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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 ... to make progress in “immunogenomics” Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  2. Brain and Behavior Research Foundation.

    Science.gov (United States)

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

  3. Children's Brain Tumor Foundation

    Science.gov (United States)

    ... Become a monthly donor Volunteer Support LIMA Cares Sponsored by Jenna's Rainbow Foundation Jenna's Corner Online Community Username Password Not a member yet? Join Now Forgot password? CBTF Blog How do you all feel?? By: Tom | Sunday, ...

  4. Imaging brain plasticity after trauma

    OpenAIRE

    Kou, Zhifeng; Iraji, Armin

    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 demonstrated both structural reorganization as well as functional compensation by the recruitment of other brain regions. ...

  5. 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.

  6. Imaging brain plasticity after trauma

    Science.gov (United States)

    Kou, Zhifeng; Iraji, Armin

    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 demonstrated 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 field is still short of proper means on how to guide the choice of TBI rehabilitation or treatment plan to promote brain plasticity. The authors also point out the new direction of brain plasticity investigation. PMID:25206874

  7. Fetal trauma: brain imaging in four neonates

    International Nuclear Information System (INIS)

    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.)

  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. Erythropoietin Treatment in Traumatic Brain Injury: Operation Brain Trauma Therapy.

    Science.gov (United States)

    Bramlett, Helen M; Dietrich, W Dalton; Dixon, C Edward; Shear, Deborah A; Schmid, Kara E; Mondello, Stefania; Wang, Kevin K W; Hayes, Ronald L; Povlishock, John T; Tortella, Frank C; Kochanek, Patrick M

    2016-03-15

    Experimental studies targeting traumatic brain injury (TBI) have reported that erythropoietin (EPO) is an endogenous neuroprotectant in multiple models. In addition to its neuroprotective effects, it has also been shown to enhance reparative processes including angiogenesis and neurogenesis. Based on compelling pre-clinical data, EPO was tested by the Operation Brain Trauma Therapy (OBTT) consortium to evaluate therapeutic potential in multiple TBI models along with biomarker assessments. Based on the pre-clinical TBI literature, two doses of EPO (5000 and 10,000 IU/kg) were tested given at 15 min after moderate fluid percussion brain injury (FPI), controlled cortical impact (CCI), or penetrating ballistic-like brain injury (PBBI) with subsequent behavioral, histopathological, and biomarker outcome assessments. There was a significant benefit on beam walk with the 5000 IU dose in CCI, but no benefit on any other motor task across models in OBTT. Also, no benefit of EPO treatment across the three TBI models was noted using the Morris water maze to assess cognitive deficits. Lesion volume analysis showed no treatment effects after either FPI or CCI; however, with the 5000 IU/kg dose of EPO, a paradoxical increase in lesion volume and percent hemispheric tissue loss was seen after PBBI. Biomarker assessments included measurements of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) in blood at 4 or 24 h after injury. No treatment effects were seen on biomarker levels after FPI, whereas treatment at either dose exacerbated the increase in GFAP at 24 h in PBBI but attenuated 24-4 h delta UCH-L1 levels at high dose in CCI. Our data indicate a surprising lack of efficacy of EPO across three established TBI models in terms of behavioral, histopathological, and biomarker assessments. Although we cannot rule out the possibility that other doses or more prolonged treatment could show different effects, the lack of efficacy of EPO reduced

  12. 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.

  13. GLP-1 improves neuropathology after murine cold lesion brain trauma

    DEFF Research Database (Denmark)

    DellaValle, Brian; Hempel, Casper; Johansen, Flemming Fryd;

    2014-01-01

    cAMP response element binding protein (CREB) pathway in the brain in vivo, and whether activation leads to observable increases in protective, anti-neurodegenerative proteins. Finally, we report the first use of a highly sensitive in vivo imaging agent to assess reactive species generation after...... brain trauma. METHODS: Severe trauma was induced with a stereotactic cryo-lesion in mice and thereafter treated with vehicle, liraglutide, or liraglutide + GLP-1 receptor antagonist. A therapeutic window was established and lesion size post-trauma was determined. Reactive oxygen species were visualized...... the GLP-1 receptor. Reactive species generation was reduced by ∼40-60%. Necrotic and apoptotic tone maintained similar to sham in diseased animals with Lira treatment. Phosphorylation of CREB was markedly increased by Lira in a GLP-1 receptor-dependent manner. CREB-regulated cytoprotective and anti-neurodegenerative...

  14. 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…

  15. Sexual trauma and the female brain.

    Science.gov (United States)

    Shors, Tracey J; Millon, Emma M

    2016-04-01

    Sexual aggression and violence against women (VAM) are not only social problems; they are mental health problems. Women who experience sexual trauma often express disruptions in emotional and cognitive processes, some of which lead to depression and post-traumatic stress disorder (PTSD). Animal models of neurogenesis and learning suggest that social yet aggressive interactions between a pubescent female and an adult male can disrupt processes of learning related to maternal care, which in turn reduce survival of new neurons in the female hippocampus. Mental and Physical (MAP) Training is a novel clinical intervention that was translated from neurogenesis research. The intervention, which combines meditation and aerobic exercise, is currently being used to help women learn to recover from traumatic life experiences, especially those related to sexual violence and abuse. PMID:27085856

  16. Change in tissue thromboplastin content of brain following trauma

    Directory of Open Access Journals (Sweden)

    Pathak Ashis

    2005-01-01

    Full Text Available Background: Tissue thromboplastin (TTP is an integral membrane protein contributing to coagulopathy after trauma of brain, which is a rich source of TTP. Aims: A study was undertaken to establish the TTP content of various areas of normal brain and estimate the changes in TTP activity of brain in response to varying degrees of trauma. Materials and Methods: Samples from different areas of brain of ten cadavers were used as controls and they were compared with contused brain tissue obtained after surgery in 25 head injury (HI patients of varying severity. Results: In the study group, the TTP activity of the frontal, parietal, and temporal lobes after HI was significantly raised in contrast to that of the control group. The TTP activity was also significantly higher in the severe HI patients than those having moderate HI. The mode of injury and the time lapse after HI had no significant bearing on the TTP activity. Subjects above 40 years of age demonstrated a higher mean TTP activity after HI, though it was not statistically significant. Conclusion: The study provides quantitative data on TTP activity of normal brain and highlights the role of TTP in coagulopathy following HI through its increased activity after HI, more so in the severe HI group.

  17. 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.

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

    OpenAIRE

    Rafael Simas; Paulina Sannomiya; José Walber M. C Cruz; Cristiano de Jesus Correia; Fernando Luiz Zanoni; Maurício Kase; Laura Menegat; Isaac Azevedo Silva; Moreira, Luiz Felipe P.

    2012-01-01

    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 inflatio...

  19. 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.

  20. 99Tcm-Neurolite brain SPECT imaging as an outcome predictor after brain trauma: initial experience

    International Nuclear Information System (INIS)

    Full text: The aim of this study was to use semi-quantitative 99Tcm-ethylene cysteine dimer (Neurolite) cerebral blood flow (CBF) SPET brain imaging to assess its role in predicting outcome after brain trauma. Twelve adult patients (9 males, 3 females) who sustained moderate to severe brain trauma were studied by CBF/SPET within 4 weeks of the injury (scan A) and again after 1 year (scan B). Clinical assessment was also performed at these times and included extensive neuropsychometric testing. Patients received 800-850 MBq 99Tcm-Neurolite intravenously, and were imaged using a triple-headed gamma camera with LEUHR fan beam collimators. Processing, filtering, reconstruction and data set selection were identical for scans A and B. Semi-quantitative analysis was performed using 25 regions of interest in the cerebral cortex and deep structures in 2 coronal, 2 sagittal and 3 oblique planes. Normalized mean counts per pixel for the whole brain, and regional brain ratios were calculated. Scans A and B were compared and correlated to the clinical outcome data. Two patients with minimal CBF abnormalities made full recoveries. The remaining 10 had moderate to severe focal CBF defects, which showed no significant improvement at 12 months. Of these patients, 2 had moderate disability, 3 had severe to moderate disability and 2 had severe disability at 12 months. Patients with persisting focal abnormal CBF showed persisting neurological deficits. Neurolite brain CBF imaging is a useful method of predicting outcome after moderate to severe head injury

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

    OpenAIRE

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

    2013-01-01

    【Abstract】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 subarach-noid hemorrhage without pneumocephalus. On the seventh day after a big sneeze brain CT scan was re-performed, which showed pneumocephalus. After ano...

  2. 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.

  3. 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.

  4. 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

  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. Foundational model of neuroanatomy: implications for the Human Brain Project.

    OpenAIRE

    Martin, R F; Mejino, J. L.; Bowden, D. M.; Brinkley, J. F.; Rosse, C.

    2001-01-01

    In order to meet the need for a controlled terminology in neuroinformatics, we have integrated the extensive terminology of NeuroNames into the Foundational Model of anatomy. We illustrate the application of foundational principles for the establishment of an inheritance hierarchy, which accommodates anatomical attributes of neuroanatomical concepts and provides the foundation to which other information may be linked.

  7. Changes in the neurochemistry of athletes with repetitive brain trauma: preliminary results using localized correlated spectroscopy

    OpenAIRE

    Lin, Alexander P.; Ramadan, Saadallah; Stern, Robert A.; Box, Hayden C; Nowinski, Christopher J.; Ross, Brian D.; Mountford, Carolyn E.

    2015-01-01

    Introduction: The goal was to identify which neurochemicals differ in professional athletes with repetitive brain trauma (RBT) when compared to healthy controls using a relatively new technology, in vivo Localized COrrelated SpectroscopY (L-COSY). Methods: To achieve this, L-COSY was used to examine five former professional male athletes with 11 to 28 years of exposure to contact sports. Each athlete who had had multiple symptomatic concussions and repetitive sub concussive trauma during thei...

  8. Voluntary exercise may engage proteasome function to benefit the brain after trauma

    OpenAIRE

    Szabo, Zsofia; Ying, Zhe; Radak, Zsolt; Gomez-Pinilla, Fernando

    2009-01-01

    Brain trauma is associated with long-term decrements in synaptic plasticity and cognitive function, which likely reside on the acute effects of the injury on protein structure and function. Based on the action of proteasome on protein synthesis and degradation we have examined the effects of brain injury on proteasome level/activity and the potential of exercise to interact with the effects of the injury. Exercise has a healing ability but its action on proteasome function is not understood. ...

  9. 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…

  10. 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

  11. 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.

  12. 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. PMID:24166450

  13. Focal brain trauma in the cryogenic lesion model in mice

    Directory of Open Access Journals (Sweden)

    Raslan Furat

    2012-04-01

    Full Text Available Abstract The method to induce unilateral cryogenic lesions was first described in 1958 by Klatzo. We describe here an adaptation of this model that allows reliable measurement of lesion volume and vasogenic edema by 2, 3, 5-triphenyltetrazolium chloride-staining and Evans blue extravasation in mice. A copper or aluminium cylinder with a tip diameter of 2.5 mm is cooled with liquid nitrogen and placed on the exposed skull bone over the parietal cortex (coordinates from bregma: 1.5 mm posterior, 1.5 mm lateral. The tip diameter and the contact time between the tip and the parietal skull determine the extent of cryolesion. Due to an early damage of the blood brain barrier, the cryogenic cortical injury is characterized by vasogenic edema, marked brain swelling, and inflammation. The lesion grows during the first 24 hours, a process involving complex interactions between endothelial cells, immune cells, cerebral blood flow, and the intracranial pressure. These contribute substantially to the damage from the initial injury. The major advantage of the cryogenic lesion model is the circumscribed and highly reproducible lesion size and location.

  14. Behavioural training during acute brain trauma rehabilitation: an empirical case study.

    Science.gov (United States)

    Slifer, K J; Cataldo, M D; Kurtz, P F

    1995-01-01

    Operant conditioning-based behavioural interventions are commonly used for the behavioural problems of individuals with mental retardation. There is also growing evidence of the benefits of these interventions for treating some of the behavioural problems of individuals with acquired cognitive deficits resulting from brain trauma. However, the effects of behavioural interventions on behavioural problems occurring during acute neurorehabilitation, when orientation and memory are most impaired, have not been studied. In this empirical case study, operant conditioning-based procedures were applied with an 8-year-old girl recovering from brain trauma and related neurosurgery. Screaming, non-compliance and aggression, which were disrupting rehabilitation therapies and follow-up neuroimaging, were treated using differential positive reinforcement techniques. Beneficial behavioural intervention effects were demonstrated using single-subject experimental methods. Aberrant behaviour during physical and occupational therapies was reduced, and cooperation with a computerized tomography (CT) scan without sedation was accomplished using operant behavioural intervention. Results support the use of operant interventions early in recovery from brain trauma, and highlight the importance of interdisciplinary collaboration for the implementation and further study of early behavioural interventions.

  15. 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.

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

    International Nuclear Information System (INIS)

    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. (orig.)

  17. Two Routes to Losing One’s Past Life: A Brain Trauma, an Emotional Trauma

    Directory of Open Access Journals (Sweden)

    Julie Ouellet

    2008-01-01

    Full Text Available Organic and psychogenic retrograde amnesia have long been considered as distinct entities and as such, studied separately. However, patterns of neuropsychological impairments in organic and psychogenic amnesia can bear interesting resemblances despite different aetiologies. In this paper, two cases with profound, selective and permanent retrograde amnesia are presented, one of an apparent organic origin and the other with an apparent psychogenic cause. The first case, DD, lost his memory after focal brain injury from a nail gun to the right temporal lobe. The second case, AC, lost her memory in the context of intense psychological suffering. In both cases, pre-morbid autobiographical memory for people, places and events was lost, and no feeling of familiarity was experienced during relearning. In addition, they both lost some semantic knowledge acquired prior to the onset of the amnesia. This contrasts with the preservation of complex motor skills without any awareness of having learned them. Both DD and AC showed mild deficits on memory tests but neither presented any anterograde amnesia. The paradox of these cases–opposite causes yet similar clinical profile–exemplifies the hypothesis that organic and psychogenic amnesia may be two expressions of the same faulty mechanism in the neural circuitry.

  18. Diffuse pachymeningeal enhancement on brain MRI: spontaneous intracranial hypotension and head trauma

    International Nuclear Information System (INIS)

    We evaluated the MRI finding of pachymeningeal enhancement in patients with intracranial hypotension and head trauma with particular attention to differential findings and change in follow-up study, and in order to support the knowledge about the pathophysiology of dural enhancement. The findings of enhanced brain MRI of fifteen patients who showed diffuse pachymeningeal enhancement were retrospectively examined. Seven of fifteen patients were finally diagnosed as spontaneous intracranial hypotension (SIH). Eight of fifteen patients had a recent history of head trauma. We analyzed the shape, thickness, continuity and extent of dural enhancement, and the others concerned with positive MR findings. We also analyzed findings suggested displacement of brain parenchyma-displacement of the iter and cerebellar tonsil, and flattening of the anterior aspect of the pons-. Four of seven patients with SIH and four of eight patients with head trauma, underwent follow-up MRI. In the follow-up study, the presence of resolving pachymeningeal enhancement and symptom improvement was investigated. In all cases of SIH, the dura showed diffuse, even 3(1mm thick, global and contiguous enhancement along both cerebral convexities, both tentoria, and the falx. Displacement of the iter was noted in six cases and flattening of the anterior aspect of the pons in five. Displacement of the cerebellar tonsil was noted in one case. Five of seven cases showed small amount of subdural fluid collection. In all cases of head trauma, the dura was enhanced diffusely and asymmetrically, and showed no contiguity. Its distribution was consistent with the locations of traumatic lesions. Displacement of the iter was noted in one case. In four cases of SIH, clinical symptoms had improved, and three showed complete resolution of dural enhancement, in one patient continuously showed partial dural enhancement. Four cases of head trauma showed complete resolution of dural enhancement. Reversible diffuse

  19. Foundations

    Science.gov (United States)

    Harteveld, Casper

    A building will more likely collapse if it does not have any proper foundations. Similarly, the design philosophy of Triadic Game Design (TGD) needs to reside on solid building blocks, otherwise the concept will collapse as well. In this level I will elaborate on these building blocks. First I will explain what the general idea of TGD is. It is a design philosophy, for sure, but one which stresses that an “optimum” needs to be found in a design space constituted by three different worlds: Reality, Meaning, and Play. Additionally, these worlds need to be considered simultaneously and be treated equally. The latter requires balancing the worlds which may result in different tensions, within and between two or three of the worlds. I continue by discussing each of the worlds and showing their perspective on the field of games with a meaningful purpose. From this, we clearly see that it is feasible to think of each world and that the idea makes sense. I substantiate this further by relating the notion of player and similar approaches to this framework. This level is quite a tough pill to swallow yet essential for finishing the other levels. Do not cheat or simply skip this level, but just take a big cup of coffee or tea and start reading it.

  20. [Music and brain: neuroscientific foundations and musical disorders].

    Science.gov (United States)

    Soria-Urios, Gema; Duque, Pablo; García-Moreno, José M

    2011-01-01

    Music is present in every culture and, from the earliest ages, we all have the basic capacities needed to process it, although this processing takes place in different modules that involve different regions of the brain. Do these regions form paths that are specific to musical processing? As we shall see, the production and perception of music engage a large part of our cognitive capabilities, involving areas of the auditory cortex and the motor cortex. On the other hand, music produces emotional responses within us that involve other cortical and subcortical areas. Are they the same paths as the ones engaged in the processing of emotions in general? We review the existing literature on these questions, as well as the different musical neurological disorders that exist, which range from musicogenic epilepsy to amusia, together with the different possible means of treatment. PMID:21246493

  1. Goal-directed therapy in trauma induced coagulopathy and focus on traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Klaus Görlinger

    2013-08-01

    Full Text Available In recent years there have been major advances in the management of trauma-induced coagulopathy (TIC and many experiences have demonstrated how we can achieve significant improvements with multidisciplinary approach and implementation of standardized protocols and algorithms. Central nervous system injuries and exanguination remain the primary causes of early trauma-related mortality. Traumatic brain injuries (TBI make hemostasis in TIC even more complex and it is known that the onset of coagulopathy in a patient with severe brain injury has a negative impact on the patient’s outcome in terms of mortality. Standard coagulation tests provide limited information on coagulation disorder. The advantages of whole-blood viscoelastic tests, such as rotational thromboelastometry or thrombelastography, are shorter turn-around time and better diagnostic performance compared to routine plasmatic coagulation tests. In contrast to a fixed ratio of FFP:PC:RBC, the aim of the goal-directed coagulation therapy is to set treatment to the actual needs of the individual patient, based on viscoelastic test results. This article describes the improvements achieved through the implementation of ROTEM-guided treatment algorithms for visceral surgery and liver trasplantation, severe trauma and post-partum hemorrhage and cardiovascular surgery.http://dx.doi.org/10.7175/rhc.v4i3s.877

  2. Changes in platelet parameters and secondary brain injury in acute craniocerebral trauma

    Institute of Scientific and Technical Information of China (English)

    Xiaoping Tang; Zhangyang Gou; Junwei Duan; Shun Li; Chao You; Hua Peng; Tao Zhang; Wenguo Tang; Jian Qi; Renguo Luo; Yuanchuan Wang; Ling Feng

    2011-01-01

    Changes in platelet parameters are important in secondary brain injury in acute craniocerebral trauma. We selected 163 patients with craniocerebral trauma who were admitted within 24 hours with nonoperative therapy. Platelet parameters of 40 healthy subjects served as controls. Platelet number was decreased, while mean platelet volume and platelet distribution width values were increased, at 1 and 3 days after injury. Platelet number was lower and mean platelet volume and platelet distribution width were larger in patients with traumatic cerebral infarction and those in Glasgow Coma Scale score < 8 group. Platelet number was negatively correlated to volume of cerebral edema, but positively correlated to Glasgow Outcome Scale score. These data indicate that changes in platelet parameters may be utilized to indicate the state of central nervous system injury and patient prognosis.

  3. Supporting women with substance use issues: trauma-informed care as a foundation for practice in the NICU.

    Science.gov (United States)

    Marcellus, Lenora

    2014-01-01

    Infants with neonatal abstinence syndrome and their mothers require extended support through health and social service systems. Practitioners are interested in exploring innovative approaches to caring for infants and mothers. There is now compelling evidence linking women's substance use to experiences of trauma and violence. A significant shift in the fields of addiction and mental health has been awareness of the impact of trauma and violence on infants and children, women, their families, and communities. In this article, the current state of knowledge of trauma-informed care is reviewed, in particular for application to practice within the NICU. Trauma survivors are at risk of being retraumatized because of health care providers' limited understanding of how to work effectively with them. Recognizing the impact of trauma and implementing evidence-based trauma-informed practices in the NICU holds promise for improving outcomes for women and their infants. PMID:25391589

  4. A web ontology for brain trauma patient computer-assisted rehabilitation.

    Science.gov (United States)

    Zikos, Dimitrios; Galatas, George; Metsis, Vangelis; Makedon, Fillia

    2013-01-01

    In this paper we describe CABROnto, which is a web ontology for the semantic representation of the computer assisted brain trauma rehabilitation. This is a novel and emerging domain, since it employs the use of robotic devices, adaptation software and machine learning to facilitate interactive and adaptive rehabilitation care. We used Protégé 4.2 and Protégé-Owl schema editor. The primary goal of this ontology is to enable the reuse of the domain knowledge. CABROnto has nine main classes, more than 50 subclasses, existential and cardinality restrictions. The ontology can be found online at Bioportal.

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

    International Nuclear Information System (INIS)

    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

  6. 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

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

    OpenAIRE

    Jofizal Jannis

    2004-01-01

    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...

  8. 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.

  9. 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.)

  10. 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.

  11. Brain Activity in Response to Trauma-specific, Negative, and Neutral Stimuli. A fMRI Study of Recent Road Traffic Accident Survivors

    Science.gov (United States)

    Nilsen, Andre S.; Blix, Ines; Leknes, Siri; Ekeberg, Øivind; Skogstad, Laila; Endestad, Tor; Østberg, Bjørn C.; Heir, Trond

    2016-01-01

    Most studies of neuro-functional patterns in trauma-exposed individuals have been conducted considerable time after the traumatic event. Hence little is known about neuro-functional processing shortly after trauma-exposure. We investigated brain activity patterns in response to trauma reminders as well as neutral and negative stimuli in individuals who had recently (within 3 weeks) been involved in a road traffic accident (RTA). Twenty-three RTA survivors and 17 non-trauma-exposed healthy controls (HCs) underwent functional MRI while viewing Trauma-specific, Negative, and Neutral pictures. Data were analyzed from four a priori regions of interest, including bilateral amygdala, subcallosal cortex, and medial prefrontal cortex. In addition, we performed a whole brain analysis and functional connectivity analysis during stimulus presentation. For both groups, Negative stimuli elicited more activity in the amygdala bilaterally than did Neutral and Trauma-specific stimuli. The whole brain analysis revealed higher activation in sensory processing related areas (bilateral occipital and temporal cortices and thalamus) as well as frontal and superior parietal areas, for the RTA group compared to HC, for Trauma-specific stimuli contrasted with Neutral stimuli. We also observed higher functional connectivity for Trauma-specific stimuli, between bilateral amygdala and somatosensory areas, for the RTA group compared to controls, when contrasted with Neutral stimuli. We argue that these results might indicate an attentional sensory processing bias toward Trauma-specific stimuli for trauma exposed individuals, a result in line with findings from the post-traumatic stress disorder literature.

  12. 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.

  13. Role of brain CT scan in the diagnosis of patients with minor head injury in trauma emergency center

    Directory of Open Access Journals (Sweden)

    Ali Mousavi Jafarabad

    2014-07-01

    Full Text Available Currently, a large burden of hospital admissions is related to minor head trauma and its related imaging studies. One of the challenging issues for emergency physicians is brain computed tomography scan. Sensible use of computed tomography studies could minimize unnecessary radiation exposure and resource use. On the other hand, it can result in delayed or missed early treatment of intracranial injury. The aim of this review is to evaluate and summarize the costs and benefits of using diagnostic measurements in minor head trauma with particular focus on computed tomography scan and the advances and limitations of available guidelines. We studied different issues related to the current approach to minor head trauma in emergency departments. Altogether, it seems using brain computed tomography scan in the setting of emergency is a cost-effective method for the selected patients with minor head injury. However, concerning considerable costs of caring for patients with head injury and high sensitivity of brain computed tomography in terms of minor head injury, it seems reasonable to use brain computed tomography scan for a wider range of patients with minor head injury.

  14. 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

  15. 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.

  16. 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.

  17. Cannabinoids in Neurodegenerative Disorders and Stroke/Brain Trauma: From Preclinical Models to Clinical Applications.

    Science.gov (United States)

    Fernández-Ruiz, Javier; Moro, María A; Martínez-Orgado, José

    2015-10-01

    Cannabinoids form a singular family of plant-derived compounds (phytocannabinoids), endogenous signaling lipids (endocannabinoids), and synthetic derivatives with multiple biological effects and therapeutic applications in the central and peripheral nervous systems. One of these properties is the regulation of neuronal homeostasis and survival, which is the result of the combination of a myriad of effects addressed to preserve, rescue, repair, and/or replace neurons, and also glial cells against multiple insults that may potentially damage these cells. These effects are facilitated by the location of specific targets for the action of these compounds (e.g., cannabinoid type 1 and 2 receptors, endocannabinoid inactivating enzymes, and nonendocannabinoid targets) in key cellular substrates (e.g., neurons, glial cells, and neural progenitor cells). This potential is promising for acute and chronic neurodegenerative pathological conditions. In this review, we will collect all experimental evidence, mainly obtained at the preclinical level, supporting that different cannabinoid compounds may be neuroprotective in adult and neonatal ischemia, brain trauma, Alzheimer's disease, Parkinson's disease, Huntington's chorea, and amyotrophic lateral sclerosis. This increasing experimental evidence demands a prompt clinical validation of cannabinoid-based medicines for the treatment of all these disorders, which, at present, lack efficacious treatments for delaying/arresting disease progression, despite the fact that the few clinical trials conducted so far with these medicines have failed to demonstrate beneficial effects. PMID:26260390

  18. 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 pediatric 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 pediatric sports-related TBI, the severities of head and extracranial traumas are important

  19. 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

  20. Low central venous saturation predicts poor outcome in patients with brain injury after major trauma: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Chiostri Marco

    2009-05-01

    Full Text Available Abstract Background Continuous monitoring of central venous oxygen saturation (ScvO2 has been proposed as a prognostic indicator in several pathological conditions, including cardiac diseases, sepsis, trauma. To our knowledge, no studies have evaluated ScvO2 in polytraumatized patients with brain injury so far. Thus, the aim of the present study was to assess the prognostic role of ScvO2 monitoring during first 24 hours after trauma in this patients' population. Methods This prospective, non-controlled study, carried out between April 2006 and March 2008, was performed in a higher level Trauma Center in Florence (Italy. In the study period, 121 patients affected by major brain injury after major trauma were recruited. Inclusion criteria were: 1. Glasgow Coma Scale (GCS score ≤ 13; 2. an Injury Severity Score (ISS ≥ 15. Exclusion criteria included: 1. pregnancy; 2. age 2 monitoring within 2 hours from the trauma. Demographic and clinical data were collected, including Abbreviated Injury Scale (AIS, Injury Severity Score (ISS, Simplified Acute Physiologic Score II (SAPS II, Marshall score. The worst values of lactate and ScvO2 within the first 24 hours from trauma, ICU length of stay (LOS, and 28-day mortality were recorded. Results Patients who deceased within 28 days showed higher age (53 ± 16.6 vs 43.8 ± 19.6, P = 0.043, ISS core (39.3 ± 14 vs 30.3 ± 10.1, P 2 resulted significantly lower (66.7% ± 11.9 vs 70.1% ± 8.9 vs, respectively; P = 0.046. Patients with ScvO2 values ≤ 65% also showed higher 28-days mortality rate (31.3% vs 13.5%, P = 0.034, ICU LOS (28.5 ± 15.2 vs 16.6 ± 13.8, P 2 > 65%. Conclusion ScvO2 value less than 65%, measured in the first 24 hours after admission in patients with major trauma and head injury, was associated with higher mortality and prolonged hospitalization.

  1. 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......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 rehabilitation in the Eastern part of Denmark during a 5-year period from 2005 to 2009. Methods: Level of consciousness was assessed consecutively during rehabilitation and at 1 year post-trauma. Severity of traumatic brain injury was classified according to duration of post-traumatic amnesia. The cognitive...... was documented among patients with severe traumatic brain injury during the first year post-trauma. The results of the current study suggest that absence of consciousness at discharge from acute care should not preclude patients from being referred to specialized sub-acute rehabilitation....

  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. Vulnerability imposed by diet and brain trauma for anxiety-like phenotype: implications for post-traumatic stress disorders.

    Directory of Open Access Journals (Sweden)

    Ethika Tyagi

    Full Text Available Mild traumatic brain injury (mTBI, cerebral concussion is a risk factor for the development of psychiatric illness such as posttraumatic stress disorder (PTSD. We sought to evaluate how omega-3 fatty acids during brain maturation can influence challenges incurred during adulthood (transitioning to unhealthy diet and mTBI and predispose the brain to a PTSD-like pathobiology. Rats exposed to diets enriched or deficient in omega-3 fatty acids (n-3 during their brain maturation period, were transitioned to a western diet (WD when becoming adult and then subjected to mTBI. TBI resulted in an increase in anxiety-like behavior and its molecular counterpart NPY1R, a hallmark of PTSD, but these effects were more pronounced in the animals exposed to n-3 deficient diet and switched to WD. The n-3 deficiency followed by WD disrupted BDNF signaling and the activation of elements of BDNF signaling pathway (TrkB, CaMKII, Akt and CREB in frontal cortex. TBI worsened these effects and more prominently in combination with the n-3 deficiency condition. Moreover, the n-3 deficiency primed the immune system to the challenges imposed by the WD and brain trauma as evidenced by results showing that the WD or mTBI affected brain IL1β levels and peripheral Th17 and Treg subsets only in animals previously conditioned to the n-3 deficient diet. These results provide novel evidence for the capacity of maladaptive dietary habits to lower the threshold for neurological disorders in response to challenges.

  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. Does distracting pain justify performing brain computed tomography in multiple traumas with mild head injury?

    Science.gov (United States)

    Sadeghian, Homa; Motiei-Langroudi, Rouzbeh

    2016-06-01

    Traumatic brain injury (TBI) is a significant health concern classified as mild, moderate, and severe. Although the indications to perform brain computed tomography (CT) are clear in moderate and severe cases, there still exists controversy in mild TBI (mTBI). We designed the study to evaluate the significance of distracting pain in patients with mTBI. The study population included patients with mild traumatic brain injury (GCS ≥13). Moderate and high risk factors including age cerebral edema in brain CT (p > 0.99). No patients had any neurologic symptoms or signs in follow-up. Our results show that in the absence of any other risk factors, distracting pain from other organs (limbs, pelvis, and non-cervical spine) cannot be regarded as a brain CT indication in patients with mild TBI, as it is never associated with significant intracranial lesions. PMID:26931118

  8. 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 dire...

  9. Combined age- and trauma-related proteomic changes in rat neocortex: a basis for brain vulnerability

    OpenAIRE

    Mehan, Neal D.; Strauss, Kenneth I

    2011-01-01

    This proteomic study investigates the widely observed clinical phenomenon, that after comparable brain injuries, geriatric patients fare worse and recover less cognitive and neurologic function than younger victims. Utilizing a rat traumatic brain injury model, sham surgery or a neocortical contusion was induced in 3 age groups. Geriatric (21 months) rats performed worse on behavioral measures than young adults (12–16 weeks) and juveniles (5– 6 weeks). Motor coordination and certain cognitive...

  10. Disrupted topological organization in the whole-brain functional network of trauma-exposed firefighters: A preliminary study.

    Science.gov (United States)

    Jung, Wi Hoon; Chang, Ki Jung; Kim, Nam Hee

    2016-04-30

    Given that partial posttraumatic stress disorder (pPTSD) may be a specific risk factor for the development of posttraumatic stress disorder (PTSD), it is important to understand the neurobiology of pPTSD. However, there are few extant studies in this domain. Using resting-state functional magnetic resonance imaging (rs-fMRI) and a graph theoretical approach, we compared the topological organization of the whole-brain functional network in trauma-exposed firefighters with pPTSD (pPTSD group, n=9) with those without pPTSD (PC group, n=8) and non-traumatized healthy controls (HC group, n=11). We also examined changes in the network topology of five individuals with pPTSD before and after eye movement desensitization and reprocessing (EMDR) therapy. Individuals with pPTSD exhibited altered global properties, including a reduction in values of a normalized clustering coefficient, normalized local efficiency, and small-worldness. We also observed altered local properties, particularly in the association cortex, including the temporal and parietal cortices, across groups. These disruptive global and local network properties presented in pPTSD before treatment were ameliorated after treatment. Our preliminary results suggest that subthreshold manifestation of PTSD may be due to a disruption in the optimal balance in the functional brain networks and that this disruption can be ameliorated by psychotherapy. PMID:27107156

  11. 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.

  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. Roller coasters, g forces, and brain trauma: on the wrong track?

    Science.gov (United States)

    Smith, Douglas H; Meaney, David F

    2002-10-01

    There has been enormous attention in the general press on the possibility that high G force roller coasters are inducing brain injury in riders. Armed with a handful of anecdotal case reports of brain injuries, the U.S. Congress has recently proposed legislation to regulate the level of G forces of roller coasters. However, high G forces are well tolerated during many activities and, therefore, are a poor measure for the risk of brain injury. Rather, accelerations of the head that can be caused by G forces are the key to producing injury. To determine the extent of head accelerations during roller coaster rides, we acquired G force data from three popular high G roller coasters. We used the highest recorded G forces in a simple mathematical model of head rotational acceleration, with the head rigidly pivoting from the base of the skull at a radius representing typical men and women. With this model, we calculated peak head rotational accelerations in three directions. Even for a conservative worst-case scenario, we found that the highest estimated peak head accelerations induced by roller coasters were far below conventional levels that are predicted for head injuries. Accordingly, our findings do not support the contention that current roller coaster rides produce high enough forces to mechanically deform and injure the brain. PMID:12427321

  14. 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

  15. 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.

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

    OpenAIRE

    R, Namas; A, Ghuma; L, Hermus; R, Zamora; DO Okonkwo; TR, Billiar; Y, Vodovotz

    2009-01-01

    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 inherently detrimental, but rather required for immune surveillance, optimal post-injury tissue repair, and rege...

  17. Trauma Kimia

    OpenAIRE

    Lubis, Rodiah Rahmawaty

    2015-01-01

    Mata merupakan organ yang keberadaannya berhubungan langsung dengan lingkungan luar sehingga sering menyebabkan mata terkena dampak dari posisi anatominya tersebut. Mata sering terpapar dengan keadaan lingkungan sekitar seperti udara, debu, benda asing dan suatu trauma yang dapat langsung mengenai mata. Trauma pada mata meliputi trauma tumpul, trauma tajam, trauma kimia, dan trauma radiasi. Rodiah Rahmawaty Lubis

  18. 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.

  19. 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.

  20. Sexual Conspecific Aggressive Response (SCAR): A Model of Sexual Trauma that Disrupts Maternal Learning and Plasticity in the Female Brain.

    Science.gov (United States)

    Shors, Tracey J; Tobόn, Krishna; DiFeo, Gina; Durham, Demetrius M; Chang, Han Yan M

    2016-01-01

    Sexual aggression can disrupt processes related to learning as females emerge from puberty into young adulthood. To model these experiences in laboratory studies, we developed SCAR, which stands for Sexual Conspecific Aggressive Response. During puberty, a rodent female is paired daily for 30-min with a sexually-experienced adult male. During the SCAR experience, the male tracks the anogenital region of the female as she escapes from pins. Concentrations of the stress hormone corticosterone were significantly elevated during and after the experience. Moreover, females that were exposed to the adult male throughout puberty did not perform well during training with an associative learning task nor did they learn well to express maternal behaviors during maternal sensitization. Most females that were exposed to the adult male did not learn to care for offspring over the course of 17 days. Finally, females that did not express maternal behaviors retained fewer newly-generated cells in their hippocampus whereas those that did express maternal behaviors retained more cells, most of which would differentiate into neurons within weeks. Together these data support SCAR as a useful laboratory model for studying the potential consequences of sexual aggression and trauma for the female brain during puberty and young adulthood. PMID:26804826

  1. An Unusual Case of Asystole following Penetrating Neck Trauma and Anoxic Brain Injury

    Directory of Open Access Journals (Sweden)

    Matthew Nayor

    2011-01-01

    Full Text Available Bradycardia and transient asystole are well-described sequelae of a myriad of neurologic insults, ranging from focal to generalized injuries. Increased vagal tone also predisposes many individuals, particularly adolescents, to transient neurally mediated bradyarrhythmia. However, prolonged periods of sinus arrest without junctional or ventricular escape are quite rare, even after significant neurologic injury. We describe the case of a 17-year-old man who presented with anoxic brain injury secondary to hemorrhagic shock from a stab wound to the neck. His recovery was complicated by prolonged periods of sinus arrest and asystole, lasting over 60 seconds per episode. This case illustrates that sustained asystolic episodes may occur following significant neurologic injury, and may continue to recur even months after an initial insult. Pacemaker implantation for such patients should be strongly considered.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. Concomitant upregulation of nuclear factor-kB activity, proinflammatory cytokines and ICAM-1 in the injured brain after cortical contusion trauma in a rat model

    Directory of Open Access Journals (Sweden)

    Hang Chun

    2005-01-01

    Full Text Available Background: Nuclear factor kappa B (NF-kB, proinflammatory cytokines and intercellular adhesion molecule 1 (ICAM-1 are frequently upregulated in the injured brain after traumatic brain injury (TBI. However, the temporal pattern of upregulation is not well defined. Aims: The current study was undertaken to investigate the temporal profile of the expression of NF-kB, proinflammatory cytokines and ICAM-1 in the injured brain after cortical contusion trauma of the rat brain. Settings and Design: A rat model of cortical contusion was produced by a free-falling weight on the exposed dura of right parietal lobe. The rats were randomly divided into control group and TBI groups at hours 3, 12, 24 and 72, and on day 7. Material and Methods: NF-kB binding activity in the surrounding brain of injured area was studied by electrophoretic mobility shift assay (EMSA. The levels of TNF-a and IL-6 were detected using ELISA and ICAM-1 expression studied by immunohistochemistry. Statistical analysis: The data were analyzed by one-way ANOVA followed by Student-Newman-Keuls post hoc test. Relation between variables was analyzed using bivariate correlation with two-tailed test. Results: Compared with that of control group, NF-kB binding activity in the injured brain was significantly increased through 12 h and 7 days postinjury, with the maximum at 72 h. The concentrations of TNF-a and IL-6 in the injured brain were significantly increased from 3 h to 7 days and maximal at 24 h postinjury. The number of ICAM-1 immunostained microvessels was significantly increased in the injured brain from 24 h to 7 days postinjury, with its peak at 72 h. Concomitant upregulation of TNF-a, IL-6, ICAM-1 and the cytokine mediators NF-kB in the injured brain was observed in the injured brain after cortical contusion, and there was a highly positive relation among these variables. Conclusions: Cortical contusion trauma could induce a concomitant and persistent upregulation of NF

  10. 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...

  11. Brain Aneurysm Foundation

    Science.gov (United States)

    ... … Continue Reading Read All News Latest Research NEWTON 2 Study Details October 7, 2016 05/29/ ... Oral Nimodipine in Adults With Aneurysmal Subarachnoid Hemorrhage (NEWTON 2) Details: Edge Therapeutics is recruiting patients ...

  12. 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

  13. Facial trauma

    Science.gov (United States)

    Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries ... Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: ...

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

    International Nuclear Information System (INIS)

    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.)

  15. 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.)

  16. 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.

  17. 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. PMID:24617751

  18. Substance Abuse and Trauma.

    Science.gov (United States)

    Simmons, Shannon; Suárez, Liza

    2016-10-01

    There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD. PMID:27613348

  19. 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.)

  20. Collaborative European Neuro Trauma Effectiveness Research in traumatic brain injury (CENTER-TBI): a prospective longitudinal observational study

    NARCIS (Netherlands)

    van der Naalt, Joukje

    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: T

  1. Geriatric Trauma.

    Science.gov (United States)

    Reske-Nielsen, Casper; Medzon, Ron

    2016-08-01

    Within the next 15 years, 1 in 5 Americans will be over age 65. $34 billion will be spent yearly on trauma care of this age group. This section covers situations in trauma unique to the geriatric population, who are often under-triaged and have significant injuries underestimated. Topics covered include age-related pathophysiological changes, underlying existing medical conditions and certain daily medications that increase the risk of serious injury in elderly trauma patients. Diagnostic evaluation of this group requires liberal testing, imaging, and a multidisciplinary team approach. Topics germane to geriatric trauma including hypothermia, elder abuse, and depression and suicide are also covered. PMID:27475011

  2. 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…

  3. 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..

  4. 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

    the number of apoptotic cells. Metallothioneins (MTs) are important zinc- and copper-binding proteins in the CNS, which could influence significantly the brain response to TBI because of their putative roles in metal homeostasis and antioxidant defenses. MT-I+II expression was dramatically increased by TBI...

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

    NARCIS (Netherlands)

    Namas, R.; Ghuma, A.; Hermus, L.; Zamora, R.; Okonkwo, D. O.; Billiar, T. R.; Vodovotz, Y.

    2009-01-01

    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

  6. Distributions of ethanol and intubation-related lidocaine in the brain of a trauma patient who was brain dead for about 5 days.

    Science.gov (United States)

    Moriya, Fumio; Hashimoto, Yoshiaki; Nakanishi, Akinori

    2003-03-01

    A 48-year-old intoxicated man was admitted to a hospital with an acute subarachnoid hemorrhage from a blow to the head following a drinking session. Lidocaine jelly was used to facilitate intubation during cardiopulmonary resuscitation. While his heart resumed beating, he was classified as brain dead and his heart stopped 114 h after admission. His brain was soft and weighed 1.7 kg at autopsy. A small rupture (0.5 by 0.3 cm) of the left vertebral artery and diffuse subarachnoid hemorrhage were observed. Ethanol was detected only in the cerebrum, cerebellum and clotted blood in the superior sagittal sinus at 0.29, 0.15 and 0.12 mg/g, respectively. Lidocaine was also found in these areas at levels of 28, 24 and 7 ng/g, respectively. Significant amounts of ethanol were present in his brain because blood flow stopped after the injury. Smaller amounts of intubation-related lidocaine were probably distributed to the brain by limited cerebral circulation and remained there after circulation ceased. Toxicological analysis of the brain after death was useful for evaluating his state during treatment. PMID:12935567

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. The many levels of causal brain network discovery. Comment on "Foundational perspectives on causality in large-scale brain networks" by M. Mannino and S.L. Bressler

    Science.gov (United States)

    Valdes-Sosa, Pedro A.

    2015-12-01

    Unraveling the dynamically changing networks of the brain is probably the single most important current task for the neurosciences. I wish to commend the authors on this refreshing and provocative paper [1], which not only recapitulates some of the longstanding philosophical difficulties involved in the analysis of causality in the sciences, but also summarizes current work on statistical methods for determining causal networks in the brain. I fully concur with several of the opinions defended by the authors: The most fruitful level of analysis for systems neuroscience is that of neural masses, each comprising thousands of neurons. This is what is known as the mesoscopic scale.

  13. 早期气管切开对重型脑外伤的影响%Effects of early tracheostomy on patients with acute severe brain trauma

    Institute of Scientific and Technical Information of China (English)

    张庚; 胡马洪; 陈扬波; 金心; 王定坤

    2012-01-01

    Objective To evaluate the effects of early and late tracbeostomy on patients with acute severe cerebral trauma.Methods In the retrospective study,167 patients with severe brain trauma ( GCS < 9 ) requiring prolonged mechanical ventilation ( MV ) were managed by percutaneous dilational tracheostomy (PDT) from May 2001 to December 2010.According to the transoral incubation MV duration,the patients were divided into the early tracheostomy (ET) group ( MV duration≤7 d,81 cases)and late tracheostomy (LT) group (MV duration > 7 d,86 cases).The basic clinical characteristics,pre-and post-PDT MV period,total MV duration,length of post-PDT ICU stay,length of ICU stay,length of hospital stay and mortality were compared between the two groups.Results The two groups showed no statistical differences in aspects of age,sex,acute physiology and chronic health evaluation Ⅱ (A-PACHE Ⅱ ) score,GCS,trauma index and craniotomy rate (P>0.05).Compared with LT group,ET group significantly shortened the pre-PDT MV period [ (5.16 ± 1.33 ) d∶ ( 1 1.64 ± 4.25 ) d,P < 0.01 ],post-PDT MV period ( median:15.0 d∶ 17.0 d,P < 0.05 ),total MV duration ( median:18.0 d∶26.0 d,P<0.05),length of post-PDT ICU stay (median:16.0 d∶21.0 d,P<0.01 ) and length of ICU stay (median:21.0 d∶32.0 d,P <0.01 ).But the two groups had no statistical differences concerning the length of hospital stay ( P > 0.05 ),ICU mortality ( 17% ∶ 14%,P > 0.05 ) and in-hospital mortality (25%∶28.4%,P >0.05).Kaplan-Meier curves showed that the frequency of MV and ICU stay rate within 60 days in ET group were significantly lower than those in LT group.Conclusions For patients with severe brain trauma,early tracheostomy shortens the duration of MV and length of ICU stay without affecting their prognosis.Thereby,tracheostomy can be performed at early stage when managing acute severe brain injury.%目的 评价早期气管切开(early tracheostomy

  14. Abdominal trauma

    International Nuclear Information System (INIS)

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  15. Hemostasis and thrombosis in trauma patients.

    Science.gov (United States)

    Gando, Satoshi

    2015-02-01

    Hemostasis and thrombosis in trauma patients consist of physiological hemostasis for wound healing and the pathological reaction of disseminated intravascular coagulation (DIC). Whole body trauma, isolated brain injury, and fat embolism syndrome, if extremely severe, can cause DIC and affect a patient's prognosis. Shock-induced hyperfibrinolysis causes DIC with the fibrinolytic phenotype, contributing to oozing-type severe bleeding. If uncontrolled, this phenotype progresses to thrombotic phenotype at the late stage of trauma, followed by microvascular thrombosis, leading to organ dysfunction. Another type of pathological hemostatic change is acute coagulopathy of trauma shock (ACOTS), which gives rise to activated protein C-mediated systemic hypocoagulation, resulting in bleeding. ACOTS occurs only in trauma associated with shock-induced hypoperfusion and there is nothing to suggest DIC in this phenomenon. This review will provide information about the recent advances in hemostasis and thrombosis in trauma and will clarify the pathogeneses of the pathological processes observed in trauma patients. PMID:25602698

  16. Increased Risk of Post-Trauma Stroke after Traumatic Brain Injury-Induced Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Chen, Gunng-Shinng; Liao, Kuo-Hsing; Bien, Mauo-Ying; Peng, Giia-Sheun; Wang, Jia-Yi

    2016-07-01

    This study determines whether acute respiratory distress syndrome (ARDS) is an independent risk factor for an increased risk of post-traumatic brain injury (TBI) stroke during 3-month, 1-year, and 5-year follow-ups, respectively, after adjusting for other covariates. Clinical data for the analysis were from the National Health Insurance Database 2000, which covered a total of 2121 TBI patients and 101 patients with a diagnosis of TBI complicated with ARDS (TBI-ARDS) hospitalized between January 1, 2001 and December 31, 2005. Each patient was tracked for 5 years to record stroke occurrences after discharge from the hospital. The prognostic value of TBI-ARDS was evaluated using a multivariate Cox proportional hazard model. The main outcome found that stroke occurred in nearly 40% of patients with TBI-ARDS, and the hazard ratio for post-TBI stroke increased fourfold during the 5-year follow-up period after adjusting for other covariates. The increased risk of hemorrhagic stroke in the ARDS group was considerably higher than in the TBI-only cohort. This is the first study to report that post-traumatic ARDS yielded an approximate fourfold increased risk of stroke in TBI-only patients. We suggest intensive and appropriate medical management and intensive follow-up of TBI-ARDS patients during the beginning of the hospital discharge. PMID:26426583

  17. 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...

  18. 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.

  19. 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

  20. Imaging in spinal trauma

    International Nuclear Information System (INIS)

    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

  1. Brain

    Science.gov (United States)

    ... will return after updating. Resources Archived Modules Updates Brain Cerebrum The cerebrum is the part of the ... the outside of the brain and spinal cord. Brain Stem The brain stem is the part of ...

  2. Shock trauma.

    Science.gov (United States)

    Trunkey, D D

    1984-09-01

    Trauma - accidental or intentional injury - is a major health and social problem. It is still the chief cause of death in people between the ages of 1 and 38 years. In the United States, the mortality due to trauma between the ages of 15 and 24 years increased by 13% from 1960 to 1978. During the same period, the mortality for people aged 25 to 64 years declined by 16%. Murders have increased from 8464 in 1960, to 26 000 in 1982. The overall death rate of American teenagers and young adults is 50% higher than that of their counterparts in Britain, Sweden and Japan. Trauma affects young, productive citizens, and the estimated costs for death, disability and loss of productivity exceed $230 million a day. The most tragic statistic is that at least 40% of the deaths are needless and preventable if better treatment and prevention programs were available. Trauma deaths that might be prevented are those due to motor vehicle accidents, homicide, burns, and alcohol and drug abuse. In this paper suggestions for prevention are made. They include improved crash worthiness of motor vehicles, revocation of drunk drivers' licences, use of devices that limit drunk drivers, increased tax on alcohol and random breathalyser tests, and the use of seat belts and motorcycle helmets. Control of hand-guns and burn characteristics of cigarettes could also reduce deaths. The problems and issues in trauma care can be divided into two broad categories: system and professional. System problems include prehospital care, in-hospital care, rehabilitation and prevention. Professional problems include education, research, economics, and quality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6478325

  3. Ventilatory strategies in trauma patients.

    Science.gov (United States)

    Arora, Shubhangi; Singh, Preet Mohinder; Trikha, Anjan

    2014-01-01

    Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS) secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented. PMID:24550626

  4. Ventilatory strategies in trauma patients

    Directory of Open Access Journals (Sweden)

    Shubhangi Arora

    2014-01-01

    Full Text Available Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented.

  5. Ventilatory strategies in trauma patients

    OpenAIRE

    Shubhangi Arora; Preet Mohinder Singh; Anjan Trikha

    2014-01-01

    Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS) secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tis...

  6. 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,…

  7. 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.

  8. 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

  9. 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...... of monopod bucket foundations supporting offshore wind turbines....

  10. 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

  11. Corporate Foundations

    DEFF Research Database (Denmark)

    Herlin, Heidi; Thusgaard Pedersen, Janni

    2013-01-01

    responsibility (CSR). The paper hence illuminates the fascinating and overlooked role of corporate foundations as potential bridges between business and civil society. It also informs theory on boundary organizations by clarifying challenges and limits of such institutions.......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...

  12. 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...

  13. Glaucoma Foundation

    Science.gov (United States)

    ... Honors Presented at 2016 Think Tank Dinner The Glaucoma Foundation (TGF) has awarded Ursula Schlötzer-Schrehardt, PhD, ... Robert Ritch Award for Excellence and Innovation in Glaucoma for her distinguished career in glaucoma research. This ...

  14. Dysautonomia Foundation

    Science.gov (United States)

    ... disease most people have never heard of ... Familial Dysautonomia (FD) is a rare genetic neurological disorder that ... birth. (More about FD .) Research funded by the Dysautonomia Foundation has led to a number of breakthroughs ...

  15. 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.

  16. 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

  17. 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?"......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?"...

  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. Management of Temporal Bone Trauma

    OpenAIRE

    Patel, Alpen; Groppo, Eli

    2010-01-01

    The temporal bones are paired structures located on the lateral aspects of the skull and contribute to the skull base. Trauma is usually the result of blunt head injury and can result in damage to the brain and meninges, the middle and internal ear, and the facial nerve. Complications can include intracranial hemorrhage, cerebral contusion, CSF leak and meningitis, hearing loss, vertigo, and facial paralysis. To prevent these complications, diagnosis followed by appropriate medical and surgic...

  1. Neuroimaging differential diagnoses to abusive head trauma

    International Nuclear Information System (INIS)

    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.)

  2. 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.)

  3. 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.

  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. Clinical characteristics and risk factors of prognosis in children with brain trauma in PICU%PICU儿童颅脑外伤的临床特点及预后相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    郭张妍; 裴亮; 刘春峰

    2015-01-01

    目的 探讨儿童颅脑外伤的临床特点及预后相关的危险因素.方法 对2009年1月至2014年12月中国医科大学附属盛京医院PICU收治的符合颅脑外伤患儿的临床资料进行回顾性分析,采用单因素和多因素Logistic回归分析方法,分析入院时Glasgow昏迷评分(GCS)评分,入院24h内的血糖、血乳酸、PT、INR、血钠、血钾、脉搏以及入院时间、年龄、性别、是否手术治疗,发生呼吸衰竭、休克及脑疝等因素与患儿生存预后的关系.结果 125例患儿中,存活84例,死亡41例,病死率为32.8%.相关危险因素单因素分析结果显示,入院时GCS评分、血糖、血乳酸、INR、呼吸衰竭、休克对儿童颅脑外伤预后有显著影响(P<0.05).多因素Logistic回归分析显示GCS评分、血糖、血乳酸、呼吸衰竭是影响儿童颅脑外伤预后的独立危险因素(OR分别为7.434、0.473、0.615、0.000,P<0.05).结论 儿童颅脑外伤具有病情凶险、预后差、致残致死率高的临床特点,入院时GCS评分,入院24h内的血糖、血乳酸水平及发生呼吸衰竭是影响儿童颅脑外伤预后的独立危险因素.%Objective To analyze the clinical characteristics and risk factors of prognosis in children with brain trauma.Methods We retrospectively analyzed the clinical data of 125 cases diagnosed as brain trauma in PICU of Shengjing Hospital affiliated to China Medical University from January 2009 to December 2014.The risk factors influencing prognosis were analyzed by using single factor analysis and multiple factors Logistic regression methods.The risk factors included Glasgow coma score (GCS) on admission,blood glucose,lactic acid,prothrombin time,international normalized ratio (INR),serum sodium,serum potassiumin,pulse within 24 hours after admission,gender,age,time for therapy,shock,respiratory failure,cerebral hermia and surgery.Results Eighty-four cases survived and 41 cases died.The fatality rate was 32.8

  6. Relationship between trauma narratives and trauma pathology.

    Science.gov (United States)

    Amir, N; Stafford, J; Freshman, M S; Foa, E B

    1998-04-01

    In this study we examined the relationship between posttrauma pathology and the level of articulation (complexity) in rape narratives recounted by victims shortly after the assault. Degree of articulation was operationalized as the reading level of the narrative as determined by a computer program. Shortly after the trauma, reading level was correlated with severity of anxiety but not with posttraumatic stress disorder (PTSD) symptoms. Degree of the narrative articulation shortly after the trauma, however, was related to severity of later PTSD. These results are consistent with the hypothesis that the less developed trauma narratives hinder recovery from trauma. PMID:9565923

  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. Contemporary management of blunt aortic trauma.

    Science.gov (United States)

    Dubose, J J; Azizzadeh, A; Estrera, A L; Safi, H J

    2015-10-01

    Blunt thoracic aortic injury (BTAI) remains a common cause of death following blunt mechanisms of trauma. Among patients who survive to reach hospital care, significant advances in diagnosis and treatment afford previously unattainable survival. The Society for Vascular Surgery (SVS) guidelines provide current best-evidence suggestions for treatment of BTAI. However, several key areas of controversy regarding optimal BTAI care remain. These include the refinement of selection criteria, timing for treatment and the need for long-term follow-up data. In addition, the advent of the Aortic Trauma Foundation (ATF) represents an important development in collaborative research in this field. PMID:25868973

  9. Head Trauma, First Aid

    Science.gov (United States)

    ... rashes clinical tools newsletter | contact Share | Head Trauma, First Aid A A A Head trauma signs and symptoms ... to take care for potential neck/spinal injury. First Aid Guide If you suspect either a serious head ...

  10. Common Reactions After Trauma

    Science.gov (United States)

    ... here Enter ZIP code here Common Reactions After Trauma Public This section is for Veterans, General Public, Family, & Friends Common Reactions After Trauma Available in Spanish: Reacciones Comunes Después de un ...

  11. 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,…

  12. MANAGEMENT OF LIVER TRAUMA

    OpenAIRE

    Dova Subba; Mallapraggada Rama Chandra; Erabatti

    2016-01-01

    AIM To estimate the incidence of Liver Trauma injuries and grade their severity of injury. To assess the factors responsible for morbidity and mortality after Liver Trauma. To study the postoperative complications and the management of Liver Trauma. MATERIALS AND METHODS The present prospective study was conducted on 100 patients who were admitted to Department of General Surgery for treatment who were managed operatively or non-operatively for abdominal trauma and h...

  13. Analysis of projects received and funded in fields of emergency and intensive care medicine/trauma/burns/plastic surgery from National Natural Science Foundation of China during 2010-2013%2010年至2013年国家自然科学基金对急重症医学/创伤/烧伤/整形领域项目资助情况分析

    Institute of Scientific and Technical Information of China (English)

    熊鲲; 王琳琳; 陈旭林; 曹永倩; 向川; 薛丽香; 闫章才

    2014-01-01

    资助量呈明显递增趋势,4年平均资助率为20.9%;自噬相关项目在2011年实现“零”的突破,2011年至2013年总资助率为32.6%.结论 国家自然科学基金对急重症医学/创伤/烧伤/整形相关领域的资助项目数和经费在快速提高.基金项目的申请应重视科学问题的凝练和提升,提高基金申请课题的质量;注重研究内容的深入性和系统性以及交叉学科(如免疫学)研究.脓毒症、创伤、烧伤仍将会是急重症医学/创伤/烧伤/整形领域研究和资助的主流方向;创面愈合与瘢痕、体表组织器官畸形、损伤与修复再生、体表组织器官移植与再造、颅颌面畸形与矫正等领域的研究是将来发展的重要方向.%Objective To summarized the projects received and funded in the fields of emergency and intensive care medicine/trauma/burns/plastic surgery from National Natural Science Foundation of China (NSFC) during 2010-2013,put forward the thinking and perspective of this future trend in these fields.Methods The number of the funded project and total funding in the fields of emergency and intensive care medicine/trauma/burns/plastic surgery from NSFC during 2010-2013 had been statistical analyzed,in the meantime,the overview situation of various branches in basic research and further preliminary analysis the research frontier and hot issues have been analyzed.Results ① The number of funded project were 581 in H 15 of NSFC during 2010-2013,total funding reached to 277.13 million RMB,including 117 projects in H 1511 (emergency and intensive care medicine/trauma/burns/plastic surgery and other science issue),96 projects in H1507 (wound healing and scar),88 projects in H1502 (multi-organ failure),71 projects in H 1505 (burn),61 projects in H 1504 (trauma) ② The top 10 working unit for project funding in the field of Emergency and intensive care medicine/trauma/burns/plastic surgery present as Third Military Medical University (70

  14. Helping Youth Overcome Trauma

    Science.gov (United States)

    Chambers, Jamie C.

    2005-01-01

    The effects of trauma can roll on unchecked like a spirit of death. In its path are strewn its once vibrant victims. Human bonds are rent asunder by the disgrace of trauma. These are the youngsters who have been verbally bashed, physically battered, sexually assaulted, and spiritually exploited. Other traumas of childhood neglect include: (1)…

  15. 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.

  16. Reduction of Cerebral Edema after Traumatic Brain Injury Using an Osmotic Transport Device

    OpenAIRE

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

    2014-01-01

    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 transpo...

  17. Stochastic causality, criticality, and non-locality in brain networks. Comment on "Foundational perspectives on causality in large-scale brain networks" by M. Mannino and S.L. Bressler

    Science.gov (United States)

    Kozma, Robert; Hu, Sanqing

    2015-12-01

    For millennia, causality served as a powerful guiding principle to our understanding of natural processes, including the functioning of our body, mind, and brain. The target paper presents an impressive vista of the field of causality in brain networks, starting from philosophical issues, expanding on neuroscience effects, and addressing broad engineering and societal aspects as well. The authors conclude that the concept of stochastic causality is more suited to characterize the experimentally observed complex dynamical processes in large-scale brain networks, rather than the more traditional view of deterministic causality. We strongly support this conclusion and provide two additional examples that may enhance and complement this review: (i) a generalization of the Wiener-Granger Causality (WGC) to fit better the complexity of brain networks; (ii) employment of criticality as a key concept highly relevant to interpreting causality and non-locality in large-scale brain networks.

  18. 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.

  19. 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

  20. 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.

  1. Head trauma in female professional wrestlers

    International Nuclear Information System (INIS)

    The clinical characteristics of head trauma were evaluated in 18 wrestlers belonging to a female professional wrestling organization, 13 regular members and five trainees aged 15-34 years. Medical examinations for head trauma were performed in all wrestlers, and wrestlers treated at our emergency outpatient department were clinically evaluated. In addition, the relationships of head trauma with duration of the wrestling career of 1-16 years (mean 8 years) in the regular members, and less than 1 year in the five trainees, and body mass index (BMI) of 21.0-32.0 in the 16 subjects, excluding two trainees, was evaluated. Chronic symptoms were noted in four of the 18 wrestlers with long wrestling careers (16 years in 1, 13 years in 1, and 5 years in 2). Three wrestlers with symptoms immediately after head trauma showed recurrent retrograde amnesia and had low BMI (21.6, 21.6, and 23.1). Five wrestlers were treated at our emergency outpatient clinic, three required hospitalization and two showed intracranial traumatic changes on computed tomography (acute subdural hematoma in 1 and diffuse brain swelling in 1). Head trauma in female professional wrestlers is associated with longer wrestling career and low BMI. Periodic medical examinations are recommended to monitor for signs of head trauma. (author)

  2. 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.

  3. 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...

  4. Critical perspectives on causality and inference in brain networks: Allusions, illusions, solutions?. Comment on: "Foundational perspectives on causality in large-scale brain networks" by M. Mannino and S.L. Bressler

    Science.gov (United States)

    Diwadkar, Vaibhav A.

    2015-12-01

    The human brain is an impossibly difficult cartographic landscape to map out. Within it's convoluted and labyrinthine structure is folded a million years of phylogeny, somehow expressed in the ontogeny of the specific organism; an ontogeny that conceals idiosyncratic effects of countless genes, and then the (perhaps) countably infinite effects of processes of the organism's lifespan subsequently resulting in remarkable heterogeneity [1,2]. The physical brain itself is therefore a nearly un-decodable "time machine" motivating more questions than frameworks for answering those questions: Why has evolution endowed it with the general structure that is possesses [3]; Is there regularity in macroscopic metrics of structure across species [4]; What are the most meaningful structural units in the brain: molecules, neurons, cortical columns or cortical maps [5]? Remarkably, understanding the intricacies of structure is perhaps not even the most difficult aspect of understanding the human brain. In fact, and as recently argued, a central issue lies in resolving the dialectic between structure and function: how does dynamic function arises from static (at least at the time scales at which human brain function is experimentally studied) brain structures [6]? In other words, if the mind is the brain "in action", how does it arise?

  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. Management of duodenal trauma

    OpenAIRE

    Chen, Guo-Qing; Hua YANG

    2011-01-01

    【Abstract】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...

  7. Trauma is danger

    OpenAIRE

    Porterfield Nancy; Hwang Paul F; Pannell Dylan; Davis Thomas A; Elster Eric A

    2011-01-01

    Abstract Background Trauma is one of the leading causes of death in young adult patients. Many pre-clinical and clinical studies attempt to investigate the immunological pathways involved, however the true mediators remain to be elucidated. Herein, we attempt to describe the immunologic response to systemic trauma in the context of the Danger model. Data Sources A literature search using PubMed was used to identify pertinent articles describing the Danger model in relation to trauma. Conclusi...

  8. 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 ...

  9. Deterministic versus probabilistic causality in the brain: To cut or not to cut. Comment on "Foundational perspectives on causality in large-scale brain networks" by M. Mannino and S.L. Bressler

    Science.gov (United States)

    Zhang, Mengsen; Nordham, Craig; Kelso, J. A. Scott

    2015-12-01

    In recent decades the rapid growth of new imaging technologies and measurement tools has dramatically changed how neuroscientists explore the function of the brain. A careful examination of the conceptual basis of causal inference using such methods is long overdue. Mannino and Bressler (M&B) [1] provide an informative review on the notion of causality from the perspectives of philosophy, physics, complex systems and brain sciences.

  10. 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.

  11. Trauma-specific Grey Matter Alterations in PTSD.

    Science.gov (United States)

    Meng, Linghui; Jiang, Jing; Jin, Changfeng; Liu, Jia; Zhao, Youjin; Wang, Weina; Li, Kaiming; Gong, Qiyong

    2016-01-01

    Previous studies have demonstrated that patients with posttraumatic stress disorder (PTSD) caused by different types of trauma may show divergence in epidemiology, clinical manifestation and treatment outcome. However, it is still unclear whether this divergence has neuroanatomic correlates in PTSD brains. To elucidate the general and trauma-specific cortical morphometric alterations, we performed a meta-analysis of grey matter (GM) changes in PTSD (N = 246) with different traumas and trauma-exposed controls (TECs, N = 347) using anisotropic effect-size signed differential mapping and its subgroup analysis. Our results revealed general GM reduction (GMR) foci in the prefrontal-limbic-striatal system of PTSD brains when compared with those of TECs. Notably, the GMR patterns were trauma-specific. For PTSD by single-incident traumas, GMR foci were found in bilateral medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), insula, striatum, left hippocampus and amygdala; and for PTSD by prolonged traumas in the left insula, striatum, amygdala and middle temporal gyrus. Moreover, Clinician-Administered PTSD Scale scores were found to be negatively associated with the GM changes in bilateral ACC and mPFC. Our study indicates that the GMR patterns of PTSD are associated with specific traumas, suggesting a stratified diagnosis and treatment for PTSD patients. PMID:27651030

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

    OpenAIRE

    Maggie Wai-Ling Poon

    2012-01-01

    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 dy...

  13. Trauma in pregnancy.

    Science.gov (United States)

    Oxford, Corrina M; Ludmir, Jonathan

    2009-12-01

    In the United States, trauma is the leading nonobstetric cause of maternal death. The principal causes of trauma in pregnancy include motor vehicle accidents, falls, assaults, homicides, domestic violence, and penetrating wounds. The managing team evaluating and coordinating the care of the pregnant trauma patient should be multidisciplinary so that it is able to understand the physiologic changes in pregnancy. Blunt trauma to the abdomen increases the risk of placental abruption. Evaluation of the pregnant trauma patient requires a primary and secondary survey with emphasis on airway, breathing, circulation, and disability. The use of imaging studies, invasive hemodynamics, critical care medications, and surgery, if necessary, should be individualized and guided by a coordinating team effort to improve maternal and fetal conditions. A clear understanding of gestational age and fetal viability should be documented in the record. PMID:20393413

  14. 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...

  15. 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

  16. 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.

  17. [Long-term survival after severe trauma].

    Science.gov (United States)

    Mutschler, W; Mutschler, M; Graw, M; Lefering, R

    2016-07-01

    Long-term survival after severe trauma is rarely addressed in German trauma journals although knowledge of life expectancy and identification of factors contributing to increased mortality are important for lifetime care management, development of service models, and targeting health promotion and prevention interventions. As reliable data in Germany are lacking, we compiled data mainly from the USA and Australia to describe life expectancy, risk factors, and predictors of outcome in patients experiencing traumatic spinal cord injury, traumatic brain injury, and polytrauma. Two years after trauma, life expectancy in all three categories was significantly lower than that of the general population. It depends strongly on severity of disability, age, and gender and is quantifiable. Whereas improvements in medical care have led to a marked decline in short-term mortality, surprisingly long-term survival in severe trauma has not changed over the past 30 years. Therefore, there is need to intensify long-term trauma patient care and to find new strategies to limit primary damage. PMID:27342106

  18. Book Review: Ingrid G. Farreras, Caroline Hannaway and Victoria A. Harden (eds). Mind, Brain, Body, and Behavior. Foundations of Neuroscience and Behavioral Research at the National Institutes of Health. Amsterdam: IOS Press, 2004. Pp. xxvi + 366. $92.00. ISBN 1-58603-471-5

    OpenAIRE

    2007-01-01

    Book Review: Ingrid G. Farreras, Caroline Hannaway and Victoria A. Harden (eds). Mind, Brain, Body, and Behavior. Foundations of Neuroscience and Behavioral Research at the National Institutes of Health. Amsterdam: IOS Press, 2004. Pp. xxvi + 366. $92.00. ISBN 1-58603-471-5 Harvard University - (Guenther, Katja)

  19. 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

  20. Juggling-exposure therapy: an innovation in trauma treatment.

    Science.gov (United States)

    Welburn, Ken

    2015-01-01

    Three case studies are presented illustrating an innovative treatment approach that integrated a juggling task with exposure therapy for clients who had benefited from trauma therapy but had residual trauma symptoms. All 3 clients reported benefiting considerably from adding the juggling task to the exposure therapy. The effects appeared to be rapid and minimally stressful and generalized to in vivo situations. I suggest that the treatment may have enhanced the response flexibility in brain circuitry involved with preconscious threat detection. PMID:25365703

  1. 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.

  2. 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 ...

  3. Trauma and Coagulation

    Directory of Open Access Journals (Sweden)

    Murat Yılmaz

    2011-08-01

    Full Text Available Bleeding and coagulation disorders related to trauma are pathological processes which are frequently seen and increase mortality. For the purpose, trauma patients should be protected from hypoperfusion, hypothermia, acidosis and hemodilution which may aggravate the increase in physiological responses to trauma as anticoagulation and fibrinolysis. Performing damage control surgery and resuscitation and transfusion of adequate blood and blood products in terms of amount and content as stated in protocols may increase the rate of survival. Medical treatments augmenting fibrin formation (fibrinogen, desmopressin, factor VIIa or preventing fibrin degradation (tranexamic acid have been proposed in selected cases but the efficacy of these agents in trauma patients are not proven. (Journal of the Turkish Society Intensive Care 2011; 9:71-6

  4. Suspension Trauma / Orthostatic Intolerance

    Science.gov (United States)

    ... such fatalities often are referred to as "harnessinduced pathology" or "suspension trauma." Signs & symptoms that may be ... move legs Hypothermia Pain Shock Injuries during fall Cardiovascular disease Fatigue Respiratory disease Dehydration Blood loss References: ...

  5. 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...

  6. 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...

  7. London Trauma Conference 2015

    OpenAIRE

    Avery, Pascale; Salm, Leopold; Bird, Flora; Hutchinson, Anja; Jarman, Heather; Nilsson, Maria Bergman; Konig, Tom; Tai, Nigel; Fevang, Espen; Hognestad, Børge; Abrahamsen, Håkon B.; Cheetham, Olivia V.; Thomas, Matthew J C; Rooney, Kieron D.; Murray, Josephine

    2016-01-01

    Table of contents I1: Trauma, Pre-hospital and Cardiac Arrest Care 2015 Pascale Avery, Leopold Salm, Flora Bird A1: Retrospective evaluation of HEMS ‘Direct to CT’ protocol Anja Hutchinson, Ashley Matthies, Anthony Hudson, Heather Jarman A2 Rush hour – Crush hour: temporal relationship of cyclist vs. HGV trauma admissions. A single site observational study Maria Bergman Nilsson, Tom Konig, Nigel Tai A3 Semiprone position endotracheal intubation during continuous cardiopulmonary resuscitation ...

  8. Noninvasive ventilation in trauma

    OpenAIRE

    Karcz, Marcin K; Peter J. Papadakos

    2015-01-01

    Trauma patients are a diverse population with heterogeneous needs for ventilatory support. This requirement depends mainly on the severity of their ventilatory dysfunction, degree of deterioration in gaseous exchange, any associated injuries, and the individual feasibility of potentially using a noninvasive ventilation approach. Noninvasive ventilation may reduce the need to intubate patients with trauma-related hypoxemia. It is well-known that these patients are at increased risk to develop ...

  9. Trauma registry reengineered.

    Science.gov (United States)

    Wargo, Christina; Bolig, Nicole; Hixson, Heather; McWilliams, Nate; Rummerfield, Heather; Stratton, Elaine; Woodruff, Tracy

    2014-01-01

    A successful trauma registry balances accuracy of abstraction and timeliness of case submissions to achieve quality performance. Staffing to achieve quality performance is a challenge at times based on competitive institutional need. The aim of this performance improvement timing study was to identify trauma registry job responsibilities and redesign the responsibilities to create increased abstraction time and maintain accuracy of data abstraction. The outcome is measured by case submission rates with existing staffing and interrater reliability outcomes. PMID:25397337

  10. Childhood trauma in bipolar disorder

    OpenAIRE

    Watson, S; Gallagher, P.; Dougall, D.; R Porter; 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 bipo...

  11. Noninvasive ventilation in trauma.

    Science.gov (United States)

    Karcz, Marcin K; Papadakos, Peter J

    2015-02-01

    Trauma patients are a diverse population with heterogeneous needs for ventilatory support. This requirement depends mainly on the severity of their ventilatory dysfunction, degree of deterioration in gaseous exchange, any associated injuries, and the individual feasibility of potentially using a noninvasive ventilation approach. Noninvasive ventilation may reduce the need to intubate patients with trauma-related hypoxemia. It is well-known that these patients are at increased risk to develop hypoxemic respiratory failure which may or may not be associated with hypercapnia. Hypoxemia in these patients is due to ventilation perfusion mismatching and right to left shunt because of lung contusion, atelectasis, an inability to clear secretions as well as pneumothorax and/or hemothorax, all of which are common in trauma patients. Noninvasive ventilation has been tried in these patients in order to avoid the complications related to endotracheal intubation, mainly ventilator-associated pneumonia. The potential usefulness of noninvasive ventilation in the ventilatory management of trauma patients, though reported in various studies, has not been sufficiently investigated on a large scale. According to the British Thoracic Society guidelines, the indications and efficacy of noninvasive ventilation treatment in respiratory distress induced by trauma have thus far been inconsistent and merely received a low grade recommendation. In this review paper, we analyse and compare the results of various studies in which noninvasive ventilation was applied and discuss the role and efficacy of this ventilator modality in trauma. PMID:25685722

  12. 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

  13. 亚低温治疗对脑创伤后三磷酸腺苷酶的影响%Effects of hypothermia on ATPase following brain trauma in rats

    Institute of Scientific and Technical Information of China (English)

    黄慧玲; 只达石; 张琳瑛; 王颖; 张玲

    2001-01-01

    目的观察亚低温治疗对大鼠脑外伤后脑组织Na+-K+-ATP酶、Mg2+-ATP酶以及Ca2+-ATP酶的影响。方法 75只大鼠随机分为常温对照组(33只)、常温受伤组(22只)和亚低温治疗组(20只),后两组用自由落体方法致大鼠左侧脑外伤,亚低温治疗组受伤后用冰袋全身降温至脑温30 ℃后维持1 h,然后加热复温至37℃。每组大鼠在伤后3 h、1,3, 5 和7 d取大脑组织,测定组织匀浆液中ATP酶的活性。结果 (1)Na+-K+-ATP酶:常温受伤组和亚低温治疗组在3 h明显高于对照组,而后明显下降。亚低温治疗组在第3天明显高于常温受伤组;(2)Mg2+-ATP酶:常温受伤组和亚低温治疗组在1 d后才开始明显下降,但亚低温治疗组在1 d和3 d中较常温组下降速度明显变慢;(3)Ca2+-ATP酶:常温受伤组第1天就较常温对照组明显下降,而亚低温治疗组3 h和第1天保持正常,第3天才明显下降,但仍然显著高于常温受伤组。结论 (1)脑外伤大鼠脑细胞Na+-K+-ATP酶早期对脑外伤有应激反应,亚低温治疗对细胞钠通道的作用不明显;(2)亚低温对钙泵有明显的调节作用,较常温受伤组显著提高脑细胞Ca2+-Mg2+-ATP酶的活性;(3)亚低温治疗能延缓脑细胞钙通道的损伤时间,且在7 d内脑细胞的钠通道和钙通道在低水平保持相对稳定,从而减少Ca2+的内流,减轻脑水肿。%Objective To investigate the effects of hypothermia on the contents of Na+-K+-ATPase, Mg2+-ATPase and Ca2+-ATPase in traumatic rats.  Methods  Seventy five Wistar rats were divided randomly into three groups : the non-traumatic control group (n=33), the normothermia traumatic group (n=22) and the hypothermia-treated group (n=20). Brain trauma was induced on the left cerebrum by free falling objects. The whole body of the animals in the hypothermia-treated group was cooled to 30℃ for 1 hour, then heated to 37℃. The cerebrum

  14. Advances in the understanding of trauma-induced coagulopathy.

    Science.gov (United States)

    Chang, Ronald; Cardenas, Jessica C; Wade, Charles E; Holcomb, John B

    2016-08-25

    Ten percent of deaths worldwide are due to trauma, and it is the third most common cause of death in the United States. Despite a profound upregulation in procoagulant mechanisms, one-quarter of trauma patients present with laboratory-based evidence of trauma-induced coagulopathy (TIC), which is associated with poorer outcomes including increased mortality. The most common causes of death after trauma are hemorrhage and traumatic brain injury (TBI). The management of TIC has significant implications in both because many hemorrhagic deaths could be preventable, and TIC is associated with progression of intracranial injury after TBI. This review covers the most recent evidence and advances in our understanding of TIC, including the role of platelet dysfunction, endothelial activation, and fibrinolysis. Trauma induces a plethora of biochemical and physiologic changes, and despite numerous studies reporting differences in coagulation parameters between trauma patients and uninjured controls, it is unclear whether some of these differences may be "normal" after trauma. Comparisons between trauma patients with differing outcomes and use of animal studies have shed some light on this issue, but much of the data continue to be correlative with causative links lacking. In particular, there are little data linking the laboratory-based abnormalities with true clinically evident coagulopathic bleeding. For these reasons, TIC continues to be a significant diagnostic and therapeutic challenge. PMID:27381903

  15. Cooley's Anemia Foundation

    Science.gov (United States)

    Cooley's Anemia Foundation Leading the Fight against Thalassemia About Us Mission/Purpose History About Thomas Benton Cooley Medical Research ... Gabriella was diagnosed with thalassemia, and the Cooley’s Anemia Foundation continues to play an almost-daily role ...

  16. 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 foundat......, further research, development and prototype testing are required, before the monopod bucket foundation can be commercialized.......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...

  17. American Vitiligo Research Foundation

    Science.gov (United States)

    ... life can acquire vitiligo Welcome to The American Vitiligo Foundation "Embracing Diversity" bracelets are available to help ... animal testing. Please Visit Our Donations Page American Vitiligo Research Foundation "We Walk By Faith, Not By ...

  18. 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 ...

  19. Robert Wood Johnson Foundation

    Science.gov (United States)

    Robert Wood Johnson Foundation Search How We Work Our Focus Areas About RWJF Search Menu How We ... lives. Learn more For Grantees and Grantseekers The Robert Wood Johnson Foundation supports a wide array of ...

  20. Pulmonary Fibrosis Foundation

    Science.gov (United States)

    ... the most current news and updates from the Pulmonary Fibrosis Foundation. Life with PF Education & Support About PF ... open ! JOIN NOW We Imagine a World Without Pulmonary Fibrosis The Pulmonary Fibrosis Foundation mobilizes people and resources ...

  1. Patterns of ocular trauma

    International Nuclear Information System (INIS)

    To describe the patterns of ocular trauma, cause of injury and its effects on eye. A retrospective case series. Medical records of 1105 patients admitted with ocular trauma were reviewed. The details of patients regarding age, gender, literacy, cause of injury and its effects on eye were entered into specially-designed performa. Sample selection consisted of all patients with history of ocular trauma and who were admitted to hospital. Population details consisted patients who were referred to the hospital from all parts of N.W.F.P. Thus, the frequency of trauma in the hospital admissions was analysed. Ophthalmic trauma comprised 6.78% of the hospital admission. One thousand one hundred and five patients presented with eye injuries. Out of them, 21 patients suffered from trauma to both eyes. Almost 80% patients were male and 69% patients were below 30 years of age. Delayed presentation was more common and 63.61% patients presented after one week. Open globe injuries were more common (520 eyes (46.18%)) than closed globe injuries (484 eyes (42.98%)). 23.26% of open globe injuries were associated with intraocular and intra-orbital foreign bodies. Superficial non-perforating, eyelid and adnexal and burns were seen in 122 eyes (10.83%). Among the complications, lens damage and hyphema was seen in more than 50% of the patients, 16.60% eyes were infected at the time of admission and 4.88% of eyes needed enucleation or evisceration. The common causes of injury were violence in 37.37%, occupational in 24.43% and domestic accidents in 19.18%. Ophthalmic trauma is a major public health problem. Majority of the involved are male and under 30 years of age. Delayed presentation is more common. Open globe injuries are more frequent. Violence and occupational injuries are the major causes. (author)

  2. 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.

  3. 高压氧治疗兔创伤性脑损伤的磁共振观察%Effects of hyperbaric oxygen therapy on the brain trauma injury in rabbits with magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    傅敏; 赵晖; 张陆弟; 励琤; 陈晓; 叶宁

    2011-01-01

    Objective To observe the effects of HBO therapy on cerebral edema, blood-brain barrier and neural behavioral scores, induced by brain trauma injury in rabbits with magnetic resonance imaging ( MRI). Methods Twenty-four rabbits were randomly divided into three groups: the sham operation group (n =5), with a skull window of only 8 mm in diameter; the control group (n = 10) , sustained with shock injury (shock intensity of 0.2 Mpa) following skull fenestration; the HBO group(n=90), also sustained with shock injury following skull fenestration, but with HBO treatment. Following the development of the model, MRI scans were made at 6th, 24th, 72nd, and 120th hours to calculate the volume of cerebral edema, apparent diffusion coefficient ( ADC), and neurological behavioral scores. Results After HBO treatment, neurological behavioral scores of the HBO group improved significantly, when compared with that of the control group (P< 0. 05). MRI showed that abnormality was not noted in the sham operation group. Before treatment, significant cerebral edema and damage of blood-brain barrier could be seen in both the HBO group and the control group. However, following HBO treatment, cerebral edema and blood-brain barrier damage of the HBO group recovered more rapidly, when a comparison was made between the groups (P<0. 01) and ADC value of the HBO group was lower than that of the control group (P<0. 05). Conclusions HBO could hasten recovery of the blood-brain barrier damage induced by cerebral damage with hydraulic impetus, reduce cerebral edema, significantly decrease symptoms of brain injury, and reduce disability rate.%目的 应用磁共振(MRI)动态观察高压氧(HBO)治疗对创伤性脑损伤导致的脑水肿、血脑屏障和神经行为学评分的影响.方法 将24只兔按数字随机表法分为3组:假手术组5只,仅开直径8 mm颅骨窗;对照组10只,颅骨开窗后给予0.2 MPa液压冲击;HBO组9只,在对照组的基础上给予HBO

  4. 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 ...

  5. 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.

  6. 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.

  7. 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.

  8. Childhood trauma exposure and toxic stress: what the PNP needs to know.

    Science.gov (United States)

    Hornor, Gail

    2015-01-01

    Trauma exposure in childhood is a major public health problem that can result in lifelong mental and physical health consequences. Pediatric nurse practitioners must improve their skills in the identification of trauma exposure in children and their interventions with these children. This continuing education article will describe childhood trauma exposure (adverse childhood experiences) and toxic stress and their effects on the developing brain and body. Adverse childhood experiences include a unique set of trauma exposures. The adverse childhood experiences or trauma discussed in this continuing education offering will include childhood exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, domestic violence, household substance abuse, household mental illness, parental separation or divorce, and a criminal household member. Thorough and efficient methods of screening for trauma exposure will be discussed. Appropriate intervention after identification of trauma exposure will be explored. PMID:25697767

  9. 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...

  10. 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.

  11. Trauma-Focused CBT for Youth who Experience Ongoing Traumas

    OpenAIRE

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

    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 this in some way impair their responding to current or ongoing trauma? The paper addresses practical strategies for implementing one evidence-based ...

  12. 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...

  13. 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.

  14. 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

  15. Transfusion protocol in trauma

    Directory of Open Access Journals (Sweden)

    Kaur Paramjit

    2011-01-01

    Full Text Available Blood and blood components are considered drugs because they are used in the treatment of diseases. As with any drug, adverse effects may occur, necessitating careful consideration of therapy. Like any other therapeutic decision, the need for transfusion should be considered on the basis of risks and benefits and alternative treatments available to avoid over- and under-transfusion. This review is focused on the blood transfusion protocol in trauma patients with hemorrhagic shock. Besides, issues related to emergency and massive transfusion have also been elaborated. We conducted a comprehensive MEDLINE search and reviewed the relevant literature, with particular reference to emergency medical care in trauma.

  16. 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.

  17. 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.

  18. 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…

  19. Ecopsychology: A Perspective on Trauma

    OpenAIRE

    Milton, MJ; Corbett, L

    2011-01-01

    Literature has suggested that the cyclical nature of psychological trauma can cause enduring long-term effects on individuals and those around them. This review examines the effects of psychological trauma and its relationship to ecopsychology to provoke questions about integration and stimulate debate pertinent to trauma therapy. While being relatively unexplored with regards to psychological trauma, empirical evidence is beginning to amass to suggest that ecopsychology could be incorporated...

  20. 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

  1. 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....

  2. 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.

  3. 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…

  4. Trauma and Symbolic Violence

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    2011-01-01

    Our understanding of 'reactions to trauma' is dominated by concepts like Post-Traumatic Stress Disorder. The use of such concepts has been criticised but simultaneously integrated in folk-psychology. Connecting emotional and cognitive processes as well as acts - such as in gendered practices...

  5. 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.

  6. Skeleton scintigraphy in trauma

    International Nuclear Information System (INIS)

    Skeletal trauma is common and presents both an opportunity and a problem in skeletal scintigraphy. The opportunity arises in the ability of skeletal scintigraphy to demonstrate abnormalities early after direct trauma. It is well recognized that the early detection of fractures in some sites cannot be reliably achieved by standard radiography, especially in the femoral neck and scaphoid bone. The problem comes in recognizing the effects of skeletal trauma when using skeletal scintigraphy for another purpose, such as the detection of metastatic disease. iatrogenic trauma to either the skeleton or soft tissues may be manifest scintigraphic ally. For example Craniotomy typically leaves a rim pattern at the surgical margin. Rib Retraction during thoracotomy can elicit periosteal reaction. Areas of the skeletal receiving curative levels of ionizing radiation (typically 4000 rads or greater) characteristically demonstrate decreased uptake within 6 months to 1 year after therapy. The generally high sensitivity of the skeletal scintigraphy seems to make it an ideal survey test in cases of suspected child abuse especially in which radiographs are unrevealing. Because of difficulties in obtaining a history of trauma from a preschool child or even eliciting a satisfactory description of the location and nature of the pain, skeletal scintigraphy provides a simple and reliable investigation in these children. Subtle trauma, such as that from stress fractures is often difficult to visualize on a plain radiograph. Skeletal scintigraphy is frequently positive at the time of clinical presentation. Skeletal scintigraphy is exquisitely sensitive to the remodeling process and typically shows abnormalities 1 to 2 weeks or more before the appearance of radiographic changes in stress fractures. The periosteal reaction can be visualized within hours of the injury. Insufficiency and fatigue fractures such as vertebral compression fracture, which is probably the most common consequence of

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

    International Nuclear Information System (INIS)

    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. Paediatric trauma care

    Directory of Open Access Journals (Sweden)

    Sebastian van As A

    2010-01-01

    Full Text Available Background: Childhood trauma has become a major cause of mortality and morbidity, disability and socio-economic burden and it is expected by the World Health Organization (WHO that by 2020 it will be the number 1 disease globally. The WHO and UNICEF have published their third World Report on Child Injury Prevention in December 2008. Materials and Methods: A systematic review was performed on the history and magnitude of paediatric trauma worldwide. Additionally exciting developments and new trends were assessed and summarized. Results: Paediatric trauma is a growing field of clinical expertise. New developments include total body digital imaging of children presenting with polytrauma; targeted management of head injuries; conservative management of abdominal injuries in children and diagnostic laparoscopy, including the laparoscopic management of complications following the conservative management of solid organ injuries. Conclusion: Paediatric trauma has long been neglected by the medical profession. In order to deal with it appropriately, it makes sense to adopt the public health approach, requiring that we view child injuries similarly to any other disease or health problem. The greatest gain in our clinical practice with dealing with child injuries will result from a strong focus on primary (preventing the injury, secondary (dealing with the injury in the most efficient manner as well as tertiary prevention (making sure that children treated for trauma will be appropriately reintegrated within our society. By actively promoting child safety we will not only achieve a most welcome reduction in medical cost and disability, but also the ever-so-much desired decline of avoidable childhood misery and suffering.

  9. MANAGEMENT OF LIVER TRAUMA

    Directory of Open Access Journals (Sweden)

    Dova Subba

    2016-03-01

    Full Text Available AIM To estimate the incidence of Liver Trauma injuries and grade their severity of injury. To assess the factors responsible for morbidity and mortality after Liver Trauma. To study the postoperative complications and the management of Liver Trauma. MATERIALS AND METHODS The present prospective study was conducted on 100 patients who were admitted to Department of General Surgery for treatment who were managed operatively or non-operatively for abdominal trauma and having liver injury forms the material of the study. This study was conducted over a span of 24 months from June 2013 to November 2015. RESULTS Maximum number of patients are in the age group of 21-30 years (46%. 85% patients (85/100 are males and 15% of patients (15/100 are females. Lapse time of injury and admission varied from 25 minutes to 66 hours and 30 minutes. 75 % of the patients (75/100 presented within 24 hours after injury. Death rate of patients who reached hospital after 24 hours of injury was higher than the patients who reached hospital within 24 hours of injury. 28% of patients (28/100 had associated bony injuries, out of which 5% of patients (5/100 expired due to primary haemorrhage of fractured femur. More than one segment was injured in many patients. Segment V is involved commonly making 55% (55/100 of patients. Next common segment involved is segment VII, making 39% (39/100. CONCLUSION Mechanism of injury is the important factor which is responsible for morbidity in liver injury. Nonoperative management proved to be safe and effective and often has been used to treat patients with liver trauma.

  10. Gênero e trauma Gender and trauma

    OpenAIRE

    Gláucio Ary Dillon Soares; Dayse Miranda

    2005-01-01

    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 de...

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

    OpenAIRE

    Lin Jin-Mann S; Nater Urs M; Majer Matthias; Capuron Lucile; Reeves William C

    2010-01-01

    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, ...

  12. 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.

  13. 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…

  14. 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...

  15. Brain and head injury in infancy and childhood

    International Nuclear Information System (INIS)

    This article describes typical head injuries in infants and children. In comparison with adults there are distinct differences in the etiology of trauma and in the kind of reaction of the skull and brain. In infants and children there are three different types of trauma: birth trauma, accidental and non-accidental injury. The typical injuries in these three groups are described. (orig.)

  16. 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

  17. 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.

  18. 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.

  19. Clinical review: Statins and trauma--a systematic review.

    Science.gov (United States)

    Jansen, Jan O; Lord, Janet M; Thickett, David R; Midwinter, Mark J; McAuley, Daniel F; Gao, Fang

    2013-01-01

    Statins, in addition to their lipid-lowering properties, have anti-inflammatory actions. The aim of this review is to evaluate the effect of pre-injury statin use, and statin treatment following injury. MEDLINE, EMBASE, and CENTRAL databases were searched to January 2012 for randomised and observational studies of statins in trauma patients in general, and in patients who have suffered traumatic brain injury, burns, and fractures. Of 985 identified citations, 7 (4 observational studies and 3 randomised controlled trials (RCTs)) met the inclusion criteria. Two studies (both observational) were concerned with trauma patients in general, two with patients who had suffered traumatic brain injury (one observational, one RCT), two with burns patients (one observational, one RCT), and one with fracture healing (RCT). Two of the RCTs relied on surrogate outcome measures. The observational studies were deemed to be at high risk of confounding, and the RCTs at high risk of bias. Three of the observational studies suggested improvements in a number of clinical outcomes in patients taking statins prior to injury (mortality, infection, and septic shock in burns patients; mortality in trauma patients in general; mortality in brain injured patients) whereas one, also of trauma patients in general, showed no difference in mortality or infection, and an increased risk of multi-organ failure. Two of three RCTs on statin treatment in burns patients and brain injured patients showed improvements in E-selectin levels and cognitive function. The third, of patients with radial fractures, showed no acceleration in fracture union. In conclusion, there is some evidence that pre-injury statin use and post-injury statin treatment may have a beneficial effect in patients who have suffered general trauma, traumatic brain injury, and burns. However, these studies are at high risk of confounding and bias, and should be regarded as 'hypothesisgenerating'. A well-designed RCT is required to

  20. 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. PMID:24238937

  1. 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.

  2. 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.

  3. Trauma is danger

    Directory of Open Access Journals (Sweden)

    Porterfield Nancy

    2011-06-01

    Full Text Available Abstract Background Trauma is one of the leading causes of death in young adult patients. Many pre-clinical and clinical studies attempt to investigate the immunological pathways involved, however the true mediators remain to be elucidated. Herein, we attempt to describe the immunologic response to systemic trauma in the context of the Danger model. Data Sources A literature search using PubMed was used to identify pertinent articles describing the Danger model in relation to trauma. Conclusions Our knowledge of Danger signals in relation to traumatic injury is still limited. Danger/alarmin signals are the most proximal molecules in the immune response that have many possibilities for effector function in the innate and acquired immune systems. Having a full understanding of these molecules and their pathways would give us the ability to intervene at such an early stage and may prove to be more effective in blunting the post-injury inflammatory response unlike previously failed cytokine experiments.

  4. Imaging of laryngeal trauma

    International Nuclear Information System (INIS)

    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

  5. ACR Appropriateness Criteria Head Trauma.

    Science.gov (United States)

    Shetty, Vilaas S; Reis, Martin N; Aulino, Joseph M; Berger, Kevin L; Broder, Joshua; Choudhri, Asim F; Kendi, A Tuba; Kessler, Marcus M; Kirsch, Claudia F; Luttrull, Michael D; Mechtler, Laszlo L; Prall, J Adair; Raksin, Patricia B; Roth, Christopher J; Sharma, Aseem; West, O Clark; Wintermark, Max; Cornelius, Rebecca S; Bykowski, Julie

    2016-06-01

    Neuroimaging plays an important role in the management of head trauma. Several guidelines have been published for identifying which patients can avoid neuroimaging. Noncontrast head CT is the most appropriate initial examination in patients with minor or mild acute closed head injury who require neuroimaging as well as patients with moderate to severe acute closed head injury. In short-term follow-up neuroimaging of acute traumatic brain injury, CT and MRI may have complementary roles. In subacute to chronic traumatic brain injury, MRI is the most appropriate initial examination, though CT may have a complementary role in select circumstances. Advanced neuroimaging techniques are areas of active research but are not considered routine clinical practice at this time. In suspected intracranial vascular injury, CT angiography or venography or MR angiography or venography is the most appropriate imaging study. In suspected posttraumatic cerebrospinal fluid leak, high-resolution noncontrast skull base CT is the most appropriate initial imaging study to identify the source, with cisternography reserved for problem solving. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:27262056

  6. Explore different treatments for severe brain trauma injury lateral fissure zones clinical effect of contrast%探讨不同治疗方法治疗重型颅脑外伤侧裂区损伤的临床效果对比

    Institute of Scientific and Technical Information of China (English)

    杜振海; 刘明; 王立彬; 刘俊

    2015-01-01

    Objective To study different methods of treatment of severe brain trauma injury lateral fissure zones clinical ef-fects of contrast. Methods patients with severe brain trauma injury sylvian area hospital in november 2012 March 2014 admitted 60 cases were randomly divided into two groups, namely the observation group and control group, the observation group to take Standard craniotomy hematoma treatment; large control group taking conventional craniotomy hematoma treatment, by observing the postoperative indicators, to compare the treatment effect in both groups. Results The observation group were significantly higher GcS score, Icp, cerebral edema volume and midline shift were significantly lower than the control group, and the obser-vation group was significantly higher survival rate was 86.67% 46.67% overall survival, which the difference was statistically significant, p<0.05 conclusion standard craniotomy hematoma on the treatment of severe brain trauma injury sylvian area with good effect, worthy of clinical use.%目的:研究不同的方法对治疗重型颅脑外伤侧裂区损伤的临床效果对比。方法选取我院2012年11月-2014年3月收治的重型颅脑外伤侧裂区损伤患者60例,将其随机分为两组,分别为观察组和对照组,其中观察组采取标准大骨瓣开颅血肿清除术治疗;对照组采取常规大骨瓣开颅血肿清除术治疗,通过观察两组术后各项指标,来对比两组的治疗效果。结果观察组术后GCS评分明显高于对照组,ICp、脑水肿体积和中线移位均明显低于对照组,且观察组总生存率为86.67%明显高于对照组总生存率46.67%,两组对比差异具有统计学意义,P<0.05。结论标准大骨瓣开颅血肿清除术对治疗重型颅脑外伤侧裂区损伤具有较好的疗效,值得临床推广使用。

  7. Children's Cardiomyopathy Foundation

    Science.gov (United States)

    Search The Children's Cardiomyopathy Foundation (CCF) is a national, non-profit organization focused on pediatric cardiomyopathy, a chronic disease of the heart muscle. CCF is dedicated to accelerating the search for ...

  8. Melanoma International Foundation

    Science.gov (United States)

    ... 501(c)(3) charity, also registered as a non-profit charity in the state of Pennsylvania, certificate #29498 © 2013 Melanoma International Foundation. All Rights Reserved. Privacy Policy | Terms of Use ...

  9. 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 ...

  10. 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 10 Other Languages . Resource Video See ...

  11. National Fragile X Foundation

    Science.gov (United States)

    ... Anthology Advocacy National Fragile X Foundation Advocacy Day STAR: Local Advocacy Agenda and Accomplishments Community Events International ... Feeding and Fragile X Toilet Training the Older Child Oppositional or Merely Anxious? Public or Private? Managing ...

  12. Foundation for Sarcoidosis Research

    Science.gov (United States)

    ... Clinical Trials Fail: FSR’s New Initiative to Bridge Gap between Industry Leaders, Researchers, and Patients Guest post ... 1 2 3 … 10 Next → Foundation for Sarcoidosis Research 1820 W. Webster Ave Suite 304 Chicago, Illinois ...

  13. 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 © | ...

  14. Cleft Palate Foundation

    Science.gov (United States)

    ... Spanish , and Mandarin ! Information on Cleft Lip and Palate Our booklets and factsheets address a variety of ... Bear. –Paige with her Cleftline™ teddy bear– Cleft Palate Foundation 1504 East Franklin Street, Suite 102 Chapel ...

  15. 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.

  16. National Psoriasis Foundation

    Science.gov (United States)

    ... handle bullies in the classroom. 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 ...

  17. Morris Animal Foundation

    Science.gov (United States)

    ... the transmission of serious illnesses. Read more » Morris Animal Foundation Receives $750,000 Grant for Cancer Studies. ... Give Partners Become a Partner Meet Our Partners Animal Lovers Our Work Ways to Give Pet Health ...

  18. Mesothelioma Applied Research Foundation

    Science.gov (United States)

    ... Percentage Donations Tribute Wall Other Giving/Fundraising Opportunities Bitcoin Donation Form FAQs Help us raise awareness and ... Percentage Donations Tribute Wall Other Giving/Fundraising Opportunities Bitcoin Donation Form FAQs © 2013 Mesothelioma Applied Research Foundation, ...

  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. National Emphysema Foundation

    Science.gov (United States)

    ... August 15, 2016 A recent study finds that music therapy benefits chronic obstructive p... July 04, 2016 A new recommendation from US Preventive Services Task Force is encoura... Copyright © 2016, National Emphysema Foundation, all rights reserved home ...

  1. 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

  2. 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.

  3. 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....

  4. More Years Playing Football, Greater Risk of Brain Disease

    Science.gov (United States)

    ... gov/news/fullstory_161841.html More Years Playing Football, Greater Risk of Brain Disease: Study Researchers track ... say they can show that brain inflammation from football head trauma may lead to the development of ...

  5. 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...

  6. 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.

  7. The epidemiology of renal trauma

    OpenAIRE

    Voelzke, Bryan B.; Leddy, Laura

    2014-01-01

    Introduction Nonoperative and minimally invasive management techniques for both blunt and penetrating renal trauma have become standard of care over the past decades. We sought to examine the modern epidemiology of renal trauma over the past decade. Methods A systematic review of PubMed from the past decade was conducted to examine adult and pediatric renal trauma. A total of 605 articles were identified. Of these, 15 adult and 5 pediatric articles met our a priori search criteria. Results Th...

  8. 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

  9. 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.

  10. 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.

  11. Retroclival collections associated with abusive head trauma in children

    International Nuclear Information System (INIS)

    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.)

  12. 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.)

  13. 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

  14. Trauma and Symbolic Violence

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    2011-01-01

    Our understanding of 'reactions to trauma' is dominated by concepts like Post-Traumatic Stress Disorder. The use of such concepts has been criticised but simultaneously integrated in folk-psychology. Connecting emotional and cognitive processes as well as acts - such as in gendered practices...... seeks to undertake a discussion of personal meanings attributed to 'traumatisation'. It raises questions as to whether concepts of this kind and related practices may constitute symbolic violence and contribute to victimisation through looping-processes. Furthermore it aims at unfolding an understanding...

  15. 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…

  16. 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.

  17. Cyclosporin A affects the level of anti-myelin basic protein in serum and myelinoclasis after rat brain trauma%环孢素A对大鼠脑损伤后髓鞘碱性蛋白抗体及继发性脱髓鞘病变的影响

    Institute of Scientific and Technical Information of China (English)

    褚建成; 李卫; 刘灵慧; 李虹; 陈善成

    2010-01-01

    Objective To investigate the effect of cyclosporin A(CsA)on the level of anti-myelin basic protein(anti-MBP)in the serum and myelinoclasis in rat models after brain trauma.Methods Seventy-seven SD rats were randomized into blank control group(n=7),model group(n=35)and CsA-treated group(n=35).The 0.9% normal saline(5 mg/kg/d)was intraperitoneally injected into the model group and 5 mg/mL CsA(5 mg/kg/d)was injected into the CsA-treated group.Different time points(1,4,10,20 and 30 d)after the brain trauma,the MBP content and anti-MBP titer in the serum were measured using enzyme-linked immunosorbent assay(ELISA)and the degree of myelinoclasis in the brain stem slices was assessed with Marchi's method.Results As compared with that in the blank control group,the MBP and Anti-MBP contents in the model group were significantly increased(P0.05).However,lower level of anti-MBP in the serum 1 d after the injury and degree of myelinoclasis in the brain stem 4 daRer the injury in the CsA-treated group were observed as compared with those in the model group(P0.05),而伤后1d开始Anti-MBP含量降低、伤后4 d开始变性髓鞘数量降低.差异有统计学意义(P<0.05);Pearson相关分析显示CsA组与模型组大鼠血清Anti-MBP含量与脑干变性髓鞘的数量呈正相关关系(r=0.959,P=0.000).结论 CsA可以干预脑组织损伤后大鼠的免疫系统,在一定程度上可以减少Anti-MBP的产生、减轻大鼠继发性脑干脱髓鞘病变的程度.

  18. CONSTITUTIONAL FOUNDATIONS OF JURISDICTION

    Directory of Open Access Journals (Sweden)

    Alexandre Jamal Batista

    2016-06-01

    Full Text Available At the current stage of our State of Law there is no way to separate the study of the civil procedural law from the Federal Constitution, especially the jurisdiction, because it is in the Constitution that there are the legitimizing foundations of the jurisdiction institute. In this article, we carry on about the constitutional foundations of jurisdiction, such as: the principle of natural justice, principle of access to justice, principle of impartiality, principle of publicity, principle of motivation and principle of submission to res judicata. The conclusion is, after all, that jurisdiction, as one of the bulwarks of the citizen, finds in the “Citizen Constitution” of 1988 its foundations and decisive bases.

  19. Bone scintigraphy in children: trauma

    International Nuclear Information System (INIS)

    The sensitivity of radionuclide imaging in identifying skeletal trauma in children has been established. Growth plates present a set of problems unique to pediatric studies and diagnotic accuracy is very technique dependent. Imaging for sports injuries and suspected child abuse has been productive. An expanding role for bone scintigraphy in the management of orthopedic problems post-trauma is developing

  20. 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.

  1. Spinal trauma. An imaging approach

    International Nuclear Information System (INIS)

    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.)

  2. 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.

  3. 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,…

  4. Peripheral Cytokines as a Chemical Mediator for Postconcussion Like Sickness Behaviour in Trauma and Perioperative Patients: Literature Review

    OpenAIRE

    Yasir Rehman; Nadia Rehman; Riaz Rehman

    2014-01-01

    Besides brain injury and systemic infection, cognitive and concussion like sickness behaviour is associated with muscular trauma and perioperative patients, which represents a major obstacle to daily activities and rehabilitation. The neuroinflammatory response triggers glial activation and consequently the release of proinflammatory cytokines within the hippocampus. We review clinical studies that have investigated neurocognitive and psychosomatic symptoms related to muscular trauma and in p...

  5. 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

  6. 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 intr......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...

  7. Optimization Foundations and Applications

    CERN Document Server

    Miller, H Ronald

    2011-01-01

    A thorough and highly accessible resource for analysts in a broad range of social sciences. Optimization: Foundations and Applications presents a series of approaches to the challenges faced by analysts who must find the best way to accomplish particular objectives, usually with the added complication of constraints on the available choices. Award-winning educator Ronald E. Miller provides detailed coverage of both classical, calculus-based approaches and newer, computer-based iterative methods. Dr. Miller lays a solid foundation for both linear and nonlinear models and quickly moves on to dis

  8. 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

  9. 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

  10. 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

  11. 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.

  12. Penetrating abdominal trauma.

    Science.gov (United States)

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  13. Foundations of Corporate Governance

    OpenAIRE

    Volonté, Christophe

    2012-01-01

    This paper outlines the foundations of corporate governance. The discussion includes a review on the modern corporation, transaction costs theory, agency costs theory, legal investor protection, investor protection by corporate governance and its various mechanisms, as well as an overview of the determinants of corporate governance.

  14. Foundation Fighting Blindness

    Science.gov (United States)

    ... Boston VisionWalk Kick Off 8th Annual Central Ohio Golf For Sight Golf Classic San Antonio/Austin Chapter Speaker Series Presentations ... Foundation Fighting Blindness’ 2015 Annual Report. Read More Learn more about the latest retinal research news and ...

  15. Sjogren's Syndrome Foundation

    Science.gov (United States)

    ... on Twitter, YouTube, Facebook, and Linkedin! anxiety © 2016 Sjögren’s Syndrome Foundation, Inc. 6707 Democracy Blvd, Ste 325, Bethesda, MD 20817 (Privacy Policy) 1-800 475-6473 · 301 530-4415 (Fax)

  16. 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

  17. Impedance of Bucket Foundations

    DEFF Research Database (Denmark)

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

    2008-01-01

    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....

  18. Foundations for Farming Website

    OpenAIRE

    Foundations for Farming

    2011-01-01

    Metadata only record This website provides information on the activities and outcomes of Foundations for Farming, an international NGO dedicated to promoting Conservation Agriculture as a means of poverty reduction and food security. The organization currently works in Zimbabwe, South Africa, and Malawi, hosting training sessions and facilitating the dissemination of Conservation Agriculture ideologies and practices.

  19. 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.

  20. Radiology of trauma to kidney and lower urinary tract

    International Nuclear Information System (INIS)

    The contents are trauma to kidney, imaging of kidney trauma, management of renal trauma, delayed complications, trauma to the lower urinary tract, trauma to urinary bladder, radiologic diagnosis, ethiology of blunt bladder injury, urethal injury (6 refs.)

  1. Grouting for Pile Foundation Improvement

    OpenAIRE

    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 (safeguarding the piles of the foundation against possible damage resulting from underground construction activities in the vicinity). A full-scale test, of which the general set-up and consistency check ar...

  2. FRAXA Research Foundation

    Science.gov (United States)

    ... to restore Fragile X protein in neurons Brain Revolution: French scientists Barbara Bardoni, PhD, and Thomas Maurin, ... many other top-notch scientists make up our Scientific Advisory Board. FRAXA has funded over $25,000, ...

  3. An ecological view of psychological trauma and trauma recovery.

    Science.gov (United States)

    Harvey, M R

    1996-01-01

    This paper presents an ecological view of psychological trauma and trauma recovery. Individual differences in posttraumatic response and recovery are the result of complex interactions among person, event, and environmental factors. These interactions define the interrelationship of individual and community and together may foster or impede individual recovery. The ecological model proposes a multidimensional definition of trauma recovery and suggests that the efficacy of trauma-focused interventions depends on the degree to which they enhance the person-community relationship and achieve "ecological fit" within individually varied recovery contexts. In attending to the social, cultural and political context of victimization and acknowledging that survivors of traumatic experiences may recover without benefit of clinical intervention, the model highlights the phenomenon of resiliency, and the relevance of community intervention efforts. PMID:8750448

  4. 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.

  5. [Brain abscess - overview].

    Science.gov (United States)

    Sveinsson, Olafur Arni; Asgeirsson, Hilmir; Olafsson, Ingvar H

    2013-01-01

    Brain abscess is a life threatening illness, demanding rapid diagnosis and treatment. Its development requires seeding of an organism into the brain parenchyma, often in an area of damaged brain tissue or in a region with poor microcirculation. The lesion evolves from a cerebritis stage to capsule formation. Brain abscesses can be caused by contiguous or haematogenous spread of an infection, or by head trauma/ neurosurgical procedure. The most common presentation is that of headache and vomiting due to raised intracranial pressure. Seizures have been reported in up to 50% of cases. Focal neurological deficits may be present, depending on the location of the lesion. Treatment of a brain abscess involves aspiration or excision, along with parenteral antibiotic therapy. The outcome has improved dramatically in the last decades due to improvement in diagnostic techniques, neurosurgery, and broad-spectrum antibiotics. The authors provide an overview of the pathogenesis, diagnosis and management of brain abscesses. PMID:23341403

  6. 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…

  7. Unusual delayed presentation of head trauma complicating outcome of facial nerve decompression surgery

    OpenAIRE

    Thakur, J S; Shekar, Vidya; Saluja, Manika; Mohindroo, N K

    2013-01-01

    Late presentation of head trauma is rare. A young boy presented with a traumatic facial paralysis after head trauma. A CT scan of the head showed temporal bone fracture without intracranial insult. Facial nerve decompression was performed and paralysis started improving. However, he presented with vertigo and sensorineural hearing loss after 2 months. Clinical examination also showed cerebellar sign. We suspected iatrogenic injury to the cochlea; however, brain MRI showed haemorrhage in the a...

  8. Netherlands foundation for radioastronomy

    International Nuclear Information System (INIS)

    A report of the board is followed by departmental reports from the Westerbork Telescope Group, Dwingeloo Telescope Group, Computer Group, Laboratory and Central Technical Services, Astronomy Group, Administration of the Foundation/General Affairs and Personnel Council. Astronomical reports describe radio astronomical research carried out by the Foundation staff and at the Kapteyn Laboratory Groningen, Leiden Observatory, Utrecht Observatory and the Laboratorio di Radioastronomia Bologna, Italy. Progress in the extension of the synthesis radio telescope and investigations into the possibility of substantially increasing the SRT data rate for solar observations, are outlined. Appendices shows the organisational structure, the names of the employees, the operating budget, the observing facilities at Westerbork and Dwingeloo, and the publications and reports published in 1978 and related to observations made with these facilities. (C.F.)

  9. Foundation doctors’ induction experiences

    OpenAIRE

    Miles, Susan; Kellett, Joanne; Leinster, Sam J.

    2015-01-01

    Background It is well established that trainee doctors struggle with the transition from medical school to starting work and feel unprepared for many aspects of their new role. There is evidence that suitable induction experiences improve competence and confidence, but available data indicate that trainee doctors on the UK Foundation Programme are commonly not experiencing useful inductions. The aim of the reported research was to explore trainee doctors’ experiences with induction during the...

  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. Foundations for Intrusion Prevention

    OpenAIRE

    Alderman, Ian D.; Parter, David W.; Rubin, Shai; Vernon, Mary K.

    2004-01-01

    We propose an infrastructure that helps a system administrator to identify a newly published vulnerability on the site hosts and to evaluate the vulnerability’s threat with respect to the administrator’s security priorities. The infrastructure foundation is the vulnerability semantics, a small set of attributes for vulnerability definition. We demonstrate that with a few attributes it is possible to define the majority of the known vulnerabilities in a way that (i) facilitates ...

  12. 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

  13. Foundations of Inference

    OpenAIRE

    Kevin H. Knuth; John Skilling

    2012-01-01

    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 thes...

  14. Foundations of Mathematics

    OpenAIRE

    Chaitin, G. J.

    2002-01-01

    This article discusses what can be proved about the foundations of mathematics using the notions of algorithm and information. The first part is retrospective, and presents a beautiful antique, Godel's proof, the first modern incompleteness theorem, Turing's halting problem, and a piece of postmodern metamathematics, the halting probability Omega. The second part looks forward to the new century and discusses the convergence of theoretical physics and theoretical computer science and hopes fo...

  15. Fractal Topology Foundations

    OpenAIRE

    Porchon, Helene

    2012-01-01

    In this paper, we introduce the foundation of a fractal topological space constructed via a family of nested topological spaces endowed with subspace topologies, where the number of topological spaces involved in this family is related to the appearance of new structures on it. The greater the number of topological spaces we use, the stronger the subspace topologies we obtain. The fractal manifold model is brought up as an illustration of space that is locally homeomorphic to the fractal topo...

  16. 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. PMID:27573997

  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. Physicians and foundation hospitals.

    Science.gov (United States)

    Cooper, John; Black, Carol

    2003-01-01

    Foundation NHS Trusts will be constituted in the same way as Mutual Societies, and local people and patients will be invited to become subscribers. Subscribers will elect a board of governors who will appoint the non-executive directors of the Trusts. Foundation Trusts will be outside the performance management system, but will be subject to a regulator and to inspection. Contracts with commissioners will be legally enforceable. Issues discussed in the article include: financial borrowing; whether competition is being reintroduced; poaching staff; fears of a two-tier health service; fragmentation of the NHS; the impact on research and teaching; and the impact on the current 'target culture'. Local communities and patient groups may welcome involvement with their local hospitals, but special interest groups could be a danger. Foundation Trusts may bring back some of the better features of NHS Trusts as originally conceived, and offer better opportunities for clinicians to influence local policies and priorities. Fears of yet another organisational change are an important issue. Only time will tell whether the outcome will justify the effort the changes will involve. PMID:14703035

  20. 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.

  1. 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.

  2. Clinical study on renal trauma

    International Nuclear Information System (INIS)

    We analyzed 26 cases of renal trauma, which occurred during the last 7 years and 6 months. Computed tomography was performed in all cases. Four cases were of type Ib, 13 cases of type II, 3 cases of type IIIa, 5 cases of type IIIb and 1 case of type IVa, according to the classification of renal injury by the Japanese association for the surgery of trauma. Conservative treatment was done in 21 cases, selective transcatheter arterial embolization (TAE) in 4 cases, and surgical treatment in 1 case. Conservative treatment was effective for type I and II renal trauma. In the cases of type IIIa and IIIb renal trauma, open surgery could be avoided and the affected kidney preserved by early TAE. (author)

  3. Factors for vertebral artery injury accompanied by cervical trauma

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Masaaki; Shingu, Hikosuke; Kimura, Isao; Nasu, Yoshiro; Shiotani, Akihide [San-in Rosai Hospital, Yonago, Tottori (Japan). Spine and Low Back Pain Center

    2001-09-01

    Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

  4. Factors for vertebral artery injury accompanied by cervical trauma

    International Nuclear Information System (INIS)

    Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

  5. Processing Trauma: A Case Study

    OpenAIRE

    Hamilton, Jenny

    2013-01-01

    This dissertation is informed by a bio psychosocial model of trauma, synthesising elements of emotional processing, information processing, social cognitive, biochemical, evolutionary and psychosocial perspectives. It is an adaptive model of individuals striving to make sense of, narrate and come to terms with difficult events, as part of the organisms’ tendency towards growth. However, Person Centred theory has so far accounted for trauma through a defence model (Joseph, 2004). Warner (2005,...

  6. Imaging of cervicothoracic junction trauma

    OpenAIRE

    Kaewlai, Rathachai

    2013-01-01

    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...

  7. Regional anesthesia for trauma patients

    OpenAIRE

    TONKOVIĆ, DINKO; NESEK ADAM, VIŠNJA; BARONICA, ROBERT; BANDIĆ PAVLOVIĆ, DANIJELA; DRVAR, ŽELJKO; Zah Bogović, Tajana

    2013-01-01

    Trauma patients demands special medical care. Pain is frequently undertreated in the early phase of trauma. Pain is a major symptom of surgical conditions and minimizing pain could lead to misdiagnoses and technical facilities are not appropriate for adequate pain treatment. Consequences of inappropriate pain treatment could aggravate stress response, increases oxygen demand and led to myocardial ischemia Analgesia with parenteral opioids is effective but carries a risk of respiratory depr...

  8. Using the core curriculum on childhood trauma to strengthen clinical knowledge in evidence-based practitioners.

    Science.gov (United States)

    Layne, Christopher M; Strand, Virginia; Popescu, Marciana; Kaplow, Julie B; Abramovitz, Robert; Stuber, Margaret; Amaya-Jackson, Lisa; Ross, Leslie; Pynoos, Robert S

    2014-01-01

    The high prevalence of trauma exposure in mental health service-seeking populations, combined with advances in evidence-based practice, competency-based training, common-elements research, and adult learning make this an opportune time to train the mental health workforce in trauma competencies. The Core Curriculum on Childhood Trauma (CCCT) utilizes a five-tiered conceptual framework (comprising Empirical Evidence, Core Trauma Concepts, Intervention Objectives, Practice Elements, and Skills), coupled with problem-based learning, to build foundational trauma knowledge and clinical reasoning skills. We present findings from three studies: Study 1 found that social work graduate students' participation in a CCCT course (N = 1,031) was linked to significant pre-post increases in self-reported confidence in applying core trauma concepts to their clinical work. Study 2 found significant pre-post increases in self-reported conceptual readiness (N = 576) and field readiness (N = 303) among social work graduate students participating in a "Gold Standard Plus" educational model that integrated classroom instruction in core trauma concepts, training in evidence-based trauma treatment (EBTT), and implementation of that EBTT in a supervised field placement. Students ranked the core concepts course as an equivalent or greater contributor to field readiness compared to standard EBTT training. Study 3 used qualitative methods to "distill" common elements (35 intervention objectives, 59 practice elements) from 26 manualized trauma interventions. The CCCT is a promising tool for educating "next-generation" evidence-based practitioners who possess competencies needed to implement modularized, individually tailored trauma interventions by strengthening clinical knowledge, clinical reasoning, and familiarity with common elements. PMID:24484506

  9. 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.

  10. Radiographic evaluation of hepatic trauma

    International Nuclear Information System (INIS)

    The incidence of significant abdominal trauma continues to rise and accounts currently for approximately 10 percent of the annual 130,000 trauma-related deaths in the United States. Over 60 percent of patients are from 10 to 40 years of age, with a striking predominance of males. Children are mostly victims of blunt trauma, while some large reviews of liver trauma in adults show a prevalence of penetrating injuries. Injury to the liver is second only to the spleen in incidence of intraperitoneal injuries. Morbidity and mortality from hepatic trauma are related to the mechanism and extent of injury. Penetrating injuries generally have a lower mortality, about 5 percent, especially if they are due to stab wounds or low velocity gunshot wounds. Shotgun and high velocity gunshot wounds may cause massive fragmentation of the liver and are associated with proportionately greater mortality. The mortality from blunt trauma is from 15 to 45 percent in many large series. Death from isolated liver injury is uncommon, but is usually due to uncontrolled hemorrhage. Injury to other abdominal organs is associated in many cases, as are injuries to the head, chest, and limbs. The extraabdominal injuries are frequently more apparent clinically, but may mask potentially life-threatening abdominal visceral injuries

  11. Imaging of blunt chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Wicky, S.; Wintermark, M.; Schnyder, P.; Capasso, P.; Denys, A. [Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland). Dept. of Radiology

    2000-10-01

    In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. (orig.)

  12. 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.

  13. 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

  14. 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....

  15. Establishment of animal model of intestinal motility disorders after severe craniocerebral trauma%重型颅脑损伤后肠动力障碍动物模型的建立

    Institute of Scientific and Technical Information of China (English)

    方欢; 张丽梅; 张索飞; 朱京慈

    2013-01-01

    目的 采用改良的自由落体撞击法建立小鼠重型颅脑损伤后肠动力障碍(intestinal motility disorders,IMD)模型,为进一步研究损伤后IMD机制奠定基础.方法 采用自制圆柱套杆撞击器对小鼠致伤,于伤后1,6h、1,3,7d各时相点观察脑、肠组织的病理学改变,检测脑含水量、小肠推进率.结果 重型颅脑损伤后在脑组织出血水肿时期,肠道亦有急性炎症、充血等表现;脑含水量于6h增加,24 h达高峰;损伤后1h即出现小肠推进率的下降,6h达最低值.结论 小鼠重型颅脑损伤后存在IMD,本装置采用改良Feeney自由落体撞击法可成功建立重型颅脑损伤后IMD的小鼠模型.%Objective To build model of intestinal motility disorders (IMD) in mice after severe craniocerebral trauma by using modified free fall impact method so as to lay the foundation for further study on development mechanism of postinjury IMD.Methods Severe craniocerebral trauma in mice was induced by a cylindrical sleeve rod impactor.Pathological changes of cerebral and intestinal tissue in mice were observed at 1,6 hours and 1,3,7 days after severe craniocerebral trauma.Brain water content and intestinal propulsion percentage were detected in each time point as well.Results Acute inflammation and congestion of the intestine were observed in phase of cerebral hemorrhage and edema after severe craniocerebral trauma in mice.Brain water content was increased at 6 hours and reached the peak at 24 hours.Intestine propulsion percentage showed a fall at one hour and dropped to the lowest level at 6 hours.Conclusions IMD exists in mice with severe craniocerebral trauma.The device involving modified Feeney free fall impact method can successfully establish animal model of IMD in mice with severe craniocerebral trauma.

  16. American foundations : roles and contributions

    OpenAIRE

    Helmut K. Anheier; Hammack, David

    2010-01-01

    Foundations play an essential part in the philanthropic activity that defines so much of American life. No other nation provides its foundations with so much autonomy and freedom of action as does the United States. Liberated both from the daily discipline of the market and from direct control by government, American foundations understandably attract great attention. As David Hammack and Helmut Anheier note in this volume, "Americans have criticized foundations for... their alleged conservat...

  17. 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....

  18. 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

  19. 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....

  20. 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

  1. 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.

  2. 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.

  3. 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, ...

  4. Exploring trauma associated appraisals in trauma survivors from collectivistic cultures.

    Science.gov (United States)

    Engelbrecht, Alberta; Jobson, Laura

    2016-01-01

    Appraisals are a key feature in understanding an individual's experience; this is especially important when the experience is a traumatic one. However, research is diminutive when looking at the interaction between trauma appraisals and culture in relation to posttraumatic stress disorder using qualitative methodologies. This study explored cultural differences in perceptions and appraisals of trauma using three qualitative focus groups with community members (n = 11) from collectivistic cultures who had experienced a traumatic event and three qualitative individual key informant interviews with mental health practitioners (n = 3) routinely working with trauma survivors. Using template analysis, eight emergent themes were highlighted from the data sets [(1) trauma and adjustment; (2) cultural and social roles; (3) traumatised self; (4) relationships; (5) external attribution; (6) future; (7) education; (8) language] that potentially have significant consequences for posttrauma psychological adjustment and recovery. Cumulatively, while a number of themes are similar to that which is emphasised in current literature (e.g. damaged self, negative appraisals of the world, others, future) a number of themes were also resonant and warrant further scrutiny. For instance, the importance and interconnectedness of the group to the individual and the impact trauma has on this; the importance of social roles, cultural appropriateness and violations of cultural values and norms; findings and implications are discussed. PMID:27652138

  5. Trauma-Informed Care in the Massachusetts Child Trauma Project.

    Science.gov (United States)

    Bartlett, Jessica Dym; Barto, Beth; Griffin, Jessica L; Fraser, Jenifer Goldman; Hodgdon, Hilary; Bodian, Ruth

    2016-05-01

    Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC. PMID:26564909

  6. 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.

  7. Cellular High-energy Cavitation Trauma - description of a novel in vitro trauma model in three different cell types.

    Directory of Open Access Journals (Sweden)

    Yuli eCao

    2016-02-01

    Full Text Available The mechanisms involved in traumatic brain injury (TBI have yet to be fully characterized. One mechanism that, especially in high energy trauma, could be of importance is cavitation. Cavitation can be described as a process of vaporization, bubble generation and bubble implosion as a result of a decrease and subsequent increase in pressure. Cavitation as an injury mechanism is difficult to visualize and model due to its short duration and limited spatial distribution. One strategy to analyze the cellular response of cavitation is to employ suitable in vitro models. The flyer plate is an in vitro high energy trauma model that includes cavitation as a trauma mechanism. A copper fragment is accelerated by means of a laser, hits the bottom of a cell culture well causing cavitation and shock waves inside the well and cell medium. We have found the flyer plate model to be efficient, reproducible and easy to control. In this study we have used the model to analyze the cellular response to microcavitation in SH-SY5Y neuroblastoma, Caco-2, and C6 glioma cell lines. Mitotic activity in neuroblastoma and glioma was investigated with BrdU staining, and cell numbers were calculated using automated time-lapse imaging. We found variations between cell types and between different zones surrounding the lesion with these methods. It was also shown that the injured cell cultures released S-100B in a dose dependent manner. Using gene expression microarray a number of gene families of potential interest were found to be strongly, but differently regulated in neuroblastoma and glioma at 24 hr post trauma. The data from the gene expression arrays may be used to identify new candidates for biomarkers in cavitation trauma. We conclude that our model is useful for studies of trauma in vitro and that it could be applied in future treatment studies.

  8. Cellular High-Energy Cavitation Trauma – Description of a Novel In Vitro Trauma Model in Three Different Cell Types

    Science.gov (United States)

    Cao, Yuli; Risling, Mårten; Malm, Elisabeth; Sondén, Anders; Bolling, Magnus Frödin; Sköld, Mattias K.

    2016-01-01

    The mechanisms involved in traumatic brain injury have yet to be fully characterized. One mechanism that, especially in high-energy trauma, could be of importance is cavitation. Cavitation can be described as a process of vaporization, bubble generation, and bubble implosion as a result of a decrease and subsequent increase in pressure. Cavitation as an injury mechanism is difficult to visualize and model due to its short duration and limited spatial distribution. One strategy to analyze the cellular response of cavitation is to employ suitable in vitro models. The flyer-plate model is an in vitro high-energy trauma model that includes cavitation as a trauma mechanism. A copper fragment is accelerated by means of a laser, hits the bottom of a cell culture well causing cavitation, and shock waves inside the well and cell medium. We have found the flyer-plate model to be efficient, reproducible, and easy to control. In this study, we have used the model to analyze the cellular response to microcavitation in SH-SY5Y neuroblastoma, Caco-2, and C6 glioma cell lines. Mitotic activity in neuroblastoma and glioma was investigated with BrdU staining, and cell numbers were calculated using automated time-lapse imaging. We found variations between cell types and between different zones surrounding the lesion with these methods. It was also shown that the injured cell cultures released S-100B in a dose-dependent manner. Using gene expression microarray, a number of gene families of potential interest were found to be strongly, but differently regulated in neuroblastoma and glioma at 24 h post trauma. The data from the gene expression arrays may be used to identify new candidates for biomarkers in cavitation trauma. We conclude that our model is useful for studies of trauma in vitro and that it could be applied in future treatment studies. PMID:26869990

  9. Cellular High-Energy Cavitation Trauma - Description of a Novel In Vitro Trauma Model in Three Different Cell Types.

    Science.gov (United States)

    Cao, Yuli; Risling, Mårten; Malm, Elisabeth; Sondén, Anders; Bolling, Magnus Frödin; Sköld, Mattias K

    2016-01-01

    The mechanisms involved in traumatic brain injury have yet to be fully characterized. One mechanism that, especially in high-energy trauma, could be of importance is cavitation. Cavitation can be described as a process of vaporization, bubble generation, and bubble implosion as a result of a decrease and subsequent increase in pressure. Cavitation as an injury mechanism is difficult to visualize and model due to its short duration and limited spatial distribution. One strategy to analyze the cellular response of cavitation is to employ suitable in vitro models. The flyer-plate model is an in vitro high-energy trauma model that includes cavitation as a trauma mechanism. A copper fragment is accelerated by means of a laser, hits the bottom of a cell culture well causing cavitation, and shock waves inside the well and cell medium. We have found the flyer-plate model to be efficient, reproducible, and easy to control. In this study, we have used the model to analyze the cellular response to microcavitation in SH-SY5Y neuroblastoma, Caco-2, and C6 glioma cell lines. Mitotic activity in neuroblastoma and glioma was investigated with BrdU staining, and cell numbers were calculated using automated time-lapse imaging. We found variations between cell types and between different zones surrounding the lesion with these methods. It was also shown that the injured cell cultures released S-100B in a dose-dependent manner. Using gene expression microarray, a number of gene families of potential interest were found to be strongly, but differently regulated in neuroblastoma and glioma at 24 h post trauma. The data from the gene expression arrays may be used to identify new candidates for biomarkers in cavitation trauma. We conclude that our model is useful for studies of trauma in vitro and that it could be applied in future treatment studies. PMID:26869990

  10. 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. PMID:21303323

  11. Prudent care of head trauma in the elderly: a case report

    OpenAIRE

    Ross, Allen GP

    2014-01-01

    Introduction Severe traumatic brain injury is a major public health problem that accounts for one-third of all deaths due to trauma in the United States. This case report illustrates some of the challenges faced by the elderly in accessing essential emergency services for traumatic brain injury. Case presentation A 74-year-old Caucasian man presented with head trauma at his local acute care hospital (level III/IV) in Canada at 2:30 PM. He was triaged at 4:00 PM and was seen by the emergency r...

  12. Static Behaviour of Bucket Foundations

    DEFF Research Database (Denmark)

    Larsen, Kim André

    as well as large-scale tests on bucket foundations subjected to low vertical load are performed during this work. Numerical simulations of the tests performed are carried out using the Mohr Coulomb material model and the commercial finite element code ABAQUS. Based on the present work, the finite element......One new foundation concept in relation to offshore wind turbines is bucket foundations. The concept is known from the oil and gas industry, though the load conditions here are significantly different. The bucket foundation can be used as monopod or e.g. tripod foundations for offshore wind turbines....... 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...

  13. 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.

  14. 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...

  15. Delta Alerts: Changing Outcomes in Geriatric Trauma.

    Science.gov (United States)

    Wiles, Lynn L; Day, Mark D; Harris, LeAnna

    2016-01-01

    Geriatric trauma patients (GTPs) suffering minor injuries have suboptimal outcomes compared with younger populations. Patients 65 years or older account for 10% of all traumas but 28% of all trauma deaths. This trauma center established a third tier trauma alert specifically targeting GTPs at risk for poor outcomes. A Delta Alert is activated when GTPs suffer injuries that fall outside traditional trauma alert guidelines. Early identification and treatment of injuries and expedited referral to specialty groups have improved our GTPs' outcomes including decreased mortality and length of stay and increased percentage of GTPs who are discharged home. PMID:27414140

  16. Blunt force trauma to skull with various instruments.

    Science.gov (United States)

    Sulaiman, Nur Amirah; Osman, Khairul; Hamzah, Noor Hazfalinda; Amir, Sri Pawita Albakri

    2014-04-01

    Deaths due to blunt force trauma to the head as a result of assault are some of the most common cases encountered by the practicing forensic pathologist. Previous studies have shown inflicting injury to the head region is one of the most effective methods of murder. The important factors that determine severity of trauma include the type of weapon used, type and site of skull fracture, intracranial haemorrhage and severity of brain injury. The aim of this study was to determine the characteristics of blunt force trauma to the skull produced by different instruments. Nine adult monkeys (Macaca fascicularis) skulls were used as models. Commonly found blunt objects comprising of Warrington hammer, hockey stick and open face helmet were used in this study. A machine calibrated force generator was used to hold the blunt object in place and to hit the skulls at forces of 12.5N and 25N. Resultant traumatic effects and fractures (linear, depressed, basilar, comminuted, and distastic) were analyzed according to type of blunt object used; surface area of contact and absolute force (N/cm(2)) delivered. Results showed that all investigated instruments were capable of producing similar injuries. The severity of trauma was not related to the surface area of contact with the blunt objects. However, only high absolute forces produced comminuted fractures. These findings were observational, as the samples were too small for statistical conclusions. PMID:24763233

  17. 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

  18. Scientific foundations of engineering

    CERN Document Server

    McKnight, Stephen

    2015-01-01

    Providing an overview of the foundations of engineering from a fundamental scientific and physical perspective, this book reinforces the basic scientific and mathematical principles which underpin a range of engineering disciplines and applications. It covers the basics of physics, including quantum physics, as well as some key topics in chemistry, making it a valuable resource for both students and professionals looking to gain a more coherent and interdisciplinary understanding of engineering systems. Throughout, the focus is on common features of physical systems (such as mechanical and electronic resonance), showing how the same underlying principles apply to different disciplines. Problems are provided at the end of each chapter including conceptual questions and examples to demonstrate the practical application of fundamental scientific principles. These include real-world examples, which are solvable using computational packages such as MATLAB.

  19. 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.

  20. Foundations of Quantum Decoherence

    CERN Document Server

    Gamble, John

    2008-01-01

    The conventional interpretation of quantum mechanics, though it permits a correspondence to classical physics, leaves the exact mechanism of transition unclear. Though this was only of philosophical importance throughout the twentieth century, over the past decade new technological developments, such as quantum computing, require a more thorough understanding of not just the result of quantum emergence, but also its mechanism. Quantum decoherence theory is the model that developed out of necessity to deal with the quantum-classical transition explicitly, and without external observers. In this thesis, we present a self-contained and rigorously argued full derivation of the master equation for quantum Brownian motion, one of the key results in quantum decoherence theory. We accomplish this from a foundational perspective, only assuming a few basic axioms of quantum mechanics and deriving their consequences. We then consider a physical example of the master equation and show that quantum decoherence successfull...

  1. Foundations of signal processing

    CERN Document Server

    Vetterli, Martin; Goyal, Vivek K

    2014-01-01

    This comprehensive and engaging textbook introduces the basic principles and techniques of signal processing, from the fundamental ideas of signals and systems theory to real-world applications. Students are introduced to the powerful foundations of modern signal processing, including the basic geometry of Hilbert space, the mathematics of Fourier transforms, and essentials of sampling, interpolation, approximation and compression. The authors discuss real-world issues and hurdles to using these tools, and ways of adapting them to overcome problems of finiteness and localisation, the limitations of uncertainty and computational costs. Standard engineering notation is used throughout, making mathematical examples easy for students to follow, understand and apply. It includes over 150 homework problems and over 180 worked examples, specifically designed to test and expand students' understanding of the fundamentals of signal processing, and is accompanied by extensive online materials designed to aid learning, ...

  2. Radiation Effects Research Foundation

    International Nuclear Information System (INIS)

    The last day of March 1978 marked the completion of the first 3 years of operation of the Radiation Effects Research Foundation in Hiroshima and Nagasaki. RERF was established on 1 April 1975 as successor to the Atomic Bomb Casualty Commission which had been in continuous operation since 1947. This record of the first 3 years of operation consists of selected reports and other documents prepared in the course of conducting the business of RERF and includes a brief history, a late radiation effects that might be conducted at RERF. The wisdom and thought given to the research program and its operation by the Scientific Council and the Board of Directors is reflected in the minutes of their meetings which are included in the Appendix. (Mori, K.)

  3. Foundations of Geomagnetism

    Science.gov (United States)

    Jackson, Andy

    The study of the magnetic field of the Earth, or geomagnetism, is one of the oldest lines of scientific enquiry. Indeed, it has often been said that William Gilbert's De Magnete, published in 1600 and predating Isaac Newton's Principia by 87 years, can claim to be the first true scientific textbook; his study was essentially the first of academic rather than practical interest.What then, we may ask, has been accomplished in the nearly 400 intervening years up to the publication of Foundations of Geomagnetism? In short, a wealth of observational evidence, considerable physical understanding, and a great deal of mathematical apparatus have accrued, placing the subject on a much surer footing.The latter two categories are described in considerable detail, and with attendant rigor, in this book. The sphericity of the Earth means that a frequent theme in the book is the solution of the partial differential equations of electrodynamics in a spherical geometry.

  4. 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.

  5. 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.

  6. 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.]. PMID:27322172

  7. Age Dependency of Trauma-Induced Neocortical Epileptogenesis

    Directory of Open Access Journals (Sweden)

    Igor eTimofeev

    2013-09-01

    Full Text Available 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 et al., 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 et al., 2006; Nita and Timofeev, 2007; Nita et al., 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.

  8. Complicaciones en el trauma raquimedular

    OpenAIRE

    López, M

    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...

  9. [Polyvagal theory and emotional trauma].

    Science.gov (United States)

    Leikola, Anssi; Mäkelä, Jukka; Punkanen, Marko

    2016-01-01

    According to the polyvagal theory, the autonomic nervous system can, in deviation from the conventional theory, be divided in three distinct parts that are in hierarchical relationship with each other. The most-primitive autonomic control results in depression of vital functions, the more evolved one in fighting or escape and the most evolved one in social involvement. Practical application of the polyvagal theory has resulted in positive results above all in the treatment of emotional trauma. in Finland, therapy of complex trauma is founded on the theory of structural dissociation of the personality, which together with the polyvagal theory forms a practical frame of reference for psychotherapeutic work. PMID:27044181

  10. Component separation in abdominal trauma.

    Science.gov (United States)

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

  11. 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.

  12. 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.

  13. Rural Emergency Medical Services (EMS) and Trauma

    Science.gov (United States)

    ... View more Rural Emergency Medical Services (EMS) and Trauma Emergency medical services (EMS) providers care for individuals ... hospital be part of the regional and statewide trauma system? Yes. According to Safety in Numbers: Are ...

  14. Abusive Head Trauma (Shaken Baby Syndrome)

    Science.gov (United States)

    ... Things to Know About Zika & Pregnancy 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 ...

  15. 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

  16. Causal influence in neural systems: Reconciling mechanistic-reductionist and statistical perspectives. Comment on "Foundational perspectives on causality in large-scale brain networks" by M. Mannino & S.L. Bressler

    Science.gov (United States)

    Griffiths, John D.

    2015-12-01

    The modern understanding of the brain as a large, complex network of interacting elements is a natural consequence of the Neuron Doctrine [1,2] that has been bolstered in recent years by the tools and concepts of connectomics. In this abstracted, network-centric view, the essence of neural and cognitive function derives from the flows between network elements of activity and information - or, more generally, causal influence. The appropriate characterization of causality in neural systems, therefore, is a question at the very heart of systems neuroscience.

  17. Influence of interactions between genes and childhood trauma on refractoriness in psychiatric disorders.

    Science.gov (United States)

    Kim, Ji Sun; Lee, Seung-Hwan

    2016-10-01

    Psychiatric disorders are excellent disease models in which gene-environmental interaction play a significant role in the pathogenesis. Childhood trauma has been known as a significant environmental factor in the progress of, and prognosis for psychiatric illness. Patients with refractory illness usually have more severe symptoms, greater disability, lower quality of life and are at greater risk of suicide than other psychiatric patients. Our literature review uncovered some important clinical factors which modulate response to treatment in psychiatric patients who have experienced childhood trauma. Childhood trauma seems to be a critical determinant of treatment refractoriness in psychotic disorder, bipolar disorder, major depressive disorder, and post-traumatic stress disorder. In patients with psychotic disorders, the relationship between childhood trauma and treatment-refractoriness appears to be mediated by cognitive impairment. In the case of bipolar disorder, the relationship appears to be mediated by greater affective disturbance and earlier onset, while in major depressive disorder the mediating factors are persistent, severe symptoms and frequent recurrence. In suicidal individuals, childhood maltreatment was associated with violent suicidal attempts. In the case of PTSD patients, it appears that childhood trauma makes the brain more vulnerable to subsequent trauma, thus resulting in more severe, refractory symptoms. Given that several studies have suggested that there are distinct subtypes of genetic vulnerability to childhood trauma, it is important to understand how gene-environment interactions influence the course of psychiatric illnesses in order to improve therapeutic strategies. PMID:26827636

  18. 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

  19. 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.

  20. 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

  1. Negotiated knowledge positions : communication in trauma teams

    OpenAIRE

    Härgestam, Maria

    2015-01-01

    Background Within trauma teams, effective communication is necessary to ensure safe and secure care of the patient. Deficiencies in communication are one of the most important factors leading to patient harm. Time is an essential factor for rapid and efficient disposal of trauma teams to increase patients’ survival and prevent morbidity. Trauma team training plays an important role in improving the team’s performance, while the leader of the trauma team faces the challenge of coordinating and...

  2. 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.

  3. Hypoadrenalism Following Trauma: Is Sepsis Always Necessary?

    OpenAIRE

    Paquette, Ian M; Burchard, Kenneth W.

    2008-01-01

    Purpose of the Study: Trauma patients can exhibit the systemic inflammatory response syndrome (SIRS) without evidence of infection. SIRS from infection has been associated with hypoadrenalism. We hypothesized that hypoadrenalism can accompany SIRS from trauma without infection. To investigate this further, we performed a retrospective study of trauma patients admitted to the ICU at our rural academic level 1 trauma center from October 2003- June 2005, with measurement of blood cortisol in the...

  4. Neuroprotective effects of tetracyclines on blunt head trauma: An experimental study on rats

    Directory of Open Access Journals (Sweden)

    Ozhan Merzuk Uckun

    2015-01-01

    Full Text Available Background: Prevention of primary damage caused by head trauma may be avoided with protective measures and techniques which is a public health concern. Experimental and clinical studies about treatment of head trauma were all centered to prevent secondary damage caused by physiopathological changes following primary injury. Neuroprotective features of tetracyclines were the focus of several experimental studies in the last decade. In the present study we aimed to investigate the neuroprotective effects of tetracycline in an experimental model of blunt brain injury in rats. Materials and Methods: 32 male Sprague-Dawley rats were divided into four experimental groups (n = 8. Head trauma was not performed in control group (group 1, craniectomy only. In the second group, head trauma and craniectomy were performed. Intraperitoneal saline was used in addition to trauma and craniectomy for treatment in group 3 whereas intraperitoneal tetracycline and saline were used for treatment in group 4. Results: When histological examinations performed by transmission electron microscopy were evaluated, injury at ultrastructural level was demonstrated to be less pronounced in tetracycline group with decreased lipid peroxidation levels. Conclusion: In accordance with these findings, we conclude that systemic tetracycline administration is effective in reduction of secondary brain damage and brain edema and thus it may be considered as a therapeutic option.

  5. 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.

  6. 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

  7. 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

  8. 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…

  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. 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.

  11. Clinic Research of Nursing Intervention on Prognosis of Patients with Hyperglycemia after Skull and Brain Trauma%护理干预对颅脑外伤后高血糖患者治疗转归的临床研究

    Institute of Scientific and Technical Information of China (English)

    姚琼珍; 陈素英; 龙贵珍; 严艳玲; 何巧媚; 邓羡勇

    2009-01-01

    To investigate the effect of nursing intervention on prognosis of patients with hyperglycemia after skull and brain trauma. Methods: 190 cases of patients with traumatic brain injury, who were randomized into two hyperglycemia group (n=74) and normal blood sugar group (n=116). The patients in hyperglycemia group were phlebotomized to measure the fasting blood-glucose at the morning of admission, and at the following 1, 2, 3, 5, 7, 10, 14 mornings after injury. Used and adjusted the dosage of insulin on the basis of blood sugar value. Monitored the peripheral blood sugar dynamically during using insulin, until fasting blood-glucose becoming 2 times continuous normal. At the same time, set down the nursing intervention of diet, and gave the pertinence health education to the patients or their relations [1].Result: the patient who cerebral vasospasm after severe cranioncerebral injury,his blood sugar is positively related with GCS grade ,state of an illness and life sign.the group of blood sugar elevate after carry out nurseing and cureing,the blood sugar became normal.the group of blood elevate and the normal group no difference in blood sugar(p>0.05).12 patients because brain severe injury,blood sugar continue elevate, the prognosis is difference from the normal group(p0.05),12例因原发性脑损害严重,血糖持续升高,其预后与血糖正常组差异有统计学意义,p<0.01,6例患者因伤情重而死亡.结论 对重症颅脑损伤后血糖升高患者进行动态血糖监测,尽早调控血糖及实施护理干预,能降低病死率,使患者获得更好的转归,对提高患者生命质量具有重要的意义.

  12. 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....

  13. 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.

  14. 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…

  15. Liver trauma: WSES position paper

    OpenAIRE

    Coccolini, Federico; Montori, Giulia; Catena, Fausto; Di Saverio, Salomone; Biffl, Walter; Moore, Ernest E; Peitzman, Andrew B; Rizoli, Sandro; Tugnoli, Gregorio; Sartelli, Massimo; Manfredi, Roberto; Ansaloni, Luca

    2015-01-01

    The liver is the most injured organ in abdominal trauma. Road traffic crashes and antisocial, violent behavior account for the majority of liver injuries. The present position paper represents the position of the World Society of Emergency Surgery (WSES) about the management of liver injuries.

  16. 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…

  17. 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 i...

  18. 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.

  19. 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

  20. The National Trauma Research Repository: Ushering in a New ERA of trauma research (Commentary).

    Science.gov (United States)

    Smith, Sharon L; Price, Michelle A; Fabian, Timothy C; Jurkovich, Gregory J; Pruitt, Basil A; Stewart, Ronald M; Jenkins, Donald H

    2016-09-01

    Despite being the leading cause of death in the United States for individuals 46 years and younger and the primary cause of death among military service members, trauma care research has been underfunded for the last 50 years. Sustained federal funding for a coordinated national trauma clinical research program is required to advance the science of caring for the injured. The Department of Defense is committed to funding studies with military relevance; therefore, it cannot fund pediatric or geriatric trauma clinical trials. Currently, trauma clinical trials are often performed within a single site or a small group of trauma hospitals, and research data are not available for secondary analysis or sharing across studies. Data-sharing platforms encourage transfer of research data and knowledge between civilian and military researchers, reduce redundancy, and maximize limited research funding. In collaboration with the Department of Defense, trauma researchers formed the Coalition for National Trauma Research (CNTR) in 2014 to advance trauma research in a coordinated effort. CNTR's member organizations are the American Association for the Surgery of Trauma (AAST), the American College of Surgeons Committee on Trauma (ACS COT), the Eastern Association for the Surgery of Trauma (EAST), the Western Trauma Association (WTA), and the National Trauma Institute (NTI). CNTR advocates for sustained federal funding for a multidisciplinary national trauma research program to be conducted through a large clinical trials network and a national trauma research repository. The initial advocacy and research activities underway to accomplish these goals are presented. PMID:27496599

  1. 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.

  2. Organizational network in trauma management in Italy

    OpenAIRE

    Osvaldo Chiara; Stefania Cimbanassi; Alba Fava; Sergio Vesconi

    2005-01-01

    In Italy, as in other western countries, trauma is a leading cause of death during the first four decades of life, with almost 18.000 of deaths per year. Since 80s organized systems for trauma care, including a pre-hospital emergency medical system and a network of hospitals designated as Trauma Centres, have been developed in north American countries. Effectiveness of trauma systems has been investigated comparing the post-system to the pre-system trauma care with the method of panel evaluat...

  3. [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.

  4. South African music learners and psychological trauma: educational solutions to a societal dilemma

    OpenAIRE

    Swart, I.

    2013-01-01

    Emotional trauma affects a large proportion of the South African population. This article addresses its influence on music learners, including its effects on brain development, relational development, learning and music-making. The power of the educator to reshape a child’s brain by providing a nurturing and consistent environment is stressed. The effect of the environment in modulating epigenetic expression is discussed in conjunction with object relations theory as a model fo...

  5. 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.

  6. 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...

  7. Antithetic Foundations of Economics

    Directory of Open Access Journals (Sweden)

    Marin Dinu

    2011-03-01

    Full Text Available This paper aims at decrypting the manner in which the foundations of Economics as a science and the meanings of the relevant explanatory formulas are being shaped. My analytical endeavor focuses on understanding the peculiarities of what is referred to as the object of study of the science known as Economics, an academic synthesis of concept-related breakthroughs regarding economicity. The explicit purpose of this analysis is to identify perennial benchmarks in economic cognition whereby this ensures its consistency. The implicit purpose is to shape a cognitive model in line with the specifics of the conceptual universe of Economics, as well as with the sources of the economic realities that are subject to a sui-generis relativism. The primary benefit of this endeavor consists in systemizing the conceptual prospects with an antithetic nature that allow for the explanations of the state of economic rationality and generate the understanding of what the source of economicity is and how it behaves. As such, the conclusions are marked by the stringent need of more precisely defining economic knowledge in order to match the changing nature of economic reality, as an expression that embraces the meeting point of two ontological vistas that are methodologically separated by some theories: human nature and human condition. Economics as a science thus features, apart from a conceptual substrate that needs to be spotted, an ontological background that needs to be revealed. The role played by this background appears to be most frequently ignored. The joint identification of both direct and contextual determinants for a sensitive area of humankind, i.e. the economy, is a direction to be followed by the royal path of rational knowledge.

  8. 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.

  9. [Regional vasoactive and metabolic therapy of patients with severe cranio-cerebral traumas].

    Science.gov (United States)

    Lapshin, V N; Shakh, B N; Teplov, V M; Smirnov, D B

    2012-01-01

    In patients with severe cranio-cerebral traumas an investigation was performed of the efficiency of using vasoactive therapy in complex treatment directed to earlier recovery of the microcirculatory blood flow and aerobic metabolism in ischemic parts of the brain. PMID:22880433

  10. 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…

  11. 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....

  12. 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…

  13. 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

  14. The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews

    OpenAIRE

    Lee Courtney; Crawford Cindy; Wallerstedt Dawn; York Alexandra; Duncan Alaine; Smith Jennifer; Sprengel Meredith; Welton Richard; Jonas Wayne

    2012-01-01

    Abstract Background Co-morbid symptoms (for example, chronic pain, depression, anxiety, and fatigue) are particularly common in military fighters returning from the current conflicts, who have experienced physical and/or psychological trauma. These overlapping conditions cut across the boundaries of mind, brain and body, resulting in a common symptomatic and functional spectrum of physical, cognitive, psychological and behavioral effects referred to as the ‘Trauma Spectrum Response’ (TSR). Wh...

  15. Mental Imagery and Post-Traumatic Stress Disorder: A Neuroimaging and Experimental Psychopathology Approach to Intrusive Memories of Trauma

    OpenAIRE

    Clark, Ian A; Mackay, Clare E.

    2015-01-01

    This hypothesis and theory paper presents a pragmatic framework to help bridge the clinical presentation and neuroscience of intrusive memories following psychological trauma. Intrusive memories are a hallmark symptom of post-traumatic stress disorder (PTSD). However, key questions, including those involving etiology, remain. In particular, we know little about the brain mechanisms involved in why only some moments of the trauma return as intrusive memories while others do not. We first prese...

  16. Mental Imagery and Posttraumatic Stress Disorder: a neuroimaging and experimental psychopathology approach to intrusive memories of trauma

    OpenAIRE

    Clark, Ian A; Clare E Macaky

    2015-01-01

    This hypothesis and theory paper presents a pragmatic framework to help bridge the clinical presentation and neuroscience of intrusive memories following psychological trauma. Intrusive memories are a hallmark symptom of Posttraumatic Stress Disorder. However, key questions, including those involving aetiology remain. In particular, we know little about the brain mechanisms involved in why only some moments of the trauma return as intrusive memories while others do not. We first present an ov...

  17. 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.

  18. 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

  19. Hypotensive Resuscitation among Trauma Patients

    Science.gov (United States)

    Carrick, Matthew M.; Leonard, Jan; Slone, Denetta S.; Mains, Charles W.

    2016-01-01

    Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur. The randomized controlled trials examining restricted fluid resuscitation have demonstrated that aggressive fluid resuscitation in the prehospital and hospital setting leads to more complications than hypotensive resuscitation, with disparate findings on the survival benefit. Since the populations studied in each randomized controlled trial are slightly different, as is the timing of intervention and targeted vitals, there is still a need for a large, multicenter trial that can examine the benefit of hypotensive resuscitation in both blunt and penetrating trauma patients. PMID:27595109

  20. 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

  1. : FMRI in acoustic trauma sequelae

    OpenAIRE

    Job, Agnès; Pons, Yoann; Lamalle, Laurent; Jaillard, Assia; Buck, Karl; Segebarth, Christoph; Delon-Martin, Chantal

    2012-01-01

    International audience The most common consequences of acute acoustic trauma (AAT) are hearing loss at frequencies above 3 kHz and tinnitus. In this study, we have used functional Magnetic Resonance Imaging (fMRI) to visualize neuronal activation patterns in military adults with AAT and various tinnitus sequelae during an auditory "oddball" attention task. AAT subjects displayed overactivities principally during reflex of target sound detection, in sensorimotor areas and in emotion-related...

  2. Contemporary Management of Renal Trauma

    Science.gov (United States)

    Shoobridge, Jennifer J; Corcoran, Niall M; Martin, Katherine A; Koukounaras, Jim; Royce, Peter L; Bultitude, Matthew F

    2011-01-01

    In the management of renal trauma, surgical exploration inevitably leads to nephrectomy in all but a few specialized centers. With current management options, the majority of hemodynamically stable patients with renal injuries can be successfully managed nonoperatively. Improved radiographic techniques and the development of a validated renal injury scoring system have led to improved staging of injury severity that is relatively easy to monitor. This article reviews a multidisciplinary approach to facilitate the care of patients with renal injury. PMID:21941463

  3. Component separation in abdominal trauma

    OpenAIRE

    Rawstorne, Edward; Smart, Christopher J.; Fallis, Simon A.; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and t...

  4. The spectrum of agricultural trauma.

    Science.gov (United States)

    Cogbill, T H; Busch, H M

    1985-01-01

    During the past 6 years, 375 patients were hospitalized with injuries resulting from farm accidents. The mechanism of injury was farm animal in 135 patients (36%), tractor in 89 (24%), corn picker or auger in 57 (15%), power take-off in 29 (8%), other farm machinery in 50 (13%), and miscellaneous in 15 (4%). Injury severity score (ISS) of 25 or greater was calculated for 29 individuals (8%). Eleven groups of surgical subspecialists performed 539 procedures. Eight patients (2.1%) died as a result of their injuries. All eight deaths occurred after tractor accidents secondary to pelvic fractures, head and spinal cord injury, or blunt chest trauma. Thirty-nine patients (10%) were left with serious permanent disability. Unnecessary morbidity and mortality in many cases were attributed to excessive prehospital care times within a largely rural area. Better prevention by farmer education and the initiation of mandatory safety devices on agricultural equipment may lower the incidence of farm accidents. Major agricultural trauma is frequent and diverse and is optimally managed in a regional trauma center. PMID:4093573

  5. Radionuclide evaluation of lung trauma.

    Science.gov (United States)

    Lull, R J; Tatum, J L; Sugerman, H J; Hartshorne, M F; Boll, D A; Kaplan, K A

    1983-07-01

    Nuclear medicine imaging procedures can play a significant role in evaluating the pulmonary complications that are seen in trauma patients. A quantitative method for measuring increased pulmonary capillary permeability that uses Tc-99m HSA allows early diagnosis of acute respiratory distress syndrome (ARDS) and accurately differentiates this condition from pneumonia or cardiogenic pulmonary edema. This technique may be of great value in following the response to therapy. The use of 133Xe to diagnose inhalation injury remains an important diagnostic tool, particularly at hospitals with specialized burn units. Regional decreases in ventilation-perfusion images reliably localize aspirated foreign bodies. Radionuclide techniques that are used to demonstrate gastropulmonary aspiration remain controversial and require further clinical evaluation. Pulmonary perfusion imaging, although nonspecific, may provide the earliest clue for correct diagnosis of fat embolism, air embolism, contusion, or laceration. Furthermore, the possibility of perfusion abnormality due to these uncommon conditions must be remembered whenever trauma patients are evaluated for pulmonary thromboembolism with scintigraphy. Occasionally, liver or spleen scintigraphy may be the most appropriate procedure when penetrating chest trauma also involves these subdiaphragmatic organs. PMID:6226097

  6. Radionuclide evaluation of lung trauma

    Energy Technology Data Exchange (ETDEWEB)

    Lull, R.J.; Tatum, J.L.; Sugerman, H.J.; Hartshorne, M.F.; Boll, D.A.; Kaplan, K.A.

    1983-07-01

    Nuclear medicine imaging procedures can play a significant role in evaluating the pulmonary complications that are seen in trauma patients. A quantitative method for measuring increased pulmonary capillary permeability that uses Tc-99m HSA allows early diagnosis of acute respiratory distress syndrome (ARDS) and accurately differentiates this condition from pneumonia or cardiogenic pulmonary edema. This technique may be of great value in following the response to therapy. The use of 133Xe to diagnose inhalation injury remains an important diagnostic tool, particularly at hospitals with specialized burn units. Regional decreases in ventilation-perfusion images reliably localize aspirated foreign bodies. Radionuclide techniques that are used to demonstrate gastropulmonary aspiration remain controversial and require further clinical evaluation. Pulmonary perfusion imaging, although nonspecific, may provide the earliest clue for correct diagnosis of fat embolism, air embolism, contusion, or laceration. Furthermore, the possibility of perfusion abnormality due to these uncommon conditions must be remembered whenever trauma patients are evaluated for pulmonary thromboembolism with scintigraphy. Occasionally, liver or spleen scintigraphy may be the most appropriate procedure when penetrating chest trauma also involves these subdiaphragmatic organs.

  7. Radionuclide evaluation of lung trauma

    International Nuclear Information System (INIS)

    Nuclear medicine imaging procedures can play a significant role in evaluating the pulmonary complications that are seen in trauma patients. A quantitative method for measuring increased pulmonary capillary permeability that uses Tc-99m HSA allows early diagnosis of acute respiratory distress syndrome (ARDS) and accurately differentiates this condition from pneumonia or cardiogenic pulmonary edema. This technique may be of great value in following the response to therapy. The use of 133Xe to diagnose inhalation injury remains an important diagnostic tool, particularly at hospitals with specialized burn units. Regional decreases in ventilation-perfusion images reliably localize aspirated foreign bodies. Radionuclide techniques that are used to demonstrate gastropulmonary aspiration remain controversial and require further clinical evaluation. Pulmonary perfusion imaging, although nonspecific, may provide the earliest clue for correct diagnosis of fat embolism, air embolism, contusion, or laceration. Furthermore, the possibility of perfusion abnormality due to these uncommon conditions must be remembered whenever trauma patients are evaluated for pulmonary thromboembolism with scintigraphy. Occasionally, liver or spleen scintigraphy may be the most appropriate procedure when penetrating chest trauma also involves these subdiaphragmatic organs

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. [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.

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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

  18. The Swiss National Science Foundation

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ Introduction The Swiss National Science Foundation (SNSF) is Switzerland's leading provider of scientific research funding.The SNSF annually supports some 7200 researchers, almost 80 percent of whom are aged 35 years or younger.

  19. 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

  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. 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)

  2. Offshore Wind Turbine Foundation Design

    DEFF Research Database (Denmark)

    Passon, Patrik; Hvenekær Rasmussen, Jørgen

    continued into 2015 it is even more important to drive down the costs of energy for renewable energy sources such as offshore wind energy in order to arrive at a sustainable future on a global level.Cost of energy reductions for offshore wind turbines (OWTs) can be achieved by optimizations on different......-wave correlations are typically subjected to sequential load calculation approaches in an iterative and collaborative process between foundation designer and wind turbine manufacturer. Involvement of these different design parties may be motivated by various aspects such as introduction of state-of-the-art design...... in the specific context of OWTs and individual foundation type characteristics. For example, modelling and load calculation approaches for jacket type foundations of OWTs are often inherited from existing experiences of monopile type foundations or from their counterparts in the offshore oil & gas industry...

  3. 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 ...

  4. 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.

  5. 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

  6. 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

  7. Physical Foundations of Cosmology

    International Nuclear Information System (INIS)

    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 orientable surface of genus

  8. 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 

  9. Brain MR imaging in child abuse

    International Nuclear Information System (INIS)

    Intracranial injuries represent the most severe manifestation of child abuse. CT of the brain is the current standard for evaluation of these infants; however, MR imaging offers several potential advantages. MR imaging and CT were performed in ten infants who suffered intracranial trauma owing to child abuse. CT was slightly better at demonstrating subarachnoid hemorrhage and had definite advantages for defining fractures. MR imaging was superior in the demonstration of subacute extraaxial hemorrhage, deep brain injuries owing to shearing effects from shaking, and anoxic injuries. MR imaging has a definite complementary role in the evaluation of acute intracranial trauma in child abuse victims

  10. 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.)

  11. Imaging of accidental paediatric head trauma

    International Nuclear Information System (INIS)

    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.)

  12. Disability evaluation in acoustic blast trauma

    OpenAIRE

    Ganesan Raju

    2015-01-01

    Introduction: Acoustic blast trauma is different from Noise induced hearing loss. Blast trauma can damage the tympanic membrane, ossicles and cochlea singly or in combination. It produces immediate severe hearing loss and may be associated with tinnitus and vestibular symptoms. Hearing loss recovers spontaneously in many cases but may be permanent in 30-55% cases. Thirteen patients working in an explosive manufacturing unit in Andhra Pradesh were exposed to blast trauma at work place. All the...

  13. Existential Therapy: A Useful Approach to Trauma?

    OpenAIRE

    Corbett, L; Milton, M

    2011-01-01

    Background: Literature has suggested that the cyclical nature of psychological trauma can lead to enduring long-term effects on individuals and those around them. Content and Focus: This review examines the effects of psychological trauma and its relationship with existential therapy, not to endorse a particular approach in isolation, but to explore a variety of understandings of psychological trauma pertinent to counselling psychology. Despite being relatively unexplored with regards to psyc...

  14. Renal Trauma: Case Reports and Overview

    OpenAIRE

    Tait, Campbell D.; Somani, B. K.

    2012-01-01

    Introduction. Renal trauma patients are largely managed conservatively but on occasion have to be embolised or taken to theatre for definitive surgical management, usually in the form of emergency nephrectomy. Review. We present an overview of renal trauma as illustrated by three interesting cases of blunt renal trauma who presented in quick succession of each other to the Emergency Department. The first case—a 48-year-old-female passenger in a road traffic accident—was treated with life-savi...

  15. Development of an interactive dental trauma guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; 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 on the...... 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....

  16. 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.

  17. 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....

  18. Serum electrolyte changes in major surgical trauma

    OpenAIRE

    Ram Ranjan Singh; Sudhanshu Shekhar; Md. Jawed Akhtar; Vijay Shankar

    2016-01-01

    Background: Operative trauma is followed by a series of changes collectively referred to as metabolic response to injury, the magnitude and duration of the response being directly proportional to the severity of the trauma. Operative trauma imposes a great impact in the physiology of fluid and electrolytes within the body. Fluid and electrolyte management has thus been an integral part of care of each and every surgical patient. In the present study, an attempt has been made to study the elec...

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Organizational network in trauma management in Italy

    Directory of Open Access Journals (Sweden)

    Osvaldo Chiara

    2005-10-01

    Full Text Available In Italy, as in other western countries, trauma is a leading cause of death during the first four decades of life, with almost 18.000 of deaths per year. Since 80s organized systems for trauma care, including a pre-hospital emergency medical system and a network of hospitals designated as Trauma Centres, have been developed in north American countries. Effectiveness of trauma systems has been investigated comparing the post-system to the pre-system trauma care with the method of panel evaluation of preventable death rates and comparison of observed survival with expected probability of survival. In Italy, a pre-hospital emergency medical system has been implemented on a national scale, while a trauma network has not been developed. Nowadays, trauma patients are often admitted to the closest hospital, independently from local resources. The Superior Council of Ministry of Health has presented in 2004 a new trauma system model (SIAT based on the recognition in the field of patients with more serious injuries and the transportation to general hospitals with resources and multidisciplinary teams specialized in trauma care (trauma team. The designation of few trauma team hospitals, one highly specialized Centre (CTS and two area Centres (CTZ every two millions of inhabitants allows each Centre to treat at least 250 severe trauma patients per year to increase experience. Less severe injured patients may be treated in non-trauma team acute care facilities, according to the inclusive system model. The development of trauma team services in some Italian hospitals has demonstrated an increase in survival and a decrease in preventable death rate from 42% to 7,6%. Economic studies of Ministry of Health have established that the implementation of a trauma system model on a national scale with a 25% decrease of preventable trauma deaths and disabilities would save 7500 million of euros of public money. Therefore, in our country the concentration of severely

  4. Expanding Trauma through Space and Time: Mapping the Rhetorical Strategies of Trauma Carrier Groups

    Science.gov (United States)

    Degloma, Thomas

    2009-01-01

    In this article, I detail two rhetorical strategies that trauma carrier groups--including social movement organizations, professional mental health associations, and patient advocacy groups--use to expand the relevance of trauma and Post-Traumatic Stress Disorder (PTSD) through space and time: the social transmission of trauma and the social…

  5. Isolated hip fracture care in an inclusive trauma system : A trauma system wide evaluation

    NARCIS (Netherlands)

    van Laarhoven, J. J E M; van Lammeren, G. W.; Houwert, R. M.; van Laarhoven, C. J H C M; Hietbrink, F.; Leenen, L. P H; Verleisdonk, E. J M M

    2015-01-01

    Introduction: Elderly patients with a hip fracture represent a large proportion of the trauma population; however, little is known about outcome differences between different levels of trauma care for these patients. The aim of this study is to analyse the outcome of trauma care in patients with a h

  6. An evolution of trauma care evaluation: A thesis on trauma registry and outcome prediction models

    NARCIS (Netherlands)

    P. Joosse

    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

  7. Demographic patterns and outcomes of patients in level I trauma centers in three international trauma systems

    NARCIS (Netherlands)

    Gunning, Amy C.; Lansink, K. W. W.; van Wessem, Karlijn J. P.; Balogh, Zsolt J.; Rivara, Frederick P.; Maier, Ronald V.; Leenen, Luke P. H.

    2015-01-01

    Introduction Trauma systems were developed to improve the care for the injured. The designation and elements comprising these systems vary across countries. In this study, we have compared the demographic patterns and patient outcomes of Level I trauma centers in three international trauma systems.

  8. 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 ...

  9. 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 ...

  10. Brain Basics

    Medline Plus

    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... learning more about how the brain grows and works in healthy people, and how normal brain development ...

  11. 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.

  12. The trauma of a recession.

    Science.gov (United States)

    Murphy, S M; Kieran, I; Shaughnessy, M O

    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. PMID:21431394

  13. 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. PMID:26592466

  14. Pneumothorax in severe thoracic traumas

    International Nuclear Information System (INIS)

    The authors reviewed CT scans and supine chest X-ray of 47 patients affected by severe thoracic trauma, examined in 1985-86. The sensibility of the two methodologies in the assessment of pneumothorax was compared. CT detected 25 pneumothorax, whereas supine chest X-ray allowed a diagnosis in 18 cases only. In 8 of the latter (44.4%) the diagnosis was made possible by the presence of indirect signs of pneumothorax only - the most frequent being the deep sulcus sign. The characterization of pneumothorax is important especially in the patients who need to be treated with mechanical ventilation therapy, or who are to undergo surgery in total anaesthesia

  15. Interactive work place trauma (IWPT).

    Science.gov (United States)

    Shewchuk, Muriel

    2005-06-01

    Tragically, horizontal violence and bullying behaviour being master minded by nursing colleagues is firmly entrenched in many perioperative environments--just like a serious pathological bacteria. Interactive Workplace Trauma (IWPT) is ugly, mean, destructive, demoralizing and counterproductive to efficient, effective patient care and positive staff performance. Get educated and use astute observations to ensure you clearly understand what is occurring. Make sure the staff feel safe and have the appropriate, necessary protection to deal with unacceptable conduct. Deal effectively with the bullies. Remember if it is not documented, it didn't happen! PMID:16092572

  16. 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.

  17. The Owner's Manual for the Brain: Everyday Applications from Mind-Brain Research. Second Edition.

    Science.gov (United States)

    Howard, Pierce J.

    This book discusses what is known about the brain and memory storage and how people can improve their recall of information. There are 10 parts with 37 chapters. Part 1, "Forming a Foundation: The Context for Using Your Owner's Manual," includes topics like brain basics and brain imaging. Part 2, "Wellness: Getting the Most Out of Every Day,"…

  18. Trauma

    Science.gov (United States)

    ... a society whose purpose is to facilitate the integration of basic and clinical disciplines in the study of ... of Health and Human Services National Institutes of Health: NIH...Turning Discovery Into ...

  19. [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

  20. Imaging following acute knee trauma.

    Science.gov (United States)

    Kijowski, R; Roemer, F; Englund, M; Tiderius, C J; Swärd, P; Frobell, R B

    2014-10-01

    Joint injury has been recognized as a potent risk factor for the onset of osteoarthritis. The vast majority of studies using imaging technology for longitudinal assessment of patients following joint injury have focused on the injured knee joint, specifically in patients with anterior cruciate ligament injury and meniscus tears where a high risk for rapid onset of post-traumatic osteoarthritis is well known. Although there are many imaging modalities under constant development, magnetic resonance (MR) imaging is the most important instrument for longitudinal monitoring after joint injury. MR imaging is sensitive for detecting early cartilage degeneration and can evaluate other joint structures including the menisci, bone marrow, tendons, and ligaments which can be sources of pain following acute injury. In this review, focusing on imaging following acute knee trauma, several studies were identified with promising short-term results of osseous and soft tissue changes after joint injury. However, studies connecting these promising short-term results to the development of osteoarthritis were limited which is likely due to the long follow-up periods needed to document the radiographic and clinical onset of the disease. Thus, it is recommended that additional high quality longitudinal studies with extended follow-up periods be performed to further investigate the long-term consequences of the early osseous and soft tissue changes identified on MR imaging after acute knee trauma. PMID:25278054

  1. 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...

  2. 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.

  3. Nepali concepts of psychological trauma: the role of idioms of distress, ethnopsychology and ethnophysiology in alleviating suffering and preventing stigma.

    Science.gov (United States)

    Kohrt, Brandon A; Hruschka, Daniel J

    2010-06-01

    In the aftermath of a decade-long Maoist civil war in Nepal and the recent relocation of thousands of Bhutanese refugees from Nepal to Western countries, there has been rapid growth of mental health and psychosocial support programs, including posttraumatic stress disorder treatment, for Nepalis and ethnic Nepali Bhutanese. This medical anthropology study describes the process of identifying Nepali idioms of distress and local ethnopsychology and ethnophysiology models that promote effective communication about psychological trauma in a manner that minimizes stigma for service users. Psychological trauma is shown to be a multifaceted concept that has no single linguistic corollary in the Nepali study population. Respondents articulated different categories of psychological trauma idioms in relation to impact on the heart-mind, brain-mind, body, spirit, and social status, with differences in perceived types of traumatic events, symptom sets, emotion clusters and vulnerability. Trauma survivors felt blamed for experiencing negative events, which were seen as karma transmitting past life sins or family member sins into personal loss. Some families were reluctant to seek care for psychological trauma because of the stigma of revealing this bad karma. In addition, idioms related to brain-mind dysfunction contributed to stigma, while heart-mind distress was a socially acceptable reason for seeking treatment. Different categories of trauma idioms support the need for multidisciplinary treatment with multiple points of service entry. PMID:20309724

  4. Brain Prostheses as a Dynamic System (Immortalizing the Human Brain?)

    CERN Document Server

    Astakhov, Vadim

    2007-01-01

    Interest in development of brain prostheses, which might be proposed to recover mental functions lost due to neuron-degenerative disease or trauma, requires new methods in molecular engineering and nanotechnology to build artificial brain tissues. We develop a Dynamic Core model to analyze complexity of damaged biological neural network as well as transition and recovery of the system functionality due to changes in the system environment. We provide a method to model complexity of physical systems which might be proposed as an artificial tissue or prosthesis. Delocalization of Dynamic Core model is developed to analyze migration of mental functions in dynamic bio-systems which undergo architecture transition induced by trauma. Term Dynamic Core is used to define a set of causally related functions and Delocalization is used to describe the process of migration. Information geometry and topological formalisms are proposed to analyze information processes. A holographic model is proposed to construct dynamic e...

  5. High Dynamic Range Characterization of the Trauma Patient Plasma Proteome

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Tao; Qian, Weijun; Gritsenko, Marina A.; Xiao, Wenzhong; Moldawer, Lyle L.; Kaushal, Amit; Monroe, Matthew E.; Varnum, Susan M.; Moore, Ronald J.; Purvine, Samuel O.; Maier, Ronald V.; Davis, Ronald W.; Tompkins, Ronald G.; Camp, David G.; Smith, Richard D.

    2006-06-08

    While human plasma represents an attractive sample for disease biomarker discovery, the extreme complexity and large dynamic range in protein concentrations present significant challenges for characterization, candidate biomarker discovery, and validation. Herein, we describe a strategy that combines immunoaffinity subtraction and chemical fractionation based on cysteinyl peptide and N-glycopeptide captures with 2D-LC-MS/MS to increase the dynamic range of analysis for plasma. Application of this ''divide-and-conquer'' strategy to trauma patient plasma significantly improved the overall dynamic range of detection and resulted in confident identification of 22,267 unique peptides from four different peptide populations (cysteinyl peptides, non-cysteinyl peptides, N-glycopeptides, and non-glycopeptides) that covered 3654 nonredundant proteins. Numerous low-abundance proteins were identified, exemplified by 78 ''classic'' cytokines and cytokine receptors and by 136 human cell differentiation molecules. Additionally, a total of 2910 different N-glycopeptides that correspond to 662 N-glycoproteins and 1553 N-glycosylation sites were identified. A panel of the proteins identified in this study is known to be involved in inflammation and immune responses. This study established an extensive reference protein database for trauma patients, which provides a foundation for future high-throughput quantitative plasma proteomic studies designed to elucidate the mechanisms that underlie systemic inflammatory responses.

  6. Construct Validity of the Childbirth Trauma Index for Adolescents

    OpenAIRE

    Anderson, Cheryl

    2011-01-01

    The potentially traumatic nature of childbirth for adult mothers has been confirmed in research; however, adolescent childbirth trauma is unexplored. This article presents research on the construct validity of the Childbirth Trauma Index by providing a conceptual analysis of psychological childbirth trauma, factor validity of the Childbirth Trauma Index, and discussion of testing the Childbirth Trauma Index via contrasted-groups approach. Childbirth trauma can result in an acute stress reacti...

  7. Characteristic Behavior of Bucket Foundations

    DEFF Research Database (Denmark)

    Barari, Amin

    The world is currently facing serious problems brought about by oil dependence. Reducing oil consumption provides an opportunity to increase competitiveness, technological development, and progress. Wind energy is currently the most costcompetitive form of renewable energy, and there are strong...... 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. 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

  9. 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

  10. 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.

  11. 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

  12. 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

  13. Chest trauma in childhood. Radiological findings

    International Nuclear Information System (INIS)

    Blunt thoracic trauma is frequently associated with further injuries (head and/or blunt abdominal trauma). The prognosis also depends on the concurrent injuries. The initial evaluation of an injured child is based on the chest X-ray and abdominal ultrasound examination. Additional information can be obtained by a CT scan in mediastinal injuries. (orig./MG)

  14. Cardiac injuries in blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Tobon-Gomez Catalina

    2009-09-01

    Full Text Available Abstract Blunt chest traumas are a clinical challenge, both for diagnosis and treatment. The use of Cardiovascular Magnetic Resonance can play a major role in this setting. We present two cases: a 12-year-old boy and 45-year-old man. Late gadolinium enhancement imaging enabled visualization of myocardial damage resulting from the trauma.

  15. Trauma theory and postcolonial literary studies

    NARCIS (Netherlands)

    Visser, I.

    2011-01-01

    Abstract The plurality and growing number of responses to cultural trauma theory in postcolonial criticism demonstrate the ongoing appeal of trauma theory despite the fact that it is also increasingly critiqued as inadequate to the research agenda of postcolonial studies. In the dialogue between tra

  16. Trauma and suicidality in war affected communities

    NARCIS (Netherlands)

    J. Jankovic; S. Bremner; M. Bogic; D. Lecic-Tosevski; D. Ajdukovic; T. Franciskovic; G.M. Galeazzi; A. Kucukalic; N. Morina; M. Popovski; M. Schützwohl; S. Priebe

    2012-01-01

    Purpose: The aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered. Materials and methods: In the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruite

  17. Trauma-Informed Forensic Child Maltreatment Investigations

    Science.gov (United States)

    Pence, Donna M.

    2011-01-01

    Trauma-informed child welfare systems (CWSs) are the focus of several recent national and state initiatives. Since 2005 social work publications have focused on systemic and practice changes within CW which seek to identify and reduce trauma to children and families experiencing child maltreatment or other distressing events, as well as to the…

  18. Trauma among Street-Involved Youth

    Science.gov (United States)

    Bender, Kimberly A.; Thompson, Sanna J.; Ferguson, Kristin M.; Yoder, Jamie R.; Kern, Leah

    2014-01-01

    Previous research documents that street-involved youth experience rates of trauma and posttraumatic stress disorder (PTSD) that are significantly higher than their housed counterparts. Trauma and PTSD are of particular concern for homeless youth as they can negatively affect youths' ability to function adaptively and to transition off the…

  19. Healing Trauma, Building Resilience: SITCAP in Action

    Science.gov (United States)

    Steele, William; Kuban, Caelan

    2014-01-01

    Childhood trauma is marked by an overwhelming sense of terror and powerlessness. Loss of loving relationships is yet another type of trauma that produces the pain of sadness and grief. The resulting symptoms only reflect the neurological, biological, and emotional coping systems mobilized in the struggle to survive. These young people need new…

  20. Tips for Teachers during Times of Trauma.

    Science.gov (United States)

    Adkins, Myrna Ann; Harper, Eric

    This guide for teachers in times of trauma was updated after the events of September 11, 2001--the terrorist attacks on the World Trade Center and the Pentagon. These traumatic events could cause refugees to experience trauma or become re-traumatized. For many refugees, their English-as-a-Second-Language (ESL) programs are the places where they…