in the effects of oral treatment of a different class of GLP-1 based therapy, dipeptidyl peptidase IV (DPP-IV) inhibition on mice after TBI. DPP-IV inhibitors reduce the degradation of endogenous GLP-1 and extend circulation of this protective peptide in the bloodstream. This class has yet to be investigated...... as a potential therapy for TBI. Methods: Mice were administrated once-daily 50 mg/kg of sitagliptin in a Nutella® ball or Nutella® alone throughout the study, beginning 2 days before severe trauma was induced with a stereotactic cryo-lesion. At 2 days post trauma, lesion size was determined. Brains were isolated...

  19. Spreading depolarizations have prolonged direct current shifts and are associated with poor outcome in brain trauma

    DEFF Research Database (Denmark)

    Hartings, Jed A; Watanabe, Tomas; Bullock, M Ross

    2011-01-01

    Cortical spreading depolarizations occur spontaneously after ischaemic, haemorrhagic and traumatic brain injury. Their effects vary spatially and temporally as graded phenomena, from infarction to complete recovery, and are reflected in the duration of depolarization measured by the negative direct...... current shift of electrocorticographic recordings. In the focal ischaemic penumbra, peri-infarct depolarizations have prolonged direct current shifts and cause progressive recruitment of the penumbra into the core infarct. In traumatic brain injury, the effects of spreading depolarizations are unknown......, although prolonged events have not been observed in animal models. To determine whether detrimental penumbral-type depolarizations occur in human brain trauma, we analysed electrocorticographic recordings obtained by subdural electrode-strip monitoring during intensive care. Of 53 patients studied, 10...

  20. Oral administration of sitagliptin activates CREB and is neuroprotective in murine model of brain trauma

    Directory of Open Access Journals (Sweden)

    Brian Dellavalle

    2016-12-01

    Full Text Available Introduction: Traumatic brain injury is a major cause of mortality and morbidity. We have previously shown that the injectable glucagon-like peptide-1 (GLP-1 analogue, liraglutide, significantly improved the outcome in mice after severe traumatic brain injury (TBI. In this study we are interested in the effects of oral treatment of a different class of GLP-1 based therapy, dipeptidyl peptidase IV (DPP-IV inhibition on mice after TBI. DPP-IV inhibitors reduce the degradation of endogenous GLP-1 and extend circulation of this protective peptide in the bloodstream. This class has yet to be investigated as a potential therapy for TBI. Methods: Mice were administrated once-daily 50 mg/kg of sitagliptin in a Nutella® ball or Nutella® alone throughout the study, beginning two days before severe trauma was induced with a stereotactic cryo-lesion. At two days post trauma, lesion size was determined. Brains were isolated for immunoblotting for assessment of selected biomarkers for pathology and protection.Results: Sitagliptin treatment reduced lesion size at day 2 post-injury by ~28% (p0.05. Conversely, apoptotic tone (alpha-spectrin fragmentation, Bcl-2 levels and the neuroinflammatory markers IL-6, and Iba-1 were not affected by treatment.Conclusions: This study shows, for the first time, that DPP-IV inhibition ameliorates both anatomical and biochemical consequences of TBI and activates CREB in the brain. Moreover, this work supports previous studies suggesting that the effect of GLP-1 analogues in models of brain damage relates to GLP-1 receptor stimulation in a dose-dependent manner.Keywords: GLP-1, Traumatic Brain Injury, TBI, sitagliptin, liraglutide, CREB, Oxidative Stress, GIP, DPP-IV, DPP-4

  1. Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Kadom, Nadja [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Boston University Medical Center, Boston, MA (United States); Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Rice, Amy [Independent Consultant (Biostatistics), Chevy Chase, MD (United States); Hinds, Tanya [Children' s National Medical Center, Child and Adolescent Protection Center, Washington, DC (United States)

    2014-07-15

    In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

  2. Noise Trauma Induced Plastic Changes in Brain Regions outside the Classical Auditory Pathway

    Science.gov (United States)

    Chen, Guang-Di; Sheppard, Adam; Salvi, Richard

    2017-01-01

    The effects of intense noise exposure on the classical auditory pathway have been extensively investigated; however, little is known about the effects of noise-induced hearing loss on non-classical auditory areas in the brain such as the lateral amygdala (LA) and striatum (Str). To address this issue, we compared the noise-induced changes in spontaneous and tone-evoked responses from multiunit clusters (MUC) in the LA and Str with those seen in auditory cortex (AC). High-frequency octave band noise (10–20 kHz) and narrow band noise (16–20 kHz) induced permanent thresho ld shifts (PTS) at high-frequencies within and above the noise band but not at low frequencies. While the noise trauma significantly elevated spontaneous discharge rate (SR) in the AC, SRs in the LA and Str were only slightly increased across all frequencies. The high-frequency noise trauma affected tone-evoked firing rates in frequency and time dependent manner and the changes appeared to be related to severity of noise trauma. In the LA, tone-evoked firing rates were reduced at the high-frequencies (trauma area) whereas firing rates were enhanced at the low-frequencies or at the edge-frequency dependent on severity of hearing loss at the high frequencies. The firing rate temporal profile changed from a broad plateau to one sharp, delayed peak. In the AC, tone-evoked firing rates were depressed at high frequencies and enhanced at the low frequencies while the firing rate temporal profiles became substantially broader. In contrast, firing rates in the Str were generally decreased and firing rate temporal profiles become more phasic and less prolonged. The altered firing rate and pattern at low frequencies induced by high frequency hearing loss could have perceptual consequences. The tone-evoked hyperactivity in low-frequency MUC could manifest as hyperacusis whereas the discharge pattern changes could affect temporal resolution and integration. PMID:26701290

  3. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration.

    Science.gov (United States)

    Morley, Wendy A; Seneff, Stephanie

    2014-01-01

    The number of sports-related concussions has been steadily rising in recent years. Diminished brain resilience syndrome is a term coined by the lead author to describe a particular physiological state of nutrient functional deficiency and disrupted homeostatic mechanisms leading to increased susceptibility to previously considered innocuous concussion. We discuss how modern day environmental toxicant exposure, along with major changes in our food supply and lifestyle practices, profoundly reduce the bioavailability of neuro-critical nutrients such that the normal processes of homeostatic balance and resilience are no longer functional. Their diminished capacity triggers physiological and biochemical 'work around' processes that result in undesirable downstream consequences. Exposure to certain environmental chemicals, particularly glyphosate, the active ingredient in the herbicide, Roundup(®), may disrupt the body's innate switching mechanism, which normally turns off the immune response to brain injury once danger has been removed. Deficiencies in serotonin, due to disruption of the shikimate pathway, may lead to impaired melatonin supply, which reduces the resiliency of the brain through reduced antioxidant capacity and alterations in the cerebrospinal fluid, reducing critical protective buffering mechanisms in impact trauma. Depletion of certain rare minerals, overuse of sunscreen and/or overprotection from sun exposure, as well as overindulgence in heavily processed, nutrient deficient foods, further compromise the brain's resilience. Modifications to lifestyle practices, if widely implemented, could significantly reduce this trend of neurological damage.

  4. Oral Administration of Sitagliptin Activates CREB and Is Neuroprotective in Murine Model of Brain Trauma.

    Science.gov (United States)

    DellaValle, Brian; Brix, Gitte S; Brock, Birgitte; Gejl, Michael; Rungby, Jørgen; Larsen, Agnete

    2016-01-01

    Introduction: Traumatic brain injury is a major cause of mortality and morbidity. We have previously shown that the injectable glucagon-like peptide-1 (GLP-1) analog, liraglutide, significantly improved the outcome in mice after severe traumatic brain injury (TBI). In this study we are interested in the effects of oral treatment of a different class of GLP-1 based therapy, dipeptidyl peptidase IV (DPP-IV) inhibition on mice after TBI. DPP-IV inhibitors reduce the degradation of endogenous GLP-1 and extend circulation of this protective peptide in the bloodstream. This class has yet to be investigated as a potential therapy for TBI. Methods: Mice were administrated once-daily 50 mg/kg of sitagliptin in a Nutella® ball or Nutella® alone throughout the study, beginning 2 days before severe trauma was induced with a stereotactic cryo-lesion. At 2 days post trauma, lesion size was determined. Brains were isolated for immunoblotting for assessment of selected biomarkers for pathology and protection. Results: Sitagliptin treatment reduced lesion size at day 2 post-injury by ~28% (p < 0.05). Calpain-driven necrotic tone was reduced ~2-fold in sitagliptin-treated brains (p < 0.001) and activation of the protective cAMP-response element binding protein (CREB) system was significantly more pronounced (~1.5-fold, p < 0.05). The CREB-regulated, mitochondrial antioxidant protein manganese superoxide dismutase (MnSOD) was increased in sitagliptin-treated mice (p < 0.05). Conversely, apoptotic tone (alpha-spectrin fragmentation, Bcl-2 levels) and the neuroinflammatory markers IL-6, and Iba-1 were not affected by treatment. Conclusions: This study shows, for the first time, that DPP-IV inhibition ameliorates both anatomical and biochemical consequences of TBI and activates CREB in the brain. Moreover, this work supports previous studies suggesting that the effect of GLP-1 analogs in models of brain damage relates to GLP-1 receptor stimulation in a dose-dependent manner.

  5. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration

    Directory of Open Access Journals (Sweden)

    Wendy A Morley

    2014-01-01

    Full Text Available The number of sports-related concussions has been steadily rising in recent years. Diminished brain resilience syndrome is a term coined by the lead author to describe a particular physiological state of nutrient functional deficiency and disrupted homeostatic mechanisms leading to increased susceptibility to previously considered innocuous concussion. We discuss how modern day environmental toxicant exposure, along with major changes in our food supply and lifestyle practices, profoundly reduce the bioavailability of neuro-critical nutrients such that the normal processes of homeostatic balance and resilience are no longer functional. Their diminished capacity triggers physiological and biochemical ′work around′ processes that result in undesirable downstream consequences. Exposure to certain environmental chemicals, particularly glyphosate, the active ingredient in the herbicide, Roundup; , may disrupt the body′s innate switching mechanism, which normally turns off the immune response to brain injury once danger has been removed. Deficiencies in serotonin, due to disruption of the shikimate pathway, may lead to impaired melatonin supply, which reduces the resiliency of the brain through reduced antioxidant capacity and alterations in the cerebrospinal fluid, reducing critical protective buffering mechanisms in impact trauma. Depletion of certain rare minerals, overuse of sunscreen and/or overprotection from sun exposure, as well as overindulgence in heavily processed, nutrient deficient foods, further compromise the brain′s resilience. Modifications to lifestyle practices, if widely implemented, could significantly reduce this trend of neurological damage.

  6. Relational trauma and the developing right brain: an interface of psychoanalytic self psychology and neuroscience.

    Science.gov (United States)

    Schore, Allan N

    2009-04-01

    Psychoanalysis, the science of unconscious processes, has recently undergone a significant transformation. Self psychology, derived from the work of Heinz Kohut, represents perhaps the most important revision of Freud's theory as it has shifted its basic core concepts from an intrapsychic to a relational unconscious and from a cognitive ego to an emotion-processing self. As a result of a common interest in the essential, rapid, bodily based, affective processes that lie beneath conscious awareness, a productive dialogue is now occurring between psychoanalysis and neuroscience. Here I apply this interdisciplinary perspective to a deeper understanding of the nonconscious brain/mind/body mechanisms that lie at the core of self psychology. I offer a neuropsychoanalytic conception of the development and structuralization of the self, focusing on the experience-dependent maturation of the emotion-processing right brain in infancy. I then articulate an interdisciplinary model of attachment trauma and pathological dissociation, an early forming defense against overwhelming affect that is a cardinal feature of self-psychopathologies. I end with some thoughts on the mechanism of the psychotherapeutic change process and suggest that self psychology is, in essence, a psychology of the unique functions of the right brain and that a rapprochement between psychoanalysis and neuroscience is now at hand.

  7. Neck Flexion Induces Larger Deformation of the Brain Than Extension at a Rotational Acceleration, Closed Head Trauma

    Directory of Open Access Journals (Sweden)

    Hans-Arne Hansson

    2014-01-01

    Full Text Available A closed head trauma induces incompletely characterized temporary movement and deformation of the brain, contributing to the primary traumatic brain injury. We used the pressure patterns recorded with light-operated miniature sensors in anaesthetized adult rabbits exposed to a sagittal plane rotational acceleration of the head, lasting 1 ms, as a measure of brain deformation. Two exposure levels were used and scaled to correspond to force levels reported to cause mild and moderate diffuse injury in an adult man, respectively. Flexion induced transient, strong, extended, and predominantly negative pressures while extension generated a short positive pressure peak followed by a minor negative peak. Low level flexion caused as strong, extended negative pressures as did high level extension. Time differences were demonstrated between the deformation of the cerebrum, brainstem, and cerebellum. Available X-ray and MRI techniques do not have as high time resolution as pressure recordings in demonstrating complex, sequential compression and stretching of the brain during a trauma. The exposure to flexion caused more protracted and extensive deformation of the brain than extension, in agreement with a published histopathological report. The severity and extent of the brain deformation generated at a head trauma thus related to the direction at equal force.

  8. Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI)

    DEFF Research Database (Denmark)

    Maas, Andrew I R; Menon, David K; Steyerberg, Ewout W

    2015-01-01

    BACKGROUND: Current classification of traumatic brain injury (TBI) is suboptimal, and management is based on weak evidence, with little attempt to personalize treatment. A need exists for new precision medicine and stratified management approaches that incorporate emerging technologies. OBJECTIVE......: To improve characterization and classification of TBI and to identify best clinical care, using comparative effectiveness research approaches. METHODS: This multicenter, longitudinal, prospective, observational study in 22 countries across Europe and Israel will collect detailed data from 5400 consenting...... in process and clinical care. Results will be integrated with living systematic reviews in a process of knowledge transfer. The study initiation was from October to December 2014, and the recruitment period was for 18 to 24 months. EXPECTED OUTCOMES: Collaborative European NeuroTrauma Effectiveness Research...

  9. Relationship between trauma-induced coagulopathy and progressive hemorrhagic injury in patients with traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Jia Liu; Heng-Li Tian

    2016-01-01

    Progressive hemorrhagic injury (PHI) can be divided into coagulopathy-related PHI and normal coagulation PHI.Coagulation disorders after traumatic brain injuries can be included in trauma-induced coagulopathy (TIC).Some studies showed that TIC is associated with PHI and increases the rates of disability and mortality.In this review,we discussed some mechanisms in TIC,which is of great importance in the development of PHI,including tissue factor (TF) hypothesis,protein C pathway and thrombocytopenia.The main mechanism in the relation of TIC to PHI is hypocoagulability.We also reviewed some coagulopathy parameters and proposed some possible risk factors,predictors and therapies.

  10. Correlation between MRI findings and long-term outcome in patients with severe brain trauma

    Energy Technology Data Exchange (ETDEWEB)

    Pierallini, A.; Pantano, P.; Fantozzi, L.M.; Bonamini, M. [Dept. of Neurological Sciences, Univ. di Roma (Italy); Vichi, R.; Zylberman, R.; Pisarri, F. [Hospital San Giovanni Battista, SMOM, Roma (Italy); Colonnese, C. [IRCCS Neuromed, Pozzilli (Italy); Bozzao, L. [Dept. of Neurological Sciences, Univ. di Roma (Italy); IRCCS Neuromed, Pozzilli (Italy)

    2000-12-01

    Our aim was to relate MRI findings in patients with severe traumatic brain injury (TBI) to clinical severity and long-term outcome. We studied 37 patients with severe TBI, who were submitted to clinical assessment for disability and cognition and to MRI 60-90 days after trauma. Clinical assessment was also performed 3, 6 and 12 months later. The number and volume of lesions in various cerebral structures were calculated semiautomatically from FLAIR and fast field-echo images. Possible correlations between total and regional lesion volume and clinical deficits were then investigated. The frontal and temporal lobes were most frequently involved. Total lesion volume on FLAIR images correlated significantly with clinical outcome, whereas that on FFE images did not. Regional analysis showed that FLAIR lesion volume in the corpus callosum correlated significantly with scores on disability and cognition scales at the first clinical assessment. FLAIR lesion volume in the frontal lobes correlated significantly with clinical scores 1 year later. (orig.)

  11. The brain's emotional foundations of human personality and the Affective Neuroscience Personality Scales.

    Science.gov (United States)

    Davis, Kenneth L; Panksepp, Jaak

    2011-10-01

    Six of the primary-process subcortical brain emotion systems - SEEKING, RAGE, FEAR, CARE, GRIEF and PLAY - are presented as foundational for human personality development, and hence as a potentially novel template for personality assessment as in the Affective Neurosciences Personality Scales (ANPS), described here. The ANPS was conceptualized as a potential clinical research tool, which would help experimentalists and clinicians situate subjects and clients in primary-process affective space. These emotion systems are reviewed in the context of a multi-tiered framing of consciousness spanning from primary affect, which encodes biological valences, to higher level tertiary (thought mediated) processing. Supporting neuroscience research is presented along with comparisons to Cloninger's Temperament and Character Inventory and the Five Factor Model (FFM). Suggestions are made for grounding the internal structure of the FFM on the primal emotional systems recognized in affective neuroscience, which may promote substantive dialog between human and animal research traditions. Personality is viewed in the context of Darwinian "continuity" with the inherited subcortical brain emotion systems being foundational, providing major forces for personality development in both humans and animals, and providing an affective infrastructure for an expanded five factor descriptive model applying to normal and clinical human populations as well as mammals generally. Links with ontogenetic and epigenetic models of personality development are also presented. Potential novel clinical applications of the CARE maternal-nurturance system and the PLAY system are also discussed.

  12. Effect of secondary prehospital risk factors on outcome in severe traumatic brain injury in the context of fast access to trauma care

    NARCIS (Netherlands)

    Franschman, G.; Peerdeman, S.M.; Andriessen, T.M.J.C.; Greuters, S.; Toor, A.E.; Vos, P.E.; Bakker, F.C.; Loer, S.A.; Boer, C.

    2011-01-01

    BACKGROUND: Prevention of secondary prehospital risk factors such as hypoxia and hypotension is likely to improve patient prognosis in severe traumatic brain injury (TBI). Because the Dutch trauma care organization is characterized by fast access to specialized trauma care due to the geographical si

  13. Adult sports-related traumatic brain injury in United States trauma centers.

    Science.gov (United States)

    Winkler, Ethan A; Yue, John K; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E

    2016-04-01

    OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to

  14. Organ retrieval and banking in brain dead trauma patients: Our experience at level-1 trauma centre and current views

    Directory of Open Access Journals (Sweden)

    Chhavi Sawhney

    2013-01-01

    Full Text Available Background: Organ retrieval from brain dead patients is getting an increased attention as the waiting list for organ recipients far exceeds the organ donor pool. In our country, despite a large population the number of brain dead donors undergoing organ donation is very less (2% in our study. Aims: The present study was undertaken to address issues related to organ donation and share our experience for the same. Methods: A retrospective case record analysis of over 5 years from September 2007 to August 2012 was performed and the patients fulfilling brain death criterion as per Transplantation of Human Organs and Tissue (Amendment Act were included. Patient demographics (age, sex, mode of injury, time from injury to the diagnosis of brain death, time from diagnosis of brain death to organ retrieval and complications were analysed. Statistics Analysis: Student′s t test was used for parametric data and Chi square was used for categorical data. Results: Out of 205 patients who were identified as brain dead, only 10 patients became potential organ donors. Conclusion: Aggressive donor management, increasing public awareness about the concept of organ donation, good communication between clinician and the family members and a well-trained team of transplant coordinators can help in improving the number of organ donations.

  15. WMS-III findings in litigants following moderate to extremely severe brain trauma.

    Science.gov (United States)

    Langeluddecke, Pauline M; Lucas, Sara K

    2005-07-01

    Published information pertaining to the clinical utility of the WMS-III in assessing memory impairment in traumatic brain injury (TBI) remains inadequate. WMS-III findings are reported for 180 litigants with post-acute moderate to extremely severe TBI, classified into three groups according to injury severity, and a healthy control group. A significant "dose-response" relationship was found between memory impairment and TBI severity for most of the WMS-III indexes and subtests. Effect sizes were large for the Immediate and General Memory Indexes and medium for the Working Memory Index. In general, TBI had a greater effect on the Visual than Auditory Indexes. Effect sizes were greatest for Family Pictures and least for the auditory recognition and working memory tasks. Group findings indicate the immediate memory tasks to be clinically useful in relation to a severe or extremely severe TBI, but not for less severe trauma. Delayed memory tasks do not provide information additional to that obtained from immediate memory measures. The revised Tulsky indexes are no more sensitive to the effects of TBI than the original ones. Differences between WMS-III memory indexes are unlikely to be of diagnostic utility although memory-intelligence discrepancies may be.

  16. Pediatric sports-related traumatic brain injury in United States trauma centers.

    Science.gov (United States)

    Yue, John K; Winkler, Ethan A; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E

    2016-04-01

    OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the authors characterize the demographics of sports-related TBI in the pediatric population and identify predictors of prolonged hospitalization and of increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from children (age 0-17 years) across 5 sports categories: fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged length of stay (LOS) in the hospital or intensive care unit (ICU), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were recorded in the NTDB, and these injuries represented 11,614 incidents nationally after sample weighting. Fall or interpersonal contact events were the greatest contributors to sports-related TBI (47.4%). Mild TBI represented 87.1% of the injuries overall. Mean (± SEM) LOSs in the hospital and ICU were 2.68 ± 0.07 days and 2.73 ± 0.12 days, respectively. The overall mortality rate was 0.8%, and the prevalence of medical complications was 2.1% across all patients. Severities of head and extracranial injuries were significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Hypotension on admission to the ED was a significant predictor of failure to discharge to home (OR 0.05, 95% CI 0.03-0.07, p injury incurred during roller sports was independently associated with prolonged hospital LOS compared

  17. The offer network protocol: Mathematical foundations and a roadmap for the development of a global brain

    Science.gov (United States)

    Heylighen, Francis

    2017-01-01

    The world is confronted with a variety of interdependent problems, including scarcity, unsustainability, inequality, pollution and poor governance. Tackling such complex challenges requires coordinated action. The present paper proposes the development of a self-organizing system for coordination, called an "offer network", that would use the distributed intelligence of the Internet to match the offers and needs of all human, technological and natural agents on the planet. This would maximize synergy and thus minimize waste and scarcity of resources. Implementing such coordination requires a protocol that formally defines agents, offers, needs, and the network of condition-action rules or reactions that interconnect them. Matching algorithms can then determine self-sustaining subnetworks in which each consumed resource (need) is also produced (offer). After sketching the elements of a mathematical foundation for offer networks, the paper proposes a roadmap for their practical implementation. This includes step-by-step integration with technologies such as the Semantic Web, ontologies, the Internet of Things, reputation and recommendation systems, reinforcement learning, governance through legal constraints and nudging, and ecosystem modeling. The resulting intelligent platform should be able to tackle nearly all practical and theoretical problems in a bottom-up, distributed manner, thus functioning like a Global Brain for humanity.

  18. The offer network protocol: Mathematical foundations and a roadmap for the development of a global brain

    Science.gov (United States)

    Heylighen, Francis

    2016-12-01

    The world is confronted with a variety of interdependent problems, including scarcity, unsustainability, inequality, pollution and poor governance. Tackling such complex challenges requires coordinated action. The present paper proposes the development of a self-organizing system for coordination, called an "offer network", that would use the distributed intelligence of the Internet to match the offers and needs of all human, technological and natural agents on the planet. This would maximize synergy and thus minimize waste and scarcity of resources. Implementing such coordination requires a protocol that formally defines agents, offers, needs, and the network of condition-action rules or reactions that interconnect them. Matching algorithms can then determine self-sustaining subnetworks in which each consumed resource (need) is also produced (offer). After sketching the elements of a mathematical foundation for offer networks, the paper proposes a roadmap for their practical implementation. This includes step-by-step integration with technologies such as the Semantic Web, ontologies, the Internet of Things, reputation and recommendation systems, reinforcement learning, governance through legal constraints and nudging, and ecosystem modeling. The resulting intelligent platform should be able to tackle nearly all practical and theoretical problems in a bottom-up, distributed manner, thus functioning like a Global Brain for humanity.

  19. Cognitive activity limitations one year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury

    DEFF Research Database (Denmark)

    Sommer, Jens Bak; Norup, Anne; Poulsen, Ingrid;

    2013-01-01

    Objective: To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. Subjects: The study included 119 patients with severe traumatic brain injury admitted to centralized sub-acute re...

  20. Craniectomia descompresiva en trauma craneoencefalico: experiencia en el hospital occidente de Kennedy

    OpenAIRE

    Solano Romero, Juan Pablo

    2011-01-01

    El trauma craneoencefálico (TCE) afecta hasta el 2% de la población por año según lo publicado por BRAIN TRAUMA FOUNDATION1; el trauma es la principal causa de muerte en las primeras cuatro décadas de la vida, estando el trauma craneoencefálico implicado en por lo menos la mitad de los casos. Se presenta una serie de pacientes (52 adultos y 14 pediátricos) desde 2003 al 2010 en el Hospital Occidente de Kennedy, mediante revisión retrospectiva de historias clínicas con diferentes variables. S...

  1. [The dynamics of the individual profiles of brain asymmetry in patients with craniocerebral trauma under the influence of emoxipin treatment].

    Science.gov (United States)

    Fedulov, A S; Teterkina, T I; Oleshkevich, F V

    1992-01-01

    The authors studied the effect of the drug emoxypin on the brain functional asymmetry (A) in 36 patients with craniocerebral trauma attended by occurrence of focal traumatic injuries (FTI) to the brain (experimental group). The control group consisted of 61 patients who received the traditional intensive therapy for FTI (isolated brain contusion of moderate and severe degree, intracerebral hematomas measuring 30-50 cm3 in volume in the contusion focus). Favorable changes of the brain FA indices in the individual asymmetry profiles were noted, respectively, in 76.7% and 40.9% of patients given and not given emoxypin. Complete normalization of brain FA indices by the 25th-30th day after the beginning of treatment was recorded in 60.9% of patients in the control group and in 37% of those in the experimental group. The dynamics of individual asymmetry profiles in patients with FTI provides evidence that emoxypin improves the attention, mental efficiency, memory capacity, and selectivity of mnemonic processes.

  2. The use of brain CT Scan in craniocerebral trauma with Glasgow coma scale scores of 13 – 15 in Dr. Cipto Mangunkusumo Hospital 1999-2001

    Directory of Open Access Journals (Sweden)

    Jofizal Jannis

    2004-09-01

    Full Text Available There is still a controversy among the neurologists whether brain CT scan must be performed on the mild head trauma patients. This study was executed to find out the correlation between the brain CT scan image findings and its clinical impairment among the mild head trauma patients with Glasgow coma scale (GCS score of 13 to 15. The study was a retrospective study by analyzing the uniform medical records of the head trauma patients hospitalized at the Neurology ward of Dr. Cipto Mangunkusumo Hospital within the period of 1999 to 2001. During that period 1,663 patients were hospitalized due to head trauma, and 1,166 of them (70.1 % were suffered from mild head trauma patients with GCS score of 13-15. Among those with brain CT scan examinations (N: 271, the neurological abnormalities were found on 144 (53.1% of patients, consisted of cerebral edema (11,4%, intracerebral hemorrhage (5.5%, epidural hemorrhage (16.2%, subdural hemorrhage (18.1%, subarachnoid hemorrhage (5.5%, and combination (13.8%. The further analysis showed that cranial nerves disturbance, amnesia, loss of conciousness for more than 10 minutes, and vomiting are significantly correlated to the brain CT scan abnormality. Combination of the above four clinical signs and symptoms have sensitivity of 90 % in predicting brain insults. This findings may be used as a simple set of clinical criteria for identifying mild head trauma patients who need undergo CT scan examination. (Med J Indones 2004; 13: 156-60 Keywords: mild head injury, brain CT scan

  3. A novel brain trauma model in the mouse : effects of dexamethasone treatment

    NARCIS (Netherlands)

    Hortobágyi, Tibor; Hortobagyi, S; Gorlach, C; Harkany, T; Benbyo, Z; Gorogh, T; Nagel, W; Wahl, M

    2000-01-01

    We describe a novel methodological approach for inducing cold lesion in the mouse as a model of human cortical contusion trauma. To validate its reproducibility and reliability, dexamethasone (Dxm) was repeatedly applied to demonstrate possible antioedematous drug effects. Following tho induction of

  4. Experimental study on alteration of adrenergic receptors activity in neuronal membranes protein of cerebral cortex following brain trauma in rats

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin-wei; XU Ru-xiang; QI Yi-long; CHEN Chang-cai

    2001-01-01

    Objective: To define the course of changes taken by α1 and β adrenergic receptors (AR) activity after traumatic brain injury (TBI) and explore the approach for secondary brain injury (SBI) management. Methods: The neuronal membrane protein of cortex were extracted from the rats subject to traumatic brain injury, and the changes of α1- and β-AR activities in the neuronal membranes were examined by radio ligand binding assay (RLBA). Results: α1- and β-AR activities underwent obvious changes, reaching their peak values at 24 h after TBI. α1-AR binding density (Bmax) reduced by 22.6%while the ligand affinity increased by 66.7%, and for β-AR, however, Bmax increased by 116.9% and the ligand affinity reduced by 50.7%. Their antagonists could counteract the changes ofα1- and β-AR activity. Conclusion: The patterns of changes varies between α1- and β-AR activity after TBI, suggesting their different roles in the neuronal membranes after brain trauma, and timely administration of AR antagonists is potentially beneficial in TBI management.

  5. Childhood trauma and platelet brain-derived neurotrophic factor (BDNF) after a three month follow-up in patients with major depressive disorder.

    Science.gov (United States)

    Jeon, Hong Jin; Kang, Eun-Suk; Lee, Eun Ho; Jeong, Eu-Gene; Jeon, Ju-Ri; Mischoulon, David; Lee, Dongsoo

    2012-07-01

    A large amount of brain-derived neurotrophic factor (BDNF) is stored in the human platelets and only small amounts of it circulate in the plasma. However, a few studies have focused on platelet BDNF in patients with major depressive disorder (MDD) and childhood trauma. Our study population consisted of 105 MDD patients and 50 healthy controls. We used the mini-international neuropsychiatric interview (M.I.N.I.), the early trauma inventory self report-short form (ETISR-SF), as well as measured serum, plasma, and platelet BDNF at baseline, 1 month, and 3 month periods. There was a significant association between childhood trauma and platelet BDNF at baseline, 1 month, and 3 months, after adjusting for age, gender, education, body mass index, severity of depression, anxiety, alcohol consumption, and current stress. Conversely, plasma and serum BDNF did not have a significant association with childhood trauma. MDD patients revealed significantly higher levels of platelet BDNF in those with childhood trauma than in those without (t = 2.4, p = 0.018), and platelet BDNF was significantly higher in cases with sexual abuse on post-hoc analysis (p = 0.042). However, no significant differences were found in healthy controls, according to whether or not they had experienced childhood trauma. Platelet BDNF showed a significant correlation with severity of childhood trauma at baseline (r = 0.25, p = 0.012) and at 3 months (r = 0.38, p = 0.003) in MDD. In conclusion, platelet BDNF was significantly higher in MDD patients with childhood trauma than in those without, and it was correlated with severity of trauma.

  6. Observation on the change of inflammatory stress and metabolic status of patients with severe traumatic brain injury during the perioperative period of standard large trauma craniotomy

    Institute of Scientific and Technical Information of China (English)

    Lei Luan

    2016-01-01

    Objective:To observe and study the change state of inflammatory stress and metabolic status of patients with severe traumatic brain injury during the perioperative period of standard large trauma craniotomy. Methods:A total of 58 surgical patients with severe traumatic brain injury in our hospital from January 2013 to July 2015 were selected as the study object, and 29 cases of them were divided into control group (conventional craniotomy group) and other 29 cases into observation group (standard large trauma craniotomy group) by the differences of operation methods, then the cerebral metabolism, proteometabolism and inflammatory stress indexes of two groups before the surgery and at first, third and fifth day after the surgery were compared. Results:The cerebral metabolism, proteometabolism and inflammatory stress indexes of two groups before the surgery all had no significant differences, the cerebral metabolism, proteometabolism and inflammatory stress indexes of observation group at first, third and fifth day after the surgery were all better than those of control group, the differences of two groups at differences time after the surgery were all significant. Conclusion:The bad fluctuations of inflammatory stress and metabolic status of patients with severe traumatic brain injury during the perioperative period of standard large trauma craniotomy are smaller than those of conventional craniotomy, so the standard large trauma craniotomy are more suitable for the patients with severe traumatic brain injury.

  7. Brain lesion-pattern analysis in patients with olfactory dysfunctions following head trauma

    Directory of Open Access Journals (Sweden)

    Jörn Lötsch

    2016-01-01

    Full Text Available The presence of cerebral lesions in patients with neurosensory alterations provides a unique window into brain function. Using a fuzzy logic based combination of morphological information about 27 olfactory-eloquent brain regions acquired with four different brain imaging techniques, patterns of brain damage were analyzed in 127 patients who displayed anosmia, i.e., complete loss of the sense of smell (n = 81, or other and mechanistically still incompletely understood olfactory dysfunctions including parosmia, i.e., distorted perceptions of olfactory stimuli (n = 50, or phantosmia, i.e., olfactory hallucinations (n = 22. A higher prevalence of parosmia, and as a tendency also phantosmia, was observed in subjects with medium overall brain damage. Further analysis showed a lower frequency of lesions in the right temporal lobe in patients with parosmia than in patients without parosmia. This negative direction of the differences was unique for parosmia. In anosmia, and also in phantosmia, lesions were more frequent in patients displaying the respective symptoms than in those without these dysfunctions. In anosmic patients, lesions in the right olfactory bulb region were much more frequent than in patients with preserved sense of smell, whereas a higher frequency of carriers of lesions in the left frontal lobe was observed for phantosmia. We conclude that anosmia, and phantosmia, are the result of lost function in relevant brain areas whereas parosmia is more complex, requiring damaged and intact brain regions at the same time.

  8. Oral Administration of Sitagliptin Activates CREB and Is Neuroprotective in Murine Model of Brain Trauma

    OpenAIRE

    Brian Dellavalle; Gitte Stokvad Brix; Birgitte Brock; Michael Gejl; Jørgen Rungby; Agnete Larsen

    2016-01-01

    Introduction: Traumatic brain injury is a major cause of mortality and morbidity. We have previously shown that the injectable glucagon-like peptide-1 (GLP-1) analogue, liraglutide, significantly improved the outcome in mice after severe traumatic brain injury (TBI). In this study we are interested in the effects of oral treatment of a different class of GLP-1 based therapy, dipeptidyl peptidase IV (DPP-IV) inhibition on mice after TBI. DPP-IV inhibitors reduce the degradation of endogenous ...

  9. EXPERIMENTAL AND THEORETICAL FOUNDATIONS AND PRACTICAL IMPLEMENTATION OF TECHNOLOGY BRAIN-COMPUTER INTERFACE

    Directory of Open Access Journals (Sweden)

    A. Ya. Kaplan

    2013-01-01

    Full Text Available Technology brain-computer interface (BCI allow saperson to learn how to control external devices via thevoluntary regulation of own EEG directly from the brain without the involvement in the process of nerves and muscles. At the beginning the main goal of BCI was to replace or restore motor function to people disabled by neuromuscular disorders. Currently, the task of designing the BCI increased significantly, more capturing different aspects of life a healthy person. This article discusses the theoretical, experimental and technological base of BCI development and systematized critical fields of real implementation of these technologies.

  10. When Physics Meets Biology: Low and High Velocity Penetration, Blunt Trauma and Blast Injuries to the Brain

    Directory of Open Access Journals (Sweden)

    Leanne eYoung

    2015-05-01

    Full Text Available The incidence of TBI in the US has reached epidemic proportions with well over 2 million new cases reported each year. TBI can occur in both civilians and warfighters, with head injuries occurring in both combat and non-combat situations from a variety of threats, including ballistic penetration, acceleration, blunt impact, and blast. Most generally, TBI is a condition in which physical loads exceed the capacity of brain tissues to absorb without injury. More specifically, TBI results when sufficient external force is applied to the head and is subsequently converted into stresses that must be absorbed or redirected by protective equipment. If the stresses are not sufficiently absorbed or redirected, they will lead to damage of extracranial soft tissue and the skull. Complex interactions and kinematics of the head, neck and jaw cause strains within the brain tissue, resulting in structural, anatomical damage that is characteristic of the inciting insult. This mechanical trauma then initiates a neuro-chemical cascade that leads to the functional consequences of TBI, such as cognitive impairment. To fully understand the mechanisms by which TBI occurs, it is critically important to understand the effects of the loading environments created by these threats. In the following, a review is made of the pertinent complex loading conditions and how these loads cause injury. Also discussed are injury thresholds and gaps in knowledge, both of which are needed to design improved protective systems.

  11. Brain-Like Artificial Intelligence for Automation – Foundations, Concepts and Implementation Examples

    Directory of Open Access Journals (Sweden)

    Rosemarie Velik

    2013-10-01

    Full Text Available Over the last decades, automation technology has made serious progress and can today automate a wide range of tasks having before needed human physical and mental abilities. Nevertheless, a number of important problem domains remain that cannot yet be handled by our current machines and computers. A few prominent examples are applications involving “realworld” perception, situation assessment, and decision-making tasks. Recently, researchers have suggested to use concepts of “Brain-Like Artificial Intelligence”, i.e. concepts inspired by the functioning principles of the human or animal brain, to further advance in these problem domains. This article discusses the potential of Brain-Like Artificial Intelligence for innovative automation solutions and reviews a number of approaches developed together with the ICT cognitive automation group of the Vienna University of Technology targeting the topics “real-world” perception, situation assessment, and decision-making for applications in building automation environments and autonomous agents. Additionally, it is demonstrated by a concrete example howsuch developments can also contribute to an advancement of the state of the art in the field of brain sciences.

  12. Influence of a brief episode of anesthesia during the induction of experimental brain trauma on secondary brain damage and inflammation.

    Directory of Open Access Journals (Sweden)

    Clara Luh

    Full Text Available It is unclear whether a single, brief, 15-minute episode of background anesthesia already modulates delayed secondary processes after experimental brain injury. Therefore, this study was designed to characterize three anesthesia protocols for their effect on molecular and histological study endpoints. Mice were randomly separated into groups that received sevoflurane (sevo, isoflurane (iso or an intraperitoneal anesthetic combination (midazolam, fentanyl and medetomidine; comb prior to traumatic brain injury (controlled cortical impact, CCI; 8 m/s, 1 mm impact depth, 3 mm diameter. Twenty-four hours after insult, histological brain damage, neurological function (via neurological severity score, cerebral inflammation (via real-time RT-PCR for IL6, COX-2, iNOS and microglia (via immunohistochemical staining for Iba1 were determined. Fifteen minutes after CCI, the brain contusion volume did not differ between the anesthetic regimens (sevo = 17.9±5.5 mm(3; iso = 20.5±3.7 mm(3; comb = 19.5±4.6 mm(3. Within 24 hours after injury, lesion size increased in all groups (sevo = 45.3±9.0 mm(3; iso = 31.5±4.0 mm(3; comb = 44.2±6.2 mm(3. Sevo and comb anesthesia resulted in a significantly larger contusion compared to iso, which was in line with the significantly better neurological function with iso (sevo = 4.6±1.3 pts.; iso = 3.9±0.8 pts.; comb = 5.1±1.6 pts.. The expression of inflammatory marker genes was not significantly different at 15 minutes and 24 hours after CCI. In contrast, significantly more Iba1-positive cells were present in the pericontusional region after sevo compared to comb anesthesia (sevo = 181±48/mm(3; iso = 150±36/mm(3; comb = 113±40/mm(3. A brief episode of anesthesia, which is sufficient for surgical preparations of mice for procedures such as delivering traumatic brain injury, already has a significant impact on the extent of secondary brain damage.

  13. Influence of a Brief Episode of Anesthesia during the Induction of Experimental Brain Trauma on Secondary Brain Damage and Inflammation

    OpenAIRE

    Clara Luh; Katharina Gierth; Ralph Timaru-Kast; Kristin Engelhard; Christian Werner; Thal, Serge C.

    2011-01-01

    It is unclear whether a single, brief, 15-minute episode of background anesthesia already modulates delayed secondary processes after experimental brain injury. Therefore, this study was designed to characterize three anesthesia protocols for their effect on molecular and histological study endpoints. Mice were randomly separated into groups that received sevoflurane (sevo), isoflurane (iso) or an intraperitoneal anesthetic combination (midazolam, fentanyl and medetomidine; comb) prior to tra...

  14. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration

    OpenAIRE

    Morley, Wendy A.; Stephanie Seneff

    2014-01-01

    The number of sports-related concussions has been steadily rising in recent years. Diminished brain resilience syndrome is a term coined by the lead author to describe a particular physiological state of nutrient functional deficiency and disrupted homeostatic mechanisms leading to increased susceptibility to previously considered innocuous concussion. We discuss how modern day environmental toxicant exposure, along with major changes in our food supply and lifestyle practices, profoundly red...

  15. Oral Administration of Sitagliptin Activates CREB and Is Neuroprotective in Murine Model of Brain Trauma

    DEFF Research Database (Denmark)

    DellaValle, Brian; Brix, Gitte S; Brock, Birgitte;

    2016-01-01

    for immunoblotting for assessment of selected biomarkers for pathology and protection. Results: Sitagliptin treatment reduced lesion size at day 2 post-injury by ~28% (p Calpain-driven necrotic tone was reduced ~2-fold in sitagliptin-treated brains (p

  16. Spreading Depolarizations Have Prolonged Direct Current Shifts and Are Associated with Poor Outcome in Brain Trauma

    Science.gov (United States)

    2011-01-01

    prognosis . Keywords: cortical spreading depression; electroencephalography; craniotomy; signal processing; acute brain injury Introduction Cortical...GCS =Glasgow coma scale. differed from normality and Kruskai-Wallis tests were used for non-parametric analysis of variance. Data are reported as...graded prognosis corresponding to 100% (isoelectric depolarizations), 60% (depolarizations with de- pression periods) and 23% (no depolarizations) of

  17. Fatal outcome after brain stem infarction related to bilateral vertebral artery occlusion - case report of a detrimental complication of cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Beauchamp Kathryn M

    2011-07-01

    Full Text Available Abstract Background Vertebral artery injury (VAI after blunt cervical trauma occurs more frequently than historically believed. The symptoms due to vertebral artery (VA occlusion usually manifest within the first 24 hours after trauma. Misdiagnosed VAI or delay in diagnosis has been reported to cause acute deterioration of previously conscious and neurologically intact patients. Case presentation A 67 year-old male was involved in a motor vehicle crash (MVC sustaining multiple injuries. Initial evaluation by the emergency medical response team revealed that he was alert, oriented, and neurologically intact. He was transferred to the local hospital where cervical spine computed tomography (CT revealed several abnormalities. Distraction and subluxation was present at C5-C6 and a comminuted fracture of the left lateral mass of C6 with violation of the transverse foramen was noted. Unavailability of a spine specialist prompted the patient's transfer to an area medical center equipped with spine care capabilities. After arrival, the patient became unresponsive and neurological deficits were noted. His continued deterioration prompted yet another transfer to our Level 1 regional trauma center. A repeat cervical spine CT at our institution revealed significantly worsened subluxation at C5-C6. CT angiogram also revealed complete occlusion of bilateral VA. The following day, a repeat CT of the head revealed brain stem infarction due to bilateral VA occlusion. Shortly following, the patient was diagnosed with brain death and care was withdrawn. Conclusion Brain stem infarction secondary to bilateral VA occlusion following cervical spine trauma resulted in fatal outcome. Prompt imaging evaluation is necessary to assess for VAI in cervical trauma cases with facet joint subluxation/dislocation or transverse foramen fracture so that treatment is not delayed. Additionally, multiple transportation events are risk factors for worsening when unstable cervical

  18. Recent Research in Behind-Armor Blunt Trauma and Traumatic Brain Injury

    Science.gov (United States)

    2014-02-01

    biomechanics that may cause injury from blast impact. Rafaels et al. (8) used animal models in their research to suggest that blast TBI may also depend on...vasculature of neck primarily proposed by Cernak et al. (20). The blast wave generated from a shock front followed by blast overpressure can have...design of new or existing equipment used to mitigate blast exposures. El Sayed et al. (42) studied the biomechanical modeling of the brain tissue

  19. The salutary effects of DHA dietary supplementation on cognition, neuroplasticity, and membrane homeostasis after brain trauma.

    Science.gov (United States)

    Wu, Aiguo; Ying, Zhe; Gomez-Pinilla, Fernando

    2011-10-01

    The pathology of traumatic brain injury (TBI) is characterized by the decreased capacity of neurons to metabolize energy and sustain synaptic function, likely resulting in cognitive and emotional disorders. Based on the broad nature of the pathology, we have assessed the potential of the omega-3 fatty acid docosahexaenoic acid (DHA) to counteract the effects of concussive injury on important aspects of neuronal function and cognition. Fluid percussion injury (FPI) or sham injury was performed, and rats were then maintained on a diet high in DHA (1.2% DHA) for 12 days. We found that DHA supplementation, which elevates brain DHA content, normalized levels of brain-derived neurotrophic factor (BDNF), synapsin I (Syn-1), cAMP-responsive element-binding protein (CREB), and calcium/calmodulin-dependent kinase II (CaMKII), and improved learning ability in FPI rats. It is known that BDNF facilitates synaptic transmission and learning ability by modulating Syn-I, CREB, and CaMKII signaling. The DHA diet also counteracted the FPI-reduced manganese superoxide dismutase (SOD) and Sir2 (a NAD+-dependent deacetylase). Given the involvement of SOD and Sir2 in promoting metabolic homeostasis, DHA may help the injured brain by providing resistance to oxidative stress. Furthermore, DHA normalized levels of calcium-independent phospholipase A2 (iPLA2) and syntaxin-3, which may help preserve membrane homeostasis and function after FPI. The overall results emphasize the potential of dietary DHA to counteract broad and fundamental aspects of TBI pathology that may translate into preserved cognitive capacity.

  20. Critical care management of severe traumatic brain injury in adults

    OpenAIRE

    Haddad Samir H; Arabi Yaseen M

    2012-01-01

    Abstract Traumatic brain injury (TBI) is a major medical and socio-economic problem, and is the leading cause of death in children and young adults. The critical care management of severe TBI is largely derived from the "Guidelines for the Management of Severe Traumatic Brain Injury" that have been published by the Brain Trauma Foundation. The main objectives are prevention and treatment of intracranial hypertension and secondary brain insults, preservation of cerebral perfusion pressure (CPP...

  1. 管饲匀浆对脑外伤并使用呼吸机患者的营养支持治疗%Nutritional support for ventilator dependent patients with brain trauma by tube feeding

    Institute of Scientific and Technical Information of China (English)

    徐辉

    2002-01-01

    @@ Background: Human depend on breathing and nourishment while maintaining their life .Patients with brain trauma are sustained breath by ventilator, gain time for treatment. But it is not think much of a balanced diet providing nutrition for sick body.

  2. An epidemiological study of traumatic brain injury cases in a trauma centre of New Delhi (India)

    Science.gov (United States)

    Shekhar, Chandra; Gupta, Laxmi Narayan; Premsagar, Ishwar Chandra; Sinha, Madhu; Kishore, Jugal

    2015-01-01

    Background: Trauma is one of the leading causes of death and disability in Indian population. Aim: To correlate various variables like epidemiology, clinical status, severity of TBI & associated co-morbid conditions and its outcome. Settings and Design: This study involved retrospective collection, prospective management and follow up of 796 cases of TBI admitted to the neurosurgery department of a tertiary care hospital in New Delhi during one year study duration. Materials and Methods: All the relevant variables recorded and analyzed with Glasgow Outcome Scale (GOS) in 6 months into 3 groups i.e. group 1 (GOS-1/Dead), group 2 (GOS-2&3/Bad) and group 3- (GOS-3&4/good). Statistical Analysis: Compiled data collected, analyzed and difference between two proportions was analyzed using Chi Square test. Results: This study included 791 cases with 569 (72%) males and 222 (28%) females with average age of 24 years. Fall from height was the main cause of TBI (56%) followed by road traffic injury (RTI) (36%). Majority (61%) patients reached the hospital within 6 hours of injury out of which 27% patients were unconscious. As per Glasgow coma scale mild, moderate & severe grade of TBI was seen in 62%, 22% &16% cases respectively. Radiological examination of other body parts revealed injuries in 11% cases. Only 11% cases required surgical management, rest was managed conservatively. Good outcome noted in 80% cases and 20% cases expired. Average duration of hospital stay was 5 days. According to multivariate analysis, the factors which correlated with poor prognosis are presence of radiological injuries to other body parts, GCS, abnormal cranial nerve examination, abnormal plantar and abnormal pupillary reflex. (P < 0.05) Conclusion: TBI predominantly affects young male population and most of these are preventable. Early transportation to the hospital and first aid results in good outcome. Mortality increases with the severity of TBI and associated injuries therefore

  3. Précis of Foundations of language: brain, meaning, grammar, evolution.

    Science.gov (United States)

    Jackendoff, Ray

    2003-12-01

    The goal of this study is to reintegrate the theory of generative grammar into the cognitive sciences. Generative grammar was right to focus on the child's acquisition of language as its central problem, leading to the hypothesis of an innate Universal Grammar. However, generative grammar was mistaken in assuming that the syntactic component is the sole course of combinatoriality, and that everything else is "interpretive." The proper approach is a parallel architecture, in which phonology, syntax, and semantics are autonomous generative systems linked by interface components. The parallel architecture leads to an integration within linguistics, and to a far better integration with the rest of cognitive neuroscience. It fits naturally into the larger architecture of the mind/brain and permits a properly mentalistic theory of semantics. It results in a view of linguistic performance in which the rules of grammar are directly involved in processing. Finally, it leads to a natural account of the incremental evolution of the language capacity.

  4. Astrogliosis in the neonatal and adult murine brain post-trauma

    DEFF Research Database (Denmark)

    Rostworowski, M; Balasingam, V; Chabot, S

    1997-01-01

    to a greater extent by an NC-implant injury, which produced astrogliosis, than after an NC-stab, with minimal astrogliosis. We determined whether endogenous interferon (IFN)-gamma could be responsible for the observed increases in IL-1 and TNF-alpha, because IFN-gamma is a potent microglia/macrophage activator...... of a neutralizing antibody to IFN-gamma did not attenuate astrogliosis. Third, in IFN-gamma knockout adult mice, astrogliosis and increases in levels of IL-1alpha and TNF-alpha were induced rapidly by injury. The marked elevation of inflammatory cytokines is discussed in the context of astrogliosis and general CNS...... inflammatory cytokines in injury systems in which the presence or absence of astrogliosis could be produced selectively. A stab injury to the adult mouse brain using a piece of nitrocellulose (NC) membrane elicited a prompt and marked increase in levels of transcripts for interleukin (IL)-1alpha, IL-1beta...

  5. Polypathology and dementia after brain trauma: Does brain injury trigger distinct neurodegenerative diseases, or should they be classified together as traumatic encephalopathy?

    Science.gov (United States)

    Washington, Patricia M; Villapol, Sonia; Burns, Mark P

    2016-01-01

    Neuropathological studies of human traumatic brain injury (TBI) cases have described amyloid plaques acutely after a single severe TBI, and tau pathology after repeat mild TBI (mTBI). This has helped drive the hypothesis that a single moderate to severe TBI increases the risk of developing late-onset Alzheimer's disease (AD), while repeat mTBI increases the risk of developing chronic traumatic encephalopathy (CTE). In this review we critically assess this position-examining epidemiological and case control human studies, neuropathological evidence, and preclinical data. Epidemiological studies emphasize that TBI is associated with the increased risk of developing multiple types of dementia, not just AD-type dementia, and that TBI can also trigger other neurodegenerative conditions such as Parkinson's disease. Further, human post-mortem studies on both single TBI and repeat mTBI can show combinations of amyloid, tau, TDP-43, and Lewy body pathology indicating that the neuropathology of TBI is best described as a 'polypathology'. Preclinical studies confirm that multiple proteins associated with the development of neurodegenerative disease accumulate in the brain after TBI. The chronic sequelae of both single TBI and repeat mTBI share common neuropathological features and clinical symptoms of classically defined neurodegenerative disorders. However, while the spectrum of chronic cognitive and neurobehavioral disorders that occur following repeat mTBI is viewed as the symptoms of CTE, the spectrum of chronic cognitive and neurobehavioral symptoms that occur after a single TBI is considered to represent distinct neurodegenerative diseases such as AD. These data support the suggestion that the multiple manifestations of TBI-induced neurodegenerative disorders be classified together as traumatic encephalopathy or trauma-induced neurodegeneration, regardless of the nature or frequency of the precipitating TBI.

  6. TH-A-18C-09: Ultra-Fast Monte Carlo Simulation for Cone Beam CT Imaging of Brain Trauma

    Energy Technology Data Exchange (ETDEWEB)

    Sisniega, A; Zbijewski, W; Stayman, J [Department of Biomedical Engineering, Johns Hopkins University (United States); Yorkston, J [Carestream Health (United States); Aygun, N [Department of Radiology, Johns Hopkins University (United States); Koliatsos, V [Department of Neurology, Johns Hopkins University (United States); Siewerdsen, J [Department of Biomedical Engineering, Johns Hopkins University (United States); Department of Radiology, Johns Hopkins University (United States)

    2014-06-15

    Purpose: Application of cone-beam CT (CBCT) to low-contrast soft tissue imaging, such as in detection of traumatic brain injury, is challenged by high levels of scatter. A fast, accurate scatter correction method based on Monte Carlo (MC) estimation is developed for application in high-quality CBCT imaging of acute brain injury. Methods: The correction involves MC scatter estimation executed on an NVIDIA GTX 780 GPU (MC-GPU), with baseline simulation speed of ~1e7 photons/sec. MC-GPU is accelerated by a novel, GPU-optimized implementation of variance reduction (VR) techniques (forced detection and photon splitting). The number of simulated tracks and projections is reduced for additional speed-up. Residual noise is removed and the missing scatter projections are estimated via kernel smoothing (KS) in projection plane and across gantry angles. The method is assessed using CBCT images of a head phantom presenting a realistic simulation of fresh intracranial hemorrhage (100 kVp, 180 mAs, 720 projections, source-detector distance 700 mm, source-axis distance 480 mm). Results: For a fixed run-time of ~1 sec/projection, GPU-optimized VR reduces the noise in MC-GPU scatter estimates by a factor of 4. For scatter correction, MC-GPU with VR is executed with 4-fold angular downsampling and 1e5 photons/projection, yielding 3.5 minute run-time per scan, and de-noised with optimized KS. Corrected CBCT images demonstrate uniformity improvement of 18 HU and contrast improvement of 26 HU compared to no correction, and a 52% increase in contrast-tonoise ratio in simulated hemorrhage compared to “oracle” constant fraction correction. Conclusion: Acceleration of MC-GPU achieved through GPU-optimized variance reduction and kernel smoothing yields an efficient (<5 min/scan) and accurate scatter correction that does not rely on additional hardware or simplifying assumptions about the scatter distribution. The method is undergoing implementation in a novel CBCT dedicated to brain

  7. The Acute Inflammatory Response in Trauma / Hemorrhage and Traumatic Brain Injury: Current State and Emerging Prospects

    Directory of Open Access Journals (Sweden)

    Y Vodovotz

    2009-01-01

    Full Text Available Traumatic injury/hemorrhagic shock (T/HS elicits an acute inflammatory response that may result in death. Inflammation describes a coordinated series of molecular, cellular, tissue, organ, and systemic responses that drive the pathology of various diseases including T/HS and traumatic brain injury (TBI. Inflammation is a finely tuned, dynamic, highly-regulated process that is not inherentlydetrimental, but rather required for immune surveillance, optimal post-injury tissue repair, and regeneration. The inflammatory response is driven by cytokines and chemokines and is partiallypropagated by damaged tissue-derived products (Damage-associated Molecular Patterns; DAMP’s.DAMPs perpetuate inflammation through the release of pro-inflammatory cytokines, but may also inhibit anti-inflammatory cytokines. Various animal models of T/HS in mice, rats, pigs, dogs, and nonhumanprimates have been utilized in an attempt to move from bench to bedside. Novel approaches, including those from the field of systems biology, may yield therapeutic breakthroughs in T/HS andTBI in the near future.

  8. Contribution of psychological trauma to outcomes after traumatic brain injury: assaults versus sporting injuries.

    Science.gov (United States)

    Mathias, Jane L; Harman-Smith, Yasmin; Bowden, Stephen C; Rosenfeld, Jeffrey V; Bigler, Erin D

    2014-04-01

    Clinical research into outcomes after traumatic brain injury (TBI) frequently combines injuries that have been sustained through different causes (e.g., car accidents, assaults, and falls), the effect of which is not well understood. This study examined the contribution of injury-related psychological trauma—which is more commonly associated with specific types of injuries—to outcomes after nonpenetrating TBI in order to determine whether it may be having a differential effect in samples containing mixed injuries. Data from three groups that were prospectively recruited for two larger studies were compared: one that sustained a TBI as a result of physical assaults (i.e., psychologically traumatizing) and another as a result of sporting injuries (i.e., nonpsychologically traumatizing), as well as an orthopedic control group (OC). Psychosocial and emotional (postconcussion symptoms, injury-related stress, and depression), cognitive (memory, abstract reasoning, problem solving, and verbal fluency), and functional (general outcome; resumption of home, social, and work roles) outcomes were all assessed. The TBI(assault) group reported significantly poorer psychosocial and emotional outcomes and higher rates of litigation (criminal rather than civil) than both the TBI(sport) and OC groups approximately 6 months postinjury, but there were no differences in the cognitive or functional outcomes of the three groups. The findings suggest that the cause of a TBI may assist in explaining some of the differences in outcomes of people who have seemingly comparable injuries. Involvement in litigation and the cause of an injury may also be confounded, which may lead to the erroneous conclusion that litigants have poorer outcomes.

  9. Analysis of patients with spinal cord trauma associated with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    João Simão de Melo Neto

    2014-12-01

    Full Text Available Objective: Characterize victims of spinal cord injury (SCI associated with traumatic brain injury (TBI and risk factors. Methods: Study conducted with 52 victims of SCI associated with TBI. The variables studied were: sex; age; marital status; occupation; educational level; religion; etiology and the lesion area; neurological condition by the ASIA scale; associated injuries and potential risk factors. Results: The male (85%, aged between 21-30 years (25%, civil status stable union (56%, low level of education (69% and the Roman Catholic religion (77% presented the greater number of victims. Motor vehicle accidents (58% were the main etiology. The cervical segment had higher injury risk (RR=3.48, p<0.0001. The neurological status ASIA-E (52%, the syndromic neck pain (35% and the rate of mild TBI (65% were the most frequent. Complications occurred in 13 patients with increased frequency of pneumonia (62%. The length of hospital stay was significantly higher (20±28 days and 17% of patients died. Men (RR=2.14, p=0.028 and individuals exposed to motor vehicle accidents (RR=1.91, p=0.022 showed a higher risk of these lesions concurrently. Moreover, these patients had 2.48 (p<0.01 higher risk of death than victims of SCI alone. Conclusion: The SCI associated with TBI was more frequent in men, young adults, and individuals exposed to motor vehicle accidents. The cervical spine is more likely to be affected. Furthermore, the length of hospitalization is significantly higher and the subjects analyzed have higher risk of death.

  10. Adaptive algorithms to map how brain trauma affects anatomical connectivity in children

    Science.gov (United States)

    Dennis, Emily L.; Prasad, Gautam; Babikian, Talin; Kernan, Claudia; Mink, Richard; Babbitt, Christopher; Johnson, Jeffrey; Giza, Christopher C.; Asarnow, Robert F.; Thompson, Paul M.

    2015-12-01

    Deficits in white matter (WM) integrity occur following traumatic brain injury (TBI), and often persist long after the visible scars have healed. Heterogeneity in injury types and locations can complicate analyses, making it harder to discover common biomarkers for tracking recovery. Here we apply a newly developed adaptive connectivity method, EPIC (evolving partitions to improve connectomics) to identify differences in structural connectivity that persist longitudinally. This data comes from a longitudinal study, in which we scanned participants (aged 8-19 years) with anatomical and diffusion MRI in both the post-acute and chronic phases (1-6 months and 13-19 months post-injury). To identify patterns of abnormal connectivity, we trained a model on data from 32 TBI patients in the post-acute phase and 45 well-matched healthy controls, reducing an initial 68x68 connectivity matrix to a 14x14 matrix. We then applied this reduced parcellation to the chronic data in participants who had returned for their chronic assessment (21 TBI and 26 healthy controls) and tested for group differences. We found significant differences in two connections, comprising callosal fibers and long anterior-posterior fibers, with the TBI group showing increased fiber density relative to controls. Longitudinal analysis revealed that these were connections that were decreasing over time in the healthy controls, as is a common developmental phenomenon, but they were increasing in the TBI group. While we cannot definitively tell why this may occur with our current data, this study provides targets for longitudinal tracking, and poses questions for future investigation.

  11. Head and brain injuries in children; Schaedel-Hirn-Trauma im Kindesalter

    Energy Technology Data Exchange (ETDEWEB)

    Trittmacher, S. [Giessen Univ. (Germany). Abt. fuer Neuroradiologie; Huegens-Penzel, M. [Giessen Univ. (Germany). Abt. fuer Neuroradiologie; Traupe, H. [Giessen Univ. (Germany). Abt. fuer Neuroradiologie

    1995-06-01

    Depending on the clinical symptomatology, computed tomography (CT) is the predominant examination technique. CT reliably shows live-threatening intra- or extracerebral hemorrhage. Typical localization and distribution of blood allow differentiation between extradural and/or subarachnoidal effusion. Dislocation of the midline structures or of cortical relief shows the mass effect of intracranial hemorrhage. In many cases localized edema can be identified, but because of the normally very narrow cortical sulci in children and younger people, the general post-traumatic brain swelling is often diagnosed only retrospectively. Magnetic resonance tomography is more sensitive than CT concerning subtle changes in the depth of the white matter and should be used for follow-up studies as a supplementary examination. (orig.) [Deutsch] In der Akutdiagnostik der Schaedel-Hirn-Verletzungen bei Kindern steht in Abhaengigkeit vom klinischen Befund die kranielle Computertomographie (CT) an erster Stelle. Zuverlaessig koennen mit diesem Verfahren lebensbedrohliche extra- und intrazerebrale Blutungen dargestellt werden. Anhand typischer Verteilungsmuster kann Blut epi- oder subdural und/oder im Liquor nachgewiesen werden. Durch Deformierung oder Verlagerung der Mittellinienstrukturen und kortikalen Sulci laesst sich das Ausmass der intrakraniellen Raumforderung bestimmen. In vielen Faellen koennen umschriebene Hirnschwellungen abgegrenzt werden. Bei den ohnehin schmalen aeusseren Liquorraeumen der Kinder kann ein generalisiertes Oedem u.U. erst retrospektiv diagnostiziert werden. Die Kernspintomographie (KST) weist im Vergleich zur CT bei um ueber die Akutdiagnostik hinausgehenden Fragen eine hoehere Sensibilitaet auf. Tiefer gelegene kleinste Laesionen insbesondere im Balken, Mittelhirn und Hirnstamm sowie Prozesse nahe der knoechernen Schaedelbasis werden zuverlaessiger erfasst. Durch den Vorteil multiplanarer Schichten sowie dem langen Nachweis von Blutabbauprodukten eignet sich

  12. Epidemiology, clinical characteristics and outcomes of traumatic brain injury: Evidences from integrated level 1 trauma center in India

    Science.gov (United States)

    Kamal, Vineet Kumar; Agrawal, Deepak; Pandey, Ravindra Mohan

    2016-01-01

    Introduction: Traumatic brain injury (TBI) is a leading cause of mortality, morbidity, disability, and socioeconomic losses in the Indian subcontinent. However, for policymaking and research, there is a lack of reliable and larger data in our settings. Aims and Objectives: To evaluate and describe the epidemiological, clinical characteristics, and outcomes of patients with TBI in a Level 1 Trauma Center in India. Materials and Methods: In this retrospective study, all patients with moderate or severe TBI, based on emergency department Glasgow Coma Scale, admitted to neurosurgery Intensive Care Unit (ICU) during May 2010–July 2012 were evaluated to provide detailed information on TBI-related variables and outcomes using descriptive statistics. Results: Among the 1527 patients with moderate or severe TBI patients with mean age 32.15 ± 16.76 years (range: 1–90) and male:female ratio 6.5:1, 1281 (83.89%) had severe TBI. The majority of cases took place in the age group of 21–40 years (50.24%) with the most common mode of injury as road traffic accidents (RTAs) (64.96%). Surgical intervention (craniotomy) was done in 49.12% of patients. About 34.58% (n = 528) patients died in hospital, and 67.21% (n = 701) had unfavorable outcome at 6 months. Conclusions: This is the first study of its kind from the Indian subcontinent that gives data on the admission characteristics, mortality, and 6 months outcome of such patients. Most of the injuries occurred due to RTAs, more common among the economic productive age groups and mostly in males with a high rate of mortality and unfavorable outcome.

  13. ECMO support for right main bronchial disruption in multiple trauma patient with brain injury--a case report and literature review.

    Science.gov (United States)

    Zhou, R; Liu, B; Lin, K; Wang, R; Qin, Z; Liao, R; Qiu, Y

    2015-07-01

    Extracorporeal membrane oxygenation (ECMO) may offer life-saving treatment in severe pulmonary contusion or acute respiratory distress syndrome when conventional treatments have failed. However, because of the bleeding risk of systemic anticoagulation, ECMO should be performed only as a last resort in multiple trauma victims. Here, we report ECMO as a bridge for right main bronchus reconstruction and recovery of traumatic wet lung in a 31-year-old male multi-trauma patient with right main bronchial disruption, bilateral pulmonary contusion, cerebral contusion and long bone fracture. The patient was discharged without any obvious complication. ECMO support in a traumatic brain injured patient with severe hypoxemia caused by lung contusion and/or tracheal bronchus disruption is not an absolute contraindication.

  14. Children's Brain Tumor Foundation

    Science.gov (United States)

    ... SHOWS PROMISE AGAINST GLIOBLASTOMA 2016-12-01 “21st CENTURY CURES ACT": HOUSE PASSES RESEARCH BILL 2016-10- ... America, Africa and Asia with the lowest in Chinese populations and for blacks in South Africa (both ...

  15. Brain Aneurysm Foundation

    Science.gov (United States)

    ... Us BAF at a Glance Staff/Board of Directors Medical Advisory Board Publications BAF Newsletters Annual Reports News Public Service Announcements Press Releases Blog Administrative Tax Returns and Financial Statements 501 (c) (3) IRS Determination Letter Rally Congress! ...

  16. Studies of selective TNF inhibitors in the treatment of brain injury from stroke and trauma: a review of the evidence to date

    Directory of Open Access Journals (Sweden)

    Tuttolomondo A

    2014-11-01

    Full Text Available Antonino Tuttolomondo, Rosaria Pecoraro, Antonio Pinto Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, Italy Abstract: The brain is very actively involved in immune-inflammatory processes, and the response to several trigger factors such as trauma, hemorrhage, or ischemia causes the release of active inflammatory substances such as cytokines, which are the basis of second-level damage. During brain ischemia and after brain trauma, the intrinsic inflammatory mechanisms of the brain, as well as those of the blood, are mediated by leukocytes that communicate with each other through cytokines. A neuroinflammatory cascade has been reported to be activated after a traumatic brain injury (TBI and this cascade is due to the release of pro- and anti-inflammatory cytokines and chemokines. Microglia are the first sources of this inflammatory cascade in the brain setting. Also in an ischemic stroke setting, an important mediator of this inflammatory reaction is tumor necrosis factor (TNF-α, which seems to be involved in every phase of stroke-related neuronal damage such as inflammatory and prothrombotic events. TNF-α has been shown to have an important role within the central nervous system; its properties include activation of microglia and astrocytes, influence on blood–brain barrier permeability, and influences on glutamatergic transmission and synaptic plasticity. TNF-α increases the amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA receptor density on the cell surface and simultaneously decreases expression of γ-aminobutyric acid receptor cells, and these effects are related to a direct neurotoxic effect. Several endogenous mechanisms regulate TNF-α activity during inflammatory responses. Endogenous inhibitors of TNF include prostaglandins, cyclic adenosine monophosphate, and glucocorticoids. Etanercept, a biologic TNF antagonist, has a reported effect of decreasing microglia activation in

  17. Trauma Induced Coagulopathy

    DEFF Research Database (Denmark)

    Genét, Gustav Folmer; Johansson, Per; Meyer, Martin Abild Stengaard

    2013-01-01

    It remains debated whether traumatic brain injury (TBI) induces a different coagulopathy compared to non-TBI. This study investigated traditional coagulation tests, biomarkers of coagulopathy and endothelial damage in trauma patients with and without TBI. Blood from 80 adult trauma patients were...... sampled (median of 68 min (IQR 48-88) post-injury) upon admission to our trauma centre. Plasma/serum were retrospectively analysed for biomarkers reflecting sympathoadrenal activation (adrenaline, noradrenaline), coagulation activation/inhibition and fibrinolysis (protein C, activated protein C, tissue...

  18. Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury.

    Directory of Open Access Journals (Sweden)

    Leonardo Lorente

    Full Text Available OBJECTIVE: Matrix metalloproteinases (MMPs and tissue inhibitors of matrix metalloproteinases (TIMPs play a role in neuroinflammation after brain trauma injury (TBI. Previous studies with small sample size have reported higher circulating MMP-2 and MMP-9 levels in patients with TBI, but no association between those levels and mortality. Thus, the aim of this study was to determine whether serum TIMP-1 and MMP-9 levels are associated with mortality in patients with severe TBI. METHODS: This was a multicenter, observational and prospective study carried out in six Spanish Intensive Care Units. Patients with severe TBI defined as Glasgow Coma Scale (GCS lower than 9 were included, while those with Injury Severity Score (ISS in non-cranial aspects higher than 9 were excluded. Serum levels of TIMP-1, MMP-9 and tumor necrosis factor (TNF-alpha, and plasma levels of tissue factor (TF and plasminogen activator inhibitor (PAI-1 plasma were measured in 100 patients with severe TBI at admission. Endpoint was 30-day mortality. RESULTS: Non-surviving TBI patients (n = 27 showed higher serum TIMP-1 levels than survivor ones (n = 73. We did not find differences in MMP-9 serum levels. Logistic regression analysis showed that serum TIMP-1 levels were associated 30-day mortality (OR = 1.01; 95% CI = 1.001-1.013; P = 0.03. Survival analysis showed that patients with serum TIMP-1 higher than 220 ng/mL presented increased 30-day mortality than patients with lower levels (Chi-square = 5.50; P = 0.02. The area under the curve (AUC for TIMP-1 as predictor of 30-day mortality was 0.73 (95% CI = 0.624-0.844; P<0.001. An association between TIMP-1 levels and APACHE-II score, TNF- alpha and TF was found. CONCLUSIONS: The most relevant and new findings of our study, the largest series reporting data on TIMP-1 and MMP-9 levels in patients with severe TBI, were that serum TIMP-1 levels were associated with TBI mortality and could be used as a prognostic biomarker of mortality

  19. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  20. Alex's Lemonade Stand Foundation Infant and Childhood Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2007-2011.

    Science.gov (United States)

    Ostrom, Quinn T; de Blank, Peter M; Kruchko, Carol; Petersen, Claire M; Liao, Peter; Finlay, Jonathan L; Stearns, Duncan S; Wolff, Johannes E; Wolinsky, Yingli; Letterio, John J; Barnholtz-Sloan, Jill S

    2015-01-01

    The CBTRUS Statistical Report: Alex's Lemonade Stand Foundation Infant and Childhood Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2007–2011 comprehensively describes the current population-based incidence of primary malignant and non-malignant brain and CNS tumors in children ages 0–14 years, collected and reported by central cancer registries covering approximately 99.8% of the United States population (for 2011 only, data were available for 50 out of 51 registries). Overall, brain and CNS tumors are the most common solid tumor, the most common cancer, and the most common cause of cancer death in infants and children 0–14 years. This report aims to serve as a useful resource for researchers, clinicians, patients, and families.

  1. Biochemical indications of cerebral ischaemia and mitochondrial dysfunction in severe brain trauma analysed with regard to type of lesion

    DEFF Research Database (Denmark)

    Nordström, Carl-Henrik; Nielsen, Troels Halfeld; Schalén, Wilhelm

    2016-01-01

    ), cerebral haemorrhagic contusion (CHC) and no mass lesion (NML). Altogether about 150,000 biochemical analyses were performed during the initial 96 h after trauma. Compromised aerobic metabolism occurred during 38 % of the study period. The biochemical pattern indicating mitochondrial dysfunction was more...

  2. Ear trauma.

    Science.gov (United States)

    Eagles, Kylee; Fralich, Laura; Stevenson, J Herbert

    2013-04-01

    Understanding basic ear anatomy and function allows an examiner to quickly and accurately identify at-risk structures in patients with head and ear trauma. External ear trauma (ie, hematoma or laceration) should be promptly treated with appropriate injury-specific techniques. Tympanic membrane injuries have multiple mechanisms and can often be conservatively treated. Temporal bone fractures are a common cause of ear trauma and can be life threatening. Facial nerve injuries and hearing loss can occur in ear trauma.

  3. 脑损伤患者空腹血糖水平变化及其与脑损伤程度的关系分析%Analysis of fasting blood glucose level changes in patients with brain trauma and its correlations with the extent of brain trauma

    Institute of Scientific and Technical Information of China (English)

    蒋海蓉; 颜幼玲; 毛蓓

    2015-01-01

    目的:分析空腹血糖水平变化在脑损伤患者中的临床意义及其与脑损伤程度的关系,为判断患者的预后、指导临床治疗提供理论依据。方法选取本院2009年6月至2011年6月收治的213例脑损伤患者,按照其脑损伤程度分为轻、中、重度脑损伤组,比较三组患者空腹血糖水平差异,同时分析患者预后与空腹血糖水平的相关性。结果 T1~T3时段重度脑损伤组患者空腹血糖水平显著高于中、轻度脑损伤组,中度脑损伤组患者空腹血糖水平亦显著高于轻度脑损伤组(P<0.05);轻度脑损伤组患者T2时即见空腹血糖水平降低,中、重度脑损伤组患者T2时空腹血糖水平上升,T3时空腹血糖水平降低。三组患者均获得有效随访,平均随访时间为(11.7±0.5)个月。随访中可见,预后良好65例,预后较差103例,死亡45例。死亡组患者T1~T3时段空腹血糖水平均显著高于预后较差组及预后良好组,预后较差组患者空腹血糖水平亦显著高于预后良好组(P<0.05);预后良好组患者T2时空腹血糖水平降至正常值,预后较差及死亡患者T3时空腹血糖水平出现降低趋势,但未降至正常水平。以空腹血糖水平为自变量,格拉斯哥昏迷评分(GCS)为因变量,Spearman's相关分析提示y=-0.74x+17.305,空腹血糖水平与GCS评分呈负相关,即血糖增高程度与脑损伤程度呈高度正相关(r=0.74,P<0.01)。结论脑损伤患者受伤后出现明显的空腹血糖升高反应,而空腹血糖升高程度与患者的脑损伤程度呈正相关,在今后的治疗中,应密切监测脑损伤患者的空腹血糖水平,及时调整治疗策略,防止神经系统后遗症的发生,保证患者的生活及生存质量。%Objective To analyze the clinical signiifcance of fasting blood glucose level changes in patients with brain trauma and its correlations with

  4. Pediatric head trauma: the evidence regarding indications for emergent neuroimaging

    Energy Technology Data Exchange (ETDEWEB)

    Kuppermann, Nathan [UC Davis Medical Center, Department of Emergency Medicine, Sacramento, CA (United States); University of California, Davis School of Medicine, Departments of Emergency Medicine and Pediatrics, Davis, CA (United States)

    2008-11-15

    Traumatic brain injury (TBI) is a leading cause of childhood death and disability worldwide. In the United States, childhood head trauma results in approximately 3,000 deaths, 50,000 hospitalizations, and 650,000 emergency department (ED) visits annually. Children presenting to the ED with seemingly minor head trauma account for approximately one-half of children with documented TBIs. Despite the frequency and importance of childhood minor head trauma, there exists no highly accurate, reliable and validated clinical scoring system or prediction rule for assessing risk of TBI among those with minor head trauma. At the same time, use of CT scanning in these children in recent years has increased substantially. The major benefit of CT scanning is early identification (and treatment) of TBIs that might otherwise be missed and result in increased risk of morbidity and mortality. Unnecessary CT imaging, however, exposes the child needlessly to the risk of radiation-induced malignancies. What constitutes appropriate criteria for obtaining CT scans in children after minor blunt head trauma remains controversial. Current evidence to guide clinicians in this regard is limited; however, large studies performed in multi-center research networks have recently been conducted. These studies should provide the foundation of evidence to guide CT decisions by clinicians, help identify TBIs in a timely fashion, and reduce unnecessary radiation exposure. (orig.)

  5. Systemic trauma.

    Science.gov (United States)

    Goldsmith, Rachel E; Martin, Christina Gamache; Smith, Carly Parnitzke

    2014-01-01

    Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering.

  6. The Biology of Trauma: Implications for Treatment

    Science.gov (United States)

    Solomon, Eldra P.; Heide, Kathleen M.

    2005-01-01

    During the past 20 years, the development of brain imaging techniques and new biochemical approaches has led to increased understanding of the biological effects of psychological trauma. New hypotheses have been generated about brain development and the roots of antisocial behavior. We now understand that psychological trauma disrupts homeostasis…

  7. Physical Trauma as an Etiological Agent in Mental Retardation.

    Science.gov (United States)

    Angle, Carol R., Ed.; Bering, Edgar A., Jr., Ed.

    The conference on Physical Trauma as a Cause of Mental Retardation dealt with two major areas of etiological concern - postnatal and perinatal trauma. Following two introductory statements on the problem of and issues related to mental retardation (MR) after early trauma to the brain, five papers on the epidemiology of head trauma cover…

  8. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

    2014-01-15

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  9. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: a case report.

    Science.gov (United States)

    Mimata, Yoshikuni; Murakami, Hideki; Sato, Kotaro; Suzuki, Yoshiaki

    2014-01-01

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important.

  10. Recuperação das vítimas de traumatismo cranio-encefálico no período de 1 ano após o trauma Traumatic brain injury pacients 1 year after trauma

    Directory of Open Access Journals (Sweden)

    Regina Marcia Cardoso de Sousa

    1996-12-01

    Full Text Available Estudo prospectivo longitudinal sobre a recuperação aos 12 meses, de vítimas de traumatismo crânio-encefálico (TCE de diferentes gravidades, com idade entre 12 e 60 anos. As vítimas foram avaliadas 1 ano após o trauma considerando-se tanto suas limitações funcionais mensuradas pela Escala de Resultados de Glasgow (ERG em sua versão de oito categorias, como também, o seu retorno à produtividade. Aos 12 meses, 77,2% das vitimas alcançaram a pontuação 0 e 1 na ERG ampliada. Destas, 38,6% obtiveram a pontuação 0, ou seja, recuperação total . Indivíduos incapazes (pontuação > 1 foram 22,8% sendo aqueles com incapacidade moderada (+, ERG2, e grave (+, ERG4, os mais freqüentes. Retorno à produtividade ocorreu em 83,3% das vítimas e destas, 19,4% tinham alterações na ocupação principal.A prospective longitudinal study of traumatic brain, injury (TBI patients was conduced to identify the recovery pattern 1 year after trauma. Patients with all levels of injury and age between 12 and 60 years were observed. They were analyzed using the eight-point Glasgow Outcome Scale (GOS as well as their return to productivity in that period. The majority of victims (77,2% made good recovery, that is (GOS = 0 or 1 and complete recovery or GOS 0 was achieved in 38,6% of then. However at the 1 year mark, 22,8% of the victims showed disabilities. Overall , victims had returned to productivity in that period (83,3% but 19,4% of them have had changes in their productivity and 16,7% didn't return to your job..

  11. Expression of trkB mRNA is altered in rat hippocampus after experimental brain trauma.

    Science.gov (United States)

    Hicks, R R; Zhang, L; Dhillon, H S; Prasad, M R; Seroogy, K B

    1998-08-31

    Recent investigations have shown that expression of mRNAs for the neurotrophins brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) is differentially altered in the hippocampus following traumatic brain injury. In the present study, modulation of neurotrophin receptor expression was examined in the hippocampus in a rat model of traumatic brain injury using in situ hybridization. Messenger RNA for trkB, the high-affinity receptor for BDNF and neurotrophin-4 (NT-4), was increased between 3 and 6 h bilaterally in the dentate gyrus following a lateral fluid-percussion brain injury of moderate severity (2.0-2.1 atm). No time-dependent alterations were observed for trkB mRNA in hippocampal subfields CA1 and CA3. Levels of mRNA for trkC, the high-affinity receptor for NT-3, did not change in any region of the hippocampus. These data demonstrate that lateral fluid-percussion injury modulates expression of trkB mRNA in the hippocampus and support a role for BDNF/trkB signalling mechanisms in secondary events associated with traumatic brain injury.

  12. Quality management for trauma patients in the emergency department

    NARCIS (Netherlands)

    Lubbert, P.H.W.

    2010-01-01

    The quality of care for trauma patients seems to have dramatically improved in the last decades. Both political and medical changes have influenced these changes. In the Netherlands the organization of a trauma system started in the eighties of last century with the foundation of the Dutch Trauma So

  13. Zinc or copper deficiency-induced impaired inflammatory response to brain trauma may be caused by the concomitant metallothionein changes

    DEFF Research Database (Denmark)

    Penkowa, Milena; Giralt, M.; Thomsen, Pernille Sjølin;

    2001-01-01

    damage to neurons as indicated by neuron specific enolase (NSE) ir, and the number of cells undergoing apoptosis (measured by TUNEL) was dramatically increased. Zinc deficiency significantly altered brain response to TBI, potentiating the microgliosis and reducing the astrogliosis, while increasing...

  14. [Chest trauma].

    Science.gov (United States)

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe.

  15. Protective effects and time course of Huangqion early-stage free radical injury following brain trauma in rats

    Institute of Scientific and Technical Information of China (English)

    Hongjie Wang; Xingbo Liu; Xun Wang

    2008-01-01

    BACKGROUND: Huangqi (Astragalus mongholicus), a Chinese herb, has already been included in the "Chinese Pharmacopoeia" for the treatment of ischemic cerebrovascular disease. Secondary injury following brain injury is associated with free radical production, and Huangqi possesses the ability to ameliorate free radical-mediated injury. OBJECTIVE: This study was designed to observe the correlation between anti-free-radical properties of Huangqi and early histological changes of brain tissues following traumatic brain injury. DESIGN, TIME AND SETTING: This study, a randomized, controlled, animal experiment, was performed from May 2006 to June 2007 at the Experimental Center of Science and Technology, School of Basic Science, Liaoning Medical University, Jinzhou City, Liaoning Province, China. MATERIALS: Healthy, adult, Sprague Dawley rats of either gender were included. Huangqi injection was purchased from Heilongjiang Provincial Zhenbaodao Pharmaceutical Co., Ltd., China (National License Medical Number: Z23020781). Na+-K+-adenosine triphosphatase (ATPase), Ca2+-ATPase, and Mg2+-ATPase, as well as kits to measure superoxide dismutase (SOD) activity and malondialdehyde (MDA) content, were purchased from Nanjing Jiancheng Biological Reagent Company, China. METHODS: Seventy-two rats were randomly divided into three groups, with 24 rats in each group: (1) sham-operated group: rats were only exposed, but not injured; (2) model group: brain focal laceration rat models were established by free-falling. These groups were intraperitoneally injected with saline, once every 10 hours; (3) Huangqi group: rats were intraperitoneally injected with 4 mL/kg Huangqi (2 g/mL), once every 10 hours, following brain focal laceration by free-falling. MAIN OUTCOME MEASURES: Ultrastructural changes in brain tissue were observed under an electron microscope 24 hours after injury. The water content of brain tissue was measured using the dry-wet weight method. In addition, the activity of ATPase

  16. Biosensors for Brain Trauma and Dual Laser Doppler Flowmetry: Enoxaparin Simultaneously Reduces Stroke-Induced Dopamine and Blood Flow while Enhancing Serotonin and Blood Flow in Motor Neurons of Brain, In Vivo

    Directory of Open Access Journals (Sweden)

    Edwin H. Kolodny

    2010-12-01

    enoxaparin and reperfusion effects actually while enoxaparin is inhibiting blood clots to alleviate AIS symptomatology. This research is directly correlated with the medical and clinical needs of stroke victims. The data are clinically relevant, not only to movement dysfunction but also to the depressive mood that stroke patients often endure. These are the first studies to image brain neurotransmitters while any stroke medications, such as anti-platelet/ anti-thrombotic and/or anti-glycoprotein are working in organ systems to alleviate the debilitating consequences of brain trauma and stroke/brain attacks.

  17. Effects of acute substance use and pre-injury substance abuse on traumatic brain injury severity in adults admitted to a trauma centre

    Directory of Open Access Journals (Sweden)

    Schanke Anne-Kristine

    2010-05-01

    Full Text Available Abstract Background The aims of this study were to describe the occurrence of substance use at the time of injury and pre-injury substance abuse in patients with moderate-to-severe traumatic brain injury (TBI. Effects of acute substance use and pre-injury substance abuse on TBI severity were also investigated. Methods A prospective study of 111 patients, aged 16-55 years, injured from May 2005 to May 2007 and hospitalised at the Trauma Referral Centre in Eastern Norway with acute TBI (Glasgow Coma Scale 3-12. Based on structural brain damages shown on a computed tomography (CT scan, TBI severity was defined by modified Marshall classification as less severe (score Results Forty-seven percent of patients were positive for substance use on admission to hospital. Significant pre-injury substance abuse was reported by 26% of patients. Substance use at the time of injury was more frequent in the less severe group (p = 0.01. The frequency of pre-injury substance abuse was higher in the more severe group (30% vs. 23%. In a logistic regression model, acute substance use at time of injury tended to decrease the probability of more severe intracranial injury, but the effect was not statistically significant after adjusting for age, gender, education, cause of injury and substance abuse, OR = 0.39; 95% CI 0.11-1.35, p = 0.14. Patients with positive screens for pre-injury substance abuse (CAGE ≥2 were more likely to have more severe TBI in the adjusted regression analyses, OR = 4.05; 95% CI 1.10-15.64, p = 0.04. Conclusions Acute substance use was more frequent in patients with less severe TBI caused by low-energy events such as falls, violence and sport accidents. Pre-injury substance abuse increased the probability of more severe TBI caused by high-energy trauma such as motor vehicle accidents and falls from higher levels. Preventive efforts to reduce substance consumption and abuse in at-risk populations are needed.

  18. Corporate Foundations

    DEFF Research Database (Denmark)

    Herlin, Heidi; Thusgaard Pedersen, Janni

    2013-01-01

    This paper aims to explore the potential of Danish corporate foundations as boundary organizations facilitating relationships between their founding companies and non-governmental organizations (NGOs). Hitherto, research has been silent about the role of corporate foundations in relation to cross......-sector partnerships. The results of this paper are based on interviews, participant observations, and organizational documents from a 19-month empirical study of a Danish corporate foundation. Findings suggest that corporate foundations have potential to act as boundary organizations and facilitate collaborative...... action between business and NGOs through convening, translation, collaboration, and mediation. Our study provides valuable insights into the tri-part relationship of company foundation NGO by discussing the implications of corporate foundations taking an active role in the realm of corporate social...

  19. Trauma Africa

    Directory of Open Access Journals (Sweden)

    Victor Y. Kong

    2013-11-01

    Full Text Available “Major Trauma. Dr. Kong, please come to the Trauma Unit immediately. Dr. Kong, please come to the Trauma Unit immediately.” Even though I have been working at Edendale Hospital as a trauma registrar for over a year, whenever I hear this announcement over the hospital intercom system, my heart beats just a little faster than normal. When I first arrived at Edendale my colleagues told me that the adrenaline rush I would experience after being called out to attend a new emergency would decrease over time, and indeed they were right. However, it is also true to say that on some occasions more than others, it is still felt more strongly than ever.

  20. Is the shock index based classification of hypovolemic shock applicable in multiple injured patients with severe traumatic brain injury?—an analysis of the TraumaRegister DGU®

    OpenAIRE

    Fröhlich, Matthias; Driessen, Arne; Böhmer, Andreas; Nienaber, Ulrike; Igressa, Alhadi; Probst, Christian; Bouillon, Bertil; Maegele, Marc; Mutschler, Manuel; ,

    2016-01-01

    Background A new classification of hypovolemic shock based on the shock index (SI) was proposed in 2013. This classification contains four classes of shock and shows good correlation with acidosis, blood product need and mortality. Since their applicability was questioned, the aim of this study was to verify the validity of the new classification in multiple injured patients with traumatic brain injury. Methods Between 2002 and 2013, data from 40 888 patients from the TraumaRegister DGU® were...

  1. Caracterização de cuidadores de vítimas de trauma crânio-encefálico em seguimento ambulatorial Caracterización de cuidadores de víctimas de trauma cráneo-encefálico con seguimiento ambulatorio Characterization of caregivers of victims of traumatic brain injury on an outpatient follow-up program

    Directory of Open Access Journals (Sweden)

    Edilene Curvelo Hora

    2005-09-01

    Full Text Available O presente estudo caracterizou o cuidador familiar principal de 50 vítimas de trauma crânio-encefálico em seguimento ambulatorial, em um centro para atendimento de trauma na cidade de São Paulo, por meio de entrevista e análise de prontuário. Os resultados revelaram que os cuidadores tinham idade média de 44,90 anos, eram em sua maioria do sexo feminino, solteiros, católicos, não haviam completado o ensino fundamental e não tinham ocupação remunerada antes do trauma. A metade dos cuidadores principais era mãe da vítima, 22% esposa(o e 18% irmã(ão. A presença do cuidador secundário foi observada em 48% dos casos avaliados.En el presente estudio se caracterizó al cuidador familiar principal de 50 víctimas de trauma cráneo-encefálico con seguimiento ambulatorio, de un centro para atención de traumas en la ciudad de São Paulo, por medio de entrevista y análisis de la historia clínica. Los resultados revelaron que los cuidadores tenían como edad promedio 44,90 años, en su mayoría eran del sexo femenino, solteros, católicos, no habían completado sus estudios básicos y no tenían ocupación remunerada antes del trauma. La mitad de los cuidadores principales era madre de la víctima, 22% esposa(o y el 18% hermano(a. La presencia del cui-dador secundario fue observada en 48% de los casos evaluados.The present study characterized the main family caregiver of 50 victims of traumatic brain injury on an outpatient follow-up program of a trauma center in São Paulo through interviews and record analyses. The results revealed that caregivers had average age of 44.9, were mostly female, single, Catholic, had not completed elementary school and had no paid occupation prior to the trauma. One half of the main caregivers was the victim's mother, 22 percent was the spouse and 18 percent was a sibling. The presence of a secondary caregiver was observed in 48 percent of the cases.

  2. Foundation Structure

    DEFF Research Database (Denmark)

    2009-01-01

    Method of installing a bucket foundation structure comprising one, two, three or more skirts, into soils in a controlled manner. The method comprises two stages: a first stage being a design phase and the second stage being an installation phase. In the first stage, design parameters are determined...... relating to the loads on the finished foundation structure; soil profile on the location; allowable installation tolerances, which parameters are used to estimate the minimum diameter and length of the skirts of the bucket. The bucket size is used to simulate load situations and penetration into foundation...

  3. Children and Facial Trauma

    Science.gov (United States)

    ... an ENT Doctor Near You Children and Facial Trauma Children and Facial Trauma Patient Health Information News ... staff at newsroom@entnet.org . What is facial trauma? The term facial trauma means any injury to ...

  4. Glaucoma Foundation

    Science.gov (United States)

    ... IMPORTANT RESEARCH FINDING First Cellular Model of Exfoliation Glaucoma Research is advancing in the quest to find ... cure for exfoliation syndrome and its associated exfoliation glaucoma, the current focus of The Glaucoma Foundation. Exfoliation ...

  5. Foundation Structure

    OpenAIRE

    Schakenda, Bruno; Nielsen, Søren Andreas; Ibsen, Lars Bo

    2009-01-01

    Method of installing a bucket foundation structure comprising one, two, three or more skirts, into soils in a controlled manner. The method comprises two stages: a first stage being a design phase and the second stage being an installation phase. In the first stage, design parameters are determined relating to the loads on the finished foundation structure; soil profile on the location; allowable installation tolerances, which parameters are used to estimate the minimum diameter and length of...

  6. Imaging in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Goethem, J.W.M. van [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium); Algemeen Ziekenhuis Maria Middelares, Department of Radiology, Sint-Niklaas (Belgium); Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M. [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium)

    2005-03-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  7. Trauma Theory

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    There are two main trends in psychological approaches to human suffering related to what we term trauma. Although they have their respective limitations both approaches may help us explore and alleviate human suffering. One trend, primarily using concepts like traumatic events and traumatisation ...

  8. Trauma Ultrasound.

    Science.gov (United States)

    Wongwaisayawan, Sirote; Suwannanon, Ruedeekorn; Prachanukool, Thidathit; Sricharoen, Pungkava; Saksobhavivat, Nitima; Kaewlai, Rathachai

    2015-10-01

    Ultrasound plays a pivotal role in the evaluation of acute trauma patients through the use of multi-site scanning encompassing abdominal, cardiothoracic, vascular and skeletal scans. In a high-speed polytrauma setting, because exsanguinations are the primary cause of trauma morbidity and mortality, ultrasound is used for quick and accurate detection of hemorrhages in the pericardial, pleural, and peritoneal cavities during the primary Advanced Trauma Life Support (ATLS) survey. Volume status can be assessed non-invasively with ultrasound of the inferior vena cava (IVC), which is a useful tool in the initial phase and follow-up evaluations. Pneumothorax can also be quickly detected with ultrasound. During the secondary survey and in patients sustaining low-speed or localized trauma, ultrasound can be used to help detect abdominal organ injuries. This is particularly helpful in patients in whom hemoperitoneum is not identified on an initial scan because findings of organ injuries will expedite the next test, often computed tomography (CT). Moreover, ultrasound can assist in detection of fractures easily obscured on radiography, such as rib and sternal fractures.

  9. Blunt Head Trauma and Headache

    Directory of Open Access Journals (Sweden)

    Ana B Chelse

    2015-04-01

    Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

  10. The Trauma-Sensitive Teacher

    Science.gov (United States)

    Craig, Susan E.

    2016-01-01

    According to the National Center for Mental Health Promotion and Youth Violence Prevention, about one quarter of children in the United States will witness or experience a traumatic event before the age of four. In this article, Susan E. Craig explains how these early trauma histories prime a child's brain to expect certain experiences,…

  11. Retorno à produtividade após reabilitação de pacientes deambuladores vítimas de trauma craniencefálico Return to productivity after rehabilitation by walking patients, traumatic brain injury survivors

    Directory of Open Access Journals (Sweden)

    Cleuza Braga da Silva

    2008-01-01

    Full Text Available Vítimas de trauma craniencefálico (TCE freqüentemente alcançam independência nas atividades de vida diária, mas encontram limitações quanto à participação na comunidade ou no trabalho produtivo. Este estudo visou verificar o índice de retorno, após programa de reabilitação, à produtividade (estudo e/ou trabalho de sujeitos que haviam tido TCE. Participaram 60 sujeitos deambuladores comunitários (média de idade 30,4 anos, mínima 18, máxima 53, selecionados dentre os prontuários de pacientes com diagnóstico de TCE que freqüentaram o programa de reabilitação entre 2002 a 2004 no Setor de Fisioterapia Adulto da Associação de Assistência à Criança Deficiente (AACD em São Paulo, SP. Em entrevista, foi aplicado um questionário elaborado pela equipe da AACD. Os participantes - 51 homens e 9 mulheres - tinham sofrido em sua maioria (95% trauma grave. Os resultados mostram que 71,7% dos participantes retomaram atividades ocupacionais ou escolares, mas apenas 38,3% estavam trabalhando por ocasião da entrevista. Embora sem significância estatística, o tempo decorrido entre o trauma e o início da reabilitação parece estar associado ao retorno à produtividade. O nível de escolaridade prévio ao trauma mostrou ter influência (pTraumatic brain injury (TBI survivors are frequently independent regarding daily life activities, but often face limitations concerning community participation or productive work. This study aimed at determining the rate of return to productivity (studying or working of subjects having suffered TBI. Sixty walking TBI patients (mean age 30.4, range 18 to 53 years old were selected by chart review of TBI patients who attended a rehabilitation program between 2002 and 2004 in AACD, São Paulo, and were interviewed to answer a questionnaire. Participants - 51 men, 9 women - had mostly (95% undergone severe trauma. Results show that 71.7% of the patients returned to productivity (but only 38.3% were

  12. Mild traumatic brain injury and immediate hypopituitarism in children = Trauma cranioencefálico leve e hipopituitarismo imediato em crianças

    Directory of Open Access Journals (Sweden)

    Nordon, David Gonçalves

    2012-01-01

    Conclusões: Os resultados deste estudo apontam para disfunções endócrinas provavelmente pouco importantes, já que algumas das alterações encontradas podem estar relacionadas à resposta ao trauma agudo. Considerando a literatura e os resultados, é possível especular que a relação do trauma cranioencefálico com hipopituitarismo em crianças é diferente dos adultos

  13. Wiener-Granger causality for effective connectivity in the hidden states: Indication from probabilistic causality. Comment on "Foundational perspectives on causality in large-scale brain networks" by M. Mannino and S.L. Bressler

    Science.gov (United States)

    Tang, Wei

    2015-12-01

    Statistics and probability theory have advanced our understanding of random processes widely observed in the physical world. There is a remarkable trend in studying the brain by looking into the stochastic information processing in large-scale brain networks [1,2]. As the review by Mannino and Bressler [3] points out, the probabilistic notion of causality, with its rooted philosophical foundations, represents a revolutionary view on how different parts of the brain interact and integrate to generate function. Specifically, Probabilistic Causality (PC) asserts that a cause should increase the probability of occurrence of its effect, and PC between two brain regions entails that the probability for the activity in one region to occur increases when conditioned on the activity of the other. This definition claims inherent randomness in the causal relationship.

  14. Dentoalveolar trauma.

    Science.gov (United States)

    Olynik, Christopher R; Gray, Austin; Sinada, Ghassan G

    2013-10-01

    Dentoalveolar injuries are an important and common component of craniomaxillofacial trauma. The dentition serves as a vertical buttress of the face and fractures to this area may result in malalignment of facial subunits. Furthermore, the dentition is succedaneous with 3 phases-primary dentition, mixed dentition, and permanent dentition-mandating different treatment protocols. This article is written for nondental providers to diagnose and treat dentoalveolar injuries.

  15. Applied Foundations

    DEFF Research Database (Denmark)

    Kohlenbach, Ulrich

    2002-01-01

    A central theme in the foundations of mathematics, dating back to D. Hilbert, can be paraphrased by the following question "How is it that abstract methods (`ideal elements´) can be used to prove `real´ statements e.g. about the natural numbers and is this use necessary in principle?"...

  16. Bucket foundations

    DEFF Research Database (Denmark)

    Foglia, Aligi; Ibsen, Lars Bo

    In this report, bearing behaviour and installation of bucket foundations are reviewed. Different methods and standards are compared with the experimental data presented in Foglia and Ibsen (2014a). The most important studies on these topics are suggested. The review is focused on the response...

  17. Os efeitos das alterações comportamentais das vítimas de trauma crânio-encefálico para o cuidador familiar Los efectos de las alteraciones comportamentales de las victimas de trauma cráneo encefálico para el cuidador familiar Effect of the behavioral alterations of victims of traumatic brain injury for the family caregiver

    Directory of Open Access Journals (Sweden)

    Edilene Curvelo Hora

    2005-02-01

    variación de humor. Los seis primeros comportamientos mencionados fueron los que más incidieron negativamente sobre el cuidador. No se encontró relación entre el tiempo transcurrido y los efectos de las alteraciones comportamentales.This study aimed to identify alterations in the intensity at which the negative behaviors of the victims of traumatic brain injury (TBI affect the main family caregiver comparing the periods before and after the trauma and to verify the relation between the intensity of these alterations and time passed after the traumatic event. Participants were 50 caregivers of victims with different levels of dependence after TBI. The effect of the victim’s behaviors on the caregiver was measured by means of a Likert scale, in view of eleven negative behaviors cited in literature. According to the caregiver, the victim was more aggressive, anxious, dependent, depressed, irritated, and forgetful after the trauma, with a more explosive temperament, more self-centered, impulsive, with greater social inadequacy and mood oscillation. The first six cited behaviors were the ones that affected the caregiver more negatively. No relation was found between the passed time and the effect of the behavioral alterations

  18. 颅骶技术用于脑外伤后遗症康复治疗%Craniosacral technique used in the treatment of brain trauma sequela rehabilitation: a personalized scheme

    Institute of Scientific and Technical Information of China (English)

    狄荣科; 曾建; 卜浪; 谭文捷

    2012-01-01

    Objective To use craniosacral technology for brain trauma sequela, to discuss the curative effect of personalized scheme of craniosacral therapy and its feasibility. Methods One patient with brain trauma sequela more than ten years was treated with comprehensive treatment plan of the craniosacral therapy. Conditions of Zang and Fu visceral organs and Meridian function were evaluated by meridian detector respectively before and after treatment. Results After treatment, Zang and Fu visceral organs and meridian function of the patient were improved obviously, self-conscious symptom was disappeared (all P < 0.05). Conclusion Craniosacral therapy has the obvious stimulative effect for the rehabilitation after traumatic brain injury by adjusting the integrated function of Zang and Fu visceral organs and Meridians.%目的 应用颅骶技术治疗脑外伤后遗症,探讨颅骶疗法个性化方案的疗效及其可行性.方法 选取脑外伤后遗症患者1例,采用颅骶疗法综合治疗方案,分别于治疗前和治疗后用经络检测仪评价脏腑和经络功能状态.结果 治疗后患者在脏腑和经络功能均有明显改善,自觉症状消失,差异均有统计学意义(均P < 0.05).结论 颅骶疗法通过调节脏腑和经络的整体功能,对脑外伤后遗留的身心损伤的康复具有明显的促进作用.

  19. Fatores de risco para dependência após trauma crânio-encefálico Factores de riesgo para la dependencia despues del trauma crâneo-encefálico Risk factors for dependency after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Regina Márcia Cardoso de Sousa

    2005-12-01

    dependientes que los demás. CONCLUSIÓN: los mayores factores de riesgo para la dependencia según la Abbreviated Injury Scale fueron los de la región de la cabeza y el tiempo de internamiento.OBJECTIVE: to predict which characteristics of traumatic brain injury patients (age, sex, education, patient history, days of hospitalization, post-traumatic complications and indicators of the severity of trauma and cranial lesion were risk factors for unfavorable prognosis. METHODS: Data were collected from 63 blunt trauma patients, aged 12 to 65 years old who were six months to three years post-trauma, and were receiving follow-up treatment at a trauma center. Multiple logistic regression was used to analyze the data and develop a model for functional status. RESULTS: Individuals who had a maximum score, five points on the Abbreviated Injury Scale (AIS for head trauma, were 4.89 times more likely to be dependent than those who had lower scores. Trauma victims who remained hospitalized for 12 days or more were 5.76 times more likely to become dependent than those who had a shorter length of hospitalization. CONCLUSION: Highest score on the AIS, and longer length of hospitalization were the major risk factors for dependency.

  20. Neuroimaging differential diagnoses to abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Aix Marseille University, UMR CNRS 7339, Marseille (France); Brunel, Herve; Dory-Lautrec, Philippe [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Chabrol, Brigitte [AP-HM Timone, Department of Pediatric Neurology, Marseille (France)

    2016-05-15

    Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

  1. Trauma during pregnancy.

    Science.gov (United States)

    Tweddale, Carla J

    2006-01-01

    Trauma is the leading nonobstetrical cause of maternal death. The effect of trauma on the pregnant woman and unborn fetus can be devastating. The major causes of maternal injury are blunt trauma, penetrating trauma, burns, falls, and assaults. There are specific changes associated with pregnancy that are important for the clinician to consider when providing care to these patients. Initial management of traumatic injuries during pregnancy is essential for maternal and fetal well-being. This review outlines common causes of maternal trauma, the initial assessment of the pregnant trauma patient, and ongoing care for the pregnant trauma patient and unborn fetus.

  2. Depressão: uma possível consequência adversa do trauma crânio-encefálico para o cuidador familiar Depresión: una posible consecuencia adversa del trauma cráneo-encefálico para el cuidador familiar Depression: a possible adverse consequence of the traumatic brain injury for the family caregiver

    Directory of Open Access Journals (Sweden)

    Edilene Curvelo Hora Serna

    2005-06-01

    con el estado de la víctima y el tiempo transcurrido después del evento traumático.Descriptive study, with quantitative approach, developed in the Clinic of the Cranium Trauma with 50 caregivers and 50 victims of Traumatic Brain Injury, with the objective to verify the presence of depressive symptoms and its association with the passed time of the traumatic event and the condition of the victim six months or more time after the trauma. The Inventory of Depression by Beck was applied to the caregivers and Glasgow Results Scale in the evaluation of the condition of the victims, applied the test homogeneity Qui-square and the coefficient of correlation by Pearson. Of the appraised caregivers 34% presented suggestive results of depression, there was not association among the categorization for the Inventory of Beck and the classification in the Glasgow Results Scale and time of the trauma, in other words, the presence of depressive symptoms in the caregiver does not seem to be related with the condition of the victim and the passed time after the traumatic event.

  3. [Minor craniocerebral trauma].

    Science.gov (United States)

    Scharplatz, D; Zimmermann, H

    2002-09-04

    Mild craniocerebral injury or mild traumatic brain injury (MTBI) predominates, occurring with an 80% frequency. A 1997 publication by the American Academy of Neurology clearly defines MTBI as a transient alteration of mental status, without any neurological deficit, that may or may not involve loss of consciousness or amnesia. On the Glasgow Coma Scale (GCS), mild craniocerebral injury corresponds to a score of 14 and 15. The GCS must be taken immediately. Advanced trauma life support follows primary survey methodology and ABCDE protocol. The prognosis in MTBI is significantly worse when the patient suffers from intercurrent hypotension and hypoxia. In smaller hospitals, 24-hour monitoring is imperative. Wherever computerized tomography (CT) is available, a CT examination is broadly indicated. There is no knowledge of any adverse effects on patients whose GCS worsened when the CT revealed normal findings.

  4. The clinical application of hyperbaric oxygen therapy for brain trauma cognitive disorder%高压氧治疗脑外伤认知障碍的临床应用

    Institute of Scientific and Technical Information of China (English)

    徐春江; 韩扬

    2013-01-01

    The cognitive disorder is common in patients with traumatic brain injury,one of the pathogenesis of cognitive disorde after brain injury is very complex and in close contact,cognitive disorde assessment method is mainly neuropsychological scale,MMSE is one of the most influential cognitive screening tool that is widely used at home and abroad.At present in the treatment of cognitive disorde,traumatic brain injury rehabilitation training is regarded as a routine treatment,and should be performed as early as possible.Based on the cognitive rehabilitation of computer-aided remote rehabilitation abroad has developed rapidly,the Chinese medicine,acupuncture,drug therapy,hyperbaric oxygen therapy and the integrated use of various treatment methods,is currently the head trauma treatment commonly used cognitive disorde.Hyperbaric oxygen therapy of brain trauma,less experimental studies of cognitive disorde.Hyperbaric oxygen therapy of brain trauma cognitive disorde is mainly the mechanism of hyperbaric oxygen on cerebral protection and repair of damage function.Brain injury rehabilitation of cognitive disorder,need to be adopted,including conventional drugs,rehabilitation training,hyperbaric oxygen therapy,family training,distance and other rehabilitation method,the overall plan,the clinical curative effect is expected to increase significantly.%认知功能障碍是脑外伤患者常见的表现之一,脑外伤后认知障碍的发病机制十分复杂且密切联系,认知障碍的的评定方法主要是神经心理量表,精神状态简易速检表(MMSE)是最具影响力的认知功能筛查工具,在国内外被广泛应用.目前对脑外伤认知障碍的治疗中,康复训练被认为是常规的治疗手段,并且被认为应及早进行.基于电脑辅助的认知康复即远程康复在国外发展迅速,中药、针灸、药物治疗、高压氧治疗及各种治疗方法的综合运用,是目前脑外伤认知障碍的常用治疗手段.高压氧治疗脑外

  5. Head trauma.

    Science.gov (United States)

    Gean, Alisa D; Fischbein, Nancy J

    2010-11-01

    Worldwide, an estimated 10 million people are affected annually by traumatic brain injury (TBI). More than 5 million Americans currently live with long-term disability as a result of TBI and more than 1.5 million individuals sustain a new TBI each year. It has been predicted that TBI will become the third leading cause of death and disability in the world by the year 2020. This article outlines the classification of TBI, details the types of lesions encountered, and discusses the various imaging modalities available for the evaluation of TBI.

  6. Mudanças nos papéis sociais: uma conseqüência do trauma crânio-encefálico para o cuidador familiar Cambios en los roles sociales: una consecuencia del trauma cráneo-encefálico para el cuidador familiar Changes in social roles: a consequence of traumatic brain injury for the family caregiver

    Directory of Open Access Journals (Sweden)

    Edilene Curvelo Hora Serna

    2006-04-01

    study changes in the caregiver's social roles after traumatic brain injury (TBI, relating them with the degree of importance of these roles and with the condition of the victim six months or more after the TBI. The research was developed at the Brain Trauma Clinic of the University of São Paulo Hospital das Clínicas with 50 caregivers and 50 victims of TBI, by means of interviews and patient file analysis. A checklist was used for the interview with the caregiver, in order to identify the changes and importance of their social roles. The roles that had suffered most interruption due to the trauma were: friend, amateur/entertainment, family member and worker. The role of being a caregiver was the one that presented more modification. No association was found between change of role and the variables: condition of victim after TBI and importance of the social roles for the caregiver.

  7. Clinical and Physiological Events That Contribute to the Success Rate of Finding "Optimal" Cerebral Perfusion Pressure in Severe Brain Trauma Patients

    NARCIS (Netherlands)

    Weersink, Corien S. A.; Aries, Marcel J. H.; Dias, Celeste; Liu, Mary X.; Kolias, Angelos G.; Donnelly, Joseph; Czosnyka, Marek; van Dijk, J. Marc C.; Regtien, Joost; Menon, David K.; Hutchinson, Peter J.; Smielewski, Peter

    2015-01-01

    Objective: Recently, a concept of an individually targeted level of cerebral perfusion pressure that aims to restore impaired cerebral vasoreactivity has been advocated after traumatic brain injury. The relationship between cerebral perfusion pressure and pressure reactivity index normally is suppos

  8. Trauma-Sensitive Schools: An Evidence-Based Approach

    Science.gov (United States)

    Plumb, Jacqui L.; Bush, Kelly A.; Kersevich, Sonia E.

    2016-01-01

    Adverse childhood experiences (ACEs) are a common and pervasive problem. There is a positive correlation between ACEs and difficulties across the lifespan. Unlike healthy forms of stress, ACEs have a detrimental impact on the developing brain. There are three types of trauma: acute, chronic, and complex. Most ACEs are considered complex trauma,…

  9. Suspension Trauma / Orthostatic Intolerance

    Science.gov (United States)

    ... of Science and Technology Assessment Printer Friendly Version Suspension Trauma/Orthostatic Intolerance Safety and Health Information Bulletin ... information about the hazards of orthostatic intolerance and suspension trauma when using fall arrest systems. This bulletin: ...

  10. Trauma Facts for Educators

    Science.gov (United States)

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This paper offers facts which can help educators deal with children undergoing trauma. These include: (1) One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior; (2) Trauma can impact school performance; (3) Trauma can impair learning; (4) Traumatized children may experience…

  11. Trauma resuscitation time.

    NARCIS (Netherlands)

    Olden, G.D.J. van; Vugt, A.B. van; Biert, J.; Goris, R.J.A.

    2003-01-01

    Documenting the timing and organisation of trauma resuscitation can be utilised to assess performance standards, and to ensure a high quality of trauma resuscitation procedures. Since there is no European literature available on trauma resuscitation time (TRT) in the emergency room, the aim of this

  12. Skin Cancer Foundation

    Science.gov (United States)

    ... Host a Fundraising Event | About Us | Store The Skin Cancer Foundation The Skin Cancer Foundation is the ... A "Sunscreen Gene"? Skin Cancer Facts & Statistics The Skin Cancer Foundation's Champions for Change Gala 2016 Learn ...

  13. What is the nature of causality in the brain? - Inherently probabilistic. Comment on "Foundational perspectives on causality in large-scale brain networks" by M. Mannino and S.L. Bressler

    Science.gov (United States)

    Dhamala, Mukesh

    2015-12-01

    Understanding cause-and-effect (causal) relations from observations concerns all sciences including neuroscience. Appropriately defining causality and its nature, though, has been a topic of active discussion for philosophers and scientists for centuries. Although brain research, particularly functional neuroimaging research, is now moving rapidly beyond identification of brain regional activations towards uncovering causal relations between regions, the nature of causality has not be been thoroughly described and resolved. In the current review article [1], Mannino and Bressler take us on a beautiful journey into the history of the work on causality and make a well-reasoned argument that the causality in the brain is inherently probabilistic. This notion is consistent with brain anatomy and functions, and is also inclusive of deterministic cases of inputs leading to outputs in the brain.

  14. Factor analysis of high cost for patients with traumatic brain injury combined multiple trauma%脑外伤合并多发伤患者高额费用发生分析

    Institute of Scientific and Technical Information of China (English)

    李蕊; 汤可; 林济南; 柴琳

    2014-01-01

    目的:通过总结、分析颅脑外伤合并多发伤患者的临床资料,评估颅脑外伤合并多发伤患者发生高额住院费用的危险因素。方法:回顾性分析我院颅脑外伤合并多发伤患者的临床资料,查询住院费用,通过卡方检验筛选发生高额费用的危险因素,经多因素Logistic回归分析确定独立危险因素。结果:出院结算时发生高额费用90例(35.29%)。Pearson卡方检验显示入院时AIS-ISS评分、GCS评分、全身麻醉手术治疗、机械通气、肺部感染、泌尿系感染、腹泻、吸烟史等因素与发生高额费用相关性差异有统计学意义(P<0.05),Logistic回归多因素分析显示入院时AIS-ISS评分、全身麻醉手术治疗、肺部感染、泌尿系感染、吸烟史等因素为颅脑外伤合并多发伤患者发生高额费用的独立危险因素。结论:对于颅脑外伤合并多发伤患者,应在全面评估伤情基础上明确手术指征,并且积极预防感染,从而降低患者发生高额医疗费用的风险。%To summarize the clinical parameters of patients with traumatic brain injury combined multiple trauma and evaluate risk factors of high cost in hospital. Methods: The clinical data of patients suffering traumatic brain injury combined multiple trauma in our institution were analyzed retrospectively. Chi-square test was used to select risk factors for high cost. Non-condition logistic regression analysis was used to define the independent risk factors. Results: There were 90 (35.29%) cases with high cost at discharge. Factors including AIS-ISS and GCS score on admission, operation under general anesthesia, mechanical ventilation, peumonia, urinary infections, diarrhea and smoking were revealed as the factors significantly related to high cost by Pearson chi-square test. Then, AIS-ISS score on admission (OR=15.842, 95%CI 4.375-57.355,P<0.01), operation under general anesthesia (OR=7.946,95%CI 2.262-27.919,P<0

  15. Effectiveness of Somatosensory Vibro-music Therapy for Patients with Brain Trauma%体感音乐疗法治疗颅脑外伤的初步研究

    Institute of Scientific and Technical Information of China (English)

    潘文平; 范建中; 张建宏; 吴红瑛; 刘休强; 王惠娟

    2011-01-01

    Objective: To analyze the therapeutic effect of somatosensory vibro-music therapy for patients with brain trauma. Methods: Thirty-one patients with mild or serious brain trauma were randomly divided into test group ( 16 cases) and control group ( 15 cases). Before and after intervention, electroencephalogram (EEG) and brainstem auditory evoked potential (BAEP) were recorded, and Glasgow Outcome Scale (GOS) was used to assess the rehabilitation outcome after intervention. The test group received the combined intervention of somatosensory vibromusic therapy and comprehensive rehabilitation for 4 weeks, while the control group received comprehensive rehabilitation intervention. Results: After 4 weeks, the activity of cerebral cortex in the test group was significantly increased as compared with the control group (P< 0.05). Brain stem conduction function had no significant difference between the test group and the control group (P>0.05). The scores of GOS in the test group were significantly higher than those in the control group (P<0.05). Conclusion: somatosensory vibro-music therapy can promote the recovery of multiple systems of patients with trauma, and improve the prognosis to some extent and quality of life.%目的:探讨体感音乐疗法对颅脑外伤患者的作用.方法:31例中、重度颅脑外伤患者随机分为音乐组16例和对照组15例,均接受药物及综合康复治疗.音乐组并增加体感音乐疗法,将音乐耳机置于双耳,昏迷患者倾听以维瓦尔第的经演绎和古典变奏曲为主;清醒患者倾听莫扎特的为主治疗.治疗前后检测2组脑电图(EEG)、脑干诱发电位(BAEP)的变化及应用格拉斯哥结局量表(GOS)评定患者治疗后的临床康复效果.结果:治疗1个月后,EEG显示2组脑皮层活动恢复明显优于治疗前,音乐组优于对照组(P<0.05);BAFP显示2组与治疗前差异无统计学意义;GOS评定音乐组中轻度患者例数明显多于对照组.结论:体感音乐

  16. Bilateral cortical atrophy after severe brain trauma and extradural homatoma Atrofia cortical bilateral após traumatismo cranioencefálico grave e hematoma extradural

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Louzada

    2007-12-01

    Full Text Available We report the case of a severe head injured 43-year old male patient with a large extradural hematoma, Glasgow Coma Scale 3 and dilated fixed pupils. Patient was promptly submitted to surgical evacuation of the lesion, but remained in persistent vegetative state in the post-operative time. Head computed tomography scans performed before surgery, and at early and late post-operative periods comparatively revealed extreme bilateral cortical atrophy. Late consequences of severe head trauma drastically affect the prognosis of patients, being its prevention, and neuroprotection against secondary injury still a therapeutical challenge for neurosurgeons.Relatamos o caso de um paciente de 43 anos, com traumatismo cranioencefálico grave, com grande hematoma extradural, Escala de Coma de Glasgow 3 e pupilas fixas e dilatadas. O paciente foi prontamente submetido à evacuação cirúrgica da lesão mas permaneceu em estado vegetativo persistente no período pós-operatório. As TC de crânio realizadas antes da cirurgia e nos períodos pós-operatórios precoce e tardio revelaram comparativamente extrema atrofia cerebral bilateral. As conseqüências tardias do traumatismo craniano grave afetam drasticamente o prognóstico dos pacientes, sendo sua prevenção, e a neuroproteção contra a injúria secundária ainda um desafio terapêutico para os neurocirurgiões.

  17. Injury modality, survival interval, and sample region are critical determinants of qRT-PCR reference gene selection during long-term recovery from brain trauma.

    Science.gov (United States)

    Harris, Janna L; Reeves, Thomas M; Phillips, Linda L

    2009-10-01

    In the present study we examined expression of four real-time quantitative RT-PCR reference genes commonly applied to rodent models of brain injury. Transcripts for beta-actin, cyclophilin A, GAPDH, and 18S rRNA were assessed at 2-15 days post-injury, focusing on the period of synaptic recovery. Diffuse moderate central fluid percussion injury (FPI) was contrasted with unilateral entorhinal cortex lesion (UEC), a model of targeted deafferentation. Expression in UEC hippocampus, as well as in FPI hippocampus and parietotemporal cortex was analyzed by qRT-PCR. Within-group variability of gene expression was assessed and change in expression relative to paired controls was determined. None of the four common reference genes tested was invariant across brain region, survival time, and type of injury. Cyclophilin A appeared appropriate as a reference gene in UEC hippocampus, while beta-actin was most stable for the hippocampus subjected to FPI. However, each gene may fail as a suitable reference with certain test genes whose RNA expression is targeted for measurement. In FPI cortex, all reference genes were significantly altered over time, compromising their utility for time-course studies. Despite such temporal variability, certain genes may be appropriate references if limited to single survival times. These data provide an extended baseline for identification of appropriate reference genes in rodent studies of recovery from brain injury. In this context, we outline additional considerations for selecting a qRT-PCR normalization strategy in such studies. As previously concluded for acute post-injury intervals, we stress the importance of reference gene validation for each brain injury paradigm and each set of experimental conditions.

  18. Nursing Experience of Severe Brain Trauma Coma Patients%重症脑外伤昏迷患者的护理体会

    Institute of Scientific and Technical Information of China (English)

    薛明琴

    2014-01-01

    Objective To explore ef icient nursing methods for coma patients with severe brain contusion. Methods 32 cases of severe brain contusion patients were selected. During the therapy session, they experienced a series of nursing process, including careful disease observation, ef icient basic nursing, airway management, hyperbaric oxygen therapy and rehabilitation nursing. The nursing ef ects are carefully compared and analyzed. Results Through treatment and nurse care, 12 patients were total y cured and 18 patients turned bet er. The curative rate is 94%. Conclusion The effective nursing procedure is a significant process of preventing complications and reducing the possibilities of disability for severe brain contusion patients.%目的探讨重症脑外伤昏迷患者的合理有效的护理方法。方法对32例重症脑外伤昏迷患者进行严密的病情观察、有效的基础护理、气道管理、高压氧治疗的护理、康复护理。结果经过治疗和护理,治愈12例,好转18例,治愈好转率占94%。结论有效的护理是预防并发症,降低致残率的重要环节。

  19. The Danish Industrial Foundations

    DEFF Research Database (Denmark)

    Thomsen, Steen

    Industrial foundations are foundations that own companies. Typically, they combine charitable and business goals. This book is about industrial foundation ownership of business companies and what we can learn about it from the Danish evidence. It is about how foundation ownership is ruled, taxed...... and governed, what role it plays in the Danish economy, and how industrial foundation-owned companies perform. The book is the result of a large collaborative research project, led by the author, on industrial foundations. Some global companies such as IKEA, Robert Bosch or the Tata Group are foundation...

  20. Urogenital trauma: imaging upper GU trauma

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, Stanford M. E-mail: Stanford.M.Goldman@uth.tmc.edu; Sandler, Carl M

    2004-04-01

    Objectives: This article will define the current controversies and concepts in the classification, clinical presentation, imaging approaches and management of upper urinary tract trauma. Materials and methods, results: This review will include the experience of the authors in the field of renal trauma over a 32-year period. Current thinking accepts the view that significant renal trauma is generally present when there is gross hematuria, signs of shock, or other clinical signs of severe injury. In most patients, suspected renal injury will be evaluated as a part of the overall assessment of the patient for suspected intraperitoneal injury. The authors will stress some exceptions to the rule. Conclusions: Most trauma experts now advocate conservative management, unless the patient is unstable or a renal vascular thrombosis or avulsion is suspected. Similarly, penetrating trauma to the kidney in and of itself no longer requires mandatory surgery. In the United States, computed tomography (CT), especially spiral CT, is considered the best diagnostic study, if available. Intravenous pyelography (IVP) is adequate if this is the only imaging modality available and if no concomitant injuries to the abdominal structure are suspected. Ultrasound, although strongly advocated in some countries, can lead to some significant false negatives. The diagnosis and management of unusual problems such as the traumatic AV fistula, the patient with an absent kidney or injury to the congenitally abnormal kidney, the serendipitous renal tumor in a patient with trauma, or serious bleeding after an apparent minor injury (i.e., spontaneous hemorrhage) are also reviewed in this article.

  1. ATLS® and damage control in spine trauma

    Directory of Open Access Journals (Sweden)

    Gosse Andreas

    2009-03-01

    Full Text Available Abstract Substantial inflammatory disturbances following major trauma have been found throughout the posttraumatic course of polytraumatized patients, which was confirmed in experimental models of trauma and in vitro settings. As a consequence, the principle of damage control surgery (DCS has developed over the last two decades and has been successfully introduced in the treatment of severely injured patients. The aim of damage control surgery and orthopaedics (DCO is to limit additional iatrogenic trauma in the vulnerable phase following major injury. Considering traumatic brain and acute lung injury, implants for quick stabilization like external fixators as well as decided surgical approaches with minimized potential for additional surgery-related impairment of the patient's immunologic state have been developed and used widely. It is obvious, that a similar approach should be undertaken in the case of spinal trauma in the polytraumatized patient. Yet, few data on damage control spine surgery are published to so far, controlled trials are missing and spinal injury is addressed only secondarily in the broadly used ATLS® polytrauma algorithm. This article reviews the literature on spine trauma assessment and treatment in the polytrauma setting, gives hints on how to assess the spine trauma patient regarding to the ATLS® protocol and recommendations on therapeutic strategies in spinal injury in the polytraumatized patient.

  2. 重型颅脑外伤灌注CT结果与脑灌注压的相关性%Correlation of brain perfusion computed tomography results and cerebral perfusion pressure in patients with severe head trauma

    Institute of Scientific and Technical Information of China (English)

    徐裕; 冯东侠; 高恒; 那汉荣; 徐伟东; 周新民

    2012-01-01

    目的 探讨重型颅脑外伤患者灌注CF结果与脑灌注压监测结果的相关性.方法 50例重型颅脑外伤患者分为两组:T组28例,C组22例,人院时头颅CT平扫有明显异常.在行灌注CT时,同时监测平均动脉压(MAP)及颅内压(ICP),计算脑灌注压(CPP).应用直线回归分析灌注CT参数[局部脑血容量(rCBV)、局部脑血流(rCBF)和平均通过时间(MTT)]与CPP的相关性.结果 根据灌注CT结果,T组分为两个亚组:T1组,16例,灌注CT结果与CPP呈弱相关;T2组,12例,两者存在强相关.T1、T2和C组间的灌注CT参数均有明显差异.T1组的rCBF为(18.8±8.0)cm3·100g1·min-2,明显低于T2组的(60.2±21.3)cm3·100g1·min-1和C组的(48.3±11.0)CM3·100g1·min-1(P<0.01).T1、T2组灌注CT参数与相应CPP值之间均显著相关(P<0.01).结论 灌注CT结合ICP监测能提供有价值的评估脑血管自动调节功能是否完好的信息,有助于指导治疗.%Objective To investigate the correlation of brain perfusion computed tomography (CT) results and cerebral perfusion pressure (CPP) in patients with severe head trauma. Methods Perfusion CT results of 50 patients with head trauma were analyzed , who were divided into two groups of T(28 cases, severe head trauma with abnormal CT findings during admission) and C(22 cases,head trauma with normal CT findings during admission). The patients underwent perfusion CT and MAP and ICP were measured at the same time, by which CPP was calculated. The correlation between perfusion CT results [regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF) and MTT] and corresponding CPP was analyzed using linear regression analysis. Results According to perfusion CT results, group T was divided into two subgroups of Tl (16 cases, characterized by a weak correlation between the perfusion-CT results and the corresponding CPP values) and T2(12 cases,characterized by a strong correlation between the perfusion-CT results and the corresponding

  3. Management of duodenal trauma

    Institute of Scientific and Technical Information of China (English)

    CHEN Guo-qing; YANG Hua

    2011-01-01

    Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high,duodenal trauma should be treated in time and tactfully.And application of new technology can help improve the management. In this review, we discussed the incidence,diagnosis, management, and complications as well as mortality of duodenal trauma.

  4. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Gerds, Thomas Alexander

    2012-01-01

    Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often...... combined, the result is that more than 100 trauma scenarios exist, when the two dentitions are combined. Each of these trauma scenarios has a specific treatment demand and prospect for healing. With such a complexity in diagnosis and treatment, it is obvious that even experienced practitioners may have...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.DentalTrauma...

  5. Highlighting intracranial pressure monitoring in patients with severe acute brain trauma Ressaltando a monitorização da pressão intracraniana em pacientes com traumatismo cerebral agudo grave

    Directory of Open Access Journals (Sweden)

    Antonio L. E Falcão

    1995-09-01

    Full Text Available Intracranial pressure (ICP monitoring was carried out in 100 patients with severe acute brain trauma, primarily by means of a subarachnoid catheter. Statistical associations were evaluated between maximum ICP values and: 1 Glasgow Coma Scale (GCS scores; 2 findings on computed tomography (CT scans of the head; and 3 mortality. A significant association was found between low GCS scores (3 to 5 and high ICP levels, as well as between focal lesions on CT scans and elevated ICP. Mortality was significantly higher in patients with ICP > 40 mm Hg than in those with ICP Monitorização da pressão intracraniana (PIC foi adotada em 100 pacientes com traumatismo cerebral agudo grave, usando-se preferencialmente um catéter subaracnóide. Associações estatísticas foram avaliadas entre valores máximos de PIC e : 1 número de pontos na Escala de Coma de Glasgow (ECG; 2 achados na tomografia computadorizada (TC da cabeça; e 3 mortalidade. Encontrou-se associação significante entre baixo número de pontos (3 a 5 na ECG e PIC elevada, assim como entre lesões focais na TC e hipertensão intracraniana. A mortalidade foi significantemente maior em pacientes com PIC > 40 mm Hg do que naqueles com PIC < 20 mm Hg.

  6. [Scrotal trauma: management strategy].

    Science.gov (United States)

    Culty, T; Ravery, V

    2006-04-01

    Scrotal traumas are rare. Most are blunt traumas caused by a direct blow on the scrotum. The testicle is projected against the pubic arch. Early surgical investigation has considerably improved the prognosis of testicular trauma, and reduced orchidectomy rate. ULtrasonography has also improved the management of scrotal trauma. But there is a controversy about accuracy of ultrasonography in predicting presence or absence of testicular disruption. ULtrasonography should not challenge the dogma regarding systematic surgical investigation of hematocele and enlarged scrotum. Long term outcomes (testicular atrophy, infertility) may be more frequent as previously thought and should be detected.

  7. Trauma e temporalidade

    Directory of Open Access Journals (Sweden)

    Ana Maria Rudge

    Full Text Available O trauma tem sido abordado na literatura psicanalítica especialmente como um trauma infantil de natureza sexual. A neurose traumática é tomada como modelo para a circunscrição de uma acepção de trauma que não se confunde com o trauma estrutural eficaz na constituição do psiquismo, e cuja sintomatologia não pode ser diretamente remetida à experiência infantil de natureza sexual.

  8. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health Administration? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 12, ...

  9. Psychological Foundations of Language

    Institute of Scientific and Technical Information of China (English)

    王敏

    2016-01-01

    语言在我们的进化史中只是新近才出现的一种现象,而导致这惊人发展的力量是什么尚不清楚。我们知道部分原因是特化于语言功能的脑结构的演变。语言行为,和所有的行为一样,要通过脑结构的作用,但因为语言极其微妙并涉及多个方面,所以要在大脑中有一个特别复杂的表征。我们会看到,我们语言能力的各个方面,不是纯粹的抽象物,而是在闹中有独立的,能具体说明的表征。另外,语言的心理学基础研究会扩展我们对语言理解,语言产生和语言习得的讨论。这篇文章首先对语言的心理学基础做了一个简单的介绍使我们对为什么要做这个研究有一个清晰的观点。然后讨论了大脑机制和语言。不同的语言技能涉及脑的不同部位,遭受脑受伤的个体常常只是在语言的某些方面表现缺陷。接着描述了语言进程的侧化,对脑裂病人和正常人的研究表明,对大部分人来说,脑的左半球控制语言,特别是句法过程和语言产生,而右半球则是语用方面和语言理解。最后,对关于大脑的智力,性别和遗传因素和语言的关系做了简要的描述。%The emergence of language occurred only recently in our evolutionary history,and the set of forces that led to this extraordinary de-velopment is not yet clear.We do know that part of the story concerns the evolution of brain mechanisms specialized for language functions.Lan-guage behavior,like all behavior,is mediated by brain structures,but because language is extremely subtle and multifaceted,it has a particularly complex representation in the brain.We will learn that various aspects of our language capacity are not mere abstractions but rather have separate and specifiable representations in the brain.Moreover,the study of the psychological foundations of language extends our discussion of language comprehension,production and

  10. Anesthetic Efficacy Study in 60 Patients with Severe Brain Trauma Emergency Surgery%60例重症颅脑外伤手术的麻醉体会

    Institute of Scientific and Technical Information of China (English)

    王丽杰

    2015-01-01

    Objective To investigate the efective anesthesia of emergency surgery in patients with severe traumatic brain injury.Methods60 cases of severe traumatic brain injury patients for the study were randomly divided into two groups, the experimental group and the control group, each of 30 cases. Patients in the experimental group were treated with total intravenous anesthesia, while patients in the control group were implemented inhalation anesthesia. The eficacy of anesthesia was compared between the two groups of patients.Results The heart rate and mean arterial pressure of the experimental group patients in incision and cut the dura were significantly lower than the control group, and the recovery time and extubation time of patients were significantly shorter than the control group (P<0.05).ConclusionPatients with severe traumatic brain injury treated with emergency surgery inhalation anesthesia can maintain a good depth of anesthesia, which has an important role in implementation of surgery.%目的:分析重症颅脑外伤手术的麻醉方法。方法选择在我院进行治疗60例重症颅脑外伤患者作为研究对象,将其随机分为对照组和观察组,每组30例,对照组接受静吸复合麻醉,观察组接受全凭静脉麻醉,比较两组患者的麻醉效果。结果和对照组患者相比较,观察组患者切皮、切硬脑膜时心率和平均动脉压都较低,患者苏醒和拔管时间也较短(P<0.05)。结论重症颅脑外伤患者进行手术时使用全凭静脉麻醉具有良好的麻醉效果且能维持患者的麻醉深度,能够促进手术的顺利进行,值得临床推广使用。

  11. Advanced Trauma Life Support. ABCDE from a radiological point of view.

    NARCIS (Netherlands)

    Kool, D.R.; Blickman, J.G.

    2007-01-01

    Accidents are the primary cause of death in patients aged 45 years or younger. In many countries, Advanced Trauma Life Support(R) (ATLS) is the foundation on which trauma care is based. We will summarize the principles and the radiological aspects of the ATLS, and we will discuss discrepancies with

  12. Head Trauma with or without Mild Brain Injury Increases the Risk of Future Traumatic Death: A Controlled Prospective 15-Year Follow-Up Study.

    Science.gov (United States)

    Vaaramo, Kalle; Puljula, Jussi; Tetri, Sami; Juvela, Seppo; Hillbom, Matti

    2015-10-15

    Patients who have recovered from traumatic brain injury (TBI) show an increased risk of premature death. To investigate long-term mortality rates in a population admitted to the hospital for head injury (HI), we conducted a population-based prospective case-control, record-linkage study, All subjects who were living in Northern Ostrobothnia, and who were admitted to Oulu University Hospital in 1999 because of HI (n=737), and 2196 controls matched by age, gender, and residence randomly drawn from the population of Northern Ostrobothnia were included. Death rate and causes of death in HI subjects during 15 years of follow-up was compared with the general population controls. The crude mortality rates were 56.9, 18.6, and 23.8% for subjects having moderate-to-severe traumatic brain injury (TBI), mild TBI, and head injury without TBI, respectively. The corresponding approximate annual mortality rates were 6.7%, 1.4%, and 1.9%. All types of index HI predicted a significant risk of traumatic death in the future. Subjects who had HI without TBI had an increased risk of both death from all causes (hazard ratio 2.00; 95% confidence interval 1.57-2.55) and intentional or unintentional traumatic death (4.01, 2.20-7.30), compared with controls. The main founding was that even HI without TBI carries an increased risk of future traumatic death. The reason for this remains unknown and further studies are needed. To prevent such premature deaths, post-traumatic therapy should include an interview focusing on lifestyle factors.

  13. Treating childhood trauma.

    Science.gov (United States)

    Terr, Lenore C

    2013-01-01

    This review begins with the question "What is childhood trauma?" Diagnosis is discussed next, and then the article focuses on treatment, using 3 basic principles-abreaction, context, and correction. Treatment modalities and complications are discussed, with case vignettes presented throughout to illustrate. Suggestions are provided for the psychiatrist to manage countertransference as trauma therapy proceeds.

  14. Ultrasound in trauma.

    Science.gov (United States)

    Rippey, James C R; Royse, Alistair G

    2009-09-01

    Point-of-care ultrasound is well suited for use in the emergency setting for assessment of the trauma patient. Currently, portable ultrasound machines with high-resolution imaging capability allow trauma patients to be imaged in the pre-hospital setting, emergency departments and operating theatres. In major trauma, ultrasound is used to diagnose life-threatening conditions and to prioritise and guide appropriate interventions. Assessment of the basic haemodynamic state is a very important part of ultrasound use in trauma, but is discussed in more detail elsewhere. Focussed assessment with sonography for Trauma (FAST) rapidly assesses for haemoperitoneum and haemopericardium, and the Extended FAST examination (EFAST) explores for haemothorax, pneumothorax and intravascular filling status. In regional trauma, ultrasound can be used to detect fractures, many vascular injuries, musculoskeletal injuries, testicular injuries and can assess foetal viability in pregnant trauma patients. Ultrasound can also be used at the bedside to guide procedures in trauma, including nerve blocks and vascular access. Importantly, these examinations are being performed by the treating physician in real time, allowing for immediate changes to management of the patient. Controversy remains in determining the best training to ensure competence in this user-dependent imaging modality.

  15. Advances in forefoot trauma.

    Science.gov (United States)

    Clements, J Randolph; Schopf, Robert

    2013-07-01

    Forefoot traumas, particularly involving the metatarsals, are commonly occurring injuries. There have been several advances in management of these injuries. These advances include updates in operative technique, internal fixation options, plating constructs, and external fixation. In addition, the advances of soft tissue management have improved outcomes. This article outlines these injuries and provides an update on techniques, principles, and understanding of managing forefoot trauma.

  16. American Vitiligo Research Foundation

    Science.gov (United States)

    ... life can acquire vitiligo Welcome to The American Vitiligo Foundation 2017 AVRF Calendars Order your calendar with ... animal testing. Please Visit Our Donations Page American Vitiligo Research Foundation "We Walk By Faith, Not By ...

  17. Toxicology Education Foundation

    Science.gov (United States)

    ... bodies and our world. Welcome to the Toxicology Education Foundation! Our mission is to enhance public understanding ... TEF In the Classroom Our Goal The Toxicology Education Foundation seeks to help build the public's understanding ...

  18. Cooley's Anemia Foundation

    Science.gov (United States)

    ... role in their lives. Welcome to the Cooley's Anemia Foundation Website The Cooley's Anemia Foundation is dedicated to serving people afflicted with ... major form of this genetic blood disease, Cooley's anemia/thalassemia major. Our mission is advancing the treatment ...

  19. American Hospice Foundation

    Science.gov (United States)

    American Hospice Foundation Skip to content Home Caregiving Learning About Hospice Grief Grieving Children Grief at School Grief at ... for all who come after us. The American Hospice Foundation (AHF) closed its doors in June 2014. ...

  20. 选择性音乐疗法对脑外伤意识障碍患者的康复促醒疗效研究%Therapeutic effect of selective music therapy on rehabilitation of patients with consciousness disturbance after brain trauma

    Institute of Scientific and Technical Information of China (English)

    戴敏超; 杨红专; 孙骏; 邵君飞; 张晓路

    2016-01-01

    Objective To explore the rehabilitation effect of selective music therapy on disturbance of consciousness in brain trauma patients. Methods Patients of disturbance of consciousness due to brain trauma were divided into groups by randomized and controlled method, and were treated as grouped. The Glasgow coma scale, call reaction, and the brain stem auditory evoked potential results were recorded, the counting data were statistical analyzed by Chi square test. Results Music therapy raised the Glasgow coma scale, enhanced call reaction, and improved brain stem auditory evoked potential. Furthermore, the selective music therapy showed better effect. Conclusions The selective music therapy plays a better role in promoting the rehabilitation of consciousness in brain trauma patients.%目的:探讨选择性音乐治疗对脑外伤意识障碍患者的康复促醒作用。方法采用随机对照方法,对脑外伤意识障碍患者进行分组干预,并进行格拉斯哥昏迷评分(GCS)、呼唤反应、脑干听觉诱发电位(BAEP)检测,对计数资料结果进行χ2检验。结果音乐疗法有助于提高脑外伤患者GCS评分,增强呼唤反应,改善BAEP结果,选择性音乐治疗效果更佳。结论选择性音乐疗法能更好地发挥脑外伤意识障碍患者的康复促醒作用。

  1. Trauma-induced coagulopathy.

    Science.gov (United States)

    Katrancha, Elizabeth D; Gonzalez, Luis S

    2014-08-01

    Coagulopathy is the inability of blood to coagulate normally; in trauma patients, it is a multifactorial and complex process. Seriously injured trauma patients experience coagulopathies during the acute injury phase. Risk factors for trauma-induced coagulopathy include hypothermia, metabolic acidosis, hypoperfusion, hemodilution, and fluid replacement. In addition to the coagulopathy induced by trauma, many patients may also be taking medications that interfere with hemostasis. Therefore, medication-induced coagulopathy also is a concern. Traditional laboratory-based methods of assessing coagulation are being supported or even replaced by point-of-care tests. The evidence-based management of trauma-induced coagulopathy should address hypothermia, fluid resuscitation, blood components administration, and, if needed, medications to reverse identified coagulation disorders.

  2. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; Christensen, Søren Steno Ahrensburg

    2012-01-01

    Diagnose and treatment of traumatic dental injuries is very complex due to the multiple trauma entities represented by 6 lunation types and 9 fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and lunation injuries are often combined......, the result is, that more than 100 trauma scenario exist when the two dentitions are combined. Each of these trauma scenarios have a specific treatment demand and prospect for healing. With such a complexity in diagnose and treatment it is obvious that even experienced practitioners may have problems may have...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an internet based knowledge base consisting of 4000 dental trauma cases with long term follow up is now available to the public and professionals, on the internet using the address www...

  3. Haemostatic resuscitation in trauma

    DEFF Research Database (Denmark)

    Stensballe, Jakob; Ostrowski, Sisse Rye; Johansson, Par I.

    2016-01-01

    PURPOSE OF REVIEW: To discuss the recent developments in and evolvement of next generation haemostatic resuscitation in bleeding trauma. RECENT FINDINGS: Mortality from major trauma is a worldwide problem, and massive haemorrhage remains a major cause of potentially preventable deaths. Development...... of coagulopathy further increases trauma mortality emphasizing that coagulopathy is a key target in the phase of bleeding. The pathophysiology of coagulopathy in trauma reflects at least three distinct mechanisms that may be present isolated or coexist: acute traumatic coagulopathy, coagulopathy associated...... with the lethal triad, and consumptive coagulopathy. The concepts of 'damage control surgery' and 'damage control resuscitation' have been developed to ensure early control of bleeding and coagulopathy to improve outcome in bleeding trauma. Haemostatic resuscitation aims at controlling coagulopathy and consists...

  4. Unique neurobiology during the sensitive period for attachment produces distinctive infant trauma processing

    Directory of Open Access Journals (Sweden)

    Maya Opendak

    2016-11-01

    Full Text Available Background: Trauma has neurobehavioral effects when experienced at any stage of development, but trauma experienced in early life has unique neurobehavioral outcomes related to later life psychiatric sequelae. Recent evidence has further highlighted the context of infant trauma as a critical variable in determining its immediate and enduring consequences. Trauma experienced from an attachment figure, such as occurs in cases of caregiver child maltreatment, is particularly detrimental. Methods: Using data primarily from rodent models, we review the literature on the interaction between trauma and attachment in early life, which highlights the role of the caregiver's presence in engagement of attachment brain circuitry and suppressing threat processing by the amygdala. We then consider how trauma with and without the caregiver produces long-term changes in emotionality and behavior, and suggest that these experiences initiate distinct pathways to pathology. Results: Together these data suggest that infant trauma processing and its enduring effects are impacted by both the immaturity of brain areas for processing trauma and the unique functioning of the early-life brain, which is biased toward processing information within the attachment circuitry. Conclusion: An understanding of developmental differences in trauma processing as well as the critical role of the caregiver in further altering early life brain processing of trauma is important for developing age-relevant treatment and interventions.

  5. Trauma: the seductive hypothesis.

    Science.gov (United States)

    Reisner, Steven

    2003-01-01

    In much of contemporary culture, "trauma" signifies not so much terrible experience as a particular context for understanding and responding to a terrible experience. In therapy, in the media, and in international interventions, the traumatized are seen not simply as people who suffer and so are deserving of concern and aid; they are seen also as people who suffer for us, who are given special dispensation. They are treated with awe if they tell a certain kind of trauma story, and are ignored or vilified if they tell another. Trauma has become not simply a story of pain and its treatment, but a host of sub-stories involving the commodification of altruism, the justification of violence and revenge, the entry point into "true experience," and the place where voyeurism and witnessing intersect. Trauma is today the stuff not only of suffering but of fantasy. Historically, trauma theory and treatment have shown a tension, exemplified in the writings of Freud and Janet, between those who view trauma as formative and those who view it as exceptional. The latter view, that trauma confers exceptional status deserving of special privilege, has gained ground in recent years and has helped to shape the way charitable dollars are distributed, how the traumatized are presented in the media, how governments justify and carry out international responses to trauma, and how therapists attend to their traumatized patients. This response to trauma reflects an underlying, unarticulated belief system derived from narcissism; indeed, trauma has increasingly become the venue, in society and in treatment, where narcissism is permitted to prevail.

  6. The Monopod Bucket Foundation

    DEFF Research Database (Denmark)

    Bakmar, Christian LeBlanc; Ahle, Kim; Nielsen, Søren A.;

    2009-01-01

    Following the successful installation of a prototype of a monopod bucket foundation, also called a “monopod suction caisson”, at Horns Rev 2 Offshore Wind Farm, Denmark, in 2009, DONG Energy is currently developing a commercialization strategy. The monopod bucket foundation is a promising...... foundation concept for offshore wind turbines and can be installed using suction assisted penetration, combined with other installation methods. This selfinstalling foundation concept, may avoid the use of expensive jack-ups and scour protection, and thus significantly reduces installation costs. However......, further research, development and prototype testing are required, before the monopod bucket foundation can be commercialized....

  7. A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity?

    Science.gov (United States)

    Tanriverdi, Fatih; De Bellis, Annamaria; Ulutabanca, Halil; Bizzarro, Antonio; Sinisi, Antonio A; Bellastella, Giuseppe; Amoresano Paglionico, Vanda; Dalla Mora, Liliana; Selcuklu, Ahmed; Unluhizarci, Kursad; Casanueva, Felipe F; Kelestimur, Fahrettin

    2013-08-15

    Traumatic brain injury (TBI) has been recently recognized as a common cause of pituitary dysfunction. However, there are not sufficient numbers of prospective studies to understand the natural history of TBI induced hypopituitarism. The aim was to report the results of five years' prospective follow-up of anterior pituitary function in patients with mild, moderate and severe TBI. Moreover, we have prospectively investigated the associations between TBI induced hypopituitarism and presence of anti-hypothalamus antibodies (AHA) and anti-pituitary antibodies (APA). Twenty five patients (20 men, five women) were included who were prospectively evaluated 12 months and five years after TBI, and 17 of them also had a third-year evaluation. Growth hormone (GH) deficiency is the most common pituitary hormone deficit at one, three, and five years after TBI. Although most of the pituitary hormone deficiencies improve over time, there were substantial percentages of pituitary hormone deficiencies at the fifth year (28% GH, 4% adrenocorticotropic hormone [ACTH], and 4% gonadotropin deficiencies). Pituitary dysfunction was significantly higher in strongly AHA- and APA-positive (titers ≥1/16) patients at the fifth year. In patients with mild and moderate TBI, ACTH and GH deficiencies may improve over time in a considerable number of patients but, although rarely, may also worsen over the five-year period. However in severe TBI, ACTH and GH status of the patients at the first year evaluation persisted at the fifth year. Therefore, screening pituitary function after TBI for five years is important, especially in patients with mild TBI. Moreover, close strong associations between the presence of high titers of APA and/or AHA and hypopituitarism at the fifth year were shown for the first time.

  8. Cognitive, functional, and psychosocial outcome after severe traumatic brain injury: A cross-sectional study at a tertiary care trauma center

    Directory of Open Access Journals (Sweden)

    Sumit Sinha

    2013-01-01

    Full Text Available Background: Traumatic brain injury (TBI constitutes a significant public health problem. Objectives: To assess cognitive, functional, and psychosocial outcome in patients with severe TBI (STBI. Materials and Methods: A total of 77 survivors of STBI treated at our center were prospectively assessed in the outpatient department 1 year after the injury. These patients were assessed for cognitive, functional, and psychosocial outcome using cognitive outcome tests, dysfunctional analysis questionnaire, and personality trait inventory, respectively. Cognitive and functional outcome was graded as average and above average recovery (good recovery or below average recovery (poor recovery. Psychosocial outcome was assessed as average recovery (good recovery or mild impairment and severe impairment (poor to very poor recovery. Statistical analysis was done using Chi-square and Fisher′s exact tests. Results: The ability to learn new things was most affected aspect of cognitive function and only 1% of patients had good recovery in this domain. However, 44% had good outcome for simple memory. A total of 61% showed good recovery in several aspects of functional status. At the end of 1 year, 62.5% patients still remained unemployed. 45.4% patients had good recovery, while 37% had severe impairment for various personality traits and 40% of patients had impaired emotional stability, while 57% patients showed impaired recovery in depressive tendency. Conclusion: In this study 61% patients with STBI had good recovery in functional outcome and 45.4% in psychosocial outcome at 1 year follow-up. However, improvement in cognitive outcome was not so optimistic with the ability to learn new things being most affected.

  9. Effects of Comprehensive Care on the Quality of Life and Complications in Patients with Brain Trauma%综合护理干预对脑外伤患者并发症及生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    唐琴; 刘江

    2015-01-01

    目的:探讨综合护理干预对脑外伤患者生活质量、并发症及满意度的影响。方法:选择符合标准的患者63例,随机分为观察组31例和对照组32例,均给予常规护理,观察组实施综合护理干预,比较二者生活质量等护理效果。结果:出院时,观察组WHOQOL100各维度评分均高于对照组,差异有统计学意义( P<0.05)。观察组患者并发症发生率29.03%,低于对照组的46.88%,差异有统计学意义( P<0.05)。观察组患者护理满意度优20例、良8例、中2例和差1例,对照组优10例、良11例、中6例和差5例,差异有统计学意义( P<0.05)。结论:综合护理能有效预防脑外伤患者住院期间并发症,改善生活质量,提高护理满意度,值得临床推广应用。%Objective:To investigate the effects of comprehensive care on the quality of life, complica-tions and degree of satisfaction in patients with brain trauma.Method:A total of 63 eligible patients were se-lected and randomly divided into observation group (31 patients) and control group (32 patients).All the patients were given with usual care, but the patients in the observation group given with comprehensive care additionally, and the effects including quality of life were compared between the two groups.Result:When discharge, the patients of the observation group had higher scores of each dimension of WHOQOL100, and the difference was statistically significant ( P<0.05) .The incidence of complications of the patients of the ob-servation group was 29.03%, which was lower than that of the control group (46.88%), and the difference was statistically significant ( P<0.05) .Of the observation group, 20 patients had excellent degree of satisfac-tion , 8 cases had good degree of satisfaction, 2 had moderate degree of satisfaction, and 1 had poor degree of satisfaction;while of the control group, 10 patients had excellent degree of satisfaction

  10. Hidden Wounds? Inflammatory Links Between Childhood Trauma and Psychopathology.

    Science.gov (United States)

    Danese, Andrea; Baldwin, Jessie R

    2017-01-03

    Childhood trauma is a key risk factor for psychopathology. However, little is known about how exposure to childhood trauma is translated into biological risk for psychopathology. Observational human studies and experimental animal models suggest that childhood exposure to stress can trigger an enduring systemic inflammatory response not unlike the bodily response to physical injury. In turn, these "hidden wounds" of childhood trauma can affect brain development, key behavioral domains (e.g., cognition, positive valence systems, negative valence systems), reactivity to subsequent stressors, and, ultimately, risk for psychopathology. Further research is needed to better characterize the inflammatory links between childhood trauma and psychopathology. Detecting and healing these hidden wounds may help prevent and treat psychopathology emerging after childhood trauma.

  11. Environmental Foundations in Germany

    Directory of Open Access Journals (Sweden)

    Thomas Krikser

    2015-05-01

    Full Text Available Foundations in Germany were examined in the context of environmental issues. Data from environmental foundations show that there is huge difference between private and public foundations concerning financial settings. Furthermore, environment is often not the only objective and sometimes not even processed. Our analysis shows that there are different types of foundations with regard to environmental scopes and activities. Although “attractive topics” such as biodiversity and landscape conservation seem to be more important to foundations, less visible topics such as pollution prevention remain merely a “blind spot.” Together, these findings suggest that there is only a limited potential of private foundations compared with public foundations. Nevertheless, there might be an impact on environmental awareness and local sustainability.

  12. 现代网络院前急救模式对重型颅脑损伤预后影响%Influence of modern network pre-hospital emergency care mode on the prognosis of severe brain trauma

    Institute of Scientific and Technical Information of China (English)

    张守祥; 王诚; 戴利强; 吴涛; 刘胜

    2012-01-01

    目的 探讨现代网络院前急救模式对重型颅脑损伤患者预后的影响.方法 将院前重型颅脑外伤患者分成两组;现代网络院前急救模式(A组,162例)由经过专业培训的急救队伍组成,能够进行基础、高级生命支持,配备先进急救设备和现代交通工具等,利用现代网络连接快捷的特点,在深圳市急救中心调度下开展院前现场急救工作;传统模式组(B组,124例)患者自行到达医院,无医务人员现场抢救及陪同.统计调度时间、到达时间、现场时间、返回时间、总时间,同时对受伤类型、颅内损伤程度、格拉斯哥预后分级( GOS)进行统计学分析.结果 A组和B组的受伤类型、颅内损伤程度差异无显著性(P>0.05).A组预后伤残程度评级:良好72.22%,中残19.14%,重残1.85%,植物状态0.62%,死亡6.17%;B组预后伤残程度评级:良好47.58%,中残24.19%,重残12.10%,植物状态2.23%,死亡14.51%;A组预后优于B组,差异有显著性(P<0.05).结论 现代网络院前急救模式能提升重型颅脑损伤急救速度,降低死亡率和改善预后.%Objective To explore the influence of modern network pre-hospital emergency care mode on the prognosis of the patients with severe brain trauma.Methods Divided the patients with severe brain trauma into 2 groups:modern network pre-hospital emergency care mode group( A group,162 cases ),which had a professional rescue team that equipped with advanced first-aid equipment and had modern transportation and modem fast network,carried pre-hospital emergency rescue work out under the management of the Shenzhen City Emergency Center; Patients in traditional mode group ( B group,124 cases ) went to hospital with no health care and no companionship of medical worker.Then recorded the scheduling time,running time,rescue time,returning time,and total time; statistically analyzed the traumatic type,traumatic degree,and Glasgow Outcome Scale( GOS ) in both

  13. Closed lung trauma.

    Science.gov (United States)

    Feden, Jeffrey P

    2013-04-01

    Pulmonary injuries from blunt thoracic trauma are seen regularly with high-energy mechanisms but described less frequently in association with sports. Pneumothorax, hemothorax, pneumomediastinum, and pulmonary contusion are uncommon with athletic participation and often follow a benign clinical course. Life-threatening complications may arise, and athletes with chest trauma deserve close attention. Appropriate diagnosis is suggested by history and physical examination; conventional chest radiography is preferred as the initial imaging study but has limitations. Use of CT for trauma has improved diagnostic sensitivity for occult injury, although this may not alter management or outcomes. Return to play is guided by resolution of symptoms and radiographic findings.

  14. Mothers’ Unresolved Trauma Blunts Amygdala Response to Infant Distress

    OpenAIRE

    Kim, S.; Fonagy, P; Allen, J.; Strathearn, L.

    2014-01-01

    While the neurobiology of post-traumatic stress disorder has been extensively researched, much less attention has been paid to the neural mechanisms underlying more covert but pervasive types of trauma (e.g., those involving disrupted relationships and insecure attachment). Here, we report on a neurobiological study documenting that mothers' attachment-related trauma, when unresolved, undermines her optimal brain response to her infant's distress. We examined the amygdala blood oxygenation le...

  15. Kids' Mild Brain Injury Can Have Long-Term Effects

    Science.gov (United States)

    ... Brain Injury Can Have Long-Term Effects Early head trauma linked to psychiatric, financial issues as adults, study ... HealthDay News) -- Young people who suffer even mild head trauma are more likely to have serious issues later ...

  16. Trauma no idoso Trauma in the elderly

    Directory of Open Access Journals (Sweden)

    JOSÉ ANTONIO GOMES DE SOUZA

    2002-03-01

    Full Text Available O crescimento populacional de idosos, associado a uma forma de vida mais saudável e mais ativa, deixa este grupo de pessoas mais exposto ao risco de acidentes. Em alguns países, o trauma do idoso responde por uma elevada taxa de mortalidade, a qual se apresenta de forma desproporcionalmente maior do que a observada entre a população de adultos jovens. Tal fato acarreta um grande consumo de recursos financeiros destinados à assistência da saúde e um elevado custo social. As características fisiológicas próprias do idoso, assim como a presença freqüente de doenças associadas, faz com que estes pacientes se comportem diferentemente e de forma mais complexa do que os demais grupos etários. Estas particularidades fazem com que o atendimento ao idoso vítima de trauma se faça de forma diferenciada. A presente revisão aborda aspectos da epidemiologia, da prevenção, da fisiologia, do atendimento e da reabilitação do idoso vítima de trauma.The populational growth of the elderly, associated to a healthier and more active life, make this group of people more exposed to accidents. In some countries, trauma in the elderly is responsible for a high mortality rate, desproportionately higher than in the adults. This fact consumes a great portion of health care resources and implies in a high social cost. The distinct physiologic characteristics of the elderly and the frequent presence of associated diseases make that these patients behave diferently and in a more complex way than patients of other ages. These particularities make that health care to the elderly victims of trauma have to be different. The present revision is about aspects of epidemiology, prevention, physiology, health care and reabilitation of the elderly victims of trauma.

  17. Military Sexual Trauma

    Science.gov (United States)

    ... VHA Forms & Publications Quality & Safety Quality of Care Ethics VA/DOD Clinical Practice Guidelines Hospital ... Trauma Overview Programs & Services Articles & Fact Sheets Other Resources Help with VA Services ...

  18. Tailbone trauma - aftercare

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000573.htm Tailbone trauma - aftercare To use the sharing features on this ... fractured one of these bones. More about Your Injury Most tailbone injuries lead to bruising and pain. ...

  19. Platelet aggregation following trauma

    DEFF Research Database (Denmark)

    Windeløv, Nis A; Sørensen, Anne M; Perner, Anders

    2014-01-01

    We aimed to elucidate platelet function in trauma patients, as it is pivotal for hemostasis yet remains scarcely investigated in this population. We conducted a prospective observational study of platelet aggregation capacity in 213 adult trauma patients on admission to an emergency department (ED......). Inclusion criteria were trauma team activation and arterial cannula insertion on arrival. Blood samples were analyzed by multiple electrode aggregometry initiated by thrombin receptor agonist peptide 6 (TRAP) or collagen using a Multiplate device. Blood was sampled median 65 min after injury; median injury...... severity score (ISS) was 17; 14 (7%) patients received 10 or more units of red blood cells in the ED (massive transfusion); 24 (11%) patients died within 28 days of trauma: 17 due to cerebral injuries, four due to exsanguination, and three from other causes. No significant association was found between...

  20. Acute coagulopathy of trauma

    DEFF Research Database (Denmark)

    Johansson, P I; Ostrowski, S R

    2010-01-01

    Acute coagulopathy of trauma predicts a poor clinical outcome. Tissue trauma activates the sympathoadrenal system resulting in high circulating levels of catecholamines that influence hemostasis dose-dependently through immediate effects on the two major compartments of hemostasis, i.......e., the circulating blood and the vascular endothelium. There appears to be a dose-dependency with regards to injury severity and the hemostatic response to trauma evaluated in whole blood by viscoelastic assays like thrombelastography (TEG), changing from normal to hypercoagulable, to hypocoagulable and finally......, is an evolutionary developed response that counterbalances the injury and catecholamine induced endothelial activation and damage. Given this, the rise in circulating catecholamines in trauma patients may favor a switch from hyper- to hypocoagulability in the blood to keep the progressively more procoagulant...

  1. Childhood trauma in bipolar disorder

    OpenAIRE

    Watson, Stuart; Gallagher, Peter; Dougall, Dominic; Porter, Richard; Moncrieff, Joanna; Ferrier, I Nicol; Young, Allan H.

    2014-01-01

    Objective: There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder. Methods: Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipo...

  2. Childhood trauma in bipolar disorder.

    OpenAIRE

    Watson, S; Gallagher, P.; Dougall, D.; Porter, R.; Moncrieff, J; Ferrier, I N; Young, A.H.

    2014-01-01

    Objective:There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder.Methods:Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipolar...

  3. Linear abdominal trauma.

    Science.gov (United States)

    Danto, L A; Wolfman, E F

    1976-03-01

    Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.

  4. Venous injury in abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Arabinda K. [Nemours A. I. duPont Hospital for Children, Department of Radiology, Wilmington, DE (United States); Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

    2015-11-15

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  5. Airway management in trauma

    Directory of Open Access Journals (Sweden)

    Rao B

    2004-01-01

    Full Text Available Airway Management for the victims of major trauma is the first priority in the care of the trauma victim and is a core skill in emergency medicine and critical care. Endotracheal intubation remains the gold standard for trauma airway management. Airway management in trauma patients is not just the capability to insert an oral/nasal airway or endotracheal tube beyond the vocal cords. The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. A trauma patient may require airway management in a variety of physical circumstances. Whereas, the commonly used airway management algorithms may not suffice in all these situations, the construction of a truly complete decision tree is also virtually impossible. There is consensus that it is not the intervention per se but rather the conditions, skills, and performance that might be the possible variables that affect outcome. Paramedics have only limited experience and on-the-job skills for invasive airway management. Difficult airway management is best left for the experienced physicians to handle.

  6. Airway management in trauma.

    Science.gov (United States)

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration.

  7. Effects of adenohypophysis function after treating with thyrotropin releasing hormone in patients with brain trauma%促甲状腺激素释放激素对脑外伤后腺垂体功能的影响

    Institute of Scientific and Technical Information of China (English)

    李斌; 赵保; 叶晶亮; 于烽; 盛文国; 苏国军; 马强; 徐信龙

    2014-01-01

    Objective To analyze the effects of adenohypophysis function after treating with thyrotropin releasing hormone and its clinical significance in patients with brain trauma. Methods There were 22 cases with traumatic brain injuries from July 2010 to September 2012 in Chinese people's Liberation Army nine eight hospital,after injuried within 4 to 12 hours,then 1 1 cases who were given thyrotropin-releasing hormone(TRH)were selected as experimental group,while 1 1 cases who were given the same amount of isotonic saline were selected as control group,then the score of GCS, ICS,RLS85 and the improvement of adenohypophysis function were observed. Results After treatment,the score of glasgow coma scale (GCS ), innsbruck coma scale (ICS),and the reaction level scale (RLS85)between two groups were significantly increased in three days compared with before treatment,and within three days after injury situation,the improvements of ICS and RLS85 in experimental group were better than control group(P<0.05 ). Compared with control group,the levels of each gland pituitary hormone in experimental group were significantly increased(P<0.05 ),and on the third day,the growth hormone (GH)was reduced significantly,finally 50%of that in control group. Conclusion Patients with brain injury treated with thyrotropin releasing hormone,has no significant adverse reactions,with the characteristics of safe and effective.%目的:分析研究促甲状腺激素释放激素治疗脑外伤后腺垂体功能的变化情况及其临床意义。方法选取中国人民解放军第九八医院从2010年7月~2012年9月期间接诊的脑外伤患者22例,将在伤后4~12 h内接受促甲状腺激素释放激素治疗的11例患者作为实验组,接受等量的等渗盐水11例患者作为对照组。2组患者在伤后第9 d,采用格拉斯哥昏迷量表(glasgow coma scale,GCS)、因斯布鲁克昏迷量表(Innsbruck coma scale,ICS)、反应水平量表(the reaction level

  8. Systemic inflammation after trauma.

    Science.gov (United States)

    Lenz, Andreas; Franklin, Glen A; Cheadle, William G

    2007-12-01

    Trauma is still one of the main reasons for death among the population worldwide. Mortality occurring early after injury is due to "first hits", including severe organ injury, hypoxia, hypovolaemia or head trauma. Massive injury leads to activation of the immune system and the early inflammatory immune response after trauma has been defined as systemic inflammatory response syndrome (SIRS). "Second hits" such as infections, ischaemia/reperfusion or operations can further augment the pro-inflammatory immune response and have been correlated with the high morbidity and mortality in the latter times after trauma. SIRS can lead to tissue destruction in organs not originally affected by the initial trauma with subsequent development of multi-organ dysfunction (MOD). The initial pro-inflammatory response is followed by an anti-inflammatory response and can result in immune suppression with high risk of infection and sepsis. Trauma causes activation of nearly all components of the immune system. It activates the neuroendocrine system and local tissue destruction and accumulation of toxic byproducts of metabolic respiration leads to release of mediators. Extensive tissue injury may result in spillover of these mediators into the peripheral bloodstream to further maintain and augment the pro-inflammatory response. Hormones like ACTH, corticosteroids and catecholamines as well as cytokines, chemokines and alarmins play important roles in the initiation and persistence of the pro-inflammatory response after severe injury. The purpose of this review is therefore to describe the immunological events after trauma and to introduce important mediators and pathways of the inflammatory immune response.

  9. Foundations for Critical Thinking

    Science.gov (United States)

    Bers, Trudy; Chun, Marc; Daly, William T.; Harrington, Christine; Tobolowsky, Barbara F.

    2015-01-01

    "Foundations for Critical Thinking" explores the landscape of critical-thinking skill development and pedagogy through foundational chapters and institutional case studies involving a range of students in diverse settings. By establishing a link between active learning and improved critical thinking, this resource encourages all higher…

  10. Modelling Foundations and Applications

    DEFF Research Database (Denmark)

    This book constitutes the refereed proceedings of the 8th European Conference on Modelling Foundations and Applications, held in Kgs. Lyngby, Denmark, in July 2012. The 20 revised full foundations track papers and 10 revised full applications track papers presented were carefully reviewed and sel...

  11. Severe Cranioencephalic Trauma: Prehospital Care, Surgical Management and Multimodal Monitoring

    Directory of Open Access Journals (Sweden)

    Luis Rafael Moscote-Salazar

    2016-01-01

    Full Text Available Traumatic brain injury is a leading cause of death in developed countries. It is estimated that only in the United States about 100,000 people die annually in parallel among the survivors there is a significant number of people with disabilities with significant costs for the health system. It has been determined that after moderate and severe traumatic injury, brain parenchyma is affected by more than 55% of cases. Head trauma management is critical is the emergency services worldwide. We present a review of the literature regarding the prehospital care, surgical management and intensive care monitoring of the patients with severe cranioecephalic trauma.

  12. Clinical Symptoms of Minor Head Trauma and Abnormal Computed Tomography Scan

    Directory of Open Access Journals (Sweden)

    Maghsoudi

    2015-11-01

    Full Text Available Background Minor head trauma accounts for 70% to 90% of all head traumas. Previous studies stated that minor head traumas were associated with 7% - 20% significant abnormal findings in brain computed tomography (CT-scans. Objectives The aim of this study was to reevaluate clinical criteria of taking brain CT scan in patients who suffered from minor head trauma. Patients and Methods We enrolled 680 patients presented to an academic trauma hospital with minor head trauma in a prospective manner. All participants underwent brain CT scan if they met the inclusion criteria and the results of scans were compared with clinical examination finding. Results Loss of consciousness (GCS drop or amnesia was markedly associated with abnormal brain CT scan (P < 0.05. Interestingly, we found 7 patients with normal clinical examination but significant abnormal brain CT scan. Conclusions According to the results of our study, we recommend that all patients with minor head trauma underwent brain CT scan in order not to miss any life-threatening head injuries.

  13. Brain Injury Association of America

    Science.gov (United States)

    ... Only) 1-800-444-6443 Welcome to the Brain Injury Association of America (BIAA) Brain injury is not an event or an outcome. ... misunderstood, under-funded neurological disease. People who sustain brain injuries must have timely access to expert trauma ...

  14. Epidemiology of severe trauma.

    Science.gov (United States)

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions.

  15. Trauma in pregnancy

    Directory of Open Access Journals (Sweden)

    A Rudra

    2007-01-01

    Full Text Available Trauma is the most common non-obstetrical cause of death in pregnant women. Pregnancy must always be suspected in any female trauma patient of childbearing age until proved otherwise. Unique changes in anatomy and physiology that takes place during pregnancy alter the pathophysiology and location of maternal injuries in pregnancy, which may be significantly different from the non-pregnant state. Trauma from road traffic accidents, falls and domestic violence are the most common causes of abdominal blunt trauma. As pregnancy progresses, the change of accidental injury increases. Head and neck injuries, respiratory failure, and hypovolemic shock constitute the most frequent causes of trauma related maternal death in pregnancy. Even the pregnant woman with minor injuries should be carefully observed. Initial management is directed at resuscitation and stabilization of the mother that takes precedence over that of the fetus, unless vital signs cannot be maintained and perimortem cesarean section decided upon. Fetal monitoring should be maintained after satisfactory resuscitation and stabilization of the mother. Preventive measures include proper seat belt use and identifying and counseling victims of suspected domestic violence.

  16. Operation Brain Trauma Therapy Extended Studies

    Science.gov (United States)

    2015-05-01

    iodide uptake ultimately went on to die whether or not they were in the treatment group. Kollidon VA 64 also attenuated caspase 3/7 activation. The...Binder et al (Glia 53:631-636, 2006) reported slowed potassium recovery and longer seizure duration in AQP4 KO mice (vs WT) subjected to...maintaining the rigorous administration paradigm utilized in the rodent models. All animals were assessed for systemic physiological stability and

  17. Depressão: uma possível consequência adversa do trauma crânio-encefálico para o cuidador familiar Depresión: una posible consecuencia adversa del trauma cráneo-encefálico para el cuidador familiar Depression: a possible adverse consequence of the traumatic brain injury for the family caregiver

    OpenAIRE

    Edilene Curvelo Hora Serna; Regina Márcia Cardoso de Sousa

    2005-01-01

    Estudo descritivo com abordagem quantitativa, desenvolvido no ambulatório do Trauma de Crânio com 50 cuidadores e 50 vítimas de Trauma Crânio-Encefálico, com o objetivo de verificar entre os cuidadores familiares a presença de sintomas depressivos e sua associação com o tempo decorrido do evento traumático e a condição da vítima seis meses ou mais após o trauma. O Inventário de Depressão de Beck foi aplicado aos cuidadores e a Escala de Resultados de Glasgow na avaliação da condição das vítim...

  18. Trauma care system in Iran

    Institute of Scientific and Technical Information of China (English)

    Moussa Zargar; Sarah Ganji; Mahmoud Khodabandeh; Shahab Abdollahi Far; Morteza Abdollahi; Mohammad Reza Zarei; Seyed Mohammad Reza Kalantar Motamedi; Mojgan Karbakhsh; Seyed Mohammad Ghodsi; Vafa Rahimi-Movaghar; Farzad Panahi; Soheil Saadat; Ali Khaji; Seyed Mahdi Davachi

    2011-01-01

    Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function. Methods: The current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers.Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries,but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement,hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance,financial resources), it is not yet established in our system of trauma care.Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.

  19. In-hospital mortality and the Glasgow Coma Scale in the first 72 hours after traumatic brain injury Escala de Coma de Glasgow en las primeras 72 horas postrauma encefalocraneano y mortalidad hospitalaria Escala de Coma de Glasgow nas primeiras 72 horas após trauma cranioencefálico e mortalidade hospitalar

    Directory of Open Access Journals (Sweden)

    Cristina Helena Costanti Settervall

    2011-12-01

    Full Text Available This study verifies and compares the performance of three different scores obtained in the Glasgow Coma Scale (GCS in the first 72 hours post trauma in predicting in-hospital mortality. The studied scores included those obtained after initial care was provided at the hospital, and the worst and best scores obtained in the scale in the first 72 hours post trauma. The scale’s predictive ability was assessed by the Receiver Operator Characteristic (ROC curve. A total of 277 victims with different severity levels of blunt traumatic brain injuries were studied. The performance of the three scores that were analyzed to predict hospital mortality was moderate (0.74 to 0.79 and the areas under the curve did not present statistically significant differences. These findings suggest that any of the three studied scores can be applied in clinical practice to estimate the outcome of victims with blunt traumatic brain injuries, taking into consideration the instrument’s moderate discriminatory power.El estudio tiene como objetivos verificar y comparar el desempeño de puntajes de la Escala de Coma de Glasgow (ECGl observados en las primeras 72 horas postrauma para predecir la mortalidad hospitalaria. Los valores analizados fueron los puntajes obtenidos después de la atención inicial intra-hospitalaria, además de los peores y mejores resultados de la escala en las primeras 72 horas postrauma. La capacidad de predicción de los puntajes de la ECGl para el Estado Vital a la Salida Hospitalaria fue evaluada, utilizando la curva Reciever Operator Characteristic. Fueron estudiadas 277 víctimas, con trauma encefalocraneano contuso de diferentes gravedades. El desempeño de los puntajes de la ECGl para el estado vital a la salida hospitalaria fue moderado (0,74 a 0,79 y las áreas bajo la curva no presentaron diferencia significativa. Los resultados sugieren que cualquiera de los tres valores de la ECGl analizados pueden ser aplicados en la práctica cl

  20. Transfusion practices in trauma

    Directory of Open Access Journals (Sweden)

    V Trichur Ramakrishnan

    2014-01-01

    Full Text Available Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury.

  1. Neuroprotective Strategies after Repetitive Mild Traumatic Brain Injury

    Science.gov (United States)

    2011-06-01

    performance in the HBOT groups improved sig- nificantly and was highly correlated with increased ipsilat- eral hippocampal blood volume ( cerebrovascular ...Oxygen Therapy Induces Cerebrovascular Changes and Improves Complex Learning/Memory in a Rat Open Head Bonk Chronic Brain Contusion Model. Undersea...injury. Dynamic brain trauma includes direct injury where trauma is directly imposed on the brain (e.g., non- accidental trauma, contact sports, falls

  2. Escala de coma de Glasgow e qualidade de vida pós-trauma cranioencefálico Escala de coma de Glasgow y calidad de vida post-trauma craneoencefálico Glasgow Coma Scale and quality of life after traumatic brain injury

    OpenAIRE

    Cristina Helena Costanti Settervall; Regina Marcia Cardoso de Sousa

    2012-01-01

    OBJETIVO: Avaliar o desempenho de diferentes escores da Escala de Coma de Glasgow (ECGl) observados nas primeiras 72 horas pós trauma perante a qualidade de vida e mudança percebida do estado de saúde, após um ano do evento traumático. MÉTODOS: Estudo de abordagem quantitativa, observacional, longitudinal, descritivo e correlacional com vítimas de trauma cranioencefálico contuso (TCEC) avaliadas, diariamente durante a internação hospitalar, e após um ano por meio do Medical Outcome Study 36-i...

  3. Trauma-Focused CBT for Youth Who Experience Ongoing Traumas

    Science.gov (United States)

    Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura K.

    2011-01-01

    Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will…

  4. Sonography of scrotal trauma

    Directory of Open Access Journals (Sweden)

    Meka Srinivasa Rao

    2012-01-01

    Full Text Available The purpose of this article is to depict the spectrum of scrotal injuries in blunt trauma. Scrotal injuries are not very common and are mostly due to blunt trauma from direct injury, sports injuries or motor vehicle accidents. To minimize complications and ensure testicular salvage, rapid and accurate diagnosis is necessary. High-resolution USG is the investigation of choice, as it is readily available, accurate and has been seen to improve outcomes. An understanding of and familiarity with the sonographic appearance of scrotal injuries on the part of the radiologist/sonographer is therefore of key importance.

  5. Onycholysis due to trauma

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2014-04-01

    Full Text Available Female patient, 35 years old who came to the private office due to discoloration of her left thumbnail and little pain since 1 month ago. Clinical examination shows nail disease on her left thumbnail with onycholysis and dyschromia, dermatoscopy showed white-yellowish discoloration (Fig. 1A, B. The rest of the clinical examination was normal. Patient use to using acrylic nails since 2 years ago and denied some trauma at the nail. The diagnosis of onycholysis due to trauma was done and recommended her not to use acrylic nail, maintain the nail short and avoid wetness.

  6. Eye trauma in boxing.

    Science.gov (United States)

    Corrales, Gustavo; Curreri, Anthony

    2009-10-01

    In boxing, along with a few other sports, trauma is inherent to the nature of the sport; therefore it is considered a high-risk sport for ocular injuries. The long-term morbidity of ocular injuries suffered by boxers is difficult to estimate due to the lack of structured long-term follow-up of these athletes. Complications of blunt ocular trauma may develop years after the athlete has retired from the ring and is no longer considered to be at risk for boxing-related injuries. This article describes the wide range of eye injuries a boxer can sustain, and their immediate and long-term clinical management.

  7. Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas

    Directory of Open Access Journals (Sweden)

    Faruk Altinel

    2014-06-01

    Full Text Available Traumatic injury is one of the most important cause of disseminated intravascular coagulation (DIC. It occurs because of blood loss and hemodilution due to fluid resuscitation. The incidence of trauma associated DIC is mainly higher in the craniocerebral traumas. Even though craniocerebral trauma related DIC is well defined, the pathophysiology has been poorly characterized in the literature. Due to the fact that brain tissue is highly significant for procoagulant molecules, craniocerebral traumas are closely related to DIC. In the current study, 30 patients admitted to emergency room have been considered on the first and fifth day of admission to the hospital for the coagulation tests to evaluate DIC in both two groups. [Cukurova Med J 2014; 39(3.000: 488-495

  8. Hepatitis B Foundation

    Science.gov (United States)

    ... worldwide 2 Billion People have been infected with Hepatitis B Worldwide The Hepatitis B Foundation is working ... of people living with hepatitis B. Learn About Hepatitis B in 11 Other Languages . Resource Video See ...

  9. Kessler Foundation Research Center

    Science.gov (United States)

    ... download directions in PDF format >> Map it with Google Maps Our other location 1199 Pleasant Valley Way West ... download directions in PDF format >> Map it with Google Maps email us @ info@kesslerfoundation.org Kessler Foundation 2015 © | ...

  10. National Psoriasis Foundation

    Science.gov (United States)

    ... is treated in their countries. Previous Next National Psoriasis Foundation provides you with the help you need to best manage your psoriasis or psoriatic arthritis, while promoting research to find ...

  11. Scleroderma Research Foundation

    Science.gov (United States)

    ... always on, like the clock light on a microwave; others sit unused for years at a time, ... by Formative © 2016 srfcure.org | All rights reserved. The Scleroderma Research Foundation is a 501(c)3 nonprofit organization ...

  12. Mesothelioma Applied Research Foundation

    Science.gov (United States)

    ... Percentage Donations Tribute Wall Other Giving/Fundraising Opportunities Bitcoin Donation Form FAQs Speak with Mary Hesdorffer, Nurse ... Percentage Donations Tribute Wall Other Giving/Fundraising Opportunities Bitcoin Donation Form FAQs © 2017 Mesothelioma Applied Research Foundation, ...

  13. Restless Legs Syndrome Foundation

    Science.gov (United States)

    ... Into Relieved Are you experiencing symptoms linked to restless legs syndrome (RLS)? Find tools and support to help get ... I couldn’t sleep. Fortunately, I found the Restless Legs Syndrome Foundation and learned what type of doctor to ...

  14. Lupus Foundation of America

    Science.gov (United States)

    ... and Testing New Treatments Learn More About the Lupus Foundation of America We are devoted to solving ... Spam Control Text: Please leave this field empty Lupus FAQ What is lupus? What are the common ...

  15. Sjogren's Syndrome Foundation

    Science.gov (United States)

    ... and receive discounts on Sjögren's resources. Follow Us Online! Join the SSF on Twitter, YouTube, Facebook, and Linkedin! anxiety © 2016 Sjögren’s Syndrome Foundation, Inc. 6707 Democracy Blvd, Ste 325, Bethesda, ...

  16. Carcinoid Cancer Foundation

    Science.gov (United States)

    ... Assistance News Blog E-News Archives Contact Donate Carcinoid Cancer Foundation Navigation Home About Back Our Founder Mission ... FREQUENTLY ASKED QUESTIONS SUPPORT GROUPS The ABC's of Carcinoid and Neuroendocrine Tumors Three of the world’s leading ...

  17. The foundations of statistics

    CERN Document Server

    Savage, Leonard J

    1972-01-01

    Classic analysis of the foundations of statistics and development of personal probability, one of the greatest controversies in modern statistical thought. Revised edition. Calculus, probability, statistics, and Boolean algebra are recommended.

  18. Stuttering Foundation of America

    Science.gov (United States)

    ... is from their doctor. Read More Powerful New Film Reveals Emotional Impact of Stuttering The life impact ... President Introduces Award-Winning Author at St. Simons School Stuttering Foundation President Jane Fraser had the honor ...

  19. Prostate Cancer Foundation

    Science.gov (United States)

    ... P 2 rovocative Questions PCCTC Scientific Retreat Coffey-Holden Research News Faces of Prostate Cancer [4] Survivors ... Foundation News The Prostate Cancer Foundation’s 2016 Coffey-Holden Prostate Cancer Academy Meeting accelerates advances in the ...

  20. Foundational aspects of security

    DEFF Research Database (Denmark)

    Chatzikokolakis, Konstantinos; Mödersheim, Sebastian Alexander; Palamidessi, Catuscia

    2014-01-01

    This Special Issue of the Journal of Computer Security focuses on foundational aspects of security, which in recent years have helped change much of the way we think about and approach system security.......This Special Issue of the Journal of Computer Security focuses on foundational aspects of security, which in recent years have helped change much of the way we think about and approach system security....

  1. Foundations of measurement

    CERN Document Server

    Suppes, Patrick

    1989-01-01

    Foundations of Measurement offers the most coherently organized treatment of the topics and issues central to measurement. Much of the research involved has been scattered over several decades and a multitude of journals--available in many instances only to specialties. With the publication of Volumes two and three of this important work, Foundations of Measurement is the most comprehensive presentation in the area of measurement.

  2. Modelling Foundations and Applications

    DEFF Research Database (Denmark)

    This book constitutes the refereed proceedings of the 8th European Conference on Modelling Foundations and Applications, held in Kgs. Lyngby, Denmark, in July 2012. The 20 revised full foundations track papers and 10 revised full applications track papers presented were carefully reviewed......, as well as the high quality of the results presented in these accepted papers, demonstrate the maturity and vibrancy of the field....

  3. Trauma and the endocrine system.

    Science.gov (United States)

    Mesquita, Joana; Varela, Ana; Medina, José Luís

    2010-12-01

    The endocrine system may be the target of different types of trauma with varied consequences. The present article discusses trauma of the hypothalamic-pituitary axes, adrenal glands, gonads, and pancreas. In addition to changes in circulating hormone levels due to direct injury to these structures, there may be an endocrine response in the context of the stress caused by the trauma.

  4. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  5. Gênero e trauma Gender and trauma

    Directory of Open Access Journals (Sweden)

    Gláucio Ary Dillon Soares

    2005-04-01

    Full Text Available As conseqüências sociais e psicológicas da violência urbana sobre os parentes e amigos de pessoas vitimadas por mortes violentas (homicídio, suicídio ou acidentes são analisadas à luz das diferenças de gênero. A literatura especializada nesta área propõe que mulheres e homens vivenciam experiências traumáticas de forma peculiar. Porém, os traumas típicos são diferentes em cada gênero, deixando em aberto a questão sobre quanto das diferenças entre as respostas se devem a gênero e quanto se devem ao tipo de trauma. Testamos a hipótese de que as mulheres são mais suscetíveis à desordem de estresse pós-trauma (DEPT numa situação traumática comum, usando dados qualitativos e quantitativos. Comparamos os sintomas do trauma e as percepções sobre o significado da perda de seus entes queridos. A amostra, de 425 mulheres (62% e 265 homens (38%, foi retirada de uma lista de parentes de pessoas que sofreram morte violenta na cidade do Rio de Janeiro. Incluímos trinta relatos de parentes e amigos próximos das vítimas diretas. Os resultados revelaram que 54% das mulheres e 41% dos homens tiveram o cotidiano alterado depois da morte de um parente/amigo. Há diferenças estatisticamente significativas nos problemas de saúde e na diversão. Essa área foi a mais afetada, atingindo metade dos entrevistados. Uma variável intimamente correlacionada com os sintomas da DEPT é o contato com o corpo: controlando a extensão do contato (fez o reconhecimento do corpo; viu, mas não reconheceu e nem viu nem reconheceu. Em cada uma dessas categorias, as mulheres foram mais afetadas do que os homens. O artigo conclui que as mulheres sentem mais as perdas do que os homens, mas que parte das diferenças não são internas aos gêneros, mas externas a eles, dependendo das interações e dos contatos pessoais.The social and psychological consequences endured by friends and relatives of people victimized by violent death (homicide, suicide or

  6. Acupuncture Treatment of Facial Paralysis Caused by Craniocerebral Trauma in 50 Cases

    Institute of Scientific and Technical Information of China (English)

    赵建平

    2003-01-01

    @@ Cooperating with doctors in the Department of Brain Surgery, the author have treated 50 cases of facial paralysis caused by craniocerebral trauma in recent 3 years. The results are reported as follows.

  7. Radiologic assessment of maxillofacial, mandibular, and skull base trauma

    Energy Technology Data Exchange (ETDEWEB)

    Schuknecht, Bernhard [University Hospital of Zurich, Institute of Neuroradiology, Zurich (Switzerland); MRI-Medizinisch Radiodiagnostisches Institut, Zurich (Switzerland); Graetz, Klaus [University Hospital of Zurich, Department of Maxillofacial Surgery, Zurich (Switzerland)

    2005-03-01

    Cranio-maxillofacial injuries affect a significant proportion of trauma patients either in isolation or concurring with other serious injuries. Contrary to maxillofacial injuries that result from a direct impact, central skull base and lateral skull base (petrous bone) fractures usually are caused by a lateral or sagittal directed force to the skull and therefore are indirect fractures. The traditional strong role of conventional images in patients with isolated trauma to the viscerocranium is decreasing. Spiral multislice CT is progressively replacing the panoramic radiograph, Waters view, and axial films for maxillofacial trauma, and is increasingly being performed in addition to conventional films to detail and classify trauma to the mandible as well. Imaging thus contributes to accurately categorizing mandibular fractures based on location, into alveolar, mandibular proper, and condylar fractures - the last are subdivided into intracapsular and extracapsular fractures. In the midface, CT facilitates attribution of trauma to the categories central, lateral, or combined centrolateral fractures. The last frequently encompass orbital trauma as well. CT is the imaging technique of choice to display the multiplicity of fragments, the degree of dislocation and rotation, or skull base involvement. Transsphenoid skull base fractures are classified into transverse and oblique types; lateral base (temporal bone) trauma is subdivided into longitudinal and transverse fractures. Supplementary MR examinations are required when a cranial nerve palsy occurs in order to recognize neural compression. Early and late complications of trauma related to the orbit, anterior cranial fossa, or lateral skull base due to infection, brain concussion, or herniation require CT to visualize the osseous prerequisites of complications, and MR to define the adjacent brain and soft tissue involvement. (orig.)

  8. Early Childhood Trauma

    Science.gov (United States)

    National Child Traumatic Stress Network, 2010

    2010-01-01

    Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants' and young children's reactions may be different from older children's, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the…

  9. The Ocular Trauma Score

    Directory of Open Access Journals (Sweden)

    Robert Scott

    2016-01-01

    Full Text Available Relatively junior doctors or allied health workers, with little or no training in ophthalmology, are often tasked with the recognition and initial management of eye trauma. In these situations, the lack of clear instructions and guidance to support decision making has been a key challenge, which has been compounded by the inconsistent terminologies used to describe eye injuries.

  10. Post trauma abdominal cocoon.

    Science.gov (United States)

    Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev

    2015-01-01

    Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  11. Level Classifications of Foundation Stiffness

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten

    2007-01-01

    This article describes a foundation module developed and implemented in both HAWC and FLEX capable of to simulate the frequency dependent stiffness and damping of foundations e.g. pile, gravitation and bucket foundations.......This article describes a foundation module developed and implemented in both HAWC and FLEX capable of to simulate the frequency dependent stiffness and damping of foundations e.g. pile, gravitation and bucket foundations....

  12. [Biochemical and immunohistochemical markers of brain injury].

    Science.gov (United States)

    Vajtr, D; Průsa, R; Houst'ava, L; Sámal, F; Kukacka, J; Pachl, J

    2006-07-01

    Proteins released to circulation from affected tissues during primary or secondary trauma brain injury might be used as serum markers of glial or ganglial cells damage (neuron specific enolasis and S100 B protein). Other markers of trauma can be proved as relatively specific of diffuse axonal injury by immunohistochemical detectoin (amyloid prekurzor protein, neuron specific enolasis, glial fibrilar acidic protein and superficial antigen receptor CD 68). Some markers are associated with blood brain barrier damage (matrix metaloproteinases (MMP-2, MMP-9) and synthase of nitric oxide (iNOS)). We aimed in our short communication on biomechanics of developed of trauma, primary or secondary kinds of trauma brain injury and use of trauma brain injury markers for clinical diagnostics and management of patients.

  13. Lacunar stroke in a teenager after minor head trauma: case report and literature review.

    Science.gov (United States)

    Zwank, Michael D; Dummer, Benjamin W; Danielson, Levi T; Haake, Bret C

    2014-09-01

    Ischemic strokes in children and young adults are fortunately rare. Contrasted with adult ischemic strokes, pediatric stroke etiologies vary greatly and are often unknown. Childhood lacunar strokes and trauma-induced strokes represent particularly uncommon subsets and have been reported infrequently in the literature. It is unique to find a combination of the 2-a lacunar stroke induced by trauma. Underreporting of these trauma-induced ischemic strokes could be responsible for perpetuating the lack of recognition. Here we present a lacunar stroke in a young woman associated with a water sport accident and explore relevant literature encircling deep brain ischemia coinciding with trauma.

  14. Trauma care system in Iran

    Directory of Open Access Journals (Sweden)

    Zargar Moussa

    2011-06-01

    Full Text Available 【Abstract】Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to de- scribe the current status of trauma system regarding the components and function. Methods: The current status of trauma system in all components of a trauma system was described through ex- pert panels and semi-structured interviews with trauma spe- cialists and policy makers. Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of pub- lic education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training stan- dards of the front line medical team and continuing educa- tion and evaluation are yet to be addressed. Trauma regis- try has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources, it is not yet established in our system of trauma care. Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system. Key words: Emergency medical services; Trauma centers; Wounds and injuries

  15. Nursing intervention of CSI for patients with brain trauma coma complicated with pulmonary infection%脑状态指数对脑外伤昏迷并发肺部感染患者的监测及护理干预

    Institute of Scientific and Technical Information of China (English)

    程锦珍; 吴惠平; 周仲辉; 朱彩云; 林育青

    2014-01-01

    Objective Discuss detecting meaning of cerebral state index (CSI) for patients with brain trauma coma complicated with pulmonary infection ,so as to make conclusion for related nursing intervention .Method Choose 65 cases of patients with brain trauma coma complicated with pulmonary infection in our hospital during July ,2011 to July .2013 ,and process CSI and clinical pulmonary infection (CPIS) to analyze the relationship of them and summa-rize the preventive nursing measures .Result The lower CPIS score ,the higher CSI score and the relationship between them is negative correlation .Conclusion CSI and CPIS score have a certain value for brain injury prognosis judgment , and implement preventive nursing can effectively reduce the incidence of pulmonary infection ,so as to help to im-prove the prognosis ,reduce mortality .%目的:探讨脑状态指数(CSI)对脑外伤昏迷并发肺部感染患者的监测意义,总结相应的护理干预。方法选择2011年7月~2013年7月在我院住院治疗的脑外伤昏迷并发肺部感染的65例患者为研究对象,分别行CSI评分和临床肺部感染评分(CPIS),分析两者之间相关性,总结预防性护理措施。结果CSI评分越高,CPIS评分越低,CSI与CPIS之间呈负相关。结论 CSI和CPIS评分对脑外伤预后判断有一定价值,实施预防性护理,可有效降低肺部感染的发生,有助于改善预后,降低病死率。

  16. Airway management in trauma

    Directory of Open Access Journals (Sweden)

    Rashid M Khan

    2011-01-01

    Full Text Available Trauma has assumed epidemic proportion. 10% of global road accident deaths occur in India. Hypoxia and airway mismanagement are known to contribute up to 34% of pre-hospital deaths in these patients. A high degree of suspicion for actual or impending airway obstruction should be assumed in all trauma patients. Objective signs of airway compromise include agitation, obtundation, cyanosis, abnormal breath sound and deviated trachea. If time permits, one should carry out a brief airway assessment prior to undertaking definitive airway management in these patients. Simple techniques for establishing and maintaining airway patency include jaw thrust maneuver and/or use of oro- and nas-opharyngeal airways. All attempts must be made to perform definitive airway management whenever airway is compromised that is not amenable to simple strategies. The selection of airway device and route- oral or -nasal, for tracheal intubation should be based on nature of patient injury, experience and skill level.

  17. Professional Windows Workflow Foundation

    CERN Document Server

    Kitta, Todd

    2007-01-01

    If you want to gain the skills to build Windows Workflow Foundation solutions, then this is the book for you. It provides you with a clear, practical guide on how to develop workflow-based software and integrate it into existing technology landscapes. Throughout the pages, you'll also find numerous real-world examples and sample code that will help you to get started quickly.Each major area of Windows Workflow Foundation is explored in depth along with some of the fundamentals operations related to generic workflow applications. You'll also find detailed coverage on how to develop workflow in

  18. Foundations of Risk Analysis

    CERN Document Server

    Aven, Terje

    2012-01-01

    Foundations of Risk Analysis presents the issues core to risk analysis - understanding what risk means, expressing risk, building risk models, addressing uncertainty, and applying probability models to real problems. The author provides the readers with the knowledge and basic thinking they require to successfully manage risk and uncertainty to support decision making. This updated edition reflects recent developments on risk and uncertainty concepts, representations and treatment. New material in Foundations of Risk Analysis includes:An up to date presentation of how to understand, define and

  19. Foundations of predictive analytics

    CERN Document Server

    Wu, James

    2012-01-01

    Drawing on the authors' two decades of experience in applied modeling and data mining, Foundations of Predictive Analytics presents the fundamental background required for analyzing data and building models for many practical applications, such as consumer behavior modeling, risk and marketing analytics, and other areas. It also discusses a variety of practical topics that are frequently missing from similar texts. The book begins with the statistical and linear algebra/matrix foundation of modeling methods, from distributions to cumulant and copula functions to Cornish--Fisher expansion and o

  20. TCP/IP foundations

    CERN Document Server

    Blank, Andrew G

    2006-01-01

    The world of IT is always evolving, but in every area there are stable, core concepts that anyone just setting out needed to know last year, needs to know this year, and will still need to know next year. The purpose of the Foundations series is to identify these concepts and present them in a way that gives you the strongest possible starting point, no matter what your endeavor. TCP/IP Foundations provides essential knowledge about the two protocols that form the basis for the Internet, as well as many other networks. What you learn here will benefit you in the short term, as you acquire and

  1. Foundations of stochastic analysis

    CERN Document Server

    Rao, M M; Lukacs, E

    1981-01-01

    Foundations of Stochastic Analysis deals with the foundations of the theory of Kolmogorov and Bochner and its impact on the growth of stochastic analysis. Topics covered range from conditional expectations and probabilities to projective and direct limits, as well as martingales and likelihood ratios. Abstract martingales and their applications are also discussed. Comprised of five chapters, this volume begins with an overview of the basic Kolmogorov-Bochner theorem, followed by a discussion on conditional expectations and probabilities containing several characterizations of operators and mea

  2. Foundations of Inference

    CERN Document Server

    Knuth, Kevin H

    2010-01-01

    We present a foundation for inference that unites and significantly extends the approaches of Kolmogorov and Cox. Our approach is based on quantifying finite lattices of logical statements in a way that satisfies general lattice symmetries. With other applications in mind, our derivations assume minimal symmetries, relying on neither complementarity nor continuity or differentiability. Each relevant symmetry corresponds to an axiom of quantification, and these axioms are used to derive a unique set of rules governing quantification of the lattice. These rules form the familiar probability calculus. We also derive a unique quantification of divergence and information. Taken together these results form a simple and clear foundation for the quantification of inference.

  3. Impedance of Bucket Foundations

    DEFF Research Database (Denmark)

    Andersen, Lars; Ibsen, Lars Bo; Liingaard, Morten

    2008-01-01

    Modern offshore wind turbines are flexible structures with natural frequencies near the excitation frequencies related to wave and wind-induced loads. In order to obtain a reliable prediction of the structural response, the dynamic stiffness of the foundation must be evaluated accurately...... solutions, finding that the present boundary-element-finite-element model provides accurate results. The influence of the soil properties as well as the skirt length of the foundation is analysed, and each dynamic stiffness component is computed as function of a non-dimensional frequency....

  4. CRANIOROFACIAL TRAUMA - RADIODIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Zambrano JCR

    2013-09-01

    Full Text Available Clinical examination of Craniorofacial injuries are often limited in patients with trauma to the head and neck region due to obscuration by overlying edema, hematoma, hemorrhage, and soft-tissue injury. Craniorofacial injuries require accurate and prompt diagnosis for management. For Proper clinical examination and treatment plan, high resolution radiographs are always essential which will indirectly contribute to render a good medical care to the patients.

  5. Post trauma abdominal cocoon

    Directory of Open Access Journals (Sweden)

    Supreet Kaur

    2015-01-01

    Full Text Available Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  6. Imaging of laryngeal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Minerva, E-mail: Minerva.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Leuchter, Igor, E-mail: Igor.Leuchter@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Platon, Alexandra, E-mail: Alexandra.Platon@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Becker, Christoph D., E-mail: Christoph.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Dulguerov, Pavel, E-mail: Pavel.Dulguerov@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Varoquaux, Arthur, E-mail: Arthur.Varoquaux@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland)

    2014-01-15

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed.

  7. Imaging of laryngeal trauma.

    Science.gov (United States)

    Becker, Minerva; Leuchter, Igor; Platon, Alexandra; Becker, Christoph D; Dulguerov, Pavel; Varoquaux, Arthur

    2014-01-01

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed.

  8. Fluid resuscitation in trauma

    Directory of Open Access Journals (Sweden)

    Rudra A

    2006-01-01

    Full Text Available Appropriate fluid replacement is an essential component of trauma fluid resuscitation. Once hemorrhage is controlled, restoration of normovolemia is a priority. In the presence of uncontrolled haemorrhage, aggressive fluid management may be harmful. The crystalloid-colloid debate continues but existing clinical practice is more likely to reflect local biases rather than evidence based medicine. Colloids vary substantially in their pharmacology and pharmacokinetics,and the experimental finding based on one colloid cannot be extrapolated reliably to another. In the initial stages of trauma resuscitation the precise fluid used is probably not important as long as an appropriate volume is given. Later, when the microcirculation is ′leaky′, there may be some advantages to high or medium weight colloids such as hydroxyethyl starch. Hypertonic saline solutions may have some benefit in patients with head injuries. A number of hemoglobin solutions are under development, but one of the most promising of these has been withdrawn recently. It is highly likely that at least one of these solutions will eventually become routine therapy for trauma patient resuscitation. In the meantime, contrary to traditional teaching, recent data suggest that restrictive strategy of red cell transfusion may improve outcome in some critically ill patients.

  9. Grouting for Pile Foundation Improvement

    NARCIS (Netherlands)

    Van der Stoel, A.E.C.

    2001-01-01

    The aim of this research was to examine the use of grouting methods for pile foundation improvement, a generic term that is used here to define both foundation renovation (increasing the bearing capacity of a pile foundation that has insufficient bearing capacity) and foundation protection (safeguar

  10. Advanced Trauma Life Support. ABCDE from a radiological point of view.

    Science.gov (United States)

    Kool, Digna R; Blickman, Johan G

    2007-07-01

    Accidents are the primary cause of death in patients aged 45 years or younger. In many countries, Advanced Trauma Life Support(R) (ATLS) is the foundation on which trauma care is based. We will summarize the principles and the radiological aspects of the ATLS, and we will discuss discrepancies with day to day practice and the radiological literature. Because the ATLS is neither thorough nor up-to-date concerning several parts of radiology in trauma, it should not be adopted without serious attention to defining the indications and limitations pertaining to diagnostic imaging.

  11. Advanced Trauma Life Support®. ABCDE from a radiological point of view

    OpenAIRE

    2007-01-01

    Accidents are the primary cause of death in patients aged 45 years or younger. In many countries, Advanced Trauma Life Support® (ATLS®) is the foundation on which trauma care is based. We will summarize the principles and the radiological aspects of the ATLS®, and we will discuss discrepancies with day to day practice and the radiological literature. Because the ATLS® is neither thorough nor up-to-date concerning several parts of radiology in trauma, it should not be adopted without serious a...

  12. Foundations of factor analysis

    CERN Document Server

    Mulaik, Stanley A

    2009-01-01

    Introduction Factor Analysis and Structural Theories Brief History of Factor Analysis as a Linear Model Example of Factor AnalysisMathematical Foundations for Factor Analysis Introduction Scalar AlgebraVectorsMatrix AlgebraDeterminants Treatment of Variables as Vectors Maxima and Minima of FunctionsComposite Variables and Linear Transformations Introduction Composite Variables Unweighted Composite VariablesDifferentially Weighted Composites Matrix EquationsMulti

  13. National Emphysema Foundation

    Science.gov (United States)

    ... HOME THE LUNG COPD / Emphysema Advice for COPD/Emphysema Patients from Dr. Petty Asthma Interstitial Lung Disease PREVENTION Smoking Pollution and the Environment Occupational Health Hazards Early Detection LIVING with COPD Therapeutic ... joomla Welcome to the National Emphysema Foundation (NEF) This site is for the benefit ...

  14. Jeffrey Modell Foundation

    Science.gov (United States)

    ... with the PI Community VILLAGE PARK Apply to WIN or have fun at the Kids Zone AIRPORT Fly into our airport & become a “Dream ... Café Social Hub Vicki's Voice Resources Village Park WIN Patients Organizations World PI Week Kids Zone Airport Roots & Wings Jeffrey Modell Foundation Global PI ...

  15. Sarcoma Foundation of America

    Science.gov (United States)

    ... Google+ Twitter LinkedIn YouTube © 2017 Sarcoma Foundation of America | All Rights Reserved. | Terms of Use | Privacy Policy Website Design & Hosting by 270net Technologies, Inc. X - Enter Your Location - - or - Get your current location Home About Us History People Public Filings News & Media SFA in the ...

  16. The Broad Foundations, 2006

    Science.gov (United States)

    Broad Foundation, 2006

    2006-01-01

    The mission of the Broad Foundations is to transform K-12 urban public education through better governance, management, labor relations and competition; make significant contributions to advance major scientific and medical research; foster public appreciation of contemporary art by increasing access for audiences worldwide; and lead and…

  17. Spinal cord injury and its association with blunt head trauma

    Directory of Open Access Journals (Sweden)

    Paiva WS

    2011-09-01

    Full Text Available Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patients admitted in the emergency unit was carried out. Of these patients, 180 with moderate or severe head injury were enrolled. All patients were submitted to three-view spine series X-ray and thin cut axial CT scans for spine trauma investigations.Results: 112 male patients and 78 female patients, whose ages ranged from 11 to 76 years (mean age, 34 years. The most common causes of brain trauma were pedestrians struck by motor vehicles (31.1%, car crashes (27.7%, and falls (25%. Systemic lesions were present in 80 (44.4% patients and the most common were fractures, and lung and spleen injuries. 52.8% had severe and 47.2% moderate head trauma. Fourteen patients (7.8% suffered spinal cord injury (12 in cervical spine, one in lumbar, and one thoracic spine. In elderly patients, the presence of associated lesions and Glasgow Coma Scale (GCS < 9 were statistically significant as risk factors (P < 0.05 for spine injury.Conclusion: Spinal cord injury related to moderate and severe brain trauma usually affects the cervical spine. The incidence of spinal lesions and GCS < 9 points were related to greater incidence of spinal cord injury.Keywords: head injury, spine trauma, risk factors

  18. Global trauma: the great divide

    OpenAIRE

    Paniker Jayanth; Graham Simon Matthew; Harrison James William

    2015-01-01

    Road trauma is an emergent global issue. There is huge disparity between the population affected by road trauma and the resource allocation. If the current trend continues, a predicted extra 5 million lives will be lost in this decade. This article aims to create an awareness of the scale of the problem of road trauma and the inequality in the resources available to address this problem. It also describes the responses from the international organisations and the orthopaedic community in deal...

  19. Trauma Studies: prospettive e problemi

    Directory of Open Access Journals (Sweden)

    Rachele Branchini

    2013-12-01

    Full Text Available The trauma paradigm pervades contemporary life. In newspapers, on television, on the web, even in ordinary conversation, experiences of every kind (both figurative and positive ones are described as “traumatic”. Thus the very meaning of the term is often overturned. This article seeks to reshape the limits of the concept of trauma by tracing its evolution from the psychological debate of the early nineteenth century to the recent setting up of the specific discipline of Trauma Studies.

  20. Neuronal Cell Death Induced by Mechanical Percussion Trauma in Cultured Neurons is not Preceded by Alterations in Glucose, Lactate and Glutamine Metabolism

    DEFF Research Database (Denmark)

    Jayakumar, A R; Bak, L K; Rama Rao, K V

    2016-01-01

    Traumatic brain injury (TBI) is a devastating neurological disorder that usually presents in acute and chronic forms. Brain edema and associated increased intracranial pressure in the early phase following TBI are major consequences of acute trauma. On the other hand, neuronal injury, leading...... not appear to contribute to the neuronal death in the early stages following trauma....

  1. Global trauma: the great divide.

    Science.gov (United States)

    Paniker, Jayanth; Graham, Simon Matthew; Harrison, James William

    2015-01-01

    Road trauma is an emergent global issue. There is huge disparity between the population affected by road trauma and the resource allocation. If the current trend continues, a predicted extra 5 million lives will be lost in this decade. This article aims to create an awareness of the scale of the problem of road trauma and the inequality in the resources available to address this problem. It also describes the responses from the international organisations and the orthopaedic community in dealing with this issue. The International Orthopaedic community has a unique opportunity and moral obligation to play a part in changing this trend of global trauma.

  2. Global trauma: the great divide

    Directory of Open Access Journals (Sweden)

    Paniker Jayanth

    2015-01-01

    Full Text Available Road trauma is an emergent global issue. There is huge disparity between the population affected by road trauma and the resource allocation. If the current trend continues, a predicted extra 5 million lives will be lost in this decade. This article aims to create an awareness of the scale of the problem of road trauma and the inequality in the resources available to address this problem. It also describes the responses from the international organisations and the orthopaedic community in dealing with this issue. The International Orthopaedic community has a unique opportunity and moral obligation to play a part in changing this trend of global trauma.

  3. International Rett Syndrome Foundation

    Science.gov (United States)

    ... Research awards Our research will help millions A cure for Rett will yield major advances toward treatments for millions of people around the world with Autism, Parkinson's, Alzheimers, Schizophrenia and Traumatic Brain Injuries. Make ...

  4. Escala de coma de Glasgow e qualidade de vida pós-trauma cranioencefálico Escala de coma de Glasgow y calidad de vida post-trauma craneoencefálico Glasgow Coma Scale and quality of life after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Cristina Helena Costanti Settervall

    2012-01-01

    Full Text Available OBJETIVO: Avaliar o desempenho de diferentes escores da Escala de Coma de Glasgow (ECGl observados nas primeiras 72 horas pós trauma perante a qualidade de vida e mudança percebida do estado de saúde, após um ano do evento traumático. MÉTODOS: Estudo de abordagem quantitativa, observacional, longitudinal, descritivo e correlacional com vítimas de trauma cranioencefálico contuso (TCEC avaliadas, diariamente durante a internação hospitalar, e após um ano por meio do Medical Outcome Study 36-item Short Form Health Survey (SF-36. RESULTADOS: sob as curvas Reciever Operator Characteristics dos valores da ECGl referentes à mudança percebida do estado de saúde não apresentaram diferença significativa e variaram de 0,63 a 0,71. Correlação, estatisticamente significante, porém fraca, foi observada entre os escores da ECGl e alguns dos domínios do SF-36. CONCLUSÃO: Verificou-se que os diferentes valores da ECGl apresentaram limitações para que fossem aplicados na prática clínica para estimar as consequências do TCEC a longo prazo.OBJETIVO: Evaluar el desempeño de diferentes escores de la Escala de Coma de Glasgow (ECGl observados en las primeras 72 horas post trauma frente a la calidad de vida y cambio percibido en el estado de salud, después de un año del evento traumático. MÉTODOS: Estudio de abordaje cuantitativo, observacional, longitudinal, descriptivo y correlacional realizado con víctimas de trauma craneoencefálico contuso (TCEC evaluadas, diariamente durante el internamiento hospitalario, y después de un año por medio del Medical Outcome Study 36-item Short Form Health Survey (SF-36. RESULTADOS: bajo las curvas Reciever Operator Characteristics de los valores de la ECGl referentes al cambio percibido en el estado de salud no presentaron diferencia significativa y variaron de 0,63 a 0,71. Correlación, estadísticamente significativa, no obstante débil, fue observada entre los escores de la ECGl y algunos de los

  5. Retroclival collections associated with abusive head trauma in children

    Energy Technology Data Exchange (ETDEWEB)

    Silvera, V.M.; Danehy, Amy R.; Carducci, Chiara; Grant, P.E.; Kleinman, Paul K. [Harvard Medical School, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States); Newton, Alice W. [Harvard Medical School, Child Protection Program, Department of Pediatrics, Massachusetts General Hospital, Boston, MA (United States); Stamoulis, Catherine [Harvard Medical School, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States); Harvard Medical School, Department of Neurology, Boston Children' s Hospital, Boston, MA (United States); Wilson, Celeste R. [Harvard Medical School, Division of General Pediatrics, Department of Medicine, Boston Children' s Hospital, Boston, MA (United States)

    2014-12-15

    Retroclival collections are rare lesions reported almost exclusively in children and strongly associated with trauma. We examine the incidence and imaging characteristics of retroclival collections in young children with abusive head trauma. We conducted a database search to identify children with abusive head trauma ≤3 years of age with brain imaging performed between 2007 and 2013. Clinical data and brain images of 65 children were analyzed. Retroclival collections were identified in 21 of 65 (32%) children. Ten (48%) were subdural, 3 (14%) epidural, 2 (10%) both, and 6 (28%) indeterminate. Only 8 of 21 retroclival collections were identifiable on CT and most were low or intermediate in attenuation. Eighteen of 21 retroclival collections were identifiable on MRI: 3 followed cerebral spinal fluid in signal intensity and 15 were bloody/proteinaceous. Additionally, 2 retroclival collections demonstrated a fluid-fluid level and 2 enhanced in the 5 children who received contrast material. Sagittal T1-weighted images, sagittal fluid-sensitive sequences, and axial FLAIR (fluid-attenuated inversion recovery) images showed the retroclival collections best. Retroclival collections were significantly correlated with supratentorial and posterior fossa subdural hematomas and were not statistically correlated with skull fracture or parenchymal brain injury. Retroclival collections, previously considered rare lesions strongly associated with accidental injury, were commonly identified in this cohort of children with abusive head trauma, suggesting that retroclival collections are an important component of the imaging spectrum in abusive head trauma. Retroclival collections were better demonstrated on MRI than CT, were commonly identified in conjunction with intracranial subdural hematomas, and were not significantly correlated with the severity of brain injury or with skull fractures. (orig.)

  6. 枪弹射击致防弹衣后长白猪远达脑组织损伤特点及其机制%Characteristics and mechanism of behind armour blunt trauma in Landrace brain

    Institute of Scientific and Technical Information of China (English)

    苏正林; 许民辉; 赖西南; 张波; 黄艺峰; 王丽丽

    2011-01-01

    Objective To study the characteristics of behind armor blunt trauma extending to the brain and to investigate the biomechanics mechanism of the remote injury. Methods Eighteen male Landraces were randomly divided into a sham injury group (n =4) , a bullet velocity 910 m/s group (re =6), a 740 m/s group (n =4) and a S90 m/s group (n =4). The injury model was anesthetized Landrace in right lateral position and wrapped in a two-layer bullet-proof vest. The outer layer was ceramic hard armor with NIJ Ⅲ protection grade. The inner layer was police grade II ultra-high molecular polyethylene soft body armor. Caliber 5. 8 mm ballistic guns were fired at 25 m range and three different projectile velocities, aimed at the left midclavicular line 4, 5 intercostal (heart window). Air bomb shooting was applied to sham injury group. EEG, ECG, invasive arterial blood pressure, heart rate and respiratory changes before and after injury were continuously monitored. Plasma was collected at 1, 2 and 3 h before and after injury to detect markers of brain injury. Lumbar puncture was taken at 3 h before and after injury to test specific brain injury protein in cerebrospinal fluid. In 3 h after injury the animals were deep anesthetized and bled to death. Their brain blocks were collected for toluidine blue staining and electron microscopy. The other 4 Landrace pigs were used for biomechanical testing. On the basis of the above model pressure sensors were placed in the subcutaneous layer of precordium at the point of impact, pericardial cavity, left chest, left common carotid artery and cranial cavity. Acceleration sensors and force sensors were placed in the sixth rib at precordial midclavicular line. When the target was hit, each parts biomechanical parameters and duration were recorded and analyzed. Results In the 3 groups of different speed, spectrum intensity of low-frequency EEG Delta and Theta wave within 2 minutes after injury was significantly lower than that before injury (P

  7. A Civilian/Military Trauma Institute: National Trauma Coordinating Center

    Science.gov (United States)

    2012-10-01

    Rehabilitation Physical therapy/ rehabilitation evaluation Fracture femur OR tibia OR pelvis AND not in ICU 25. Evaluation Abdominal CT scans during...Trauma, ICU , education, research, training, analysis, practice 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT...POC encompassed all aspects of trauma care, including initial evaluation, resuscitation, oper- ative care, critical care, rehabilitation , and injury

  8. Trauma-Focused CBT for Youth with Complex Trauma

    Science.gov (United States)

    Cohen, Judith A.; Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2012-01-01

    Objectives: Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive…

  9. Mathematical foundations of neurocomputing

    Energy Technology Data Exchange (ETDEWEB)

    Amari, S. (Tokyo Univ. (Japan). Faculty of Engineering)

    1990-09-01

    Neurocomputing makes use of parallel dynamical interactions of modifiable neuron-like elements. It is important to show, by mathematical treatments, the capabilities and limitations of information processing by various architectures of neural networks. This paper, gives mathematical foundations to neurocomputing. It considers the capabilities of transformations by layered networks, statistical neurodynamics, the dynamical characteristics of associative memory, a general theory of neural learning, and self-organization of neural networks.

  10. Foundations of image science

    CERN Document Server

    Barrett, Harrison H

    2013-01-01

    Winner of the 2006 Joseph W. Goodman Book Writing Award! A comprehensive treatment of the principles, mathematics, and statistics of image science In today's visually oriented society, images play an important role in conveying messages. From seismic imaging to satellite images to medical images, our modern society would be lost without images to enhance our understanding of our health, our culture, and our world. Foundations of Image Science presents a comprehensive treatment of the principles, mathematics, and st

  11. Buckling of Bucket Foundations

    DEFF Research Database (Denmark)

    Madsen, Søren; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo

    2012-01-01

    In this paper, the risk of structural buckling during installation of large-diameter bucket foundations is addressed using numerical methods. Imperfect geometries are introduced based on the pre-buckling mode shapes from a linear Eigenvalue buckling analysis. Various imperfect geometries...... are introduced to reveal how sensitive the buckling load is to the mentioned imperfections. Including the first 21 mode shapes as imperfect geometries reduces the buckling pressure compared to only considering mode 1....

  12. Stochastic Games. I. Foundations,

    Science.gov (United States)

    1982-04-01

    stimulate discussion and critical coment. Requests for single copies of a Paper will be filled by the Cowles Foundation within the limits of the supply...underpinning for the theory of stochastic games. Section 2 is a reworking of the Bevley- Kohlberg result integrated with Shapley’s; the "black magic" of... Kohlberg : The values of the r-discount game, and the stationary optimal strategies, have Puiseaux expansions. L.. 11" 6 3. More generally, consider an

  13. The Foundation of Morality

    OpenAIRE

    Juul-Larsen, Astrid; Cathmont-Prynn, Penelope Josefine; Magnúsdóttir, Gu∂rún Ása; Brudvig, Mette Rubeck; Kirkegaard, Marie Louise

    2008-01-01

    In this project we have been working on the phenomenon of morality, more specifically the foundation in relation to religion. We have been looking into both psychology and philosophy, in aim to find answers to our research. As main objects of investigation we have worked with the philosopher and psychologist William James, along with the theologian Paul Tillich. Furthermore we have looked into the Divine command theory, along with several theories and arguments from various professionals with...

  14. Topological Foundations of Electromagnetism

    CERN Document Server

    Barrett, Terrence W

    2008-01-01

    Topological Foundations of Electromagnetism seeks a fundamental understanding of the dynamics of electromagnetism; and marshals the evidence that in certain precisely defined topological conditions, electromagnetic theory (Maxwell's theory) must be extended or generalized in order to provide an explanation and understanding of, until now, unusual electromagnetic phenomena. Key to this generalization is an understanding of the circumstances under which the so-called A potential fields have physical effects. Basic to the approach taken is that the topological composition of electromagnetic field

  15. Mathematical foundations of thermodynamics

    CERN Document Server

    Giles, R; Stark, M; Ulam, S

    2013-01-01

    Mathematical Foundations of Thermodynamics details the core concepts of the mathematical principles employed in thermodynamics. The book discusses the topics in a way that physical meanings are assigned to the theoretical terms. The coverage of the text includes the mechanical systems and adiabatic processes; topological considerations; and equilibrium states and potentials. The book also covers Galilean thermodynamics; symmetry in thermodynamics; and special relativistic thermodynamics. The book will be of great interest to practitioners and researchers of disciplines that deal with thermodyn

  16. Design of road foundations

    OpenAIRE

    Thom, Nicholas

    1988-01-01

    Research has been conducted into the fundamental mechanical properties of a granular material. This has involved the use of both a repeated load triaxial apparatus and a new hollow cylinder apparatus, which has required development and modification. Building on the foundation of earlier research at Nottingham, models have been developed which predict the stress-strain behaviour of a dry granular material under any combination of applied stresses. This includes repeatable elastic behaviour and...

  17. Wronski's Foundations of Mathematics.

    Science.gov (United States)

    Wagner, Roi

    2016-09-01

    Argument This paper reconstructs Wronski's philosophical foundations of mathematics. It uses his critique of Lagrange's algebraic analysis as a vignette to introduce the problems that he raised, and argues that these problems have not been properly appreciated by his contemporaries and subsequent commentators. The paper goes on to reconstruct Wronski's mathematical law of creation and his notions of theory and techne, in order to put his objections to Lagrange in their philosophical context. Finally, Wronski's proof of his universal law (the expansion of a given function by any series of functions) is reviewed in terms of the above reconstruction. I argue that Wronski's philosophical approach poses an alternative to the views of his contemporary mainstream mathematicians, which brings up the contingency of their choices, and bridges the foundational concerns of early modernity with those of the twentieth-century foundations crisis. I also argue that Wronski's views may be useful to contemporary philosophy of mathematical practice, if they are read against their metaphysical grain.

  18. Foundations of chaotic mixing.

    Science.gov (United States)

    Wiggins, Stephen; Ottino, Julio M

    2004-05-15

    The simplest mixing problem corresponds to the mixing of a fluid with itself; this case provides a foundation on which the subject rests. The objective here is to study mixing independently of the mechanisms used to create the motion and review elements of theory focusing mostly on mathematical foundations and minimal models. The flows under consideration will be of two types: two-dimensional (2D) 'blinking flows', or three-dimensional (3D) duct flows. Given that mixing in continuous 3D duct flows depends critically on cross-sectional mixing, and that many microfluidic applications involve continuous flows, we focus on the essential aspects of mixing in 2D flows, as they provide a foundation from which to base our understanding of more complex cases. The baker's transformation is taken as the centrepiece for describing the dynamical systems framework. In particular, a hierarchy of characterizations of mixing exist, Bernoulli --> mixing --> ergodic, ordered according to the quality of mixing (the strongest first). Most importantly for the design process, we show how the so-called linked twist maps function as a minimal picture of mixing, provide a mathematical structure for understanding the type of 2D flows that arise in many micromixers already built, and give conditions guaranteeing the best quality mixing. Extensions of these concepts lead to first-principle-based designs without resorting to lengthy computations.

  19. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be seen ...

  20. Are trauma patients better off in a trauma ICU?

    Directory of Open Access Journals (Sweden)

    Duane Therese

    2008-01-01

    Full Text Available There is very little data on the value of specialized intensive care unit (ICU care in the literature. To determine if specialize ICU care for the trauma patient improved outcomes in this patient population. Level I Trauma Center Compared outcomes of trauma patients treated in a surgical trauma ICU (STICU to those treated in non- trauma ICUs (non-STICU. Retrospective review of trauma registry data. Statistical Analysis: Wilcoxon Rank Test , Fischer′s Exact test, logistic regression. There were 1146 STICU patients compared to 1475 non-STICU. In all ISS groups there were more penetrating trauma patients in the STICU (32.54% STICU vs. 18.15% non-STICU, P < 0.0001 (ISS< 15, (21.03% STICU vs. 12.98% non-STICU, P =0.0074 (ISS between 15-25, and (19.42% STICU vs. 11.35% non-STICU, P =0.0026 (ISS> 25. All groups had similar lengths of stay. The blunt trauma patients were sicker in the STICU (20.8 ISS ± 12.2 STICU vs. 19.7 ISS ± 11.9 non-STICU, P =0.03 yet had similar outcomes to the non-STICU group. Logistic regression identified penetrating trauma and not ICU location as a predictor of mortality. Sicker STICU patients do as well as less injured non-STICU patients. Severely injured patients should be preferentially treated in a STICU where they are better equipped to care for the complex multi-trauma patient. All patients, regardless of location, do well when their management is guided by a surgical critical care team.

  1. Management of liver trauma.

    LENUS (Irish Health Repository)

    Badger, S A

    2012-02-01

    BACKGROUND: Blunt and penetrating liver trauma is common and often presents major diagnostic and management problems. METHODS: A literature review was undertaken to determine the current consensus on investigation and management strategies. RESULTS: The liver is the most frequently injured organ following abdominal trauma. Immediate assessment with ultrasound has replaced diagnostic peritoneal lavage in the resuscitation room, but computerised tomography remains the gold standard investigation. Nonoperative management is preferred in stable patients but laparotomy is indicated in unstable patients. Damage control techniques such as perihepatic packing, hepatotomy plus direct suture, and resectional debridement are recommended. Major complex surgical procedures such as anatomical resection or atriocaval shunting are now thought to be redundant in the emergency setting. Packing is also recommended for the inexperienced surgeon to allow control and stabilisation prior to transfer to a tertiary centre. Interventional radiological techniques are becoming more widely used, particularly in patients who are being managed nonoperatively or have been stabilised by perihepatic packing. CONCLUSIONS: Management of liver injuries has evolved significantly throughout the last two decades. In the absence of other abdominal injuries, operative management can usually be avoided. Patients with more complex injuries or subsequent complications should be transferred to a specialist centre to optimise final outcome.

  2. The Significance of Human-Animal Relationships as Modulators of Trauma Effects in Children: A Developmental Neurobiological Perspective

    Science.gov (United States)

    Yorke, Jan

    2010-01-01

    Emotional stress and trauma impacts the neurobiology of children. They are especially vulnerable given the developmental plasticity of the brain. The neural synaptic circular processes between the anterior cingulated cortex, prefrontal cortex, amygdala and the hypothalamus are altered. Trauma results in the release of the peptide glucocortisoid,…

  3. Clinical management of abdominal trauma

    Institute of Scientific and Technical Information of China (English)

    FANG Guo-en; LUO Tian-hang; DU Cheng-hui; BI Jian-wei; XUE Xu-chao; WEI Guo; WENG Zhao-zhang; MA Li-ye; HUA Ji-de

    2008-01-01

    Objective: To improve the prognosis of patients with abdominal trauma. Methods: Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years ranging from 3-82 years. All abdominal traumas consisted of closed traumas 360 cases, 86.7% and open traumas 55 cases, 13.3%. Results: Atotal of 407 cases 98.1% were fully recovered from trauma and the other 8 cases 1.9% died of multiple injuries. The mean injury severity score ISS of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds 6 cases, pancreatic fistula 2 cases and intestinal fistula 1 case. All these postoperative complications were cured by the conservative treatment. Conclusion: Careful case history inquisition and physical examination are the basic methods to diagnose abdomi- nal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.

  4. Sexual Trauma, Spirituality, and Psychopathology

    Science.gov (United States)

    Krejci, Mark J.; Thompson, Kevin M.; Simonich, Heather; Crosby, Ross D.; Donaldson, Mary Ann; Wonderlich, Stephen A.; Mitchell, James E.

    2004-01-01

    This study assessed the association between spirituality and psychopathology in a group of sexual abuse victims and controls with a focus on whether spirituality moderated the association between sexual trauma and psychopathology. Seventy-one sexual trauma victims were compared to 25 control subjects on spiritual well-being, the Eating Disorder…

  5. Novel insights in elbow trauma

    NARCIS (Netherlands)

    Claessen, F.M.A.P.

    2016-01-01

    Musculoskeletal trauma is among the ten most common causes for loss of healthy life years (disability adjusted life years) in Western Countries. Nine percent of all musculoskeletal trauma is related to the elbow; in athletes the prevalence is 11 percent. Approximately 80 percent of patients that had

  6. Prehospital fluid resuscitation in trauma

    NARCIS (Netherlands)

    Raum, M. R.; Waydhas, C.

    2009-01-01

    The indications for and type and amount of fluid resuscitation for trauma patients in the field remains highly controversial. There is unanimity, however, that trauma victims may suffer from acute blood loss. In addition to stopping the bleeding fluid resuscitation is the second mainstay in shock th

  7. Comparação entre instrumentos de mensuração das consequências do trauma crânio-encefálico Comparación de instrumentos de medida de las consecuencias del traumatismo encéfalocraneano Comparisons among measurement tools in traumatic brain injury outcomes

    Directory of Open Access Journals (Sweden)

    Regina Márcia Cardoso de Sousa

    2006-06-01

    mayor sensibilidad para detectar alteraciones en las víctimas con mejores condiciones post-traumáticas.Traumatic brain injury (TBI is considered the most important cause of disability among young people and the most common neurological cause of morbidity. Consequently, there is increasing interest in scales to monitor recovery in TBI. Among these scales, two have been widely adopted: the Glasgow Outcome Scale (GOS and the Disability Rating Scale (DRS. The purpose of this paper is to compare the results found in DRS and in the original and extended GOS. Sixty-three closed-head injury victims, aged between 12 and 65, on an outpatient follow-up program at a trauma center in the city of São Paulo, with 6 months to 3 years post-TBI, had their characteristics and outcomes assessed. When comparing the results obtained by the scales, it was concluded that although the three of them were strongly correlated, extended GOS showed to be more sensitive in detecting changes in victims with better post-traumatic conditions.

  8. Scour around Offshore Windturbine Foundations

    DEFF Research Database (Denmark)

    Larsen, Brian Juul; De Vos, Leen; Frigaard, Peter

    For the present report a testprogramme has been performed to determine the scour around offshore windturbine foundations.......For the present report a testprogramme has been performed to determine the scour around offshore windturbine foundations....

  9. Maternal mortality due to trauma.

    Science.gov (United States)

    Romero, Vivian Carolina; Pearlman, Mark

    2012-02-01

    Maternal mortality is an important indicator of adequacy of health care in our society. Improvements in the obstetric care system as well as advances in technology have contributed to reduction in maternal mortality rates. Trauma complicates up to 7% of all pregnancies and has emerged as the leading cause of maternal mortality, becoming a significant concern for the public health system. Maternal mortality secondary to trauma can often be prevented by coordinated medical care, but it is essential that caregivers recognize the unique situation of providing simultaneous care to 2 patients who have a complex physiologic relationship. Optimal management of the pregnant trauma victim requires a multidisciplinary team, where the obstetrician plays a central role. This review focuses on the incidence of maternal mortality due to trauma, the mechanisms involved in traumatic injury, the important anatomic and physiologic changes that may predispose to mortality due to trauma, and finally, preventive strategies that may decrease the incidence of traumatic maternal death.

  10. Wave Forces on Windturbine Foundations

    DEFF Research Database (Denmark)

    Larsen, Brian Juul; Frigaard, Peter

    A testprogramme has been performed to determine the wave forces on two types of foundations for an offshore windturbine. the tested foundation types are a monopile and cone. Furthermore the shaft of the cone has been tested.......A testprogramme has been performed to determine the wave forces on two types of foundations for an offshore windturbine. the tested foundation types are a monopile and cone. Furthermore the shaft of the cone has been tested....

  11. Essential Trauma Care: strengthening trauma systems round the world.

    Science.gov (United States)

    Joshipura, Manjul; Mock, Charles; Goosen, Jacques; Peden, Margie

    2004-09-01

    Injury has become a major cause of death and disability world-wide. Systematic approaches to its prevention and treatment are needed. In terms of treatment, there are many low-cost improvements that could be made particularly in low- and middle-income countries to strengthen their trauma systems. These can be formalised under "Essential Trauma Care" programme, similar to other global programmes for major public health problems. World Health Organisation (WHO), leading the initiative in this direction, convened a meeting at Geneva in June 2002, involving Injuries and Violence Prevention Department of the WHO, the Working Group for Essential Trauma Care of the International Association for Trauma and Surgical Intensive Care (IATSIC), representatives of other organisations and trauma care clinicians representing Africa, Asia, and Latin America. The meeting developed a preliminary list of Essential Trauma Care services and a model template for the skills and equipment needed to assure them. It is intended to be used to assist individual countries in planning their own trauma care services.

  12. Problem solving in foundation engineering using foundationPro

    CERN Document Server

    Yamin, Mohammad

    2016-01-01

    This book is at once a supplement to traditional foundation engineering textbooks and an independent problem-solving learning tool. The book is written primarily for university students majoring in civil or construction engineering taking foundation analysis and design courses to encourage them to solve design problems. Its main aim is to stimulate problem solving capability and foster self-directed learning. It also explains the use of the foundationPro software, available at no cost, and includes a set of foundation engineering applications. Taking a unique approach, Dr. Yamin summarizes the general step-by-step procedure to solve various foundation engineering problems, illustrates traditional applications of these steps with longhand solutions, and presents the foundationPro solutions. The special structure of the book allows it to be used in undergraduate and graduate foundation design and analysis courses in civil and construction engineering. The book stands as valuable resource for students, faculty, ...

  13. Foundations of Power

    DEFF Research Database (Denmark)

    Lev, Amnon

    of state power. This sets the modern state apart from the societies of the Middle Ages in which civil authority was either seen to be founded in religion (Christian doctrine) or in custom (Roman law). In the age of the modern state, it is law, or rather, constitutional doctrine that serves as the medium...... legal thought arises out of the ruins of natural law and it argues that, even as 20th century legal thought has distanced itself from natural law, it has not ceased to return to its fundamental problem: the problem of the foundation of power....

  14. System Reliability Analysis: Foundations.

    Science.gov (United States)

    1982-07-01

    performance formulas for systems subject to pre- ventive maintenance are given. V * ~, , 9 D -2 SYSTEM RELIABILITY ANALYSIS: FOUNDATIONS Richard E...reliability in this case is V P{s can communicate with the terminal t = h(p) Sp2(((((p p)p) p)p)gp) + p(l -p)(((pL p)p)(p 2 JLp)) + p(l -p)((p(p p...For undirected networks, the basic reference is A. Satyanarayana and Kevin Wood (1982). For directed networks, the basic reference is Avinash

  15. Instant Zurb Foundation 4

    CERN Document Server

    Arévalo, Jorge

    2013-01-01

    A quick and easy guide that follows a practical approach to rapidly create responsive web pages using Foundation 4 framework, following the mobile-first philosophy.If you are a web developer who wants to get the most out of your HTML5/CSS/JavaScript skills, this book is ideal for you. It is assumed that you will have some experience with these languages, but for those who don't, you can also be up and running in an instant.

  16. Mathematical foundations of elasticity

    CERN Document Server

    Marsden, Jerrold E

    1994-01-01

    This advanced-level study approaches mathematical foundations of three-dimensional elasticity using modern differential geometry and functional analysis. It is directed to mathematicians, engineers and physicists who wish to see this classical subject in a modern setting with examples of newer mathematical contributions. Prerequisites include a solid background in advanced calculus and the basics of geometry and functional analysis.The first two chapters cover the background geometry ― developed as needed ― and use this discussion to obtain the basic results on kinematics and dynamics of con

  17. Foundations of Galois theory

    CERN Document Server

    Postnikov, MM; Stark, M; Ulam, S

    1962-01-01

    Foundations of Galois Theory is an introduction to group theory, field theory, and the basic concepts of abstract algebra. The text is divided into two parts. Part I presents the elements of Galois Theory, in which chapters are devoted to the presentation of the elements of field theory, facts from the theory of groups, and the applications of Galois Theory. Part II focuses on the development of general Galois Theory and its use in the solution of equations by radicals. Equations that are solvable by radicals; the construction of equations solvable by radicals; and the unsolvability by radica

  18. Web services foundations

    CERN Document Server

    Bouguettaya, Athman; Daniel, Florian

    2013-01-01

    Web services and Service-Oriented Computing (SOC) have become thriving areas of academic research, joint university/industry research projects, and novel IT products on the market. SOC is the computing paradigm that uses Web services as building blocks for the engineering of composite, distributed applications out of the reusable application logic encapsulated by Web services. Web services could be considered the best-known and most standardized technology in use today for distributed computing over the Internet.Web Services Foundations is the first installment of a two-book collection coverin

  19. Foundations of Inference

    Directory of Open Access Journals (Sweden)

    Kevin H. Knuth

    2012-06-01

    Full Text Available We present a simple and clear foundation for finite inference that unites and significantly extends the approaches of Kolmogorov and Cox. Our approach is based on quantifying lattices of logical statements in a way that satisfies general lattice symmetries. With other applications such as measure theory in mind, our derivations assume minimal symmetries, relying on neither negation nor continuity nor differentiability. Each relevant symmetry corresponds to an axiom of quantification, and these axioms are used to derive a unique set of quantifying rules that form the familiar probability calculus. We also derive a unique quantification of divergence, entropy and information.

  20. [A case of Meige's syndrome associated with post head trauma].

    Science.gov (United States)

    Kimura, T; Deshimaru, M; Inukai, K; Matsunaga, T; Miyakawa, T

    1992-11-01

    The pathogenesis of Meige's syndrome (MS) is controversial and has yet to be determined up to today. We studied a case of MS associated with post head trauma. The patient was a 52-year-old female. At the age of 46, she began to suffer from oro-lingual dystonia after head trauma induced by a traffic accident and the brief administration of neuroleptics to the delusion deteriorated the dystonia. She showed a wry appearance after 1 year and 6 months of the trauma and began to exhibit blepharospasms, oro-mandibular dystonia and cervical dystonia after 2 years and 3 months. For these symptoms her daily life became difficult. These symptoms were resistant to various drug therapies, although trihexyphenidyl relieved the symptoms transiently. Laboratory examinations and cranial MRI findings were normal. By surface electromyogram of ocular orbicular muscles, bilateral continuous discharge was observed. This patient was diagnosed as MS by clinical symptoms and surface electromyogram findings. It was inferred that the head trauma was associated with the development of MS. We discussed the pathogenesis of MS in the present case and it was speculated that MS was presented by a minute lesion of the brain stem which was produced at the time of the head trauma.

  1. Trauma-affected refugees

    DEFF Research Database (Denmark)

    Sonne, Charlotte Kærgaard

    2016-01-01

    . The aim of PTF3 was to examine differences in the effects of venlafaxine and sertraline on Post-traumatic Stress Disorder (PTSD), depression and functional impairments in trauma-affected refugees as well as research predictors for treatment outcome. The patients included were 207 adult refugees diagnosed......-reported depression and anxiety symptoms measured on Hopkins Symptom Check List-25 (HSCL-25), self-reported social functioning measured on the Social Adjustment Scale Self Report, short version (SAS-SR), and observer-rated depression and anxiety symptoms assessed on the Hamilton Depression and Anxiety Ratings Scales......=0.06). The only item from the rating scale that was significantly correlated to outcome on HTQ was job status, while a number of other items were significantly related to changes in depression and anxiety symptoms. The size of correlation coefficients was, however, modest. In addition, we found...

  2. Orthopedic trauma in pregnancy.

    Science.gov (United States)

    Desai, Pratik; Suk, Michael

    2007-11-01

    Trauma sustained during pregnancy can trigger uncertainty and anxiety for patient and orthopedic surgeon alike. In particular, orthopedic-related injuries raise concerns about preoperative, intraoperative, and postoperative care. In this article, we review common concerns about radiation exposure, leukemia, pain management, anticoagulation, and anesthesia. One finding is that radiation risk is minimal when obtaining x-rays for operative planning, provided that the cumulative dose is within 5 rad. We also address safety concerns about patient positioning and staff radiation exposure. In addition, we found that most anesthetics used in pregnancy are category C (ie, safe). Perioperative opioid use for pain management is recommended with little risk. Regarding anticoagulation, low-molecular-weight heparin and fondaparinux are the safest choices. Last, pregnancy is not a contraindication to operative management of pelvic and acetabular fractures.

  3. Lightweight Trauma Module - LTM

    Science.gov (United States)

    Hatfield, Thomas

    2008-01-01

    Current patient movement items (PMI) supporting the military's Critical Care Air Transport Team (CCATT) mission as well as the Crew Health Care System for space (CHeCS) have significant limitations: size, weight, battery duration, and dated clinical technology. The LTM is a small, 20 lb., system integrating diagnostic and therapeutic clinical capabilities along with onboard data management, communication services and automated care algorithms to meet new Aeromedical Evacuation requirements. The Lightweight Trauma Module is an Impact Instrumentation, Inc. project with strong Industry, DoD, NASA, and Academia partnerships aimed at developing the next generation of smart and rugged critical care tools for hazardous environments ranging from the battlefield to space exploration. The LTM is a combination ventilator/critical care monitor/therapeutic system with integrated automatic control systems. Additional capabilities are provided with small external modules.

  4. Mathematical foundations of biomechanics.

    Science.gov (United States)

    Niederer, Peter F

    2010-01-01

    The aim of biomechanics is the analysis of the structure and function of humans, animals, and plants by means of the methods of mechanics. Its foundations are in particular embedded in mathematics, physics, and informatics. Due to the inherent multidisciplinary character deriving from its aim, biomechanics has numerous connections and overlapping areas with biology, biochemistry, physiology, and pathophysiology, along with clinical medicine, so its range is enormously wide. This treatise is mainly meant to serve as an introduction and overview for readers and students who intend to acquire a basic understanding of the mathematical principles and mechanics that constitute the foundation of biomechanics; accordingly, its contents are limited to basic theoretical principles of general validity and long-range significance. Selected examples are included that are representative for the problems treated in biomechanics. Although ultimate mathematical generality is not in the foreground, an attempt is made to derive the theory from basic principles. A concise and systematic formulation is thereby intended with the aim that the reader is provided with a working knowledge. It is assumed that he or she is familiar with the principles of calculus, vector analysis, and linear algebra.

  5. Dental Trauma. A Case Report

    Directory of Open Access Journals (Sweden)

    Alain Soto Ugalde

    2015-06-01

    Full Text Available Dental traumas in children are common; therefore the dentist should be trained to solve them. This paper presents the diagnosis, treatment and outcome of a child with a 12 mm overjet, mouth breathing habit and bilabial incompetence who suffered a severe trauma to tooth number 11, causing its mobility. A splint was applied to the affected tooth and subsequently, a root canal filling was performed, all with a satisfactory outcome. Although these traumas are common, the presentation of this case is important due to its use in the teaching context.

  6. The Dental Trauma Internet Calculator

    DEFF Research Database (Denmark)

    Gerds, Thomas Alexander; Lauridsen, Eva Fejerskov; Christensen, Søren Steno Ahrensburg

    2012-01-01

    Background/Aim Prediction tools are increasingly used to inform patients about the future dental health outcome. Advanced statistical methods are required to arrive at unbiased predictions based on follow-up studies. Material and Methods The Internet risk calculator at the Dental Trauma Guide...... provides prognoses for teeth with traumatic injuries based on the Copenhagen trauma database: http://www.dentaltraumaguide.org The database includes 2191 traumatized permanent teeth from 1282 patients that were treated at the dental trauma unit at the University Hospital in Copenhagen (Denmark...

  7. Right temporal cortical hypertrophy in resilience to trauma: an MRI study

    OpenAIRE

    Sevenius Nilsen, André; Hilland, Eva; Kogstad, Norunn; Heir, Trond; Hauff, Edvard; Lien, Lars; Endestad, Tor

    2016-01-01

    Background In studies employing physiological measures such as magnetic resonance imaging (MRI), it is often hard to distinguish what constitutes risk-resilience factors to posttraumatic stress disorder (PTSD) following trauma exposure and what the effects of trauma exposure and PTSD are. Objective We aimed to investigate whether there were observable morphological differences in cortical and sub-cortical regions of the brain, 7–8 years after a single potentially traumatic event. Methods Twen...

  8. Secondary Trauma in Children and School Personnel

    Science.gov (United States)

    Motta, Robert W.

    2012-01-01

    A review of childhood secondary trauma is presented. Secondary trauma involves the transfer and acquisition of negative affective and dysfunctional cognitive states due to prolonged and extended contact with others, such as family members, who have been traumatized. As such, secondary trauma refers to a spread of trauma reactions from the victim…

  9. Fraction Sense: Foundational Understandings.

    Science.gov (United States)

    Fennell, Francis Skip; Karp, Karen

    2016-08-09

    The intent of this commentary is to identify elements of fraction sense and note how the research studies provided in this special issue, in related but somewhat different ways, validate the importance of such understandings. Proficiency with fractions serves as a prerequisite for student success in higher level mathematics, as well as serving as a gateway to many occupations and varied contexts beyond the mathematics classroom. Fraction sense is developed through instructional opportunities involving fraction equivalence and magnitude, comparing and ordering fractions, using fraction benchmarks, and computational estimation. Such foundations are then extended to operations involving fractions and decimals and applications involving proportional reasoning. These components of fraction sense are all addressed in the studies provided in this issue, with particular consideration devoted to the significant importance of the use of the number line as a central representational tool for conceptually understanding fraction magnitude.

  10. Foundations of quantum gravity

    CERN Document Server

    Lindesay, James

    2013-01-01

    Exploring how the subtleties of quantum coherence can be consistently incorporated into Einstein’s theory of gravitation, this book is ideal for researchers interested in the foundations of relativity and quantum physics. The book examines those properties of coherent gravitating systems that are most closely connected to experimental observations. Examples of consistent co-gravitating quantum systems whose overall effects upon the geometry are independent of the coherence state of each constituent are provided, and the properties of the trapping regions of non-singular black objects, black holes, and a dynamic de Sitter cosmology are discussed analytically, numerically, and diagrammatically. The extensive use of diagrams to summarise the results of the mathematics enables readers to bypass the need for a detailed understanding of the steps involved. Assuming some knowledge of quantum physics and relativity, the book provides textboxes featuring supplementary information for readers particularly interested ...

  11. The foundation of physicianship.

    Science.gov (United States)

    Fuks, Abraham; Brawer, James; Boudreau, J Donald

    2012-01-01

    Although the practice of medicine continually changes in response to new biomedical understanding, novel technologies, and evolving cultural contexts, the ethical foundations of the clinical relationship between patient and physician paradoxically remain constant. There are fundamental characteristics with respect to character, behavior, and responsibilities that are descriptive of and necessary to the role of healer and that underpin the notion of physicianship. This article discusses the underlying characteristics or virtues that are necessary to the practice of medicine from the perspectives of three different philosophic traditions: the Aristotelian idea of phronesis as developed in the work of Edmund Pellegrino; the notion of alterity as framed by Emmanuel Levinas; and the attributes necessary to healing as laid out in the kabbala.

  12. Disrupted insula-based neural circuit organization and conflict interference in trauma-exposed youth

    Directory of Open Access Journals (Sweden)

    Hilary A. Marusak

    2015-01-01

    Full Text Available Childhood trauma exposure is a potent risk factor for psychopathology. Emerging research suggests that aberrant saliency processing underlies the link between early trauma exposure and later cognitive and socioemotional deficits that are hallmark of several psychiatric disorders. Here, we examine brain and behavioral responses during a face categorization conflict task, and relate these to intrinsic connectivity of the salience network (SN. The results demonstrate a unique pattern of SN dysfunction in youth exposed to trauma (n = 14 relative to comparison youth (n = 19 matched on age, sex, IQ, and sociodemographic risk. We find that trauma-exposed youth are more susceptible to conflict interference and this correlates with higher fronto-insular responses during conflict. Resting-state functional connectivity data collected in the same participants reveal increased connectivity of the insula to SN seed regions that is associated with diminished reward sensitivity, a critical risk/resilience trait following stress. In addition to altered intrinsic connectivity of the SN, we observed altered connectivity between the SN and default mode network (DMN in trauma-exposed youth. These data uncover network-level disruptions in brain organization following one of the strongest predictors of illness, early life trauma, and demonstrate the relevance of observed neural effects for behavior and specific symptom dimensions. SN dysfunction may serve as a diathesis that contributes to illness and negative outcomes following childhood trauma.

  13. Disrupted insula-based neural circuit organization and conflict interference in trauma-exposed youth

    Science.gov (United States)

    Marusak, Hilary A.; Etkin, Amit; Thomason, Moriah E.

    2015-01-01

    Childhood trauma exposure is a potent risk factor for psychopathology. Emerging research suggests that aberrant saliency processing underlies the link between early trauma exposure and later cognitive and socioemotional deficits that are hallmark of several psychiatric disorders. Here, we examine brain and behavioral responses during a face categorization conflict task, and relate these to intrinsic connectivity of the salience network (SN). The results demonstrate a unique pattern of SN dysfunction in youth exposed to trauma (n = 14) relative to comparison youth (n = 19) matched on age, sex, IQ, and sociodemographic risk. We find that trauma-exposed youth are more susceptible to conflict interference and this correlates with higher fronto-insular responses during conflict. Resting-state functional connectivity data collected in the same participants reveal increased connectivity of the insula to SN seed regions that is associated with diminished reward sensitivity, a critical risk/resilience trait following stress. In addition to altered intrinsic connectivity of the SN, we observed altered connectivity between the SN and default mode network (DMN) in trauma-exposed youth. These data uncover network-level disruptions in brain organization following one of the strongest predictors of illness, early life trauma, and demonstrate the relevance of observed neural effects for behavior and specific symptom dimensions. SN dysfunction may serve as a diathesis that contributes to illness and negative outcomes following childhood trauma. PMID:26199869

  14. Imaging of cervicothoracic junction trauma

    Directory of Open Access Journals (Sweden)

    Wongwaisayawan S

    2013-01-01

    Full Text Available Sirote Wongwaisayawan,1 Ruedeekorn Suwannanon,2 Rathachai Kaewlai11Department of Radiology, Ramathibodi Hospital and Mahidol University, Bangkok, Thailand; 2Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandAbstract: Cervicothoracic junction trauma is an important cause of morbidity and mortality in trauma patients. Imaging has played an important role in identifying injuries and guiding appropriate, timely therapy. Computed tomography is currently a method of choice for diagnosing cervicothoracic junction trauma, in which the pattern of injuries often suggests possible mechanisms and potential injuries. In this article, the authors describe and illustrate common and uncommon injuries that can occur in the cervicothoracic junction.Keywords: cervicothoracic junction, cervical spine, trauma, imaging, radiology

  15. Epidemiology of acute wrist trauma

    DEFF Research Database (Denmark)

    Larsen, C F; Lauritsen, Jens

    1993-01-01

    Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria for care and thus deriving estimates of provisions for care according to currently desirable standards. In a 1-year study all patients > or = 15 years with acute wrist trauma and treated...... in the emergency room were examined according to an algorithm until a diagnosis was established. The overall incidence of wrist trauma was 69 per 10,000 inhabitants per year. Incidence of wrist trauma requiring x-ray examination was 58 per 10,000 per year. The incidence of distal radius fractures was 27 per 10...... using data from a population-based study. A completeness rate of 0.56 (95% confidence interval: 0.31-0.78) was found. An x-ray had been taken for all patients reporting a fracture thus justifying the use of fractures as an incidence measure when comparing groups of patients with wrist trauma....

  16. [Cardiopulmonary resuscitation in cardiac arrest following trauma].

    Science.gov (United States)

    Leidel, B A; Kanz, K-G

    2016-11-01

    For decades, survival rates of cardiac arrest following trauma were reported between 0 and 2 %. Since 2005, survival rates have increased with a wide range up to 39 % and good neurological recovery in every second person injured for unknown reasons. Especially in children, high survival rates with good neurologic outcomes are published. Resuscitation following traumatic cardiac arrest differs significantly from nontraumatic causes. Paramount is treatment of reversible causes, which include massive bleeding, hypoxia, tension pneumothorax, and pericardial tamponade. Treatment of reversible causes should be simultaneous. Chest compression is inferior following traumatic cardiac arrest and should never delay treatment of reversible causes of the traumatic cardiac arrest. In massive bleeding, bleeding control has priority. Damage control resuscitation with permissive hypotension, aggressive coagulation therapy, and damage control surgery represent the pillars of initial treatment. Cardiac arrest due to hypoxia should be resolved by airway management and ventilation. Tension pneumothorax should be decompressed by finger thoracostomy, pericardial tamponade by resuscitative thoracotomy. In addition, resuscitative thoracotomy allows direct and indirect bleeding control. Untreated impact brain apnea may rapidly lead to cardiac arrest and requires quick opening of the airway and effective oxygenation. Established algorithms for treatment of cardiac arrest following trauma enable a safe, structured, and effective management.

  17. Cost effectiveness in trauma care.

    Science.gov (United States)

    Elliott, D C; Rodriguez, A

    1996-02-01

    The above discussion brings together a vast body of data that together proclaim with fervent clarity: Traumatic injuries are expensive. The expense is paid in productive lives lost, in permanent disability, in pain and suffering, and in health care resources consumed. As local and regional trauma systems struggle for development and survival, competition for the health care dollar casts in the additional necessity of providing the service of trauma care with maximum efficiency. Despite the variety of cost-efficiency measures described above, a majority of trauma centers continue to operate "in the red." Such cannot continue indefinitely. Fiscal responsibility dictates that health care institutions must balance budgets in order to maintain operations. Four primary strategies for cost containment appear from the above discussion: 1. Improve reimbursement rates from trauma patients. 2. Increase outside funding from government sources. 3. Improve cost efficiency of diagnostic and therapeutic procedures used in trauma patient management. 4. Increase efforts aimed at primary prevention of intentional and unintentional injuries. In the final analysis, most authors agree that the last strategy offers the best hope. As stated in their article, "The Economic Impact of Injuries," Harlan and colleagues conclude that "the most effective medical and cost reduction strategy would be prevention." The same article goes on to detail how greater funding for research into optimal prevention modalities could reap societal and economic benefits far beyond the value of the initial outlay. Yet such research funding continues to be inadequate. For every dollar spent on medical care of cancer patients, nine cents is directed to research. For every dollar spent on trauma care, less than a penny is spent on research. Until the public recognizes the terrible toll trauma extracts in lives, livelihood, and money wasted and until it realizes the pre-eminent importance of prevention, care of the

  18. Spinal trauma. An imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire (United Kingdom). Dept. of Radiology; Imhof, H. [University and General Hospital Vienna (Austria). Dept. of Radiodiagnostics

    2006-07-01

    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  19. Cerebrospinal fluid scintigraphy in traumas to the nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Nikolov, P. (Meditsinska Akademiya, Sofia (Bulgaria). Nauchen Inst. po Rentgenologiya i Radiobiologiya)

    1983-01-01

    The results of cerebrospinal fluid scintigraphy in 48 patients who had undergone trauma to the nervous system were studied. This method has gained rather insufficient acceptance in the diagnosis of this disease, in fact, it was helpful in detecting a high percentage of pathologic changes (80 per cent). Their type and localization structure was as follows: Narrowing of the spinal CSF space in 25 patients and 1 suspective; encephalonasal fistula - 3 patients; blockade of the lateral pathway of the CSF to the brain convexity - 4 patients; pathologic CSF circulation; dilatation of the convex brain cysterns with disturbances at the resorption site - 3 patients; combined spino-encephalic lesion - 1 patient.

  20. Renal Trauma: The Rugby Factor

    Science.gov (United States)

    Freeman, Catherine M.; Kelly, Michael E.; Nason, Gregory J.; McGuire, Barry B.; Kilcoyne, Aoife; Ryan, John; Lennon, Gerald; Galvin, David; Quinlan, David; Mulvin, David

    2015-01-01

    Introduction Renal trauma accounts for 5% of all trauma cases. Rare mechanisms of injuries including sports participation are increasingly common. Rugby-related trauma poses a conundrum for physicians and players due to the absence of clear guidelines and a paucity of evidence. Our series highlights traumatic rugby-related renal injuries in our institution, and emphasize the need for international guidelines on management. Methods A retrospective review of all abdominal traumas between January 2006 and April 2013, specifically assessing for renal related trauma that were secondary to rugby injuries was performed. All patients' demographics, computerized tomography results, hematological and biochemical results and subsequent management were recorded. Results Five male patients presented with rugby-related injuries. Mean age was 21 years old. All patients were hemodynamically stable and managed conservatively in acute setting. One patient was detected to have an unknown pre-existing atrophic kidney that had been subsequently injured, and was booked for an elective nephrectomy an 8-week interval. Conclusion Rugby-related trauma has generated essential attention. This paper serves to highlight this type of injury and the need for defined guidelines on role of imaging and international consensus on timing of return to contact sport, in both professional and amateur settings. PMID:26889132

  1. Trauma of the midface

    Directory of Open Access Journals (Sweden)

    Kühnel, Thomas S.

    2015-12-01

    Full Text Available Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygomatic fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate. Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair.

  2. Pharmaceutical Care for a Brain Trauma Patient with Mixed Infection of Multiple Pathogenic Microorganisms by Clinical Pharmacists%临床药师参与1例脑外伤后多种微生物混合感染患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    任彤; 丁建强; 朱军; 王军

    2013-01-01

    OBJECTIVE:To explore how the clinical pharmacists work best on pharmaceutical care for brain trauma patient,so as to provide reference for anti-infection treatment of the patients with mixed infection of multiple pathogenic microorganisms.METHODS:Clinical pharmacists participated in therapy for a brain trauma patient with mixed infection of multiple pathogenic microorganisms and provided advices on the formulation of anti-infection therapy scheme.Combination treatment strategy of fosfomycin and piperacillin/tazobactam was used,which was time difference attack therapy and amphotericin B ultrasonic atomizing inhalation.RESULTS:Clinical pharmacists provided reasonable therapy scheme and obtained good curative effect.The body temperature and routine blood test of the patient returned to normal and spontaneous breathing was maintained.Pharmaceutical care was enhanced for allergic shock induced by fosfomycin and nephrotoxicity of amphotericin B.CONCLUSIONS:Time difference attack therapy and amphotericin B ultrasonic atomizing inhalation of piperacillin/tazobactam combined with fosfomycin provide a choice for the treatment of mixed infection after severe brain trauma.Through clinical pharmacists provide pharmaceutical care and optimize therapy scheme,the effect of clinical treatment have been improved,the bacterial drug resistance and adverse drug reactions have been reduced.%目的:探讨临床药师在脑外伤患者的药学监护中如何发挥作用,为多种微生物混合感染患者的抗感染治疗提供参考.方法:临床药师参与1例脑外伤后多种微生物混合感染患者的联合治疗,对抗感染药物治疗方案的制订提出了具体意见,采取磷霉素联合哌拉西林/他唑巴坦时间差攻击疗法和两性霉素B超声雾化的治疗方案.结果:临床药师提供的合理治疗方案取得了良好的治疗效果,患者体温、血常规恢复正常,自主呼吸.治疗的同时加强对磷霉素可能导致过敏性休克、两性

  3. The logical foundations of mathematics

    CERN Document Server

    Hatcher, William S

    1981-01-01

    The Logical Foundations of Mathematics offers a study of the foundations of mathematics, stressing comparisons between and critical analyses of the major non-constructive foundational systems. The position of constructivism within the spectrum of foundational philosophies is discussed, along with the exact relationship between topos theory and set theory.Comprised of eight chapters, this book begins with an introduction to first-order logic. In particular, two complete systems of axioms and rules for the first-order predicate calculus are given, one for efficiency in proving metatheorems, and

  4. Foundations of resilience thinking.

    Science.gov (United States)

    Curtin, Charles G; Parker, Jessica P

    2014-08-01

    Through 3 broad and interconnected streams of thought, resilience thinking has influenced the science of ecology and natural resource management by generating new multidisciplinary approaches to environmental problem solving. Resilience science, adaptive management (AM), and ecological policy design (EPD) contributed to an internationally unified paradigm built around the realization that change is inevitable and that science and management must approach the world with this assumption, rather than one of stability. Resilience thinking treats actions as experiments to be learned from, rather than intellectual propositions to be defended or mistakes to be ignored. It asks what is novel and innovative and strives to capture the overall behavior of a system, rather than seeking static, precise outcomes from discrete action steps. Understanding the foundations of resilience thinking is an important building block for developing more holistic and adaptive approaches to conservation. We conducted a comprehensive review of the history of resilience thinking because resilience thinking provides a working context upon which more effective, synergistic, and systems-based conservation action can be taken in light of rapid and unpredictable change. Together, resilience science, AM, and EPD bridge the gaps between systems analysis, ecology, and resource management to provide an interdisciplinary approach to solving wicked problems.

  5. Clinical Study on Ocular Trauma in Children

    Institute of Scientific and Technical Information of China (English)

    Zicai Huang; Hongni Li; Yixia Huang; Zhongxia Zhou

    2002-01-01

    Purpose: To investigate the clinical characteristics of ocular trauma in children and put forward the major treatment and prevention of ocular trauma in children.Methods: To analyze the clinical data by 77 eyes in 77 cases of ocular trauma in children from April 1999 to February 2002. Results: The male and female were in the ratio of 2.21: 1. Right eye ocular traumas were more than left ones. Ocular penetrating trauma was 83.12% and blunt trauma 12.99%. 41 cases (53.25%) were injured by themselves while 33 cases by others. 90.91% patients came from the countryside.Conclusion: The rate of blindness of children with ocular trauma could be reduced by prompt treatment. The study indicated that ocular trauma preventive publicity should be faced in the countryside in order to improve the understanding of the severity of ocular trauma and treat it as a social problem.

  6. Warfare facial trauma: who will treat?

    Science.gov (United States)

    Holmes, D K

    1996-09-01

    Most of the facial trauma in the United States is treated in trauma centers in large urban or university medical centers, with limited trauma care taking place in our military medical treatment facilities. In many cases, active duty facial trauma surgeons may lack the current experience necessary for the optimal care of facial wounds of our inquired military personnel in the early stages of the conflict. Consequently, the skills of the reservist trauma surgeons who staff our civilian trauma centers and who care for facial trauma victims daily will be critical in caring for our wounded. These "trauma-current" reservists may act as a cadre of practiced surgeons to aid those with less experience. A plan for refresher training of active duty facial trauma surgeons is presented.

  7. Characteristic Behavior of Bucket Foundations

    DEFF Research Database (Denmark)

    Barari, Amin

    the design of offshore wind turbine foundations. The work was divided into two main research efforts: geotechnical engineering experiments to gain insight into the behavior of offshore bucket foundations, and development of methods to improve the study of infiltration into unsaturated soils, an important...

  8. Dressing-related trauma: clinical sequelae and resource utilization in a UK setting

    Directory of Open Access Journals (Sweden)

    Charlesworth B

    2014-04-01

    Full Text Available Bruce Charlesworth,1 Claire Pilling,1 Paul Chadwick,2 Martyn Butcher31Adelphi Values, Macclesfield, 2Salford Royal Foundation Trust, Salford, 3Northern Devon Healthcare Trust, Devon, UKBackground: Dressings are the mainstay of wound care management; however, adherence of the dressing to the wound or periwound skin is common and can lead to dressing-related pain and trauma. Dressing-related trauma is recognized as a clinical and economic burden to patients and health care providers. This study was conducted to garner expert opinion on clinical sequelae and resource use associated with dressing-related trauma in a UK setting.Methods: This was an exploratory study with two phases: qualitative pilot interviews with six wound care specialists to explore dressing-related trauma concepts, sequelae, and resource utilization; and online quantitative research with 30 wound care specialists to validate and quantify the concepts, sequelae, and resource utilization explored in the first phase of the study. Data were collected on mean health care professional time, material costs, pharmaceutical costs, and inpatient management per sequela occurrence until resolution. Data were analyzed to give total costs per sequela and concept occurrence.Results: The results demonstrate that dressing-related trauma is a clinically relevant concept. The main types of dressing-related trauma concepts included skin reactions, adherence to the wound, skin stripping, maceration, drying, and plugging of the wound. These were the foundation for a number of clinical sequelae, including wound enlargement, increased exudate, bleeding, infection, pain, itching/excoriation, edema, dermatitis, inflammation, and anxiety. Mean total costs range from £56 to £175 for the complete onward management of each occurrence of the six main concepts.Conclusion: These results provide insight into the hidden costs of dressing-related trauma in a UK setting. This research successfully conceptualized

  9. Effects of magnesium sulfate on traumatic brain edema in rats

    Institute of Scientific and Technical Information of China (English)

    冯东福; 朱志安; 卢亦成

    2004-01-01

    Objective: To investigate the effects of magnesium sulfate on traumatic brain edema and explore its possible mechanism.Methods: Forty-eight Sprague-Dawley ( SD ) rats were randomly divided into three groups: Control, Trauma and Treatment groups. In Treatment group, magnesium sulfate was intraperitoneally administered immediately after the induction of brain trauma. At 24 h after trauma, total tissue water content and Na + , K + , Ca2 + , Mg2+ contents were measured. Permeability of blood-brain barrier (BBB)was assessed quantitatively by Evans Blue (EB) dye technique. The pathological changes were also studied.Results: Water, Na + , Ca2 + and EB contents in Treatment group were significantly lower than those in Trauma group ( P < 0. 05 ). Results of light microscopy and electron microscopy confirmed that magnesium sulfate can attenuate traumatic brain injury and relieve BBB injury.Conclusions: Treatment with MgSO4 in the early stage can attenuate traumatic brain edema and prevent BBB injury.

  10. Static Behaviour of Bucket Foundations

    DEFF Research Database (Denmark)

    Larsen, Kim André

    . The monopod concept is investigated in this thesis, regarding the static behaviour from loads relevant to offshore wind turbines. The main issue in this concept is the rotational stiffness of the foundation and the combined capacity dominated by moments. The vertical bearing capacity of bucket foundations...... theory is proposed. The proposed expression applies to plane strain as well as axis-symmetric stress conditions for foundations with smooth or rough bases. A thorough experimental investigation of the static behaviour of bucket foundations subjected to combined loading is carried out. Laboratory tests...... method is concluded to be a superior method in estimating the post peak behaviour as well as the combined capacity of bucket foundations in relation to the offshore wind turbine problem....

  11. Low hemorrhage-related mortality in trauma patients in a Level I trauma center employing transfusion packages and early thromboelastography-directed hemostatic resuscitation with plasma and platelets

    DEFF Research Database (Denmark)

    Johansson, Pär I; Sørensen, Anne Marie Møller; Larsen, Claus F;

    2013-01-01

    % with blunt trauma). Overall 28-day mortality was 12% with causes of death being exsanguinations (14%), traumatic brain injury (72%, two-thirds expiring within 24 hr), and other (14%). One-fourth, 16 and 15% of the patients, received red blood cells (RBCs), plasma, or platelets (PLTs) within 2 hours from...

  12. The study of psychic trauma.

    Science.gov (United States)

    Bacciagaluppi, Marco

    2011-01-01

    This article starts from the DSM definition of psychic trauma. A central source in this field is the 1992 book by Judith Herman. One line of investigation is the sexual abuse of women and children. In an early phase, both Janet and Freud described dissociation as a reaction to trauma. In 1897, Freud disputed the reality of sexual trauma, a position countered later by Ferenczi. In a later phase, this subject was investigated by the American feminist movement. Studies of physical abuse are then described, followed by mental abuse and neglect. Another line of investigation is combat neurosis. The two lines converged in the definition of PTSD and its incorporation into the DSM in 1980. The views on trauma of John Bowlby and Alice Miller are also discussed. The integration of the relational model in psychoanalysis with the trauma literature is presented. The most recent advances are located in neurobiology. The discussion makes a preliminary investigation of the remote causes of war and sexual violence.

  13. Potential risk factors for developing heterotopic ossification in patients with severe traumatic brain injury

    NARCIS (Netherlands)

    Kampen, P.J. van; Martina, J.D.; Vos, P.E.; Hoedemaekers, C.W.E.; Hendricks, H.T.

    2011-01-01

    BACKGROUND: Heterotopic ossification (HO) is a frequent complication after traumatic brain injury (TBI). The current preliminary study is intended to provide additional data on the potential roles that brain injury severity, concomitant orthopaedic trauma, and specific intensive care complicating ev

  14. Integration of cognitive and personality-based conceptualization and treatment of psychological trauma.

    Science.gov (United States)

    Everly, George S; Lating, Jeffrey M

    2005-01-01

    In the wake of the numerous terrorist attacks and horrific natural disasters that have occurred beginning on September 11, 2001, there has been increased interest in the effects of trauma, including posttraumatic stress disorder (PTSD). The purpose of this article is to provide an overview of a synergistic multicomponent approach to therapy that incorporates the integrated use of cognitive and personality-guided approaches to conceptualizing and treating psychological trauma. With Millon's personality classification system serving as a foundation, a case example is provided along with an explanation of the therapeutic stages beginning with establishing the therapeutic alliance to decreasing hyperarousal to restoring assumptive worldviews.

  15. NEWS: Solid foundations?

    Science.gov (United States)

    2000-07-01

    Among the initiatives to be found at UK universities is a vocational award with the title `University Foundation Degree' at Nottingham Trent University. This qualification will be offered in 14 different subjects including four in the Faculty of Science and Mathematics, in the areas of applied biology, applied sciences, chemistry and physics. The courses will be available on a two-year full-time, three-year sandwich or a part-time basis. Set at a higher standard and specification than the Higher National Diplomas which it replaces, the UFD has been devised in consultation with industry and will cover the technical and specialist areas demanded by employers to combat skills shortages. The UFD in applied sciences concentrates on practical applications through laboratory, IT and project work, supported by lectures and seminars. At the end students can enter the employment market or transfer onto the second year of a degree course. Science-based careers including research and development would be the aim of those taking the UFD in physics. The first year develops the fundamentals of modern physics supported by studies in mathematics, IT and computer programming, whilst year 2 is vocational in nature with industrial problem solving and work experience as well as an academic theme associated with environmental aspects of the subject. Those who complete the UFD will be allowed automatic progression to a specified honours degree course and would normally be expected to study for a further two years for this award. However, those demonstrating an outstanding academic performance can transfer to the linked degree programme at the end of the first year via fast-track modules. Back in May the UK's Quality Assurance Agency (QAA) announced new standard benchmarks for degrees. These will be introduced into higher education institutions from 2002 to outline the knowledge, understanding and skills a student should gain from a particular higher education course. These benchmark

  16. Management of Acute Skin Trauma

    Institute of Scientific and Technical Information of China (English)

    Joel W. Beam

    2010-01-01

    @@ Acute skin trauma (ie, abrasions, avulsions, blisters, incisions, lacerations, and punctures) is common among individuals involved in work, recreational, and athletic activities. Appropriate management of these wounds is important to promote healing and lessen the risk of cross-contamination and infection. Wound management techniques have undergone significant changes in the past 40 years but many clinicians continue to manage acute skin trauma with long-established, traditional techniques (ie, use of hydrogen peroxide, adhesive strips/patches, sterile gauze, or no dressing) that can delay healing and increase the risk of infection. The purpose of this review is to discuss evidence-based cleansing, debridement, and dressing techniques for the management of acute skin trauma.

  17. Treatment strategy for hepatic trauma

    Institute of Scientific and Technical Information of China (English)

    Wu-Yong Yu; Qu-Jin Li; Jian-Ping Gong

    2016-01-01

    Liver is one of the organs with the highest injury rate,and in recent decades,the guidelines for the treatment of liver trauma have changed considerably.Now,there is a growing consensus that the most important step is diagnosis and depending upon the degree of severity,non-operative therapy is the main treatment method for hepatic trauma if conditions permit.For serious hepatic trauma patients such as those with hemodynamic instability,they should be operated upon as soon as possible.Regardless of the surgical options,doctors should control damage to patients and try to prevent complications.New therapies such as hepatic artery embolization and liver transplantation have been more and more used for the treatment of serious hepatic damage in clinics.

  18. Age dependency of trauma-induced neocortical epileptogenesis.

    Science.gov (United States)

    Timofeev, Igor; Sejnowski, Terrence J; Bazhenov, Maxim; Chauvette, Sylvain; Grand, Laszlo B

    2013-01-01

    Trauma and brain infection are the primary sources of acquired epilepsy, which can occur at any age and may account for a high incidence of epilepsy in developing countries. We have explored the hypothesis that penetrating cortical wounds cause deafferentation of the neocortex, which triggers homeostatic plasticity and lead to epileptogenesis (Houweling etal., 2005). In partial deafferentation experiments of adult cats, acute seizures occurred in most preparations and chronic seizures occurred weeks to months after the operation in 65% of the animals (Nita etal., 2006,2007; Nita and Timofeev, 2007). Similar deafferentation of young cats (age 8-12 months) led to some acute seizures, but we never observed chronic seizure activity even though there was enhanced slow-wave activity in the partially deafferented hemisphere during quiet wakefulness. This suggests that despite a major trauma, the homeostatic plasticity in young animals was able to restore normal levels of cortical excitability, but in fully adult cats the mechanisms underlying homeostatic plasticity may lead to an unstable cortical state. To test this hypothesis we made an undercut in the cortex of an elderly cat. After several weeks this animal developed seizure activity. These observations may lead to an intervention after brain trauma that prevents epileptogenesis from occurring in adults.

  19. Vascular Injury in Orthopedic Trauma.

    Science.gov (United States)

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N

    2016-07-01

    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.].

  20. Male genital trauma in sports.

    Science.gov (United States)

    Hunter, Stanley R; Lishnak, Timothy S; Powers, Andria M; Lisle, David K

    2013-04-01

    Male genital trauma is a rare but potentially serious sports injury. Although such an injury can occur by many different mechanisms, including falls, collisions, straddle injuries, kicks, and equipment malfunction, the clinical presentation is typically homogeneous, characterized by pain and swelling. Almost all sports-related male genital injury comes from blunt force trauma, with involvement of scrotal structures far more common than penile structures. Most injuries can be treated conservatively, but catastrophic testicular injury must first be ruled out. Despite being relatively uncommon compared with other sports injuries, more than half of all testicular injuries are sustained during sports.

  1. Complicaciones en el trauma raquimedular

    OpenAIRE

    M. López(Universidad Complutense, Madrid, Spain)

    2013-01-01

    El trauma raquimedular es un enfermedad que afecta principalmente a adultos jóvenes y suele resultar en muerte o discapacidad con sus complicaciones implícitas. Las personas con trauma raquimedular presentan complicaciones multisistemicas según el tipo y nivel de lesión, además, su aparición depende del manejo médico y terapéutico temprano. Entre las complicaciones más comunes se encuentran las respiratorias, cardiovasculares (hipotensión ortostatica, disrreflexia autonómica y trombosis venos...

  2. Prehospital Care of Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    TVSP Murthy

    2008-01-01

    Full Text Available Traumatic brain injury (TBI occurs when a sudden trauma causes brain damage. Depending on the severity, outcome can be anything from complete recovery to permanent disability or death. Emergency medical services play a dominant role in provision of primary care at the site of injury. Since little can be done to reverse the initial brain damage due to trauma, attempts to prevent further brain damage and stabilize the patient before he can be brought to a specialized trauma care centre play a pivotal role in the final outcome. Recognition and early treatment of hypoten-sion, hypoxemia, and hypoglycemia, objective neurological assessment based on GCS and pupils, and safe transport to an optimal care centre are the key elements of prehospital care of a TBI patient.

  3. Polish Foundation for Energy Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    The Polish Foundation for Energy Efficiency (FEWE) was established in Poland at the end of 1990. FEWE, as an independent and non-profit organization, has the following objectives: to strive towards an energy efficient national economy, and to show the way and methods by use of which energy efficiency can be increased. The activity of the Foundation covers the entire territory of Poland through three regional centers: in Warsaw, Katowice and Cracow. FEWE employs well-known and experienced specialists within thermal and power engineering, civil engineering, economy and applied sciences. The organizer of the Foundation has been Battelle Memorial Institute - Pacific Northwest Laboratories from the USA.

  4. Trauma care systems in India - An overview

    Directory of Open Access Journals (Sweden)

    Joshipura M

    2004-01-01

    Full Text Available Trauma-care systems in India are at a nascent stage of development. Industrialized cities, rural towns and villages coexist, with variety of health care facilities and almost complete lack of organized trauma care. There is gross disparity between trauma services available in various parts of the country. Rural India has inefficient services for trauma care, due to the varied topography, financial constraints and lack of appropriate health infrastructure. There is no national lead agency to coordinate various components of a trauma system. No mechanism for accreditation of trauma centres and professionals exists. Education in trauma life-support skills has only recently become available. A nationwide survey encompassing various facilities has demonstrated significant deficiencies in current trauma systems. Although injury is a major public-health problem, the government, medical fraternity and the society are yet to recognize it as a growing challenge.

  5. Trauma care in India: current scenario.

    Science.gov (United States)

    Joshipura, M K

    2008-08-01

    Trauma-care systems in India are at a nascent stage of development. Industrialized cities, rural towns, and villages coexist with a variety of health care facilities and an almost complete lack of organized trauma care. There is gross disparity between trauma services available in various parts of the country. Rural India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. There is no national lead agency to coordinate various components of a trauma system. No mechanism for accreditation of trauma centers and professionals exists. Education in trauma life-support skills has only recently become available. A nationwide survey encompassing various facilities has documented significant deficiencies in current trauma systems. Some initiatives on improving prehospital systems have been seen recently. Although injury is a major public-health problem, the government, medical fraternity, and the society are yet to recognize it as a significant public health challenge.

  6. Rural Emergency Medical Services (EMS) and Trauma

    Science.gov (United States)

    ... freestanding program. Your state's EMS agency can provide information about regional or statewide trauma systems. How can local EMS agencies be integrated into the local and regional systems of trauma ...

  7. Abusive Head Trauma (Shaken Baby Syndrome)

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Abusive Head Trauma (Shaken Baby Syndrome) KidsHealth > For Parents > Abusive Head ... babies tend to cry the most. How These Injuries Happen Abusive head trauma results from injuries caused ...

  8. Cultural Trauma and Life Stories / Ene Kõresaar

    Index Scriptorium Estoniae

    Kõresaar, Ene

    2007-01-01

    Aili Aarelaid-Tarti 15-aastase uuringu tulemused raamatus "Cultural Trauma and Life Stories", Hesinki, Kikimora Publications, 2006. Uuritud on kolme suurt rahvusgruppi 1940-test tingitud trauma kontekstis: eestlased kodumaal, eestlased eksiilis ja venekeelne rahvusgrupp Eestis postsovetlikus diskursuses

  9. Sexual Trauma: Women Veterans Health Care

    Science.gov (United States)

    ... ZIP code here Enter ZIP code here Health Awareness Campaigns: Sexual Trauma Sexual Trauma Women Veterans Health ... abuse drugs or alcohol or engage in risky sexual behavior. In some cases, anger and stress stemming from ...

  10. Blast and the Consequences on Traumatic Brain Injury-Multiscale Mechanical Modeling of Brain

    Science.gov (United States)

    2011-02-17

    brain and spinal cord injury, is the largest contributor to a poor neurological outcome in survivors of brain and spinal cord trauma. Microscale...anatomical features of a 50th percentile male head, including the brain, falx and tentorium, cerebral spinal fluid (CSF), duramater, piamater, facial...discretized finite elements. (b) Sections of the head model; the right half of the head model is shown with the brain, the meningeal layers (dura

  11. Blood component therapy in trauma guided with the utilization of the perfusionist and thromboelastography.

    Science.gov (United States)

    Walsh, Mark; Thomas, Scott G; Howard, Janet C; Evans, Edward; Guyer, Kirk; Medvecz, Andrew; Swearingen, Andrew; Navari, Rudolph M; Ploplis, Victoria; Castellino, Francis J

    2011-09-01

    25-35% of all seriously injured multiple trauma patients are coagulopathic upon arrival to the emergency department, and therefore early diagnosis and intervention on this subset of patients is important. In addition to standard plasma based tests of coagulation, the thromboelastogram (TEG) has resurfaced as an ideal test in the trauma population to help guide the clinician in the administration of blood components in a goal directed fashion. We describe how thromboelastographic analysis is used to assist in the management of trauma patients with coagulopathies presenting to the emergency department, in surgery, and in the postoperative period. Indications for the utilization of the TEG and platelet mapping as point of care testing that can guide blood component therapy in a goal directed fashion in the trauma population are presented with emphasis on the more common reasons such as massive transfusion protocol, the management of traumatic brain injury with bleeding, the diagnosis and management of trauma in patients on platelet antagonists, the utilization of recombinant FVIIa, and the management of coagulopathy in terminal trauma patients in preparation for organ donation. The TEG allows for judicious and protocol assisted utilization of blood components in a setting that has recently gained acceptance. In our program, the inclusion of the perfusionist with expertise in performing and interpreting TEG analysis allows the multidisciplinary trauma team to more effectively manage blood products and resuscitation in this population.

  12. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    NARCIS (Netherlands)

    Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; Achterberg, T. van

    2013-01-01

    BACKGROUND: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. OBJECTIVE: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. METHODS: We con

  13. Witnessing Trauma:A Reading of A Pale of Hills Based on Trauma Theory

    Institute of Scientific and Technical Information of China (English)

    王肖

    2016-01-01

    This thesis tries to interpret A Pale View of Hills based on trauma theory, and to have a detailed analysis from the aspects of trauma experience and memory and recovery from trauma in order to illustrate the connotations behind trauma and how to get healed and regain new hope for the future.

  14. External Validation of the Emergency Trauma Score for Early Prediction of Mortality in Trauma Patients

    NARCIS (Netherlands)

    Joosse, Pieter; de Jong, Willem-Jan J.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel; Reitsma, J.

    2014-01-01

    Objectives: The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base exc

  15. NEUROCOGNITIVE DEFICITS IN HIV-INFECTED WOMEN AND VICTIMS OF CHILDHOOD TRAUMA

    Science.gov (United States)

    Spies, G; Fennema-Notestine, C; Archibald, SL; Cherner, M; Seedat, S

    2015-01-01

    Objectives The study investigated the behavioral and brain effects of childhood trauma and HIV-infection, both separately and in combination, and assessed potential interactions in women who were dually affected. Methods 83 HIV-positive and 47 matched HIV-negative South African women underwent neuromedical, neuropsychiatric and neurocognitive assessments. Univariate tests of significance assessed if either HIV infection or childhood trauma, or the combination, had a significant effect on neurocognitive performance. Results The majority of women were Black (96%) and had an average age of 30. An analysis of covariance revealed significant HIV effects for the Hopkins Verbal Learning Test (HVLT) learning and delay trials (p < .01) and the Halstead Category test (p < .05). A significant trauma effect was seen on the HVLT delay trial (p < .05). Conclusion The results provide evidence for neurocognitive dysfunction in memory and executive functions in HIV-infected women and memory disturbances in trauma exposed women. PMID:22672200

  16. Prazosin reduces trauma-related nightmares in older men with chronic posttraumatic stress disorder.

    Science.gov (United States)

    Peskind, Elaine R; Bonner, Lauren T; Hoff, David J; Raskind, Murray A

    2003-09-01

    Trauma-related nightmares in posttraumatic stress disorder (PTSD) rarely respond to pharmacologic treatment. Neurobiologic data suggest that enhanced brain responsiveness to adrenergic stimulation may contribute to the pathophysiology of trauma-related nightmares in PTSD. Nine older men with chronic PTSD secondary to military or Holocaust trauma were prescribed the lipophilic alpha-1 adrenergic antagonist prazosin for treatment-resistant trauma-related nightmares. Prazosin 2 mg to 4 mg 1 hour before bedtime substantially reduced nightmares and moderately or markedly reduced overall PTSD severity in 8 of 9 subjects. Prazosin was well tolerated. These open-label results are consistent with demonstrated therapeutic efficacy of prazosin for PTSD nightmares and sleep disturbance in a recent placebo-controlled trial in Vietnam veterans.

  17. The role of interventional radiology in trauma

    Institute of Scientific and Technical Information of China (English)

    Douglas M. Coldwell

    2007-01-01

    @@ Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient. In all hospitals, regardless of size, the Interventional Radiologist must consider their relationships with the trauma service in order to quickly and efficiently render aid to the trauma victim. Such consideration should take place in the light of day as it seems that most trauma occurs in the middle of the night or another inconvenient time. The watchwords of trauma IR are speed and efficiency.

  18. Impact of Beta-Blockers on Nonhead Injured Trauma Patients.

    Science.gov (United States)

    Hendrick, Leah E; Schroeppel, Thomas J; Sharpe, John P; Alsbrook, Diana; Magnotti, Louis J; Weinberg, Jordan A; Johnson, Benjamin P; Lewis, Richard H; Clement, L Paige; Croce, Martin A; Fabian, Timothy C

    2016-07-01

    Catecholamine surge after traumatic injury may lead to dysautonomia with increased morbidity. Small retrospective studies have shown potential benefit of beta-blockers (BB) in trauma patients with and without traumatic brain injury (TBI). This study evaluates a large multiply injured cohort without TBI that received BB. Patients were identified from the trauma registry from January 1, 2003 to December 31, 2011. Patients who received >1 dose of BB were compared to controls. Patients with TBI, length of stay (LOS) ratio (OR) 0.952; confidence interval (CI) 0.620-1.461]. In conclusion, in this largest study to date, patients receiving BB were older, more severely injured, and had a higher mortality. Unlike TBI patients, multivariable regression showed no benefit from BB in this population.

  19. Aplastic Anemia & MDS International Foundation

    Science.gov (United States)

    ... Menu Donate I'm Like You. "The Aplastic Anemia and MDS International Foundation is helping patients like ... cope with bone marrow failure disease." Diseases Aplastic Anemia Myelodysplastic Syndromes (MDS) Paroxysmal Nocturnal Hemoglobinuria (PNH) Related ...

  20. Kaiser Family Foundation - Content Search

    Data.gov (United States)

    U.S. Department of Health & Human Services — Chartpacks, chartbooks, factsheets, reports, and slide presentations bring Kaiser Family Foundation information to life, and can be easily incorporated into your...

  1. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    <正>The Rural Development Foundation (RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college in Andhra

  2. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    <正>The Rural Development Foundation ( RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providin gquality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college in

  3. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    <正>The Rural Development Foundation ( RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children. RDF founded and continues to operate five schools

  4. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    <正>The Rural Development Foundation ( RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college in

  5. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    <正>The Rural Development Foundation(RDF),founded in1996,is an Indian nonprofit organization with the mission of providingquality education for underprivileged rural children.RDF founded and continues to operate five schools and one junior college in

  6. Foundation for Film and Science

    Science.gov (United States)

    van der Veen, G.

    1976-01-01

    Provides a comprehensive discussion on the Stichting Film en Wetenschap, SFW (Foundation for Film and Science), in Utrecht. Various aspects of the use of audio-visual aids in university teaching are looked at in detail. (Editor/RK)

  7. Crohn's & Colitis Foundation of America

    Science.gov (United States)

    ... enabled to enjoy the full interactive experience. Crohn's & Colitis Foundation of America Find a Doctor Find a ... Local Chapters News Events Search: What are Crohn's & Colitis? What is Crohn's Disease What is Ulcerative Colitis ...

  8. Decolonizing Trauma Theory : Retrospect and Prospects

    NARCIS (Netherlands)

    Visser, Irene

    2015-01-01

    Decolonizing trauma theory has been a major project in postcolonial literary scholarship ever since its first sustained engagements with trauma theory. Since then, trauma theory and postcolonial literary studies have been uneasy bedfellows, and the time has now come to take stock of what remains in

  9. Addressing Trauma in Substance Abuse Treatment

    Science.gov (United States)

    Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

    2016-01-01

    Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

  10. Helpers in Distress: Preventing Secondary Trauma

    Science.gov (United States)

    Whitfield, Natasha; Kanter, Deborah

    2014-01-01

    Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…

  11. Triage and mortality in 2875 consecutive trauma patients

    DEFF Research Database (Denmark)

    Meisler, Rikke; Thomsen, A B; Abildstrøm, H

    2010-01-01

    Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage.......Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage....

  12. Foundations of genetic algorithms 1991

    CERN Document Server

    FOGA

    1991-01-01

    Foundations of Genetic Algorithms 1991 (FOGA 1) discusses the theoretical foundations of genetic algorithms (GA) and classifier systems.This book compiles research papers on selection and convergence, coding and representation, problem hardness, deception, classifier system design, variation and recombination, parallelization, and population divergence. Other topics include the non-uniform Walsh-schema transform; spurious correlations and premature convergence in genetic algorithms; and variable default hierarchy separation in a classifier system. The grammar-based genetic algorithm; condition

  13. Experimental Research of Engine Foundations

    Directory of Open Access Journals (Sweden)

    Violeta-Elena Chiţan

    2004-01-01

    Full Text Available This paper tries a compact presentation of experimental research of engine-foundations. The dynamic phenomena are so complex, that the vibrations cannot be estimated in the design stage. The design engineer of an engine foundation must foresee through a dynamic analysis of the vibrations, those measures that lead to the avoidance or limiting of the bad effects caused by the vibrations.

  14. The effect observation of early hyperbaric oxygen combined music therapy on brain trauma coma wake and prognosis%早期高压氧联合音乐疗法对脑外伤昏迷促醒及预后的效果

    Institute of Scientific and Technical Information of China (English)

    黄的; 徐斌

    2016-01-01

    目的:观察早期高压氧联合音乐疗法对脑外伤昏迷促醒率及预后程度。方法:将170例脑外伤昏迷的患者,随机分为对照组和观察组,各85例。对照组给予常规药物治疗及康复护理,观察组在此基础上给予高压氧及音乐疗法,随访6个月,比较两组患者清醒时间及格拉斯哥预后结局量表(Glasgow outcome scale,GOS)等级情况。结果:两组患者的清醒时间及格拉斯哥预后结局等级比较,差异有统计学意义( P <0.05)。结论:早期高压氧联合音乐疗法对脑外伤昏迷促醒有较好的临床疗效,而且能减轻后遗症。%Objective:To observe the effect of early hyperbaric oxygen combined music therapy on brain trauma coma wake and prognosis. Nethods:170 cases of brain injury coma were randomly divided into control group(85 cases)and observation group(85cases). The control group was given conventional drugs and rehabilitation nursing,and the observation group with music therapy and hyperbaric oxygen treatment. After active treatment and follow - up for six months,the awake time,and Glasgow Outcome Scale for prognostic outcomes in the two groups were compared. Results:The comparison of awake time,and Glasgow Outcome Scale for prognostic outcomes between the two groups difference was statistically sig-nificant( P < 0. 05). Conclusion:Early hyperbaric oxygen combined music therapy on brain injury coma wake has better clinical curative effect, and can reduce sequel.

  15. Medicating Relational Trauma in Youth

    Science.gov (United States)

    Foltz, Robert

    2008-01-01

    Children who have experienced relational trauma present a host of problems and are often diagnosed with psychiatric disorders and then medicated. But there is evidence that commonly used drugs interfere with oxytocin or vasopressin, the human trust and bonding hormones. Thus, psychotropic drugs may impair interpersonal relationships and impede…

  16. MDCT in blunt intestinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy)]. E-mail: stefromano@libero.it; Scaglione, Mariano [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Tortora, Giovanni [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Martino, Antonio [Trauma Center, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Di Pietto, Francesco [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Romano, Luigia [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Grassi, Roberto [Department ' Magrassi-Lanzara' , Section of Radiology, Second University of Naples, 80138 Naples (Italy)

    2006-09-15

    Injuries to the small and large intestine from blunt trauma represent a defined clinical entity, often not easy to correctly diagnose in emergency but extremely important for the therapeutic assessment of patients. This article summarizes the MDCT spectrum of findings in intestinal blunt lesions, from functional disorders to hemorrhage and perforation.

  17. Transforming Cultural Trauma into Resilience

    Science.gov (United States)

    Brokenleg, Martin

    2012-01-01

    One of the biggest challenges facing Aboriginal populations increasingly is being called "intergenerational trauma." Restoring the cultural heritage is a central theme in the book, "Reclaiming Youth at Risk." That work describes the Circle of Courage model for positive development which blends Native child and youth care philosophy with research…

  18. Probiotics for severe trauma patients

    OpenAIRE

    Rijkers, Ger T

    2011-01-01

    Probiotics are live micro-organisms with a health promoting effect. Because of their immunomodulating capacity as well as improvement of gut barrier function, probiotics have the capacity to prevent infectious complications in a variety of clinical settings. Now selected probiotics show potential for improving the clinical outcome of severe trauma patients.

  19. Bilateral acetabular fracture without trauma

    OpenAIRE

    De Rosa, M. A.; G. Maccauro; D’Arienzo, M.

    1999-01-01

     In the absence of trauma fracture of the acetabulum is an extremely rare injury. We describe a 70 year old man who spontaneously developed fractures in both acetabulae due to bony insufficiency. It was successfully treated by bilateral total hip replacement.

  20. Transforming Cultural Trauma into Resilience

    Science.gov (United States)

    Brokenleg, Martin

    2012-01-01

    One of the biggest challenges facing Aboriginal populations increasingly is being called "intergenerational trauma." Restoring the cultural heritage is a central theme in the book, "Reclaiming Youth at Risk." That work describes the Circle of Courage model for positive development which blends Native child and youth care…

  1. Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

    Directory of Open Access Journals (Sweden)

    Faul, Mark

    2014-11-01

    Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.   Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need.     Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need.  Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the

  2. Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

    Science.gov (United States)

    Faul, Mark; Sasser, Scott M.; Lairet, Julio; Mould-Millman, Nee-Kofi; Sugerman, David

    2015-01-01

    Introduction The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care. Methods We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I–IV trauma center (n=443). The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need”) as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM) was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need. Results Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need. Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the construction of new trauma centers or

  3. Physical Foundations of Cosmology

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, J M [University of Cambridge (United Kingdom)

    2006-02-07

    In 1952, Mme Yvonne Choquet-Bruhat published a major paper, Theoreme d'existence pour certains systemes d'equations aux derivees partielles non lineaires (Acta Math. 88 141-225), which laid the foundation for modern studies of the Cauchy problem in general relativity. The fiftieth anniversary of this event was celebrated with an eponymous Cargese Summer School in 2002. The proceedings of that summer school are summarized electronically (as audio, video, transparencies and lecture notes, where available) on a DVD archive included with this volume, and are also available on the internet. However the organizers decided that a separate volume describing the 'state of the art in mathematical general relativity' would be useful, and this book is the result. It includes some material not covered in the school and excludes some school material which has been covered adequately elsewhere. About one fifth of the book is devoted to a survey of Smoothness at Null Infinity and the Structure of Initial Data by Helmut Friedrich. This is a modern study of gravitational radiation, and the analysis of Einstein's equations. It is extremely helpful to survey all of this material, including some of the latest developments, using a consistent notation. This article is strongly recommended to anyone hoping to gain a foothold in this area. Lars Andersson has surveyed, in The Global Existence Problem in General Relativity, some results and conjectures about the global properties of 3+1-dimensional spacetimes with a compact Cauchy surface. Again it is very useful to have essentially all of the known results presented in a consistent notation. This material is not on the DVD. Yvonne Choquet-Bruhat has contributed a long research paper, Future Complete U(1) Symmetric Einsteinian Spacetimes, the Unpolarized Case. There is a non-linear stability theorem due to her and Vincent Moncrief in which spacetime is of the form M x R where M is a circle bundle over a compact

  4. Drama Queen or Trauma Queen: Does Elevating Self-Awareness Impact the Colonized Consciousness of Female Clergy?

    Science.gov (United States)

    Clifton, Angelita

    2013-01-01

    This project design incorporates three Aramaic phrases enhancing an existing ministry model for women victimized by trauma. "Talitha Cum-Woman Arise," "Ephpatha-Be Opened" and "Maranatha-O'Lord Come," serve as the foundation for a three tiered spiritual support system for female clergy. This project design…

  5. Drama Queen or Trauma Queen: Does Elevating Self-Awareness Impact the Colonized Consciousness of Female Clergy?

    Science.gov (United States)

    Clifton, Angelita

    2013-01-01

    This project design incorporates three Aramaic phrases enhancing an existing ministry model for women victimized by trauma. "Talitha Cum-Woman Arise," "Ephpatha-Be Opened" and "Maranatha-O'Lord Come," serve as the foundation for a three tiered spiritual support system for female clergy. This project design serves: (1)…

  6. 重症颅脑外伤患者急诊手术的麻醉疗效研究%Anesthetic efficacy study in patients with severe brain trauma emergency surgery

    Institute of Scientific and Technical Information of China (English)

    马忠良

    2014-01-01

    ObjectiveTo investigate the effective anesthesia of emergency surgery in patients with severe traumatic brain injury.Methods 60 cases of severe traumatic brain injury patients from January 2011 to October 2013 in our hospital received for the study were randomly divided into two groups,the experimental group and the control group,each of 30 cases.Patients in the experimental group were treated with total intravenous anesthesia,while patients in the control group were implemented inhalation anesthesia.The efficacy of anesthesia was compared between the two groups of patients.ResultsThe heart rate and mean arterial pressure of the experimental group patients in incision and cut the dura were significantly lower than the control group,and the recovery time and extubation time of patients were significantly shorter than the control group,the difference was statistical significance(P<0.05). Conclusion Patients with severe traumatic brain injury treated with emergency surgery inhalation anesthesia can be effectively controlled in patients with stable heart rate and blood pressure.The anesthetic effect is significant, and can reduce the patient's recovery time and extubation time,maintain a good depth of anesthesia,which has an important role in implementation of surgery.%目的:探讨重症颅脑外伤患者急诊手术的有效麻醉方法。方法选择2011年1月~2013年10月我院接收的60例重症颅脑外伤患者为研究对象,随机分成两组,实验组与对照组,各30例。实验组患者给予全凭静脉麻醉,对照组患者实施静吸复合麻醉,比较疗效患者的麻醉疗效。结果实验组患者切皮、切硬脑膜的心率和平均动脉压均较对照组有明显降低,患者的苏醒时间和拔管时间也较对照组明显缩短,两组比较差异有统计学意义(P<0.05)。结论重症颅脑外伤患者急诊手术时实施静吸复合麻醉可以有效控制患者心率和血压的稳定,麻醉效果显著

  7. A behaviorological thanatology: Foundations and implications

    Science.gov (United States)

    Fraley, Lawrence E.

    1998-01-01

    Foundation principles supporting a behaviorological thanatology are reviewed, including concepts of life, person, death, value, right, ethic, and body/person distinctions. These natural science foundations are contrasted with traditional foundations, and their respective implications are speculatively explored. PMID:22478293

  8. [Emergence of early childhood trauma in adult psychiatric symptomatology].

    Science.gov (United States)

    Bouras, G; Lazaratou, E

    2012-06-01

    DNA methylation and brain development. Supporting the family and break the silence that frequently covers the traumatic events and feelings, will give the opportunity for the elaboration of all these aspects which could capture and imprison the subject in a dramatic circle of psychopathology. Moreover, the effectiveness of early interventions and child psychotherapy is now a common ground, so we have to use all our clinical instruments (dialogue, symbolic play, drawing, storytelling) in order to help the child and have the best possible result. Finally, concerning clinical practice, the emergence of early childhood trauma in adult psychiatric symptomatology is so frequent that mental health experts should take it into serious account while developing an appropriate clinical treatment for such patients.

  9. Recent advance and current status of management of head trauma in China

    Institute of Scientific and Technical Information of China (English)

    JIANG Ji-yao

    2008-01-01

    @@ It is estimated that more than 1 million Chinese people sustain traumatic brain injury (TBI) annually, nearly 10% of whom are dead and 30% are complicated with physical, cognitive, behavioral and/or psychosocial impairments in China. A lot of experimental researches and clinical trials of head trauma have been made in China recently, which improves the understanding of pathological mechanisms and prognosis of severe traumatic brain injury.

  10. Nonpathologizing trauma interventions in abnormal psychology courses.

    Science.gov (United States)

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research.

  11. The family of the trauma victim.

    Science.gov (United States)

    Solursh, D S

    1990-03-01

    Emergency room and trauma unit work offers unique challenges to the nurse, both professionally and personally. One of these challenges is understanding and dealing with the behavior of victims' families. Some of the factors that impact on the behavior of families include (1) the sudden and unpredictable nature of trauma; (2) the nature of the relationship of the specific family member and the trauma victim; (3) the issues of responsibility, anger, and guilt; (4) religious beliefs; and (5) trauma sequelae. The development of organ and tissue donor programs and of psychotraumatology as ways to help ease the plight of trauma victims' families are also discussed.

  12. Direction of Head Trauma and its Effect on Olfactory Bulb Volume in Post-Traumatic Anosmia

    Directory of Open Access Journals (Sweden)

    S Farshchi

    2012-09-01

    Full Text Available Background: Anosmia is a physical sign in post-traumatic patients, which significantly reduces the quality of life. Anosmia occurs in up to 30% of cases with head trauma. In this study we aimed to compare the Olfactory Bulb Volume (OBV in patients with posttraumatic anosmia in different impact positions and also with healthy individuals to find the relation between the two variables. Methods: Thirty-eight patients with posttraumatic anosmia and 27 healthy individuals with normal olfactory function were recruited in this case-control study performed in Amir Alam Hospital in Tehran, Iran. Variables of age, sex, time of trauma, site of trauma (frontoparietal/occipital, side of trauma, OBV, the results of olfactory identification tests and olfactory threshold were extracted and evaluated. We used non-contrasted 1.5-Tesla coronal brain MRI for the measurement of OBV.Results: There were no significant differences between cases and controls regarding sex and age. Olfactory bulb volume was significantly smaller in cases compared to the controls (P=0.004. Among the case group, OBV was smaller in anterior versus posterior head traumas (P=0.02. OBV was also smaller in ipsilateral rather than the contralateral side of trauma (P=0.01.Conclusion: The direction of trauma had a significant effect on OBV and it was smaller in traumas to the anterior and also ipsilateral sides of the head. It seems that changes in OBV differ due to the direction of head trauma and it can be helpful in predicting the prognosis of posttraumatic anosmia. Further studies are required for more conclusive statements.

  13. EMDR in Competition with Fate: A Case Study in a Chinese Woman with Multiple Traumas

    Directory of Open Access Journals (Sweden)

    Maggie Wai-Ling Poon

    2012-01-01

    Full Text Available This paper described the application of eye movement desensitization reprocessing (EMDR for addressing the posttraumatic stress disorder (PTSD symptoms in a Chinese woman who had experienced multiple traumas in her childhood. EMDR is an integrative therapeutic intervention that uses a standardized eight-phase approach to treatment. It is also a proven, effective, and efficient treatment for trauma. In this client with multiple traumas, the etiological event that lay the foundation of her dysfunctional responses was reprocessed first. The successful resolution of this event allowed the positive treatment effects to transfer to other traumatic events of a similar theme. This case also illustrates the importance of identifying a culturally appropriate positive cognition (PC in contributing to the success of the treatment.

  14. Trauma Spectrum Disorders: Emerging Perspectives on the Impact on Military and Veteran Families

    Science.gov (United States)

    O'Donnell, Lolita; Begg, Lisa; Lipson, Linda; Elvander, Erika

    2011-01-01

    This article summarizes the findings from the Second Annual Trauma Spectrum Disorders Conference, which was held in December 2009 and was sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury in conjunction with the Department of Veterans Affairs and the National Institutes of Health. The conference…

  15. Impact of Hemorrhage on Trauma Outcome: An Overview of Epidemiology, Clinical Presentations, and Therapeutic Considerations

    Science.gov (United States)

    2006-01-01

    or heart failure, can cause cardiogenic shock. In addition, cardiovascular physi- Fig. 2. Multiple organ failure in trauma patients through the 1990s...the opposite. And the same was in the brain: it decreases not only the hematoma but also edema . I would like to make a comment. It’s time to realize

  16. History of the Dental Trauma Guide.

    Science.gov (United States)

    Andreasen, Jens Ove; Ahrensburg, Søren Steno

    2012-10-01

    The history of the Dental Trauma Guide dates back to 1965, where guidelines were developed for trauma records and treatment of various trauma entities at the Department of Oral and Maxillofacial Surgery at the University Hospital in Copenhagen. In 1972, a unique possibility came up at the Serum Institute in Copenhagen to test various dental trauma procedures in monkeys, which served as kidney donors in the polio vaccine production. Over the years, 40 000 dental trauma patients were treated at the Trauma Centre according to established guidelines, and 4000 of these have been enrolled in long-term follow-up of various trauma entities. This has resulted in 79 clinical studies, and 64 studies in monkeys have examined the effect of various treatment procedures and the aetiology of most healing complications.

  17. History of the Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg

    2012-01-01

    The history of the Dental Trauma Guide dates back to 1965, where guidelines were developed for trauma records and treatment of various trauma entities at the Department of Oral and Maxillofacial Surgery at the University Hospital in Copenhagen. In 1972, a unique possibility came up at the Serum...... Institute in Copenhagen to test various dental trauma procedures in monkeys, which served as kidney donors in the polio vaccine production. Over the years, 40 000 dental trauma patients were treated at the Trauma Centre according to established guidelines, and 4000 of these have been enrolled in long......-term follow-up of various trauma entities. This has resulted in 79 clinical studies, and 64 studies in monkeys have examined the effect of various treatment procedures and the aetiology of most healing complications....

  18. A Civilian/Military Trauma Institute: National Trauma Coordinating Center

    Science.gov (United States)

    2015-12-01

    update trauma research subject areas based upon the basis of impact on survival or care of patients, existing funding, and funding availability...Lastly, this is a retrospective post hoc analysis and therefore the data is not powered to prevent a type 2 error. Based on our data, we found no...Scale Attitude and Willingness Items Table 1 – Demographics of the Study Population Table 2 – Univariate Analysis of AVERT Attitude and EFIC

  19. Advances in Brain Research: Implications for Educators

    Science.gov (United States)

    Stickel, Sue A.

    2005-01-01

    Cognitive neuroscience will provide theoretical foundations for areas of educational policy and practice. Educators will benefit from knowledge in the basic sciences related to brain development and function. Brain development begins at birth and the brain remains capable of complex changes throughout the lifespan. Educators will want to be aware…

  20. Trauma care systems in Spain.

    Science.gov (United States)

    Queipo de Llano, E; Mantero Ruiz, A; Sanchez Vicioso, P; Bosca Crespo, A; Carpintero Avellaneda, J L; de la Torre Prado, M V

    2003-09-01

    Trauma care systems in Spain are provided by the Nacional Health Service in a decentralized way by the seventeen autonomous communities whose process of decentralization was completed in January 2002. Its organisation is similar in all of them. Public sector companies of sanitary emergencies look after the health of citizens in relation to medical and trauma emergencies with a wide range of up to date resources both technical and human. In the following piece there is a description of the emergency response teams divided into ground and air that are responsible for the on site care of the patients in coordination with other public services. They also elaborate the prehospital clinical history that is going to be a valuable piece of information for the teams that receive the patient in the Emergency Hospital Unit (EHU). From 1980 to 1996 the mortality rate per 10.000 vehicles and the deaths per 1.000 accidents dropped significantly: in 1980 6.4 and 96.19% and in 1996, 2.8 and 64.06% respectively. In the intrahospital organisation there are two differentiated areas to receive trauma patients the casualty department and the EHU. In the EHU the severe and multiple injured patients are treated by the emergency hospital doctors; first in the triage or resuscitation areas and after when stabilised they are passed too the observation area or to the Intensive Care Unit (ICU) and from there the EHU or ICU doctors call the appropriate specialists. There is a close collaboration and coordination between the orthopaedic surgeon the EHU doctors and the other specialists surgeons in order to comply with treatment prioritization protocols. Once the patient has been transferred an entire process of assistance continuity is developed based on interdisciplinary teams formed in the hospital from the services areas involved in trauma assistance and usually coordinated by the ICU doctors. There is also mentioned the assistance registry of trauma patients, the ICU professional training

  1. The Focused Assessment With Sonography For Trauma (FAST) Examination And Pelvic Trauma: Indications And Limitations.

    Science.gov (United States)

    Shaukat, Nadia Maria; Copeli, Nikolai; Desai, Poonam

    2016-03-01

    Pelvic trauma accounts for only 3% of all skeletal injuries but may have mortality as high as 45% in cases of severe trauma. Significant high-grade-mechanism trauma to the pelvis must always take the abdomen into consideration for evaluation. The focused assessment with sonography for trauma (FAST) examination has been shown to be a valuable tool in assessing the unstable trauma patient with blunt abdominal injury, though its diagnostic utility is much less well-defined than in primary pelvic trauma. This systematic review explores the utility and limitations of the FAST examination in patients with blunt pelvic trauma and discusses the timing for the examination during the trauma survey. Newer techniques for emergency department management of the unstable trauma patient are also addressed.

  2. A proposed algorithm for multimodal liver trauma management from a surgical trauma audit in a western European trauma center.

    Science.gov (United States)

    Di Saverio, S; Sibilio, A; Coniglio, C; Bianchi, E; Biscardi, A; Villani, S; Gordini, G; Tugnoli, G

    2014-11-01

    Management of liver trauma is challenging and may vary widely given the heterogeneity of liver injuries' anatomical configuration, the hemodynamic status, the settings and resources available. Perhaps the use of non-operative management (NOM) may have potential drawbacks and the role of damage control surgery (DCS) and angioembolization represents a major evolving concept.1 Most severe liver trauma in polytrauma patients accounts for a significant morbidity and mortality. Major liver trauma with extensive parenchymal injury and uncontrollable bleeding is therefore a challenge for the trauma team. However a safe and effective surgical hemostasis and a carefully planned multidisciplinary approach can improve the outcome of severe liver trauma. The technique of perihepatic packing, according to DCS approach, is often required to achieve fast, early and effective control of hemorrhage in the highest grades of liver trauma and in unstable patients. A systematic and standardized technique of perihepatic packing may contribute to improve hemostatic efficacy and overall outcomes if wisely combined in a stepwise "sandwich" multimodal approach. DCS philosophy evolved alongside with damage control resuscitation (DCR) in the management of trauma patients, requiring close interaction between surgery and resuscitation. Therefore, as a result of a combined surgical and critical care clinical audit activity in our western European trauma center, a practical algorithm for multimodal sequential management of liver trauma has been developed based on a historical cohort of 253 liver trauma patients and subsequently validated on a prospective cohort of 135 patients in the period 2010-2013.

  3. [Priorities in the ICU care of the trauma patients].

    Science.gov (United States)

    Konn, Akihide

    2016-02-01

    Priority in ICU care of multiple trauma should be given to shock, respiratory failure, intracranial hypertension, and the identification of occult injuries. Diagnosis and treatment must occur simultaneously. If metabolic acidosis and hyperlactatemia persist despite normalization of vital signs, prolonged hypoperfusion may exist. Threshold of treatment for intracranial hypertension is 15 to 25 mmHg in accompanied traumatic brain injury. Stabilization of ABCDE should be prioritized in first 24 hours, followed by controlling double I (infection and ischemia). Early enteral nutrition has been estimated to reduce the incidence of infectious complication.

  4. Trace Element Concentrations in Human Tissues of Death Cases Associated With Secondary Infection and MOF After Severe Trauma.

    Science.gov (United States)

    Xu, Guangtao; Su, Ruibing; Li, Bo; Lv, Junyao; Sun, Weiqi; Hu, Bo; Li, Xianxian; Gu, Jiang; Yu, Xiaojun

    2015-12-01

    Proper trace element level is crucial for the organs in maintaining normal physiological functions. Multiple organ failure (MOF) might be added to critically ill patients due to a lack of trace elements. Alterations of trace element levels in brain, heart, liver, and kidney after severe trauma, however, have been little studied so far. In this study, tissue samples of the frontal cortex of the brain, interventricular septum of the heart, right lobe of the liver, and upper pole of the kidney were obtained from forensic autopsies, of which 120 cases died during the 5th to 15th day of hospitalization, whereas the trauma death group and 43 cases immediately died due to severe craniocerebral trauma as the control group. Copper (Cu), iron (Fe), zinc (Zn), and selenium (Se) were quantified by inductively coupled plasma atomic emission spectrophotometry (ICP-AES). Cu, Fe, Zn, and Se concentrations in the brain, heart, liver, and kidney in the trauma group decreased dramatically (pMOF) in the trauma death group were 78.33 and 29.17%, respectively. The concentrations of all elements exhibited a significant correlation with secondary infection and MOF (pMOF after severe trauma, which to some extent results in death.

  5. Burden of maxillofacial trauma at level 1 trauma center.

    Science.gov (United States)

    Kaul, Ruchi Pathak; Sagar, Sushma; Singhal, Maneesh; Kumar, Abhishek; Jaipuria, Jiten; Misra, Mahesh

    2014-06-01

    There is an upward trend in facial injuries following changes in population pattern, increasing industrialization and urbanization, hence maxillofacial trauma is becoming a burden and a leading medical problem in emergency rooms worldwide. This study was performed to evaluate the pattern of maxillofacial fractures, associated injuries, and treatment used at Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India, between January 2007 and June 2010. The study provides basis for establishment of trauma as major etiology of maxillofacial injuries and planning for preventive strategies. A retrospective study of patients seen and treated at JPNATC, AIIMS, New Delhi, between January 2007 and June 2010 was performed. Data extracted from patient records included etiology, age, sex, types and sites of fractures, treatment modality, and concomitant injuries. There were 795 fractures of the maxillofacial skeleton and 86 concomitant injuries from 542 patients. Road traffic accident (RTA) (56.8%) was the most common etiologic factor, followed by falls (22.3%) and fights (18.5%). The age range was from 3 to 75 years (mean, 34.7 years) with a peak incidence in the third decade with a male-to-female ratio of 3.7:1. The most common location of maxillofacial fractures was the mandible 615 (77%) and middle third 180 (23%). With regard to mandibular fractures, the body (29.6%) was the most common site, followed by the angle (24.4%), ramus (19.5%), dentoalveolar (14.6%), symphysis (11.0%), condyle (0.8%) while in the middle third, the nasal bone (36.7%) was the most common, followed by zygomatic bone (27.8), Lefort II (14.4), Lefort I (7.8%), dentoalveolar (10.0%), and Lefort III (3.3%). Majority of the patients were treated by open reduction and internal fixation (70.6). Concomitant injuries were 84 (10.8%) with orthopedic injuries accounting for the majority (63.9%). Head injury was associated in 16.3% of cases. RTA was the

  6. Scour Development around Bucket Foundations

    DEFF Research Database (Denmark)

    Stroescu, Ionut Emanuel; Frigaard, Peter Bak; Fejerskov, Morten

    2015-01-01

    The design without scour protection is a sensitive topic to most offshore developers, especially in the North Sea. However, newer research show that this concept is realistic if exists extended comprehension of the scour and backfill phenomena. The present paper shows comparative results for mono......The design without scour protection is a sensitive topic to most offshore developers, especially in the North Sea. However, newer research show that this concept is realistic if exists extended comprehension of the scour and backfill phenomena. The present paper shows comparative results...... for monopile and Bucket Foundation; using experimental analysis and real scour surveys around offshore installed Bucket Foundations. The main finding reflect that Bucket Foundation is a candidate for design without scour protection behaving like scour protected monopoles, in a variety of environmental...

  7. Corporate Ownership by Industrial Foundations

    DEFF Research Database (Denmark)

    Thomsen, Steen

    1999-01-01

    Industrial foundations are self-governing non profit institutions that own business companies. This ownership structure is found in a fair number of Northern European companies, some of them successful world class competitors. Standard agency theory would predict foundation-owned companies...... to be relatively inefficient since they lack monitoring by residual claimants and access to equity finance from the stock market. Nevertheless, empirical research (Thomsen 1996) has found that Danish foundation-owned companies do no worse in terms of profitability and growth than companies with dispersed ownership...... or family ownership. The paper considers and tests alternative explanations of this paradox. Explanations based on tax incentives, alternative control mechanisms and product-market advantages are rejected, but some support is found for performance advantages related to family control and long term business...

  8. Macroelement modeling of shallow foundations

    CERN Document Server

    Chatzigogos, Charisis; Salençon, J

    2008-01-01

    The paper presents a new macroelement model for shallow foundations. The model is defined through a non-linear constitutive law written in terms of some generalized force and displacement parameters. The linear part of this constitutive law comes from the dynamic impedances of the foundation. The non-linear part comprises two mechanisms. One is due to the irreversible elastoplastic soil behavior: it is described with a bounding surface hypoplastic model, adapted for the description of the cyclic soil response. An original feature of the formulation is that the bounding surface is considered independently of the surface of ultimate loads of the system. The second mechanism is the detachment that can take place at the soil-footing interface (foundation uplift). It is totally reversible and non-dissipative and can thus be described by a phenomenological non-linear elastic model. The macroelement is qualitatively validated by application to soil-structure interaction analyses of simple real structures.

  9. Bipolar Disorder and Childhood Trauma

    Directory of Open Access Journals (Sweden)

    Evrim Erten

    2015-06-01

    Full Text Available Bipolar disorder is a chronic disorder in which irregular course of depressive, mania or mixed episodes or a complete recovery between episodes can be observed. The studies about the effects of traumatic events on bipolar disorder showed that they had significant and long-term effects on the symptoms of the disorder. Psychosocial stress might change the neurobiology of bipolar disorder over time. The studies revealed that the traumatic events could influence not only the onset of the disorder but also the course of the disorder and in these patients the rate of suicide attempt and comorbid substance abuse might increase. Bipolar patients who had childhood trauma had an earlier onset, higher number of episodes and comorbid disorders. In this review, the relationship between childhood trauma and bipolar disorder is reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 157-165

  10. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... strongly influences patient morbidity and mortality. Prolonged transport times or inadequate prehospital care increases the requirement for early rapid restoration of tissue perfusion and reversal of physiologic disturbances on patient arrival. On the other hand, in urban areas, rapid emergency medical...... services (EMS) response times and advanced prehospital care increase the number of critically injured patients surviving sufficiently long to reach a hospital “in extremis.” Both scenarios provide challenges in the management of traumatized patients. This article addresses the management of severely...

  11. Application of full process comprehensive nursing on the transport of emergency brain trauma patients%全程综合护理干预在急诊脑外伤患者院内转运中的应用效果

    Institute of Scientific and Technical Information of China (English)

    吴红缨; 陈文红

    2015-01-01

    Objective To investigate the effects of full process comprehensive nursing on the transport of emergent and brain trauma patients. Methods A total of 100 brain trauma patients in Emergency Department accepted retrospective analysis, in which 50 patients received routine transport nursing from June 2012 to May 2013 in our hospital as control group while 50 cases accepted full process comprehensive nursing intervention from June 2013 to May 2014 as observation group. We compared the transit time, check the waiting time, transport rates of adverse events and receiving departments′ satisfaction between the two groups. Results The incidence rate of adverse transfer event was 4% in the observation group, which was significantly lower than that in the control group (16%) (χ2 =4. 000,P <0. 05). The transit time, check the waiting time in the observation group were (10. 54 ± 4. 47) min and (0. 44 ± 0. 19) min, which were lower than these of the control group [(16.43 ±5.21)min and (1.57 ±0.26)min], (t=6.067, 24.813;P<0.05); the receiving transport departments′ satisfaction rate of observation group was 96%, significantly higher than that in the control group which was 84% (χ2 =4. 000,P<0. 05). Conclusions For emergency brain trauma patients, full process comprehensive nursing intervention can reduce the time of transiting and waiting for check. It also can reduce the occurrence of adverse events in hospital transport and improve receiving departments′satisfaction, so it is worthy of clinical attention.%目的:探讨全程综合护理干预在急诊脑外伤患者院内转运中的临床效果。方法对我院收治的100例急诊脑外伤患者进行回顾性分析。2012年6月—2013年5月收治的50例患者作为对照组,接受常规院内转运护理;2013年6月—2014年5月收治的50例患者作为观察组,接受全程综合护理干预。比较两组患者转运时间、检查等待时间、转运不良事件发生率及接收科室满意度。

  12. Reduction of cerebral edema after traumatic brain injury using an osmotic transport device.

    Science.gov (United States)

    McBride, Devin W; Szu, Jenny I; Hale, Chris; Hsu, Mike S; Rodgers, Victor G J; Binder, Devin K

    2014-12-01

    Traumatic brain injury (TBI) is significant, from a public health standpoint, because it is a major cause of the morbidity and mortality of young people. Cerebral edema after a TBI, if untreated, can lead to devastating damage of the remaining tissue. The current therapies of severe TBI (sTBI), as outlined by the Brain Trauma Foundation, are often ineffective, thus a new method for the treatment of sTBI is necessary. Herein, the reduction of cerebral edema, after TBI, using an osmotic transport device (OTD) was evaluated. Controlled cortical impact (CCI) was performed on adult female CD-1 mice, and cerebral edema was allowed to form for 3 h, followed by 2 h of treatment. The treatment groups were craniectomy only, craniectomy with a hydrogel, OTD without bovine serum albumin (BSA), and OTD. After CCI, brain water content was significantly higher for animals treated with a craniectomy only, craniectomy with a hydrogel, and OTD without BSA, compared to that of control animals. However, when TBI animals were treated with an OTD, brain water content was not significantly higher than that of controls. Further, brain water content of TBI animals treated with an OTD was significantly reduced, compared to that of untreated TBI animals, TBI animals treated with a craniectomy and a hydrogel, and TBI animals treated with an OTD without BSA. Here, we demonstrate the successful reduction of cerebral edema, as determined by brain water content, after TBI using an OTD. These results demonstrate proof of principle for direct water extraction from edematous brain tissue by direct osmotherapy using an OTD.

  13. The relationship between childhood trauma and adult psychosis in a UK Early Intervention Service: results of a retrospective case note study

    Directory of Open Access Journals (Sweden)

    Reeder FD

    2017-02-01

    Full Text Available Francesca D Reeder,1 Nusrat Husain,2 Abdul Rhouma,3 Peter M Haddad,2 Tariq Munshi,4 Farooq Naeem,4 Davit Khachatryan,4 Imran B Chaudhry2 1School of Medicine, 2Neurosciences and Psychiatry Unit, University of Manchester, Manchester, 3Early Intervention Service, Lancashire Care NHS Foundation Trust, Preston, UK; 4Queen’s University, Kingston, Ontario, Canada Aim: There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review.Methods: This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis.Results: The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample. Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%, parental mental illness (19%, bullying (18%, absence of a parent (13%, and ‘other’ trauma (24% – the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma.Conclusion: A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with

  14. Professional Team Foundation Server 2010

    CERN Document Server

    Blankenship, Ed; Holliday, Grant; Keller, Brian

    2011-01-01

    Authoritative guide to TFS 2010 from a dream team of Microsoft insiders and MVPs!Microsoft Visual Studio Team Foundation Server (TFS) has evolved until it is now an essential tool for Microsoft?s Application Lifestyle Management suite of productivity tools, enabling collaboration within and among software development teams. By 2011, TFS will replace Microsoft?s leading source control system, VisualSourceSafe, resulting in an even greater demand for information about it. Professional Team Foundation Server 2010, written by an accomplished team of Microsoft insiders and Microsoft MVPs, provides

  15. Physical foundations of technical acoustics

    CERN Document Server

    Malecki, I

    1969-01-01

    Physical Foundations of Technical Acoustics discusses theoretical foundations of acoustical engineering. It is not so much a technical compendium as a systematic statement of physical laws so conceived that technologists might find in it all the information they need to become acquainted with the physical meaning and mathematical expression of phenomena they encounter in their work. To facilitate the acquirement of notions, which lie beyond a layman's grasp, the plan of narration adopted consists in beginning with the simplest idealized cases and then gradually moving on to the truest possibl

  16. ITIL Foundation exam study guide

    CERN Document Server

    Gallacher, Liz

    2012-01-01

    Everything you need to prepare for the ITIL exam The ITIL (Information Technology Infrastructure Library) exam is the ultimate certification for IT service management. This essential resource is a complete guide to preparing for the ITIL Foundation exam and includes everything you need for success. Organized around the ITIL Foundation syllabus, the study guide addresses the ITIL Service Lifecycles, the ITIL processes, roles, and functions, and also thoroughly explains how the Service Lifecycle provides effective and efficient IT services. Offers an introduction to IT service management and ITI

  17. On the foundation of Mechanics

    CERN Document Server

    Alonso-Blanco, Ricardo J

    2014-01-01

    This note is an extended version of "A note on the foundations of Mechanics", arXiv: 1404.1321 [math-ph]. A presentation of its contents was given in a talk in memorial homage to the professor Juan B. Sancho Guimer\\'a. For this reason, it was written in spanish language. The matter of the note is a systematic foundation of the most classical part of Mechanics. The content by sections is: 0)Notions and basic results, 1)Conservative systems 2) Time. Time constraints, 3) Proper time. Relativistic forces, 4)Electromagnetic fields, 5) On the Hamilton-Noether Principle, 6) Schr\\"odinger equation.

  18. Professional Team Foundation Server 2012

    CERN Document Server

    Blankenship, Ed; Holliday, Grant; Keller, Brian

    2012-01-01

    A comprehensive guide to using Microsoft Team Foundation Server 2012 Team Foundation Server has become the leading Microsoft productivity tool for software management, and this book covers what developers need to know to use it effectively. Fully revised for the new features of TFS 2012, it provides developers and software project managers with step-by-step instructions and even assists those who are studying for the TFS 2012 certification exam. You'll find a broad overview of TFS, thorough coverage of core functions, a look at extensibility options, and more, written by Microsoft ins

  19. Joseph Beuys: trauma and catharsis.

    Science.gov (United States)

    Ottomann, C; Stollwerck, P L; Maier, H; Gatty, I; Muehlberger, T

    2010-12-01

    Joseph Beuys was one of the most significant artists of the 20th century. He was a gunner and radio operator in the German Air Force during World War II, and was severely injured several times. In March 1943 he had a life-changing experience after the dive bomber he was assigned to crashed in the Crimean peninsula. This trauma influenced Beuys' entire artistic career, and is known in art history as the 'Tartar Legend' or 'Tartar Myth'. Profoundly affected by the crash, the severe trauma, the near-death experience and his rescue, which he perceived as a "rebirth", Beuys no longer saw himself, other people or society as a whole in the same way as previously. With his new consciousness, he ignored boundaries and created visions whereby all mankind could experience the healing he had undergone. Beuys did not bring society far enough for the turning point towards "the healing of the world" to be visible, yet today it is important to keep his work alive as a record of his extraordinary strength, which arose from trauma and severe injury, and was carried by a passionate commitment to mankind and to life itself.

  20. Association of childhood trauma with cognitive function in healthy adults: a pilot study

    Directory of Open Access Journals (Sweden)

    Lin Jin-Mann S

    2010-07-01

    Full Text Available Abstract Background Animal and human studies suggest that stress experienced early in life has detrimental consequences on brain development, including brain regions involved in cognitive function. Cognitive changes are cardinal features of depression and posttraumatic stress disorder. Early-life trauma is a major risk factor for these disorders. Only few studies have measured the long-term consequences of childhood trauma on cognitive function in healthy adults. Methods In this pilot study, we investigated the relationship between childhood trauma exposure and cognitive function in 47 healthy adults, who were identified as part of a larger study from the general population in Wichita, KS. We used the Cambridge Neuropsychological Test Automated Battery (CANTAB and the Wide-Range-Achievement-Test (WRAT-3 to examine cognitive function and individual achievement. Type and severity of childhood trauma was assessed by the Childhood Trauma Questionnaire (CTQ. Data were analyzed using multiple linear regression on CANTAB measures with primary predictors (CTQ scales and potential confounders (age, sex, education, income. Results Specific CTQ scales were significantly associated with measures of cognitive function. Emotional abuse was associated with impaired spatial working memory performance. Physical neglect correlated with impaired spatial working memory and pattern recognition memory. Sexual abuse and physical neglect were negatively associated with WRAT-3 scores. However, the association did not reach the significance level of p Conclusions Our results suggest that physical neglect and emotional abuse might be associated with memory deficits in adulthood, which in turn might pose a risk factor for the development of psychopathology.

  1. A focal brain trauma model for rehabilitation study%一种适用于康复研究的局灶性颅脑外伤大鼠模型

    Institute of Scientific and Technical Information of China (English)

    沈夏锋; 吴军发; 于惠贤; 张宇玲; 田闪; 路微波; 胡永善; 吴毅

    2014-01-01

    Objective :To establish an animal experimental focal traumatic brain injury (TBI) model for investiga-ting the underlying mechanisms of rehabilitation .Methods :After adult SD rats had received a severe controlled corti-cal impact (CCI) injury ,they were randomly assigned to TBI group (n=8) or sham operation group (n=8) .After TBI ,the neurological deficits scoring ,foot-fault test and cylinder test were performed .On 21-25 days post-injury ,rats were tested for spatial learning and memory in a Morris Water Maze .On 28 days post-injury ,animals were sacrificed and evaluated for quantitative cortical lesion volume and pathological changes .Results :The rats in TBI group demon-strated declined neurological deficits scores ,coordination and asymmetry compared to sham operation group (P<0 .05) .The rats in TBI group showed obvious deficits in spatial learning and memory (P<0 .05) .We also observed significant change in lesion volume ,neuron loss and overexpression of microglia around the lesion in TBI group (P<0 .05) .Conclusion :Rats undergoing a severe CCI injury showed significant sensorimotor ,cognitive performance im-pairment and pathological changes .It is suggest that the model should be useful for assessing the effects of rehabili-tation in TBI .%目的:仿制一种适合康复机制研究的局灶性颅脑外伤(TBI)动物模型,为国内广泛开展颅脑损伤康复机制研究提供基础。方法:成年雄性SD大鼠16只,随机分为颅脑外伤组和假手术组各8只。颅脑外伤组制作成控制性皮层损伤(CCI)模型,术后采用神经功能缺失评分、foot-fault test和cylinder test评估动物感觉和运动能力;外伤后第21~25天行Morris水迷宫检查,评估大鼠认知功能的变化;在外伤后28d通过焦油紫(CV)染色检测脑组织病理改变和组织缺失情况。结果:颅脑外伤组大鼠较假手术组神经功能评分有明显降低(P<0.05),运动协调能力和对称使用

  2. [Leber's hereditary optic neuropathy after head trauma: a case report].

    Science.gov (United States)

    Hayashi, Shintaro; Okamoto, Koichi

    2011-10-01

    A previously healthy 34-year-old man sustained multiple skull fractures in a traffic accident. Radiological findings and visual field examination did not detect any abnormality. Shortly after the accident, he noticed blurred vision in both eyes. Six months after the accident, he gradually developed disturbance of visual acuity in the right eye. His best corrected visual acuity (BCVA) was 0.8 OD and 1.2 OS and brain MRI did not show any abnormality, while Humphrey visual field analysis demonstrated right homonymous hemianopsia. Two months after the initial presentation, his BCVA showed 0.1 OD and 0.08 OS. Visual field examination suggested that both right homonymous hemianopsia and left blind spot had become enlarged. Mitochondrial DNA analysis demonstrated G11,778A mutation and a diagnosis of Leber's hereditary optic neuropathy (LHON) was made. A few reports have documented mild acute insult to the head or blunt optic trauma as triggers of optic neuropathy in subjects with LHON. Although, the precise mechanism of LHON following trauma remains unknown, it appears that an acute insult may be sufficient to precipitate neuropathy in the optic nerve already compromised by mitochondrial dysfunction. Asymptomatic carriers should be advised to avoid possible precipitating factors such as head trauma.

  3. Trauma, genes, and the neurobiology of personality disorders.

    Science.gov (United States)

    Goodman, Marianne; New, Antonia; Siever, Larry

    2004-12-01

    A model for personality dysfunction posits an interaction between inherited susceptibility and environmental factors such as childhood trauma. Core biological vulnerabilities in personality include dimensions of affective instability, impulsive aggression, and cognition/perceptual domains. For the dimension of impulsive aggression, often seen in borderline personality disorder (BPD), the underlying neurobiology involves deficits in central serotonin function and alterations in specific brain regions in the cingulate and the medial and orbital prefrontal cortex. The role of trauma in the development of personality disorder and especially for BPD remains unclear. Although recent studies suggest that BPD is not a trauma-spectrum disorder and that it is biologically distinct from posttraumatic stress disorder, high rates of childhood abuse and neglect do exist for individuals with personality dysfunction. Personality symptom clusters seem to be unrelated to specific abuses, but they may relate to more enduring aspects of interpersonal and family environments in childhood. Whereas twin and family studies indicate a partially heritable basis for impulsive aggression, studies of serotonin-related genes to date suggest only modest contributions to behavior. Gene-environment interactions involving childhood maltreatment are demonstrated in recent studies on antisocial behaviors and aggressive rhesus monkeys and highlight the need for further research in this important area.

  4. Bucket Foundation Response Under Various Displacement Rates

    DEFF Research Database (Denmark)

    Vaitkunaite, Evelina; Nielsen, Benjaminn Nordahl; Ibsen, Lars Bo

    2016-01-01

    in a multi-bucket foundation system. The foundation model is at a scale of approximately 1:20 prototype foundation size. The tests are performed in a pressure tank with the foundation model installed in dense sand. Based on the data, the conclusion is that the bucket foundation design in a storm case should......The present testing program aims at showing the pore pressure response around a bucket foundation skirt as well as the load and displacement change due to ten different displacement rates. Research findings are useful for a numerical model calibration focusing on the design of the upwind foundation...

  5. FORD FOUNDATION PROJECTS. PROGRESS REPORT.

    Science.gov (United States)

    ROBINETT, RALPH F.; ROJAS, PAULINE M.

    THE FORD FOUNDATION PROJECTS INCLUDE--THE PREPARATION OF READING MATERIALS FOR NONENGLISH SPEAKING BILINGUAL PUPILS ENTERING THE FIRST GRADE, THE REVISION OF "FRIES AMERICAN ENGLISH SERIES" FOR NONENGLISH SPEAKING BILINGUAL PUPILS WHO CAN READ AND WRITE IN THEIR OWN VERNACULAR, THE PREPARATION OF AUDIOVISUAL MATERIAL FOR BILINGUAL…

  6. Sociolinguistic Foundations of Language Assessment.

    Science.gov (United States)

    Ornstein-Galicia, Jacob L.

    An answer to the question of what sociolinguistics has to offer to the art of language assessment is sought in exploration of the following topics: (1) a history of the development of sociolinguistics and an outline of the research on dialectology; (2) a review of basic sociolinguistic foundations and theories about language, society, domains of…

  7. Team Foundation Server 2013 customization

    CERN Document Server

    Beeming, Gordon

    2014-01-01

    This book utilizes a tutorial based approach, focused on the practical customization of key features of the Team Foundation Server for collaborative enterprise software projects.This practical guide is intended for those who want to extend TFS. This book is for intermediate users who have an understanding of TFS, and basic coding skills will be required for the more complex customizations.

  8. Characteristic Behavior of Bucket Foundations

    DEFF Research Database (Denmark)

    Barari, Amin

    reduce the risks and costsrelated to offshore geotechnics. The thesis examines: 1.Characteristic Behavior of Bucket Foundations 2. Modeling of Water Flow through Porous Media The outcomes of each of the research contributions are summarized in four research articles, either directly or indirectly...

  9. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    <正>The Rural Development Foundation ( RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providingquality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college inAndhra Pradesh State,

  10. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    <正>The Rural Development Foundation(RDF),founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children.RDF founded and continues to operate five schools and one junior college in Andhra Pradesh State,taking a unique holistic approach to education through innovative programs and methodology.Rather than using the

  11. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    <正>The Rural Development Foundation(RDF),founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children.RDF founded and continues to operate five schools and one junior college in Andhra Pradesh State,taking a unique holistic approach to education through innovative programs and methodology.Rather than using the con-

  12. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    <正>The Rural Development Foundation ( RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college in Andhra Pradesh State,taking a unique holistic approach to education through innovative programs and methodology. Rather than

  13. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    <正>The Rural Development Foundation(RDF),founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children.RDF founded and continues to operate five schools and one junior college in Andhra

  14. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    <正>The Rural Development Foundation (RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providingquality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college in AndhraPradesh State,taking a unique holistic approach to education through innovative programs and methodology. Rather than using the con-

  15. Theoretical foundations for collaboration engineering

    NARCIS (Netherlands)

    Kolfschoten, G.L.

    2007-01-01

    Collaboration is often presented as the solution to numerous problems in business and society. However, collaboration is challenging, and collaboration support is not an off-the-shelf-product. This research offers theoretical foundations for Collaboration Engineering. Collaboration Engineering is an

  16. The Foundation of Nea Paphos

    DEFF Research Database (Denmark)

    Bekker-Nielsen, Tønnes

    2000-01-01

    Traditionally it has been assumed that Nea Paphos was founded by king Nikokles, the last of the Kinyrad dynasty, around 320 BC. A critical reexamination of the evidence reveals this foundation date to be impossible; Nea Paphos was not founded in Nikokles' lifetime and probably not before 294 BC....

  17. Principles for Foundations of Education.

    Science.gov (United States)

    Britt, John

    The significance of the foundations of education approach to teaching is apparent in the ideas of John Henry Newman, Karl Jaspers, Jose Ortega y Gasset, and Mortimer Adler. Newman maintained that there is a circle of knowledge and once this unity is ignored the result is distortion in the learners and in the knowledge. To retain the whole, the…

  18. The Governance of Industrial Foundations

    DEFF Research Database (Denmark)

    Børsting, Christa; Kuhn, Johan; Poulsen, Thomas

    We study turnover among executives and directors in companies owned by Danish industrial foundations, which are held to be long term owners. Executives are members of the management board (direktionen), whereas directors a members of the supervisiory board (bestyrelsen). As expected, we find...

  19. Behavior Modeling -- Foundations and Applications

    DEFF Research Database (Denmark)

    This book constitutes revised selected papers from the six International Workshops on Behavior Modelling - Foundations and Applications, BM-FA, which took place annually between 2009 and 2014. The 9 papers presented in this volume were carefully reviewed and selected from a total of 58 papers...

  20. Research domain criteria and the study of trauma in children: Implications for assessment and treatment research.

    Science.gov (United States)

    Stover, Carla Smith; Keeshin, Brooks

    2016-11-09

    By definition, the Diagnostic and Statistical Manual (DSM) diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a traumatic event. Yet, the DSM diagnostic requirements for children and adolescents for PTSD may fail to capture traumatized youth with significant distress and functional impairment. Many important studies have utilized PTSD diagnosis as a mechanism for grouping individuals for comparative studies examining brain functioning, neuroendocrinology, genetics, attachment, and cognition; however, focusing only on those with the diagnosis of PTSD can miss the spectrum of symptoms and difficulties that impact children who experience trauma and subsequent impairment. Some studying child trauma have focused on examining brain and biology of those with exposure and potential impairment rather than only those with PTSD. This line of inquiry, complementary to PTSD specific studies, has aided our understanding of some of the changes in brain structure and neuroregulatory systems at different developmental periods following traumatic exposure. Application of the Research Domain Criteria (RDoC) framework proposed by NIMH to the study of child trauma exposure and subsequent impairment is an opportunity to examine domains of function and how they are impacted by trauma. Research to date has focused largely in the areas of negative valence, regulatory, and cognitive systems, however those studying complex or developmental trauma have identified an array of domains that are impacted which map onto many of the RDoC categories. This paper will review the relevant literature associated with child trauma as it relates to the RDoC domains, outline areas of needed research, and describe their implications for treatment and the advancement of the field.

  1. The Link: Trauma and Substance Abuse

    Directory of Open Access Journals (Sweden)

    Leslie Dawn Culpepper

    2016-03-01

    Full Text Available Trauma “is categorized as an overwhelming life-changing experience (and is typically a physical and/or emotional shock to the very fiber of one’s being.”It is a priority that those who experience trauma in their lives seek help from a licensed professional to deal with the emotional damage caused by the trauma(s and to be taught necessary coping skills to prevent them from seeking solace in unhealthy ways like abusing drugs and/or alcohol. Research proposes that all types of trauma and the aftermath that follows will likely impact the “exposed population’s behavioral health, resulting in an increase in mental and substance use disorders, along with a decline in perceived quality of life” [1]. Survey results teach us that more than 70% adolescents receiving treatment for substance abuse across the country have a history of trauma in their lives.

  2. Is paediatric trauma severity overestimated at triage?

    DEFF Research Database (Denmark)

    DO, H Q; Hesselfeldt, R; Steinmetz, J

    2014-01-01

    BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational...... follow-up study that involves one level I TC and seven local hospitals. We included paediatric (trauma patients with a driving distance to the TC > 30 minutes. The primary end-point was the proportion of trauma patients arriving in the TC. RESULTS: We included 1934...... trauma patients, 238 children and 1696 adults. A total of 33/238 children (13.9%) vs. 304/1696 adults (17.9%) were transported to the TC post-injury (P = 0.14). Among these, children were significantly less injured than adults [median Injury Severity Score (ISS) 9 vs. 14, P 

  3. Specific trauma subtypes improve the predictive validity of the Harvard Trauma Questionnaire in Iraqi refugees.

    Science.gov (United States)

    Arnetz, Bengt B; Broadbridge, Carissa L; Jamil, Hikmet; Lumley, Mark A; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E

    2014-12-01

    Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

  4. Trauma craneoencefálico atención inicial y manejo hospitalario

    Directory of Open Access Journals (Sweden)

    Luís Rafael Moscote Salazar

    2013-10-01

    Full Text Available Resumen El trauma constituye uno de los principales problemas de salud pública en el mundo y particularmente, en Colombia por su alta incidencia y sus implicaciones medicas, sociales, económicas y morales. En los Estados Unidos es la primera causa de muerte en menores de 45 años y la cuarta en todos los grupos de edad. El presente artículo pretende contribuir al conocimiento de la fisiopatología del trauma craneoencefálico como una herramienta en la mejoría continua de los pacientes portadores de esta patología. (DUAZARY 2010, 100 - 105AbstractThe trauma constitutes one of the principal problems of public health in the world and particularly, in Colombia for the high incident and the implications medicate, social, economic and moral. In the United States it is the first reason of death in 45-year-old minors and the fourth one in all the groups of age. The present article tries to contributeto the knowledge of the physiopathology of the brain traumatic injury as a tool in the constant improvement of the carrying patients of this pathology.Keywords: brain trauma; brain traumatic injury; prehospitalary attention; neurotrauma.

  5. Psychoneuroimmunology of Early-Life Stress: The Hidden Wounds of Childhood Trauma?

    Science.gov (United States)

    Danese, Andrea; J Lewis, Stephanie

    2017-01-01

    The brain and the immune system are not fully formed at birth, but rather continue to mature in response to the postnatal environment. The two-way interaction between the brain and the immune system makes it possible for childhood psychosocial stressors to affect immune system development, which in turn can affect brain development and its long-term functioning. Drawing from experimental animal models and observational human studies, we propose that the psychoneuroimmunology of early-life stress can offer an innovative framework to understand and treat psychopathology linked to childhood trauma. Early-life stress predicts later inflammation, and there are striking analogies between the neurobiological correlates of early-life stress and of inflammation. Furthermore, there are overlapping trans-diagnostic patterns of association of childhood trauma and inflammation with clinical outcomes. These findings suggest new strategies to remediate the effect of childhood trauma before the onset of clinical symptoms, such as anti-inflammatory interventions and potentiation of adaptive immunity. Similar strategies might be used to ameliorate the unfavorable treatment response described in psychiatric patients with a history of childhood trauma.

  6. New perspectives in pediatric trauma care

    Directory of Open Access Journals (Sweden)

    Andreas Fette

    2008-09-01

    Full Text Available Andreas FettePediatric Surgery, Children’s Care Center, SRH Klinikum Suhl/Thueringen, GermanyAbstract: An “American-style” pediatric trauma care symposia consisting of lectures, workshops, and skill stations was held at a pediatric trauma center to improve pre- and post-hospital care for children, facilitate communication, and to set up standards within the regional rescue chain.Keywords: trauma care, children, inhouse-training

  7. Imaging of accidental paediatric head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Phua Hwee [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Lim, Choie Cheio Tchoyoson [National Neuroscience Institute, Department of Neuroradiology, Singapore (Singapore)

    2009-05-15

    Head trauma is the most common form of injury sustained in serious childhood trauma and remains one of the top three causes of death despite improved road planning and safety laws. CT remains the first-line investigation for paediatric head trauma, although MRI may be more sensitive at picking up the full extent of injuries and may be useful for prognosis. Follow-up imaging should be tailored to answer the specific clinical question and to look for possible complications. (orig.)

  8. CraniOrofacial Trauma: The first law

    Directory of Open Access Journals (Sweden)

    Shikha Bharadwaj

    2013-09-01

    Full Text Available Trauma has been given the utmost importance in the field of medicine since ages and is still being the most common cause of mortality and disability worldwide. Every hospital must have a fully equipped trauma care unit, operation theaters and intensive care units to render a better care to trauma patients and also emergency medical services and specialist from all the medical specialties.

  9. Role of Noninvasive Hemoglobin Monitoring in Trauma

    Science.gov (United States)

    2015-03-25

    AFRL-SA-WP-SR-2015-0002 Role of Noninvasive Hemoglobin Monitoring in Trauma Betty J. Tsuei, MD; Dennis J. Hanseman, PhD...W. Gerlach, USAF, MC U.S. Air Force School of Aerospace Medicine, Center for the Sustainment of Trauma and Readiness Skills March 2015...August 2012 – August 2013 4. TITLE AND SUBTITLE Role of Noninvasive Hemoglobin Monitoring in Trauma 5a. CONTRACT NUMBER FA8650-12-2-6B14 5b

  10. Development of an interactive dental trauma guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Christensen, Søren Steno Ahrensburg

    2009-01-01

    resulting in 54 trauma scenarios of which many have specific requirements for treatment The situation is further complicated by the fact that the two dentitions have very different treatment demands. As a result it's impossible even for experienced practitioners to provide evidence-based treatment...... be available on the internet at: "www.DentalTraumaGuide.org". We hope that the Dental Trauma Guide can help improve the knowledge about dental traumatology worldwide and hereby improve the quality of treatment....

  11. Management of maxillofacial trauma in emergency: An update of challenges and controversies

    Science.gov (United States)

    Jose, Anson; Nagori, Shakil Ahmed; Agarwal, Bhaskar; Bhutia, Ongkila; Roychoudhury, Ajoy

    2016-01-01

    Trauma management has evolved significantly in the past few decades thereby reducing mortality in the golden hour. However, challenges remain, and one such area is maxillofacial injuries in a polytrauma patient. Severe injuries to the maxillofacial region can complicate the early management of a trauma patient owing to the regions proximity to the brain, cervical spine, and airway. The usual techniques of airway breathing and circulation (ABC) management are often modified or supplemented with other methods in case of maxillofacial injuries. Such modifications have their own challenges and pitfalls in an already difficult situation. PMID:27162439

  12. Management of maxillofacial trauma in emergency: An update of challenges and controversies

    Directory of Open Access Journals (Sweden)

    Anson Jose

    2016-01-01

    Full Text Available Trauma management has evolved significantly in the past few decades thereby reducing mortality in the golden hour. However, challenges remain, and one such area is maxillofacial injuries in a polytrauma patient. Severe injuries to the maxillofacial region can complicate the early management of a trauma patient owing to the regions proximity to the brain, cervical spine, and airway. The usual techniques of airway breathing and circulation (ABC management are often modified or supplemented with other methods in case of maxillofacial injuries. Such modifications have their own challenges and pitfalls in an already difficult situation.

  13. [First aid and management of multiple trauma: in-hospital trauma care].

    Science.gov (United States)

    Boschin, Matthias; Vordemvenne, Thomas

    2012-11-01

    Injuries remain the leading cause of death in children and young adults. Management of multiple trauma patients has improved in recent years by quality initiatives (trauma network, S3 guideline "Polytrauma"). On this basis, strong links with preclinical management, structured treatment algorithms, training standards (ATLS®), clear diagnostic rules and an established risk- and quality management are the important factors of a modern emergency room trauma care. We describe the organizational components that lead to successful management of trauma in hospital.

  14. Trauma pattern in a level I east-European trauma center

    Directory of Open Access Journals (Sweden)

    Bogdan Stoica

    2015-10-01

    Conclusions: Our trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

  15. Decolonizing Trauma Theory: Retrospect and Prospects

    Directory of Open Access Journals (Sweden)

    Irene Visser

    2015-06-01

    Full Text Available Decolonizing trauma theory has been a major project in postcolonial literary scholarship ever since its first sustained engagements with trauma theory. Since then, trauma theory and postcolonial literary studies have been uneasy bedfellows, and the time has now come to take stock of what remains in postcolonial trauma studies from the original formulations of trauma theory, and see which further steps must be envisaged in order to reach the ideal of a truly decolonized trauma theory today. To this end, this article presents a detailed overview of the short history and the present situation of the trajectory of decolonizing trauma theory for postcolonial studies, clarifying the various re-routings that have so far taken place, and delineating the present state of the project, as well as the need for further developments towards an increased expansion and inclusiveness of the theory. I argue that openness to non-Western belief systems and their rituals and ceremonies in the engagement with trauma is needed in order to achieve the remaining major objectives of the long-standing project of decolonizing trauma theory.

  16. An evolution of trauma care evaluation: A thesis on trauma registry and outcome prediction models

    NARCIS (Netherlands)

    Joosse, P.

    2013-01-01

    Outcome prediction models play an invaluable role in the evaluation and improvement of modern trauma care. Trauma registries underlying these outcome prediction models need to be accurate, complete and consistent. This thesis focused on the opportunities and limitations of trauma registries and outc

  17. Acupuncture for the Trauma Spectrum Response: Scientific Foundations, Challenges to Implementation

    Science.gov (United States)

    2011-01-01

    beneficiaries may use CIM at certain sites.69 A large survey conducted by the Samueli Institute (Alexandria, VA) in conjunction with the DoD Health Be- haviors...by the RAND– Samueli Program on Integrative Medicine Policy focused on economic analysis issues in CIM, which will help inform the DoD about the best...response. Ann Intern Med. 2002;136: 471–476. Address correspondence to: Wayne B. Jonas, MD Samueli Institute, 1737 King Street, Suite 600 Alexandria VA 22314 E-mail: wjonas@siib.org 262 JONAS ET AL.

  18. Disability rating scale for severe head trauma: coma to community.

    Science.gov (United States)

    Rappaport, M; Hall, K M; Hopkins, K; Belleza, T; Cope, D N

    1982-03-01

    The objective of this study was to develop one instrument for assessing quantitatively the disability of severe head trauma patients so their rehabilitative progress could be followed from coma through different levels of awareness and functioning to their return to the community. This disability rating (DR) instrument was designed to be easily learned, quickly completed, valid, predictive of outcome and to have a high inter-rater reliability. The DR Scale consists of 8 items divided into 4 categories; 1. Arousal and awareness; 2. Cognitive ability to handle self-care functions; 3. Physical dependence upon others; 4. Psychosocial adaptability for work, housework, or school. Completed independently by several raters for more than 88 serious head injury patients, inter-rater correlations were highly significant. The admission DR was significantly related to clinical outcome at 1 year after injury and was significantly related to electrophysiologic measures of brain dysfunction as reflected in degree of abnormality of evoked brain potential patterns. The DR Scale is more sensitive than the Glasgow Outcome Scale in detecting and measuring clinical changes in individuals who have sustained severe head trauma. Also it can be used to help identify patients most likely to benefit from intensive rehabilitation care within a hospital setting. It provides a shorthand global description of a head injury patient's condition that facilitates understanding and communication.

  19. Occupation as therapy for trauma recovery: a case study.

    Science.gov (United States)

    Precin, Patricia

    2011-01-01

    In this case study, a young women who has chronic verbal, emotional, and physical abuse and was exposed to repetitive adult acts of abuse as a child initially presented with Posttraumatic Stress Disorder (PTSD) marked by constriction and disconnection, which resulted in her feeling passive and tortured. As part of her occupational therapy intervention, based on the occupational adaptation, psychoanalytic, and recovery frames of reference, she was able to use her skills as a musician and lyricist to work through her trauma by performing heavy metal music. She used work to express emotions and tell and retell her story to audiences eager to hear her. Work helped her develop an identity that allowed her to be active in the world and reach out to others through her music. This case study focuses on the intervention - how music and occupation functioned as a foundation for relieving her PTSD.

  20. Imaging of male pelvic trauma.

    Science.gov (United States)

    Avery, Laura L; Scheinfeld, Meir H

    2012-11-01

    Prompt imaging plays an important role in the evaluation of male pelvic soft tissue trauma. Using appropriate imaging modalities, with optimization of contrast administration when appropriate, is essential for accurate diagnosis. Traumatic bladder rupture, either extraperitoneal or intraperitoneal, is diagnosed with high accuracy using computed tomography cystography. Suspicion of urethral injury warrants evaluation with retrograde urethrography to evaluate for the presence of injury and injury location. Early identification of laceration of the testicular tunica albuginea is essential. Understanding both normal penile anatomy and the imaging appearance of corpus rupture (as opposed to a hematoma) is imperative for proper diagnosis and management.

  1. Taser-Related Testicular Trauma.

    Science.gov (United States)

    Theisen, Katherine; Slater, Rick; Hale, Nathan

    2016-02-01

    The Thomas A. Swift's Electric Rifle (Taser) is an electrical weapon designed as a nonlethal means to subdue violent or fleeing subjects. Several reports have been published on the safety and efficacy of, as well as injury profile from, police Tasers. Documented urologic involvement is rare. The sequela of an electrical current from a Taser gun to the testis in regard to both short- and long-term functions is unknown. Herein we present a case of penetrating trauma to the scrotum from a Taser dart.

  2. Musculoskeletal Ultrasound in Pediatric Trauma

    Directory of Open Access Journals (Sweden)

    A. Shakeri Bavil

    2008-01-01

    Full Text Available Radiographs are the initial diagnostic modality used in evaluation of trauma, but sonography lacks ionizing radiation risks and allows in depth assessment of no ossified joint areas, soft tissues and superficial bone-to-soft tissue interfaces. Regarding the use of sonography to asses soft tissue injuries, the ultrasonographic evaluation of clavicle fractures, proximal humerus epiphysiolysis and fractures of hip has been well standardized."nThe aim of this review is to present the currently applied clinical ultrasound imaging techniques and to provide guidelines for efficient evaluation of musculoskeletal injuries and disorders in children.

  3. Cranial birth trauma; Kraniales Geburtstrauma

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Roth, C.; Politi, M.; Zimmer, A.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Rohrer, T. [Universitaetsklinikum des Saarlandes, Klinik fuer Allgemeine Paediatrie und Neonatologie, Homburg/Saar (Germany)

    2009-10-15

    Injuries to an infant that result during the birth process are categorized as birth trauma. Cranial injuries due to mechanical forces such as compression or traction include caput succedaneum, cephalhematoma, subgaleal hematoma and intracranial hemorrhaging. Hypoxic ischemic encephalopathy is the consequence of systemic asphyxia occurring during birth. (orig.) [German] Als Geburtstrauma werden die Verletzungen des Saeuglings bezeichnet, die waehrend der Geburt stattfinden. Zu den Verletzungen, die am Schaedel auftreten koennen und hauptsaechlich durch mechanische Kraefte wie Kompression oder Traktion verursacht werden, gehoeren das Caput succedaneum, das Zephalhaematom, das subgaleale Haematom und die intrakranielle Blutung. Die hypoxisch-ischaemische Enzephalopathie ist die Folge einer systemischen Asphyxie waehrend der Geburt. (orig.)

  4. Trauma social y memoria colectiva

    Directory of Open Access Journals (Sweden)

    Margarita Iglesias Saldaña

    2009-04-01

    Full Text Available El trauma social y la memoria colectiva, o memorias colectivas están de la mano en la América latina post-dictatorial. Desde fines de los años ochenta, se fueron destituyendo las dictaduras latinoamericanas, la mayoría sobre bases de consensos entre las fuerzas dictatoriales y los negociadores políticos de corrientes democráticas. La fuerza de los movimientos sociales sirvió de puente para las negociaciones, pero no logró estar del todo en las transacciones hacia los procesos de transición. Si así hubiera sido, la justicia y la verdad hubieran tenido un lugar privilegiado en los procesos denominados de "transición a las democracias" en distintos países del cono sur latinoamericano. La memoria colectiva ligada al trauma social tendrá varios componentes que abarcan también la memoria individual, incluyendo los espacios de la experiencia, propia y ajena. Este artículo pretende bucear en las interacciones entre ambos ámbitos de la memoria y sus conexiones con el tiempo presente.__________ABSTRACT:Social trauma and collective memory or collective memories are linked to the post-dictatorial Latin America. Since the late eighties, Latin American dictatorships were progressively dismissing, the majority on the basis of consensus between the dictatorial forces and the political mediators of the democratic part. The strength of social movements formed the bridge to negotiations, but could not entirely participate in the transactions to the transition process. If it would have been so, justice and truth would have had a special place in the process called "transition to democracy" in several Latin American Southern Cone countries. The collective memory linked to social trauma will have several components that also include individual memory, including personal and collective spaces of experience. This article aims to analyze the interactions between the two areas of memory and its connections to the present time.

  5. The trauma of a recession.

    LENUS (Irish Health Repository)

    Murphy, S M

    2011-09-01

    Employment in construction in Ireland fell by 10% from nearly 282,000 in the second quarter of 2007 to 255,000 in the same period of 2008. Our study looks at the differences in soft tissue upper limb trauma dynamics of a pre- and post-recession Ireland. Construction accounted for 330 patients (27%) of all hand injuries in 2006, but only 18 (3%) in 2009. Our data shows a significant drop in hand injuries related to the construction industry, and more home\\/DIY cases and deliberate self-harm presenting in their stead.

  6. Brain Basics

    Medline Plus

    Full Text Available ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  7. Brain Basics

    Science.gov (United States)

    ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  8. Linear programming foundations and extensions

    CERN Document Server

    Vanderbei, Robert J

    2001-01-01

    Linear Programming: Foundations and Extensions is an introduction to the field of optimization. The book emphasizes constrained optimization, beginning with a substantial treatment of linear programming, and proceeding to convex analysis, network flows, integer programming, quadratic programming, and convex optimization. The book is carefully written. Specific examples and concrete algorithms precede more abstract topics. Topics are clearly developed with a large number of numerical examples worked out in detail. Moreover, Linear Programming: Foundations and Extensions underscores the purpose of optimization: to solve practical problems on a computer. Accordingly, the book is coordinated with free efficient C programs that implement the major algorithms studied: -The two-phase simplex method; -The primal-dual simplex method; -The path-following interior-point method; -The homogeneous self-dual methods. In addition, there are online JAVA applets that illustrate various pivot rules and variants of the simplex m...

  9. Philosophical foundations of human rights

    CERN Document Server

    Liao, Matthew S

    2015-01-01

    What makes something a human right? What is the relationship between the moral foundations of human rights and human rights law? What are the difficulties of appealing to human rights? This book offers the first comprehensive survey of current thinking on the philosophical foundations of human rights. Divided into four parts, this book focusses firstly on the moral grounds of human rights, for example in our dignity, agency, interests or needs. 'Secondly, it looks at the implications that different moral perspectives on human rights bear for human rights law and politics. Thirdly, it discusses specific and topical human rights including freedom of expression and religion, security, health and more controversial rights such as a human right to subsistence. The final part discusses nuanced critical and reformative views on human rights from feminist, Kantian and relativist perspectives among others. The essays represent new and canonical research by leading scholars in the field. Each part is comprised of a set...

  10. Mono pile foundation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Lyngesen, S.; Brendstrup, C.

    1997-02-01

    The use of mono piles as foundations for maritime structures has been developed during the last decades. The installation requirements within the offshore sector have resulted in equipment enabling driving of piles up to 3-4 m to large penetration depths. The availability of this equipment has made the use of large mono piles feasible as foundations for structures like wind turbines. The mono pile foundations consists of three parts; the bare pile, a conical transition and a boat landing. All parts are prefitted at the yard in order to minimise the installation work that has to be carried out offshore. The study of a mono pile foundations for a 1.5 MW wind turbine has been conducted for two locations, Horns Rev and Roedsand. Three different water depths: 5, 8 and 11 m have been investigated in the study. The on-site welding between pile and conical transition is performed by an automatic welding machine. Final testing and eventually repair of the weld are conducted at least 16 hours after welding. This is followed by final installation of J-tube, tie-in to subsea cables and installation of the impressed current system for corrosive protection of the mono pile. The total cost for procurement and installation of the mono pile using the welded connection is estimated. The price does not include procurement and installation of access platform and boat landing. These costs are estimated to 250.000 DKK. Depending on water depth the cost of the pile ranges from 2,2 to 2,7 million DKK. Procurement and fabrication of the pile are approx. 75% of the total costs. The remaining 25% are due to installation. The total costs are very sensitive to the unit price of pile steel. During the project it became obvious that ice load has a very large influence on the dimensions of the mono pile. (EG)

  11. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    <正>The Rural Development Foundation ( RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college in Andhra Pradesh State,taking a unique holistic approach to education through innovative programs and methodology. Rather than using the conventional method of rote memorization,RDF focuses on cultivating critical thinking skills and

  12. Cognitive Foundations for Visual Analytics

    Energy Technology Data Exchange (ETDEWEB)

    Greitzer, Frank L.; Noonan, Christine F.; Franklin, Lyndsey

    2011-02-25

    In this report, we provide an overview of scientific/technical literature on information visualization and VA. Topics discussed include an update and overview of the extensive literature search conducted for this study, the nature and purpose of the field, major research thrusts, and scientific foundations. We review methodologies for evaluating and measuring the impact of VA technologies as well as taxonomies that have been proposed for various purposes to support the VA community. A cognitive science perspective underlies each of these discussions.

  13. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    <正>The Rural Development Foundation ( RDF) ,founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children. RDF founded and continues to operate five schools and one junior college in Andhra Pradesh State,taking a unique holistic approach to education through innovative programs and methodology. Rather than using the conventional method of rote memorization,RDF focuses on cultivating critical thinking skills and encouraging students to

  14. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    <正>The Rural Development Foundation(RDF),founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children.RDF founded and continues to operate five schools and one junior college in Andhra Pradesh State,taking a unique holistic approach to education through innovative programs and methodology.Rather than using the conventional method of rote memorization,RDF focuses on cultivating critical thinking skills and encouraging students to understand and

  15. About The Rural Development Foundation

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    <正>The Rural Development Foundation(RDF),founded in 1996,is an Indian nonprofit organization with the mission of providing quality education for underprivileged rural children.RDF founded and continues to operate five schools and one junior college in Andhra Pradesh State,taking a unique holistic approach to education through innovative programs and methodology.Rather than using the conventional method of rote memorization,RDF focuses on cultivating critical thinking skills and encouraging students to understand and

  16. Offshore Wind Turbine Foundation Design

    DEFF Research Database (Denmark)

    Passon, Patrik

    be established under proper consideration of the dynamics of the whole system requiring adequate models of the individual subsystems and environment. This is due to the fact that OWTs introduce complex interactions between individual subsystems and the environment. Hence, a thorough understanding of the overall...... foundations have individual characteristics and show differences in the interactions with other subsystems leading to varying requirements regarding structural modelling, environmental modelling and load calculations in the design process. Hence, it is important to carefully assess particular aspects...

  17. [The mind-brain problem (I): onto-epistemological foundations].

    Science.gov (United States)

    Goni-Saez, F; Tirapu-Ustarroz, J

    2016-08-01

    Introduccion. La ciencia y la filosofia han abordado a lo largo de la historia del pensamiento y desde diferentes perspectivas epistemicas el problema mente-cerebro. La primera de ellas acota areas especificas de la realidad y construye hipotesis de corto alcance y multiple conectividad intercientifica con el objetivo de validar modelos teoricos; la segunda extiende su arquitectura sistemica al conjunto de lo real (incluida la actividad cientifica). Desarrollo. La complejidad del problema mente-cerebro exige generar un vinculo de conexion disciplinar entre la filosofia y la ciencia; nuestros presupuestos ontoepistemologicos se erigen, por lo tanto, en el marco de una filosofia orientada cientificamente (filosofia cientifica). Se defiende el materialismo emergentista como solucion filosofico-cientifica coherente y contrastable en contraposicion a otras propuestas desarrolladas desde diferentes modelos ontologicos (por ejemplo, dualismo interaccionista, funcionalismo, teoria de la identidad, epifenomenalismo...). Conclusiones. La respuesta al problema mente-cerebro solo es factible desde una neurociencia cognitiva fundamentada filosoficamente: el materialismo emergentista –postulado ontologico– afirma que la mente es una propiedad emergente (novedad cualitativa) del cerebro; el realismo cientifico –postulado epistemologico– sostiene que la neurociencia cognitiva es la herramienta teorico-experimental basica que posibilita el acceso cognoscitivo tanto al cerebro como a sus procesos neurocognitivos. Consideramos que a partir de esta fundamentacion filosofica, la neurociencia cognitiva adquiere legitimidad epistemica para acometer el estudio del proceso mental mas genuinamente humano: la conciencia.

  18. From computer to brain foundations of computational neuroscience

    CERN Document Server

    Lytton, William W

    2002-01-01

    Biology undergraduates, medical students and life-science graduate students often have limited mathematical skills. Similarly, physics, math and engineering students have little patience for the detailed facts that make up much of biological knowledge. Teaching computational neuroscience as an integrated discipline requires that both groups be brought forward onto common ground. This book does this by making ancillary material available in an appendix and providing basic explanations without becoming bogged down in unnecessary details. The book will be suitable for undergraduates and beginning graduate students taking a computational neuroscience course and also to anyone with an interest in the uses of the computer in modeling the nervous system.

  19. [Diagnosis of pancreatic injuries in closed combined trauma].

    Science.gov (United States)

    Panasenko, S I; Baramiia, N M; Dorosh, V M

    2003-08-01

    Problems of diagnosis of the closed pancreatic injury (CPI) in combined trauma are discussed. The CPI peculiarity in closed combined trauma is the absence of pathognomonic symptoms. Rational application of instrumental diagnostic methods permits to diagnose CPI in combined trauma.

  20. [Neurobiological inscriptions of psychological trauma during early childhood].

    Science.gov (United States)

    Giannopoulou, I

    2012-06-01

    Neurodevelopment is a highly complex process, influenced by a wide range of interacting genetic and environmental factors. Recent developments in fetal, neonatal and infant behavioural genetics and brain imaging methods have allowed for more detailed investigation of the effects of early adverse environment on the developing brain. This review aims to provide background for neurobiological understanding of how the prolonged exposure to stress or trauma during early childhood affects subsequent cognitive, emotional and social development. Initially, a brief overview of brain development is provided - focusing, in particular, on the limbic system structures, which are closely linked to emotional experiences and reactions, learning and memory. Emphasis is placed on the concept of neural plasticity, which is the biological base of memory and learning - the two most important mechanisms through which the environment affects the behavior. Moreover, the concept of sensitive periods, that is to say periods of "vulnerability" or "opportunity" during which particular experiences affect brain growth, functional organization and maturation, is discussed. Brief overview of the neuroendocrine stress response system and the long-term effects of prolonged exposure to stress hormones on early brain development clarify further why children are more vulnerable than adults to the effects of stress. The section dealing with the memory, which is closely linked to the limbic system, attempts to discuss how early exposure to chronic stress or psychological trauma, through neurobiological effects and the process of learning, can lead to dysfunctional behaviors, which in its extreme form can be mental disorders. The two types of memory are discussed: (a) the implicit (nondeclarative), which develops during the prelingual stage of child's development and refers to unconscious memories of previous experiences, and (b) the explicit (declarative) memory, which is closely linked to language