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Sample records for traumatic spondyloptosis resulting

  1. One-stage surgery through posterior approach-for L5-S1 spondyloptosis

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    Hikmet Turan Suslu

    2011-01-01

    Full Text Available Grade 5 spondylolisthesis or spondyloptosis is a rare condition. Generally, the surgical management of spondyloptosis includes multi-staged procedures instead of one-staged procedures. One-stage treatment for spondyloptosis is very rare. A 15-year-old girl with L5-S1 spondyloptosis was admitted with severe low back pain. There was no history of trauma. The patient underwent L5 laminectomy, L5-S1 discectomy, resection of sacral dome, reduction, L3-L4-L5-S1 pedicular screw fixation, and interbody-posterolateral fusion through the posterior approach. The reduction was maintained with bilateral L5-S1 discectomy, resection of the sacral dome, and transpedicular instrumentation from L3 to S1. In this particular case, one-staged approach was adequate for the treatment of L5-S1 spondyloptosis. One-staged surgery using the posterior approach may be adequate for the treatment of L5-S1 spondyloptosis while avoiding the risks inherent in anterior approaches.

  2. Traumatic high-grade spondylolisthesis at C7-T1 with no neurological deficits: Case series, literature review, and biomechanical implications

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    Ha Son Nguyen

    2017-01-01

    Full Text Available Traumatic high-grade spondylolisthesis in subaxial cervical spine is frequently associated with acute spinal cord injury and quadriparesis. There have been rare cases where such pathology demonstrates minimal to no neurological deficits. Assessment of the underlying biomechanics may provide insight into the mechanism of injury and associated neurological preservation. Patient 1 is a 63-year-old female presenting after a motor vehicle collision with significant right arm pain without neurological deficits. Imaging demonstrated C7/T1 spondyloptosis, associated with a locked facet on the left at C6/7 and a locked facet on the right at C7/T1, with a fracture of the left C7 pedicle and right C7 lamina. Patient 2 is a 60-year-old male presenting after a bicycle collision with transient bilateral upper extremity paresthesias without neurological deficits. Imaging demonstrated C7/T1 spondyloptosis, with fractures of bilateral C7 pedicles, C7/T1 facets, and C7 lamina. Patient 3 is a 36-year-old male presenting after a motor vehicle collision with diffuse tingling sensation throughout all extremities. His neurological examination was nonfocal. Imaging demonstrated a grade 4 spondylolithesis at C7/T1, associated with bilateral C7/T1 locked facets. From literature, most cases were noted to be dislocations resulting from fractures of the posterior elements. A minority of cases has been found to involve facet dislocations without fractures. Further biomechanical studies are needed to understand the underlying mechanisms.

  3. Dementia resulting from traumatic brain injury

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    Joana Ramalho

    Full Text Available ABSTRACT Traumatic brain injury (TBI represents a significant public health problem in modern societies. It is primarily a consequence of traffic-related accidents and falls. Other recently recognized causes include sports injuries and indirect forces such as shock waves from battlefield explosions. TBI is an important cause of death and lifelong disability and represents the most well-established environmental risk factor for dementia. With the growing recognition that even mild head injury can lead to neurocognitive deficits, imaging of brain injury has assumed greater importance. However, there is no single imaging modality capable of characterizing TBI. Current advances, particularly in MR imaging, enable visualization and quantification of structural and functional brain changes not hitherto possible. In this review, we summarize data linking TBI with dementia, emphasizing the imaging techniques currently available in clinical practice along with some advances in medical knowledge.

  4. Vicissitudes in adult life resulting from traumatic experiences in adolescence.

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    Maldonado, Jorge Luis

    2006-10-01

    The author deals with the difficulties in combining the concepts of trauma and phantasy. He evaluates Freudian observations relating to chance and trauma. He considers traumatic effects of chance in relation to the rupture of a narcissistic phantasy of invulnerability. The narrating of traumatic events may awaken in the analyst tendencies to repeat the aggression of these traumatic events towards the subject. The accusatory interpretation can be one of the means by which this repetition is established. The author explores a type of trauma which is essentially related to the disturbance of the structure which contains the ideals of the subject. This disturbance is a consequence of disillusionment resulting from the loss of an object who was the depository of these ideals. Trauma generates a state of mourning for lost ideals. The author describes traumatic events which occurred in a patient's life at puberty; paradoxical behaviours in the patient's parents caused the patient to have new traumas. The reluctance to explore the derivatives of the unconscious, and to investigate possible meaning in symbols, was a central problem in this patient's analysis. The author discusses disturbances in symbolization, and he examines the subject of projective identifications that were received by patients from their primary objects.

  5. Dementia resulting from traumatic brain injury: what is the pathology?

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    Shively, Sharon; Scher, Ann I; Perl, Daniel P; Diaz-Arrastia, Ramon

    2012-10-01

    Traumatic brain injury (TBI) is among the earliest illnesses described in human history and remains a major source of morbidity and mortality in the modern era. It is estimated that 2% of the US population lives with long-term disabilities due to a prior TBI, and incidence and prevalence rates are even higher in developing countries. One of the most feared long-term consequences of TBIs is dementia, as multiple epidemiologic studies show that experiencing a TBI in early or midlife is associated with an increased risk of dementia in late life. The best data indicate that moderate and severe TBIs increase risk of dementia between 2- and 4-fold. It is less clear whether mild TBIs such as brief concussions result in increased dementia risk, in part because mild head injuries are often not well documented and retrospective studies have recall bias. However, it has been observed for many years that multiple mild TBIs as experienced by professional boxers are associated with a high risk of chronic traumatic encephalopathy (CTE), a type of dementia with distinctive clinical and pathologic features. The recent recognition that CTE is common in retired professional football and hockey players has rekindled interest in this condition, as has the recognition that military personnel also experience high rates of mild TBIs and may have a similar syndrome. It is presently unknown whether dementia in TBI survivors is pathophysiologically similar to Alzheimer disease, CTE, or some other entity. Such information is critical for developing preventive and treatment strategies for a common cause of acquired dementia. Herein, we will review the epidemiologic data linking TBI and dementia, existing clinical and pathologic data, and will identify areas where future research is needed.

  6. Traumatic expulsion of T4 vertebral body into the spinal canal treated by vertebrectomy and spine shortening.

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    Cappuccio, Michele; Corghi, Alessandro; De Iure, Federico; Amendola, Luca

    2014-05-20

    A case report. To describe an exceptional case of traumatic 2-level adjacent disk disruption with expulsion of the vertebral body into the spinal canal treated by vertebrectomy and spine shortening. Traumatic spondyloptosis is a very rare injury caused by high-energy trauma. Vertebral body expulsion is mostly the result of tremendous flexion-extension shearing forces causing a double contiguous disk disruption. A 49-year-old male was admitted to the emergency department of another hospital because of a high-speed car crash. He was conscious and collaborating and showed a complete paraplegia. Spinal computed tomographic scan showed a posterior expulsion of the T4 vertebral body and dislocation into the spinal canal. Magnetic resonance imaging of the spine confirmed the presence of a 2-level adjacent T3-T4 and T4-T5 disk disruption and severe compression of the spinal cord by the T4 vertebral body. We performed a posterior stabilization from T1 to T8 with T4 vertebrectomy and spine shortening. A postoperative computed tomographic scan showed a tolerable sagittal and frontal alignment and apposition of the endplates of T3 and T5. At present, 12 months after surgery, the patient is neurologically unchanged, but he can keep the sitting position without support. Total vertebrectomy and spinal shortening are safe and replicable procedures applicable in few patients with paraplegia. A surgical procedure after 3 weeks makes a complete reduction and a perfect sagittal alignment of the spine difficult to be obtained.

  7. Traumatic eye injuries as a result of blunt impact

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    Clemente, Chiara; Esposito, Luca; Bonora, Nicola; Limido, Jerome; Lacome, Jean-Luc; Rossi, Tommaso

    2013-06-01

    The detachment or tearing of the retina in the human eye as a result of a collision is a phenomenon that occurs very often. This research is aimed at identifying and understanding the actual dynamic physical mechanisms responsible for traumatic eye injuries accompanying blunt impact, with particular attention to the damage processes that take place at the retina. To this purpose, a numerical and experimental investigation of the dynamic response of the eye during an impact event was performed. Numerical simulation of both tests was performed with IMPETUS-FEA, a general non-linear finite element software which offers NURBS finite element technology for the simulation of large deformation and fracture in materials. Computational results were compared with the experimental results on fresh enucleated porcine eyes impacted with airsoft pellets. The eyes were placed in a container filled with 10 percent ballistic gelatin simulating the fatty tissue surrounding the eye. A miniature pressure transducer was inserted into the eye bulb through the optic nerve in order to measure the pressure of the eye during blunt-projectile impacts. Each test was recorded using a high speed video camera. The ocular injuries observed in the impacted eyes were assessed by an ophthalmologist in order to evaluate the correlation between the pressure measures and the risk of retinal damage.

  8. Surgical treatment of congenital thoracolumbar spondyloptosis in a 2-year-old child with vertebral column resection and posterior-only circumferential reconstruction of the spine column: case report.

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    Gressot, Loyola V; Mata, Javier A; Luerssen, Thomas G; Jea, Andrew

    2015-02-01

    Spondyloptosis refers to complete dislocation of a vertebral body onto another. The L5-S1 level is frequently affected. As this condition is rare, few published reports describing its clinical features and surgical outcomes exist, especially in the pediatric patient population. The authors report the presentation, pathological findings, and radiographic studies of a 2-year-old girl who presented to Texas Children's Hospital with a history since birth of progressive spastic paraparesis. Preoperative CT and MRI showed severe spinal cord compression associated with T11-12 spondyloptosis. The patient underwent a single-stage posterior approach for complete resection of the dysplastic vertebral bodies at the apex of the spinal deformity with reconstruction and stabilization of the vertebral column using a titanium expandable cage and pedicle screws. At the 12-month follow-up, the patient remained neurologically stable without any radiographic evidence of instrumentation failure or loss of alignment. To the best of the authors' knowledge, there have been only 2 other children with congenital thoracolumbar spondyloptosis treated with the above-described strategy. The authors describe their case and review the literature to discuss the aggregate clinical features, surgical strategies, and operative outcomes for congenital thoracolumbar spondyloptosis.

  9. Surgical Algorithm and Results of Isolated Traumatic Axillary Nerve Injuries.

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    Chen, Wayne A; Schippert, David W; Daws, Snow B; Koman, L Andrew; Li, Zhongyu

    2016-03-01

    Axillary nerve injuries are common and typically occur during high-energy, traumatic events. The purpose of this study is to propose a treatment algorithm for acute isolated axillary nerve injuries and report the outcomes of surgically treated patients. A retrospective review identified 14 patients surgically treated for an isolated axillary nerve injury. Axillary nerve neurolysis was performed for all patients, and a triceps branch of the radial nerve was transferred to the axillary nerve in patients without evidence of deltoid function following intraoperative axillary nerve stimulation. Four patients were treated with neurolysis alone and 10 patients received a transfer. Pre- and postoperative deltoid strength, shoulder abduction, and the Disabilities of the Arm, Shoulder, and Hand (DASH) outcome score were evaluated. At most recent follow-up, both the neurolysis and nerve transfer groups had significant improvement in deltoid strength, with 86% achieving M4 or greater. Shoulder abduction improved from a mean of 63 to 127 degrees. This difference was significant in the nerve transfer group and when all patients were analyzed together. DASH scores significantly improved from a mean of 47 to 34 when all patients were analyzed together. No patients experienced a decrease in elbow extension strength following nerve transfer. In patients with preserved triceps strength, a triceps branch of the radial nerve can be coapted directly to the axillary nerve in the absence of deltoid contraction following electrical stimulation. Functional improvements were seen in patients treated with neurolysis alone and in combination with nerve transfer, supporting the use of intraoperative axillary nerve stimulation to guide treatment. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Acute traumatic instability of the coccyx: results in 28 consecutive coccygectomies.

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    Ramieri, Alessandro; Domenicucci, Maurizio; Cellocco, Paolo; Miscusi, Massimo; Costanzo, Giuseppe

    2013-11-01

    Coccygeal instability includes hypermobility, subluxation and fracture-dislocation. Surgical resection is still controversial, with intractable post-traumatic coccygodynia being an indication to surgery. From 2001 to 2010, we enrolled 31 patients with post-traumatic coccygodynia (19 females, 12 males; mean age 31 years, range 21-47). Conservative treatment failed in 28 patients, who underwent surgical resection of the coccyx. Twenty-one were total, while seven were partial coccygectomies. At follow-up (mean 33 months; range 24-70), clinical outcomes evaluation included measurement of complications rate, pain relief and satisfaction degree. Nineteen patients experienced complete pain relief, while two had incomplete, and four had no relief. Partial coccygectomies were associated with poor results. Twenty-one patients were satisfied, whilst four were not. Coccygectomy is the treatment of choice for post-traumatic instability. Patients' selection allowed excellent or good results. This study favors a more aggressive approach including total resection of the coccyx.

  11. Post-traumatic Stress Disorder Symptoms Resulting from Torture and Other Traumatic Events among Syrian Kurdish Refugees in Kurdistan Region, Iraq

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    Ibrahim, Hawkar; Hassan, Chiya Q.

    2017-01-01

    Political violence is known to cause psychological distress. There is a large body of empirical studies drawing correlations between war trauma, torture, and post-traumatic stress disorder (PTSD). However, there are few studies on the effects of war-related trauma among Syrian refugees after events following the ‘Arab Spring’ uprisings between 2010 and 2012. This study examines the association of PTSD symptoms with torture and other traumatic events among Syrian Kurdish refugees living in Kurdistan Region, Iraq. The experiences and PTSD symptoms among 91 Syrian Kurdish refugees in the Arbat camp in the Sulaymaniyah Governorate of the Kurdistan Region of Iraq were assessed using the Harvard Trauma Questionnaire, sections I, IV, and V. Results showed that the estimated levels of PTSD symptoms were high: between 35 and 38%. There were no significant gender differences in the occurrence of PTSD symptoms. However, men reported more general traumatic experiences than women. There were significant positive correlations between PTSD symptoms with traumatic events and torture (r = 0.500, r = 0.366, respectively). Examining the mental health impact of torture and other traumatic events among refugees has possible implications for organizations managing rehabilitation programs for individuals who have been exposed to traumatic events. PMID:28265252

  12. Post-traumatic Stress Disorder Symptoms Resulting from Torture and Other Traumatic Events among Syrian Kurdish Refugees in Kurdistan Region, Iraq.

    Science.gov (United States)

    Ibrahim, Hawkar; Hassan, Chiya Q

    2017-01-01

    Political violence is known to cause psychological distress. There is a large body of empirical studies drawing correlations between war trauma, torture, and post-traumatic stress disorder (PTSD). However, there are few studies on the effects of war-related trauma among Syrian refugees after events following the 'Arab Spring' uprisings between 2010 and 2012. This study examines the association of PTSD symptoms with torture and other traumatic events among Syrian Kurdish refugees living in Kurdistan Region, Iraq. The experiences and PTSD symptoms among 91 Syrian Kurdish refugees in the Arbat camp in the Sulaymaniyah Governorate of the Kurdistan Region of Iraq were assessed using the Harvard Trauma Questionnaire, sections I, IV, and V. Results showed that the estimated levels of PTSD symptoms were high: between 35 and 38%. There were no significant gender differences in the occurrence of PTSD symptoms. However, men reported more general traumatic experiences than women. There were significant positive correlations between PTSD symptoms with traumatic events and torture ( r = 0.500, r = 0.366, respectively). Examining the mental health impact of torture and other traumatic events among refugees has possible implications for organizations managing rehabilitation programs for individuals who have been exposed to traumatic events.

  13. Amputation - traumatic

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    ... sharing features on this page, please enable JavaScript. Traumatic amputation is the loss of a body part, usually ... fitting and functional prosthesis can speed rehabilitation. Causes Traumatic amputations usually result from factory, farm, power tool accidents, ...

  14. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

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    Tan Andrew HC

    2011-06-01

    Full Text Available Abstract Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008. Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA shoulder rating scale and the Simple Shoulder Test (SST score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

  15. Delayed Presentation of Traumatic Diaphragmatic Hernia: The Evaluation of Surgical Treatment Results

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    Ali Sadrizadeh

    2015-06-01

    Full Text Available Introduction: Diaphragmatic hernia could be caused by congenital disorders, blunt trauma or penetrating injuries. The diagnosis of traumatic diaphragmatic hernia is normally neglected during the first presentation leading to late complications and considerably increased mortality and morbidity among the patients. Materials and Methods: In this retrospective, descriptive study, we reviewed the medical records of patients presented with traumatic diaphragmatic hernia who had undergone surgical operations between 1982-2015 in Ghaem Hospital and Omid Hospital affiliated to Mashhad University of Medical Sciences, Iran. The studied variables included age, gender, clinical symptoms, location of hernia, involved organs, type of imaging modalities, surgical techniques, length of hospital stay, mortality rate and surgical complications. Results: In this study, 38 patients were diagnosed with traumatic diaphragmatic hernia consisting of 28 men and 10 women. In total, 79% and 21% of the patients suffered from penetrating trauma and blunt trauma, respectively. In addition, left-sided, right-sided and bilateral hernias were present in 33%, 4% and 1% of the patients, respectively. The most frequently herniated organ was the stomach, and the most common clinical symptoms were abdominal pain (84% and dyspnea (53%. Initially, chest radiographs were performed on all the patients, and thoracotomy was performed to repair diaphragmatic tears in all the cases (100%. In this study, 3 patients had previously undergone Hartmann’s operation for gangrenous herniated colon, and devolvulation of gastric volvulus had also been performed on 3 patients. The main post-operative complications were reported to be pneumonia and respiratory insufficiency (2 cases, and the mean length of hospital stay was 6 days (5-8 days which was longer (1-2 months in patients with gangrenous bowel (3 patients. Furthermore, no mortality was reported during the course of hospitalization in these

  16. [Contact lens correction of post-traumatic unilateral aphakia. Late visual and orthoptic results].

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    Nesser, U; Thaller-Antlanger, H

    1982-11-01

    From 1978 to 1981 total of 122 perforating eye injuries were treated in the eye department of the Salzburg provincial clinic. In 25% of the cases treated the opacified lens had to be removed. The authors followed up 35 patients with unilateral post-traumatic aphakia. Of these, 27 proved suitable candidates for contact lenses. Visual function was good in 15 patients, but reduced in 12 due to post-traumatic changes. Ten patients achieved binocular vision, while in 12 it was possible to restore binocular vision by appropriate measures. The paper deals particular with the restoration of binocular vision and maintenance of binocular function in cases of unilateral post-traumatic aphakia.

  17. Post-Traumatic Stress Disorder in Children as a Result of Violence: A Review of Current Literature.

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    Karcher, Christopher Robb

    This review of research on post-traumatic stress disorder (PTSD) in children resulting from human violence focuses on methodological issues, types of violence, treatment issues, and directions for future research. Literature reviewed is predominantly that published since 1986. An introduction offers background information and examines the…

  18. Traumatic eye injuries as a result of blunt impact: computational issues

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    Clemente, C.; Esposito, L.; Bonora, N.; Limido, J.; Lacome, J. L.; Rossi, T.

    2014-05-01

    The detachment or tearing of the retina in the human eye as a result of a collision is a phenomenon that occurs very often. Reliable numerical simulations of eye impact can be very useful tools to understand the physical mechanisms responsible for traumatic eye injuries accompanying blunt impact. The complexity and variability of the physical and mechanical properties of the biological materials, the lack of agreement on their related experimental data as well as the unsuitability of specific numerical codes and models are only some of the difficulties when dealing with this matter. All these challenging issues must be solved to obtain accurate numerical analyses involving dynamic behavior of biological soft tissues. To this purpose, a numerical and experimental investigation of the dynamic response of the eye during an impact event was performed. Numerical simulations were performed with IMPETUS-AFEA, a new general non-linear finite element (FE) software which offers non uniform rational B-splines (NURBS) FE technology for the simulation of large deformation and fracture in materials. IMPETUS code was selected in order to solve hourglass and locking problems typical of nearly incompressible materials like eye tissues. Computational results were compared with the experimental results on fresh enucleated porcine eyes impacted with airsoft pellets.

  19. The functional results of acute nerve grafting in traumatic sciatic nerve injuries.

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    Vayvada, Haluk; Demirdöver, Cenk; Menderes, Adnan; Yılmaz, Mustafa; Karaca, Can

    2013-03-01

    The sciatic and peroneal nerves are the most frequently injured in lower extremities, followed by tibial and femoral nerves. The aim of this study is to evaluate the functional results of acute nerve grafting in traumatic sciatic nerve injuries. A total of 9 patients with sciatic nerve defect were treated with primary nerve grafting. The mean age was 31.7 years. The etiologic factors were gunshot wounds, traffic accident, and penetrating trauma. All of the patients had sciatic nerve defects ranging from 3.4 to 13.6 cm. The follow-up period ranged between 25 and 84 months. The tibial nerve motor function was "good" or "very good" (M3-M4) in 5 patients (55.6%). The plantar flexion was not sufficient for the rest of the patients. The peroneal nerve motor function was also "good" and "very good" in 3 patients (33.3%). The functional results of the acute nerve grafting of the sciatic nerve within the first week after the injury are poorer than reported in the related literature. This protocol should only be applied to select patients who have adequate soft tissue coverage and healthy nerve endings.

  20. Surgical Treatment of Severe Traumatic Brain Injury in Switzerland: Results from a Multicenter Study.

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    Rossi-Mossuti, Frédéric; Fisch, Urs; Schoettker, Patrick; Gugliotta, Marinella; Morard, Marc; Schucht, Philippe; Schatlo, Bawarjan; Levivier, Marc; Walder, Bernhard; Fandino, Javier

    2016-01-01

    Since the introduction of modern surgical techniques and monitoring tools for the treatment of severe traumatic brain injury (TBI) in Switzerland, standardized nationwide operative procedures are still lacking. This study aimed to assess surgical management and monitoring strategies in patients admitted throughout Switzerland with severe TBI. Demographic, clinical, and radiologic data from a prospective national cohort study on severe brain-injured patients (Patient-relevant Endpoints after Brain Injury from Traumatic Accidents [PEBITA]) were collected during a 3-year period. This study evaluated patients admitted to 7 of the 11 trauma centers included in PEBITA. We retrospectively analyzed surgery-related computed tomography (CT) findings prior to and after treatment, intracranial pressure (ICP) monitoring, size and technical features of craniotomy, as well as surgical complications. ResULTS: This study included 353 of the 921 patients enrolled in PEBITA who underwent surgical treatment for severe TBI. At admission, acute subdural hematoma was the most frequent focal lesion diagnosed (n = 154 [44%]), followed by epidural hematoma (n = 96 [27%]) and intracerebral hematoma (n = 84 [24%]). A total of 198 patients (61%) presented with midline shift. Clinical deterioration in terms of Glasgow Coma Scale scores or intractable ICP values as an indication for surgical evacuation or decompression were documented in 20% and 6%, respectively. A total of 97 (27.5%) only received a catheter/probe for ICP monitoring. Surgical procedures to treat a focal lesion or decompress the cerebrum were performed in 256 patients (72.5%). Of the 290 surgical procedures (excluding ICP probe implantation), craniotomy (137 [47.2%]) or decompressive craniectomy (133 [45.9%]) were performed most frequently. The mean size of craniectomy in terms of maximal linear width on the CT axial slice was 8.4 ± 2.9 cm. Intraoperative ICP monitoring was reported in 61% of the interventions. Significant

  1. EMDR versus Stabilization in traumatized Asylum Seekers and Refugees: Results of a pilot-study

    NARCIS (Netherlands)

    ter Heide, F.J.J.; Mooren, T.M.; Kleyn, W.; de Jongh, A.; Kleber, R.J.

    2011-01-01

    Background: Traumatised asylum seekers and refugees are clinically considered a complex population. Discussion exists on whether with this population treatment guidelines for post-traumatic stress disorder (PTSD) should be followed and Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) or Eye

  2. Outpatient follow-up after mild traumatic brain injury : Results of the UPFRONT-study

    NARCIS (Netherlands)

    de Koning, M.E.; Scheenen, M.E.; van der Horn, H.J.; Hageman, G.; Roks, G.; Yilmaz, T.; Spikman, J.M.; van der Naalt, J.

    2017-01-01

    Objective: To investigate outpatient follow-up after mild traumatic brain injury (mTBI) by various medical specialists, for both hospitalized and non-hospitalized patients, and to study guideline adherence regarding hospital admission. Methods: Patients (n = 1151) with mTBI recruited from the

  3. Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study

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    Chao Wang

    2017-05-01

    Full Text Available The objective of this research project is the identification of a physiological prodrome of post-traumatic stress disorder (PTSD that has a reliability that could justify preemptive treatment in the sub-syndromal state. Because abnormalities in event-related potentials (ERPs have been observed in fully expressed PTSD, the possible utility of abnormal ERPs in predicting delayed-onset PTSD was investigated. ERPs were recorded from military service members recently returned from Iraq or Afghanistan who did not meet PTSD diagnostic criteria at the time of ERP acquisition. Participants (n = 65 were followed for up to 1 year, and 7.7% of the cohorts (n = 5 were PTSD-positive at follow-up. The initial analysis of the receiver operating characteristic (ROC curve constructed using ERP metrics was encouraging. The average amplitude to target stimuli gave an area under the ROC curve of greater than 0.8. Classification based on the Youden index, which is determined from the ROC, gave positive results. Using average target amplitude at electrode Cz yielded Sensitivity = 0.80 and Specificity = 0.87. A more systematic statistical analysis of the ERP data indicated that the ROC results may simply represent a fortuitous consequence of small sample size. Predicted error rates based on the distribution of target ERP amplitudes approached those of random classification. A leave-one-out cross validation using a Gaussian likelihood classifier with Bayesian priors gave lower values of sensitivity and specificity. In contrast with the ROC results, the leave-one-out classification at Cz gave Sensitivity = 0.65 and Specificity = 0.60. A bootstrap calculation, again using the Gaussian likelihood classifier at Cz, gave Sensitivity = 0.59 and Specificity = 0.68. Two provisional conclusions can be offered. First, the results can only be considered preliminary due to the small sample size, and a much larger study will be required to assess

  4. Outpatient follow-up after mild traumatic brain injury: Results of the UPFRONT-study

    OpenAIRE

    de Koning, M.E.; Scheenen, M.E.; van der Horn, H.J.; Hageman, G.; Roks, G.; Yilmaz, T.; Spikman, J.M.; van der Naalt, J.

    2017-01-01

    Objective: To investigate outpatient follow-up after mild traumatic brain injury (mTBI) by various medical specialists, for both hospitalized and non-hospitalized patients, and to study guideline adherence regarding hospital admission. Methods: Patients (n = 1151) with mTBI recruited from the emergency department received questionnaires 2 weeks (n = 879), 3 months (n = 780) and 6 months (n = 668) after injury comprising outpatient follow-up by various health care providers, and outcome define...

  5. Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study.

    Science.gov (United States)

    Wang, Hongwei; Yu, Hailong; Zhou, Yue; Li, Changqing; Liu, Jun; Ou, Lan; Zhao, Yiwen; Song, Guoli; Han, Jianda; Chen, Yu; Xiang, Liangbi

    2017-09-01

    The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height fall (1059, 75.0%) and high fall (353, 25.0%). There were 2073 fractures in total and 92 patients (6.5%) presented with multiple fractures. The most common fracture sites were upper extremity fractures in 814 patients (57.6%) and lower extremity fractures in 383 patients (27.1%), followed by craniofacial fractures in 233 patients (16.5%). A total of 231 (16.4%) patients suffered a nerve injury. The frequencies of early and late complications/associated injuries were 19.5% (n = 275) and 9.2% (n = 130). The frequencies of emergency admission, nerve injury, spinal fracture, lower extremity fractures, craniofacial fracture, sternum and rib fracture, and early complications/ASOIs were significantly larger in high fall than low fall (all P fall than high fall. The frequencies of spinal fracture (P = .039), lower extremity fractures (P = .048), and craniofacial fracture (P = .041) were significantly larger in female than the male patients. The frequency of upper extremity fractures (P fall, spinal fracture, and craniofacial fracture were significantly larger in patients with nerve injury than other patients without nerve injury (all P falls and upper extremity fractures were the most common etiologies and sites, respectively. High fall, spinal fracture and craniofacial fracture were risk factors for nerve injury. Therefore, we should focus on patients who were caused by high fall and presented with spinal and craniofacial fracture to determine the presence of a nerve injury so that we

  6. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

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    Glaydson Gomes Godinho

    2016-04-01

    Full Text Available OBJECTIVE: To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. METHODS: Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A or greater than or equal to 3.0 cm (group B. All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles score and strength measurements. RESULTS: The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743. Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416. CONCLUSION: The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation.

  7. Systematic search and review procedures: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

    DEFF Research Database (Denmark)

    Cancelliere, C.; Cassidy, J. D.; Li, A.

    2014-01-01

    of interventions for mild traumatic brain injury (MTBI), identify knowledge gaps in the literature, and make recommendations for future research. DATA SOURCES: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health, and SPORTDiscus were searched between 2001 and 2012. Inclusion criteria included...... to population (eg, adults, children, and athletes) and outcomes (eg, risk of dementia after MTBI). CONCLUSIONS: After 77,914 records were screened, 299 articles were eligible and reviewed. Of these, 101 (34%) were accepted as scientifically admissible and form the basis of our findings, which are organized...

  8. A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events.

    Science.gov (United States)

    Alcorn, K L; O'Donovan, A; Patrick, J C; Creedy, D; Devilly, G J

    2010-11-01

    Childbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology. Pregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4-6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum. Of the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4-6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4-6 weeks postpartum, 6.3% at 12 weeks postpartum and 5.8% at 24 weeks postpartum. When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinically significant anxiety and depression during pregnancy, PTSD rates were less at 1.2% at 4-6 weeks, 3.1% at 12 weeks and 3.1% at 24 weeks postpartum. This is the first study to demonstrate the occurrence of full criteria PTSD resulting from childbirth after controlling for pre-existing PTSD and partial PTSD and clinically significant depression and anxiety in pregnancy. The findings indicate that PTSD can result from a traumatic birth experience, though this is not the normative response.

  9. Outpatient follow-up after mild traumatic brain injury: Results of the UPFRONT-study.

    Science.gov (United States)

    de Koning, M E; Scheenen, M E; van der Horn, H J; Hageman, G; Roks, G; Yilmaz, T; Spikman, J M; van der Naalt, J

    2017-01-01

    To investigate outpatient follow-up after mild traumatic brain injury (mTBI) by various medical specialists, for both hospitalized and non-hospitalized patients, and to study guideline adherence regarding hospital admission. Patients (n = 1151) with mTBI recruited from the emergency department received questionnaires 2 weeks (n = 879), 3 months (n = 780) and 6 months (n = 668) after injury comprising outpatient follow-up by various health care providers, and outcome defined by the Glasgow Outcome Scale Extended (GOS-E) after 6 months. Hospitalized patients (60%) were older (46.6 ± 19.9 vs. 40.6 ± 18.5 years), more severely injured (GCS Computed Tomography (CT) abnormalities on admission (21% vs. 2%) compared to non-hospitalized patients (p patients visited a neurologist at the outpatient clinic within six months (60% of the hospitalized and 25% of the non-hospitalized patients (χ 2 = 67.10, p hospitalized and 21% of non-hospitalized patients (χ 2 = 11.89, p patients consult one or more specialists within six months after injury, with 30% having an unfavourable outcome. A quarter of non-hospitalized patients was seen at the outpatient neurology clinic, underling the importance of regular follow-up of mTBI patients irrespective of hospital admittance.

  10. Acute bone changes after lower limb amputation resulting from traumatic injury.

    Science.gov (United States)

    Bemben, D A; Sherk, V D; Ertl, W J J; Bemben, M G

    2017-07-01

    Bone health is critical for lower limb amputees, affecting their ability to use a prosthesis and their risk of osteoporosis. We found large losses in hip bone mineral density (BMD) and in amputated bone strength in the first year of prosthesis use, suggesting a need for load bearing interventions early post-amputation. Large deficits in hip areal BMD (aBMD) and residual limb volumetric BMD (vBMD) occur after lower limb amputation; however, the time course of these bone quality changes is unknown. The purpose of this study was to quantify changes in the amputated bone that occur during the early stages post-amputation. Eight traumatic unilateral amputees (23-53 years) were enrolled prior to surgery. Changes in total body, hip, and spine aBMD (dual-energy X-ray absorptiometry); in vBMD, stress-strain index (SSI), and muscle cross-sectional area (MCSA) (peripheral QCT); and in bone turnover markers were assessed after amputation prior to prosthesis fitting (pre-ambulatory) and at 6 and 12 months walking with prosthesis. Hip aBMD of the amputated limb decreased 11-15%, which persisted through 12 months. The amputated bone had decreases (p 650 mg/cm 3 (58 to 43% of total area) or >480 mg/cm 3 (65% to 53%), suggesting an increase in cortical porosity after amputation. Bone alkaline phosphatase and sclerostin were elevated (p amputation and are not regained by 12 months of becoming ambulatory. Early post-amputation may be the most critical window for preventing bone loss.

  11. Age and Mortality in Pediatric Severe Traumatic Brain Injury: Results from an International Study.

    Science.gov (United States)

    Sarnaik, Ajit; Ferguson, Nikki Miller; O'Meara, A M Iqbal; Agrawal, Shruti; Deep, Akash; Buttram, Sandra; Bell, Michael J; Wisniewski, Stephen R; Luther, James F; Hartman, Adam L; Vavilala, Monica S

    2018-02-23

    Although small series have suggested that younger age is associated with less favorable outcome after severe traumatic brain injury (TBI), confounders and biases have limited our understanding of this relationship. We hypothesized that there would be an association between age and mortality in children within an ongoing observational, cohort study. The first 200 subjects from the Approaches and Decisions for Acute Pediatric TBI trial were eligible for this analysis (inclusion criteria: severe TBI (Glasgow Coma Scale [GCS] score ≤ 8], age 18 years, and intracranial pressure (ICP) monitor placed; exclusion: pregnancy). Children with suspected abusive head trauma (AHT) were excluded to avoid bias related to the association between AHT and mortality. Demographics, and prehospital and resuscitation events were collected/analyzed, and children were stratified based on age at time of injury (age subgroup describing the time of death, and log-rank was used to compare the curves. Cox proportional hazards regression models were used to assess the effect of age on time to death while controlling for covariates. In the final cohort (n = 155, 45 excluded for AHT), overall age was 9.2 years ± 0.4 and GCS was 5.3 ± 0.1. Mortality was similar between strata (14.0, 20.0, 20.9%, respectively, p = 0.58). Motor vehicle accidents were the most common mechanism across all strata, while falls tended to be more common in the youngest stratum (p = 0.08). The youngest stratum demonstrated increased incidence of spontaneous hypothermia at presentation and decreased hemoglobin concentrations and coagulopathies, while the oldest demonstrated lower platelet counts. In contrast to previous reports, we failed to detect mortality differences across age strata in children with severe TBI. We have discerned novel associations between age and various markers of injury-unrelated to AHT-that may lead to testable hypotheses in the future.

  12. Evaluation of the Results of Posterior Decompression, Corpectomy and Instrumentation in Traumatic Unstable Thoraco-Lumbar Burst Fractures

    Directory of Open Access Journals (Sweden)

    Md. Anowarul Islam

    2012-06-01

    Full Text Available Background: Thoraco-lumbar burst fractures occur as a result of axial load which often causes displacement of the middle column into the vertebral canal. Posterior surgery reduces the morbid outcomes of different other approaches. Objective: To evaluate the clinical and radiological success of posterior corpectomy and instrumentation in the management of traumatic unstable thoraco-lumbar burst fractures. Methods: It is a prospective interventional study carried out in Bangabandhu Sheikh Mujib Medical University and different private hospitals in Dhaka from July 2008 to December 2011. Total 18 patients; 13 male and 05 female within an age range of 21-40 years were selected. Total 09 cases involved L1, 05 cases at D12, 02 cases at D11 and at L2 each. Neurological status was assessed by Frankel‘s grading and pain status by Visual Analogue Score (VAS. Paired t-test was used for statistical analysis. Results: All the patients were followed up for minimum 1 year. Eleven out of 12 patients with Frankel grade-B and 04 patients out of 06 with Frankel grade-C recovered fully and could walk without support (p<0.05. Overall 03 patients ended with some degrees of persistant neurological deficit. The mean postoperative pain improvement and kyphotic angle correction was significant  (p<0.05. Conclusion: Decompression through posterior approach by laminectomy, corpectomy and fusion by cage with bone graft and stabilization by pedicle screw and rod significantly improves the clinical and radiological outcome in management of traumatic unstable thoraco-lumbar burst fractures.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10998 BSMMU J 2012; 5(1:35-41 

  13. Traumatic brain injury among female offenders in a prison population: results of the FleuryTBI study.

    Science.gov (United States)

    Durand, Eric; Watier, Laurence; Lécu, Anne; Fix, Michel; Weiss, Jean-Jacques; Chevignard, Mathilde; Pradat-Diehl, Pascale

    2017-01-01

    The study was designed to estimate the prevalence of traumatic brain injury (TBI) in a French prison population of female offenders, study the variables known to be associated with TBI, and compare our results with those obtained among male offenders as described in a previous paper. All female offenders (adults and juveniles) consecutively admitted to Fleury-Mérogis prison over a 3-month period were included in the study. During the admission procedure, female offenders were interviewed by healthcare staff using a self-reported questionnaire. In all, 100 female offenders were included. The rate of self-reported TBI was high, with a prevalence of 21%. The first cause of TBI was violence related (35%) and a majority of female offenders with a history of TBI reported having sustained more than one TBI. When compared with those who did not report a TBI, epilepsy and use of alcohol were higher among female offenders with a history of TBI. Perceived health was significantly worse for women who reported a TBI. This study findings provide additional evidence that TBI among offender populations is serious and that specific actions need to be developed and implemented in correctional settings such as screening for TBI upon arrival.

  14. Isolated oculomotor nerve palsy resulting from acute traumatic tentorial subdural hematoma

    Directory of Open Access Journals (Sweden)

    Cui V

    2016-10-01

    Full Text Available Victoria Cui,1 Timur Kouliev2 1Washington University School of Medicine, St Louis, MO, USA; 2Emergency Department, Beijing United Family Hospital, Beijing, China Abstract: Acute subdural hematoma (SDH resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. However, smaller bleeds (clot thickness <10 mm or hematomas occurring in infrequent locations, such as the tentorium cerebelli, may be difficult to recognize and patients may present with unusual or subtle signs and symptoms, including isolated cranial nerve palsies. Knowledge of neuroanatomy supported by modern neuroimaging can greatly aid in recognition and diagnosis of such lesions. In this report, we present a case of isolated oculomotor nerve palsy resulting from compressive tentorial SDH following blunt head trauma, review the literature concerning similar cases, and make recommendations regarding the diagnosis of SDH in patients presenting with isolated cranial nerve palsies. Keywords: head injury, oculomotor, palsy, subdural hematoma, trauma, tentorium, cerebral herniation, intracranial hemorrhage

  15. [Results of videonystagmographic (VNG) analysis in vestibular post-traumatic pathology].

    Science.gov (United States)

    Armato, E; Ferri, E; García Purrinos, F

    2001-10-01

    From February 1998 to July 1999, 569 patients affected by vestibular disorders--following a whiplash injury and/or a cranial trauma--were studied. The neuro-otological examination included a tonal audiometry, brain stem auditory evoked potentials, clinical and instrumental vestibular tests (caloric test, rotatory test, assessment of visually guided eye movements). The study of eye movements was conducted with the support of the Ulmer video-oculographical system. The aim of the research was to analyse, both from a qualitative and a quantitative perspective, the vestibular and clinical findings. Particular emphasis was laid on the incidence of the "up-beating" nystagmus in different categories of patients, all supported by a statistical study. As a result, an etiopathogenetical hypothesis of the nystagmus was advanced, based on altered otolithic and cervical inputs. At the same time, the importance of the video-nystagmographical system was stressed, to the extent that it leads to a standardised and objective analysis, fundamental for clinical and forensic aspects.

  16. Technetium-99m sestamibi limb scintigraphy in post-traumatic reflex sympathetic dystrophy: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Sarikaya, A.; Firat, M.F. [Dept. of Nuclear Medicine, Trakya University Hospital, Edirne (Turkey); Sarikaya, I. [Div. of Nuclear Medicine, University of Maryland Medical Center, Baltimore (United States); Pekindil, G. [Dept. of Radiology, Trakya University Hospital, Edirne (Turkey); Pekindil, Y. [Dept. of Physical Medicine and Rehabilitation, Trakya University Hospital Edirne (Turkey)

    2001-10-01

    Reflex sympathetic dystrophy (RSD) has widely variable clinical manifestations. Its pathogenesis remains partially unexplained. RSD is commonly divided into three stages; these stages are not always clearly separable, but staging remains important for correct treatment. Since the disease involves soft tissue alterations as well as bone changes, we decided to investigate whether technetium-99m sestamibi limb imaging can be used to evaluate the soft tissue appearance. Fifteen patients (seven females and eight males; age range 12-68 years) with clinically significant post-fracture RSD were evaluated with both three-phase bone scan (TPBS) and {sup 99m}Tc-sestamibi limb scintigraphy. Although, in general, patients with similar duration of disease, clinical stage and TPBS activity tended to have similar patterns of sestamibi uptake, discordant uptake patterns were observed in some patients with clinical stage 1. Thus, of 12 patients with stage I disease, eight had increased {sup 99m}Tc-sestamibi activity in the distal part of the affected limb, while three had normal activity and one had decreased activity. All three patients with stage II disease showed normal {sup 99m}Tc-sestamibi uptake. Although most of the patients with increased {sup 99m}Tc-sestamibi uptake had increased activity on all three phases of the bone scan, there were discordant results between the scan patterns in other patients. On the basis of these findings, we suggest that {sup 99m}Tc-sestamibi imaging may contribute to the differentiation between clinical stages and may permit evaluation of the disease course and selection of appropriate therapy. {sup 99m}Tc-sestamibi imaging is not, however, a primary diagnostic procedure for RSD. (orig.)

  17. Prehospital thoracostomy in patients with traumatic circulatory arrest: results from a physician-staffed Helicopter Emergency Medical Service

    NARCIS (Netherlands)

    Peters, J.H.; Ketelaars, R.; Wageningen, B. van; Biert, J.; Hoogerwerf, N.

    2017-01-01

    OBJECTIVE: Until recently, traumatic cardiac arrest (tCA) was believed to be associated with high mortality and low survival rates. New data suggest better outcomes. The most common error in tCA management is failing to treat a tension pneumothorax (TP). In the prehospital setting, we prefer

  18. Risk factors for post-traumatic pneumonia in patients with retained haemothorax: results of a prospective, observational AAST study.

    Science.gov (United States)

    Bradley, Matthew; Okoye, Obi; DuBose, Joseph; Inaba, Kenji; Demetriades, Demetrios; Scalea, Thomas; O'Connor, James; Menaker, Jay; Morales, Carlos; Shiflett, Tony; Brown, Carlos

    2013-09-01

    Retained haemothorax (RH) is a problematic sequela of thoracic trauma, reported in up to 20% of patients following chest injury. RH is associated with a higher severity of thoracic trauma and may portend the onset of other serious post-traumatic complications, including pneumonia. The development of pneumonia has previously been reported to be as high as 19.5% in the setting of traumatic RH. The purpose of this study was to identify risk factors for the development of pneumonia as a complication in RH. We utilized the American Association for the Surgery of Trauma Post-Traumatic Retained Haemothorax database. Patients with post-traumatic RH were prospectively enrolled from 2009 to 2011. Inclusion criteria were placement of a thoracostomy tube within 24h of admission for the evacuation of pneumothorax or haemothorax and subsequent chest computed tomography scan chest showing RH. Patients treated with thoracotomy before placement of tube thoracostomy were excluded. For univariate analysis, the Chi-square test with Yates correction was used for comparison of categorical risk factors and the Student's t-test or the Mann-Whitney test for comparison of continuous risk factors. To identify independent risk factors for the development of pneumonia, variables from the univariate analysis significant at p25 (adjusted OR: 7.1; 95% CI: 3.1, 16.4; ppneumonia in patients with post-traumatic RH. To our knowledge, our current study is the largest attempt to identify the independent predictors for pneumonia in this population. Our data show that elevated ISS, blunt thoracic trauma, and failure to administer peri-procedural antibiotics on tube thoracostomy placement are the statistically significant independent risk factors. Published by Elsevier Ltd.

  19. Focal traumatic brain stem injury is a rare type of head injury resulting from assault: a forensic neuropathological study.

    Science.gov (United States)

    Al-Sarraj, Safa; Fegan-Earl, Ashley; Ugbade, Antonia; Bodi, Istvan; Chapman, Rob; Poole, Simon; Swift, Ben; Jerreat, Peter; Cary, Nat

    2012-04-01

    Brainstem haemorrhage is common in cases of head injury when it is associated with space-occupying lesion and increases in the intracranial pressure (duret haemorrhage), in cases of diffuse axonal injury (in dorso-lateral quadrant) and diffuses vascular injury (in the periventricular tissue). However focal traumatic brainstem injury is rare. We identified 12 cases of focal traumatic brainstem injury from review of 319 case of head injury. The head trauma had been caused by different mechanisms of complex fall from height and assault. 10/12 are associated with skull fracture, 11/12 with contre coup contusions in the frontal and temporal lobes, 5/12 direct contusions to cerebellum, 5/12 haemorrhage in corpus callosum and 2/11 have gliding contusions. None of the cases had pathological evidence of increase in the intracranial pressure. The bleeding in the pons was at the edge in 2/12 and cross the section in 10/12. The majority of patients were unconscious immediately after the incident (10/12) and 9/12 died within one day. Focal traumatic brainstem injury occurs most likely due to direct impact at the back of the head or stretching forces affecting the brainstem in cases of complex fall from height and after assault, particularly those associated with kicks. It is a serious and commonly fatal brain damage, which needed to be differentiated from other causes of brainstem haemorrhages. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Acute non-traumatic idiopathic spinal subdural hematoma: radiographic findings and surgical results with a literature review.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Nishida, Yoshihiro; Ishiguro, Naoki

    2017-11-01

    Intraspinal hematoma is a serious condition, and early diagnosis is necessary to permit emergency treatment. Among such hematomas, non-traumatic spinal subdural hematoma is a rare occurrence. We have experienced three patients with surgically proven subdural spinal hematoma, and here we report these cases with a review of their clinical and imaging characteristics. All three cases were idiopathic with no history of disease, no coagulopathy, and no trauma. All had acute onset that brought about paralysis of the lower limbs with severe pain. Early surgery was performed, based on a relatively early diagnosis using thoracolumbar MRI and CT. Since the epidural fat is not affected by bleeding, the normal structure remains and the boundary between hematoma and fat is a significant feature in MRI and CT. Partial Gd enhancement in MRI and ring enhancement in contrast CT were also apparent. Two of the cases had subarachnoid hematomas. Preoperative diagnosis of spinal subarachnoid hematoma is difficult because there are no specific radiological findings and confirmation can only occur intraoperatively. In particular, one case had a massive hematoma causing canal stenosis, and it was difficult to distinguish between intradural and extradural hematoma. In all cases of subarachnoid or subdural hematoma, decompression was performed within 24 h after onset, and consequently, the patients had relatively good outcomes.

  1. The Relation of Exposure to Traumatic Events and Longitudinal Mental Health Outcomes for Children Enrolled in Systems of Care: Results from a National System of Care Evaluation.

    Science.gov (United States)

    Whitson, Melissa L; Connell, Christian M

    2016-06-01

    This study examined the relation between children's history of exposure to potentially traumatic events (PTEs) and clinical and functional mental health trajectories over a 18-month period among a national sample of youth referred for services in children's behavioral health systems of care (SOCs). Using data from the national evaluation of the Comprehensive Community Mental Health Services program for communities funded from 1997 to 2000, the study sample included 9556 children and their families. Latent growth modeling was used to assess the effect of history of exposure to PTEs on trajectories in a number of behavioral health outcomes during the 3-year period following referral to services, controlling for child demographic characteristics (gender, race, and age). Results revealed that, on average, children in SOCs exhibited significant improvements over time on all four outcome measures. Children with a history of exposure to PTEs had higher rates of internalizing and externalizing problem behaviors and functional impairments and fewer behavioral and emotional strengths at baseline, but experienced improvements in these outcomes at the same rates as children without exposure to a traumatic event. Finally, child race, gender, and age also were associated with differences in behavioral health trajectories among service recipients. Implications for SOCs, including approaches to make them more trauma-informed, are discussed. © Society for Community Research and Action 2016.

  2. Anger Self-Management Training for Chronic Moderate to Severe Traumatic Brain Injury: Results of a Randomized Controlled Trial.

    Science.gov (United States)

    Hart, Tessa; Brockway, Jo Ann; Maiuro, Roland D; Vaccaro, Monica; Fann, Jesse R; Mellick, David; Harrison-Felix, Cindy; Barber, Jason; Temkin, Nancy

    To test efficacy of 8-session, 1:1 treatment, anger self-management training (ASMT), for chronic moderate to severe traumatic brain injury (TBI). Three US outpatient treatment facilities. Ninety people with TBI and elevated self-reported anger; 76 significant others (SOs) provided collateral data. Multicenter randomized controlled trial with 2:1 randomization to ASMT or structurally equivalent comparison treatment, personal readjustment and education (PRE). Primary outcome assessment 1 week posttreatment; 8-week follow-up. Response to treatment defined as 1 or more standard deviation change in self-reported anger. SO-rated anger, emotional and behavioral status, satisfaction with life, timing of treatment response, participant and SO-rated global change, and treatment satisfaction. State-Trait Anger Expression Inventory-Revised Trait Anger (TA) and Anger Expression-Out (AX-O) subscales; Brief Anger-Aggression Questionnaire (BAAQ); Likert-type ratings of treatment satisfaction, global changes in anger and well-being. After treatment, ASMT response rate (68%) exceeded that of PRE (47%) on TA but not AX-O or BAAQ; this finding persisted at 8-week follow-up. No significant between-group differences in SO-reported response rates, emotional/behavioral status, or life satisfaction. ASMT participants were more satisfied with treatment and rated global change in anger as significantly better; SO ratings of global change in both anger and well-being were superior for ASMT. ASMT was efficacious and persistent for some aspects of problematic anger. More research is needed to determine optimal dose and essential ingredients of behavioral treatment for anger after TBI.

  3. Pain Phenotypes and Associated Clinical Risk Factors Following Traumatic Amputation: Results from Veterans Integrated Pain Evaluation Research (VIPER).

    Science.gov (United States)

    Buchheit, Thomas; Van de Ven, Thomas; Hsia, Hung-Lun John; McDuffie, Mary; MacLeod, David B; White, William; Chamessian, Alexander; Keefe, Francis J; Buckenmaier, Chester Trip; Shaw, Andrew D

    2016-01-01

    To define clinical phenotypes of postamputation pain and identify markers of risk for the development of chronic pain. Cross-sectional study of military service members enrolled 3-18 months after traumatic amputation injury. Military Medical Center. 124 recent active duty military service members. Study subjects completed multiple pain and psychometric questionnaires to assess the qualities of phantom and residual limb pain. Medical records were reviewed to determine the presence/absence of a regional catheter near the time of injury. Subtypes of residual limb pain (somatic, neuroma, and complex regional pain syndrome) were additionally analyzed and associated with clinical risk factors. A majority of enrolled patients (64.5%) reported clinically significant pain (pain score ≥ 3 averaged over previous week). 61% experienced residual limb pain and 58% experienced phantom pain. When analysis of pain subtypes was performed in those with residual limb pain, we found evidence of a sensitized neuroma in 48.7%, somatic pain in 40.8%, and complex regional pain syndrome in 19.7% of individuals. The presence of clinically significant neuropathic residual limb pain was associated with symptoms of PTSD and depression. Neuropathic pain of any severity was associated with symptoms of all four assessed clinical risk factors: depression, PTSD, catastrophizing, and the absence of regional analgesia catheter. Most military service members in this cohort suffered both phantom and residual limb pain following amputation. Neuroma was a common cause of neuropathic pain in this group. Associated risk factors for significant neuropathic pain included PTSD and depression. PTSD, depression, catastrophizing, and the absence of a regional analgesia catheter were associated with neuropathic pain of any severity. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

  4. Rapid increase in hospitalizations resulting from fall-related traumatic head injury in older adults in the Netherlands 1986-2008

    NARCIS (Netherlands)

    K.A. Hartholt (Klaas); E.M.M. van Lieshout (Esther); S. Polinder (Suzanne); M.J.M. Panneman (Martien); T.J.M. van der Cammen (Tischa); P. Patka (Peter)

    2011-01-01

    textabstractFalls occur frequently in older adults. With ageing populations worldwide, an increase in fall-related traumatic head injuries can be expected. The aim of our study was to determine trends in traumatic head-injury-related hospitalizations among older adults. Therefore, a secular trend

  5. Long-term Prognosis of Pulpal Status of Traumatized Teeth Exhibiting Contradictory Results between Pulp Sensibility Test and Ultrasound Doppler Flowmetry: A Retrospective Study.

    Science.gov (United States)

    Ahn, So-Yeon; Kim, Dohyun; Park, Sung-Ho

    2018-03-01

    In this retrospective study, we investigated long-term (over 3 years) follow-up results of teeth that exhibited contradictory results between the pulp sensibility test (thermal or electric pulp test) and ultrasound Doppler flowmetry (UDF) until 1 year after trauma to inspect the prognosis of the pulp. Data were collected from the records of trauma patients in our hospital between February 2012 and May 2015. The teeth that had continuously shown contrasting results on the pulp sensibility test and UDF until 1 year after trauma were chosen for the study. Cases with follow-up records of more than 3 years after trauma were finally included, and a retrospective chart review was performed. Data from 343 teeth in 147 patients who visited the hospital with traumatic dental injuries were examined. Among these, 13 teeth from 7 patients were included, and the record of each case was reviewed. All the subjects showed negative responses on the pulp sensibility test and positive responses on UDF until 1 year after trauma. Ultimately, 8 of the 13 teeth recovered pulp sensibility. Two teeth failed to recover pulp sensibility and became symptomatic; root canal treatment was performed on the teeth. The remaining 3 teeth belonged to patients suffering from nerve damage; therefore, the pulp sensibility test was not feasible. Based on this study, UDF can be effectively used for the evaluation of pulpal status in traumatized teeth. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. Differences in visual vs. verbal memory impairments as a result of focal temporal lobe damage in patients with traumatic brain injury.

    Science.gov (United States)

    Ariza, Mar; Pueyo, Roser; Junqué, Carme; Mataró, María; Poca, María Antonia; Mena, Maria Pau; Sahuquillo, Juan

    2006-09-01

    The aim of the present study was to determine whether the type of lesion in a sample of moderate and severe traumatic brain injury (TBI) was related to material-specific memory impairment. Fifty-nine patients with TBI were classified into three groups according to whether the site of the lesion was right temporal, left temporal or diffuse. Six-months post-injury, visual (Warrington's Facial Recognition Memory Test and Rey's Complex Figure Test) and verbal (Rey's Auditory Verbal Learning Test) memories were assessed. Visual memory deficits assessed by facial memory were associated with right temporal lobe lesion, whereas verbal memory performance assessed with a list of words was related to left temporal lobe lesion. The group with diffuse injury showed both verbal and visual memory impairment. These results suggest a material-specific memory impairment in moderate and severe TBI after focal temporal lesions and a non-specific memory impairment after diffuse damage.

  7. Facilitating post traumatic growth

    Directory of Open Access Journals (Sweden)

    Cox Helen

    2004-07-01

    Full Text Available Abstract Background Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal care. All participants were injured through involvement in a motor vehicle accident, with the exception of one, who was injured through falling off the roof of a house. Methods In this qualitative study, we used an audio-taped in-depth interview with each participant as the means of data collection. Interviews were transcribed verbatim and analysed thematically to determine the participants' unique perspectives on the experience of recovery from traumatic injury. In reporting the findings, all participants' were given a pseudonym to assure their anonymity. Results Most participants indicated that their involvement in a traumatic occurrence was a springboard for growth that enabled them to develop new perspectives on life and living. Conclusion There are a number of contributions that health providers may make to the recovery of individuals who have been traumatically injured to assist them to develop new views of vulnerability and strength, make changes in relationships, and facilitate philosophical, physical and spiritual growth.

  8. Head Trauma in Jail and Implications for Chronic Traumatic Encephalopathy in the United States: Case Report and Results of Injury Surveillance in NYC Jails.

    Science.gov (United States)

    Siegler, Anne; Rosner, Zachary; MacDonald, Ross; Ford, Elizabeth; Venters, Homer

    2017-01-01

    Abstract Because there is no standard reporting of injuries in jails and prisons, the national burden of head trauma during incarceration is unclear. We report on a case of repeated head trauma in the New York City (NYC) jail system, data on the incidence of head trauma and mild traumatic brain injury (mTBI), and compare those findings with national estimates. The case report revealed 64 injurious events over two years, 44% resulting in a head injury and 25% resulting in emergency hospitalization. During the 42 months of this analysis, 10,286 incidents of head trauma occurred in the NYC jail system. Mild TBI occurred in 1,507 of these instances. The rate of head trauma and mTBI was 269.0 and 39.4 per 1,000 person-years, respectively. The lack of reporting head trauma in correctional settings means that national prevalence estimates of these critical health outcomes miss the vulnerable cohort of incarcerated individuals.

  9. Prevalence of traumatic brain injury and epilepsy among prisoners in France: Results of the Fleury TBI study.

    Science.gov (United States)

    Durand, E; Watier, L; Fix, M; Weiss, J J; Chevignard, M; Pradat-Diehl, P

    2016-01-01

    The first aim of this study was to estimate the prevalence of TBI and epilepsy in a French prison population and to study variables known to be associated with TBI. The second aim was to compare prisoners with and without a history of TBI. All offenders (females, males and juveniles) admitted consecutively to Fleury-Mérogis prison over a period of 3 months were included in the study. During the admission procedure, offenders were interviewed by healthcare staff using a self-reported questionnaire. In all, 1221 prisoners were included. The rates of TBI and epilepsy were high, with a prevalence of 30.6% and 5.9%, respectively. Psychiatric care, anxiolytic and antidepressant treatment, use of alcohol and cannabis were all significantly higher among offenders with a history of TBI. Moreover, the number of times in custody and the total time spent in jail over the preceding 5 years were significantly higher among offenders with a history of TBI. These results provide further evidence that specific measures need to be developed such as, first of all, screening for TBI upon arrival in prison.

  10. Traumatic grief and traumatic stress in survivors 12 years after the genocide in Rwanda.

    Science.gov (United States)

    Mutabaruka, Jean; Séjourné, Nathalène; Bui, Eric; Birmes, Philippe; Chabrol, Henri

    2012-10-01

    The relationship between exposure to traumatic events and traumatic grief and the role of mediating and moderating variables [peritraumatic distress, post traumatic stress disorder (PTSD) symptoms and symptoms of depression] were studied in survivors of the genocide of Batutsi in Rwanda in 1994. One hundred and two survivors (70 women, mean age 45 ± 7.53 years) participated in this retrospective study. All of them had lost a member of their family. The severity of traumatic exposure (Comprehensive Trauma Inventory), peritraumatic distress (Peritraumatic Distress Inventory), current PTSD symptoms (PTSD Checklist), depressive symptoms (Beck Depression Inventory) and traumatic grief symptoms (Inventory of Traumatic Grief) was evaluated. A hierarchical multiple regression analysis was then conducted to examine the relative contribution of each variable to the symptoms of traumatic grief. The severity of traumatic exposure was related to traumatic grief symptoms (B=0.06, R=0.6, R(2) =0.36 and ß=0.6, t=7.54, p=0.00). The Baron and Kenny procedure (1986) (including three separate regressions), along with the Sobel test, was used to test mediation effects. Peritraumatic distress and PTSD symptoms may be mediating variables between traumatic exposure and traumatic grief. Traumatic grief is a complex but assessable entity, where previous distress and suffering result from both psychological trauma and the loss of a loved one. Copyright © 2011 John Wiley & Sons, Ltd.

  11. Traumatic neuralgia from pressure-point strikes in the martial arts: results from a retrospective online survey.

    Science.gov (United States)

    Kelly, Michael D

    2008-06-01

    Many techniques in Asian martial arts hand-to-hand combat systems emphasize hitting or striking specific sites on the body that correlate with exposed portions of peripheral nerves. To evaluate the prevalence and clinical effects of this unique sports-related injury. An anonymous self-administered retrospective 20-question electronic survey was posted on a high-traffic martial arts Web site. Primary outcome measures were demographic and medical history data, including martial arts experience and neuropathic symptoms associated with injury from this form of combat. Risk of symptoms was calculated by dividing the number of individuals with symptoms in each pressure-point area by the number of individuals who were struck in these areas during martial arts training. Of the 651 survey responses received, 605 met inclusion criteria. Neuropathic symptoms were reported by 291 subjects. Most symptoms occurred in individuals aged between 20 and 30 years as well as in individuals with less than 1 year of martial arts training. The majority of respondents with neuropathic symptoms reported a symptom duration of less than 1 year (207 [71%]). Individuals with more than 5 years of combat training experience had a greater risk of chronic symptoms than individuals with less experience. Strikes to pressure points on the back had the greatest risk of inducing neuropathic symptoms. Symptoms of neurapraxia can occur in individuals as a result of practicing martial arts involving strikes on pressure points. Although the majority of symptoms resolve within 1 year, individuals with prolonged exposure to pressure-point strikes may be more likely to have chronic symptoms.

  12. Concomitant use of transcranial Direct Current Stimulation and computer-assisted training for the rehabilitation of attention in traumatic brain injured patients: behavioral and neuroimaging results

    Directory of Open Access Journals (Sweden)

    Katiuscia eSacco

    2016-03-01

    Full Text Available Divided attention, the ability to distribute cognitive resources among two or more simultaneous tasks, may be severely compromised after traumatic brain injury (TBI, resulting in problems with numerous activities involved with daily living. So far, no research has investigated whether the use of non-invasive brain stimulation associated with neuropsychological rehabilitation might contribute to the recovery of such cognitive function. The main purpose of this study was to assess the effectiveness of 10 tDCS sessions combined with computer-assisted training; it also intended to explore the neural modifications induced by the treatment. Thirty-two patients with severe TBI participated in the study: sixteen were part of the experimental group, and sixteen part of the control group. The treatment included 20’ of tDCS, administered twice a day for 5 days. The electrodes were placed on the dorso-lateral prefrontal cortex. Their location varied across patients and it depended on each participant’s specific area of damage. The control group received sham tDCS. After each tDCS session, the patient received computer-assisted cognitive training on divided attention for 40’. The results showed that the experimental group significantly improved in divided attention performance between pre- and post-treatment, showing faster reaction times, and fewer omissions. No improvement was detected between the baseline assessment (i.e., one month before treatment and the pre-training assessment, or within the control group. Functional magnetic resonance imaging data, obtained on the experimental group during a divided attention task, showed post-treatment lower cerebral activations in the right superior temporal gyrus (BA 42, right and left middle frontal gyrus (BA 6, right postcentral gyrus (BA 3 and left inferior frontal gyrus (BA 9. We interpreted such neural changes as normalization of previously abnormal hyperactivations.

  13. Efficacy and safety assessment of acute sports-related traumatic soft tissue injuries using a new ibuprofen medicated plaster: results from a randomized controlled clinical trial.

    Science.gov (United States)

    Predel, Hans-Georg; Connolly, Mark P; Bhatt, Aomesh; Giannetti, Bruno

    2017-11-01

    To investigate the efficacy and safety of a recently developed ibuprofen medicated plaster in the treatment of acute sports impact injuries/contusions. In this double-blind, multi-center, placebo-controlled, parallel group, phase 3 study (EudraCT Number: 2012-003257-2) patients (n = 132; ages 18 to 60 years) diagnosed with acute sports-related traumatic blunt soft tissue injury/contusion to the upper or lower limbs were randomized to receive either ibuprofen 200 mg plaster (n = 64) or placebo plaster (n = 68). Plasters were administered once daily for five consecutive days. The primary assessment was the area under the curve (AUC) of the visual analogue scale (VAS) of pain on movement (POM) over 0 to 72 h (VAS 0-72 ). The ibuprofen medicated plaster was associated with a reduction in pain on movement (POM) based on lower VAS AUC 0-72h (2399.4 mm*h) compared with placebo (4078.9 mm*h) (least squares mean difference: - 1679.5 mm*h; P ibuprofen medicated plaster compared with placebo at 12, 48, 24, and 120 h (P ibuprofen medicated plaster was associated with greater reduction in tenderness/pain than placebo at each timepoint (P values ibuprofen plaster, and n = 6 [8.8%] for placebo). All drug-related AEs were administration site reactions and were mild in intensity. The results of this study indicate that ibuprofen medicated plaster results in rapid and clinically relevant reduction of pain in patients suffering from blunt musculoskeletal injuries or recurrent pain. The ibuprofen medicated plaster was well tolerated.

  14. Pre-hospital and acute management of traumatic spinal cord injury in the Netherlands: survey results urge the need for standardisation

    NARCIS (Netherlands)

    Fransen, B.L.; Hosman, A.J.; Middendorp, J.J. van; Edwards, M.J.; Grunsven, P.M. van; Meent, H. van de

    2016-01-01

    STUDY DESIGN: Questionnaire survey. OBJECTIVES: Although a range of novel therapeutic approaches for traumatic spinal cord injury (tSCI) are being trialled in highly standardised, pre-clinical research models, little has been published about the extent of standardisation in health service delivery

  15. A systematic review of the risk of dementia and chronic cognitive impairment after mild traumatic brain injury. Results of the International Collaboration on MTBI Prognosis (ICoMP)

    DEFF Research Database (Denmark)

    Godbolt, Allison; Cancelliere, Carol; Hincapié, Cesar A

    2014-01-01

    Objective: To synthesize the best available evidence regarding the risk of dementia and chronic cognitive impairment (CCI), following mild traumatic brain injury (MTBI). Data sources: MEDLINE and other databases were searched (2001–2012), using a previously published search strategy and pre-defin...

  16. Traumatic hemipelvectomy (amputae: Report of one case

    Directory of Open Access Journals (Sweden)

    Errol U. Hutagalung

    2001-09-01

    Full Text Available Traumatic hemipelvectomy (amputae is a catastrophic injury resulting front violent shearing forces which avulsed the lower limb at the level sacroiliac joint and symphisis pubis. Patients surviving traumatic hemipelvectomy are rare. One case of a 25 months old girl surviving traumatic hemipelvectomy, is presented. This is the first case reported from Indonesia. (Med J Indones 2001; 10: 169-73Keywords: Colostomy, skin graft, traffic accident

  17. An audit of traumatic nerve injury.

    LENUS (Irish Health Repository)

    O'Connor, G

    2009-07-01

    The impact of trauma in the Irish healthcare setting is considerable. We present the results of a retrospective assessment of referrals to a Neurophysiology department for suspected traumatic nerve injury. A broad range of traumatic neuropathies was demonstrated on testing, from numerous causes. We demonstrate an increased liklihood of traumatic nerve injury after fracture \\/ dislocation (p = 0.007). Our series demonstrates the need for clinicians to be aware of the possibility of nerve injury post trauma, especially after bony injury.

  18. [Effects of traumatic stress].

    Science.gov (United States)

    Herbst, Gesa; Jaeger, Ulrich; Leichsenring, Falk; Streeck-Fischer, Annette

    2009-01-01

    The diagnosis PTSD does not adequately describe the impact of exposure to childhood trauma of the developing child. The objective of the study was to examine the prevalence of different interpersonal trauma types and to describe the long-term effects of maltreatment and neglect in a clinical sample of 34 adolescents. The majority (62%) of the sample was exposed to two different types of trauma during childhood. Emotional abuse and emotional neglect have been the most common trauma types (59%; 53%). 71% of the traumatized adolescents did not meet the criteria for PTSD. The most common diagnosis in the sample was Borderline Personality Disorder. All average scores at SCL-90-Symptom-Scale were clinical significant. Half of the sample reported suicide attempts and self destructive behavior. One third reported substance abuse and aggressive behavior against others respectively. None of the traumatized adolescents had a positive Self-concept. Altogether the results show that abused children and adolescents have a range of psychological sequelae that are not captured in the PTSD diagnostic criteria. Therefore the results support the necessity for a new and more precise diagnosis for chronically traumatized children and adolescents.

  19. [Correlation between childhood traumatic stress and present drug abuse: results of a nationwide survey of drug addiction rehabilitation facilities in Japan].

    Science.gov (United States)

    Umeno, Mitsuru; Morita, Nobuaki; Ikeda, Tomohiro; Koda, Minoru; Abe, Yukie; Endo, Keiko; Yabe, Yohko; Hirai, Hideyuki; Takahashi, Koji; Aikawa, Yuzo; Senoo, Eiichi; Nakatani, Yoji

    2009-12-01

    Child abuse is known to correlate with drug abuse and interferes with recovery from substance-related disorders. To determine the prevalence and severity of child abuse among drug addicts, we conducted a nationwide cross-sectional survey of residents and outpatients at drug addiction rehabilitation centers (DARC) in Japan. A total of 445 participants gave informed consent and completed a self-reporting questionnaire. Sixty-eight percent of participants had experienced some kind of child abuse by the time they reached junior high school. The kinds of abuse experienced were physical (53.7%), psychological (60.4%), sexual (5.4%) abuse and neglect (24.5%). Comparison of female and male participants revealed that more female than male participants had experienced psychological (76.9% vs. 58.2%) and sexual (17.5% vs. 4.0%) abuse. Comparison of participants who had experienced some kind of child abuse ("Abused" group 68.3%) and those who had not experienced abuse ("Non-abused" group 24.3%) revealed that the "Abused" group was younger than the "Non-abused" group (35.7 SD9.0 vs. 39.7 SD10.8). Participants in the "Abused" group were found to have more severe psychological difficulties than those in the "Non-abused" group for the following: anxiety (73.0% vs. 61.1%), delusional atmosphere (48.0% vs. 28.7%), lack of energy (53.9% vs. 40.7%), ideas of persecution (48.7% vs. 29.6%), depression (62.2% vs. 43.5%) and suicidal ideation in the previous year (50.7% vs. 24.3%). The present results suggest that additional program that prepared to care the drug addicts who experienced child abuse and are experiencing suicidal ideation is needed. Furthermore, intervention for families with risk factors for child abuse should be developed in order to prevent the victim from suffering not only from post traumatic stress disorder but also from substance related disorders.

  20. Radiological Results and Clinical Patient Outcome After Implantation of a Hydraulic Expandable Vertebral Body Replacement following Traumatic Vertebral Fractures in the Thoracic and Lumbar Spine: A 3-Year Follow-Up.

    Science.gov (United States)

    Kreinest, Michael; Schmahl, Dorothee; Grützner, Paul A; Matschke, Stefan

    2017-04-15

    A prospective monocentric study. The aim of the current study was the analysis of patient outcome and radiological results 3 years after implantation of a hydraulic expandable vertebral body replacement (VBR) system. Around 70% to 90% of all traumatic spinal fractures are located in the thoracic and lumbar spine. Dorso-ventral stabilization is a frequently used procedure in traumatic vertebral body fracture treatment. VBR systems can be used to bridge bony defects. In the current study, a new VBR expanded by water pressure with adjustable endplates is used. All patients who suffered a singular traumatic fracture to a thoracic or lumbar vertebral body (Th 5-L 5) in the period from November 2009 to December 2010 and (i) underwent dorsal instrumentation and (ii) afterwards received the implantation of a hydraulic VBR were included in this study. The clinical outcome (visual analogue scale [VAS] spine score, questionnaire) and radiological findings (sagittal angle, implant subsidence, and implant position) 3 years after implantation were analyzed. The follow-up was successful for n = 47 patients (follow-up rate: 89%). Most of the patients (n = 40) were "generally/very satisfied" with their outcome. The mean rating of the VAS spine score was 65.2 ± 23.1 (range: 20.5-100.0). The analysis of the radiological data showed an average subsidence of the implants of 1.1 ± 1.2 mm (range 0.0-5.0 mm). After the initial operation, the local sagittal angle remained stable in the follow-up 3 years later both for the thoracic spine and lumbar spine. Furthermore, no change in the implant's position was observed. The implantation of a hydraulically expandable VBR allows a permanent stable fixation after traumatic fractures of the thoracic and lumbar spine. 2.

  1. Childhood Traumatic Grief

    Science.gov (United States)

    ... Sexual Abuse Effects NCTSN Resources Terrorism and Violence School Shooting Resources Mass Violence Resources NCTSN Resources Traumatic Grief ... Sexual Abuse Effects NCTSN Resources Terrorism and Violence School Shooting Resources Mass Violence Resources NCTSN Resources Traumatic Grief ...

  2. Secondary traumatic stress in nurses: a systematic review.

    Science.gov (United States)

    Beck, Cheryl Tatano

    2011-02-01

    Is there a "cost of caring" for health care providers of traumatized patients? The aim of this study is to review the literature on secondary traumatic stress in nurses in order to answer the following questions: What studies have been conducted on secondary traumatic stress in nurses in all clinical specialties? What instruments were used to measure secondary traumatic stress in nurses and what psychometric properties were reported? A systematic review. CINAHL, PubMed, and PsycINFO databases were searched for the years 1981 to the present. Keywords used in the database searches included secondary traumatic stress, compassion fatigue, vicarious traumatization, secondary trauma, PTSD, and nurses. Research studies were reviewed for the following inclusion criteria: the sample included nurses, the secondary traumatic stress symptoms were measured, and the language was English. Seven studies were found in which researchers examined secondary traumatic stress in nurses. The samples in five of these studies consisted of all nurses, whereas in the remaining two studies, nurses were included in the samples but the results were not specifically reported for the subgroup of nurses. Presence of secondary traumatic stress was reported in forensic nurses, emergency department nurses, oncology nurses, pediatric nurses, and hospice nurses. Three instruments were identified that measured secondary traumatic stress in practitioners who care for traumatized populations: Secondary Traumatic Stress Scale, Compassion Fatigue Self Test for Helpers, and the Compassion Fatigue Scale-Revised. Presence of secondary traumatic stress in nurses was reported in all of the studies included in this literature review. The use of small samples and a number of different instruments to measure secondary traumatic stress symptoms, however, hindered the ability to make comparisons across studies and to draw conclusions. None of the studies conducted to date have focused on secondary traumatic stress in

  3. Chronic traumatic encephalopathy: The unknown disease.

    Science.gov (United States)

    Martínez-Pérez, R; Paredes, I; Munarriz, P M; Paredes, B; Alén, J F

    2017-04-01

    Chronic traumatic encephalopathy is a neurodegenerative disease produced by accumulated minor traumatic brain injuries; no definitive premortem diagnosis and no treatments are available for chronic traumatic encephalopathy. Risk factors associated with chronic traumatic encephalopathy include playing contact sports, presence of the apolipoprotein E4, and old age. Although it shares certain histopathological findings with Alzheimer disease, chronic traumatic encephalopathy has a more specific presentation (hyperphosphorylated tau protein deposited as neurofibrillary tangles, associated with neuropil threads and sometimes with beta-amyloid plaques). Its clinical presentation is insidious; patients show mild cognitive and emotional symptoms before progressing to parkinsonian motor signs and finally dementia. Results from new experimental diagnostic tools are promising, but these tools are not yet available. The mainstay of managing this disease is prevention and early detection of its first symptoms. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Treatment of gay men for post-traumatic stress disorder resulting from social ostracism and ridicule: cognitive behavior therapy and eye movement desensitization and reprocessing approaches.

    Science.gov (United States)

    Carbone, Dominic J

    2008-04-01

    This report describes the clinical treatment of a sample of four gay men suffering from Post-Traumatic Stress Disorder (PTSD) attributed to their repeated experiences with peer ridicule and ostracism throughout childhood and adolescence, caused by their gender variant appearance and behavior. All of the men in the sample shared the following features: (1) a childhood history of ridicule and ostracism from both peers and adults focused on their gender variant presentation designed to elicit gender norm compliance; (2) a lack of social support networks to assist them in coping with the stress; (3) self-destructive coping responses that began in childhood and continued into adulthood in an attempt to lessen the experience of shame; and (4) symptoms of PTSD. A treatment model utilizing cognitive-behavioral therapy and eye movement desensitization and reprocessing was discussed.

  5. The efficacy of eye movement desensitization and reprocessing for post-traumatic stress disorder and depression among Syrian refugees: results of a randomized controlled trial.

    Science.gov (United States)

    Acarturk, C; Konuk, E; Cetinkaya, M; Senay, I; Sijbrandij, M; Gulen, B; Cuijpers, P

    2016-09-01

    Previous research indicates a high prevalence of post-traumatic stress disorder (PTSD) and depression among refugees. Eye movement desensitization and reprocessing (EMDR) is an effective treatment for PTSD for victims of natural disasters, car accidents or other traumatic events. The current study examined the effect of EMDR on symptoms of PTSD and depression by comparing the treatment with a wait-list control condition in Syrian refugees. Adult refugees located in Kilis Refugee Camp at the Turkish-Syrian border with a PTSD diagnosis were randomly allocated to either EMDR (n = 37) or wait-list control (n = 33) conditions. All participants were assessed with the Mini-International Neuropsychiatric Interview Plus at pre-intervention, at 1 week after finishing the intervention and at 5 weeks after finishing the intervention. The main outcome measures were the Harvard Trauma Questionnaire (HTQ) and the Impact of Event Scale-Revised. The Beck Depression Inventory and the Hopkins Symptoms Checklist-25 were included as secondary outcome measures. The Trial Registration no. is NCT01847742. Mixed-model analyses adjusted for the baseline scores indicated a significant effect of group at post-treatment indicating that the EMDR therapy group showed a significantly larger reduction of PTSD symptoms as assessed with the HTQ. Similar findings were found on the other outcome measures. There was no effect of time or group × time interaction on any measure, showing that the difference between the groups at the post-treatment was maintained to the 5-week follow-up. EMDR may be effective in reducing PTSD and depression symptoms among Syrian refugees with PTSD located in a refugee camp.

  6. Evaluation of a Clinical Protocol to Assess and Diagnose Neuropathic Pain During Acute Hospital Admission: Results From Traumatic Spinal Cord Injury.

    Science.gov (United States)

    Bélanger, Lise M A; Umedaly, Hamed S; Noonan, Vanessa K; Park, So Eyun; Prince, Jennifer; Thorogood, Nancy P; Shen, Tian; Townson, Andrea F; Street, John T; Dvorak, Marcel F; Negraeff, Michael

    2018-02-01

    A clinical protocol was developed for clinicians to routinely assess and initiate treatment for patients with neuropathic pain (NP) in an acute care setting. The objectives of this study were to: (1) determine the incidence and onset of NP in patients with traumatic spinal cord injury during acute care and (2) describe how the implementation of a clinical protocol impacts the assessment and diagnosis of NP. The study was a cohort analysis with a pre-post-test utilizing a historical control. Data were retrospectively collected from a patient registry and charts. Participants were randomly selected in cohort 1 (control) and cohort 2 (NP clinical protocol). The incidence of NP was 56% without significant difference between the cohorts (P=0.3). Onset of NP was 8 days (SD=14) across the study and >85% of the participants with NP were diagnosed within 2 weeks. Participants with incomplete injuries had a significant earlier onset than participants with complete injuries (6.2±12.8, 10.9±15.8 d; P=0.003). The mean number of days from hospital admission to initial assessment decreased with use of the NP clinical protocol (3.7±5.7 d; P=0.02). This study demonstrates a high incidence and early onset of NP in traumatic spinal cord injury during acute hospital care, with an earlier emergence in participants with incomplete injury. The NP clinical protocol ensured continuous assessment and documentation of NP while decreasing the time to an initial screen, but did not impact diagnosis.

  7. Traumatic life events and posttraumatic stress disorder among Mexican adolescents: results from a survey Eventos traumáticos de vida y trastorno de estrés postraumático en adolescentes mexicanos: resultados de encuesta

    Directory of Open Access Journals (Sweden)

    Ricardo Orozco

    2008-01-01

    Full Text Available OBJECTIVE: To estimate the prevalence and the association of Traumatic Life Events (LEs and Posttraumatic Stress Disorder (PTSD among the Mexico City Metropolitan Area (MCMA adolescent population. MATERIAL AND METHODS: Adolescents aged 12 to 17 were administered the adolescent version of the World Mental Health Composite International Diagnostic Interview (n=3 005. Data were collected using a stratified, multistage and probability sample. Prevalence, odds ratios and 95% confidence intervals for LEs and PTSD (assessed with DSM-IV criteria were obtained. RESULTS: The percentage of adolescents reporting at least one traumatic event in their lifetimes was 68.9%, with differences by sex. Prevalence for PTSD were 1.8% (2.4% females and 1.2% males, and sexual-related traumas were the LEs most associated with PTSD [OR=3.9 (CI95%=1.8-8.2], adjusted by sex, education and age. CONCLUSIONS: Exposure to traumatic life events is not uncommon among Mexico City adolescents. Effort should be made to reduce child and adolescent sexual abuse, a very traumatic event highly associated with PTSD.OBJETIVO: Estimar la prevalencia y la asociación entre los Eventos Traumáticos (ET y Trastorno de Estrés Postraumático (TEPT en la población adolescente del Área Metropolitana de la Ciudad de México (AMCM. MATERIAL Y MÉTODOS: 3 005 adolescentes del AMCM entre 12 y 17 años fueron entrevistados empleando la versión para adolescentes de la Entrevista Dia gnóstica Internacional de Salud Mental, en una muestra probabilística, estratificada y multietápica. RESULTADOS: 68.9% de los adolescentes en el AMCM reportaron por lo menos un ET alguna vez en su vida, con diferencias por sexo. La prevalencia de TEPT fue 1.8% (2.4% mujeres y 1.2% hombres, y el abuso sexual se asoció al desarrollo de TEPT [OR=3.9(CI95%=1.8-8.2], independientemente del sexo, educación o edad. CONCLUSIONES: La exposición a ET es común en los adolescentes. Se debe poner énfasis en los esfuerzos

  8. Painful Traumatic Trigeminal Neuropathy.

    Science.gov (United States)

    Rafael, Benoliel; Sorin, Teich; Eli, Eliav

    2016-08-01

    This article discusses neuropathic pain of traumatic origin affecting the trigeminal nerve. This syndrome has been termed painful traumatic trigeminal neuropathy by the International Headache Society and replaces atypical odontalgia, deafferentation pain, traumatic neuropathy, and phantom toothache. The discussion emphasizes the diagnosis and the early and late management of injuries to the trigeminal nerve and subsequent painful conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Role of Intracranial Pressure Monitoring in Management of Patients with Severe Traumatic Brain Injury: Results of a Large Level I Trauma Center in Southern Iran.

    Science.gov (United States)

    Khalili, Hosseinali; Sadraei, Nazanin; Niakan, Amin; Ghaffarpasand, Fariborz; Sadraei, Amin

    2016-10-01

    To determine the role of intracranial pressure (ICP) monitoring in management of patients with severe traumatic brain injury (TBI) admitted to a large level I trauma center in Southern Iran. This was a cohort study performed during a 2-year period in a level I trauma center in Southern Iran including all adult patients (>16 years) with severe TBI (Glasgow Coma Scale [GCS] score, 3-8) who underwent ICP monitoring through ventriculostomy. The management was based on the recorded ICP values with threshold of 20 mm Hg. Decompressive craniectomy was performed in patients with intractable intracranial hypertension (persistent ICP ≥25 mm Hg). In unresponsive patients, barbiturate coma was induced. Patients were followed for 6 months and Glasgow Outcome Scale Extended was recorded. The determinants of favorable and unfavorable outcome were also determined. Overall, we included 248 patients with mean age of 34.6 ± 16.6 years, among whom there were 216 men (87.1%) and 32 women (12.9%). Eighty-five patients (34.2%) had favorable and 163 (65.8%) unfavorable outcomes. Those with favorable outcome had significantly lower age (P = 0.004), higher GCS score on admission (P intracranial hypertension (P intracranial hypertension, and maximum recorded ICP are important determinants of outcome in patients with severe TBI. ICP monitoring assisted us in targeted therapy and management of patients with severe TBI. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Telephone Problem-Solving Treatment Improves Sleep Quality in Service Members With Combat-Related Mild Traumatic Brain Injury: Results From a Randomized Clinical Trial.

    Science.gov (United States)

    Vuletic, S; Bell, K R; Jain, S; Bush, N; Temkin, N; Fann, J R; Stanfill, K E; Dikmen, S; Brockway, J A; He, F; Ernstrom, K; Raman, R; Grant, G; Stein, M B; Gahm, G A

    2016-01-01

    Evaluate sleep quality, its correlates, and the effect of telephone-based problem-solving treatment (PST) in active duty postdeployment service members with mild traumatic brain injury (mTBI) SETTING:: Randomized clinical trial. Active duty service members with combat-related mTBI. Education-only (EO) and PST groups (N = 178 each) received printed study materials and 12 educational brochures. The PST group additionally received up to 12 PST telephone calls addressing participant-selected issues. Outcomes were evaluated postintervention (6 months) and at 12 months. Pittsburgh Sleep Quality Index. Sleep quality was manifestly poor in both groups at baseline (Pittsburgh Sleep Quality Index = 12.5 ± 4). Overall sleep quality was significantly different between the PST and EO groups at 6 months (P = .003) but not at 12 months. Longitudinally, PST significantly improved sleep quality at 6 months (P = .001) but not over the follow-up. Low sleep quality was associated with concussion symptoms, pain, depression, and posttraumatic stress disorder at all time points (P Sleep disorders, common in postdeployment service members with mTBI, are strongly associated with the presence of pain, posttraumatic stress disorder, and depression. Telephone-based PST may be an effective therapeutic approach for reducing sleep disorders in this population. Research should focus on maintenance of treatment gains.

  11. Invasive Fungal Infections Secondary to Traumatic Injury

    Directory of Open Access Journals (Sweden)

    Ryan Kronen

    2017-09-01

    Full Text Available Invasive fungal infection (IFI is a rare but serious complication of traumatic injury. The purpose of this article is to review the epidemiology, natural history, mycology, risk factors, diagnosis, treatment, and outcomes associated with post-traumatic IFI in military and civilian populations. The epidemiology of post-traumatic IFI is poorly characterized, but incidence appears to be rising. Patients often suffer from severe injuries and require extensive medical interventions. Fungi belonging to the order Mucorales are responsible for most post-traumatic IFI in both civilian and military populations. Risk factors differ between these cohorts but include specific injury patterns and comorbidities. Diagnosis of post-traumatic IFI typically follows positive laboratory results in the appropriate clinical context. The gold standard of treatment is surgical debridement in addition to systemic antifungal therapy. Patients with post-traumatic IFI may be at greater risk of amputation, delays in wound healing, hospital complications, and death as compared to trauma patients who do not develop IFI. More research is needed to understand the factors surrounding the development and management of post-traumatic IFI to reduce the significant morbidity and mortality associated with this disease.

  12. Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review.

    Science.gov (United States)

    de Graaff, Lisanne F; Honig, Adriaan; van Pampus, Mariëlle G; Stramrood, Claire A I

    2018-01-16

    Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a post-traumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related post-traumatic stress disorder. Major databases [Cochrane; Embase; PsycINFO; PubMed (Medline)] were searched using combinations of the key words and their synonyms. After screening titles and abstracts and reading 135 full-text articles, 13 studies were included. All evaluated secondary prevention, and none primary prevention. Interventions included debriefing, structured psychological interventions, expressive writing interventions, encouraging skin-to-skin contact with healthy newborns immediately postpartum and holding or seeing the newborn after stillbirth. The large heterogeneity of study characteristics precluded pooling of data. The writing interventions to express feelings appeared to be effective in prevention. A psychological intervention including elements of exposure and psycho-education seemed to lead to fewer post-traumatic stress disorder symptoms in women who delivered via emergency cesarean section. No research has been done on primary prevention of traumatic childbirth. Research on secondary prevention of traumatic childbirth and post-traumatic stress disorder following delivery provides insufficient evidence that the described interventions are effective in unselected groups of women. In certain subgroups, results are inhomogeneous. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. Factors associated with surgeon referral for physical therapy in patients with traumatic lower-extremity injury: results of a national survey of orthopedic trauma surgeons.

    Science.gov (United States)

    Archer, Kristin R; MacKenzie, Ellen J; Bosse, Michael J; Pollak, Andrew N; Riley, Lee H

    2009-09-01

    Variation in referral rates for physical therapy exists at both the individual physician and practice levels. The purpose of this study was to explore the influence of physician and practice characteristics on referral for physical therapy in patients with traumatic lower-extremity injury. A cross-sectional survey was conducted. In 2007, a Web-based survey questionnaire was distributed to 474 surgeon members of the Orthopaedic Trauma Association. The questionnaire measured physician and practice characteristics, outcome expectations, and attitude toward physical therapy. Referral for physical therapy was based on case vignettes. The response rate was 58%. Surgeons reported that 57.6% of their patients would have a positive outcome from physical therapy and 24.2% would have a negative outcome. The highest physical therapy expectations were for the appropriate use of assistive devices (80.7%) and improved strength (force-generating capacity) (76.4%). The lowest outcome expectations were for improvements in pain (35.9%), coping with the emotional aspects of disability (44.1%), and improvements in workplace limitations (51.4%). Physicians reported that 32.6% of their patients referred for physical therapy would have no improvement beyond what would occur with a surgeon-directed home exercise program. Multivariate analyses showed positive physician outcome expectations to have the largest effect on referral for physical therapy (odds ratio=2.7, Pphysical therapy based mostly on expectations for physical and motor outcomes, but may not be considering pain relief, return to work, and psychosocial aspects of recovery. Furthermore, low referral rates may be attributed to a preference for surgeon-directed home-based rehabilitation. Future research should consider the efficacy of physical therapy for pain, psychosocial and occupational outcomes, and exploring the differences between supervised physical therapy and physician-directed home exercise programs.

  14. Traumatic Endotheliopathy

    DEFF Research Database (Denmark)

    Johansson, Pär I.; Henriksen, Hanne H; Stensballe, Jakob

    2017-01-01

    cohorts and animal models but needs confirmation in a large independent patient cohort. METHODS: Prospective observational study of 424 trauma patients admitted to a level 1 Trauma Center. Admission plasma levels of catecholamines (adrenaline, noradrenaline) and biomarkers reflecting endothelial damage...... (syndecan-1, thrombomodulin, and sE-selectin) were measured and demography, injury type and severity, physiology, treatment, and mortality up till 28 days were recorded. RESULTS: Patients had a median ISS of 17 with 72% suffering from blunt injury. Adrenaline and noradrenaline correlated with syndecan-1 (r...... = 0.38, Padrenaline was the only independent predictor of syndecan-1 by multiple linear regression adjusted for age, injury severity score, Glascow Coma Scale, systolic blood pressure, base excess, platelet count, hemoglobin, prehospital plasma...

  15. Successful Endoscopic Therapy of Traumatic Bile Leaks

    Directory of Open Access Journals (Sweden)

    Matthew P. Spinn

    2013-02-01

    Full Text Available Traumatic bile leaks often result in high morbidity and prolonged hospital stay that requires multimodality management. Data on endoscopic management of traumatic bile leaks are scarce. Our study objective was to evaluate the efficacy of the endoscopic management of a traumatic bile leak. We performed a retrospective case review of patients who were referred for endoscopic retrograde cholangiopancreatography (ERCP after traumatic bile duct injury secondary to blunt (motor vehicle accident or penetrating (gunshot trauma for management of bile leaks at our tertiary academic referral center. Fourteen patients underwent ERCP for the management of a traumatic bile leak over a 5-year period. The etiology included blunt trauma from motor vehicle accident in 8 patients, motorcycle accident in 3 patients and penetrating injury from a gunshot wound in 3 patients. Liver injuries were grade III in 1 patient, grade IV in 10 patients, and grade V in 3 patients. All patients were treated by biliary stent placement, and the outcome was successful in 14 of 14 cases (100%. The mean duration of follow-up was 85.6 days (range 54-175 days. There were no ERCP-related complications. In our case review, endoscopic management with endobiliary stent placement was found to be successful and resulted in resolution of the bile leak in all 14 patients. Based on our study results, ERCP should be considered as first-line therapy in the management of traumatic bile leaks.

  16. Resultados del tratamiento quirúrgico de la catarata traumática en edad pediátrica Results of the surgical treatment of traumatic cataract at pediatric ages

    Directory of Open Access Journals (Sweden)

    Lucy Pons Castro

    2010-12-01

    Full Text Available OBJETIVO: Describir los resultados anatómicos y visuales de la cirugía de catarata traumática en niños. MÉTODOS: Se realizó un estudio descriptivo, retrospectivo, desde abril de 2006 hasta diciembre 2009 en el servicio de Oftalmología Pediátrica del Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Se estudiaron 46 pacientes con edades entre los 3 y 14 años, diagnóstico de catarata traumática y agudeza visual mejor corregida menor de 0,4. Fue realizada la extracción extracapsular del cristalino con implante o no de lente intraocular. Se analizaron los resultados de la cirugía para lo que se tuvo en cuenta la anatomía, la agudeza visual mejor corregida preoperatoria y posoperatoria a los 4 meses, y las complicaciones posoperatorias inmediatas y tardías asociadas. RESULTADOS: La edad más vulnerable a presentar catarata traumática fue de 9 a 11 años (45,6 %. Etiológicamente predominó el trauma contuso, el ojo izquierdo y el sexo masculino. Se colocó lente intraocular en un 84,8 % de los pacientes, de estos los del tipo plegables fueron los más frecuentes. La agudeza visual mejor corregida poscirugía obtenida en 19 ojos (41,4 % estuvo entre 0,5-0,7 y en el 19,5 % por encima de 0,7. Entre las complicaciones inmediatas se destaca la membrana ciclítica más uveítis 39,1 % y en las tardías la deformidad pupilar 19,6 %. CONCLUSIONES: El tratamiento quirúrgico de la catarata traumática, con implante de lente intraocular constituye la mejor opción para el infante ya que produce buenos resultados visuales con mínimo de complicaciones, lo que permite una buena visión futura.OBJECTIVE: To describe the anatomical and visual results of the traumatic cataract surgery in children. METHODS: A retrospective descriptive study was carried out from April to December 2009 in the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology pediatric ophthalmology service. Forty six patients were studied aged 3-14 years, diagnosed with

  17. Secondary Traumatic Stress

    Directory of Open Access Journals (Sweden)

    Ayla Kahil

    2018-03-01

    Full Text Available Traumatic events do not only affect the person who was directly exposed to the incident, but they might also lead to some reactions on people with whom they interact. It is argued that, reactions given to a traumatic event by being exposed to the incident either primarily or secondarily, resemble each other. While in primary exposure the perceived threat is subjective, in secondary exposure the threat belongs to the person one interacts with. Secondary exposition to trauma may lead to re-experiencing, avoidance, and increased arousal symptoms as well as impairment in daily functioning. Briefly, secondary exposition to a traumatic incident induces parallel reactions as in those who are primarily exposed. In addition to these, taking specific precautions help decreasing the negative effects of secondary traumatic stress. This review focuses on the secondary traumatic stress and secondary traumatic stress disorder of workers who offer service in relief operations. For this aim, related theoretical concepts along with the literature studies are presented and information regarding ways of coping with the negative effects of secondary traumatization is discussed.

  18. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG: toward integrated treatment of symptoms related to traumatic loss

    Directory of Open Access Journals (Sweden)

    Geert E. Smid

    2015-07-01

    Full Text Available Background: Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD with comorbid (symptoms of posttraumatic stress disorder (PTSD and/or major depressive disorder (MDD following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends. Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective: To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method: To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results: Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion: Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components.

  19. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss

    Science.gov (United States)

    Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

    2015-01-01

    Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434

  20. [Traumatic rupture of the diaphragm].

    Science.gov (United States)

    Mazuch, J; Kuník, Z; Herczegh, S; Pelc, J; Machan, L; Chamko, M

    1990-07-01

    Traumatic ruptures of the diaphragm occur most frequently at blunt injuries of the abdomen or thorax as a component of polytraumatism. At the acute stage they present a serious diagnostic problem since signs of polytrauma are predominant. The authors report 3 cases of traumatic rupture of the diaphragm with thoracotomy as the therapeutic approach. The first patient presented with severe polytraumatism and shock, rupture of the diaphragm, pericardium and lungs, along with serial fracture of the left ribs. The second patient was not in shock, he had suffered serial fracture of the left ribs and fracture of the pelvis. In both these cases of blunt injury to the thorax, careful examination of the patients resulted in early diagnosis and surgery. The third patient presented with open injury of the right side of the thorax, injured diaphragm and liver, serial fracture of the ribs, fractured sternum, and was in a state of deep shock. There was no mortality, all three patients recovered.

  1. Traumatic Brain Injury

    Science.gov (United States)

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  2. Primary traumatic patellar dislocation

    Directory of Open Access Journals (Sweden)

    Tsai Chun-Hao

    2012-06-01

    Full Text Available Abstract Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management.

  3. [Traumatic aortic valve insufficiency].

    Science.gov (United States)

    Nascimento, J; Lemos, C; Marques, A M; Antunes, M J; Gonsalves, A

    1996-02-01

    The traumatic aortic valvular insufficiency (TAVI), through less frequent after a non-penetrating thoracic traumatism, is a serious entity with a very reserved prognosis. So it must be suspected in every patients with signs or symptoms of de novo heart failure post-traumatism. The transthoracic echocardiography and eventually transesophageal echocardiography have a fundamental role in the confirmation of the diagnosis. The clinical picture of traumatic aortic regurgitation is quickly evolutionary and the non efficacy of medical therapy has placed the valvular substitution surgery as the best succeeded treatment. With the advent of the aortic valve repairing surgery some TAVI cases has been submitted to this procedure. Nevertheless, the development of residual aortic regurgitation in these situations, usually requiring later valvular replacement surgery, make the aortic valvuloplasty a controversial surgical technique. The AA describe a recent clinical case of aortic regurgitation after a non-penetrant thoracic traumatism, discussing the aspects connected with physiopathology, diagnosis and therapy. The singularity of this case was based on the fact that the initial clinical diagnosis had been prejudiced by the context of a polytraumatism and there had been a time free of symptoms between the traumatism and the beginning of the symptomatology of left ventricular failure. Even though the identification of the problem allowed an intensive treatment of this serious situation that ended with the replacement of the aortic valve by mechanical aortic prosthesis, with the patient's total recovery.

  4. Transcatheter device closure of a traumatic ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Mohamed Kasem

    2014-01-01

    Full Text Available A traumatic ventricular septal defect (VSD resulting from blunt chest injury is a very rare event in children. The clinical symptoms and timing of presentation are variable, so diagnosis and management of traumatic VSD may be challenging. Decision to close the traumatic VSD is usually based on a combination of severity of heart failure symptoms, hemodynamics, and defect size. We present a case of a 7-year-old boy who was run over by a truck and presented with head and liver injury initially. He was subsequently found to have a traumatic VSD. The VSD was closed percutaneously.

  5. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Minhas, M.S.

    2010-01-01

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  6. Arthroscopic management of traumatic anterior shoulder instability in collision athletes: analysis of 204 cases with a 4- to 9-year follow-up and results with the suture anchor technique.

    Science.gov (United States)

    Larrain, Mario Victor; Montenegro, Hugo Jorge; Mauas, David Marcelo; Collazo, Cristian Carlos; Pavón, Facundo

    2006-12-01

    The purpose of this study was to determine the effectiveness of arthroscopy in the selection of surgical procedure and treatment of both acute and recurrent traumatic anterior shoulder instability in rugby players by use of pre-established selection criteria. We describe the injury mechanisms, analyze the pathologic lesions and treatment indications based on surgical findings, and assess the results in patients treated with the arthroscopic suture anchor technique. From November 1996 to November 2001, 204 rugby players with acute or recurrent traumatic anterior instability underwent an initial arthroscopic examination. Criteria such as type of Bankart lesion, tissue quality, and presence of bony defects were evaluated and used to determine the method of stabilization: arthroscopy or open stabilization. Open surgery was indicated in patients with bone humeral deficiencies greater than one fourth of the articular humeral head, bone glenoid deficiencies greater than 25% of the glenoid extension, capsular laxity with poor tissue quality, and humeral avulsion of the glenohumeral ligament; all other patients underwent arthroscopic reconstruction via the bone suture anchor technique. The mean follow-up was 5.9 years (range, 3.9 to 8.9 years). We performed arthroscopic stabilization in 39 cases of acute instability; only 1 case (2.5%) required the mini-open technique for reinsertion of humeral avulsion of the glenohumeral ligament. Of 158 cases of recurrent instability, 121 underwent arthroscopic stabilization, and 37 (23.4%) required reconstruction with open surgery. The main cause was bony deficiency (treated with the Latarjet procedure). The results of the arthroscopic reconstructions were evaluated by use of the Rowe scale and analyzed according to stability and range of motion. Good or excellent results were found in 94.9% of cases in the acute instability group and in 91.8% in the recurrent instability group, the poor results were due to instability recurrence. In

  7. What Is Child Traumatic Stress?

    Science.gov (United States)

    ... Awareness Sustainability Policy Issues What Is Child Traumatic Stress? Order NCTSN documents and other products where you ... these challenging times. Questions & Answers about Child Traumatic Stress Network experts answer questions about child trauma and ...

  8. Traumatic rupture of the diaphragm | Jamabo | Sahel Medical Journal

    African Journals Online (AJOL)

    Those treated for traumatic rupture of the diaphragm were selected and analyzed for age, gender, cause of injury, associated injuries sustained and mode of treatment. They were all treated at the University of Port Harcourt Teaching Hospital and a private clinic in Port Harcourt. Results: 12 patients had traumatic rupture of ...

  9. Normal pressure hydrocephalus with onset following a traumatic ...

    African Journals Online (AJOL)

    Prior to above presentation patient was normal and stable with no past history of physical or mental illness. Results: Clinical features met the criteria for diagnosis of Post Traumatic Stress Disorder following a traumatic experience. Clinical examination and investigations including (skull xray) conducted were all within ...

  10. A systematic review of prognosis after mild traumatic brain injury in the military. Results of the International Collaboration on MTBI Prognosis (ICoMP)

    DEFF Research Database (Denmark)

    Boyle, Eleanor; Cancelliere, Carol; Hartvigsen, Jan

    2014-01-01

    : The evidence was synthesized qualitatively and presented in evidence tables. Results: The findings are based on three studies of US military personnel who were deployed in Iraq or Afghanistan. It was found that military personnel with MTBI report PTSD and post-concussive symptoms. In addition, reporting...... of post-concussive symptoms differed based on the levels of combat stress the individuals experienced. The evidence suggests a slight decline in neurocognitive function post-MTBI, but this decline was in the normal range of brain functioning. Conclusions: This study found limited evidence that combat...... stress, PTSD and post-concussive symptoms affect recovery and prognosis of MTBI in military personnel. Additional high quality research is needed to fully assess the prognosis of MTBI in military personnel....

  11. Centralized rehabilitation after servere traumatic brain injury

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Liebach, Annette; Nordenbo, Annette Mosbæk

    2006-01-01

    OBJECTIVES: To present results from the first 3 years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to compare results of centralized versus decentralized rehabilitation. MATERIAL AND METHODS: Prospectively, the most severely injured group of adults fr...

  12. Traumatic atlantooccipital dislocation with survival.

    Science.gov (United States)

    Woodring, J H; Selke, A C; Duff, D E

    1981-07-01

    Traumatic atlantooccipital dislocation is generally considered incompatible with life. However, there have been isolated survivals from this injury, and a few patients initially have minimal neurologic deficits disproportionate to the gravity of their injury, a feature that has not been adequately stressed. The potentially catastrophic results of delayed therapy make early radiographic detection imperative. Marked retropharyngeal soft-tissue swelling, an abnormal basion-odontoid alignment, and posterior displacement of the atlas are diagnostic of anterior atlantooccipital dislocation. In the more uncommon posterior atlantooccipital dislocation an abnormal basion-odontoid alignment associated with marked soft-tissue swelling should suggest the correct diagnosis. Conventional tomography can be confirmatory.

  13. Traumatic cervical artery dissection.

    Science.gov (United States)

    Nedeltchev, Krassen; Baumgartner, Ralf W

    2005-01-01

    Traumatic cervical artery dissection (TCAD) is a complication of severe blunt head or neck trauma, the main cause being motor vehicle accidents. TCAD are increasingly recognized, and incidences of up to 0.86% for internal carotid and 0.53% for traumatic vertebral artery dissections (TVAD) among blunt trauma victims are reported. Diagnostic evaluation for TCAD is mandatory in the presence of (1) hemorrhage of potential arterial origin originating from the nose, ears, mouth, or a wound; (2) expanding cervical hematoma; (3) cervical bruit in a patient >50 years of age; (4) evidence of acute infarct at brain imaging; (5) unexplained central or lateralizing neurological deficit or transient ischemic attack, or (6) Horner syndrome, neck or head pain. In addition, a number of centers screen asymptomatic patients with blunt trauma for TCAD. Catheter angiography is the standard of reference for diagnosis of TCAD. Color duplex ultrasound, computed tomographic, and magnetic resonance angiography are noninvasive screening alternatives, but each method has its diagnostic limitations compared to catheter angiography. Anticoagulants and antiplatelet drugs may prevent ischemic stroke, but bleeding from traumatized tissues may offset the benefits of antithrombotic treatment. Endovascular therapy of dissected vessels, thrombarterectomy, direct suture of intimal tears, and extracranial-intracranial bypass should be considered in exceptional cases. Neurological outcome is probably worse in TCAD compared to spontaneous CAD, although it is unclear whether this is due to dissection-induced ischemic stroke or associated traumatic lesions.

  14. Management of rigid post-traumatic kyphosis.

    Science.gov (United States)

    Wu, S S; Hwa, S Y; Lin, L C; Pai, W M; Chen, P Q; Au, M K

    1996-10-01

    Rigid post-traumatic kyphosis after fracture of the thoracolumbar and lumbar spine represents a failure of initial management of the injury. Kyphosis moves the center of gravity anterior. The kyphosis and instability may result in pain, deformity, and increased neurologic deficits. Management for symptomatic post-traumatic kyphosis always has presented a challenge to orthopedic surgeons. To evaluate the surgical results of one stage posterior correction for rigid symptomatic post-traumatic kyphosis of the thoracolumbar and lumbar spine. The management for post-traumatic kyphosis remains controversial. Anterior, posterior, or combined anterior and posterior procedures have been advocated by different authors and show various degrees of success. One vertebra immediately above and below the level of the deformity was instrumented posteriorly by a transpedicular system (internal fixator AO). Posterior decompression was performed by excision of the spinal process and bilateral laminectomy. With the deformed vertebra through the pedicle, the vertebral body carefully is removed around the pedicle level, approximating a wedge shape. The extent to which the deformed vertebral body should be removed is determined by the attempted correction. Correction of the deformity is achieved by manipulation of the operating table and compression of the adjacent Schanz screws above and below the lesion. Thirteen patients with post-traumatic kyphosis with symptoms of fatigue and pain caused by slow progression of kyphotic deformities received posterior decompression, correction, and stabilization as a definitive treatment. The precorrection kyphosis ranged from 30-60 degrees, with a mean of 40 degrees +/- 10.8 degrees. After correction, kyphosis was reduced to an average of 1.5 degrees +/- 3.8 degrees, with a range from -5 degrees to 5 degrees. The average angle of correction was 38.8 degrees +/- 10.4 degrees, with a range from 25 degrees to 60 degrees. Significant difference was found

  15. results

    Directory of Open Access Journals (Sweden)

    Salabura Piotr

    2017-01-01

    Full Text Available HADES experiment at GSI is the only high precision experiment probing nuclear matter in the beam energy range of a few AGeV. Pion, proton and ion beams are used to study rare dielectron and strangeness probes to diagnose properties of strongly interacting matter in this energy regime. Selected results from p + A and A + A collisions are presented and discussed.

  16. Outcome of Traumatic Extradural Haematoma Managed Surgically ...

    African Journals Online (AJOL)

    Background: Extradural haematoma (EDH) occurring as a result of traumatic head injury constitutes one of the most critical emergencies in neurosurgery. Objectives: In present ... All patients underwent a craniotomy (burr hole or trephine) or a craniectomy and evacuation of the haematoma. Overall, four patients (15%) died.

  17. Interventional management of traumatic epistaxis

    International Nuclear Information System (INIS)

    Li Qiang; Jiang Xu; Yang Jijin; Yang Caoai; Zhang Huojun; Wang Weixing

    2009-01-01

    Objective: To discuss the clinical application of transcatheter arterial embolization in the treatment of traumatic epistaxis. Methods: Transcatheter arterial embolization was performed in 15 patients with traumatic epistaxis, caused by injury or surgery, after they failed to respond to medication and nasal packing. Seldinger technique was adopted via the femoral access and the bleeding site was determined with carotid angiography, super-selective catheterization was then carried out to embolize the ruptured artery with gelfoam particles or polyvinyl alcohol (PVA) particles. The clinical data and the therapeutic results were analyzed. Results: Of 15 patients, the epistaxis was caused by injury in 9 and by surgery of nasal or paranasal sinus in 6. Gelfoam particle was used in 14 cases and PVA particle in one case. The procedure was accomplished in one manipulation in all patients. The nasal tampon was removed in 2-3 days after the treatment with no recurrence of bleeding. No serious complications occurred. Conclusions: Transcatheter arterial embolization is a safe and effective therapy for profuse epistaxis on which the conservative management exerts no effect, and the gelfoam particle is the embolization material of first choice. (authors)

  18. Traumatic Stress Among Seriously Delinquent Youth: Considering the Consequences of Neighborhood Circumstance.

    Science.gov (United States)

    Jaggers, Jeremiah W; Prattini, Robert J; Church, Wesley T

    2016-09-01

    Myriad factors have been found to have an impact on delinquent behavior and traumatic stress. This study proposes a model that tests the relationship between common predictors of delinquency (neighborhood condition, antisocial peer socialization, and exposure to violence) with traumatic stress. Serial mediation was used to test the relationships between these predictors and traumatic stress. Results indicate the mediation effect between neighborhood conditions and traumatic stress significantly reduces the total effect. Implications for traumatic stress in the context of delinquent behavior are discussed. © Society for Community Research and Action 2016.

  19. Secondary traumatic stress in nurses who care for traumatized women.

    Science.gov (United States)

    Gates, Donna M; Gillespie, Gordon L

    2008-01-01

    Each year, thousands of women experience violence, and many of these are survivors of intimate partner violence. Each year, thousands of nurses provide physical and emotional care to these women. Nurses and employers need to recognize that exposures to traumatized women place nurses at risk for the development of secondary traumatic stress disorder. This article describes secondary traumatic stress, its risk factors, and its consequences. Workplace interventions and policies are recommended to reduce the avoidance, numbness, intrusive imagery, and other negative symptoms associated with secondary traumatic stress disorder.

  20. Traumatic insemination in terrestrial arthropods.

    Science.gov (United States)

    Tatarnic, Nikolai J; Cassis, Gerasimos; Siva-Jothy, Michael T

    2014-01-01

    Traumatic insemination is a bizarre form of mating practiced by some invertebrates in which males use hypodermic genitalia to penetrate their partner's body wall during copulation, frequently bypassing the female genital tract and ejaculating into their blood system. The requirements for traumatic insemination to evolve are stringent, yet surprisingly it has arisen multiple times within invertebrates. In terrestrial arthropods traumatic insemination is most prevalent in the true bug infraorder Cimicomorpha, where it has evolved independently at least three times. Traumatic insemination is thought to occur in the Strepsiptera and has recently been recorded in fruit fly and spider lineages. We review the putative selective pressures that may have led to the evolution of traumatic insemination across these lineages, as well as the pressures that continue to drive divergence in male and female reproductive morphology and behavior. Traumatic insemination mechanisms and attributes are compared across independent lineages.

  1. BPSD following traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Renato Anghinah

    Full Text Available ABSTRACT Annually, 700,000 people are hospitalized with brain injury acquired after traumatic brain injury (TBI in Brazil. Objective: We aim to review the basic concepts related to TBI, and the most common Behavioral and Psychological Symptoms of Dementia (BPSD findings in moderate and severe TBI survivors. We also discussed our strategies used to manage such patients in the post-acute period. Methods: Fifteen TBI outpatients followed at the Center for Cognitive Rehabilitation Post-TBI of the Clinicas Hospital of the University of São Paulo were submitted to a neurological, neuropsychological, speech and occupational therapy evaluation, including the Mini-Mental State Examination. Rehabilitation strategies will then be developed, together with the interdisciplinary team, for each patient individually. Where necessary, the pharmacological approach will be adopted. Results: Our study will discuss options of pharmacologic treatment choices for cognitive, behavioral, or affective disorders following TBI, providing relevant information related to a structured cognitive rehabilitation service and certainly will offer an alternative for patients and families afflicted by TBI. Conclusion: Traumatic brain injury can cause a variety of potentially disabling psychiatric symptoms and syndromes. Combined behavioral and pharmacological strategies, in the treatment of a set of highly challenging behavioral problems, appears to be essential for good patient recovery.

  2. BPSD following traumatic brain injury

    Science.gov (United States)

    Anghinah, Renato; Freire, Fabio Rios; Coelho, Fernanda; Lacerda, Juliana Rhein; Schmidt, Magali Taino; Calado, Vanessa Tomé Gonçalves; Ianof, Jéssica Natuline; Machado, Sergio; Velasques, Bruna; Ribeiro, Pedro; Basile, Luis Fernando Hindi; Paiva, Wellingson Silva; Amorim, Robson Luis

    2013-01-01

    Annually, 700,000 people are hospitalized with brain injury acquired after traumatic brain injury (TBI) in Brazil. OBJECTIVE We aim to review the basic concepts related to TBI, and the most common Behavioral and Psychological Symptoms of Dementia (BPSD) findings in moderate and severe TBI survivors. We also discussed our strategies used to manage such patients in the post-acute period. METHODS Fifteen TBI outpatients followed at the Center for Cognitive Rehabilitation Post-TBI of the Clinicas Hospital of the University of São Paulo were submitted to a neurological, neuropsychological, speech and occupational therapy evaluation, including the Mini-Mental State Examination. Rehabilitation strategies will then be developed, together with the interdisciplinary team, for each patient individually. Where necessary, the pharmacological approach will be adopted. RESULTS Our study will discuss options of pharmacologic treatment choices for cognitive, behavioral, or affective disorders following TBI, providing relevant information related to a structured cognitive rehabilitation service and certainly will offer an alternative for patients and families afflicted by TBI. CONCLUSION Traumatic brain injury can cause a variety of potentially disabling psychiatric symptoms and syndromes. Combined behavioral and pharmacological strategies, in the treatment of a set of highly challenging behavioral problems, appears to be essential for good patient recovery. PMID:29213850

  3. Traumatic Aortic Injury

    Directory of Open Access Journals (Sweden)

    Brianna Miner

    2016-09-01

    Full Text Available History of present illness: A 48-year-old male with unknown past medical history presents as a trauma after being hit by a car traveling approximately 25 miles per hour. On initial presentation, the patient is confused, combative, and not answering questions appropriately. The patient is hypotensive with a blood pressure of 68/40 and a heart rate of 50 beats per minute, with oxygen saturation at 96% on room air. FAST scan is positive for fluid in Morrison’s pouch, splenorenal space, and pericardial space. Significant findings: The initial chest x-ray showed an abnormal superior mediastinal contour (blue line, suggestive of a possible aortic injury. The CT angiogram showed extensive circumferential irregularity and outpouching of the distal aortic arch (red arrows compatible with aortic transection. In addition, there was a circumferential intramural hematoma, which extended through the descending aorta to the proximal infrarenal abdominal aorta (green arrow. There was also an extensive surrounding mediastinal hematoma extending around the descending aorta and supraaortic branches (purple arrows. Discussion: Traumatic aortic injury is a life-threatening event. The incidence of blunt thoracic aortic injury is low, between 1 to 2 percent of those patients with blunt thoracic trauma.1 However, approximately 80% of patients with traumatic aortic injury die at the scene.2 Therefore it is imperative to diagnose traumatic aortic injury in a timely fashion. The diagnosis can be difficult due to the non-specific signs and symptoms and other distracting injuries. Clinical suspicion should be based on the mechanism of the injury and the hemodynamic status of the patient. In any patient with blunt or penetrating trauma to the chest that is hemodynamically unstable, traumatic aortic injury should be on the differential. Chest x-ray can be used as a screening tool. A normal chest x-ray has a negative predictive value of approximately 97%. CTA chest is the

  4. Traumatic transconjunctival orbital emphysema.

    OpenAIRE

    Stroh, E M; Finger, P T

    1990-01-01

    Orbital emphysema can be produced by trans-conjunctival migration of air from a high pressure airgun. In an industrial accident an 8 mm conjunctival laceration was produced in the superior fornix which acted as a portal of entry for air into the subconjunctival, subcutaneous, and retrobulbar spaces. Computed tomography revealed no evidence of orbital fracture and showed that traumatic orbital emphysema occurred without a broken orbital bone.

  5. Post-traumatic stress disorder due to childbirth: the aftermath.

    Science.gov (United States)

    Beck, Cheryl Tatano

    2004-01-01

    Childbirth qualifies as an extreme traumatic stressor that can result in post-traumatic stress disorder. The reported prevalence of post-traumatic stress disorder after childbirth ranges from 1.5% to 6%. The aim of this phenomenologic study was to describe the essence of mothers' experiences of post-traumatic stress disorder after childbirth. The qualitative research design used for this study was descriptive phenomenology. The main recruitment approach was via the Internet through the help of Trauma and Birth Stress, a charitable trust in New Zealand. Purposive sampling was used and resulted in 38 mothers participating from the countries of New Zealand, the United States, Australia, and the United Kingdom. The participants were asked to describe their experiences with post-traumatic stress disorder after childbirth. Their stories were analyzed using Colaizzi's method of data analysis. Mothers with post-traumatic stress disorder attributable to childbirth struggle to survive each day while battling terrifying nightmares and flashbacks of the birth, anger, anxiety, depression, and painful isolation from the world of motherhood. This glimpse into the lives of mothers with post-traumatic stress disorder attributable to childbirth provides an impetus to increase research efforts in this neglected area.

  6. Post-traumatic stress disorder

    Science.gov (United States)

    ... Post-traumatic stress disorder References American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. ...

  7. Direct medical costs of traumatic thoracolumbar spine fractures.

    NARCIS (Netherlands)

    van der Roer, N.; de Bruyne, M.C.; Bakker, F.C.; van Tulder, M.; Boers, M.

    2005-01-01

    Background: The costs and cost-effectiveness of treatment of thoracolumbar fractures are poorly known. Methods: We estimated the costs of hospital care and outpatient visits for patients with traumatic thoracolumbar spine fractures. Results: Stable fractures without neurological deficits were

  8. Direct medical costs of traumatic thoracolumbar spine fractures

    NARCIS (Netherlands)

    van der Roer, N.; de Bruyne, M.C.; Bakker, F.C.; van Tulder, M.; Boers, M.

    2005-01-01

    Background: The costs and cost-effectiveness of treatment of thoracolumbar fractures are poorly known. Methods: We estimated the costs of hospital care and outpatient visits for patients with traumatic thoracolumbar spine fractures. Results: Stable fractures without neurological deficits were

  9. Covering traumatic news stories: Factors associated with post-traumatic stress disorder among journalists.

    Science.gov (United States)

    Smith, River J; Drevo, Susan; Newman, Elana

    2017-08-22

    The current study examined personal and environmental factors that placed 167 U.S. journalists from diverse media organizations at risk for post-traumatic stress disorder (PTSD) after covering work-related traumatic stories. These factors included exposure to traumatic stressors in their personal lives, work-related traumatic stressors, and general organizational stressors. Further, personality attributes and coping styles associated with risk and resiliency were examined. Regression analyses identified avoidant emotional coping, higher levels of perceived organizational stressors, intensity of exposure to work-related traumatic stressors, and personal trauma history as statistically significant risk factors for PTSD. The results provide empirical support for the negative impact of organizational stressors and avoidant emotional coping on journalists covering trauma-related stories. Understanding the organizational climate journalists are working in, as well as the manner in which journalists manage work-related stressors, is important in the development of a more comprehensive model of who may develop work-related PTSD symptoms. Opportunities for news organizations to reduce PTSD risk among journalists are discussed. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Health sciences librarians, patient contact, and secondary traumatic stress.

    Science.gov (United States)

    Becker, Rachel W; McCrillis, Aileen

    2015-04-01

    The purpose of this study was to determine the prevalence of secondary traumatic stress (STS) in health sciences librarians (HSLs) who have direct contact with traumatized individuals and their families. A twenty-five-item survey and the Secondary Traumatic Stress Scale (STSS) were distributed via email to three Medical Library Association email discussion lists. A total of fifty-five HSLs responded to the survey. Survey results indicate moderate levels of STS and variability of symptoms among participants. Library and employee assistance program managers should be aware of the emotional toll of patient and/or family contact for HSLs.

  11. Traumatic events and symptoms of post-traumatic stress disorder ...

    African Journals Online (AJOL)

    Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the West Nile. ... The high prevalence of violence and symptoms of PTSD in refugee populations highlight the need for better protection and security in refugee settlements. Humanitarian agencies ...

  12. Pathophysiological links between traumatic brain injury and post-traumatic headaches [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Robert L. Ruff

    2016-08-01

    Full Text Available This article reviews possible ways that traumatic brain injury (TBI can induce migraine-type post-traumatic headaches (PTHs in children, adults, civilians, and military personnel. Several cerebral alterations resulting from TBI can foster the development of PTH, including neuroinflammation that can activate neural systems associated with migraine. TBI can also compromise the intrinsic pain modulation system and this would increase the level of perceived pain associated with PTH. Depression and anxiety disorders, especially post-traumatic stress disorder (PTSD, are associated with TBI and these psychological conditions can directly intensify PTH. Additionally, depression and PTSD alter sleep and this will increase headache severity and foster the genesis of PTH. This article also reviews the anatomic loci of injury associated with TBI and notes the overlap between areas of injury associated with TBI and PTSD.

  13. Traumatic brain injury among refugees and asylum seekers.

    Science.gov (United States)

    McPherson, Jacob I

    2017-12-28

    Refugees and asylum seekers face many challenges in their pursuit of a safe home. The journey for displaced individuals can be extremely dangerous and many do not survive or go missing. Survivors face significant risks of injury, abuse, and torture. Traumatic brain injury is one of the most common and disabling injuries sustained by these populations. This already complex condition can have profound implications on these groups and their families due to factors related to mental health, cultural perspectives, and their ability to navigate healthcare systems. A literature review was performed to investigate the incidence and prevalence of torture and traumatic brain injury in displaced and fleeing populations. Impacts of traumatic brain injury and residency status on outcomes in these individuals were also examined. The incidence and prevalence of torture and traumatic brain injury among refugees and asylum seekers is significant. These populations may access healthcare systems differently than other groups and as a result may experience a unique health-related outcomes following traumatic brain injury. This information should sensitize healthcare providers to a potential history of traumatic brain injury sustained by patients/clients who are refugees or asylum seekers and may serve to guide some clinical encounters. Implications for rehabilitation Traumatic brain injuries are commonly sustained by refugees and asylum seekers. Cultural factors may complicate how refugees and asylum seekers understand, report, and manage these injuries. The above may be worsened by cognitive, emotional, and behavioral changes following traumatic brain injury. Rehabilitation providers should be aware of potential traumatic brain injury history during encounters with refugee and asylum seeker populations, especially if a history of torture is suspected.

  14. Traumatic ileal perforation in post-traumatic ventral hernia: adding insult to injury

    International Nuclear Information System (INIS)

    Rab, A.Z.U.; Fakir, S.B.; Peethambaran, M.S.

    2007-01-01

    Rupture of abdominal wall with formation of ventral hernia is a rare complication following blunt abdominal trauma. Small intestinal rupture within such a hernial sac, resulting from a subsequent blunt trauma is rarer still. Ventral hernias often go untreated in developing countries because of their seemingly innocuous nature, ignorance and financial constraints. Blunt trauma in patients with hernia warrants a thorough clinical examination along with evaluation for intestinal injury, since even trivial trauma can cause potentially serious intra-peritoneal visceral injury. A case of fatal traumatic ileal perforation in pre-existing post-traumatic ventral hernia (from blunt trauma sustained 10 years earlier) is being reported. (author)

  15. Traumatic Brain Injury and Aggression.

    Science.gov (United States)

    Miller, Laurence

    1994-01-01

    Persons who have suffered traumatic injury to the brain may subsequently display aggressive behavior. Three main syndromes of aggression following traumatic brain injury are described: (1) episodic dyscontrol; (2) frontal lobe disinhibition; and (3) exacerbation of premorbid antisociality. The neuropsychological substrates of these syndromes are…

  16. National Child Traumatic Stress Network

    Science.gov (United States)

    ... NCTSN eBulletin Información en Español Topics What is Child Traumatic Stress Trauma Types Finding Help Trauma-Informed Screening & Assessment ... and Adolescent Trauma Education and online community. Understanding Child Traumatic Stress What it is. Why it matters. Information Resource ...

  17. Traumatic Brain Injury - Multiple Languages

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Traumatic Brain Injury URL of this page: https://medlineplus.gov/ ... W XYZ List of All Topics All Traumatic Brain Injury - Multiple Languages To use the sharing features on this page, ...

  18. Traumatic bone cyst, idiopathic origin

    African Journals Online (AJOL)

    GB

    BACKGROUND: Traumatic bone cyst (TBC) is an uncommon non-epithelial lined cavity of the jaws. Traumatic bone cysts have been reported in the literature under a variety of names: solitary bone cyst, haemorrhagic bone cyst, extravasation cyst and simple bone cyst. The multitude of names applied to this lesion implies ...

  19. Traumatic atlantooccipital dislocation. Case report.

    Science.gov (United States)

    Fruin, A H; Pirotte, T P

    1977-05-01

    A case of traumatic atlantooccipital dislocation is presented and the literature reviewed. This type of traumatic dislocation is probably produced by violent hyperextension of the upper cervical spine. Cranial nerve injuries and spinal cord injuries are common. Early fusion is recommended.

  20. Post-traumatic syringomyelia

    International Nuclear Information System (INIS)

    Freund, M.; Sartor, K.; Aschoff, A.; Spahn, B.

    1999-01-01

    The improvement of preclinical emergency medicine, better surgical and conservative therapies, and the development of intensive care units and specialized centers have improved the survival rate for patients with serious spinal cord injuries. Therefore, more sequelae of chronic spinal cord injuries such as post-traumatic spinal cord cavitations also occur. The first such case was described by Bastian in 1867. Generally, these cavitations were diagnosed from 2 months up to 32 years after the trauma. The overall prevalence of post-traumatic syringomyelia (PTS) is not known; however, with the increasing use of magnetic resonance imaging (MRI), its diagnosis has increased, ranging from 2.3% of paraplegic and tetraplegic patients in 1976 and 3.2% in 1985, to nearly 50% in a selected group of patients in 1991 and 1993. In 1995, a 4.45% incidence was reported. In our clinic we are currently treating 440 cases of syringomyelia, 140 of which are PTS. Several observations suggest more than one potential mechanism for the evolution of a post-traumatic cyst or PTS. Various factors, such as hemorrhage or, in particular, ischemia within the spinal cord, blockage of the cerebrosinal fluid (CSF) pathways around the cord or localized meningeal fibrosis either alone or in combination with other factors, may be involved. Clinically, sensory disturbances, loss of motor function, pain, and modification of the deep tendon reflexes are observed in most patients. On MRI, PTS is seen as a longitudinal, cystic cavity within the spinal cord, giving a hypointense signal on T 1 -weighted images and a hyperintense signal on T 2 -weighted images. For treatment planning it is mandatory to identify the lower and upper end of the PTS on the MRI. (orig.) [de

  1. Traumatic Wound Dehiscence following Corneal Transplantation

    Directory of Open Access Journals (Sweden)

    Mohammad-Reza Jafarinasab

    2012-01-01

    Full Text Available Purpose: To investigate the incidence, mechanisms, characteristics, and visual outcomes of traumatic wound dehiscence following keratoplasty. Methods: Medical records of 32 consecutive patients with traumatic globe rupture following keratoplasty who had been treated at our center from 2001 to 2009 were retrospectively reviewed. Results: The study population consisted of 32 eyes of 32 patients including 25 men and 7 women with history of corneal transplantation who had sustained eye trauma leading to globe rupture. Mean patient age was 38.1 (range, 8 to 87 years and median interval between keratoplasty and the traumatic event was 9 months (range, 30 days to 20 years. Associated anterior segment findings included iris prolapse in 71.9%, lens extrusion in 34.4%, and hyphema in 40.6% of eyes. Posterior segment complications included vitreous prolapse (56%, vitreous hemorrhage (28% and retinal detachment (18%. Eyes which had undergone deep anterior lamellar keratoplasty (DALK; 5 cases, 15.6% tended to have less severe presentation and better final visual acuity. There was no correlation between the time interval from keratoplasty to the traumatic event, and final visual outcomes. Conclusion: The host-graft interface demonstrates decreased stability long after surgery and the visual prognosis of traumatic wound dehiscence is poor in many cases. An intact Descemet′s membrane in DALK may mitigate the severity of ocular injuries, but even in these cases, the visual outcome of globe rupture is not good and prevention of ocular trauma should be emphasized to all patients undergoing any kind of keratoplasty.

  2. Traumatic olecranon bursitis

    International Nuclear Information System (INIS)

    Saini, M.; Canoso, J.J.

    1982-01-01

    The affected elbow of 28 patients with traumatic olecranon bursitis was radiographically compared with the homologous elbow of 28 matched controls. Olecranon spurs, amorphous calcium deposits, or both, were present in 16 patients and 4 controls (p<0.01). Air was injected in the bursa in 12 additional patients. Nodules in the bursal floor were noted in 10, and the bursa was partially septated in 8. Olecranon spurs, present in 6 patients, corresponded to the insertion of the triceps tendon. With elbow flexion the bursa flattened and lengthened while the olecranon process glided distally beneath the bursal floor. (Auth.)

  3. Traumatic atlantooccipital dislocation.

    Science.gov (United States)

    Van den Bout, A H; Dommisse, G F

    1986-03-01

    A young adult sustained a traumatic atlantooccipital dislocation together with fracture-dislocation at C.4/5 level and had total neurologic deficit below C4 segment. He retained full consciousness but required respiratory support. He developed a stress ulcer with hemorrhage and evidence of "shock lung." He responded to intensive care. Surgery on the 11th day secured reduction and internal fixation at both levels. Death due to respiratory and cardiac arrest followed on the 14th day. Postmortem examination revealed edema of the brain and brainstem.

  4. Traumatic atlantooccipital dislocation injury in children.

    Science.gov (United States)

    Nichols, J; West, J S

    1994-10-01

    The tragedy of trauma turns into triumph when the surgery team members' efforts result in victory for the patient. Nowhere is this more true than in successful pediatric trauma care. Giving a child a second chance at life and the family an opportunity for a new beginning is the highest reward for the trauma team's years of professional training and practice. Traumatic atlantoocipital dislocation injury usually results in death, but recent neurosurgery trauma advances are increasing pediatric survival rates.

  5. Risk factors for traumatic and non-traumatic lower limb pain among preadolescents: a population-based study of Finnish schoolchildren

    Directory of Open Access Journals (Sweden)

    Kautiainen Hannu

    2006-01-01

    Full Text Available Abstract Background The child's lower limb is the most commonly reported musculoskeletal location with pain and also the most commonly injured site in sports. Some potential risk factors have been studied, but the results are inconsistent. We hypothesized that distinction of traumatic from non-traumatic pain would provide a clearer picture of these factors. The aim of this study is to assess factors associated with lower extremity pain and its impact on preadolescents in a population-based cohort. Methods A structured pain questionnaire was completed by 1756 schoolchildren of third and fifth grades to assess musculoskeletal pain, psychosomatic symptoms, subjective disabilities, school absence and frequency of exercise. In addition, hypermobility and physical fitness were measured. Results The knee was the most common site of pain followed by the ankle-foot and thigh. Of the children who reported pain in their lower extremity, approximately 70% reported at least one disability and 19 % reported school absence attributed to their pain during the previous three-month period. Children with traumatic pain had a higher subjective disability index than those with non-traumatic pain (P = 0.02. Age less than 11 years, headache, abdominal pain, depressive feelings, day tiredness, and vigorous exercise were more common in children with lower limb pain than those free of it. In the stratified analysis, younger age was related to both traumatic and non-traumatic pain groups. Vigorous exercise was positively associated with traumatic pain, while subjects with non-traumatic pain had more frequent psychosomatic symptoms. Conclusion Risk factors and consequences of traumatic and non-traumatic lower limb pain are not similar. Traumatic lower limb pain is associated with practicing vigorous exercise and high level of physical fitness, while non-traumatic pain is more correlated with psychosomatic symptoms. These differences might be one of the reasons for the

  6. Old people's extensive traumatic cerebral infarction (analysis of 48 cases)

    International Nuclear Information System (INIS)

    Xu Wenhui

    2000-01-01

    Objective: To analyse clinically the genetic mechanism, clinical characteristics and the prognosis of old people's extensive traumatic cerebral infarction. Method: Forty eight such cases have been observed and analysed. Results: Old people's extensive traumatic cerebral infarction had its characteristics, which occurred mostly in the blood supply area of big branch blood vessels, and had observed nerve function defect. Conclusion: It has more clinical complication and bad prognosis. The death rate is high

  7. Intra-Articular Therapeutic Delivery for Post Traumatic Osteoarthritis

    Science.gov (United States)

    2015-10-01

    evidence of OA. These patients and younger populations who are susceptible to OA onset due to sports injuries or other factors could significantly...than 2 years after injury compared to post- traumatic OA resulting from sports injuries that takes about 10 years to develop. The goals of this work...billion per year for the U.S. economy . Post-traumatic OA (PTOA) associated with combat extremity injuries has a 26% greater incidence in active military

  8. Pharmacological Treatment of Glutamate Excitotoxicity Following Traumatic Brain Injury

    Science.gov (United States)

    2009-01-14

    In 1969, Olney found that subcutaneous injection of monosodium glutamate resulted in necrotic brain lesions in the hypothalamus of newborn mice...Thesis: "Pharmacological Treatment of Glutamate Excitotoxicity Following Traumatic Brain Injury" Name of Candidate: Michael Doh Molecular & Cell...TYPE 3. DATES COVERED 00-00-2009 to 00-00-2009 4. TITLE AND SUBTITLE Pharmacological Treatment Of Glutamate Excitotoxicity Following Traumatic

  9. [Social support after traumatism].

    Science.gov (United States)

    Maercker, A; Heim, E; Hecker, T; Thoma, M V

    2017-01-01

    The classical concept of social support has recently become of relevance again, particularly in the context of traumatized patient groups, which include refugees and migrants. This article summarizes the evidence from social support research, e. g. different types of positive effects as well as context, gender and cultural aspects. These aspects are highlighted by means of studies stemming from applied healthcare research and thus describe a wide range of health effects, e.g. increased well-being and reduced depressive symptoms, improved functional abilities, better immune status and longevity. Two new trauma-specific differentiations of the social support concept are introduced: societal acknowledgement as a trauma survivor and disclosure of traumatic experiences. Against this background several implications for working with refugees arise: promotion of self-efficacy and posttraumatic maturation as well as the treatment of mental disorders show considerable benefits from focusing on social support. Finally, possibilities emerging from digital communication media are discussed, which are particularly relevant in this context.

  10. Post-Traumatic Stress Disorder (PDQ)

    Science.gov (United States)

    ... post-traumatic stress (PTS) is a lot like post-traumatic stress disorder (PTSD) but not as severe. Patients have a ... traumatic stress (PTS), which is a lot like post-traumatic stress disorder (PTSD). PTSD is a specific group of symptoms ...

  11. Post-traumatic Stress Disorder Post Partum

    Science.gov (United States)

    Schwab, W.; Marth, C.; Bergant, A. M.

    2012-01-01

    Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD), in some cases in a subsyndromal form. Until now, the possibility that postpartum psychological symptoms might be a continuum of a pre-existing disorder in pregnancy has rarely been considered. This study therefore aimed to evaluate the proportion of women who develop post-traumatic stress disorder as a result of childbirth. Materials and Methods: 56 multiparous women were recruited for the study. The diagnosis of PTSD was made according to the criteria for psychological disorders in the DSM-IV (Diagnostics and Statistical Manual of Mental Disorders). The data were collected in structured interviews in the 30th to 38th week of gestation and in the 6th week post partum. Results: Of the 56 women participating, 52 (93 %) completed the survey. Uncontrolled results showed that 21.15 % of the multiparous women met the full diagnostic PTSD criteria in the 6th week post partum. After the exclusion of all cases already characterised by all criteria or a subsyndromal form of PTSD caused by previous traumatisation, the PTSD rate was below 8 % at 6 weeks postpartum (= incidence rate of PTSD post partum). Conclusions: The present study is the first prospective longitudinal study to demonstrate the occurrence of full criteria PTSD in multiparous women as a result of childbirth after having excluded pre-existing PTSD. The results of our study show a high prevalence rate of PTSD during pregnancy. A number of women report all aspects of post-traumatic stress disorder as a result of childbirth. PMID:25253905

  12. Preliminary questions before studying mild traumatic brain injury outcome.

    Science.gov (United States)

    Fayol, P; Carrière, H; Habonimana, D; Dumond, J-J

    2009-07-01

    To point out from the literature the issues in mild traumatic brain injury outcome. METHODOLOGY-RESULTS: The literature review allows to point out several different factors involved in the difficulty to study mild traumatic brain injury: mild traumatic brain injury definition, postconcussional syndrome definition, diagnosis threshold, severity and functional symptoms outcome, neuropsychological tests, unspecific syndrome feature, individual factors, confounding factors and treatment interventions. The mild traumatic brain injury outcome study is complicated by the definitions issues and especially their practical use and by the multiplicity and the intricate interrelationships among involved factors. The individual outcome and social cost weight is widely emphasized for an event still considered as medically trivial. The well-ordered preventive interventions necessity and the targeted treatment programs need for the persisting postconcussive symptoms complete our critical review.

  13. Antioxidant therapies in traumatic brain injury: a review

    Directory of Open Access Journals (Sweden)

    Romero-Rivera Hector Rolando

    2017-09-01

    Full Text Available Oxidative stress constitute one of the commonest mechanism of the secondary injury contributing to neuronal death in traumatic brain injury cases. The oxidative stress induced secondary injury blockade may be considered as to be a good alternative to improve the outcome of traumatic brain injury (TBI treatment. Due to absence of definitive therapy of traumatic brain injury has forced researcher to utilize unconventional therapies and its roles investigated in the improvement of management and outcome in recent year. Antioxidant therapies are proven effective in many preclinical studies and encouraging results and the role of antioxidant mediaction may act as further advancement in the traumatic brain injury management it may represent aonr of newer moadlaity in neurosurgical aramamentorium, this kind of therapy could be a good alternative or adjuct to the previously established neuroprotection agents in TBI.

  14. The shared and specific relationships between exposure to potentially traumatic events and transdiagnostic dimensions of psychopathology.

    Science.gov (United States)

    Sunderland, Matthew; Carragher, Natacha; Chapman, Cath; Mills, Katherine; Teesson, Maree; Lockwood, Emma; Forbes, David; Slade, Tim

    2016-03-01

    The experience of traumatic events has been linked to the development of psychopathology. Changing perspectives on psychopathology have resulted in the hypothesis that broad dimensional constructs account for the majority of variance across putatively distinct disorders. As such, traumatic events may be associated with several disorders due to their relationship with these broad dimensions rather than any direct disorder-specific relationship. The current study used data from 8871 Australians to test this hypothesis. Two broad dimensions accounted for the majority of relationships between traumatic events and mental and substance use disorders. Direct relationships remained between post-traumatic stress disorder and six categories of traumatic events in the total population and between drug dependence and accidents/disasters for males only. These results have strong implications for how psychopathology is conceptualized and offer some evidence that traumatic events are associated with an increased likelihood of experiencing psychopathology in general. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Specificity of Cognitive and Behavioral Complaints in Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury

    Science.gov (United States)

    Pineau, Hélène; Marchand, André; Guay, Stéphane

    2015-01-01

    Characterization of cognitive and behavioral complaints is explored in Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (MTBI) samples according to the severity of PTSD, depression and general anxiety conditions. Self-reported questionnaires on cognitive and behavioral changes are administered to PTSD, MTBI, MTBI/PTSD and control groups. Confounding variables are controlled. All groups report more complaints since the traumatic event. PTSD and MTBI/PTSD groups report more anxiety symptoms, depression and complaints compared to the MTBI group. Relatives of the PTSD group confirm most of the behavioral changes reported. Results suggest the utility of self-reported questionnaires to personalize cognitive and behavioral interventions in PTSD and MTBI to cope with the impacts of the traumatic event. PMID:25646994

  16. Specificity of Cognitive and Behavioral Complaints in Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Hélène Pineau

    2015-01-01

    Full Text Available Characterization of cognitive and behavioral complaints is explored in Post-traumatic stress disorder (PTSD and mild traumatic brain injury (MTBI samples according to the severity of PTSD, depression and general anxiety conditions. Self-reported questionnaires on cognitive and behavioral changes are administered to PTSD, MTBI, MTBI/PTSD and control groups. Confounding variables are controlled. All groups report more complaints since the traumatic event. PTSD and MTBI/PTSD groups report more anxiety symptoms, depression and complaints compared to the MTBI group. Relatives of the PTSD group confirm most of the behavioral changes reported. Results suggest the utility of self-reported questionnaires to personalize cognitive and behavioral interventions in PTSD and MTBI to cope with the impacts of the traumatic event.

  17. Traumatic avulsion of extraocular muscles: case reports

    Directory of Open Access Journals (Sweden)

    Nilza Minguini

    2013-04-01

    Full Text Available We described the clinical, surgical details and results (motor and sensory of the retrieving procedure of traumatically avulsed muscles in three patients with no previous history of strabismus or diplopia seen in the Department of Ophthalmology, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.

  18. Traumatic fistula:the case for reparations

    Directory of Open Access Journals (Sweden)

    Arletty Pinel

    2007-01-01

    Full Text Available As a conflict strategy, women are often sexually assaulted using sticks, guns, branches of trees and bottles. Women’s genitals are deliberately destroyed, some permanently. Traumatic fistula often results. As with victims of torture and other grave human rights abuses, there exists an obligation to restore the women to health as far as possible and to provide reparation for their violations.

  19. Blast-induced Mild Traumatic Brain Injury

    Science.gov (United States)

    2010-01-01

    directly to the brain after craniotomy 154 or 240 kPa Unknown 2.8 or 20 kPa 40 kPa 1 or 10 MPa Redistribution of phosphorylated neurofilament H...m a: 1𔃻) .... !l ~ Blast-induced Mild Traumatic Brain Injury 767 colleagues55 compared neuropsychological test results in a group of primarily...patterns between blast and non-blast-injured subjects, thus providing no support at the neuropsychological level that blast is different. However

  20. Treatment of lingual traumatic ulcer accompanied with fungal infections

    Directory of Open Access Journals (Sweden)

    Sella Sella

    2011-09-01

    Full Text Available Background: Traumatic ulcer is a common form of ulceration occured in oral cavity caused by mechanical trauma, either acute or chronic, resulting in loss of the entire epithelium. Traumatic ulcer often occurs in children that are usually found on buccal mucosa, labial mucosa of upper and lower lip, lateral tongue, and a variety of areas that may be bitten. To properly diagnose the ulcer, dentists should evaluate the history and clinical description in detail. If the lesion is allegedly accompanied by other infections, such as fungal, bacterial or viral infections, microbiological or serological tests will be required. One of the initial therapy given for fungal infection is nystatin which aimed to support the recovery and repair processes of epithelial tissue in traumatic ulcer case. Purpose: This case report is aimed to emphasize the importance of microbiological examination in suspected cases of ulcer accompanied with traumatic fungal infection. Case: A 12-year-old girl came to the clinic of Pediatric Dentistry, Faculty of Dentistry, University of Indonesia on June 9, 2011 accompanied with her mother. The patient who had a history of geographic tongue came with complaints of injury found in the middle of the tongue. The main diagnosis was ulcer accompanied with traumatic fungal infection based on the results of swab examination. Case management: This traumatic ulcer case was treated with Dental Health Education, oral prophylaxis, as well as prescribing and usage instructions of nystatin. The recovery and repair processes of mucosal epithelium of the tongue then occured after the use of nystatin. Conclusion: It can be concluded that microbiological examination is important to diagnose suspected cases of ulcer accompanied with traumatic fungal infection. The appropriate treatment such as nystatin can be given for traumatic fungal infection.Latar belakang: Ulkus traumatic merupakan bentuk umum dari ulserasi rongga mulut yang terjadi akibat trauma

  1. Traumatic intrapericardial diaphragmatic hernia

    Energy Technology Data Exchange (ETDEWEB)

    Kuzucu, Akin [Inonu University School of Medicine, Department of Thoracic Surgery, Malatya (Turkey); Isik, Burak [Inonu University School of Medicine, Department of General Surgery, Malatya (Turkey); Baysal, Tamer [Inonu University School of Medicine, Department of Radiology, Malatya (Turkey)]. E-mail: tbaysal@inonu.edu.tr; Soysal, Omer [Inonu University School of Medicine, Department of Thoracic Surgery, Malatya (Turkey); Ulutas, Hakki [Inonu University School of Medicine, Department of Thoracic Surgery, Malatya (Turkey)

    2007-05-15

    Herniation of abdominal viscera into the pericardial space is a rare occurrence involving a sacless entry through a rent in the pericardial portion of the diaphragm's central tendon. Intrapericardial diaphragmatic hernia is often overlooked both clinically and radiologically and more pressing cardiorespiratory and orthopaedic abnormalities are addressed. The traumatic patient presented here had air shadows above the diaphragm on his chest radiograph. Chest computed tomography showed displacement of heart and air-filled mass, suspicious of a bowel loop, in the pericardial sac. A diagnosis of intrapericardial hernia was made in this patient who was haemodynamically unstable. The diaphragmatic tear was surgically repaired and the patient's postoperative course was uncomplicated.

  2. Blunt traumatic diaphragmatic rupture

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Nogueira

    2011-09-01

    Full Text Available Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5%among patients who were victims of blunt trauma and underwent laparotomy.Clinical suspicion associated with radiological assessment contributes to earlydiagnosis. Isolated diaphragmatic injury has a good prognosis. Generallyworse outcomes are associated with other trauma injuries. Bilateral andright diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT scan of the chest and abdomen provides better diagnosticaccuracy using the possibility of image multiplanar reconstruction. Surgicalrepair via laparotomy and/ or thoracotomy in the acute phase of the injury hasa better outcome and avoids chronic complications of diaphragmatic hernia.The authors present the case of a young male patient, victim of blunt abdominaltrauma due to motor vehicle accident with rupture of the diaphragm, spleenand kidney injuries. The diagnosis was made by computed tomography of thethorax and abdomen and was confirmed during laparotomy.

  3. Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy.

    Science.gov (United States)

    Lucke-Wold, Brandon P; Turner, Ryan C; Logsdon, Aric F; Nguyen, Linda; Bailes, Julian E; Lee, John M; Robson, Matthew J; Omalu, Bennet I; Huber, Jason D; Rosen, Charles L

    2016-03-01

    Chronic traumatic encephalopathy is a progressive neurodegenerative disease characterized by neurofibrillary tau tangles following repetitive neurotrauma. The underlying mechanism linking traumatic brain injury to chronic traumatic encephalopathy has not been elucidated. The authors investigate the role of endoplasmic reticulum stress as a link between acute neurotrauma and chronic neurodegeneration. The authors used pharmacological, biochemical, and behavioral tools to assess the role of endoplasmic reticulum stress in linking acute repetitive traumatic brain injury to the development of chronic neurodegeneration. Data from the authors' clinically relevant and validated rodent blast model were compared with those obtained from postmortem human chronic traumatic encephalopathy specimens from a National Football League player and World Wrestling Entertainment wrestler. The results demonstrated strong correlation of endoplasmic reticulum stress activation with subsequent tau hyperphosphorylation. Various endoplasmic reticulum stress markers were increased in human chronic traumatic encephalopathy specimens, and the endoplasmic reticulum stress response was associated with an increase in the tau kinase, glycogen synthase kinase-3β. Docosahexaenoic acid, an endoplasmic reticulum stress inhibitor, improved cognitive performance in the rat model 3 weeks after repetitive blast exposure. The data showed that docosahexaenoic acid administration substantially reduced tau hyperphosphorylation (t = 4.111, p < 0.05), improved cognition (t = 6.532, p < 0.001), and inhibited C/EBP homology protein activation (t = 5.631, p < 0.01). Additionally the data showed, for the first time, that endoplasmic reticulum stress is involved in the pathophysiology of chronic traumatic encephalopathy. Docosahexaenoic acid therefore warrants further investigation as a potential therapeutic agent for the prevention of chronic traumatic encephalopathy.

  4. Comorbid Post-Traumatic Stress Disorder and Opioid Dependence.

    Science.gov (United States)

    Patel, Rikinkumar S; Elmaadawi, Ahmed; Nasr, Suhayl; Haskin, John

    2017-09-03

    Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions. Since opioid withdrawal symptoms mimic hyper vigilance, this results in an exaggeration of the response of patients with post-traumatic stress disorder. This comorbidity is associated with worse health outcomes, as its pathophysiology involves a common neurobiological circuit. Opioid substitution therapy and psychotherapeutic medications in combination with evidence-based cognitive behavioral therapy devised for individuals with comorbid post-traumatic stress disorder and opioid dependence may improve treatment outcomes in this population. Therefore, we conclude that the screening for post-traumatic stress disorder in the opioid-abusing population is crucial. To understand the underlying mechanisms for this comorbidity and to improve the treatment response, further research should be encouraged.

  5. [Childhood traumatization, dissociation and nonsuicidal self-injurious behavior in borderline personality disorder].

    Science.gov (United States)

    Merza, Katalin; Harmatta, János; Papp, Gábor; Kuritárné Szabó, Ildikó

    2017-05-01

    Childhood traumatization plays a significant role in the etiology of borderline personality disorder. Studies found a significant association between childhood traumatization, dissociation, and nonsuicidal self-injurious behavior. The aim of our study was to assess dissociation and nonsuicidal self-injury among borderline inpatients and to reveal the association between childhood traumatization, dissociation, and self-injurious behavior. The sample consisted of 80 borderline inpatients and 73 depressed control patients. Childhood traumatization, dissociation and self-injurious behavior were assessed by questionnaires. Borderline patients reported severe and multiplex childhood traumatization. Cumulative trauma score and sexual abuse were the strongest predictors of dissociation. Furthermore, we have found that cumulative trauma score and dissociation were highly predictive of self-injurious behavior. Our results suggest that self-injurious behavior and dissociation in borderline patients can be regarded as indicators of childhood traumatization. Orv Hetil. 2017; 158(19): 740-747.

  6. Traumatic Brain Injury Registry (TBI)

    Data.gov (United States)

    Department of Veterans Affairs — As the number of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Traumatic Brain Injury (TBI) patients has grown, so has the need to track and monitor...

  7. Witnessing traumatic events and post-traumatic stress disorder: Insights from an animal model.

    Science.gov (United States)

    Patki, Gaurav; Salvi, Ankita; Liu, Hesong; Salim, Samina

    2015-07-23

    It is becoming increasingly recognized that post-traumatic stress disorder (PTSD) can be acquired vicariously from witnessing traumatic events. Recently, we published an animal model called the "Trauma witness model" (TWM) which mimics PTSD-like symptoms in rats from witnessing daily traumatic events (social defeat of cage mate) [14]. Our TWM does not result in any physical injury. This is a major procedural advantage over the typical intruder paradigm in which it is difficult to delineate the inflammatory response of tissue injury and the response elicited from emotional distress. Using TWM paradigm, we examined behavioral and cognitive effects in rats [14] however, the long-term persistence of PTSD-like symptoms or a time-course of these events (anxiety and depression-like behaviors and cognitive deficits) and the contribution of olfactory and auditory stress vs visual reinforcement were not examined. This study demonstrates that some of the features of PTSD-like symptoms in rats are reversible after a significant time lapse of the witnessing of traumatic events. We also have established that witnessing is critical to the PTSD-like phenotype and cannot be acquired solely due to auditory or olfactory stresses. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Traumatic hand amputation while wakeboarding

    OpenAIRE

    Woodacre, Timothy; Marshall, Morwena

    2011-01-01

    Wakeboarding is a sport increasing in popularity in the UK and the rest of the world. It is known to be associated with a high incidence of relatively minor injuries to the participating sportsperson. The authors present the case of a traumatic hand amputation to an associated third party and highlight the potential for serious injuries to all those directly involved with the sport. The authors demonstrate the successful application of military principles to a traumatic amputation in a civili...

  9. Initial Management of Traumatic Wounds.

    Science.gov (United States)

    Devriendt, Nausikaa; de Rooster, Hilde

    2017-11-01

    When traumatic wounds are quickly and accurately treated, morbidity and costs can be significantly decreased. Several factors, such as time delay between injury and treatment, the degree of contamination, extension and depth of the wound, and the mechanism of injury, influence the treatment and prognosis and stress the importance of a patient-specific approach. Although all traumatic wounds are contaminated, antibiotic therapy is seldom required if correct wound management is installed. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Resilience and vulnerability among refugee children of traumatized and non-traumatized parents

    Directory of Open Access Journals (Sweden)

    Daud Atia

    2008-03-01

    Full Text Available Abstract Background The aim of the study was to explore resilience among refugee children whose parents had been traumatized and were suffering from Post-Traumatic Stress Disorder (PTSD. Methods The study comprised 80 refugee children (40 boys and 40 girls, age range 6–17 yrs, divided into two groups. The test group consisted of 40 refugee children whose parents had been tortured in Iraq before coming to Sweden. In accordance with DSM-IV criteria, these children were further divided in two sub-groups, those who were assessed as having PTSD-related symptoms (n = 31 and those who did not have PTSD-related symptoms (n = 9. The comparison group consisted of 40 children from Egypt, Syria and Morocco whose parents had not been tortured. Wechsler Intelligence Scale for Children, 3rd edn. (WISC-III, Diagnostic Interview for Children and Adolescents- Revised (DICA-R, Post-Traumatic Stress Symptoms checklist (PTSS, "I Think I am" (ITIA and Strengths and Difficulties Questionnaire (SDQ were used to assess IQ; PTSD-related symptoms; self-esteem; possible resilience and vulnerability. Results Children without PTSD/PTSS in the traumatized parents group had more favorable values (ITIA and SDQ with respect to total scores, emotionality, relation to family, peer relations and prosocial behavior than the children in the same group with PTSD/PTSS and these values were similar to those the children in the comparison group (the non-traumatized parents group. The children in the non-traumatized parents group scored significantly higher on the IQ test than the children with traumatized parents, both the children with PTSD-related symptoms and those without PTSD-related symptoms. Conclusion Adequate emotional expression, supportive family relations, good peer relations, and prosociality constituted the main indicators of resilience. Further investigation is needed to explore the possible effects of these factors and the effects of IQ. The findings of this study are

  11. Brain structure in post-traumatic stress disorder: A voxel-based morphometry analysis.

    Science.gov (United States)

    Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui

    2013-09-15

    This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

  12. Brain structure in post-traumatic stress disorder: A voxel-based morphometry analysis

    Science.gov (United States)

    Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui

    2013-01-01

    This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities. PMID:25206550

  13. Readiness to reconcile and post-traumatic distress in German survivors of wartime rapes in 1945.

    Science.gov (United States)

    Eichhorn, S; Stammel, N; Glaesmer, H; Klauer, T; Freyberger, H J; Knaevelsrud, C; Kuwert, P

    2015-05-01

    Sexual violence and wartime rapes are prevalent crimes in violent conflicts all over the world. Processes of reconciliation are growing challenges in post-conflict settings. Despite this, so far few studies have examined the psychological consequences and their mediating factors. Our study aimed at investigating the degree of longtime readiness to reconcile and its associations with post-traumatic distress within a sample of German women who experienced wartime rapes in 1945. A total of 23 wartime rape survivors were compared to age- and gender-matched controls with WWII-related non-sexual traumatic experiences. Readiness to reconcile was assessed with the Readiness to Reconcile Inventory (RRI-13). The German version of the Post-traumatic Diagnostic Scale (PDS) was used to assess post-traumatic stress disorder (PTSD) symptomatology. Readiness to reconcile in wartime rape survivors was higher in those women who reported less post-traumatic distress, whereas the subscale "openness to interaction" showed the strongest association with post-traumatic symptomatology. Moreover, wartime rape survivors reported fewer feelings of revenge than women who experienced other traumatization in WWII. Our results are in line with previous research, indicating that readiness to reconcile impacts healing processes in the context of conflict-related traumatic experiences. Based on the long-lasting post-traumatic symptomatology we observed that our findings highlight the need for psychological treatment of wartime rape survivors worldwide, whereas future research should continue focusing on reconciliation within the therapeutic process.

  14. Chronic traumatic encephalopathy.

    Science.gov (United States)

    Yi, Juneyoung; Padalino, David J; Chin, Lawrence S; Montenegro, Philip; Cantu, Robert C

    2013-01-01

    Sports-related concussion has gained increased prominence, in part due to media coverage of several well-known athletes who have died from consequences of chronic traumatic encephalopathy (CTE). CTE was first described by Martland in 1928 as a syndrome seen in boxers who had experienced significant head trauma from repeated blows. The classic symptoms of impaired cognition, mood, behavior, and motor skills also have been reported in professional football players, and in 2005, the histopathological findings of CTE were first reported in a former National Football League (NFL) player. These finding were similar to Alzheimer's disease in some ways but differed in critical areas such as a predominance of tau protein deposition over amyloid. The pathophysiology is still unknown but involves a history of repeated concussive and subconcussive blows and then a lag period before CTE symptoms become evident. The involvement of excitotoxic amino acids and abnormal microglial activation remain speculative. Early identification and prevention of this disease by reducing repeated blows to the head has become a critical focus of current research.

  15. Disconnection between the default mode network and medial temporal lobes in post-traumatic amnesia.

    Science.gov (United States)

    De Simoni, Sara; Grover, Patrick J; Jenkins, Peter O; Honeyfield, Lesley; Quest, Rebecca A; Ross, Ewan; Scott, Gregory; Wilson, Mark H; Majewska, Paulina; Waldman, Adam D; Patel, Maneesh C; Sharp, David J

    2016-12-01

    connection correlated with both associative memory and information processing speed and normalized when these functions improved. We have previously shown abnormally high posterior cingulate cortex connectivity in the chronic phase after traumatic brain injury, and this abnormality was also observed in patients with post-traumatic amnesia. Patients with post-traumatic amnesia showed evidence of widespread traumatic axonal injury measured using diffusion magnetic resonance imaging. This change was more marked within the cingulum bundle, the tract connecting the parahippocampal gyrus to the posterior cingulate cortex. These findings provide novel insights into the pathophysiology of post-traumatic amnesia and evidence that memory impairment acutely after traumatic brain injury results from altered parahippocampal functional connectivity, perhaps secondary to the effects of axonal injury on white matter tracts connecting limbic structures involved in memory processing. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain.

  16. Post-Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    Post-traumatic stress disorder (PTSD) Overview Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, ...

  17. Traumatic injuries of the diaphragm

    Directory of Open Access Journals (Sweden)

    Lokman Soyoral

    2012-06-01

    Full Text Available Objectives: In this study, patient characteristics, diagnosisand treatment of patients with traumatic injury of thediaphragm, and the outcomes were evaluated.Materials and methods: Between 2002 and 2012, 19patients were treated for blunt and penetrating diaphragmaticinjury at the Thoracic Surgery Clinics of two teachinghospitals. The patients were evaluated retrospectively.Results: The etiology of trauma was traffic accidents in8 cases, falls from height in three, earthquake-relatedwounds in two, and stab wounds in six cases (SW. Themost frequent complaints and physical findings were dyspnea,chest pain, abdominal distension and the absenceof respiratory sounds. The most frequently encounteredfinding from the chest radiography was disappearance ofdiaphragmatic shadow, elevation of the diaphragm, andvisceral herniation to the thorax. All patients underwentsurgery. A left diaphragmatic rupture was diagnosed in13, and a right diaphragmatic rupture in 6 patients. Fourteenpatients had visceral herniation without strangulation.In fourteen patients, the diaphragmatic injury wasaccompanied by intra-abdominal organ injuries, lung injuriesand the other system injuries. In one case, cardiac injury,and in four cases, an isolated diaphragmatic rupturewas diagnosed. The most commonly associated organ indiaphragmatic injury was the stomach. In all cases, thediaphragm was repaired by two layers of non-absorbablesutures. The mortality was approximately 5.6%, dependingon associated injuries.Conclusion: The prognosis of the blunt and sharp diaphragmaticinjuries depends on the severity of the concomitantinjuries, and on the problems that may arise dueto delays.

  18. Secondary Traumatization among Adult Children of PTSD Veterans: The Role of Mother-Child Relationships

    Science.gov (United States)

    Dinshtein, Yula; Dekel, Rachel; Polliack, Miki

    2011-01-01

    The study examined the level of secondary traumatization among adult children of Israeli war veterans with post-traumatic stress disorder (PTSD) as manifested in emotional distress, stress resulting from terrorist attacks, and capacity for intimacy. In addition, the role of the mother-child relationship as a moderator of these manifestations of…

  19. 38 CFR 4.129 - Mental disorders due to traumatic stress.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental disorders due to traumatic stress. 4.129 Section 4.129 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event is...

  20. Traumatic Childhood Events and Autism Spectrum Disorder

    Science.gov (United States)

    Kerns, Connor Morrow; Newschaffer, Craig J.; Berkowitz, Steven J.

    2015-01-01

    Traumatic childhood events are associated with a wide range of negative physical, psychological and adaptive outcomes over the life course and are one of the few identifiable causes of psychiatric illness. Children with autism spectrum disorder (ASD) may be at increased risk for both encountering traumatic events and developing traumatic sequelae;…

  1. Traumatic brain injury : from impact to rehabilitation

    NARCIS (Netherlands)

    Halliday, J.; Absalom, A. R.

    Traumatic brain injury is a significant cause of mortality and morbidity in our society, particularly among the young. This review discusses the pathophysiology of traumatic brain injury, and current management from the acute phase through to rehabilitation of the traumatic brain injury patient.

  2. Computational modelling of traumatic brain injury predicts the location of chronic traumatic encephalopathy pathology.

    Science.gov (United States)

    Ghajari, Mazdak; Hellyer, Peter J; Sharp, David J

    2017-02-01

    Traumatic brain injury can lead to the neurodegenerative disease chronic traumatic encephalopathy. This condition has a clear neuropathological definition but the relationship between the initial head impact and the pattern of progressive brain pathology is poorly understood. We test the hypothesis that mechanical strain and strain rate are greatest in sulci, where neuropathology is prominently seen in chronic traumatic encephalopathy, and whether human neuroimaging observations converge with computational predictions. Three distinct types of injury were simulated. Chronic traumatic encephalopathy can occur after sporting injuries, so we studied a helmet-to-helmet impact in an American football game. In addition, we investigated an occipital head impact due to a fall from ground level and a helmeted head impact in a road traffic accident involving a motorcycle and a car. A high fidelity 3D computational model of brain injury biomechanics was developed and the contours of strain and strain rate at the grey matter-white matter boundary were mapped. Diffusion tensor imaging abnormalities in a cohort of 97 traumatic brain injury patients were also mapped at the grey matter-white matter boundary. Fifty-one healthy subjects served as controls. The computational models predicted large strain most prominent at the depths of sulci. The volume fraction of sulcal regions exceeding brain injury thresholds were significantly larger than that of gyral regions. Strain and strain rates were highest for the road traffic accident and sporting injury. Strain was greater in the sulci for all injury types, but strain rate was greater only in the road traffic and sporting injuries. Diffusion tensor imaging showed converging imaging abnormalities within sulcal regions with a significant decrease in fractional anisotropy in the patient group compared to controls within the sulci. Our results show that brain tissue deformation induced by head impact loading is greatest in sulcal locations

  3. Illness representations in patients with traumatic injury: a longitudinal study.

    Science.gov (United States)

    Lee, Bih-O; Chaboyer, Wendy; Wallis, Marianne

    2010-02-01

    This study aimed to elucidate the illness representations of patients with traumatic injury and to examine what extent their illness representations change over time. Traumatic injury has attracted global concern because it is the major reason for death and disability in people under 45 years old. One model, the Common Sense Model of Illness Representation (CSMIR), has the potential to help individuals adjust to changes in health status such as traumatic injury. Longitudinal study design. This study was conducted using a and collected data prior to hospital discharge and at three and six months after hospital discharge. One individual question form and the Chinese Illness Perception Questionnaire Revised (IPQ-R) (Trauma) were used to collect demographic data, clinical data and illness representations. A total of 114 participants completed the survey three times. The overall response rate was 79.7%. Six subscales of the Chinese (Trauma): identity, emotional representations, consequences, controllability, illness coherence and causes of the Chinese IPQ-R (Trauma) changed significantly over time. Two subscales, Timeline (acute/chronic) and Timeline Cyclical, did not change significantly. Based on these findings, there may be a window of opportunity to provide appropriate interventions to individuals with traumatic injury at each time point. The results of this study have implications for nursing practice and further nursing research. Understanding illness representation in patients with traumatic injury may help nurses to provide anticipatory guidance and to design nursing interventions before and after hospital discharge, ultimately to improve health outcomes of those patients.

  4. Glutamate/glutamine concentrations in the dorsal anterior cingulate vary with Post-Traumatic Stress Disorder symptoms.

    Science.gov (United States)

    Harnett, Nathaniel G; Wood, Kimberly H; Ference, Edward W; Reid, Meredith A; Lahti, Adrienne C; Knight, Amy J; Knight, David C

    2017-08-01

    Trauma and stress-related disorders (e.g., Acute Stress Disorder; ASD and Post-Traumatic Stress Disorder; PTSD) that develop following a traumatic event are characterized by cognitive-affective dysfunction. The cognitive and affective functions disrupted by stress disorder are mediated, in part, by glutamatergic neural systems. However, it remains unclear whether neural glutamate concentrations, measured acutely following trauma, vary with ASD symptoms and/or future PTSD symptom expression. Therefore, the current study utilized proton magnetic resonance spectroscopy ( 1 H-MRS) to investigate glutamate/glutamine (Glx) concentrations within the dorsal anterior cingulate cortex (ACC) of recently (i.e., within one month) traumatized individuals and non-traumatized controls. Although Glx concentrations within dorsal ACC did not differ between recently traumatized and non-traumatized control groups, a positive linear relationship was observed between Glx concentrations and current stress disorder symptoms in traumatized individuals. Further, Glx concentrations showed a positive linear relationship with future stress disorder symptoms (i.e., assessed 3 months post-trauma). The present results suggest glutamate concentrations may play a role in both acute and future post-traumatic stress symptoms following a traumatic experience. The current results expand our understanding of the neurobiology of stress disorder and suggest glutamate within the dorsal ACC plays an important role in cognitive-affective dysfunction following a traumatic experience. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder.

    Science.gov (United States)

    Brenner, Lisa A

    2011-01-01

    Advances in imaging technology, coupled with military personnel returning home from Iraq and Afghanistan with traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD), have increased interest in the neuropsychology and neurobiology of these two conditions. There has been a particular focus on differential diagnosis. This paper provides an overview of findings regarding the neuropsychological and neurobiological underpinnings of TBI and for PTSD. A specific focus is on assessment using neuropsychological measures and imaging techniques. Challenges associated with the assessment of individuals with one or both conditions are also discussed. Although use of neuropsychological and neuroimaging test results may assist with diagnosis and treatment planning, further work is needed to identify objective biomarkers for each condition. Such advances would be expected to facilitate differential diagnosis and implementation of best treatment practices.

  6. Traumatic uveitis in the mid-Atlantic United States

    Directory of Open Access Journals (Sweden)

    Engelhard SB

    2015-10-01

    Full Text Available Stephanie B Engelhard,1 James Patrie,2 John Prenshaw,1 Asima Bajwa,1 Rose Monahan,1 Ashvini K Reddy1 1Department of Ophthalmology, 2Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA Purpose: The purpose of this study was to conduct an in-depth analysis of traumatic uveitis in patients managed in a mid-Atlantic tertiary care center with the goal of better characterizing the clinical features and outcomes of this large and important subset of uveitis patients.Methods: This was a retrospective, observational study comparing traumatic uveitis patients with nontraumatic uveitis patients seen at the University of Virginia, Charlottesville, VA, USA, from 1984 to 2014.Results: Fifty-four traumatic uveitis patients (55 eyes were identified. The patient population was 70.4% male, 57.4% Caucasian, and 37.0% African American. Mean age at diagnosis was 31.2 years; mean duration of follow-up was 5.4 years; and mean number of visits to the clinic was 4. The most common treatment modality was local steroids (77.8%. Glaucoma was medically managed in eight patients (14.8%. Cataract surgery was performed in five patients (9.3%. Mean best-corrected visual acuity at baseline for traumatic uveitis patients was 0.33 logMAR (SD 0.42 at the initial visit and 0.16 logMAR (SD 0.33 at the final visit. Mean baseline intraocular pressure (IOP in the traumatic uveitis group was 15.5 mmHg (SD 7.4 at the initial visit and 14.6 mmHg (SD 4.0 at the final visit. Patients in the traumatic uveitis cohort tended to have better visual outcomes than those in the nontraumatic uveitis cohort.Conclusion: In our series, traumatic uveitis patients tended to be young and male and present with unilateral disease, all findings consistent with other reports. Despite relatively good visual outcomes, the traumatic uveitis patients still experienced a high burden of disease, measured both in the number of clinic visits and duration of follow-up. Due to the

  7. The effect of post-traumatic stress disorder on the risk of developing prescription opioid use disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III.

    Science.gov (United States)

    Hassan, Ahmed N; Foll, Bernard Le; Imtiaz, Sameer; Rehm, Jürgen

    2017-10-01

    To evaluate the effect of baseline post-traumatic stress disorder (PTSD) and each symptoms cluster on the risk of developing opioid use disorder (OUD) in those exposed to opioid painkillers and to assess the effect of comorbid PTSD and OUD on functioning, OUD severity, and treatment seeking compared with individuals with OUD only. We obtained data from 4025 individuals exposed to opioid painkillers from the National Epidemiologic Survey on Alcohol and Related Conditions III. We matched individuals with baseline PTSD with individuals without PTSD on demographics, developmental background, family history, personalities, and exposure to stressful life events with propensity score methodology. We controlled for clinical diagnoses and other risk factors that may have occurred after PTSD onset. Quality of life was assessed with the SF-12; the number of diagnostic criteria met indicated OUD severity. Baseline PTSD predicted OUD after controlling for matching variables and other risk factors, including baseline mood/anxiety disorders and other substance use disorders (odds ratio[OR]: 1.58; 95% confidence interval[CI]: 1.14-2.17; p=0.02). Among individuals with PTSD, arousal/reactivity cluster predicted OUD. Individuals with comorbid PTSD and OUD had lower mean scores on the SF-12 scale and greater severity of OUD than individuals with OUD. There were no differences in help-seeking. Baseline PTSD increases the risk of developing OUD after exposure to opioid painkillers. Clinicians should screen for PTSD diagnosis and arousal/reactivity symptoms prior to prescribing painkillers. Integrated treatments are strongly recommended for patients with this dual diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. The impact of comorbid post-traumatic stress disorder in patients with major depressive disorder on clinical features, pharmacological treatment strategies, and treatment outcomes - Results from a cross-sectional European multicenter study.

    Science.gov (United States)

    Dold, Markus; Bartova, Lucie; Kautzky, Alexander; Souery, Daniel; Mendlewicz, Julien; Serretti, Alessandro; Porcelli, Stefano; Zohar, Joseph; Montgomery, Stuart; Kasper, Siegfried

    2017-07-01

    This international, multicenter, cross-sectional study comprising 1346 adult in- and outpatients with major depressive disorder (MDD) investigated the association between MDD as primary diagnosis and comorbid post-traumatic stress disorder (PTSD). In a cross-sectional data collection process, the presence of comorbid PTSD was determined by the Mini International Neuropsychiatric Interview (MINI) and the patients' socio-demographic, clinical, psychopharmacological, and response information were obtained. Clinical features between MDD with and without concurrent PTSD were compared using descriptive statistics, analyses of covariance (ANCOVA), and binary logistic regression analyses. 1.49% of the MDD patients suffered from comorbid PTSD. Significantly more MDD + comorbid PTSD patients exhibited atypical features, comorbid anxiety disorders (any comorbid anxiety disorder, panic disorder, agoraphobia, and social phobia), comorbid bulimia nervosa, current suicide risk, and augmentation treatment with low-dose antipsychotic drugs. In the binary logistic regression analyses, the presence of atypical features (odds ratio (OR) = 4.49, 95%CI:1.01-20.12; p≤.05), any comorbid anxiety disorder (OR = 3.89, 95%CI:1.60-9.44; p = .003), comorbid panic disorder (OR = 6.45, 95%CI:2.52-16.51; p = .001), comorbid agoraphobia (OR = 6.51, 95%CI:2.54-16.68; p≤.001), comorbid social phobia (OR = 6.16, 95%CI:1.71-22.17; p≤.001), comorbid bulimia nervosa (OR = 10.39, 95%CI:1.21-88.64; p = .03), current suicide risk (OR = 3.58, 95%CI:1.30-9.91; p = .01), and augmentation with low-potency antipsychotics (OR = 6.66, 95%CI:2.50-17.77; pdisorders, and (3.) the increased suicide risk due to concurrent PTSD. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  9. Prospective longitudinal evaluation of the effect of deployment-acquired traumatic brain injury on posttraumatic stress and related disorders: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

    Science.gov (United States)

    Stein, Murray B; Kessler, Ronald C; Heeringa, Steven G; Jain, Sonia; Campbell-Sills, Laura; Colpe, Lisa J; Fullerton, Carol S; Nock, Matthew K; Sampson, Nancy A; Schoenbaum, Michael; Sun, Xiaoying; Thomas, Michael L; Ursano, Robert J

    2015-11-01

    Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel. A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms. Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance. The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.

  10. Post-traumatic recto-spinal fistula

    International Nuclear Information System (INIS)

    Lantsberg, L.; Greenberg, G.; Laufer, L.; Hertzanu, Y.

    2000-01-01

    Acquired recto-spinal fistula has been described elsewhere as a rare complication of colorectal malignancy and Crohn's enterocolitis. We treated a young man who developed a recto-spinal fistula as a result of a high fall injury. The patient presented with meningeal signs, sepsis and perianal laceration. Computerized axial tomography revealed air in the supersellar cistern. Gastrografin enema showed that contrast material was leaking from the rectum into the spinal canal. Surgical management included a diverting sigmoid colostomy, sacral bone curettage and wide presacral drainage. To the best of our knowledge, rectospinal fistula of traumatic origin has not been previously reported in the English literature. (orig.)

  11. Traumatic brain injury and olfactory deficits

    DEFF Research Database (Denmark)

    Fortin, Audrey; Lefebvre, Mathilde Beaulieu; Ptito, Maurice

    2010-01-01

    PRIMARY OBJECTIVE: Olfactory functions are not systematically evaluated following traumatic brain injury (TBI). This study aimed at comparing two smell tests that are used in a clinical setting. RESEARCH DESIGN: The University of Pennsylvania Smell Identification Test (UPSIT) and the Alberta Smell....... RESULTS: The scores of the two smell tests were significantly correlated. Both tests indicated that patients with frontal lesion performed significantly worse than patients with other types of lesion. Mood and injury severity were not associated with olfactory impairment when age was taken into account...

  12. Preventing secondary traumatic stress in educators.

    Science.gov (United States)

    Hydon, Stephen; Wong, Marleen; Langley, Audra K; Stein, Bradley D; Kataoka, Sheryl H

    2015-04-01

    Teachers can be vulnerable to secondary traumatic stress (STS) because of their supportive role with students and potential exposure to students' experiences with traumas, violence, disasters, or crises. STS symptoms, similar to those found in posttraumatic stress disorder, include nightmares, avoidance, agitation, and withdrawal, and can result from secondary exposure to hearing about students' traumas. This article describes how STS presents, how teachers can be at risk, and how STS can manifest in schools. A US Department of Education training program is presented, and thoughts on future directions are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Vicarious traumatization and coping in medical students: a pilot study.

    Science.gov (United States)

    Al-Mateen, Cheryl S; Linker, Julie A; Damle, Neha; Hupe, Jessica; Helfer, Tamara; Jessick, Veronica

    2015-02-01

    This study explored the impact of traumatic experiences on medical students during their clerkships. Medical students completed an anonymous online survey inquiring about traumatic experiences on required clerkships during their third year of medical school, including any symptoms they may have experienced as well as coping strategies they may have used. Twenty-six percent of students reported experiencing vicarious traumatization (VT) during their third year of medical school. The experience of VT in medical students is relevant to medical educators, given that the resulting symptoms may impact student performance and learning as well as ongoing well-being. Fifty percent of the students who experienced VT in this study did so on the psychiatry clerkship. It is important for psychiatrists to recognize that this is a potential risk for students in order to increase the likelihood that appropriate supports are provided.

  14. Post traumatic stress disorder and the forensic radiographer

    International Nuclear Information System (INIS)

    Glaysher, E.; Vallis, J.; Reeves, P.

    2016-01-01

    The term post traumatic stress disorder (PTSD) is used to describe the psychological issues resulting from any traumatic event. An individual's ability to function is impaired by experiencing emotional responses to a traumatic event. Forensic radiographers need to be aware of the potential debilitating effects of this condition and those writing forensic protocols must take the condition into account and build in safeguards and welfare strategies. This narrative review looks at the origins of the term PTSD and highlights those who may be at increased risk of developing the condition including, in particular, forensic radiographers involved in mass fatality work. Signs, symptoms and possible treatments are also reviewed. - Highlights: • Presents a summary of PTSD for those working in forensic radiography. • Outlines signs & symptoms of PTSD. • Discusses treatment & prognosis of PTSD. • Suggests ways of managing factors which may predispose to PTSD.

  15. Endobronchial neurogenic tumor: A combination of traumatic neuroma and neurofibroma

    Directory of Open Access Journals (Sweden)

    Amit Tandon

    2017-01-01

    Full Text Available Traumatic neuromas are uncommon and benign lesions arising from a peripheral nerve injury during surgery. Here we describe a case with histopathologic features of both a traumatic neuroma and neurofibroma in a patient without integumentary physical exam findings nor prior surgical history. A 54 year old male was admitted for surgical debridement of a foot ulcer. During pre-operative evaluation and review of imaging multiple CT scans revealed a stable, 4 mm endobronchial lesion in the left lower lobe. Given history of nicotine abuse, bronchoscopy was performed. Bronchoscopy showed a pearly, polypoid lesion. Histopathological results showed strong positivity for S-100 protein and spindle cell proliferation. Repeat CT chest showed no new lesions in the bronchial tree. The rarity of this case is noted not only by the limited number of bronchial neurogenic tumors, but the combined features in this case of a traumatic neuroma and neurofibroma which has not been described.

  16. Traumatic Lumbar Subdural Hematoma in the Absence of Intracranial Disease.

    Science.gov (United States)

    Cooper, Jared; Gillick, John L; LaBagnara, Michael; Das, Kaushik; Hillard, Virany H

    2016-06-01

    Traumatic spinal subdural hematoma is an exceedingly rare condition, with those occurring in the absence of intracranial disease being particularly uncommon. Only 13 such cases have been reported. Although theories exist to describe the pathophysiology of traumatic spinal subdural hematoma, the precise mechanism and guidelines for management remain unclear. This report describes a 37-year-old woman who suffered a traumatic assault who developed progressive low back pain with radicular symptoms 2 days after presentation. Magnetic resonance imaging revealed a lumbar subdural hematoma extending from L1 to L5. No intracranial disease was detected on imaging. Definitive guidelines for management of this condition are uncertain; however, successful use of conservative management, lumbar drainage, and surgical evacuation has been reported. This patient underwent a lumbar laminectomy with evacuation of the hematoma, resulting in immediate pain relief and resolution of symptoms within 1 week of the procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Understanding Traumatic Stress in Children

    Science.gov (United States)

    Bassuk, Ellen L.; Konnath, Kristina; Volk, Katherine T.

    2006-01-01

    The unexpected loss of a loved one, a car accident, or exposure to a violent experience is familiar to many. Everyone reacts to such events, but the responses vary widely, ranging from numbness and withdrawal, to crying, nervousness, and agitation. Because traumatic events are prevalent, cause profound suffering, and may lead to life altering…

  18. Acute traumatic abdominal wall hernia

    NARCIS (Netherlands)

    D. den Hartog (Dennis); W.E. Tuinebreijer (Wim); P.P. Oprel (Pim); P. Patka (Peter)

    2011-01-01

    textabstractAlthough blunt abdominal trauma is frequent, traumatic abdominal wall hernias (TAWH) are rare. We describe a large TAWH with associated intra-abdominal lesions that were caused by high-energy trauma. The diagnosis was missed by clinical examination but was subsequently revealed by a

  19. Hypopituitarism in Traumatic Brain Injury

    DEFF Research Database (Denmark)

    Klose, Marianne; Feldt-Rasmussen, Ulla

    2015-01-01

    While hypopituitarism after traumatic brain injury (TBI) was previously considered rare, it is now thought to be a major cause of treatable morbidity among TBI survivors. Consequently, recommendations for assessment of pituitary function and replacement in TBI were recently introduced. Given...

  20. Organisation of traumatic head injury management in the Nordic countries

    DEFF Research Database (Denmark)

    Sollid, S; Sundstrøm, T; Ingebrigtsen, T

    2009-01-01

    with acute traumatic head injury. A substantial proportion of the operations are performed at local and central hospitals without neurosurgical expertise, despite an efficient pre and interhospital transport system. The Nordic adaption of the Brain Trauma Foundation guidelines recommends that this practice...... is a synthesis of two cross-sectional surveys. Questionnaires were used to collect data on the annual number of acute head injury operations, the infrastructure, the level of education, the use of trauma protocols and the management of traumatic head injury at Nordic hospitals. RESULTS: The proportion of acute...

  1. The dynamics and pathogenesis of traumatic subdural hygromas

    International Nuclear Information System (INIS)

    Kopp, W.

    1988-01-01

    Of 2005 patients, who had suffered blunt skull trauma, 108 developed post-traumatic subdural hygromas (TSH). CT was used to observe the course of subdural hygromas not treated surgically, with particular reference to the time of their appearance and regression. The relative incidence of TSH, and of the severity of head trauma quanitified on a 5-grade scale was determined in different age groups. From the traumatic changes demonstrated on CT, some conclusions could be drawn regarding the pathogenesis. A hypothetical model has been developed which explains TSH as a result of shearing forces. (orig.) [de

  2. Secondary traumatic stress among emergency nurses: a cross-sectional study.

    Science.gov (United States)

    Duffy, Emer; Avalos, Gloria; Dowling, Maura

    2015-04-01

    Emergency department nurses are required to deal with emotional trauma issues on a daily basis, which may result in them experiencing symptoms of secondary traumatic stress, a consequence of stress experienced when helping or wanting to help a person traumatised or suffering. This study measured emergency department nurses' self-reported levels of secondary traumatic stress. Registered nurses (n = 117) working at three emergency departments in the Western geographical region of Ireland were invited to complete the secondary traumatic stress scale (STSS). A response rate of 90% (n = 105) was achieved. Most participants (n = 67/64%) met the criteria for secondary traumatic stress. A statistically significant finding was that the highest proportion (82%) of secondary traumatic stress existed in the staff nurse group (p = 0.042). Moreover, for those nurses reporting secondary traumatic stress, statistical significance was found for the variables 'change of career considered' (p = 0.017) and 'finds alcohol helpful in alleviating work-related stress' (p = 0.004), when compared with nurses not reporting secondary traumatic stress. The findings suggest the need to examine current crisis management interventions and to introduce new systems to support nurses in Irish emergency departments. Moreover, because different types of traumatic events in the ED require different types of interventions, the prevention and management of STS among emergency department nurses must be tackled using a variety of approaches. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. The moderating effect of relationship quality on partner secondary traumatic stress among couples coping with cancer.

    Science.gov (United States)

    Brosseau, Danielle C; McDonald, Marvin J; Stephen, Joanne E

    2011-06-01

    A considerable amount of research has investigated symptoms of posttraumatic stress in cancer patients while the occurrence and correlates of secondary traumatic stress on patients' intimate partners has yet to be explored. This study examined the prevalence of secondary traumatic stress symptoms (Modified Secondary Trauma Questionnaire) in partners of cancer patients and evaluated the association of these symptoms with patients' posttraumatic stress symptoms (Impact of Event Scale-Revised). The study also investigated the moderation effect of relationship quality (Marital Satisfaction Inventory-Revised) on the association between patients' and partners' posttraumatic and secondary traumatic stress respectively. A heterogeneous sample of 90 patient-partner dyads was recruited through a provincial cancer agency. Multiple symptoms of secondary traumatic stress were reported by 23% of partners. These symptoms were experienced at a clinically significant level by 10% of all participating partners. Although patients' and partners' traumatic stress symptoms were correlated (r = .44, p traumatic stress symptoms. Therefore, of the 90 dyads in the study, 18% included at least one partner reporting clinically significant levels of traumatic stress. Relationship quality accounted for 11% of the variance in secondary traumatic stress, in addition to the 19% already accounted for by patients' posttraumatic stress. Relationship quality also exhibited buffering effects benefiting couples with higher quality relationships. Implications of results for future research and holistic health care models are discussed. ©2011 APA

  4. Management of traumatic events: influence of emotion-centered coping strategies on the occurrence of dissociation and post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Georges Brousse

    2011-03-01

    Full Text Available Georges Brousse1,2, Benjamin Arnaud1, Jordane Durand Roger1, Julie Geneste1, Delphine Bourguet1, Frederic Zaplana1, Olivier Blanc1, Jeannot Schmidt1,2, Louis Jehel31CHU Clermont Ferrand, Unité Urgences Psychiatriques, 28 place Henri Dunant BP 69, 63003 Clermont-Ferrand Cedex 01, France; 2Univ Clermont 1, UFR médecine, Clermont-Ferrand, F63001 France; 3Hopital Tenon (CHU APHP 4 rue de la Chine 75020, France, INSERM U669Abstract: Our aim was to assess the influence of the coping strategies employed for the management of traumatic events on the occurrence of dissociation and traumatic disorders. We carried out a 1-year retrospective study of the cognitive management of a traumatic event in 18 subjects involved in the same road vehicle accident. The diagnosis of post-traumatic stress disorder (PTSD was made for 33.3% of the participants. The participants with a PTSD diagnosis 1 year after the event used emotion-centered strategies during the event more often than did those with no PTSD, P < 0.02. In the year after the traumatic event, our results show a strong link between the intensity of PTSD and the severity of the post-traumatic symptoms like dissociation (P = 0.032 and the use of emotion-centered strategies (P = 0.004. Moreover, the participants who presented Peritraumatic Dissociative Experiences Questionnaire scores above 15 made greater use of emotion-centered coping strategies than did those who did not show dissociation, P < 0.04. Our results confirm that the cognitive management of traumatic events may play an essential role in the development of a state of post-traumatic stress in the aftermath of a violent event.Keywords: trauma, coping, emotions, peritraumatic dissociation, post-traumatic stress disorder

  5. Management of acute complex traumatic wound with a dermal ...

    African Journals Online (AJOL)

    Management of acute complex traumatic wound with a dermal regeneration template: Case report. ... Methods: A nine-year-old male patient presented to Kimberly Hospital with an extensive soft tissue injury of the leg associated with a tibia fracture caused by a high velocity pedestrian vehicle accident. Results: A ...

  6. Chronic foot ulcer complicating a traumatic arteriovenous fistula ...

    African Journals Online (AJOL)

    Background: Chronic foot ulcers could be a complication of traumatic arteriovenous (A-V) fistulation. We report a rare case of chronic foot ulcer and deformity resulting from arteriovenous fistula of the anterior tibial artery. Method: The clinical presentation and the outcome of treatment in a patient treated at the University of ...

  7. Post-traumatic stress disorder: Case report | Nyamai | East African ...

    African Journals Online (AJOL)

    Following exposure to a major traumatic event like the August seventh 1998 Nairobi bomb blast various reactions occur, some of which result in stress-related psychiatric disorders. We have described one such case, and used it to illustrate the salient features of posttraumatic stress disorder. We have outlined the diagnostic ...

  8. Profile and outcome of non-traumatic paraplegia in Kano ...

    African Journals Online (AJOL)

    Patients underwent a detailed clinical evaluation followed by laboratory investigation and neuroimaging studies and were followed up for 9 months to asses outcome and complications. Results: 98 patients with non-traumatic paraplegia consisting of 71 males and 27 females (M:F: 5:2) were seen. The age range of the ...

  9. Uterine Rupture due to Traumatic Assisted Fundal Pressure

    Directory of Open Access Journals (Sweden)

    Shen-Chuan Wei

    2006-06-01

    Conclusion: Assisted fundal pressure during painful delivery can be traumatic and results in uterine rupture. In this article, we suggest that uterine rupture should be considered whenever a pregnant woman experiences a sudden onset of abdominal pain during the course of assisted uterine fundal pressure.

  10. Traumatic experience and the process of reconciliation

    Directory of Open Access Journals (Sweden)

    Biro Mikloš

    2005-01-01

    Full Text Available The paper present the results of the survey that was designed to examine attitudes towards reconciliation, traumatic experience, as well as some basic values, attitudes and stereotypes in two cities of the former Yugoslavia where the nationalities that were in conflict live together. The survey was conducted on 400 subjects in Vukovar (inhabited by Serbs and Croats and 400 subjects in Prijedor (Serbs and Bosniaks. The results show that the level of traumatic experience, as a single variable, has no correlation with the readiness for reconciliation. On the other hand, in General Linear Model, best predictors of the readiness for reconciliation were attitudes and values represented by the factors “Non-Ethnocentric” and Non-Nationalistic/ Xenophobic”. Also, having friends among the “opposing” nationality and having positive experiences with the members of opposing national groups is highly related to a readiness for reconciliation. Finally, a belief in war crime trials, combined with a readiness to admit the war crimes among its own nationality, was a significant predictor of readiness for reconciliation.

  11. Secondary Traumatic Stress, Psychological Distress, Sharing of Traumatic Reminisces, and Marital Quality among Spouses of Holocaust Child Survivors.

    Science.gov (United States)

    Lev-Wiesel, Rachel; Amir, Marianne

    2001-01-01

    Examined the issue of secondary traumatic stress (STS) among spouses of Holocaust survivors who were children during World War II. Results showed that about one third of spouses suffered from some degree of STS symptoms. STS among spouses was related to hostility, anger and interpersonal sensitivity in the survivor, but not to reminiscences with…

  12. Determinants of Glasgow outcome scale in patients with severe traumatic brain injury for better quality of life

    Science.gov (United States)

    Dharmajaya, R.; Sari, D. K.; Ganie, R. A.

    2018-03-01

    Primary and secondary brain injury may occur with severe traumatic brain injury. Secondary traumatic brain injury results in a more severe effect compared to primary traumatic brain injury. Therefore, prevention of secondary traumatic brain injury is necessary to obtain maximum therapeutic results and accurate determination of prognosis and better quality of life. This study aimed to determine accurate and noninvasive prognostic factors in patients with severe traumatic brain injury. It was a cohort study on 16 subjects. Intracranial pressure was monitored within the first 24 hours after traumatic brain injury. Examination of Brain-Derived Neurotrophic Factor (BDNF) and S100B protein were conducted four times. The severity of outcome was evaluated using Glasgow Outcome Scale (GOS) three months after traumatic brain injury. Intracranial pressure measurement performed 24 hours after traumatic brain injury, low S100B protein (6.16pg/ml) 48 hours after injury indicate good prognosis and were shown to be significant predictors (pquality of GOS. The conclusion is patient with a moderate increase in intracranial pressure Intracranial pressure S100B protein, being inexpensive and non-invasive, can substitute BDNF and intracranial pressure measurements as a tool for determining prognosis 120 hours following traumatic brain injury.

  13. Middle Range Theory of Traumatic Childbirth

    Science.gov (United States)

    2015-01-01

    A middle range theory of traumatic childbirth was developed using Morse’s method of theoretical coalescence. The scope of this qualitative theory was increased by formalizing the connections between 14 individual studies all conducted by the same researcher on the same topic, with different groups, using different research designs and different types of analyses. Axioms were derived from this research program along with attributes of traumatic childbirth, posttraumatic stress, and secondary traumatic stress. This middle range theory addresses the long-term chronic consequences of a traumatic birth for mothers including its impact on breastfeeding, subsequent childbirth, and the anniversary of birth trauma. The impact on fathers and clinicians present at the traumatic birth is highlighted as secondary traumatic stress comes into play. Troubling glimpses of difficulties in mother–infant bonding are revealed. PMID:28462301

  14. Middle Range Theory of Traumatic Childbirth

    Directory of Open Access Journals (Sweden)

    Cheryl Tatano Beck

    2015-03-01

    Full Text Available A middle range theory of traumatic childbirth was developed using Morse’s method of theoretical coalescence. The scope of this qualitative theory was increased by formalizing the connections between 14 individual studies all conducted by the same researcher on the same topic, with different groups, using different research designs and different types of analyses. Axioms were derived from this research program along with attributes of traumatic childbirth, posttraumatic stress, and secondary traumatic stress. This middle range theory addresses the long-term chronic consequences of a traumatic birth for mothers including its impact on breastfeeding, subsequent childbirth, and the anniversary of birth trauma. The impact on fathers and clinicians present at the traumatic birth is highlighted as secondary traumatic stress comes into play. Troubling glimpses of difficulties in mother–infant bonding are revealed.

  15. Post traumatic tetanus and role magnesium sulphate

    International Nuclear Information System (INIS)

    Sikendr, R.I.; Samad, B.U.; Memon, M.I.

    2009-01-01

    Tetanus is a life threatening disease. Reported mortality for tetanus is 15-39%. Conventional treatment includes heavy sedation and artificial ventilation. Complications resulting from long term heavy sedation and artificial ventilation contribute to 60% of the total mortality caused by tetanus. In this study magnesium sulphate was used to reduce the need for sedation and artificial ventilation. Objectives of this prospective study were to determine the role of magnesium sulphate in post traumatic tetanus. The study was carried out in surgical Intensive Care at Pakistan Institute of Medical Sciences (PIMS), Islamabad from Jan 2004 to Dec 2007. Forty-four patients presented during this period and 33 patients were included in the study. All patients had tracheostomy done within 48 hours. Every patient was started Magnesium Sulphate therapy for control of spasms after sending baseline investigations. Patients were given ventilatory support when needed. All data was entered in well structured proforma. SPSS-10 was used to analyse data. Thirty-three patients were included in the study and all patients were given magnesium sulphate. Out of these, 45.5% cases were grade 4 tetanus, 73.6% and 63.3% cases did not require artificial ventilation and additional sedation respectively, 51.1% patients remained free of complications of tetanus. Overall mortality was 30.3%. Use of Magnesium Sulphate is safe and reduces the need for sedation and artificial ventilation in high grade tetanus thus contributing to survival benefit in adult post-traumatic tetanus cases. (author)

  16. Post-traumatic myositis ossificans

    Directory of Open Access Journals (Sweden)

    John M. Zietkiewicz

    2014-12-01

    Full Text Available Post-traumatic myositis ossificans (PTMO is characterised by abnormal heterotopic boneformation involving striated muscle. PTMO is usually associated with trauma and is most common in the second and third decades. An important teaching point is that in the early or subacute phase, clinical and imaging features can mimic a soft-tissue sarcoma. A combination of imaging modalities is required to evaluate the muscle lesion.

  17. Acute traumatic abdominal wall hernia

    OpenAIRE

    Hartog, Dennis; Tuinebreijer, Wim; Oprel, Pim; Patka, Peter

    2011-01-01

    textabstractAlthough blunt abdominal trauma is frequent, traumatic abdominal wall hernias (TAWH) are rare. We describe a large TAWH with associated intra-abdominal lesions that were caused by high-energy trauma. The diagnosis was missed by clinical examination but was subsequently revealed by a computed tomography (CT) scan. Repair consisted of an open anatomical reconstruction of the abdominal wall layers with reinforcement by an intraperitoneal composite mesh. The patient recovered well and...

  18. Post traumatic Headache and Psychological Health: Mindfulness Training for Mild TraumaticBrain Injury

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-10-1-1021 TITLE: Post-traumatic Headache and Psychological Health: Mindfulness Training for Mild Traumatic Brain Injury...traumatic Headache and Psychological Health: Mindfulness Training for Mild Traumatic Brain Injury” 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR...negative psychological/mood states, and impair overall quality of life. Comorbid anxiety, depression, PTSD and other psychological, psychosocial

  19. Irreducible Traumatic Posterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Blake Collier

    2017-01-01

    Full Text Available History of present illness: A 22-year-old male presented to the Emergency Department complaining of right shoulder pain after a motocross accident. He was traveling at approximately 10 mph around a turn when he lost control and was thrown over the handlebars, landing directly on his right shoulder. On arrival, he was holding his arm in adduction and internal rotation. An area of swelling was noted over his anterior shoulder. He was unable to abduct his shoulder. No humeral gapping was noted. He had normal neuro-vascular status distal to the injury. Significant findings: Radiographs demonstrated posterior displacement of the humeral head on the “Y” view (see white arrow and widening of the glenohumeral joint space on anterior-posterior view (see red arrow. The findings were consistent with posterior dislocation and a Hill-Sachs type deformity. Sedation was performed and reduction was attempted using external rotation, traction counter-traction. An immediate “pop” was felt during the procedure. Post-procedure radiographs revealed a persistent posterior subluxation with interlocking at posterior glenoid. CT revealed posterior dislocation with acute depressed impaction deformity medial to the biceps groove with the humeral head perched on the posterior glenoid, interlocked at reverse Hill-Sachs deformity (see blue arrow. Discussion: Posterior shoulder dislocations are rare and represent only 2% of all shoulder dislocations. Posterior shoulder dislocations are missed on initial diagnosis in more than 60% of cases.1 Posterior shoulder dislocations result from axial loading of the adducted and internally rotated shoulder, violent muscle contractions (resulting from seizures or electrocution, a direct posterior force applied to the anterior shoulder.1 Physical findings include decreased anterior prominence of the humeral head, increased palpable posterior prominence of the humeral head below the acromion, increased palpable prominence of the

  20. [Post-traumatic stress disorder after childbirth].

    Science.gov (United States)

    Korábová, I; Masopustová, Z

    2016-01-01

    The aim of this paper is to introduce the issue of post-traumatic stress disorder after childbirth to health care professionals. The text focuses on the diagnostic definition of post-traumatic stress disorder after childbirth, symptoms, physiological background, prevalence, course, risk factors and consequences of post-traumatic stress disorder after childbirth for a woman, her child and her partner. Options for interventions and therapy are outlined as well.

  1. The influence of occupational debriefing on post-traumatic stress symptomatology in traumatized police officers

    NARCIS (Netherlands)

    Carlier, I. V.; Voerman, A. E.; Gersons, B. P.

    2000-01-01

    Certain individuals, such as police officers, are exposed to traumatic events as part of their occupational roles. In an effort to prevent psychological illnesses, notably the post-traumatic stress disorder, from arising out of work-related traumatic incidents, psychological interventions have been

  2. Centralized rehabilitation after servere traumatic brain injury

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Liebach, Annette; Nordenbo, Annette Mosbæk

    2006-01-01

    OBJECTIVES: To present results from the first 3 years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to compare results of centralized versus decentralized rehabilitation. MATERIAL AND METHODS: Prospectively, the most severely injured group of adults from...... an uptake area of 2.4 million in Denmark were included at admission to a regional brain injury unit (BIU), on average 19 days after injury. Patients in the retrospective study used for comparison were randomly chosen from the national hospital register. RESULTS AND CONCLUSIONS: Out of 117 patients...... post-trauma was 0.29, and at 1 year 0.055 per 100,000 population. By comparison of 39 patients from the centralized unit injured in 2000-2003 with 21 patients injured in 1982, 1987 or 1992 and with similar PTA- and age distributions and male/female ratio, Glasgow Outcome Scale score at discharge...

  3. Post-traumatic humero-ulnar synostosis.

    Science.gov (United States)

    Mollen, Bas P; Heesterbeek, Petra J C; de Vos, Maarten J; ten Ham, Arno M

    2014-07-01

    A humero-ulnar synostosis is a bony connection between the humerus and the ulna. This is a very rare finding and it results in a serious disability of the elbow. Usually, a synostosis of the elbow occurs as a congenital anomaly. In this case, a 6-year-old girl was seen with a post-traumatic humero-ulnar synostosis, which has never been reported in the literature before. Surgical resection of the humero-ulnar synostosis was performed. Along with rapid intensive physical therapy, almost full recovery of function was achieved. The short-term result is very satisfactory, but the long-term results and recurrence rate are still unknown.

  4. Does intergenerational transmission of trauma skip a generation? No meta-analytic evidence for tertiary traumatization with third generation of Holocaust survivors.

    Science.gov (United States)

    Sagi-Schwartz, Abraham; van IJzendoorn, Marinus H; Bakermans-Kranenburg, Marian J

    2008-06-01

    In a series of meta-analyses with the second generation of Holocaust survivors, no evidence for secondary traumatization was found (Van IJzendoorn, Bakermans-Kranenburg, & Sagi-Schwartz, 2003). With regard to third generation traumatization, various reports suggest the presence of intergenerational transmission of trauma. Some scholars argue that intergenerational transmission of trauma might skip a generation. Therefore, we focus in this study on the transmission of trauma to the third generation offspring (the grandchildren) of the first generation's traumatic Holocaust experiences (referred to as "tertiary traumatization"), and we present a narrative review of the pertinent studies. Meta-analytic results of 13 non-clinical samples involving 1012 participants showed no evidence for tertiary traumatization in Holocaust survivor families. Our previous meta-analytic study on secondary traumatization and the present one on third generation's psychological consequences of the Holocaust indicate a remarkable resilience of profoundly traumatized survivors in their (grand-)parental roles.

  5. Attention and driving in traumatic brain injury : A question of coping with time-pressure

    NARCIS (Netherlands)

    Brouwer, WH; Withaar, FK; Tant, MLM; van Zomeren, AH

    Background: Diffuse and focal traumatic brain injury (TBI) can result in perceptual, cognitive, and motor dysfunction possibly leading to activity limitations in driving. Characteristic dysfunctions for severe diffuse TBI are confronted with function requirements derived from the hierarchical task

  6. Traumatic neuroma of the infraorbital nerve subsequent to inferomedial orbital decompression for Graves' orbitopathy

    NARCIS (Netherlands)

    Baldeschi, Lelio; Saeed, Peerooz; Regensburg, Noortje I.; Zacharopoulos, Ioannis; Wiersinga, Wilmar M.

    2010-01-01

    PURPOSE: To present and discuss the occurrence of a traumatic neuroma subsequent to inferomedial orbital decompression surgery in Graves' orbitopathy. METHODS: Case report. RESULTS: Approximately 1 month after surgery, a patient who underwent bilateral rehabilitative inferomedial orbital

  7. A Psychophysiologic Study of Weakening Traumatic Combat Memories With Post-Reactivation Propranolol

    National Research Council Canada - National Science Library

    Pitman, Roger K

    2008-01-01

    The objective of this project is to test whether the beta-adrenergic blocker propranolol, given following combat memory reactivation, results in a significantly greater weakening of traumatic memories...

  8. Post-Traumatic Stress Disorder: MedlinePlus Health Topic

    Science.gov (United States)

    ... Choose a Therapist for Post-Traumatic Stress and Dissociative Conditions (Sidran Institute) Post-Traumatic Stress Disorder (National Center for Complementary and Integrative Health) Posttraumatic ...

  9. Traumatic exposure and posttraumatic stress disorder among flood victims: Testing a multiple mediating model.

    Science.gov (United States)

    Quan, Lijuan; Zhen, Rui; Yao, Benxian; Zhou, Xiao

    2017-05-01

    A total of 187 flood victims from Wuhu, a Chinese city affected most severely by a flood during July 2016, were selected to complete self-report measures of traumatic exposure, feelings of safety, fear, posttraumatic negative cognition, and posttraumatic stress disorder. The results found that traumatic exposure could directly predict posttraumatic stress disorder. Besides, traumatic exposure had indirect prediction on posttraumatic stress disorder through three ways, including a one-step path of negative self-cognition, a two-step path from feelings of safety to fear, and a three-step path from feelings of safety to negative self-cognition via fear. Implications and future directions are correspondingly discussed.

  10. Nursing students' post-traumatic growth, emotional intelligence and psychological resilience.

    Science.gov (United States)

    Li, Y; Cao, F; Cao, D; Liu, J

    2015-06-01

    Nursing students in the present sample who have experienced childhood adversity have a certain level of post-traumatic growth. If introduced into nursing curricula, emotional intelligence interventions may increase emotional coping resources and enhance social skills for nurses, which may benefit their long-term occupational health. As researchers consider personal resilience a strategy for responding to workplace adversity in nurses, resilience building should be incorporated into nursing education. This is a preliminary study that may guide future investigations of the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the special sample of nursing students. Resilience, emotional intelligence and post-traumatic growth may benefit nursing students' careers and personal well-being in clinical work. Developing both their emotional intelligence and resilience may assist their individual post-traumatic growth and enhance their ability to cope with clinical stress. To investigate the relationships among post-traumatic growth, emotional intelligence and psychological resilience in vocational school nursing students who have experienced childhood adversities, a cross-sectional research design with anonymous questionnaires was conducted and self-report data were analysed. The Childhood Adversities Checklist (Chinese version), Posttraumatic Growth Inventory, Emotional Intelligence Scale and the 10-item Connor-Davidson Resilience Scale were used. Survey data were collected from 202 Chinese vocational school nursing students during 2011. Post-traumatic growth was associated with emotional intelligence and psychological resilience. Results indicated a curvilinear relationship between emotional intelligence and post-traumatic growth, and between psychological resilience and post-traumatic growth. Moderate-level emotional intelligence and psychological resilience were most associated with the greatest levels of growth

  11. Gradual Correction of Traumatic Hallux Varus With Metatarsal Hemicallotasis.

    Science.gov (United States)

    Kobayashi, Hayato; Kageyama, Yasunori; Shido, Yoji

    2016-01-01

    Traumatic hallux varus associated with osseous deformity, especially in the case of a decreased distal metatarsal articular angle, is an extremely challenging, but rewarding, deformity to treat. To the best of our knowledge, no previous reports have referred to surgical correction of traumatic hallux varus using first metatarsal hemicallotasis. We report the case of a 54-year-old male with traumatic hallux varus associated with medial subluxation of the second metatarsophalangeal joint and second metatarsocuneiform joint arthrosis. The patient was successfully treated with metatarsal hemicallotasis with medial soft tissue release, a proximal second metatarsal shortening osteotomy, and second metatarsocuneiform joint arthrodesis. After 1 year and 6 months, the correction had been maintained in a suitable position, no discomfort or pain was present, and the patient was completely satisfied with the surgical results. Metatarsal hemicallotasis can safely determine the angle of correction and minimize the risk of avascular necrosis of the metatarsal head even in deformed halluces with previous traumatic injuries and/or surgical treatment. This technique should be indicated only for hallux varus with a decreased distal metatarsal articular angle, an angular-type metatarsal head, and good metatarsophalangeal joint congruence. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Pre-Traumatic Vaccination Intervention: can dissociative symptoms be reduced?

    Science.gov (United States)

    Essar, Nir; Palgi, Yuval; Saar, Ronen; Ben-Ezra, Menachem

    2010-01-01

    The Pre-Traumatic Vaccination Intervention (PTV) has been developed in an attempt to help rescue personnel cope with anticipated and non-anticipated disasters, and to prevent trauma-related mental disorders during and after a traumatogenic exposure. Contrary to the generally accepted approach of treating trauma after it has occurred, the PTV has been designed to be administered prior to the potentially traumatic event. Based on empirical findings, the PTV training techniques were designed to prepare the participants for distressful situations. Trainees were gradually exposed to increasingly severe sights using cognitive-behavioral techniques along with foreseen situations relating to their profession. Various interventions were aimed at normalizing using personal resources and implementing relaxation techniques. The PTV was administrated as part of the Israeli Defense Forces rescue personnel's and military police training courses. The results of an uncontrolled, preliminary study suggest that the intervention reduced the level of dissociation leading to more awareness to the traumatic event's details, less suffering, lower probability of making mistakes, and increased likelihood of returning to normal functioning. Lower dissociation may suggest a lower probability to be diagnosed with post-traumatic stress disorder among rescue personnel.

  13. Anxiety and depression following traumatic limb amputation: a systematic review.

    Science.gov (United States)

    Mckechnie, P S; John, A

    2014-12-01

    Traumatic amputation can result in multiple physical, psychological and socio-economic sequalae. While there has been a significant increase in investment and public profile of the rehabilitation of patients who have experienced traumatic limb amputation, little is known about the prevalence of anxiety and depression, especially in the long term. To determine the association between traumatic limb amputation and anxiety and depression. A literature search of available databases including Cochrane, Medline, Embase, and PsycINFO was performed for relevant studies since 2002. Secondary outcomes included the effect on employment, substance misuse, relationships and quality of life. Randomised control trials, observational studies or reviews which met the inclusion, exclusion and quality criteria. Levels of anxiety and depression are significantly higher than in the general population. Significant heterogeneity exists between studies making meta-analyses inappropriate. Improved rehabilitation is having a positive effect on employment rates. There appears to be no significant effect on substance abuse and relationships. All studies demonstrated high prevalence of anxiety and depression in post-traumatic amputees. No good prospective data exists for levels of anxiety and depression beyond two years of follow up and this should be an area of future study. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  14. Cyber Bullying and Traumatic Experiences: The Impact on Learning Disabilities

    Directory of Open Access Journals (Sweden)

    Agathi Stathopoulou

    2018-03-01

    Full Text Available The aim of our research is to investigate the effects of traumatic experiences that teens with learning disorders had to go through. The sample of our study is consisted of 160 high school students who were referred in a web line evaluation form, due to low school performance. The research tool that was used was ACHENBACH’s self-report questionnaire for children and teenagers and more specifically the subscales for anxiety-depression and depression-withdrawal. Frequencies, percentages of responses and means have been calculated. An analysis of variance (one way anova to assess the differences in the averages of students' responses to the variable "experiencing a traumatic event" was also performed. The results showed that there are significant differences in the level of statistical significance p <0,01 between the means of students who say they have experienced a traumatic event and those who report that they haven’t. Particularly decisive traumatic experience for the students' mentality seems to be the in-school violence received by students and the death of a loved one. Application features that have to do with the cyber bulling are also presented briefly. 

  15. CT and MRI diagnosis of traumatic basal ganglia hemorrhage

    International Nuclear Information System (INIS)

    Wu Shike; Zhang Yalin; Xu Derong; Zou Gaowei; Chen Dan; He Sujun; Zhou Lichao

    2009-01-01

    Objective: To analyze CT and MRI features of traumatic basal ganglia hemorrhage and investigate the diagnostic value. Methods: 21 cases with traumatic basal ganglia hemorrhage diagnosed by clinic, CT and MRI in our hospital were collected in this study Plain CT scan were immediately performed in 21 cases after injury, plain MR scan were performed in 1 to 3 days. 12 cases of them underwent diffusion weighted imagine (DWI). The CT and MRI findings were retrospectively summarized. Results: 8 cases were found with simple traumatic basal ganglia hemorrhage. Complexity of basal ganglia hemorrhage occurred in 13 cases, 6 cases combined with subdural hemorrhage, 3 cases with epidural hematoma, 2 cases with subarachnoid hemorrhage, 6 cases with brain contusion and laceration in other locations, 4 cases with skull fracture. 26 lesions of basal ganglia hematoma were showed in 21 cases, 14 lesions of pallidum hemorrhage in 11 cases confirmed by MR could not be distinguished from calcification at the fast CT scan. 5 more lesions of brain contusion and laceration and 4 more lesions of brain white matter laceration were found by MR. Conclusion: CT in combination with MRI can diagnose traumatic basal ganglia hemorrhage and its complications early, comprehensively and accurately, which plays an important role in the clinical therapy selection and prognosis evaluation. (authors)

  16. Traumatic brain injury and disturbed sleep and wakefulness.

    Science.gov (United States)

    Baumann, Christian R

    2012-09-01

    Traumatic brain injury is a frequent condition worldwide, and sleep-wake disturbances often complicate the course after the injuring event. Current evidence suggests that the most common sleep-wake disturbances following traumatic brain injury include excessive daytime sleepiness and posttraumatic hypersomnia, that is, increased sleep need per 24 h. The neuromolecular basis of posttraumatic sleep pressure enhancement is not entirely clear. First neuropathological and clinical studies suggest that impaired hypocretin (orexin) signalling might contribute to sleepiness, but direct or indirect traumatic injury also to other sleep-wake modulating systems in the brainstem and the mesencephalon is likely. Posttraumatic insomnia may be less common than posttraumatic sleepiness, but studies on its frequency revealed conflicting results. Furthermore, insomnia is often associated with psychiatric comorbidities, and some patients with posttraumatic disruption of their circadian rhythm may be misdiagnosed as insomnia patients. The pathophysiology of posttraumatic circadian sleep disorders remains elusive; however, there is some evidence that reduced evening melatonin production due to traumatic brain damage may cause disruption of circadian regulation of sleep and wakefulness.

  17. Misconceptions on neuropsychological rehabilitation and traumatic brain injury.

    Directory of Open Access Journals (Sweden)

    Alberto García- Molina

    2013-12-01

    Full Text Available There are many misconceptions about traumatic brain injuries, their recovery and outcome; misconceptions that have their origin in a lack of information influenced by the image that the media show of the brain damage. Development. Based on clinical experience, the authors of this essay sets out his personal view on some of the most frequent misconceptions in the field of neuropsychological rehabilitation of traumatic brain injury: 1 All deficits are evident; 2 The recovery depends mainly on the involvement of the patient: more effort, more rapid recovery; 3 Two years after traumatic brain injury there is no possibility of improvement and recovery; and 4 The “miracle” of recovery will occur when is found the appropriate professional or treatment. These and other beliefs may influence directly or indirectly on the recovery process and the expectations placed on it by the families and patients. Conclusions. Provide accurate, clear and honest information, at the right time, helps patients and their families to better understand the deficits, the course of recovery and to adapt to the new reality resulting from a traumatic brain injury.

  18. Endovascular Treatment of Traumatic Pseudoaneurysm Presenting as Intractable Epistaxis

    Science.gov (United States)

    Zhang, Chang wei; You, Chao; Mao, Bo yong; Wang, Chao hua; He, Min; Sun, Hong

    2010-01-01

    Objective To investigate the clinical efficacy of individual endovascular management for the treatment of different traumatic pseudoaneurysms presenting as intractable epistaxis. Materials and Methods For 14 consecutive patients with traumatic pseudoaneurysm presenting as refractory epistaxes, 15 endovascular procedures were performed. Digital subtraction angiography revealed that the pseudoaneurysms originated from the internal maxillary artery in eight patients; and all were treated with occlusion of the feeding artery. In six cases, they originated from the internal carotid artery (ICA); out of which, two were managed with detachable balloons, two with covered stents, one by means of cavity embolization, and the remaining one with parent artery occlusion. All of these cases were followed up clinically from six to 18 months, with a mean follow up time of ten months; moreover, three cases were also followed with angiography. Results Complete cessation of bleeding was achieved in all the 15 instances (100%) immediately after the endovascular therapies. Of the six patients who suffered from ICA pseudoaneurysms, one presented with a permanent stroke and one had an episode of rebleeding requiring intervention. Conclusion In patients presenting with a history of craniocerebral trauma, traumatic pseudoaneurysm must be considered as a differential diagnosis. Individual endovascular treatment is a relatively safe, plausible, and reliable means of managing traumatic pseudoaneurysms. PMID:21076585

  19. The use of antioxidants in the treatment of traumatic brain injury.

    Science.gov (United States)

    Venegoni, Whitney; Shen, Qiuhua; Thimmesch, Amanda R; Bell, Meredith; Hiebert, John B; Pierce, Janet D

    2017-06-01

    The aim of this study was to discuss secondary traumatic brain injury, the mitochondria and the use of antioxidants as a treatment. One of the leading causes of death globally is traumatic brain injury, affecting individuals in all demographics. Traumatic brain injury is produced by an external blunt force or penetration resulting in alterations in brain function or pathology. Often, with a traumatic brain injury, secondary injury causes additional damage to the brain tissue that can have further impact on recovery and the quality of life. Secondary injury occurs when metabolic and physiologic processes alter after initial injury and includes increased release of toxic free radicals that cause damage to adjacent tissues and can eventually lead to neuronal necrosis. Although antioxidants in the tissues can reduce free radical damage, the magnitude of increased free radicals overwhelms the body's reduced defence mechanisms. Supplementing the body's natural supply of antioxidants, such as coenzyme Q10, can attenuate oxidative damage caused by reactive oxygen species. Discussion paper. Research literature published from 2011-2016 in PubMed, CINAHL and Cochrane. Prompt and accurate assessment of patients with traumatic brain injury by nurses is important to ensure optimal recovery and reduced lasting disability. Thus, it is imperative that nurses be knowledgeable about the secondary injury that occurs after a traumatic brain injury and aware of possible antioxidant treatments. The use of antioxidants has potential to reduce the magnitude of secondary injury in patients who experience a traumatic brain injury. © 2017 John Wiley & Sons Ltd.

  20. Exposure to war traumatic experiences, post-traumatic stress disorder and post-traumatic growth among nurses in Gaza.

    Science.gov (United States)

    Shamia, N A; Thabet, A A M; Vostanis, P

    2015-12-01

    What is known on the subject? This study builds on existing research on war-related factors that may affect health-care staff by particularly focusing on trauma exposure in both professional and everyday life, as well as on correlates of later positive psychological changes. What this paper adds to existing knowledge? It shows that one in five nursing staff working in Gaza experienced post-traumatic stress symptoms within the clinical range, 2 years after an incursion on Gaza and after being exposed to substantial trauma during this period. Participants appeared to develop a variety of post-traumatic growth responses following trauma exposure. Although nurses experienced traumatic events both as civilians and in their health-care capacity, personal exposure was strongly associated with PTSD symptoms. What are the implications for practice? Support to nursing and other health-care professionals in war situations should entail different levels, remain available well after an acute conflict, and take into consideration both personal and practice-related traumatic events. Mental health nursing practitioners can play a pivotal role in this. To establish the association between war traumatic experiences, post-traumatic stress disorder (PTSD) symptoms and post-traumatic growth among nurses in the Gaza Strip, 2 years after an incursion on Gaza, and during a period of ongoing trauma exposure. This study builds on existing evidence by considering exposure to personal and work-related traumatic events, and on factors associated with later positive psychological adaptation. The sample consisted of 274 randomly selected nurses in Gaza who completed the Gaza Traumatic Events Checklist, PTSD Checklist, and Posttraumatic Growth Inventory. Of the nurses, 19.7% reported full PTSD. There was a significant relationship between traumatic events and PTSD scores; as well as between community-related traumatic events and post-traumatic growth. Participants reported a range of traumatic

  1. Objective Neuropsychological Deficits in Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury: What Remains Beyond Symptom Similarity?

    Directory of Open Access Journals (Sweden)

    Hélène Pineau

    2014-12-01

    Full Text Available This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD and mild traumatic brain injury (mTBI using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25, mTBI (n = 19, subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD (n = 6 and controls (n = 25. Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.

  2. The longitudinal relationship between post-traumatic stress disorder and perceived social support in survivors of traumatic injury.

    Science.gov (United States)

    Nickerson, A; Creamer, M; Forbes, D; McFarlane, A C; O'Donnell, M L; Silove, D; Steel, Z; Felmingham, K; Hadzi-Pavlovic, D; Bryant, R A

    2017-01-01

    Although perceived social support is thought to be a strong predictor of psychological outcomes following trauma exposure, the temporal relationship between perceived positive and negative social support and post-traumatic stress disorder (PTSD) symptoms has not been empirically established. This study investigated the temporal sequencing of perceived positive social support, perceived negative social support, and PTSD symptoms in the 6 years following trauma exposure among survivors of traumatic injury. Participants were 1132 trauma survivors initially assessed upon admission to one of four Level 1 trauma hospitals in Australia after experiencing a traumatic injury. Participants were followed up at 3 months, 12 months, 24 months, and 6 years after the traumatic event. Latent difference score analyses revealed that greater severity of PTSD symptoms predicted subsequent increases in perceived negative social support at each time-point. Greater severity of PTSD symptoms predicted subsequent decreases in perceived positive social support between 3 and 12 months. High levels of perceived positive or negative social support did not predict subsequent changes in PTSD symptoms at any time-point. Results highlight the impact of PTSD symptoms on subsequent perceived social support, regardless of the type of support provided. The finding that perceived social support does not influence subsequent PTSD symptoms is novel, and indicates that the relationship between PTSD and perceived social support may be unidirectional.

  3. Perceptions of aging among middle-aged offspring of traumatized parents: the effects of parental Holocaust-related communication and secondary traumatization.

    Science.gov (United States)

    Shrira, Amit

    2016-01-01

    Traumatized parents may transmit anxieties of physical deterioration and demise to their offspring. These anxieties can amplify negative perceptions of the aging process when the offspring enter old age. The current study examined how middle-aged offspring of Holocaust survivors (OHS) recount trauma-related communication by their parents, and how these reports are related to offspring's perceptions of their aging process. The study included 450 respondents at the age range of 50-67 (mean age = 57.5, SD = 4.6): 300 OHS and 150 comparisons. Participants reported parental communication of the Holocaust, completed measures of subjective successful aging, aging and death anxieties, and reported secondary traumatization assessing symptoms, developed as a result of a close and continuous relationship with a traumatized parent. Latent profile analysis identified two profiles of parental Holocaust-related communication: intrusive and informative. Offspring who reported intrusive parental communication about the Holocaust perceived themselves as aging less successfully and were more anxious of aging and death than comparisons. Offspring who reported informative parental communication and comparisons did not differ in perceptions of aging. Secondary traumatization mediated these group differences, meaning, intrusive parental communication was related to higher secondary traumatization, which in turn was related to less favorable perceptions of aging. These findings allude to the possibility that secondary traumatization mold negative perceptions of the aging process among middle-aged offspring of traumatized parents. Mental health practitioners may help OHS process fragmented and intrusive remnants of parental trauma, thereby diminishing secondary traumatization, and promoting more adaptive perceptions of aging.

  4. Post-traumatic stress disorder in the perinatal period: A concept analysis.

    Science.gov (United States)

    Vignato, Julie; Georges, Jane M; Bush, Ruth A; Connelly, Cynthia D

    2017-12-01

    To report an analysis of the concept of perinatal post-traumatic stress disorder. Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs. Concept analysis via Walker and Avant's approach. The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder. Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes. Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes. © 2017 John Wiley

  5. Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder.

    Science.gov (United States)

    Lipinska, Malgorzata; Timol, Ridwana; Kaminer, Debra; Thomas, Kevin G F

    2014-06-01

    Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder. © 2014 European Sleep Research Society.

  6. MR neurography in traumatic brachial plexopathy

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyaya, Vaishali, E-mail: vshali77@yahoo.co.in [Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India); Upadhyaya, Divya N. [Department of Plastic Surgery, King George Medical University, Shah Meena Road, Chowk, Lucknow 226 003 (India); Kumar, Adarsh [Department of Plastic Surgery, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India); Gujral, Ratni B. [Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India)

    2015-05-15

    Highlights: • MR neurography is the imaging modality of choice in patients who have sustained brachial plexus injury. It is helpful in determining the level and extent of injury. • The authors have used a Visual Per-operative Scoring system to assess the usefulness of MR neurography in delineating the level and type of the lesion. • The imaging findings were classified based on the level of injury—root, trunk or cord. These findings were correlated with those seen on surgical exploration. A good correlation was found in the majority (65%) of patients and average correlation (30%) in others. - Abstract: Objectives: Imaging of the brachial plexus has come a long way and has progressed from plain radiography to CT and CT myelography to MRI. Evolution of MR imaging sequences has enabled good visualization of the small components of the plexus. The purpose of our study was to correlate the results of MR neurography (MRN) in patients with traumatic brachial plexopathy with their operative findings. We wanted to determine the usefulness of MRN and how it influenced surgical planning and outcome. Methods: Twenty patients with features of traumatic brachial plexopathy who were referred to the MRI section of the Department of Radiology between September 2012 and January 2014 and subsequently underwent exploration were included in the study. MR neurography and operative findings were recorded at three levels of the brachial plexus—roots, trunks and cords. Results: Findings at the level of roots and trunks were noted in 14 patients each and at the level of the cords in 16 patients. 10 patients had involvement at all levels. Axillary nerve involvement as a solitary finding was noted in two patients. These patients were subsequently operated and their studies were assigned a score based on the feedback from the operating surgeons. The MRN study was scored as three (good), two (average) or one (poor) depending on whether the MR findings correlated with operative

  7. Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    H Javidi

    2011-12-01

    Full Text Available Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD. Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack, being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events. PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed “acute PTSD,” otherwise, it is called “chronic PTSD.” 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%–40%; the rate in rescue workers was 10%–20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%–32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%, firefighters (21%, and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults. Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for

  8. Post-traumatic Stress Disorder.

    Science.gov (United States)

    Javidi, H; Yadollahie, M

    2012-01-01

    Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with

  9. Personality Disturbances Associated with Traumatic Brain Injury.

    Science.gov (United States)

    Prigatano, George P.

    1992-01-01

    Reviews personality disturbances associated with traumatic brain injury. Attempts to clarify terms and review empirical findings. Notes that longitudinal prospective studies that use appropriate control groups are needed. Suggests future research may benefit by considering long-term effects of early agitation following traumatic brain injury and…

  10. Traumatic experiences of Kenyan secondary school students ...

    African Journals Online (AJOL)

    Objectives: To describe the traumatic experiences of Kenyan high school students and to determine the levels of Post-traumatic Stress Disorder (PTSD) among them, and in relation ... Method: The students completed questionnaires on sociodemographic data followed by the Trauma Checklist and the Child PTSD Checklist.

  11. Traumatic Bonding: Clinical Implications in Incest.

    Science.gov (United States)

    deYoung, Mary; Lowry, Judith A.

    1992-01-01

    "Traumatic bonding" is defined as "the evolution of emotional dependency between...a child and an adult [in] a relationship characterized by periodic sexual abuse." Maintains that the concept holds promise for explaining confusing dynamics of incest. Demonstrates ways in which traumatic bonding can be applied to cases of incest…

  12. Secondary Traumatic Stress in Substance Abuse Treatment

    Science.gov (United States)

    Bride, Brian E.; Walls, Erin

    2006-01-01

    The terms secondary traumatic stress (STS), vicarious traumatization (VT), and compassion fatigue (CF) have all been used, sometimes interchangeably, to refer to the observation that those who provide clinical services to trauma survivors may themselves experience considerable emotional disruption, becoming indirect victims of the trauma.…

  13. Psychometric properties of the Questionnaire for Secondary Traumatization

    Directory of Open Access Journals (Sweden)

    Katharina Weitkamp

    2014-01-01

    Full Text Available Background: During the past several years, there has been a growing interest in the negative effects that providing therapy may have on therapists. Of special interest is a phenomenon called secondary traumatization, which can arise while working with traumatized clients. To develop a simple screening tool for secondary traumatization, a quantitative assessment instrument was constructed using a data-driven approach based on qualitative interviews with affected trauma therapists as well as experienced supervisors in trauma therapy. Objective: The aim of the current study was to analyze the psychometric properties of the newly developed Questionnaire for Secondary Traumatization (FST acute and lifetime version and to determine the most appropriate scoring procedure. Method: To this end, three independent samples of psychotherapists (n=371, trauma therapists in training (n=80, and refugee counselors (n=197 filled out an online questionnaire battery. Data structure was analyzed using factor analyses, cluster analyses, and reliability analyses. Results: Factor analyses yielded a six-factor structure for both the acute and the lifetime version with only a small number of items loading on differing factors. Cluster analyses suggested a single scale structure of the questionnaire. The FST total score showed good internal consistencies across all three samples, while internal consistency of the six extracted factors was mixed. Conclusion: With the FST, a reliable screening instrument for acute and lifetime secondary traumatization is now available which is free of charge and yields a sum score for quick evaluation. The six-factor structure needs to be verified with confirmatory factor analyses.

  14. Traumatic injuries of the hip.

    LENUS (Irish Health Repository)

    Marshall, Nina

    2009-11-01

    Traumatic lesions of the hip in athletes may be clinically challenging because of the overlap in clinical presentation due to differing pathologies and the presence of multiple injuries. Imaging of the hip in the athlete has undergone a recent resurgence of interest and understanding related to the increasing accessibility and use of hip arthroscopy, which expands the treatment options available for intra-articular pathology. MR imaging and MR arthrography have a unique role in diagnosis of these pathologies, guiding the surgeon, arthroscopist, and referring clinician in their management of bony and soft tissue injury.

  15. A Review on Post-Traumatic Aggression

    Directory of Open Access Journals (Sweden)

    Bahare Dadgari

    2017-08-01

    Full Text Available Traumatic brain injury is the first cause of death and disability in children and young adults in worldwide. During the acute phase of recovery from moderate to severe brain injury, a period of post-traumatic confusion state (PTCS will arise that is a combination of cognitive and behavioral dysfunction. Seven key symptoms of PTCS are identified and measured by Confusion Assessment Protocol (CAP  Agitation can be part of PTCS in the acute phase or, part of the recovery of consciousness in chronic phase. There are different hypothesis and classifications of acute and chronic post-traumatic aggressive syndromes. While post-traumatic aggression is common, its mechanism, assessment tool, outcome and treatment plans are not well-defined. Understanding the different aspects of post-traumatic aggression; mechanism, differential diagnosis, and treatment are reviewed in this article.

  16. [Post traumatic anterior abdominal wall hernia].

    Science.gov (United States)

    Mzoughi, Zeineb; Bayar, Rached; Khmiri, Hamdi; Gharbi, Lassad; Khalfallah, Mohamed Taher

    2016-01-01

    Post traumatic anterior abdominal wall hernia can be ignored in emergency settings. We here report the case of a 32-year-old patient with a BMI of 30 kg/m 2 , suffering from anterior abdominal wall hernia as a result of a road accident. This lesion wasn't detected during clinical examination. Abdominal tomodensitometry showed a defect of 8 cm in the anterior abdominal wall. The patient underwent surgery during which a musculoaponeurotic defect of 12 cm was detected. The repair was carried out using interrupted suture. The postoperative course was marked by a secondarily infected skin necrosis. The evolution was satisfactory after directed cicatrization. At 3 months postoperatively the patient was doing well with a healed wound and a strong abdominal wall.

  17. Brain SPECT in severs traumatic head injury

    International Nuclear Information System (INIS)

    Beaulieu, F.; Eder, V.; Pottier, J.M.; Baulieu, J.L.; Fournier, P.; Legros, B.; Chiaroni, P.; Dalonneau, M.

    2000-01-01

    The aim of this work was to compare the results of the early brain scintigraphy in traumatic brain injury to the long term neuropsychological behavior. Twenty four patients had an ECD-Tc99m SPECT, within one month after the trauma; scintigraphic abnormalities were evaluated according to a semi-quantitative analysis. The neuropsychological clinical investigation was interpreted by a synthetic approach to evaluate abnormalities related to residual motor deficit, frontal behavior, memory and language disorders. Fourteen patients (58%) had sequela symptoms. SPECT revealed 80 abnormalities and CT scan only 31. Statistical analysis of uptake values showed significantly lower uptake in left basal ganglia and brain stem in patients with sequela memory disorders. We conclude that the brain perfusion scintigraphy is able to detect more lesions than CT and that it could really help to predict the neuropsychological behavior after severe head injury. Traumatology could become in the future a widely accepted indication of perfusion SPECT. (authors)

  18. Life satisfaction 6–15 years after a traumatic brain injury

    OpenAIRE

    Jacobsson, Lars; Lexell, Jan

    2013-01-01

    Objectives: To assess satisfaction with life as a whole and 10 domains of life satisfaction in Swedish individuals after a traumatic brain injury, to describe the relationship with demographic, social and injury related variables, and to compare the level of life satisfaction with a Swedish reference sample. Subjects: Fifty-one men and sixteen women, 6-15 years after a traumatic brain injury. Methods: Life Satisfaction Questionnaire (LiSat-11). Results: Many of the participants were, to some ...

  19. The value of pneumo-arthro-CT for the diagnosis of traumatic subluxation of the shoulder

    International Nuclear Information System (INIS)

    Link, J.; Benecke, P.

    1994-01-01

    Traumatic subluxation of the shoulder in young patients may result in reluxation after further injury. 18 patients with traumatic subluxation and 22 patients with recurrent subluxation of the shoulder (after primary trauma) were examined by arthroscopy and pneumo-arthro-CT. This minimally invasive procedure showed high accuracy in the diagnosis of the typical glenoid margin and humoral head abnormalities. Nevertheless, arthroscopy cannot be abandoned for planning suitable operative treatment. (orig.) [de

  20. Use of intraocular lenses in children with traumatic cataract in south India

    OpenAIRE

    Eckstein, M.; Vijayalakshmi, P; Killedar, M.; Gilbert, C.; Foster, A.

    1998-01-01

    AIMS—To assess the long term results of intraocular lens (IOL) implantation for traumatic cataract in young children in a developing country.
METHODS—Prospective hospital based study of 52 children (age 2-10 years) undergoing unilateral cataract extraction and IOL insertion for traumatic cataract performed by a single surgeon in south India. Children were reviewed regularly and followed up initially for 3 years.
RESULTS—There were no serious operative complications. Clinically significant pos...

  1. Indirect exposure to client trauma and the impact on trainee clinical psychologists: Secondary traumatic stress or vicarious traumatization?

    Science.gov (United States)

    Makadia, Rakhee; Sabin-Farrell, Rachel; Turpin, Graham

    2017-09-01

    The study investigated the relationship between exposure to trauma work and well-being (general psychological distress, trauma symptoms, and disrupted beliefs) in trainee clinical psychologists. It also assessed the contribution of individual and situational factors to well-being. A Web-based survey was employed. The survey comprised the General Health Questionnaire, Secondary Traumatic Stress Scale, Trauma and Attachment Belief Scale, Trauma Screening Questionnaire, and specific questions about exposure to trauma work and other individual and situational factors. The link to the online survey was sent via email to trainee clinical psychologists attending courses throughout the UK RESULTS: Five hundred sixty-four trainee clinical psychologists participated. Most trainees had a caseload of one to two trauma cases in the previous 6 months; the most common trauma being sexual abuse. Exposure to trauma work was not related to general psychological distress or disrupted beliefs but was a significant predictor of trauma symptoms. Situational factors contributed to the variance in trauma symptoms; level of stress of clinical work and quality of trauma training were significant predictors of trauma symptoms. Individual and situational factors were also found to be significant predictors of general psychological distress and disrupted beliefs. This study provides support for secondary traumatic stress but lacks evidence to support belief changes in vicarious traumatization or a relationship between exposure to trauma work and general psychological distress. The measurement and validity of vicarious traumatization is discussed along with clinical, theoretical implications, and suggestions for future research. Secondary traumatic stress is a potential risk for trainee clinical psychologists. Training courses should (a) focus on quality of trauma training as it may be protective; (b) advocate coping strategies to reduce stress of clinical work, as the level of stress of

  2. Chronic neck pain patients with traumatic or non-traumatic onset: Differences in characteristics. A cross-sectional study.

    Science.gov (United States)

    Ris, Inge; Juul-Kristensen, Birgit; Boyle, Eleanor; Kongsted, Alice; Manniche, Claus; Søgaard, Karen

    2017-01-01

    for a shorter duration (88 vs. 138 months p=0.001). Participants in the traumatic group showed worse results on all measures compared with those in the non-traumatic group, significantly on neck muscle function (cervical extension mobility p=0.005, cranio-cervical flexion test p=0.007, cervical extensor test p=0.006) and cervical pressure pain threshold bilateral (p=0.002/0.004), as well on self-reported function (Neck Disability Index p=0.001 and Patient-Specific Functional Scale p=0.007), mental quality of life (mental component summary of the Short Form Health Survey p=0.004 and EuroQol-5D p=0.001) and depression (Beck Depression Inventory-II p=0.001). This study showed significant differences between chronic neck pain patients when differentiated into groups based on their onset of pain. However, no specific clinical test or self-reported characteristic could differentiate between the groups at an individual patient level. Pressure pain threshold tests, cervical muscle performance tests and patient-reported characteristics about self-perceived function and psychological factors may assist in profiling chronic neck pain patients. The need for more intensive management of those with a traumatic onset compared with those with a non-traumatic onset should be examined further. Copyright © 2016 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  3. Brain-derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress.

    Science.gov (United States)

    Dretsch, Michael N; Williams, Kathy; Emmerich, Tanja; Crynen, Gogce; Ait-Ghezala, Ghania; Chaytow, Helena; Mathura, Venkat; Crawford, Fiona C; Iverson, Grant L

    2016-01-01

    In addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment. Both pre- and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain-derived neurotropic factor (BDNF) genes. Soldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R (2)  = 0.22, P PTSD scores. These findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat-related traumatic stress in military service members.

  4. Traumatic Abdominal Wall Hernia After a Blunt Trauma: A Case Report

    Directory of Open Access Journals (Sweden)

    Ersin Dumlu

    2014-06-01

    Full Text Available Traumatic abdominal wall hernia is a rare result of blunt abdominal traumas in adults. Altough the detection of the injuries of the abdominal organs is the priority in blunt traumas, abdominal wall defect may also occur in these patients. These hernias can go undetected due to preservation of the skin overlying the hernia defect. Traumatic abdominal wall hernias can have high morbidity and mortality rates due to incarceration and perforation of tubular hollow organs, especially if there is any delay. The possibility of traumatic hernia should always be considered in cases with serious blunt trauma. Computed Tomography (CT scan examinations should be performed routinely due to their high diagnostic value if trumatic hernia is suspected. In this report, a traumatic abdominal wall hernia patient who was treated by surgery has been presented with the review of the current literature.

  5. Chronic Traumatic Brain Injury in Amateur Boxers

    Directory of Open Access Journals (Sweden)

    M. Rahmati

    2008-04-01

    Full Text Available Introduction & objective: Despite of young and adolescence intent to the boxing sport, because of dominant aggression and direct blows contact to head, face and central nervous system, it is continuously criticize by different groups. The groups of sporting and physician conventions are distinguished boxing with physical and neuropsychological disorders and some groups believe that side effects of this sport are not more than other sports. For this base the aim of this study was to determine the chronic traumatic brain injury in a group amateur boxers.Materials & Methods: In a case-control study, three groups of sport men were considered, each group contained 20 randomly selected cases. The first group were amateur boxers with 4 years minimal activity(directly has been presented to the head blows, second group were amateur soccer players with 4 years minimal activity(has been presented to the not very severe head blows, third group were non athlete subjects .The groups were matched in weight, height, age and education .To understand brain disorder interview by medicine method has been used, then Wiskancin, Bonardele, Bender geshtalt, Kim karad visual memory, Benton and wechler memory (Alef type tests has been performed and EEG has got in the same hour and condition.Results: The homogeneity of between group variances was gained by the statistical method. Also between structural–visual abilities neuropsychological aspect in groups, significant difference has been gained (p= 0.000. In Kim karad visual memory test at the mild and long term visual memory deficit, significant differences between three groups was observed (P= 0.000, P=0.009 that least score has been belonged to the boxers. Also in boxers 6 abnormal EEGs is observed.Conclusion: It can be said that of four years amateur boxing can affect on boxers visual and memory perception and their spatial orientation. Additionally our study have showed that amateur boxing has a significant

  6. A study of the traumatic bone cyst

    International Nuclear Information System (INIS)

    Oh, Kyung Ran; Park, Won Kyl; Ko, Jae Kyeung; Kim, Young Jin

    1997-01-01

    Traumatic bone cyst is a pathologic cavity that is not lined with epithelium. It is, therefore, not a true cyst. It may be a normal variant rather than a disease process. The etiology of the condition is unknown. This condition is occurred widely ranging ages(2 to 75 years), however, most are found during the second decade of life. Radiographically, this condition is radiolucent lesion with well-defined outline, scalloping of superior margins. Cyst enucleation and curettage is the treatment of choice. The authors compared and analyzed the clinicoradiologic features of the five cases of traumatic bone cyst, diagnosed at the Dental college hospital in Chosun University, Kwangju, Korea. The five cases were shown the followed results; 1. 3 cases occurred in second decade of life and no significant sex differences (M:F, 2:3) All cases occurred in mandible. 2. Two patients complained symptoms, but three cases had no symptom with encountering during routine examination. 3. In 3 of 5 cases, teeth vitality existed except one tooth and no checking of teeth vitality in two cases. 4. All cases didn't have any accurate trauma history, but one case was in orthodontic treatment, another case was postextraction site area. 5. Radiologically, 'scalloping appearance' were evident in all cases; in 3 cases, multilocular tendency and only one case seen intact mandibular canal image. 6. Histologically, all section showed bone trabeculae with ballistic activity, 2 cases showed no epithelial lining, and other 2 cases were seen inflammatory cell infiltration in edematous tissue. 7. Surgical intervention (curettage) was that treatment of choice.

  7. Computed tomographic findings of traumatic intracranial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seong Wook; Kim, Il Young; Lee, Byung Ho; Kim, Ki Jeoung; Yoon, Il Gyu [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1985-10-15

    Traumatic intracranial lesion has been one of the most frequent and serious problem in neurosurgical pathology. Computed tomography made it possible to get prompt diagnosis and surgical intervention of intracranial lesions by its safety, fastness and accuracy. Computed tomographic scan was carried out on 1309 cases at Soonchunhyang Chunan Hospital for 15 months from October 1983 to December 1984. We have reviewed the computed tomographic scans of 264 patients which showed traumatic intracranial lesion. The result were as follows: 1. Head trauma was the most frequent diagnosed disease using computed tomographic scans (57.8%) and among 264 cases the most frequent mode of injury was traffic accident (73.9%). 2. Skull fracture was accompanied in frequency of 69.7% and it was detected in CT in 38.6%: depression fracture was more easily detected in 81%. 3. Conutercoup lesion (9.5%) was usually accompanied with temporal and occipital fracture, and it appeared in lower incidence among pediatric group. 4. Intracranial lesions of all 264 cases were generalized cerebral swelling (24.6%), subdural hematoma (22.3%), epidural hematoma (20.8%), intracerebral hematoma (6.1%), and subarachnoid hemorrhage (3.0%). 5. The shape of hematoma was usually biconvex (92.7%) in acute epidural hematoma and cresentic (100%) in acute subdural hematoma, but the most chronic the case became, they showed planoconvex and bicconvex shapes. 6. Extra-axial hematoma was getting decreased in density as time gone by. 7. Hematoma density was not in direct proportion to serum hemoglobin level as single factor.

  8. Childhood adversities and post-traumatic stress disorder: evidence for stress sensitisation in the World Mental Health Surveys.

    Science.gov (United States)

    McLaughlin, Katie A; Koenen, Karestan C; Bromet, Evelyn J; Karam, Elie G; Liu, Howard; Petukhova, Maria; Ruscio, Ayelet Meron; Sampson, Nancy A; Stein, Dan J; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Borges, Guilherme; Demyttenaere, Koen; Dinolova, Rumyana V; Ferry, Finola; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Kawakami, Norito; Lee, Sing; Navarro-Mateu, Fernando; Piazza, Marina; Pennell, Beth-Ellen; Posada-Villa, José; Ten Have, Margreet; Viana, Maria Carmen; Kessler, Ronald C

    2017-11-01

    Background Although childhood adversities are known to predict increased risk of post-traumatic stress disorder (PTSD) after traumatic experiences, it is unclear whether this association varies by childhood adversity or traumatic experience types or by age. Aims To examine variation in associations of childhood adversities with PTSD according to childhood adversity types, traumatic experience types and life-course stage. Method Epidemiological data were analysed from the World Mental Health Surveys ( n = 27 017). Results Four childhood adversities (physical and sexual abuse, neglect, parent psychopathology) were associated with similarly increased odds of PTSD following traumatic experiences (odds ratio (OR) = 1.8), whereas the other eight childhood adversities assessed did not predict PTSD. Childhood adversity-PTSD associations did not vary across traumatic experience types, but were stronger in childhood-adolescence and early-middle adulthood than later adulthood. Conclusions Childhood adversities are differentially associated with PTSD, with the strongest associations in childhood-adolescence and early-middle adulthood. Consistency of associations across traumatic experience types suggests that childhood adversities are associated with generalised vulnerability to PTSD following traumatic experiences. © The Royal College of Psychiatrists 2017.

  9. Posttraumatic Stress Disorder in patients with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Schmidt Roger

    2004-03-01

    Full Text Available Abstract Background Severe traumatic stressors such as war, rape, or life-threatening accidents can result in a debilitating psychopathological development conceptualised as Posttraumatic Stress Disorder (PTSD. Pathological memory formation during an alarm response may set the precondition for PTSD to occur. If true, a lack of memory formation by extended unconsciousness in the course of the traumatic experience should preclude PTSD. Methods 46 patients from a neurological rehabilitation clinic were examined by means of questionnaires and structured clinical interviews. All patients had suffered a TBI due to an accident, but varied with respect to falling unconscious during the traumatic event. Results 27% of the sub-sample who were not unconscious for an extended period but only 3% (1 of 31 patients who were unconscious for more than 12 hours as a result of the accident were diagnosed as having current PTSD (P Conclusion TBI and PTSD are not mutually exclusive. However, victims of accidents are unlikely to develop a PTSD if the impact to the head had resulted in an extended period of unconsciousness.

  10. Feasibility of trauma-focused cognitive behavioral therapy for traumatized children in Japan: a Pilot Study.

    Science.gov (United States)

    Kameoka, Satomi; Yagi, Junko; Arai, Yoko; Nosaka, Sachiko; Saito, Azusa; Miyake, Wakako; Takada, Saeko; Yamamoto, Sayaka; Asano, Yasuko; Tanaka, Eizaburo; Asukai, Nozomu

    2015-01-01

    Trauma-focused cognitive behavioral therapy is used to treat children who have experienced traumatic events and suffer from trauma-related disorders. Its effectiveness has been demonstrated in several randomized controlled studies. However, most of these studies have been performed in the United States, with few studies conducted in Asian countries. Therefore, we aimed to evaluate the feasibility of trauma-focused cognitive behavioral therapy in children who have experienced traumatic events and who suffer from trauma-related disorders in Japan. Thirty-five traumatized children (mean age = 10.9 years; range = 3-17 years; 74.3% girls) who received trauma-focused cognitive behavioral therapy were included. The effectiveness of the program was evaluated in each case using the University of California at Los Angeles Post-Traumatic Stress Disorder Reaction Index for DSM-IV for trauma-related symptoms and the Children's Global Assessment Scale for social functioning. Pre- and post-treatment outcome measures were analyzed using two-tailed paired t tests. The results for 35 participants indicate that post-traumatic stress symptoms were significantly improved following therapy [t(35) = 8.27; p cognitive behavioral therapy is feasible for treating traumatized children of an Asian population. We discuss the implications of this result for clinical practice and future research.

  11. Emotion Regulation Strategies, Secondary Traumatic Stress, and Compassion Satisfaction in Healthcare Providers.

    Science.gov (United States)

    Măirean, Cornelia

    2016-11-16

    The aim of the present study is to examine the relationships between two emotion regulation strategies (cognitive reappraisal and expressive suppression), secondary traumatic stress, and compassion satisfaction in a sample of 190 healthcare providers. Another aim of this study is to examine if the relations between emotion regulation strategies and traumatic stress symptoms are moderated by compassion satisfaction. The respondents volunteered to take part in the research and completed self-reporting measures describing the use of emotional regulation strategies, the symptoms of secondary traumatic stress, and the compassion satisfaction. The results revealed negative associations between cognitive reappraisal and secondary traumatic stress, while expressive suppression is positively associated with arousal. Moreover, cognitive reappraisal is positively related to compassion satisfaction, while secondary traumatic stress symptoms are negatively correlated with compassion satisfaction. Furthermore, the relationship between expressive suppression and intrusions is moderated by compassion satisfaction. The implications of these results for enhancing professional quality of life in the context of secondary exposure to traumatic life events are discussed.

  12. Delayed diagnosis of traumatic cervical subluxation in patients with mandibular fractures: a 5-year retrospective study.

    Science.gov (United States)

    Tu, Po-Hsun; Liu, Zhuo-Hao; Yang, Tao-Chieh; Lee, Shih-Tseng; Chen, Jyi-Feng

    2010-11-01

    Mandibular bone fracture associated with traumatic cervical subluxation is a rare injury. The diagnosis of a traumatic cervical subluxation is more easily delayed than other conditions in patients with mandibular bone fractures. The aim of this study is to investigate the incidence of traumatic cervical subluxation associated with mandibular bone fractures. This is a retrospective cohort study of 653 consecutive emergency department patients with mandibular bone fractures investigated for evidence of concomitant traumatic cervical subluxation. This study reports on 7 patients (1.07%) with a diagnosis of traumatic cervical subluxation from a cohort of 653 with mandibular bone fractures as a result of motor vehicle accidents. Two of seven patients had their diagnosis made while in the emergency room, thus, 71.43% of these injuries were discovered on studies done up to 10 days after the trauma, including after surgical correction of the mandibular bone fracture. The importance of a thorough initial examination (both physical and radiologic) and suspicion of traumatic cervical subluxation in patients with mandibular bone fractures is worth emphasizing as delayed diagnosis and management could result in permanent neurologic injury. We suggest dynamic flexion-extension cervical radiographs and thin-slice computerized tomography scans in patients with mandibular fractures routine as an important and routine practice protocol.

  13. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    OpenAIRE

    Deniz Kamacı Şener; Özlem Taşkapılıoğlu; Nermin Kelebek Girgin; Bahattin Hakyemez; Mustafa Bakar; Yakup Tomak

    2012-01-01

    Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  14. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  15. Closed traumatic rupture of the ring finger flexor tendon pulley.

    Science.gov (United States)

    Tropet, Y; Menez, D; Balmat, P; Pem, R; Vichard, P

    1990-09-01

    We report an unusual case of closed traumatic rupture of the ring finger flexor tendon pulley not previously reported in the literature. This injury occurred in a 21-year-old athlete during rockclimbing. Lack of flexion of the distal interphalangeal joint was accompanied by a palpable subcutaneous cord on the palmar side of the proximal phalanx. A simple repair of the pulley was done. The postoperative functional result was satisfactory.

  16. Traumatic degloving lesion of penile and scrotal skin

    Directory of Open Access Journals (Sweden)

    Luiz A. Zanettini

    2005-06-01

    Full Text Available Avulsions of penile and scrotal skin are uncommon events and are caused mainly by accidents with industrial machines and agricultural machine belts. We report the case of a 30-year old patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the cavernous bodies, spongy body, and testes due to an industrial machine accident. Reconstruction was performed in steps, achieving a satisfactory esthetic result, normal voiding and reestablished sexual function.

  17. Chronic traumatic encephalopathy: the dangers of getting "dinged"

    OpenAIRE

    Lakhan, Shaheen E; Kirchgessner, Annette

    2012-01-01

    Chronic traumatic encephalopathy (CTE) is a form of neurodegeneration that results from repetitive brain trauma. Not surprisingly, CTE has been linked to participation in contact sports such as boxing, hockey and American football. In American football getting "dinged" equates to moments of dizziness, confusion, or grogginess that can follow a blow to the head. There are approximately 100,000 to 300,000 concussive episodes occurring in the game of American football alone each year. It is beli...

  18. Treatment of traumatic rupture of the thoracic aorta

    Directory of Open Access Journals (Sweden)

    Davidović Lazar

    2008-01-01

    Full Text Available INTRODUCTION Interest for traumatic thoracic aorta rupture stems from the fact that its number continually increases, and it can be rapidly lethal. OBJECTIVE The aim of this study is to present early and long term results as well as experiences of our team in surgical treatment of traumatic thoracic aorta rupture. METHOD Our retrospective study includes 12 patients with traumatic thoracic aorta rupture treated between 1985 and 2007. There were 10 male and two female patients of average age 30.75 years (18-74. RESULTS In six cases, primary diagnosis was established during the first seven days days after trauma, while in 6 more than one month later. In 11 cases, classical open surgical procedure was performed, while endovascular treatment was used in one patient. Three (25% patients died, while two (16.6% had paraplegia. Nine patients (75% were treated without complications, and are in good condition after a mean follow-up period of 9.7 years (from one month to 22 years. CONCLUSION Surgical treatment requires spinal cord protection to prevent paraplegia, using cardiopulmonary by-pass (three of our cases or external heparin-bonded shunts (five of our cases. Cardiopulmonary by-pass is followed with lower incidence of paraplegia, however it is not such a good solution for patients with polytrauma because of hemorrhage. The endovascular repair is a safe and feasible procedure in the acute phase, especially because of traumatic shock and polytrauma which contributes to higher mortality rate after open surgery. On the other hand, in chronic postrauamatic aortic rupture, open surgical treatment is connected with a lower mortality rate and good long-term results. There have been no published data about long-term results of endovascular treatment in the chronic phase.

  19. Development of Magnetic Resonance Imaging Biomarkers for Traumatic Brain Injury

    Science.gov (United States)

    2014-09-01

    had a benign fibroadenoma lesion in the right breast . A dynamic scan with eight measurements of the BORR-GRE sequence was performed, during which...pulse was implemented in a gradient echo sequence and tested on phantoms, the knee, and the breast . Results: The frequency response of the BORR pulse...clinical applications, such as the eval- uation of traumatic or degenerative cartilaginous lesions (1–3), detection and characterization of breast

  20. [Isolated traumatic dislocation of the extensor carpi ulnaris tendon].

    Science.gov (United States)

    Loty, B; Meunier, B; Mazas, F

    1986-01-01

    The authors describe one case of post-traumatic dislocation of the extensor carpi ulnaris tendon. They found eleven other cases reported in the literature. The type of lesion should be looked for in cases of trauma to the wrist without a bony lesion. The treatment should be surgical when function is impaired, either shortly after the initial trauma or if the dislocation becomes habitual. The aim is to reconstruct a tendon sheath. The results were generally satisfactory.

  1. Traumatic stress in Japanese broadcast journalists.

    Science.gov (United States)

    Hatanaka, Miho; Matsui, Yutaka; Ando, Kiyoshi; Inoue, Kako; Fukuoka, Yoshiharu; Koshiro, Eiko; Itamura, Hidenori

    2010-02-01

    Job-related traumatic stress experienced by broadcast journalists in Japan was investigated. A questionnaire inquiring about the most traumatic event they faced when covering the news and the Impact of Event Scale-Revised (IES-R) were administered to 270 journalist participants working for Japanese news companies. Of these, 6% met the IES-R criterion for potential posttraumatic stress disorder (PTSD). Moreover, posttraumatic stress reactions at the time of the survey were strongly related to symptoms of stress experienced during the stressful assignment. The early assessment of stress symptoms in journalists that experience traumatic news coverage is important for preventing the development of PTSD symptoms.

  2. Post-traumatic stress disorder after childbirth: the phenomenon of traumatic birth

    OpenAIRE

    Reynolds, J L

    1997-01-01

    CHILDBIRTH CAN BE A VERY PAINFUL EXPERIENCE, often associated with feelings of being out of control. It should not, therefore, be surprising that childbirth may be traumatic for some women. Most women recover quickly post partum; others appear to have a more difficult time. The author asserts that post-traumatic stress disorder (PTSD) may occur after childbirth. He calls this variant of PTSD a "traumatic birth experience." There is very little literature on this topic. The evidence available ...

  3. Understanding traumatic blunt cardiac injury.

    Science.gov (United States)

    El-Menyar, Ayman; Al Thani, Hassan; Zarour, Ahmad; Latifi, Rifat

    2012-01-01

    Cardiac injuries are classified as blunt and penetrating injuries. In both the injuries, the major issue is missing the diagnosis and high mortality. Blunt cardiac injuries (BCI) are much more common than penetrating injuries. Aiming at a better understanding of BCI, we searched the literature from January 1847 to January 2012 by using MEDLINE and EMBASE search engines. Using the key word "Blunt Cardiac Injury," we found 1814 articles; out of which 716 articles were relevant. Herein, we review the causes, diagnosis, and management of BCI. In conclusion, traumatic cardiac injury is a major challenge in critical trauma care, but the guidelines are lacking. A high index of suspicion, application of current diagnostic protocols, and prompt and appropriate management is mandatory.

  4. Understanding traumatic blunt cardiac injury

    Directory of Open Access Journals (Sweden)

    Ayman El-Menyar

    2012-01-01

    Full Text Available Cardiac injuries are classified as blunt and penetrating injuries. In both the injuries, the major issue is missing the diagnosis and high mortality. Blunt cardiac injuries (BCI are much more common than penetrating injuries. Aiming at a better understanding of BCI, we searched the literature from January 1847 to January 2012 by using MEDLINE and EMBASE search engines. Using the key word "Blunt Cardiac Injury," we found 1814 articles; out of which 716 articles were relevant. Herein, we review the causes, diagnosis, and management of BCI. In conclusion, traumatic cardiac injury is a major challenge in critical trauma care, but the guidelines are lacking. A high index of suspicion, application of current diagnostic protocols, and prompt and appropriate management is mandatory.

  5. Suicide and Chronic Traumatic Encephalopathy.

    Science.gov (United States)

    Iverson, Grant L

    2016-01-01

    For nearly 80 years, suicidality was not considered to be a core clinical feature of chronic traumatic encephalopathy (CTE). In recent years, suicide has been widely cited as being associated with CTE, and now depression has been proposed to be one of three core diagnostic features alongside cognitive impairment and anger control problems. This evolution of the clinical features has been reinforced by thousands of media stories reporting a connection between mental health problems in former athletes and military veterans, repetitive neurotrauma, and CTE. At present, the science underlying the causal assumption between repetitive neurotrauma, depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive. Epidemiological evidence indicates that former National Football League players, for example, are at lower, not greater, risk for suicide than men in the general population. This article aims to discuss the critical issues and literature relating to these possible relationships.

  6. Finite element investigation of human maxillary incisor under traumatic loading: Static vs dynamic analysis.

    Science.gov (United States)

    Oskui, Iman Z; Hashemi, Ata; Jafarzadeh, Hamid; Kato, Akiko

    2018-03-01

    Traumatic loading is the main form of injury sustained in dental injuries. In spite of the prevalence of dental trauma, little information is available on traumatic dental damage and the evaluation of tooth behavior under traumatic loading. Due to the short period of traumatic loading, at first sight, a dynamic analysis needs to be performed to investigate the dental trauma. However, it was hypothesized that dental traumatic loading could be regarded as quasi-static loading. Thus, the aim of the present study was to examine this hypothesis. Static and dynamic analyses of the human maxillary incisor were carried out under traumatic loading using a 3D finite element method. Also, modal analysis of the tooth model was performed in order to evaluate the assumption of the dental traumatic loading as a quasi-static one. It was revealed that the static analysis of dental trauma is preferred to the dynamic analysis when investigating dental trauma, mainly due to its lower computational cost. In fact, it was shown that including the inertia of the tooth structure does not influence the results of the dental trauma simulation. Furthermore, according to the modal analysis of the tooth structure, it was found that the mechanical properties and geometry of the periodontal ligament play significant roles in the classification of dental traumatic loading as a quasi-static one, in addition to the time duration of the applied load. This paper provides important biomechanical insights into the classification of dental loading as quasi-static, transient or impact loading in future dental studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. NON-TRAUMATIC COMA- INCIDENCE, AETIOLOGY AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Mallikarjun R. Patil

    2017-10-01

    Full Text Available BACKGROUND Acute non-traumatic coma is one of the most common paediatric emergencies, which arouses much anxiety and apprehension in both parents and physicians. Due to heterogeneity of causes in these patients, prediction of outcome is difficult and unfortunately no single clinical, laboratory or electrophysiological parameters singly predict their outcome. Aetiology of nontraumatic coma varies depending on different geographical area. We have attempted to find the incidence, aetiology and outcome and delineate neurological signs to predict the prognosis in this study. The aim of this study is to study the incidence, aetiology and outcome of non-traumatic coma in children. MATERIALS AND METHODS 100 consecutive cases of non-traumatic coma between 5months and 15 years of age were selected for the study. Clinical signs and findings were recorded at admission (‘0’ Hr and after ‘48’ Hrs. of hospital stay. Aetiology of coma is determined on the basis of clinical history, examination and relevant laboratory investigations by the treating physician. These children were followed up till the death in the hospital or discharged from the hospital. Discharged patients were asked for followup after 4 weeks. During this period, all of them were evaluated by formal neurological examination and for special sensory involvement. The neurological outcomes were categorised into 6 groups (I-VI based on the severity of neurological involvement. Chisquare test was applied to determine the predictors of outcome. RESULTS 1. The incidence of non-traumatic coma in our hospital based study was 8.02% of all paediatric admissions and 21.64% of all PICU admissions. 2. CNS infections contributed the majority (58% of cases. (Dengue encephalitis-28%, viral encephalitis-12%, TB meningitis-8%, pyogenic meningitis- 6%, Shigella encephalopathy-3% and cerebral malaria-1%. 3. Other non-infectious aetiologies were toxic and metabolic group- 21%, post status epilepticus- 9

  8. Acute respiratory distress syndrome assessment after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Shahrooz Kazemi

    2016-01-01

    Full Text Available Background: Acute respiratory distress syndrome (ARDS is one of the most important complications associated with traumatic brain injury (TBI. ARDS is caused by inflammation of the lungs and hypoxic damage with lung physiology abnormalities associated with acute respiratory distress syndrome. Aim of this study is to determine the epidemiology of ARDS and the prevalence of risk factors. Methods: This prospective study performed on patients with acute traumatic head injury hospitalization in the intensive care unit of the Shohaday-e Haftom-e-Tir Hospital (September 2012 to September 2013 done. About 12 months, the data were evaluated. Information including age, sex, education, employment, drug and alcohol addiction, were collected and analyzed. The inclusion criteria were head traumatic patients and exclusion was the patients with chest trauma. Questionnaire was designed with doctors supervision of neurosurgery. Then the collected data were analysis. Results: In this study, the incidence of ARDS was 23.8% and prevalence of metabolic acidosis was 31.4%. Most injury with metabolic acidosis was Subarachnoid hemorrhage (SAH 48 (60% and Subdural hemorrhage (SDH was Next Level with 39 (48% Correlation between Glasgow Coma Scale (GCS and Respiratory Distress Syndrome (ARDS were significantly decreased (P< 0.0001. The level of consciousness in patients with skull fractures significantly lower than those without fractures (P= 0.009 [(2.3±4.6 vs (4.02±7.07]. Prevalence of metabolic acidosis during hospitalization was 80 patients (31.4%. Conclusion: Acute respiratory distress syndrome is a common complication of traumatic brain injury. Management and treatment is essential to reduce the mortality. In this study it was found the age of patients with ARDS was higher than patients without complications. ARDS risk factor for high blood pressure was higher in men. Most victims were pedestrians. The most common injury associated with ARDS was SDH. Our analysis

  9. Evaluation of traumatic atlantooccipital dislocations.

    Science.gov (United States)

    Lee, C; Woodring, J H; Goldstein, S J; Daniel, T L; Young, A B; Tibbs, P A

    1987-01-01

    The diagnosis of traumatic atlantooccipital dislocation (AOD) from the cross-table lateral radiograph is difficult because of problems in demonstrating the complex anatomy of this area and the intricate radiographic methods used to diagnose AOD. Although CT or polytomography seem to be the most accurate diagnostic methods, it is often the lateral radiograph from which the diagnosis and further decisions are made. To determine both the best radiographic method for diagnosing AOD from the lateral radiograph and the role of CT and tomography in the diagnosis of AOD, the literature was reviewed concerning how the diagnosis of AOD has been obtained. In addition, the Wholey dens-basion line, the Powers ratio, the Dublin method of diagnosing AOD, and measurement of the atlantooccipital joint width were applied to 12 cases of traumatic AOD; and the Wholey dens-basion line and the Powers ratio were determined in 100 normal adults and 50 normal children. An alternative plain radiographic method for diagnosing AOD was developed, called the X-line method. This was the most accurate of the methods tested, correctly diagnosing AOD in 75% of cases. The Wholey dens-basion line and direct measurement of the atlantooccipital joint width were each correct in 50% of cases, the Powers ratio in 33% of cases, and the Dublin method in only 25% of cases. Ultimately, either CT or polytomography should provide the definitive diagnosis. In this regard high-resolution CT with reformatted coronal and sagittal images generated from 2-mm thin axial slices appeared to have the most promise as the first study of choice.

  10. Disconnection of network hubs and cognitive impairment after traumatic brain injury.

    Science.gov (United States)

    Fagerholm, Erik D; Hellyer, Peter J; Scott, Gregory; Leech, Robert; Sharp, David J

    2015-06-01

    Traumatic brain injury affects brain connectivity by producing traumatic axonal injury. This disrupts the function of large-scale networks that support cognition. The best way to describe this relationship is unclear, but one elegant approach is to view networks as graphs. Brain regions become nodes in the graph, and white matter tracts the connections. The overall effect of an injury can then be estimated by calculating graph metrics of network structure and function. Here we test which graph metrics best predict the presence of traumatic axonal injury, as well as which are most highly associated with cognitive impairment. A comprehensive range of graph metrics was calculated from structural connectivity measures for 52 patients with traumatic brain injury, 21 of whom had microbleed evidence of traumatic axonal injury, and 25 age-matched controls. White matter connections between 165 grey matter brain regions were defined using tractography, and structural connectivity matrices calculated from skeletonized diffusion tensor imaging data. This technique estimates injury at the centre of tract, but is insensitive to damage at tract edges. Graph metrics were calculated from the resulting connectivity matrices and machine-learning techniques used to select the metrics that best predicted the presence of traumatic brain injury. In addition, we used regularization and variable selection via the elastic net to predict patient behaviour on tests of information processing speed, executive function and associative memory. Support vector machines trained with graph metrics of white matter connectivity matrices from the microbleed group were able to identify patients with a history of traumatic brain injury with 93.4% accuracy, a result robust to different ways of sampling the data. Graph metrics were significantly associated with cognitive performance: information processing speed (R(2) = 0.64), executive function (R(2) = 0.56) and associative memory (R(2) = 0.25). These

  11. Identification of traumatic stress reactions in women at increased risk for breast cancer.

    Science.gov (United States)

    Lindberg, Nangel M; Wellisch, David K

    2004-01-01

    It has been shown that the diagnosis and treatment of cancer may constitute a traumatic event that generates in patients and some of their family members traumatic reactions that are consistent with the symptom profile of posttraumatic stress disorder (PTSD). The present study was conducted to establish the degree to which women at increased familial risk for breast cancer showed such traumatic reactions and to establish which demographic or psychological variables may contribute to the experience of such traumatic reactions in at-risk individuals. Seventy-three women from the Revlon UCLA Breast Center High Risk Clinic were assessed for traumatic reactions that might be consistent with the DSM-IV criteria for PTSD. The results showed that women at increased risk for breast cancer exhibited traumatic responses similar to those reported by cancer patients. When the authors used a self-report instrument that maps onto DSM-IV criteria, 4% of the study subjects reported symptoms consistent with criteria for a potential diagnosis of PTSD, and an additional 7% of the subjects reported symptoms consistent with potentially subclinical levels of PTSD, according to DSM-IV criteria.

  12. The Effect of Hemoglobin Levels on Mortality in Pediatric Patients with Severe Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Kevin F. Yee

    2016-01-01

    Full Text Available Objective. There is increasing evidence of adverse outcomes associated with blood transfusions for adult traumatic brain injury patients. However, current evidence suggests that pediatric traumatic brain injury patients may respond to blood transfusions differently on a vascular level. This study examined the influence of blood transfusions and anemia on the outcome of pediatric traumatic brain injury patients. Design. A retrospective cohort analysis of severe pediatric traumatic brain injury (TBI patients was undertaken to investigate the association between blood transfusions and anemia on patient outcomes. Measurements and Main Results. One hundred and twenty patients with severe traumatic brain injury were identified and included in the analysis. The median Glasgow Coma Scale (GCS was 6 and the mean hemoglobin (Hgb on admission was 115.8 g/L. Forty-three percent of patients (43% received at least one blood transfusion and the mean hemoglobin before transfusion was 80.1 g/L. Multivariable regression analysis revealed that anemia and the administration of packed red blood cells were not associated with adverse outcomes. Factors that were significantly associated with mortality were presence of abusive head trauma, increasing PRISM score, and low GCS after admission. Conclusion. In this single centre retrospective cohort study, there was no association found between anemia, blood transfusions, and hospital mortality in a pediatric traumatic brain injury patient population.

  13. Motor performance in physically well-recovered men with traumatic brain injury.

    Science.gov (United States)

    Rinne, Marjo B; Pasanen, Matti E; Vartiainen, Matti V; Lehto, Tommi M; Sarajuuri, Jaana M; Alaranta, Hannu T

    2006-07-01

    The primary aim of this study was to compare the motor performance of physically well-recovered men with traumatic brain injury with that of healthy men. Cross-sectional study in a national rehabilitation centre. Static and dynamic balance, agility and rhythm co-ordination of men with traumatic brain injury (n=34) and healthy controls (n=36) were assessed. Between-group differences in dynamic balance and agility were analysed by analysis of covariance and differences in static balance and rhythm co-ordination by logistic regression analysis. Cut-off points for clinical screening were determined by receiver operating characteristics analyses. Men with traumatic brain injury had impaired balance and agility compared with healthy men and in a rhythm co-ordination test they had difficulties in starting and sustaining simultaneous rhythmical movements of hands and feet. In receiver operating characteristics analyses a running figure-of-eight test (agility), tandem walking forwards (dynamic balance) and rhythm co-ordination test with fast tempo were found the most sensitive and specific for distinguishing between men with traumatic brain injury and the healthy men. The impairments in motor performance of physically well-recovered patients with traumatic brain injury were obvious. The results of this study extend the knowledge of problems in motor performance among patients with traumatic brain injury and provide further information for clinical rehabilitation.

  14. Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain.

    Science.gov (United States)

    Siqveland, J; Ruud, T; Hauff, E

    2017-01-01

    Background : Trauma exposure and post-traumatic stress disorder (PTSD) are risk factors for chronic pain. Objective: This study investigated how exposure to intentional and non-intentional traumatic events and PTSD are related to pain severity and outcome of treatment in chronic pain patients. Methods : We assessed exposure to potentially traumatizing events, psychiatric diagnosis with structured clinical interview, and pain severity in 63 patients at a secondary multidisciplinary pain clinic at the beginning of treatment, and assessed level of pain at follow up. Exposure to potentially traumatizing events and PTSD were regressed on pain severity at the initial session and at follow up in a set of multiple regression analysis. Results : The participants reported exposure to an average of four potentially traumatizing events, and 32% had PTSD. Exposure to intentional traumatic events and PTSD were significantly associated with more severe pain, and PTSD significantly moderated the relationship between trauma exposure and pain (all p < .05). The treatment programme reduced pain moderately, an effect that was unrelated to trauma exposure and PTSD. Conclusions : Trauma exposure is related to chronic pain in the same pattern as to mental disorders, with intentional trauma being most strongly related to pain severity. PTSD moderated the relationship between trauma exposure and pain. While pain patients with PTSD initially report more pain, they responded equally to specialist pain treatment as persons without PTSD.

  15. Intracranial traumatic lesion risk factors in elderly patients with minor head injury

    International Nuclear Information System (INIS)

    Kochi, Masato; Hori, Shigeaki

    2011-01-01

    The authors conducted a retrospective analysis of the risk factors of intracranial traumatic lesions in elderly patients with minor head injury. Sixty-nine elderly patients with Glasgow Coma Scale (GCS) scores of 13-15 after head injury who had presented within 24 hours of trauma and admitted to hospital were included in this study. The indications for admission were a GCS score of 13 or 14 on presentation, loss of consciousness, retrograde or posttraumatic amnesia, local neurological deficit, severe headache and vomiting, dangerous mechanism of injury, skull fracture and abnormal CT findings. The relationship between the clinical findings and intracranial traumatic lesions was analized by univariate and multivariate analysis. The relationship between the clinical findings and surgical intervention was also analized by the same methods in those who had intracranial traumatic lesions. The mean and median age of patients were 81.1 and 83 years, respectively. Of 69 patients, 41 had intracranial traumatic lesions present on their CT scan. Of these, 6 needed surgical intervention. Multivariable logistic regression analysis showed that a Glasgow Coma Scale score of 13 and a loss of consciousness at injury were identified as independent risk factors of intracranial traumatic lesions in elderly patients with minor head injury and a dangerous mechanism of injury was identified as an independent risk factor of surgical intervention in those who had traumatic intracranial lesions. Our results offer useful information for evaluating patients with minor head injury in Japan's aging society. (author)

  16. The prevalence of traumatic brain injury in the homeless community in a UK city.

    Science.gov (United States)

    Oddy, Michael; Moir, Jane Frances; Fortescue, Deborah; Chadwick, Sarah

    2012-01-01

    The main aim of the study was to investigate the prevalence of traumatic brain injury in a sample of homeless individuals. The researchers employed a cross-sectional survey design and contacted 12 organizations providing services for homeless individuals across a city in the UK. The sample included 100 homeless participants (75 males and 25 females) who met the inclusion criteria. A matched control group (n = 100) of individuals who were not homeless was also recruited. A questionnaire was administered to all participants to elicit information relating to history of possible traumatic brain injury. Results indicated that a significantly higher number of homeless participants (48%) reported a history of traumatic brain injury than control participants (21%). Of those homeless participants, 90% indicated they had sustained their first traumatic brain injury before they were homeless. These findings suggest that rates of traumatic brain injury are much higher among the homeless population than in the general population and that sustaining a traumatic brain injury may be a risk factor for homelessness.

  17. Assessment of traumatic dental injuries in patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    A Dubey

    2015-01-01

    Full Text Available Background: Cerebral palsy is an umbrella term for a group of conditions characterized essentially by motor dysfunctions that may be associated with sensory or cognitive impairment. Such children tend to have a higher incidence of traumatic dental injuries than the general population. This increased incidence is often attributed to poor muscular co-ordination that predisposes individuals with Cerebral palsy to trauma Aim: The study was conducted to assess different dental injuries and the risk factors for dental trauma to occur in patients with cerebral palsy. Materials and Methods: The study comprised 70 children and adolescents with cerebral palsy attending special school in Durg and Bhilai city between 7 and 18 years of age. Results: Dentinal fracture was seen in 40% of cases. Few cases had tooth displacement, discoloration, and pulpal involvement. Conclusion: Dentists should be well aware of the possible dental injuries in such patients. Preventive measure measures should be taken by health care provider to reduce traumatic exposure.

  18. Secondary traumatic stress and vicarious trauma: a validational study.

    Science.gov (United States)

    Jenkins, Sharon Rae; Baird, Stephanie

    2002-10-01

    Vicarious trauma (VT) and secondary traumatic stress (STS) or compassion fatigue both describe effects of working with traumatized persons on therapists. Despite conceptual similarities, their emphases differ: cognitive schemas vs. posttraumatic symptoms and burnout, respectively. The TSI Belief Scale (TSI-BSL) measures VT; the Compassion Fatigue Self-Test (CFST) for Psychotherapists measures STS. Neither has substantial psychometric evidence yet, nor has their association been studied. Results for 99 sexual assault and domestic violence counselors show concurrent validity between TSI-BSL and CFST, moderate convergence with burnout but useful discrimination, and strong convergence with general distress, but adequate independent shared variance. Counselors with interpersonal trauma histories scored higher on CFST, but not TSI-BSL or burnout, consistent with the CFST's emphasis on trauma symptomatology.

  19. Post-Traumatic Stress Disorder - Multiple Languages

    Science.gov (United States)

    ... Section Iraqi Health Outreach Project: Post Traumatic Stress Disorder - Sudanese Arabic (Sudanese (Arabic dialect)) Bilingual PDF Heartland Alliance Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  20. Traumatic intrusions as 'worse case scenario's'.

    Science.gov (United States)

    Merckelbach, H; Muris, P; Horselenberg, R; Rassin, E

    1998-11-01

    While some clinicians assume that traumatic intrusions are historically accurate revisualizations of traumatic incidents, others have suggested that these types of intrusions may represent a worse case scenario (i.e. exaggerated) version of the trauma. To explore this issue, a survey was conducted among undergraduate students (N = 189). Of the 69 respondents who had been the victim of or witness to a relatively recent trauma, 15 (22%) reported an exaggerated perception of the traumatic incident. Exaggerated intrusions were found to have more flashback qualities and tended to have a higher frequency than 'realistic' intrusions. These findings are well in line with the idea that intrusions are not necessarily veridical copies of traumatic events.

  1. Traumatic Brain Injury: Hope Through Research

    Science.gov (United States)

    ... a traumatic brain injury, marked by difficulty with perception, thinking, remembering, and concentration; during this acute stage, ... of nerve cells in the brain causing strange sensations, emotions, and behavior, or sometimes convulsions, muscle spasms, ...

  2. Traumatic Brain Injury (TBI) in Kids

    Science.gov (United States)

    ... Information Share Facebook Twitter Pinterest Email Print Traumatic Brain Injury (TBI): Condition Information What is TBI? TBI ... external force that affects the functioning of the brain. It can be caused by a bump or ...

  3. Dysautonomia after severe traumatic brain injury.

    NARCIS (Netherlands)

    Hendricks, H.T.; Heeren, J.H.M.; Vos, P.E.

    2010-01-01

    BACKGROUND: Dysautonomia after traumatic brain injury (TBI) is characterized by episodes of increased heart rate, respiratory rate, temperature, blood pressure, muscle tone, decorticate or decerebrate posturing, and profuse sweating. This study addresses the incidence of dysautonomia after severe

  4. Interventional therapy of traumatic pseudoaneurysms in internal carotid artery siphon

    International Nuclear Information System (INIS)

    Tang Jun; Shang Jianqiang; Chen Jie; Li Fengxin; Liu Yanjun

    2007-01-01

    Objective: To determine the methods and results of treating traumatic pseudoaneurysms in siphon segment of internal carotid artery (ICA)by interventional therapy. Methods: Twelve cases of traumatic pseudoaneurysms in siphon segment of internal carotid artery were treated. The collateral circulation of Willis circle was observed after DSA. Different methods of treatment were applied according to the collateral circulation of Willis circle. Ten cases were treated by occlusion of ICA completely, 1 case was embolized by guglielmi detachable coil (GDC) only. Results: Nine of 12 treated by occlusion of ICA were cured. In the 3 cases who had poor collateral of Willis circle, one was cured by GDC embolization alone; one died 48 hours later after ICA occlusion though his consciousness and the activity of extremities were normal during the temporary balloon test occlusion (BTO) of ICA. One died during the training to improve the collateral of the Willis circle. Conclusion: ICA embolization is feasible for treatment of traumatic pseudoaneurysms in siphon segment of internal carotid artery after evaluating the collateral circulation of Willis circle. (authors)

  5. Traumatic Hyphaema: A report of 472 consecutive cases

    Directory of Open Access Journals (Sweden)

    Ashaye Adeyinka O

    2008-11-01

    Full Text Available Abstract Background Strategies for prevention of eye injuries require knowledge of the cause of the injuries. This study was done to determine the patient characteristics, the cause of injury, and where cases of traumatic hyphaema that necessitated admission to a tertiary hospital occurred. This may enable an appropriate intervention in the prevention of such injuries. Methods Retrospective case analysis of 472 patients with traumatic hyphaema admitted to the University College Hospital, Ibadan between January 1997 and December 2006. Results The home was the single most frequent place of injury for all cases and for 75% of cases in children aged 0–10 years. Injuries that occurred at school comprised about one-fifth of cases. Sport-related injuries were uncommon. The most common activities preceeding injuries were play, corporal punishment and assault. Stones, sticks and whiplash were the agents that caused traumatic hyphaema. Occupational-related hyphaema that caused injuries was mostly in farmers and artisans, few of whom used protective goggles. The majority of patients were males. Children and young adults aged ≤ 20 years comprised 63.6% of patients. A total of 336 (76% eyes had at least one surgical intervention. While 298 (73.2% patients had visual acuity (VA less than 6/60 at presentation, 143 (37.0% of eyes had visual acuity (VA Conclusion The injuries leading to traumatic hyphaema occur mostly at home and school, and frequently affect children and young adolescents. Over one-third resulted in blindness in the affected eye. The focus should be on prevention of stick-related eye injuries at these locations and improving access to eye health services for patients who sustained eye injuries.

  6. Feature: Post Traumatic Stres Disorder PTSD: NIH Research to Results

    Science.gov (United States)

    ... to sudden loud sounds—in those treated with "virtual reality" (VR) exposure therapy. The VR therapy combines traditional therapy and exposure via VR technology that depicts scenes such as a Humvee on ...

  7. Gene Therapy for Post-Traumatic Osteoarthritis

    Science.gov (United States)

    2015-10-01

    Osteoarthritis (OA) Gene Therapy Equine Adeno-Associated Virus (AAV) Interleukin-1 Receptor Antagonist (IL-1Ra) Post-traumatic OA (PTOA) Self...AD______________ AWARD NUMBER: W81XWH-14-1-0498 TITLE: Gene Therapy for Post-Traumatic Osteoarthritis PRINCIPAL INVESTIGATOR: Steven C...COVERED 30Sept 2014 - 29 Sept 2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Gene Therapy for Posttraumatic Osteoarthritis 5b. GRANT NUMBER

  8. Prediction of Clinically Important Traumatic Brain Injury in Pediatric Minor Head Trauma; proposing Pediatric Traumatic Brain Injury (PTBI Prognostic Rule

    Directory of Open Access Journals (Sweden)

    Babak Nakhjavan-Shahraki

    2017-01-01

    Full Text Available Background: The present study assesses independent predictors of clinically important traumatic brain injury (ciTBI in order to design a prognostic rule for identification of high risk children with mild head injury. Materials and Methods: In a retrospective cross-sectional study, 3,199 children with mild traumatic brain injury (TBI brought to emergency ward of three hospitals in Tehran, Iran were gathered, from April 2014 to April 2016. The associations between probable predictors of ciTBI in children with mild TBI were assessed and a prediction rule for identification of high risk children in need of computed tomography (CT scan was designed based on a stepwise multivariate logistic regression. Results: 592 (18.5% children had ciTBI. History of loss of conciseness (odds ratio [OR]=3.0; p

  9. Relation between resiliency and post-traumatic growth in a group of paramedics: The mediating role of coping strategies

    Directory of Open Access Journals (Sweden)

    Nina Ogińska-Bulik

    2015-08-01

    Full Text Available Objectives: The purpose of the research is to investigate the mediating role of coping strategies for stress in the relation between resiliency and post-traumatic growth in a group of paramedics. Material and Methods: Data of 80 paramedics who have experienced traumatic event at their worksites was analyzed. The age range of the participants was 21–67 years old (mean: 35.47, standard deviation: 10.21. The Post-traumatic Growth Inventory, the Assessment Resiliency Scale and Inventory to Measure Coping Strategies for Stress – Mini-Cope were used in the study. Results: Venting of negative emotions and denial appeared as suppressors in analyzing the relation, while planning plays mediating role between resiliency and post-traumatic growth. Conclusions: In the process of post-traumatic growth, both avoidance and problem-focused strategies are important. Moreover, controlling such strategies as Venting and Denial may result in a high level of posttraumatic growth in the study group. The data supports that resiliency may have direct or indirect impact on post-traumatic changes. The results allow to understand the mechanisms of resiliency better, that relationship with post-traumatic growth is ambiguous.

  10. Prevalence rate of post-traumatic stress disorders (PTSD and other psychological disorders among Saudi firefighters

    Directory of Open Access Journals (Sweden)

    Mohammed Alghamd

    2013-08-01

    Full Text Available Background: Firefighters have a high probability of being exposed to a variety of traumatic events. Potentially traumatic events can occur during a single rescue such as: providing aid to seriously injured or helpless victims. Moreover, firefighters who are injured in the line of duty may have to retire as a consequence of their injury. The psychological cost of this exposure may increase the risk of long-term problems, such as post-traumatic stress disorder (PTSD symptoms, depression, and anxiety. Objective: The purpose of this study was to investigate the prevalence of PTSD symptoms, depression, anxiety, and assess related variables such as coping strategies and social support among Saudi firefighters. Method: Two hundred firefighters completed the Fire-fighter Trauma History Screen (FTHS to measure the number of traumatic events, Screen for Post-traumatic Stress Symptoms (SPTSS scale to assess the prevalence of PTSD symptoms, Hospital Anxiety and Depression Scales (HADS to assess depression and anxiety, Brief Cope (BC scale to measure coping strategies used, and Social Support scale was used to evaluate the firefighter's support received. Results: The results showed that 84% (169/200 of firefighters were exposed to at least one traumatic event. The result presented that 57% (96/169 of exposure firefighters fully met the DSM-IV criteria for PTSD with high levels of depression and anxiety; 39% (66/169 partially met the PTSD criteria. However, only 4% participants have not met the PTSD criteria. The results also revealed that adaptive coping strategies and higher perceived social support was associated with lower levels of PTSD. Conclusion: The high prevalence rate of PTSD related to the type and severity of the traumatic events and years of experience in the job. Accordingly, many firefighters were severely affected by their experiences, and we should be developing methods to help them.

  11. Rehabilitation of persons with traumatic brain injury.

    Science.gov (United States)

    The objective of this NIH Consensus Statement is to inform the biomedical research and clinical practice communities of the results of the NIH Consensus Development Conference on Rehabilitation of Persons with Traumatic Brain Injury. The statement provides state-of-the-art information regarding effective rehabilitation measures for persons who have suffered a traumatic brain injury (TBI) and presents the conclusions and recommendations of the consensus panel regarding these issues. In addition, the statement identifies those areas that deserve further investigation. Upon completion of this educational activity, the reader should possess a clear working clinical knowledge of the state of the art regarding this topic. The target audience for this statement includes, but is not limited to, pediatricians, family practitioners, internists, neurologists, physiatrists, psychologists, and behavioral medicine specialists. Participants were a non-Federal, nonadvocate, 16-member panel representing the fields of neuropsychology, neurology, psychiatry, behavioral medicine, family medicine, pediatrics, physical medicine and rehabilitation, speech and hearing, occupational therapy, nursing, epidemiology, biostatistics and the public. In addition, 23 experts from these same fields presented data to the panel and a conference audience of 883. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. A compendium of evidence was prepared by the panel which included a contribution from a patient with TBI, a report from an Evidence Based Practice Center of the Agency for Health Care Policy and Research, and a report from the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined

  12. Patients "At Risk" of Suffering from Persistent Complaints after Mild Traumatic Brain Injury: The Role of Coping, Mood Disorders, and Post-Traumatic Stress.

    Science.gov (United States)

    Scheenen, Myrthe E; Spikman, Jacoba M; de Koning, Myrthe E; van der Horn, Harm J; Roks, Gerwin; Hageman, Gerard; van der Naalt, Joukje

    2017-01-01

    Although most patients recover fully following mild traumatic brain injury (mTBI), a minority (15-25%) of all patients develop persistent post-traumatic complaints (PTC) that interfere with the resumption of previous activities. An early identification of patients who are at risk for PTC is currently performed by measuring the number of complaints in the acute phase. However, only part of this group will actually develop persisting complaints, stressing the need for studies on additional risk factors. This study aimed to compare this group of patients with many complaints with patients with few and no complaints to identify potential additional discriminating characteristics and to evaluate which of these factors have the most predictive value for being at risk. We evaluated coping style, presence of psychiatric history, injury characteristics, mood-related symptoms, and post-traumatic stress. We included 820 patients (Glasgow Coma Scale [GCS] score 13-15) admitted to three level-1 trauma centers as part of the UPFRONT-study. At 2 weeks after injury, 60% reported three or more complaints (PTC-high), 25% reported few complaints (PTC-low), and 15% reported no complaints (PTC-zero). Results showed that PTC-high consisted of more females (78% vs. 73% and 52%, p traumatic stress (37% vs. 27% and 19%, p traumatic stress symptoms had the highest predictive value and should be taken into account in the identification of at-risk patients for future treatment studies.

  13. Neuroglobin-overexpression reduces traumatic brain lesion size in mice

    Directory of Open Access Journals (Sweden)

    Zhao Song

    2012-06-01

    Full Text Available Abstract Background Accumulating evidence has demonstrated that over-expression of Neuroglobin (Ngb is neuroprotective against hypoxic/ischemic brain injuries. In this study we tested the neuroprotective effects of Ngb over-expression against traumatic brain injury (TBI in mice. Results Both Ngb over-expression transgenic (Ngb-Tg and wild-type (WT control mice were subjected to TBI induced by a controlled cortical impact (CCI device. TBI significantly increased Ngb expression in the brains of both WT and Ngb-Tg mice, but Ngb-Tg mice had significantly higher Ngb protein levels at the pre-injury baseline and post-TBI. Production of oxidative tissue damage biomarker 3NT in the brain was significantly reduced in Ngb-Tg mice compared to WT controls at 6 hours after TBI. The traumatic brain lesion volume was significantly reduced in Ngb Tg mice compared to WT mice at 3 weeks after TBI; however, there were no significant differences in the recovery of sensorimotor and spatial memory functional deficits between Ngb-Tg and WT control mice for up to 3 weeks after TBI. Conclusion Ngb over-expression reduced traumatic lesion volume, which might partially be achieved by decreasing oxidative stress.

  14. Traumatic hyphaema: a report of 472 consecutive cases.

    Science.gov (United States)

    Ashaye, Adeyinka O

    2008-11-26

    Strategies for prevention of eye injuries require knowledge of the cause of the injuries. This study was done to determine the patient characteristics, the cause of injury, and where cases of traumatic hyphaema that necessitated admission to a tertiary hospital occurred. This may enable an appropriate intervention in the prevention of such injuries. Retrospective case analysis of 472 patients with traumatic hyphaema admitted to the University College Hospital, Ibadan between January 1997 and December 2006. The home was the single most frequent place of injury for all cases and for 75% of cases in children aged 0-10 years. Injuries that occurred at school comprised about one-fifth of cases. Sport-related injuries were uncommon. The most common activities preceding injuries were play, corporal punishment and assault. Stones, sticks and whiplash were the agents that caused traumatic hyphaema. Occupational-related hyphaema that caused injuries was mostly in farmers and artisans, few of whom used protective goggles. The majority of patients were males. Children and young adults aged school, and frequently affect children and young adolescents. Over one-third resulted in blindness in the affected eye. The focus should be on prevention of stick-related eye injuries at these locations and improving access to eye health services for patients who sustained eye injuries.

  15. The effect of previous traumatic injury on homicide risk.

    Science.gov (United States)

    Griffin, Russell L; Davis, Gregory G; Levitan, Emily B; MacLennan, Paul A; Redden, David T; McGwin, Gerald

    2014-07-01

    Research has reported that a strong risk factor for traumatic injury is having a previous injury (i.e., recidivism). To date, the only study examining the relationship between recidivism and homicide reported strong associations, but was limited by possible selection bias. The current matched case-control study utilized coroner's data from 2004 to 2008. Subjects were linked to trauma registry data to determine whether the person had a previous traumatic injury. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between homicide and recidivism. Homicide risk was increased for those having a previous traumatic injury (OR 1.81, 95% CI 1.09-2.99) or a previous intentional injury (OR 2.53, 95% CI 1.24-5.17). These results suggest an association between homicide and injury recidivism, and that trauma centers may be an effective setting for screening individuals for secondary prevention efforts of homicide through violence prevention programs. © 2014 American Academy of Forensic Sciences.

  16. Post-Traumatic Stress Symptoms in Pediatric Heart Transplant Recipients.

    Science.gov (United States)

    Evan, Elana E; Patel, Payal A; Amegatcher, Alison; Halnon, Nancy

    2014-04-26

    Traumatic experiences are not unusual in pediatric heart transplant (HT) recipients before and after transplantation. Post-traumatic stress symptoms (PTSS) present at the time of transplant evaluation and developing afterward occur with an unknown frequency. We sought to determine the burden of these symptoms in heart transplant patients. We reviewed 51 consecutive HTs between 2003-2007, including 40 primary transplants and 11 re-transplants. Symptoms were present in 17 of the 51 patients (34%) at the time of orthotopic heart transplantation evaluation. None met the criteria for full post traumatic stress disorder. Transplant complications were examined. Nineteen subjects of the total sample had rejection in the first year following transplant. Rejection rates in the first year was 41% for those with PTSS (7 of 17 patients) and 36% for those without (12 of 33 patients) (P=n.s). Of those patients presenting for a second heart transplant, 55% had PTSS at the time of transplant evaluation and/or the peritransplant period; whereas, (28%) undergoing a primary transplant had PTSS. In addition to symptoms resulting from the disease process leading to HT and other prior experiences, the HT itself seems to present a large psychiatric burden on patients. All patients need to be followed before and after HT for signs and symptoms related to PTSS. Future studies should be undertaken to determine if preventative detection and treatment of patients with these PTSS symptoms early can lead to better outcomes.

  17. Traumatic injury among drywall installers, 1992 to 1995.

    Science.gov (United States)

    Chiou, S S; Pan, C S; Keane, P

    2000-11-01

    This study examined the traumatic-injury characteristics associated with one of the high-risk occupations in the construction industry--drywall installers--through an analysis of the traumatic-injury data obtained from the Bureau of Labor Statistics. An additional objective was to demonstrate a feasible and economic approach to identify risk factors associated with a specific occupation by using an existing database. An analysis of nonfatal traumatic injuries with days away from work among wage-and-salary drywall installers was performed for 1992 through 1995 using the Occupational Injury and Illness Survey conducted by the Bureau of Labor Statistics. Results from this study indicate that drywall installers are at a high risk of overexertion and falls to a lower level. More than 40% of the injured drywall installers suffered sprains, strains, and/or tears. The most frequently injured body part was the trunk. More than one-third of the trunk injuries occurred while handling solid building materials, mainly drywall. In addition, the database analysis used in this study is valid in identifying overall risk factors for specific occupations.

  18. Risk factors and outcomes associated with post-traumatic headache after mild traumatic brain injury

    NARCIS (Netherlands)

    Yilmaz, Tansel; Roks, Gerwin; de Koning, Myrthe; Scheenen, Myrthe; van der Horn, Harm; Plas, Gerben; Hageman, Gerard; Schoonman, Guus; Spikman, Jacoba; van der Naalt, Joukje

    2017-01-01

    Objectives: To determine the prevalence and potential risk factors of acute and chronic post-traumatic headache (PTH) in patients with mild to moderate traumatic brain injury (TBI) in a prospective longitudinal observational multicentre study. Acute PTH (aPTH) is defined by new or worsening of

  19. Classroom Strategies for Teaching Veterans with Post-Traumatic Stress Disorder and Traumatic Brain Injury

    Science.gov (United States)

    Sinski, Jennifer Blevins

    2012-01-01

    Postsecondary institutions currently face the largest influx of veteran students since World War II. As the number of veteran students who may experience learning problems caused by Post-Traumatic Stress Disorder and/or Traumatic Brain Injury continues to rise, the need for instructional strategies that address their needs increases. Educators may…

  20. Chronic neck pain patients with traumatic or non-traumatic onset

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Juul-Kristensen, Birgit; Boyle, Eleanor

    2017-01-01

    Background and aims Patients with chronic neck pain can present with disability, low quality of life, psychological factors and clinical symptoms. It is unclear whether patients with a traumatic onset differ from those with a non-traumatic onset, by having more complex and severe symptoms....... The purpose of this study was to investigate the clinical presentation of chronic neck pain patients with and without traumatic onset by examining cervical mobility, sensorimotor function, cervical muscle performance and pressure pain threshold in addition to the following self-reported characteristics......: quality of life, neck pain and function, kinesiophobia, depression, and pain bothersomeness. Methods This cross-sectional study included 200 participants with chronic neck pain: 120 with traumatic onset and 80 with non-traumatic onset. Participants were recruited from physiotherapy clinics in primary...

  1. Transtorno de estresse pós-traumático como acidente de trabalho em um bancário: relato de um caso Trastorno por estrés postraumático como accidente laboral en un bancario: relato de caso Post-traumatic stress disorder as a result of occupational injury: the case of a bank employee

    Directory of Open Access Journals (Sweden)

    Erika Bucasio

    2005-04-01

    .This article reports the case of a bank manager assessed by a multidisciplinary team using psychiatric and occupational history taking and a semi-structured interview (SCID for post-traumatic stress disorder (PTSD. The aim of this article is to use a clinical case to illustrate the relationship between PTSD and traumatic events in the workplace, showing that PTSD may result from an occupational injury. The notion of PTSD as an occupational disease is a new and relevant concept due to high levels of violence in Brazil. Acknowledging PTSD in the context of bank workers is important to guide health services, administrators, and human resource professionals in applying preventive measures (appropriate training, psychological support, filling out of Work Injury Reports and interventions in the organization of work that will provide improved quality of life.

  2. Visual problems associated with traumatic brain injury.

    Science.gov (United States)

    Armstrong, Richard A

    2018-02-28

    Traumatic brain injury (TBI) and its associated concussion are major causes of disability and death. All ages can be affected but children, young adults and the elderly are particularly susceptible. A decline in mortality has resulted in many more individuals living with a disability caused by TBI including those affecting vision. This review describes: (1) the major clinical and pathological features of TBI; (2) the visual signs and symptoms associated with the disorder; and (3) discusses the assessment of quality of life and visual rehabilitation of the patient. Defects in primary vision such as visual acuity and visual fields, eye movement including vergence, saccadic and smooth pursuit movements, and in more complex aspects of vision involving visual perception, motion vision ('akinopsia'), and visuo-spatial function have all been reported in TBI. Eye movement dysfunction may be an early sign of TBI. Hence, TBI can result in a variety of visual problems, many patients exhibiting multiple visual defects in combination with a decline in overall health. Patients with chronic dysfunction following TBI may require occupational, vestibular, cognitive and other forms of physical therapy. Such patients may also benefit from visual rehabilitation, including reading-related oculomotor training and the prescribing of spectacles with a variety of tints and prism combinations. © 2018 Optometry Australia.

  3. Prolonged grief and post-traumatic stress among relatives of missing persons and homicidally bereaved individuals : A comparative study

    NARCIS (Netherlands)

    Lenferink, Lonneke I M; van Denderen, Mariëtte Y; de Keijser, Jos; Wessel, Ineke; Boelen, Paul A

    BACKGROUND: Traumatic loss (e.g., homicide) is associated with elevated prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD). Several studies comparing relatives of missing persons with homicidally bereaved individuals showed inconsistent results about the difference in PGD- and

  4. The classic metaphyseal lesion and traumatic injury

    International Nuclear Information System (INIS)

    Thackeray, Jonathan D.; Wannemacher, Jacob; Adler, Brent H.; Lindberg, Daniel M.

    2016-01-01

    It is widely accepted that the classic metaphyseal lesion (CML) is a traumatic lesion, strongly associated with abuse in infants. Nevertheless, various non-traumatic origins for CMLs continue to be suggested in medical and legal settings. No studies to date systematically describe the association of CMLs with other traumatic injuries. The primary objective of this study is to examine the association of CMLs with other traumatic injuries in a large data set of children evaluated for physical abuse. This was a retrospectively planned secondary analysis of data from a prospective, observational study of children <120 months of age who underwent evaluation by a child abuse physician. For this secondary analysis, we identified all children ≤12 months of age with an identified CML and determined the number and type of additional injuries identified. Descriptive analysis was used to report frequency of additional traumatic injuries. Among 2,890 subjects, 119 (4.1%) were identified as having a CML. Of these, 100 (84.0%) had at least one additional (non-CML) fracture. Thirty-three (27.7%) had traumatic brain injury. Nearly half (43.7%) of children had cutaneous injuries. Oropharyngeal injuries were found in 12 (10.1%) children. Abdominal/thoracic injuries were also found in 12 (10.1%) children. In all, 95.8% of children with a CML had at least one additional injury; one in four children had three or more categories of injury. CMLs identified in young children are strongly associated with traumatic injuries. Identification of a CML in a young child should prompt a thorough evaluation for physical abuse. (orig.)

  5. Cerebral vasospasm following traumatic subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Bahram Aminmansour

    2009-11-01

    Full Text Available

    • Background: Cerebral vasospasm is a preventable cause of death and disability in patients who experience aneurysmal subarachnoid hemorrhage (SAH. The aim of this study is to investigate the incidence of cerebral vasospasm following traumatic SAH and its relationship with different brain injuries and severity of trauma.
    • Methods: This cross-sectional study was conducted from October 2006 to March 2007 in department of Neurosurgery in Al-Zahra Hospital. Consecutive head-injured patients who had SAH on the basis of an admission CT scan were prospectively evaluated. The severity of the trauma was evaluated by determining Glasgow Coma Scale (GCS score on admission. Transcranial Doppler ultrasonography evaluations were performed at least 48 hours after admission and one week thereafter. Vasospasm in the MCA and ACA was defined by mean flow velocity (FV of more than 120 cm/sec with a Lindegaard index (MVA/ICA FV ratio higher than 3. Basilar artery vasospasm was defined by FV higher than 85 cm/sec.
    • Results: Seventy seven patients with tSAH were enrolled from whom 13 were excluded. The remaining were 52 (81.2% men and 12 (18.7% women, with a mean age of 37.89 years. Trauma was severe in 11 (17.2%, moderate in 13 (20.3%, and mild in 40 (62.5% patients. From all, 27 patients (42.1% experienced at least one vasospasm during the study period and MCA vasospasm was the most common in the first and second weeks (55.5%.
    • Conclusions: Traumatic SAH is associated with a high incidence of cerebral vasospasm with a higher probability in patients with severe TBI.
    • Keywords: Cerebral Vasospasm, Subarachnoid Hemorrhage, Trauma, Traumatic Brain Injury.
  1. Clinical and radiological differences between traumatic and idiopathic coccygodynia.

    Science.gov (United States)

    Kim, N H; Suk, K S

    1999-06-01

    intercoccygeal angle (47.9 degree versus 72.2 degrees), and the satisfactory outcome of conservative treatment (47.4% versus 92.3%). The reference value of the intercoccygeal angle in the normal control group was 52.3 degrees, which was significantly different from that of the idiopathic group. In conclusion, the intercoccygeal angle of the idiopathic coccygodynia group was greater than that of the traumatic group and normal control group. Based on the results of this study, the increased intercoccygeal angle can be considered a possible cause of idiopathic coccygodynia. The intercoccygeal angle was a useful radiological measurement to evaluate the forward angulation deformity of the coccyx.

  2. Correlates of post-traumatic growth following childhood and adolescent cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Turner, Jasmin K; Hutchinson, Amanda; Wilson, Carlene

    2017-11-02

    A growing number of children and adolescents are experiencing and surviving cancer. This review aims to identify the demographic, medical, and psychosocial correlates of perceived post-traumatic growth in individuals of any age who were affected by paediatric cancer. Findings will highlight protective factors that may facilitate post-traumatic growth, allowing for directed social support, intervention, and follow-up care. A systematic search based on the key concepts "post-traumatic growth," "neoplasms," and "paediatric" retrieved 905 records from online databases: Embase, Ovid MEDLINE, PILOTS: Published International Literature on Traumatic Stress, PsycINFO, and Web of Science. Eligible studies were appraised as excellent quality with a high level of interrater reliability. The results of 18 studies were synthesised. After the removal of outliers, post-traumatic growth shared small, negative associations with time since diagnosis (r = -0.14) and time since treatment completion (r = -0.19), and small, positive associations with age at diagnosis (r = 0.20), age at survey (r = 0.17), post-traumatic stress symptoms (r = 0.11), and social support (r = 0.25). Post-traumatic growth was positively and moderately associated with optimism (r = 0.31). Several findings were consistent with a comparable meta-analysis in adult oncology populations. Targeted social support, clinical intervention, and education may facilitate post-traumatic growth. Longitudinal research in individuals affected by childhood and adolescent cancer would allow an examination of the effects of predictive variables on post-traumatic growth over time. Copyright © 2017 John Wiley & Sons, Ltd.

  3. The role of rumination in the occurrence of positive effects of experienced traumatic events

    Directory of Open Access Journals (Sweden)

    Nina Ogińska-Bulik

    2016-07-01

    Full Text Available Background Cognitive processes play a significant role in both the negative and positive consequences of traumatic experiences. The aim of this research was to investigate the role of rumination in the occurrence of positive effects, in the form of posttraumatic growth, of experienced traumatic events. Participants and procedure Data were collected from 227 subjects who had experienced traumatic events, including cancer patients (31.30%, women who had experienced domestic violence (39.20%, and medical rescue workers exposed to traumatic events at work (29.50%. The age of participants ranged from 19 to 67 years (M = 40.12, SD = 13.28. The Posttraumatic Growth Inventory was used to measure positive changes, and the Event Related Rumination Inventory was used to assess the two types of ruminations (intrusive and deliberate. Results Both types of ruminations (intrusive and deliberate were positively correlated with the level of posttraumatic growth in the group of cancer patients, and deliberate ruminations were associated with posttraumatic growth in the group of women who had experienced domestic violence and in the medical rescue workers. The results of regression analysis confirmed a significant role of deliberate rumination. Conclusions The study of ruminations allows us to better explain the mechanisms underlying the consequences of traumatic experiences.

  4. A bulbar artery pseudoaneurysm following traumatic urethral catheterization

    Science.gov (United States)

    Bettez, Mathieu; Aubé, Melanie; Sherbiny, Mohamed El; Cabrera, Tatiana; Jednak, Roman

    2017-01-01

    Traumatic urethral catheterization may result in a number of serious complications. A rare occurrence is the development of a urethral pseudoaneurysm. We report the case of a 13-year-old male who required placement of a Foley catheter for an orthopedic surgical procedure. The Foley was misplaced in the bulbourethra, resulting in the development of a bulbar artery pseudoaneurysm. Profuse bleeding via the urethra was noted after removal of the catheter, and the patient experienced severe intermittent hematuria during the postoperative period. Cystoscopy revealed a pulsatile mass within the bulbourethra. Angiography confirmed a bulbar artery pseudoaneurysm, which was successfully embolized with resolution of bleeding. PMID:28163815

  5. Examining the relationship between post-traumatic stress disorder and social participation among Veterans with spinal cord injuries and disorders.

    Science.gov (United States)

    Etingen, Bella; Locatelli, Sara M; Miskevics, Scott; LaVela, Sherri L

    2017-07-26

    The objectives of this study were to examine differences in social participation among Veterans with spinal cord injuries/disorders with and without post-traumatic stress disorder, and determine if lower social participation was independently associated with having post-traumatic stress disorder. A cross-sectional mailed national survey was sent to a national sample of Veterans with spinal cord injuries/disorders who received prior-year Veterans Affairs healthcare. Surveys provided data on: demographics, health conditions, injury characteristics, and social participation. Analyses included bivariate comparisons, and multivariate logistic regression to determine if lower social participation was independently associated with post-traumatic stress disorder. Veterans with (vs. without) post-traumatic stress disorder (n = 896) reported lower social participation (40.2 vs. 43.9, p post-traumatic stress disorder, while a greater number of health conditions (OR = 1.43, 95% CI: 1.25-1.64, p post-traumatic stress disorder (OR = 0.94, 95% CI: 0.90-0.98, p = 0.003). Results indicate post-traumatic stress disorder is associated with lower social participation in Veterans with spinal cord injuries/disorders, independent of other factors that may impact participation. Efforts to screen for and treat post-traumatic stress disorder among persons with spinal cord injuries/disorders, regardless of injury-specific factors, are needed to improve participation. Implications for Rehabilitation Individuals with spinal cord injuries/disorders often have post-traumatic stress disorder; in Veterans with spinal cord injuries/disorders this may be compounded by trauma incurred through military experiences. Social participation, an important aspect of rehabilitation and community integration following spinal cord injury or disorder, may be hindered by symptoms of post-traumatic stress disorder. Our data show that post-traumatic stress disorder is associated with lower

  6. The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study

    Science.gov (United States)

    Zhai, Yanxue; Liu, Kun; Zhang, Lin; Gao, Han; Chen, Zhuo; Du, Siyi; Zhang, Lili; Guo, Yu

    2015-01-01

    Background In China, a growing number of adolescents have experienced traumatic events that have resulted in PTSD (post-traumatic stress disorder). Post-traumatic symptoms are common psychological problems in adolescents who have experienced traumatic events. However, existing studies tend to focus on the factors influencing PTSD, such as the response styles and social support, and studies on the relationships between parenting style, resilience and post-traumatic symptoms are still rare. Objectives To analyze the relationships between parenting style, resilience and post-traumatic symptoms among adolescents in China. Methods A cross-sectional survey was conducted from June to December 2013 in the Liaoning Province, China. N = 5765 adolescents (aged 12 to 18 years old) were ultimately chosen to participate. The Chinese version of the Essen Trauma Inventory for Kids and Juveniles (ETI-KJ), a modified version of the Parental Authority Questionnaire, and the Chinese Resilience Scale were used to estimate the post-traumatic symptoms, parenting style, and resilience, respectively. Pearson’s correlations, multiple linear regression analyses and structural equation modeling (SEM) were applied to analyze the data. Results Of the adolescents, 39.76% (N = 2292) had been exposed to traumatic events during their lives. The prevalence of probable PTSD at the time of the interview (one-month-prevalence) was 12.65%. Parenting style and resilience were significantly associated with post-traumatic symptoms. According to the SEM, parenting style had a significant direct effect on resilience (0.70, Pparenting style had a significant indirect effect (-0.43×0.70 = -0.30. PParenting style and resilience have significant effects on adolescents’ post-traumatic symptoms. Schools and social-related departments could share knowledge on the impact of parenting style with parents enabling them to improve their own parenting style and their children’s resilience and ability to respond

  7. Traumatic sacral pseudomeningocele with spina bifida occulta.

    Science.gov (United States)

    Banno, Tomohiro; Ohishi, Tsuyoshi; Suzuki, Daisuke; Honda, Yosuke; Kobayashi, Sho; Matsuyama, Yukihiro

    2012-01-01

    Pseudomeningocele arises after spinal fracture and nerve root avulsion or after complications of spine surgery. However, traumatic pseudomeningocele with spina bifida occulta is rare. In this report, a traumatic pseudomeningocele in a patient with spina bifida occulta that required surgical treatment is documented. This 37-year-old man presented to the authors' hospital with headache and a fluctuant mass in the center of his buttocks. A CT scan with myelography and MR imaging of the sacral region revealed a large subcutaneous area of fluid retention communicating with the intradural space through a defect of the S-2 lamina. Because 3 months of conservative treatment was unsuccessful, a free fat graft was placed with fibrin glue to seal the closure of the defect, followed by 1 week of CSF drainage. This is the first report on traumatic pseudomeningocele with spina bifida occulta successfully treated in this manner.

  8. Early vasopressor use following traumatic injury

    DEFF Research Database (Denmark)

    Hylands, Mathieu; Toma, Augustin; Beaudoin, Nicolas

    2017-01-01

    OBJECTIVES: Current guidelines suggest limiting the use of vasopressors following traumatic injury; however, wide variations in practice exist. Although excessive vasoconstriction may be harmful, these agents may help reduce administration of potentially harmful resuscitation fluids. This systema......OBJECTIVES: Current guidelines suggest limiting the use of vasopressors following traumatic injury; however, wide variations in practice exist. Although excessive vasoconstriction may be harmful, these agents may help reduce administration of potentially harmful resuscitation fluids...... trials are currently ongoing. No study measured long-term quality of life or cognitive function. CONCLUSIONS: Existing data on the effects of vasopressors following traumatic injury are of very low quality according to the Grading of Recommendations, Assessment, Development and Evaluation methodology...

  9. Development and Validation of the Secondary Traumatic Stress Scale

    Science.gov (United States)

    Bride, Brian E.; Robinson, Margaret M.; Yegidis, Bonnie; Figley, Charles R.

    2004-01-01

    Objective: To describe the development and validation of the Secondary Traumatic Stress Scale (STSS), a 17-item instrument designed to measure intrusion, avoidance, and arousal symptoms associated with indirect exposure to traumatic events via one's professional relationships with traumatized clients. Method: A sample of 287 licensed social…

  10. Occurrence of delayed-onset post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Utzon-Frank, Nicolai; Breinegaard, Nina; Bertelsen, Mette

    2014-01-01

    Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1-6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic...... event (delayed-onset PTSD)....

  11. Traumatic stress and psychopathology: experiences of a trauma clinic

    African Journals Online (AJOL)

    Adele

    traumatic events were grouped according to Friedman's categorisation of traumatic exposure and experience2 as follows: Traumatic stress and psychopathology: experiences of a trauma clinic. U Subramaney. Division of Psychiatry, Department of Neurosciences, University of the Witwatersrand, and Centre for the Study of ...

  12. Perspective on Pediatric Traumatic Brain Injury | Igun | African ...

    African Journals Online (AJOL)

    Background: Traumatic brain injury is an important aspect of paediatric trauma because of its contribution to mortality ant post trauma seqeulae. Management of traumatic brain injury remains a challenge to surgeons, especially in developing countries. This study aims to determine the pattern of traumatic brain injury among ...

  13. A review of the history of traumatic stress studies in Japan: from traumatic neurosis to PTSD.

    Science.gov (United States)

    Goto, Toyomi; Wilson, John P

    2003-07-01

    Based on available literature, this review article investigates traumatic stress studies in Japan from the late 19th century to the present for English speaking audiences. First, traumatic neuroses of war victims, A-bomb survivors, and victims of work-related accidents are discussed. Second, traumatic stress studies of victims of other manmade disasters, such as the sarin gas attacks in Tokyo, domestic violence, and burn injuries. Third, psychological outcomes of natural disaster studies are discussed in relation to social support and help-seeking tendencies of Japan disaster victims.

  14. Traumatic and stressful events in the lives of the participants in the program Project learning for young adults (PUM

    Directory of Open Access Journals (Sweden)

    Martina Guzelj

    2012-12-01

    Full Text Available The article presents a review of traumatic and stressful events in the lives of the population involved in a non-formal, publicly verified, educational program - Project Learning for Young Adults (PUM. The author presents the results of a qualitative study, carried out on a highly vulnerable group of youngsters (emotional deficits, social vulnerability, drug abuse, delinquency proceedings, etc., exploring the non-transparent reasons (traumatic events for “dropping out”. The results of the study, which included 120 participants in nine PUM projects, show that the involvement rate in traumatic events in this population is higher than in the average Slovenian population; nevertheless, specific values differ significantly. This overview of traumatic events closely bears upon the relational paradigm, which provides methods to deal with their consequences, manifest in the mechanism of compulsive repetitions in the individuals’ future relationships, and also their transfer onto future generations.

  15. The management of chronic traumatic ulcer in oral cavity

    Directory of Open Access Journals (Sweden)

    Maharani Laillyza Apriasari

    2012-06-01

    Full Text Available Background: The traumatic ulcer is one of the most common oral mucosal lesions. The etiology of traumatic ulcer may result from mechanical trauma, as well as chemical, electrical, or thermal stimulus, may also be involved in addition, fractured, malposed, or malformed teeth. The clinical manifestation of traumatic ulcer are ulcer, have a yellowish floor, fibrinous center, red and inflammatory margin without induration. Purpose: The purpose of this case report is to present how to manage the patient with the chronic traumatic ulcer in oral cavity. Case: This case report is about the patient with chronic ulcer in oral cavity. Intra oral examination showed on the right tongue margin appeared the major ulcer, single, diameter 1,5 cm, pain, white color, induration and irreguler margin around the ulcer. The patient had been suffering it for 5 months. She had come to a lot of dentist and the oral maxillofacial surgery, but they could not heal the ulcer. The dental occlusion of the patient, especially 17 and 47 then 15 and 45 teeth was looked bitten the right tongue. It underlied to get the clinical diagnosis as the chronic traumatic ulcer. Case management: The main therapy of traumatic ulcer is eliminiting the etiology factor, so that decided to do teeth extraction 45 and 47 that was looked linguversion position on 45 degrees. Before doing the teeth extraction, the patient was referred to take complete blood count (CBC, blood glucose examination and biopsy. The monitoring of the ulcer must be done until 2 weeks after the teeth extraction. If the lesion was persistent, it is suspected as malignancy. Conclusion: It can be concluded that the main management of chronic traumatic ulcer in oral cavity is removing the etiology factors. If the ulcer is still persistent after 2 weeks from the etiology factor had been removing, it is suspected as the malignancy that is needed biopsy examination to get the final diagnosis.Latar belakang: Ulkus traumatikus adalah

  16. The CT manifestations and clinical analysis of traumatic cerebral infarction in children

    International Nuclear Information System (INIS)

    Zhang Tianbo; Lin Shunfa; Huang Xiaohui; Xiao Zhe; Lu Sifang

    2004-01-01

    Objective: To evaluate pathogenesis, CT manifestations, diagnosis and treatment, and prognosis of traumatic cerebral infarction in children. Methods: Axial head CT scanning was performed in 35 cases, meanwhile the treatment included vessel dilatation, anti-spasm, nerve nourishment and anti-coagulation. Results: The traumatic cerebral infarction in children was commonly located in the basal ganglia. CT scan revealed low dense lesions in all cases. 33 patients out of 35 convalesced gradually, when no anomaly was shown on CT. The rest 2 patients improved, whose lesions decreased in size on CT images. Conclusion: The major pathophysiology of traumatic cerebral infarction in children is occlusion of cerebral microcirculation and convulsion of vein after trauma. CT scan and follow-up are of great value in monitoring the damages. Early diagnosis and treatment result in good prognosis

  17. Traumatic events involving elderly patients treated with anticoagulants for atrial fibrillation: the downside of stroke prevention

    Directory of Open Access Journals (Sweden)

    Alessandro Riccardi

    2016-08-01

    Full Text Available A group of oral anticoagulant-treated patients affected by permanent atrial fibrillation was evaluated after their access to the emergency room as a result of a traumatic accident. In these patients, the re-evaluation of their risk of thromboembolism and bleeding was performed together with the evaluation of their risk of falling and institutionalization. Results show that the emergency department identifies a cohort of very elderly frail patients, who should be carefully reconsidered for anticoagulant therapy after a traumatic event.

  18. Treating traumatic injuries of the diaphragm

    Directory of Open Access Journals (Sweden)

    Dwivedi Sankalp

    2010-01-01

    Full Text Available Traumatic diaphragmatic injury (DI is a unique clinical entity that is usually occult and can easily be missed. Their delayed presentation can be due to the delayed rupture of the diaphragm or delayed detection of diaphragmatic rupture, making the accurate diagnosis of DI challenging to the trauma surgeons. An emergency laparotomy and thorough exploration followed by the repair of the defect is the gold standard for the management of these cases. We report a case of blunt DI in an elderly gentleman and present a comprehensive overview for the management of traumatic injuries of the diaphragm.

  19. [Traumatic lumbosacral dislocation - an underrated injury].

    Science.gov (United States)

    Schroeter, S; Weise, K; Badke, A

    2009-01-01

    Traumatic lumbosacral dislocations are rare. We report two cases with initially missed posttraumatic lumbosacral dislocations. The reported cases and the review of the literature show that, especially, accident victims with multiple fractures of the lumbar transverses processes may require a CT scan to confirm fractures or dislocations of L5/S1. Follow-up examinations due to persisting pain after physiotherapy should include lateral X-rays of the lumbar spine of the patient standing. According to the literature and our experience, the treatment of traumatic lumbosacral dislocation usually consists of open reduction and postero-lateral or dorso-ventral fusion of the unstable segments.

  20. Retinal detachment associated with traumatic chorioretinal rupture.

    Science.gov (United States)

    Papakostas, Thanos D; Yonekawa, Yoshihiro; Wu, David; Miller, John B; Veldman, Peter B; Chee, Yewlin E; Husain, Deeba; Eliott, Dean

    2014-01-01

    Traumatic chorioretinal rupture, also known as sclopetaria, is a full-thickness break of the choroid and retina caused by a high-velocity projectile striking or passing adjacent to, but not penetrating, the globe. Previous reports have emphasized that retinal detachment seldom occurs, and observation alone has been the recommended management strategy. However, the authors present herein a series of consecutive patients with retinal detachment associated with sclopetaria and provide a literature review of the topic. They recommend that patients with traumatic chorioretinal rupture be monitored closely for the development of retinal detachment during the first few weeks after the injury. Copyright 2014, SLACK Incorporated.

  1. Traumatic experiences and mental health of north korean refugees in South Korea.

    Science.gov (United States)

    Jeon, Woo-Teak; Yu, Shi-Eun; Cho, Young-A; Eom, Jin-Sup

    2008-12-01

    This study was conducted at Hanawon-a government sponsored educational facility for the settlement of North Korean refugees during their initial phase in South Korea-in 2004 to explore their mental health status and traumatic experiences in North Korea and during their escape period. A survey was conducted in November 2004 with 62 North Korean refugees at Hanawon, and the Trauma Checklist was used to measure their traumatic experiences. To measure their psychological-mental health status, the Personality Assessment Inventory was administered. In comparison with the traumatic experiences of the North Korean refugees found in the study conducted in 2001 at Hanawon using the same methods, the current study showed a relatively lower frequency of traumatic experiences among the participants. The Personality Assessment Inventory results revealed that the study participants scored higher than average South Koreans in all clinical scales. Particularly, their mania (62.51) and schizophrenia (61.75) scores were above 60, a clinically meaningful score. In the gender comparison, the males exhibited meaningfully higher levels of alcohol problem, non-support, and warmth scale scores. Compared to the 2001 study, the overall traumatic experiences among North Korean refugees participated in this study. But continous support is necessary for their successful adaptation to South Korean Society have declined. The North Korean refugees at Hanawon experienced difficulties maintaining their mental health and the men in particular requested more intensive care and support for this purpose.

  2. Impaired cognitive functions in mild traumatic brain injury patients with normal and pathologic magnetic resonance imaging

    International Nuclear Information System (INIS)

    Kurca, E.; Sivak, S.; Kucera, P.

    2006-01-01

    Mild traumatic brain injury (MTBI) is a common neurological (neurotraumatological) diagnosis. As well as different subjective symptoms, many patients develop neuropsychological dysfunction with objective impairment of attention, memory and certain executive functions. Magnetic resonance imaging (MRI) is not routinely used in MTBI patients despite its proven greater sensitivity and specificity in comparison with computed tomography (CT). The patient group consisted of 30 persons with MTBI and the control group consisted of 30 sex- and age-matched healthy volunteers. Both groups underwent neurological examination, neuropsychological testing (including the Postconcussion Symptoms Scale questionnaire, PCSS) and brain MRI (the patient group within 96 h after injury). The analyzed groups did not differ significantly in terms of sex, age, or level or duration of education. MRI pathological findings (traumatic and nonspecific) were present in nine patients. Traumatic lesions were found in seven patients. Nonspecific white matter lesions were found in five healthy controls. There were significant differences between MTBI patients and controls in terms of subjective symptoms (PCSS) and selected neuropsychological tests. Statistically significant neuropsychological differences were found between MTBI patients with true traumatic lesions and MTBI patients with nonspecific lesions. There is evidence that MTBI patients with true traumatic MRI lesions are neuropsychologically different from MTBI patients with nonspecific MRI lesions or normal brain MRI. These results support the hypothesis that some acute MTBI signs and symptoms have a real organic basis which can be detected by selected new MRI modalities. (orig.)

  3. Ethnic differences in symptoms of post-traumatic stress after the Exxon Valdez oil spill.

    Science.gov (United States)

    Palinkas, Lawrence A; Petterson, John S; Russell, John C; Downs, Michael A

    2004-01-01

    Previous studies have reported ethnic differences in the prevalence of post-traumatic stress disorder (PTSD), but the reasons for these differences remain unclear. Ethnic differences in the prevalence of PTSD may reflect ethnic differences in (1) exposure to traumatic events; (2) appraisal of such event as traumatic; and (3) culturally-determined responses to standardized diagnostic instruments, reflecting differences in cultural meanings associated with physical symptoms and idioms of distress. Ethnic differences in risk factors and factor structures of PTSD symptoms were examined in 188 Alaskan Natives and 371 Euro-Americans exposed to the Exxon-Valdez oil spill in 1989. High levels of social disruption were associated with PTSD one year after the oil spill in both ethnic groups. However, low family support, participation in spill clean-up activities, and a decline in subsistence activities were significantly associated with PTSD in Alaskan Natives, but not in Euro-Americans. Factor analysis of the Diagnostic Interview Schedule PTSD subscale revealed five factors for both ethnic groups. However, the items comprising these factors were dissimilar. These results suggest that social disruption is sufficiently traumatic to be associated with symptoms of post-traumatic stress, but that a diagnosis of PTSD must take into consideration local interpretations of these symptoms.

  4. A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population.

    Science.gov (United States)

    Valenzano, Teresa J; Waito, Ashley A; Steele, Catriona M

    2016-10-01

    Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multiengine literature search identified 137 articles of which five were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low-level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies; however, there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population.

  5. Characterizing Dysphagia and Swallowing Intervention in the Traumatic Spinal Injury Population

    Science.gov (United States)

    Valenzano, Teresa J.; Waito, Ashley A.; Steele, Catriona M.

    2016-01-01

    Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multi-engine literature search identified 137 articles of which 5 were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies, however there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population. PMID:27412004

  6. Traumatic experiences, alexithymia, and Internet addiction symptoms among late adolescents: A moderated mediation analysis.

    Science.gov (United States)

    Schimmenti, Adriano; Passanisi, Alessia; Caretti, Vincenzo; La Marca, Luana; Granieri, Antonella; Iacolino, Calogero; Gervasi, Alessia M; Maganuco, Noemi R; Billieux, Joël

    2017-01-01

    The association between traumatic experiences, alexithymia, and substance abuse is well established. Less is known about the role of traumatic experiences and alexithymia in the onset and maintenance of Internet-related disorders. In the present study, self-report measures on traumatic experiences, alexithymia, and problematic Internet use were administered to 358 high school students (57% females) aged 18-19years old, to test whether alexithymic traits mediated the relationship between traumatic experiences and Internet addiction symptoms, and whether gender moderated the proposed mediation in the sample. While partial mediation occurred in the entire sample, gender directly affected the relationship between the investigated constructs: Internet addiction symptoms were independently related to traumatic experiences among males, and to alexithymic traits among females. Therefore, the results of this study suggest that trauma memories among males, and problems with affect regulation among females, may increase the risk of problematic Internet use during late adolescence. Such findings might have relevant implications to inform any treatment plan for late adolescent students who are overinvolved with online activities, pointing out that tailored approaches to their problems and difficulties are particularly needed in clinical practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years

    Directory of Open Access Journals (Sweden)

    Jeong Hee Yun

    2016-12-01

    Full Text Available Background: Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture. Methods: This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities. Results: Sixteen of the 21 patients survived, and 5 (24% died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%. The right atrium was the most common location of injury (43%. Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase–myocardial band (CK-MB levels (p=0.042 and platelet counts (p= 0.004 between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007, worse Trauma and Injury Severity Scores (p=0.007, and higher Injury Severity Scores (p=0.004 than those who survived. Conclusion: We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient’s life.

  8. POST Traumatic Stress Disorder in Emergency Workers: Risk Factors and Treatment

    Science.gov (United States)

    Argentero, Piergiorgio; Dell'Olivo, Bianca; Setti, Ilaria

    Post traumatic stress disorder (PTSD) are emergent phenomena resulting from exposure to a traumatic event that causes actual or threatened death or injury and produces intense fear, helplessness, or horror. In order to assess the role of different factors contributing to this kind of emergent phenomenon prevalence rates across gender, cultures, and samples exposed to different traumas are examined. Risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and post-trauma interventions are examined as well. Several characteristics of the trauma, related to cognitions, post-trauma social support and therapeutic interventions for PTSD are also considered. Further work is needed in order to analyze the inter-relationships among these factors and underlying mechanisms. The chaotic nature of traumatic processes, the multiple and interactive impacts on traumatic events require a comprehensive perspective aimed at planning effective interventions. Treatment outcome studies recommended the combined use of training and therapies as first-line treatment for PTSD.

  9. Gender differences in self reported long term outcomes following moderate to severe traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Ratcliff Graham

    2010-10-01

    Full Text Available Abstract Background The majority of research on health outcomes after a traumatic brain injury is focused on male participants. Information examining gender differences in health outcomes post traumatic brain injury is limited. The purpose of this study was to investigate gender differences in symptoms reported after a traumatic brain injury and to examine the degree to which these symptoms are problematic in daily functioning. Methods This is a secondary data analysis of a retrospective cohort study of 306 individuals who sustained a moderate to severe traumatic brain injury 8 to 24 years ago. Data were collected using the Problem Checklist (PCL from the Head Injury Family Interview (HIFI. Using Bonferroni correction, group differences between women and men were explored using Chi-square and Wilcoxon analysis. Results Chi-square analysis by gender revealed that significantly more men reported difficulty setting realistic goals and restlessness whereas significantly more women reported headaches, dizziness and loss of confidence. Wilcoxon analysis by gender revealed that men reported sensitivity to noise and sleep disturbances as significantly more problematic than women, whereas for women, lack of initiative and needing supervision were significantly more problematic in daily functioning. Conclusion This study provides insight into gender differences on outcomes after traumatic brain injury. There are significant differences between problems reported by men compared to women. This insight may facilitate health service planners and clinicians when developing programs for individuals with brain injury.

  10. When the world collapses: changed worldview and social reconstruction in a traumatized community

    Directory of Open Access Journals (Sweden)

    Dinka Corkalo Biruski

    2014-09-01

    Full Text Available Background: Traumatic experience can affect the individual's basic beliefs about the world as a predictable and safe place. One of the cornerstones in recovery from trauma is reestablishment of safety, connectedness, and the shattered schema of a worldview. Objective: This study explored the role of negatively changed worldview in the relationship between war-related traumatization and readiness for social reconstruction of intergroup relations in a post-conflict community measured by three processes: intergroup rapprochement, rebuilding trust, and need for apology. It was hypothesized that more traumatized people are less supportive of social reconstruction and that this relationship is mediated by the changed worldview. Method: The study included a community random sample of 333 adults in the city of Vukovar, Croatia, that was most devastated during the 1991–1995 war. Six instruments were administered: Stressful Events Scale, Impact of Event Scale-Revised, Changed Worldview Scale, and three scales measuring the post-conflict social reconstruction processes: Intergroup Rapprochement, Intergroup Trust and Need for Apology. Results: Mediation analyses showed that the worldview change fully mediated between traumatization and all three aspects of social reconstruction. Conclusions: In a population exposed to war traumatization the worldview change mediates post-conflict social recovery of community relations.

  11. Current status and influencing factors of post-traumatic growth in maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    Chuyun Cui

    2017-10-01

    Full Text Available Objective: To study the post-traumatic growth level and influencing factors in patients with maintenance hemodialysis. Methods: A total of 179 patients receiving maintenance hemodialysis from a third-level grade A hospital in Tianjin, China were investigated using Post-traumatic Growth Inventory (PTGI, Perceived Social Support Scale, and Medical Coping Modes Questionnaire. Results: The total score for the PTGI was 53.73 ± 16.45. Multiple linear regression analysis showed that social support, coping style, marital status, and family income significantly influenced the post-traumatic growth level in patients undergoing maintenance hemodialysis. These factors explained 41.4% of the variance. Conclusion: Medical staff should help patients under maintenance hemodialysis to fulfill their potentials by boosting the level of social support and to effectively cope with internal conflicts. In addition, nursing staff should provide relevant psychological health education to patients to improve their post-traumatic growth. Keywords: Maintenance hemodialysis, Patients, Post-traumatic growth, Root cause analysis

  12. The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study.

    Science.gov (United States)

    Zhai, Yanxue; Liu, Kun; Zhang, Lin; Gao, Han; Chen, Zhuo; Du, Siyi; Zhang, Lili; Guo, Yu

    2015-01-01

    In China, a growing number of adolescents have experienced traumatic events that have resulted in PTSD (post-traumatic stress disorder). Post-traumatic symptoms are common psychological problems in adolescents who have experienced traumatic events. However, existing studies tend to focus on the factors influencing PTSD, such as the response styles and social support, and studies on the relationships between parenting style, resilience and post-traumatic symptoms are still rare. To analyze the relationships between parenting style, resilience and post-traumatic symptoms among adolescents in China. A cross-sectional survey was conducted from June to December 2013 in the Liaoning Province, China. N = 5765 adolescents (aged 12 to 18 years old) were ultimately chosen to participate. The Chinese version of the Essen Trauma Inventory for Kids and Juveniles (ETI-KJ), a modified version of the Parental Authority Questionnaire, and the Chinese Resilience Scale were used to estimate the post-traumatic symptoms, parenting style, and resilience, respectively. Pearson's correlations, multiple linear regression analyses and structural equation modeling (SEM) were applied to analyze the data. Of the adolescents, 39.76% (N = 2292) had been exposed to traumatic events during their lives. The prevalence of probable PTSD at the time of the interview (one-month-prevalence) was 12.65%. Parenting style and resilience were significantly associated with post-traumatic symptoms. According to the SEM, parenting style had a significant direct effect on resilience (0.70, Pparenting style had a significant indirect effect (-0.43×0.70 = -0.30. PParenting style and resilience have significant effects on adolescents' post-traumatic symptoms. Schools and social-related departments could share knowledge on the impact of parenting style with parents enabling them to improve their own parenting style and their children's resilience and ability to respond effectively to traumatic events.

  13. MENTAL ACTIVITY RESTORATION PECULIARITIES IN CHILDREN WITH SEVERE TRAUMATIC BRAIN INJURY AT THE EARLY STAGE OF REHABILITATION

    Directory of Open Access Journals (Sweden)

    A. V. Zakrepina

    2013-01-01

    Full Text Available The article is concerned with rehabilitation issues of children with severe traumatic brain injury (STBI. It gives the results of the study which was aimed at analyzing the psychophysical health restoration dynamics in children with STBI and determining the pedagogic typology of deviant development at traumatic brain injury in order to devise a training-organizational work plan for children being on the stages of complex rehabilitation.

  14. Coccygectomy as a Surgical Option in the Treatment of Chronic Traumatic Coccygodynia: A Single-Center Experience and Literature Review

    OpenAIRE

    Antoniadis, Alexander; Ulrich, Nils Harry-Bert; Senyurt, Hueseyin

    2014-01-01

    Study Design Retrospective cohort study. Purpose Trauma is the most common cause for chronic coccygodynia. The present study aims at presenting our results after complete removal of the coccyx for refractory traumatic coccygodynia in terms of pain level, complication rates, and patients' overall satisfaction. Overview of Literature There is limited extant literature describing the success rate and complications in refractory isolated traumatic coccygodynia. Methods From January 2011 to Januar...

  15. Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report

    Directory of Open Access Journals (Sweden)

    Krishna Ranga

    2012-02-01

    Full Text Available Abstract Introduction Traumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head. Specifically, mild traumatic brain injury is a clinical diagnosis that can have significant effects on an individual's life, yet is difficult to identify through traditional imaging techniques. Case presentation This is the case of a 68-year-old previously healthy African American woman who was involved in a motor vehicle accident that resulted in significant head trauma. After the accident, she experienced symptoms indicative of mild traumatic brain injury and sought a neurological consultation when her symptoms did not subside. She was initially evaluated with a neurological examination, psychological evaluation, acute concussion evaluation and a third-party memory test using software from CNS Vital Signs for neurocognitive function. A diagnosis of post-concussion syndrome was suggested. Diffusion tensor imaging revealed decreased fractional anisotropy in the region immediately adjacent to both lateral ventricles, which was used to confirm the diagnosis. Fractional anisotropy is a scalar value between zero and one that describes the degree of anisotropy of a diffusion process. These results are indicative of post-traumatic gliosis and are undetectable by magnetic resonance imaging. Our patient was treated with cognitive therapy. Conclusion Minor traumatic brain injury is a common injury with variable clinical presentation. The system of diagnosis used in this case found a significant relationship between the clinical assessment and imaging results. This would not have been possible using traditional imaging techniques and highlights the benefits of using diffusion tensor imaging in the sub-acute assessment of minor traumatic brain injury.

  16. Traumatic abdominal wall hernia: A case report and literature review.

    Science.gov (United States)

    Al Beteddini, Osama S; Abdulla, Samir; Omari, Osama

    2016-01-01

    Traumatic abdominal wall hernia is a rare but serious diagnosis resulting from blunt abdominal trauma. The clinical diagnosis is not usually straightforward and the hernia is often discovered at the time of the surgical exploration for intra-abdominal injuries or by imaging studies. A 25-year-old obese, restraint, male patient was the victim of a high-speed road traffic accident. Among other injuries, he showed extensive skin maceration and bruising over the lower abdomen and flanks upon presentation, however he did not need any surgical intervention. Contrast-enhanced computed tomography scan of the abdomen and pelvis demonstrated extensive abdominal wall muscular disruption over both flanks with herniation of the right colon. Counselled to follow up in 4-6 weeks to have the hernia surgically repaired, he showed up after 8 months with a large muscular defect resulting in a large hernia containing small and large bowel loops. The timing and type of the surgical repair of traumatic abdominal wall hernia depends upon the size of the hernia defect and the presence of associated intra-abdominal injuries. Delayed repair; however, may result in a large defect making primary, non-prosthetic repair impossible and increases the risk of abdominal compartment syndrome after surgical correction. Traumatic abdominal wall hernia presents a diagnostic as well as a therapeutic challenge. The therapeutic approach is governed by a multitude of factors emphasizing the need of a patient-tailored, case by case management plan. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  17. The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Yanxue Zhai

    Full Text Available In China, a growing number of adolescents have experienced traumatic events that have resulted in PTSD (post-traumatic stress disorder. Post-traumatic symptoms are common psychological problems in adolescents who have experienced traumatic events. However, existing studies tend to focus on the factors influencing PTSD, such as the response styles and social support, and studies on the relationships between parenting style, resilience and post-traumatic symptoms are still rare.To analyze the relationships between parenting style, resilience and post-traumatic symptoms among adolescents in China.A cross-sectional survey was conducted from June to December 2013 in the Liaoning Province, China. N = 5765 adolescents (aged 12 to 18 years old were ultimately chosen to participate. The Chinese version of the Essen Trauma Inventory for Kids and Juveniles (ETI-KJ, a modified version of the Parental Authority Questionnaire, and the Chinese Resilience Scale were used to estimate the post-traumatic symptoms, parenting style, and resilience, respectively. Pearson's correlations, multiple linear regression analyses and structural equation modeling (SEM were applied to analyze the data.Of the adolescents, 39.76% (N = 2292 had been exposed to traumatic events during their lives. The prevalence of probable PTSD at the time of the interview (one-month-prevalence was 12.65%. Parenting style and resilience were significantly associated with post-traumatic symptoms. According to the SEM, parenting style had a significant direct effect on resilience (0.70, P<0.01 and post-traumatic symptoms (-0.15, P<0.05, and resilience had a significant direct effect on the post-traumatic symptoms (-0.43, P<0.01. Furthermore, parenting style had a significant indirect effect (-0.43×0.70 = -0.30. P<0.01 on the post-traumatic symptoms through resilience. The SEM significantly explained 49% of the variance in resilience and 30% of the variance in post-traumatic symptoms

  18. MANAGEMENT OF TRAUMATIC LIVER LESIONS.

    Science.gov (United States)

    Timofte, D; Hutanu, I; Livadariu, Roxana Maria; Soroceanu, R P; Munteanu, Iulia; Diaconu, C; Ionescu, Lidia

    2015-01-01

    To determine the correct therapeutic approach to the different grades of liver trauma. The study is based on a retrospective analysis of treatment outcomes in 56 patients with abdominal trauma admitted over a 9-year period to in the IIIrd Surgical Clinic of the Iasi "Sf. Spiridon" Hospital. It is focused on operative or non-operative management of liver trauma, surgical technique used, morbidity and postoperative mortality. Data were collected from electronic medical records and observation sheets and processed and interpreted using Microsoft Excel statistical functions. In the interval May 26, 2005-April 19, 2013 56 cases of abdominal trauma were recorded, 31 (55.35%) residing in urban areas, and 25 (44.64%) in rural areas. The mean age was 39 years, range 18-83 years old. The male/female ratio was 2.5/1 and the group consisted of 40 (71.42%) male patients and 16 (28.57%) female patients. The causes of abdominal trauma were: car accident in 29 (51%) cases, fall from different heights in 6 (10%) patients, workplace-related accidents in 8 patients (14%) and direct hit injury in 12 patients (12%). In our cohort, 51 (91%) patients with abdominal trauma have been emergency admitted, 3 patients (5%) were transferred from different medical units, and 2 patients (4%) were referred by a specialist doctor. Two or more simultaneous lesions were diagnosed in 53 (96%) cases. Of the 45 patients with traumatic liver injuries diagnosed on admission, 32 (71%) required surgical intervention. In the remaining 13 (29%) patients, the therapeutic management was conservative. Hepatic traumas are often severe, and frequently associated with multiple injuries. The non-operative management is indicated in liver lesions grade I, II and III according to the American Association for the Surgery of Trauma (AAST), if abdominal cavity organs are not injured. Higher grade liver lesions (over IV) in which the hemorrhagic risk persists or reappears require surgical intervention as soon as possible

  19. [Supporting a teenager confronted with a traumatic experience].

    Science.gov (United States)

    Merchin, Clara; Benoit de Coignac, Agathe; Moro, Marie Rose

    2015-01-01

    Everyone reacts differently to a traumatic event. There is a risk of underestimating a teenager's traumatic experience by considering only the usual post-traumatic stress diagnosis criteria. However, when the trauma has not been able to be sufficiently developed, the adolescent's suffering is revealed through their behaviour. The therapeutic support of the youngster and their family enables them to reposition the traumatic event within the continuity of their history and to relaunch a thought process, often frozen by the traumatic experience. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Causal role of apoptosis-inducing factor for neuronal cell death following traumatic brain injury

    NARCIS (Netherlands)

    J.E. Slemmer (Jennifer); C.L. Zhu (Chang Lian); S. Landshamer; R. Trabold (Raimund); J. Grohm (Julia); A. Ardeshiri; E. Wagner; E. Sweeney (Elizabeth); J. Blomgren (Jenni); C. Culmsee (Carsten); J.T. Weber (John); N. Plesnila (Nikolaus)

    2008-01-01

    textabstractTraumatic brain injury (TBI) consists of two phases: an immediate phase in which damage is caused as a direct result of the mechanical impact; and a late phase of altered biochemical events that results in delayed tissue damage and is therefore amenable to therapeutic treatment. Because

  1. DBS in Treatment of Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Angelo Lavano

    2018-01-01

    Full Text Available Post-traumatic stress disorder (PTSD is a debilitating psychiatric condition for which pharmacological therapy is not always solvable. Various treatments have been suggested and deep brain stimulation (DBS is currently under investigation for patients affected by PTSD. We review the neurocircuitry and up-to-date clinical concepts which are behind the use of DBS in posttraumatic stress disorder (PTSD. The role of DBS in treatment-refractory PTSD patients has been investigated relying on both preclinical and clinical studies. DBS for PTSD is in its preliminary phases and likely to provide hope for patients with medical refractory PTSD following the results of randomized controlled studies.

  2. The National Football League and chronic traumatic encephalopathy: legal implications.

    Science.gov (United States)

    Korngold, Caleb; Farrell, Helen M; Fozdar, Manish

    2013-01-01

    The growing awareness of chronic traumatic encephalopathy (CTE) has the potential to change the public perception and on-field rules of the National Football League (NFL). More than 3,000 ex-NFL players or their relatives are engaged in litigation alleging that the NFL failed to acknowledge and address the neuropsychiatric risks associated with brain injuries that result from playing in the NFL. This article explores the intersection between the medical and legal aspects of CTE in the NFL from a forensic psychiatry perspective.

  3. Traumatic atlantoaxial rotatory subluxation in an adolescent: a case report

    Directory of Open Access Journals (Sweden)

    Meza Escobar Luis

    2012-01-01

    Full Text Available Abstract Introduction Atlantoaxial rotatory subluxation is rarely caused by trauma in adults. Usually, the treatment of choice is traction using Halo/Gardner-Wells fixation devices for up to six weeks. Case presentation We present the case of a 19-year-old Caucasian woman with traumatic atlantoaxial subluxation. Early reduction three hours after trauma and immobilization using only a soft collar were performed and yielded very good clinical results. Conclusion In the adult population, atlantoaxial subluxation is a rare condition but is severe if untreated. Early treatment implies a non-surgical approach and a good outcome. Conservative treatment is the recommended first step for this condition.

  4. Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder

    OpenAIRE

    Brenner, Lisa A.

    2011-01-01

    Advances in imaging technology, coupled with military personnel returning home from Iraq and Afghanistan with traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD), have increased interest in the neuropsychology and neurobiology of these two conditions. There has been a particular focus on differential diagnosis. This paper provides an overviev of findings regarding the neuropsychological and neurobiological underpinnings of TBI andfor PTSD. A specific focus is on assessme...

  5. Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease.

    Science.gov (United States)

    Hayes, Jasmeet P; Logue, Mark W; Sadeh, Naomi; Spielberg, Jeffrey M; Verfaellie, Mieke; Hayes, Scott M; Reagan, Andrew; Salat, David H; Wolf, Erika J; McGlinchey, Regina E; Milberg, William P; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

    2017-03-01

    Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance

  6. Potential of Jatropha multifida sap against traumatic ulcer

    Directory of Open Access Journals (Sweden)

    Basri A. Gani

    2015-09-01

    Full Text Available Background: Traumatic ulcer is a lesion in oral mucosa as a result of physical and mechanical trauma, as well as changes in salivary pH. Jatropha multifida sap can act as antimicrobial, anti-inflammatory and re-epithelialization, and can also trigger the healing process of ulcers. Purpose: Research was aimed to determine the potential of Jatropha multifida sap against traumatic ulcer base on clinical and histopathological healing process. Method: This research was conducted laboratory experimental model, with rats (Rattus norvegicus as the subject as well as Jatropha multifida sap for ulcer healing. Those subjects were divided into four groups: two treatment groups administrated with pellet and Jatropha multifida sap, one group as the positive control group administrated with 0.1% triamcinolone acetonide, and one group as the negative control group administrated with 0.9% NaCl. Ulcer manipulation was used 30% H2O2, and evaluation of ulcer healing was used clinical and histopathological approach. Result: Clinically, the healing process of ulcers in the treatment group with Jatropha multifida sap was faster than that in the positive control group with 0.1% triamcinolone acetonide, indicated with the reduction of the ulcer size until the missing of the ulcers started from the third day to the seventh one (p≤0.05. Histopathologically inflammatory cells (lymphocytes, and plasma cells declined started from the third day, and the formation of collagen and re-epithelialization then occurred. On the seventh day, the epithelial cells thickened, and the inflammatory cells infiltrated. Statistically, those groups were significant (p≤0.05. Conclusion: Jatropha multifida sap has a significant potential to cure traumatic ulcers on oral mucosa clinically and histopathologically.

  7. The Enigma of Extreme Traumatism: Trauma, Exclusion and their Impact on Subjectivity.

    Science.gov (United States)

    Viñar, Marcelo N

    2017-03-21

    My aim is to discuss the immediate effects of extreme trauma and to speculate on its long term effects. The formulations associated with the Post Traumatic Stress Syndrome generate an overly medicalized view of trauma, grossly underestimating its devastating impact. Catastrophic traumatic experience rips a hole in the representational continuity of psychic life; neither representations nor narrations are generated. Instead, a representational emptiness occurs, such that what has taken place cannot be shared or transmitted. The cathartic word becomes a robotic mocking of the interchange between human beings. There is no internalization, no ability to make the experience subjective. The resulting deep splitting in the psyche is characteristic of extreme traumatism, and its balance or perpetual working through is elaborated in this paper.

  8. Alpine ski and snowboarding traumatic injuries: incidence, injury patterns, and risk factors for 10 years.

    Science.gov (United States)

    McBeth, Paul B; Ball, Chad G; Mulloy, Robert H; Kirkpatrick, Andrew W

    2009-05-01

    Alpine skiing and snowboarding are popular winter sports in Canada. Every year participation in these activities results in traumatic injury. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with ski and snowboarding injuries. A comprehensive 10-year retrospective review of Alpine ski and snowboarding injuries from 1996 to 2006 was conducted. The Alberta Trauma Registry was used as the primary source of data. A total of 196 patients (56.6% skiers, 43.4% snowboarders) were identified as having major traumatic injuries (Injury Severity Score, >or=12). Forty-three patients required intensive care unit support. The majority of injuries were related to falls and collisions with natural objects. Head injuries were most common, followed by chest, spinal, and extremity trauma. Seventy-nine patients required emergency surgery. Skiing and snowboarding represent activities with high potential for traumatic injury. Safety initiatives should be developed to target this population.

  9. Delayed Traumatic Intracerebral Hemorrhage: For How Many Hours Should Patients with Mild Head Trauma be Observed?

    Directory of Open Access Journals (Sweden)

    Sevdegul Karadas

    2016-02-01

    Full Text Available Delayed traumatic intracerebral hematoma is a rare complication of head injury. The etiopatogenesis of DTIH is not precisely known. We herein report a case of delayed traumatic intracerebral hematoma, with mild HT. This 25-year-old male fell down while playing in a footbal match. He had headache and vertigo. He was kept under observation for about 12 hours at the emergency department. At the 26th hour after the HT incident, he presented to our hospital again with the complaints of nausea, vomiting and headache. A control brain computed tomography was performed and a traumatic intracerebral hematoma was determined in the frontal region. As a result, DTIH may be fatal. Close observation and repeat CBT scanning may reduce complications and mortality.

  10. Splenic Pathology in Traumatic Rupture of the Spleen: A Five Year Study

    Science.gov (United States)

    Al-Kindi, Hunaina; Devi, Leena; George, Mina

    2009-01-01

    Objectives To Study the histopathology of spleens with a history of traumatic rupture with a view to establish possible predisposing factors to the rupture Methods This study examined the gross and microscopic features of consecutive cases of splenectomies done for traumatic rupture during a five year period in order to evaluate the presence or absence of any pathology prior to rupture. Results Of the 17 cases of splenectomy during this period, 14 were normal and 3 cases showed pathology other than rupture. Conclusion In the five year period of studying splenic pathology in traumatic rupture, 82% of the spleens showed normal histology except for the rupture. 18% of the cases showed different pathological findings on histopathology which could have contributed to the rupture. PMID:22334849

  11. Gender, traumatic events, and mental health disorders in a rural Asian setting.

    Science.gov (United States)

    Axinn, William G; Ghimire, Dirgha J; Williams, Nathalie E; Scott, Kate M

    2013-01-01

    Research shows a strong association between traumatic life experience and mental health and important gender differences in that relationship in the western European Diaspora; but much less is known about these relationships in other settings. We investigate these relationships in a poor rural Asian setting that recently experienced a decade-long armed conflict. We use data from 400 adult interviews in rural Nepal. The measures come from World Mental Health survey instruments clinically validated for this study population to measure depression, posttraumatic stress disorder, and intermittent explosive disorder. Our results demonstrate that traumatic life experience significantly increases the likelihood of mental health disorders in this setting, and that these traumatic experiences have a larger effect on the mental health of women than men. These findings offer important clues regarding the potential mechanisms producing gender differences in mental health in many settings.

  12. Traumatic injury pattern analysis in a light rail transit death: a retrospective case study.

    Science.gov (United States)

    Kendell, Ashley E; Fleischman, Julie M; Fulginiti, Laura C

    2015-05-01

    Within the context of medical examiner's offices, forensic anthropologists are increasingly being asked to assist with the interpretation of traumatic skeletal injury. This case study presents an example of trauma analysis performed by forensic anthropologists at the Maricopa County Forensic Science Center in Phoenix, Arizona. The primary goal of this study is to document an uncommon pattern of traumatic injury-severe grinding abrasions of the lower appendage that macroscopically resemble sharp force trauma, especially as observed in dismemberment cases-resulting from an individual being dragged beneath a Light Rail train for c. 1.7 miles. The abraded skeletal elements include a femoral shaft fragment, a femoral head portion, and the right foot. Second, this study aims to illustrate the efficacy of forensic anthropological analysis of patterned skeletal trauma. Finally, this study demonstrates the critical importance of analyzing scene information before drawing conclusions as to the etiology of a traumatic injury pattern. © 2015 American Academy of Forensic Sciences.

  13. Repair of Traumatic Rhegmatogenous Retinal Detachment Combined with Congenital Falciform Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Fukutaro Mano

    2018-01-01

    Full Text Available Purpose: To report a case of surgical repair of traumatic rhegmatogenous retinal detachment combined with congenital falciform retinal detachment (FRD. Methods: A retrospective case report. Results: A 36-year-old man with traumatic rhegmatogenous retinal detachment complicating a previously known FRD was successfully treated despite residual FRD following pars plana lensectomy, vitrectomy, and encircling scleral buckling. His best corrected visual acuity improved from hand motion at 50 cm to 20/1,000. Conclusion: We concluded that the root of the FRD is susceptible to trauma because of the contraction of fibrovascular tissue. The early intervention of modern vitrectomy to traumatic rhegmatogenous retinal detachment complicating a previously known FRD is an important consideration for enhanced quality of care and optimal patient outcomes.

  14. Effect of early vitrectomy combined with silicone oil tamponade for severe infectious traumatized endophthalmitis

    Directory of Open Access Journals (Sweden)

    Xiao Zheng

    2013-08-01

    Full Text Available AIM: To explore the relations of clinical efficacy and surgical timing of vitrectomy combined with silicone oil tamponade for severe infectious traumatized endophthalmitis.METHODS: Totally 59 patients(59 eyeswith severe infectious traumatized endophthalmitis accepted vitrectomy combined with silicone oil tamponade. Patients were divided into two groups by different surgical timing. Group A accepted operation in 24 hours. Group B accepted operation 24 hours after injury. Retina status during operation, clinical efficacy and best-corrected visual acuity were observed and recorded. RESULTS: The cases of early operation group got lesser retina injury and higher efficacy and better best-corrected visual acuity. CONCLUSION:Vitrectomy combined with silicone oil tamponade is an effective way to cure severe infected traumatized endophthalmitis. Early surgical treatment is the key to achieve better effect.

  15. Delayed massive epistaxis from traumatic cavernous carotid false aneurysms: A report of two unusual cases.

    Science.gov (United States)

    Mankahla, Ncedile; LeFeuvre, David; Taylor, Allan

    2017-08-01

    Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice. Early clinical outcome was good in both patients. Wherever possible, the CARE 1 guidelines were followed in the reporting. Conclusion These cases illustrate the delayed nature of traumatic aneurysms and the need for a high index of suspicion in the presence of skull base fractures. The use of endovascular detachable balloon occlusion and coil embolization treatment with parent vessel preservation is shown.

  16. The longitudinal course of post-traumatic stress after childbirth.

    Science.gov (United States)

    Söderquist, Johan; Wijma, Barbro; Wijma, Klaas

    2006-06-01

    Post-traumatic stress was assessed in early and late pregnancy, and 1, 4, 7, and 11 months postpartum by means of questionnaires among 1224 women. Thirty-seven women (3%) had post-traumatic stress (meeting criteria B, C, and D for PTSD) at least once within 1-11 months postpartum. In pregnancy, depression, severe fear of childbirth, 'pre'-traumatic stress, previous counseling related to pregnancy/childbirth, and self-reported previous psychological problems were associated with an increased risk of having post-traumatic stress within 1-11 months postpartum. Sum-scores of post-traumatic stress did not decrease over time among women who at least once had post-traumatic stress (criteria B, C, and D) within 1-11 months postpartum. Women with post-traumatic stress also showed a decrease in perceived social support over time postpartum.

  17. Mild traumatic brain injury does not produce post-traumatic stress disorder.

    Science.gov (United States)

    Sbordone, R J; Liter, J C

    1995-01-01

    It has been widely assumed that patients who sustain mild traumatic brain injury (MTBI) or post-concussive syndrome develop post-traumatic stress disorder (PTSD) in response to their cognitive difficulties, diminished coping skills, or other losses. This study examined 70 patients who had previously been diagnosed as having either PTSD or MTBI. Each patient was asked to provide a highly detailed chronological history of the events which preceded, followed, and occurred during the traumatic event, to indicate whether they were rendered unconscious or had amnesia for the event, and to describe the various symptoms they developed. All (100.0%) of the PTSD patients were able to provide a highly detailed and emotionally charged recollection of the events which occurred within 15 minutes of the traumatic event in comparison to none (0.0%) of the MTBI patients. None of the MTBI patients reported symptoms such as intrusive recollections of the traumatic event, nightmares, hypervigilance, phobic or startle reactions, or became upset when they were asked to describe the traumatic event or were exposed to stimuli associated with it. These data suggest that PTSD and MTBI are two mutually exclusive disorders, and that it is highly unlikely that MTBI patients develop PTSD symptoms. Furthermore, these findings suggest that clinicians should exercise considerable caution in ruling out PTSD prior to making the diagnosis of MTBI.

  18. The electrocardiogram in traumatic right atrial rupture

    NARCIS (Netherlands)

    van Veldhuisen, DJ; van den Berg, MP

    1999-01-01

    We:report the case of a previously healthy 20-year-old man who had a traumatic rupture of the right atrium. On admission an electrocardiogram (ECG) was recorded which is highly remarkable and, retrospectively, suggestive for the diagnosis. The patient died soon after the EGG, and the diagnosis was

  19. Predictors of tonic immobility during traumatic events

    Directory of Open Access Journals (Sweden)

    Arturo Bados

    2015-10-01

    Full Text Available Tonic immobility (TI is a possible reaction to danger that is facilitated by intense fear, physical restraint and perceived inability to escape. Other variables that could affect TI, such as the type and characteristics of traumatic events and personal characteristics have been little or no studied. The present study evaluated the power of these variables to predict TI in a sample of 273 college students who had experienced at least one traumatic event. Of the sample, 7.7% and 13.2% responded with TI according to the two stricter definitions adopted. Most of the variables were significantly associated with TI in univariate analyses. However, in a multiple regression analysis, only certain features of the events (occurrence of physical/sexual abuse, number of different types of events experienced and certain reactions to them (perception of how traumatic were the events, severe fear response were significant predictors of TI. Since these predictors explained only 25% of the variance, the influence of other variables -such as neuroticism, negative affectivity and perceived lack of personal control or resources to cope with traumatic events- should be investigated.

  20. Factors affecting outcome after traumatic limb amputation.

    Science.gov (United States)

    Perkins, Z B; De'Ath, H D; Sharp, G; Tai, N R M

    2012-01-01

    Traumatic leg amputation commonly affects young, active people and leads to poor long-term outcomes. The aim of this review was to describe common causes of disability and highlight therapeutic interventions that may optimize outcome after traumatic leg amputation. A comprehensive search of MEDLINE, Embase and Cumulative Index to Nursing and Allied Health Literature databases was performed, using the terms 'leg injury', 'amputation' and 'outcome'. Articles reporting outcomes following traumatic leg amputation were included. Studies demonstrated that pain, psychological illness, decreased physical and vocational function, and increased cardiovascular morbidity and mortality were common causes of disability after traumatic leg amputation. The evidence highlights that appropriate preoperative management and operative techniques, in conjunction with suitable rehabilitation and postoperative follow-up, can lead to improved treatment outcome and patient satisfaction. Patients who undergo leg amputation after trauma are at risk of poor long-term physical and mental health. Clinicians involved in their care have many opportunities to improve their outcome using a variety of therapeutic variables. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  1. Burnout, vicarious traumatization and its prevention.

    Science.gov (United States)

    Pross, Christian

    2006-01-01

    Previous studies on burnout and vicarious traumatization are reviewed and summarized with a list of signs and symptoms. From the author's own observations two histories of caregivers working with torture survivors are described which exemplify the risk,implications and consequences of secondary trauma. Contributing factors in the social and political framework in which caregivers operate are analyzed and possible means of prevention suggested, particularly focussing on the conflict of roles when providing evaluations on trauma victims for health and immigration authorities. Caregivers working with victims of violence carry a high risk of suffering from burnout and vicarious traumatization unless preventive factors are considered such as: self care, solid professional training in psychotherapy, therapeutic self-awareness, regular self-examination by collegial and external supervision, limiting caseload, continuing professional education and learning about new concepts in trauma, occasional research sabbaticals, keeping a balance between empathy and a proper professional distance to clients, protecting oneself against being mislead by clients with fictitious PTSD. An institutional setting should be provided in which the roles of therapists and evaluators are separated. Important factors for burnout and vicarious traumatization are the lack of social recognition for caregivers and the financial and legal outsider status of many centers. Therefore politicians and social insurance carriers should be urged to integrate facilities for traumatized refugees into the general health care system and centers should work on more alliances with the medical mainstream and academic medicine.

  2. Traumatic orbital encephalocele: Presentation and imaging.

    Science.gov (United States)

    Wei, Leslie A; Kennedy, Tabassum A; Paul, Sean; Wells, Timothy S; Griepentrog, Greg J; Lucarelli, Mark J

    2016-01-01

    Traumatic orbital encephalocele is a rare but severe complication of orbital roof fractures. We describe 3 cases of orbital encephalocele due to trauma in children. Retrospective case series from the University of Wisconsin - Madison and Medical College of Wisconsin. Three cases of traumatic orbital encephalocele in pediatric patients were found. The mechanism of injury was motor vehicle accident in 2 patients and accidental self-inflicted gunshot wound in 1 patient. All 3 patients sustained orbital roof fractures (4 mm to 19 mm in width) and frontal lobe contusions with high intracranial pressure. A key finding in all 3 cases was progression of proptosis and globe displacement 4 to 11 days after initial injury. On initial CT, all were diagnosed with extraconal hemorrhage adjacent to the roof fractures, with subsequent enlargement of the mass and eventual diagnosis of encephalocele. Orbital encephalocele is a severe and sight-threatening complication of orbital roof fractures. Post-traumatic orbital encephalocele can be challenging to diagnose on CT as patients with this condition often have associated orbital and intracranial hematoma, which can be difficult to distinguish from herniated brain tissue. When there is a high index of suspicion for encephalocele, an MRI of the orbits and brain with contrast should be obtained for additional characterization. Imaging signs that should raise suspicion for traumatic orbital encephalocele include an enlarging heterogeneous orbital mass in conjunction with a roof fracture and/or widening fracture segments.

  3. Post-traumatic unilateral plantar hyperhidrosis.

    Science.gov (United States)

    Eren, Y; Yavasoglu, N G; Comoglu, S S

    2016-02-01

    Localized unilateral hyperhidrosis is rare and poorly understood, sometimes stemming from trauma. Feet, quite vulnerable to trauma are affected by disease-mediated plantar hyperhidrosis, usually bilaterally. This report describes partial hyperhidrosis developing post-traumatically on the left plantar region of a 52-year-old male.

  4. Spontaneous closure of traumatic tympanic membrane perforations

    DEFF Research Database (Denmark)

    Jellinge, Marlene Ersgaard; Kristensen, S.; Larsen, K

    2015-01-01

    BACKGROUND: The treatment of traumatic tympanic membrane perforations varies in different investigations, ranging from observation to early surgical repair. The present study aimed to focus on the closure rate and the closure time in a group of patients treated with a watchful waiting policy. MET...

  5. Fatigue in adults with traumatic brain injury

    DEFF Research Database (Denmark)

    Mollayeva, Tatyana; Kendzerska, Tetyana; Mollayeva, Shirin

    2013-01-01

    , assess, and critically appraise studies that assessed predictors for fatigue and the consequences of fatigue on at least two separate time points following traumatic brain injury. METHODS/DESIGN: MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, CINAHL, and PsycINFO will be systematically...

  6. Traumatic tympanic membrane perforations: characteristics and ...

    African Journals Online (AJOL)

    Objective: To characterize traumatic tympanic membrane perforation (TTMP) in terms of distribution, mechanisms, and outcome of treatment. To assess the factors influencing such outcome. Study design: Prospective analytical study, assessing outcomes post-injuries. Setting: Clinical department of a tertiary referral hospital.

  7. Traumatic and alternating delayed intracranial hematomas

    International Nuclear Information System (INIS)

    Lesoin, F.; Redford, H.; Jomin, M.; Viaud, C.; Pruvo, J.

    1984-01-01

    Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma. (orig.)

  8. Traumatic Brain Injury: Nuclear Medicine Neuroimaging

    NARCIS (Netherlands)

    Sánchez-Catasús, Carlos A; Vállez Garcia, David; Le Riverend Morales, Eloísa; Galvizu Sánchez, Reinaldo; Dierckx, Rudi; Dierckx, Rudi AJO; Otte, Andreas; de Vries, Erik FJ; van Waarde, Aren; Leenders, Klaus L

    2014-01-01

    This chapter provides an up-to-date review of nuclear medicine neuroimaging in traumatic brain injury (TBI). 18F-FDG PET will remain a valuable tool in researching complex mechanisms associated with early metabolic dysfunction in TBI. Although evidence-based imaging studies are needed, 18F-FDG PET

  9. Fitness to drive after traumatic brain injury

    NARCIS (Netherlands)

    Brouwer, WH; Withaar, FK

    This paper deals with the issue of fitness to drive in patients suffering from traumatic brain injury (TBI). Guidelines for assessment are proposed and three types of studies are reviewed: studies about impairments of attention and information processing, studies of driving competence, and driver

  10. Post-traumatic knee stiffness: surgical techniques.

    Science.gov (United States)

    Pujol, N; Boisrenoult, P; Beaufils, P

    2015-02-01

    Post-traumatic knee stiffness and loss of range of motion is a common complication of injuries to the knee area. The causes of post-traumatic knee stiffness can be divided into flexion contractures, extension contractures, and combined contractures. Post-traumatic stiffness can be due to the presence of dense intra-articular adhesions and/or fibrotic transformation of peri-articular structures. Various open and arthroscopic surgical treatments are possible. A precise diagnosis and understanding of the pathology is mandatory prior to any surgical treatment. Failure is imminent if all pathologies are not addressed correctly. From a general point of view, a flexion contracture is due to posterior adhesions and/or anterior impingement. On the other hand, extension contractures are due to anterior adhesions and/or posterior impingement. This overview will describe the different modern surgical techniques for treating post-traumatic knee stiffness. Any bony impingements must be treated before soft tissue release is performed. Intra-articular stiff knees with a loss of flexion can be treated by an anterior arthroscopic arthrolysis. Extra-articular pathology causing a flexion contracture can be treated by open or endoscopic quadriceps release. Extension contractures can be treated by arthroscopic or open posterior arthrolysis. Postoperative care (analgesia, rehabilitation) is essential to maintaining the range of motion obtained intra-operatively. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Traumatic Intrarenal Arteriovenous Fistula Treated by Conservative ...

    African Journals Online (AJOL)

    1974-06-01

    Jun 1, 1974 ... Fig. 1. Excretory urogram demonstrating normal renal parenchyma and collecting system. Renal angiogram: Selective right renal artery catheter- isation demonstrated early filling of the right renal vein consistent with an arteriovenous fistula; a small traumatic pseudo-aneurysm; a relatively avascular area in ...

  12. Bleaching of the discolored traumatized tooth

    DEFF Research Database (Denmark)

    Dahl, Jon E.; Kopperud, Siemen E.; Pallesen, Ulla

    2018-01-01

    This chapter focuses on the treatment of discolored traumatized teeth, most of them being non-vital and subsequently, endodontically treated. Tooth bleaching based upon hydrogen peroxide as the active agent, applied directly or produced in a chemical reaction from sodium perborate or carbamide pe...

  13. Centralized rehabilitation after servere traumatic brain injury

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Liebach, Annette; Nordenbo, Annette Mosbæk

    2006-01-01

    in the prospective study, six died, and 92 (1.27 per 100,000 population per year) survived after a post-traumatic amnesia (PTA) period of at least 28 days. All 19 patients with PTA 7-27 days and 48% of survivors with PTA at least 4 weeks were discharged directly home. The incidence of patients vegetative at 1 month...

  14. Whiplash and post-traumatic stress disorder

    NARCIS (Netherlands)

    Jaspers, JPC

    1998-01-01

    Purpose : This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed. Method: A review of the literature on psychological consequences of motor vehicle accidents and on

  15. Traumatic and alternating delayed intracranial hematomas

    Energy Technology Data Exchange (ETDEWEB)

    Lesoin, F.; Redford, H.; Jomin, M.; Viaud, C.; Pruvo, J.

    1984-11-01

    Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma.

  16. [Endoscopic realignment for post-traumatic rupture of posterior urethra].

    Science.gov (United States)

    Tazi, Hicham; Ouali, Mohammed; Lrhorfi, My Hfid; Moudouni, Saïd; Tazi, Karim; Lakrissa, Ahmed

    2003-12-01

    To analyse the long-term results of treatment of posterior urethral disruptions with endoscopic realignment, and to assess the efficacy, simplicity and benefit of this technique. Between 1989 and 2001, thirty six patients were treated by endoscopic realignment for traumatic rupture of the posterior urethra. The analysis of the results took in consideration the quality of urinary stream, the continence and the erectile function. With a mean follow-up of thirty four months (12 to 72 months), the 36 patients treated by endoscopic realignment are continent and urinate with a satisfactory urine output. This result was obtained after internal urethrotomy in 13 patients (36.1%), and after transperineal urethroplasty in two patients. Only 7 patients (19.4%) developed an impotence. The endoscopic realignment can be considered like initial treatment of all post-traumatic rupture of the posterior urethra. This simple and little aggressive technique doesn't compromise the recourse to another type of ulterior treatment and resulted in negligible morbidity. The secondary urethral strictures are short and accessible to an endoscopic urethrotomy.

  17. Cerebral Edema in Traumatic Brain Injury: Pathophysiology and Prospective Therapeutic Targets.

    Science.gov (United States)

    Winkler, Ethan A; Minter, Daniel; Yue, John K; Manley, Geoffrey T

    2016-10-01

    Traumatic brain injury is a heterogeneous disorder resulting from an external force applied to the head. The development of cerebral edema plays a central role in the evolution of injury following brain trauma and is closely associated with neurologic outcomes. Recent advances in the understanding of the molecular and cellular pathways contributing to the posttraumatic development of cerebral edema have led to the identification of multiple prospective therapeutic targets. The authors summarize the pathogenic mechanisms underlying cerebral edema and highlight the molecular pathways that may be therapeutically targeted to mitigate cerebral edema and associated sequelae following traumatic brain injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Coping strategies and internal resources of dispositional optimism and mastery as predictors of traumatic exposure and of PTSD symptoms: A prospective study.

    Science.gov (United States)

    Gil, Sharon; Weinberg, Michael

    2015-07-01

    This prospective study aimed at examining the role of trait internal resources and coping strategies in predicting traumatic exposure and levels of posttraumatic stress disorder (PTSD) symptoms after such exposure. In total, 870 Israeli students participated in the study, of whom 182 (20%) reported a lifetime history of traumatic exposure at baseline (t1), and a total of 231 (27%) respondents reported traumatic exposure during follow-up (t2, t3). After controlling the effect of lifetime history of traumatic exposure either by using it as a covariate in a multivariate analysis of covariance (MANCOVA) or as a predictor in regression analyses, the results indicate that individuals high on trait avoidance coping style and low on mastery are at a higher risk for traumatic exposure, while those high on trait problem-focused coping style, mastery and dispositional optimism are at a lower risk for PTSD symptoms after such exposure. (c) 2015 APA, all rights reserved).

  19. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief.

    Science.gov (United States)

    Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

    2013-07-15

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12(th), 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors.

  20. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief

    Science.gov (United States)

    Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

    2013-01-01

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12th, 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors. PMID:25206499

  1. Characteristics of the Traumatic Forensic Cases Admitted To Emergency Department and Errors in the Forensic Report Writing.

    Science.gov (United States)

    Aktas, Nurettin; Gulacti, Umut; Lok, Ugur; Aydin, İrfan; Borta, Tayfun; Celik, Murat

    2018-01-01

    To identify errors in forensic reports and to describe the characteristics of traumatic medico-legal cases presenting to the emergency department (ED) at a tertiary care hospital. This study is a retrospective cross-sectional study. The study includes cases resulting in a forensic report among all traumatic patients presenting to the ED of Adiyaman University Training and Research Hospital, Adiyaman, Turkey during a 1-year period. We recorded the demographic characteristics of all the cases, time of presentation to the ED, traumatic characteristics of medico-legal cases, forms of suicide attempt, suspected poisonous substance exposure, the result of follow-up and the type of forensic report. A total of 4300 traumatic medico-legal cases were included in the study and 72% of these cases were male. Traumatic medico-legal cases occurred at the greatest frequency in July (10.1%) and 28.9% of all cases occurred in summer. The most frequent causes of traumatic medico-legal cases in the ED were traffic accidents (43.4%), violent crime (30.5%), and suicide attempt (7.2%). The most common method of attempted suicide was drug intake (86.4%). 12.3% of traumatic medico-legal cases were hospitalized and 24.2% of those hospitalized were admitted to the orthopedics service. The most common error in forensic reports was the incomplete recording of the patient's "cooperation" status (82.7%). Additionally, external traumatic lesions were not defined in 62.4% of forensic reports. The majority of traumatic medico-legal cases were male age 18-44 years, the most common source of trauma was traffic accidents and in the summer months. When writing a forensic report, emergency physicians made mistakes in noting physical examination findings and identifying external traumatic lesions. Physicians should make sure that the traumatic medico-legal patients they treat have adequate documentation for reference during legal proceedings. The legal duties and responsibilities of physicians should be

  2. [Nanostructured bioplastic material for traumatic corneal injuries].

    Science.gov (United States)

    Kanyukov, V N; Stadnikov, A A; Trubina, O M; Yakhina, O M

    2015-01-01

    To substantiate the use of nanostructured bioplastic material for the treatment of traumatic eye injuries. The study enrolled 96 eyes of 48 rabbits and was carried out in 3 series of experiments, different in the type of induced corneal trauma: mechanical erosion, alkaline or acid burn. The animals were clinically monitored and sacrificed for morphological investigation at days 3, 7, 14, 30, and 90. The size of mechanical corneal erosions was repeatedly evaluated with fluorescein eye stain test. In the experimental group, Hyamatrix biomaterial was topically administered according to an original technique. In the controls, soft contact lenses were inserted and sutured. Complete closure of the epithelial defect with no impact on corneal properties was achieved in 3 days in the experimental group and in4 days in the control group. As for alkaline and acid corneal burns, experimental and control groups received Hyamatrix biomaterial and Solcoseryl eye gel correspondingly. In the experimental group of alkaline burn the defect closed by day 7, in the controls--by day 10-11. Acid-induced corneal edema also resolved by day 7 in the experimental group and by day 14 in the control group. 1. The results of this experimental and morphological study prove the hyaluronic acid-derived nanostructured bioplastic material effective in accelerating corneal re-epithelialization after mechanical erosions as compared with the controls. 2. Topical application of the hyaluronic acid-derived nanostructured bioplastic material shortens the exudative phase of inflammation, promotes corneal defect closure with formation of a more subtle opacification, and stimulates corneal restoration after chemical burns.

  3. Presentation and outcome of traumatic spinal fractures

    Directory of Open Access Journals (Sweden)

    Ahmed El-Faramawy

    2012-01-01

    Full Text Available Background: Motor vehicle crashes and falls account for most of the spine fractures with subsequent serious disability. Aim: To define the incidence, causes, and outcome of spinal fractures. Materials and Methods: Data were collected retrospectively from trauma registry database of all traumatic spinal injuries admitted to the section of trauma surgery in Qatar from November 2007 to December 2009. Results: Among 3712 patients who were admitted to the section of trauma surgery, 442 (12% injured patients had spinal fractures with a mean age of 33.2 ± 12 years. The male to female ratio was 11.6:1. Motor vehicle crashes (36.5% and falls from height (19.3% were the leading causes of cervical injury (P = 0.001. The injury severity score ranged between 4 and 75. Nineteen percent of cases with cervical injury had thoracic injury as well (P = 0.04. Lumber injury was associated with thoracic injury in 27% of cases (P < 0.001. Combined thoracic and lumber injuries were associated with cervical injury in 33% of cases (P < 0.001. The total percent of injuries associated with neurological deficit was 5.4%. Fifty-three cases were managed surgically for spine fractures; 14 of them had associated neurological deficits. Overall mortalityrate was 5%. Conclusions: Spine fractures are not uncommon in Qatar. Cervical and thoracic spine injuries carry the highest incidence of associated neurological deficit and injuries at other spinal levels. Young males are the most exposed population that deserves more emphasis on injury prevention programs in the working sites and in enforcement of traffic laws.

  4. Embolization Therapy for Traumatic Splenic Lacerations

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    Dasgupta, Niloy; Matsumoto, Alan H., E-mail: ahm4d@virginia.edu; Arslan, Bulent; Turba, Ulku C.; Sabri, Saher; Angle, John F. [University of Virginia Health System, Division of Vascular and Interventional Radiology, Department of Radiology (United States)

    2012-08-15

    Purpose: This study was designed to evaluate the clinical success, complications, and transfusion requirements based on the location of and agents used for splenic artery embolization in patients with splenic trauma. Methods: A retrospective study was performed of patients with splenic trauma who underwent angiography and embolization from September 2000 to January 2010 at a level I trauma center. Electronic medical records were reviewed for demographics, imaging data, technical aspects of the procedure, and clinical outcomes. Results: Fifty patients were identified (34 men and 16 women), with an average age of 48 (range, 16-80) years. Extravasation was seen on initial angiography in 27 (54%) and was absent in 23 (46%). All 27 patients with extravasation were embolized, and 18 of 23 (78.2%) without extravasation were embolized empirically. Primary clinical success was similar (>75%) across all embolization locations, embolic agents, and grades of laceration treated. Of 45 patients treated, 9 patients (20%) were embolized in the main splenic artery, 34 (75.6%) in the splenic hilum, and 2 (4.4%) were embolized in both locations. Partial splenic infarctions developed in 47.3% treated in the splenic hilum compared with 12.5% treated in the main splenic artery. There were four (8.9%) mortalities: two occurred in patients with multiple critical injuries and two from nonbleeding etiologies. Conclusions: Embolization of traumatic splenic artery injuries is safe and effective, regardless of the location of treatment. Embolization in splenic hilar branches may have a higher incidence of infarction. The grade of laceration and agents used for embolotherapy did not impact the outcomes.

  5. Influence of post-traumatic stress disorder on neuroinflammation and cell proliferation in a rat model of traumatic brain injury.

    Directory of Open Access Journals (Sweden)

    Sandra A Acosta

    Full Text Available Long-term consequences of traumatic brain injury (TBI are closely associated with the development of severe psychiatric disorders, such as post-traumatic stress disorder (PTSD, yet preclinical studies on pathological changes after combined TBI with PTSD are lacking. In the present in vivo study, we assessed chronic neuroinflammation, neuronal cell loss, cell proliferation and neuronal differentiation in specific brain regions of adult Sprague-Dawley male rats following controlled cortical impact model of moderate TBI with or without exposure to PTSD. Eight weeks post-TBI, stereology-based histological analyses revealed no significant differences between sham and PTSD alone treatment across all brain regions examined, whereas significant exacerbation of OX6-positive activated microglial cells in the striatum, thalamus, and cerebral peduncle, but not cerebellum, in animals that received TBI alone and combined TBI-PTSD compared with PTSD alone and sham treatment. Additional immunohistochemical results revealed a significant loss of CA3 pyramidal neurons in the hippocampus of TBI alone and TBI-PTSD compared to PTSD alone and sham treatment. Further examination of neurogenic niches revealed a significant downregulation of Ki67-positive proliferating cells, but not DCX-positive neuronally migrating cells in the neurogenic subgranular zone and subventricular zone for both TBI alone and TBI-PTSD compared to PTSD alone and sham treatment. Comparisons of levels of neuroinflammation and neurogenesis between TBI alone and TBI+PTSD revealed that PTSD did not exacerbate the neuropathological hallmarks of TBI. These results indicate a progressive deterioration of the TBI brain, which, under the conditions of the present approach, was not intensified by PTSD, at least within our time window and within the examined areas of the brain. Although the PTSD manipulation employed here did not exacerbate the pathological effects of TBI, the observed long

  6. Influence of post-traumatic stress disorder on neuroinflammation and cell proliferation in a rat model of traumatic brain injury.

    Science.gov (United States)

    Acosta, Sandra A; Diamond, David M; Wolfe, Steven; Tajiri, Naoki; Shinozuka, Kazutaka; Ishikawa, Hiroto; Hernandez, Diana G; Sanberg, Paul R; Kaneko, Yuji; Borlongan, Cesar V

    2013-01-01

    Long-term consequences of traumatic brain injury (TBI) are closely associated with the development of severe psychiatric disorders, such as post-traumatic stress disorder (PTSD), yet preclinical studies on pathological changes after combined TBI with PTSD are lacking. In the present in vivo study, we assessed chronic neuroinflammation, neuronal cell loss, cell proliferation and neuronal differentiation in specific brain regions of adult Sprague-Dawley male rats following controlled cortical impact model of moderate TBI with or without exposure to PTSD. Eight weeks post-TBI, stereology-based histological analyses revealed no significant differences between sham and PTSD alone treatment across all brain regions examined, whereas significant exacerbation of OX6-positive activated microglial cells in the striatum, thalamus, and cerebral peduncle, but not cerebellum, in animals that received TBI alone and combined TBI-PTSD compared with PTSD alone and sham treatment. Additional immunohistochemical results revealed a significant loss of CA3 pyramidal neurons in the hippocampus of TBI alone and TBI-PTSD compared to PTSD alone and sham treatment. Further examination of neurogenic niches revealed a significant downregulation of Ki67-positive proliferating cells, but not DCX-positive neuronally migrating cells in the neurogenic subgranular zone and subventricular zone for both TBI alone and TBI-PTSD compared to PTSD alone and sham treatment. Comparisons of levels of neuroinflammation and neurogenesis between TBI alone and TBI+PTSD revealed that PTSD did not exacerbate the neuropathological hallmarks of TBI. These results indicate a progressive deterioration of the TBI brain, which, under the conditions of the present approach, was not intensified by PTSD, at least within our time window and within the examined areas of the brain. Although the PTSD manipulation employed here did not exacerbate the pathological effects of TBI, the observed long-term inflammation and suppressed

  7. Epidemiology of traumatic spinal cord injury in Canada.

    Science.gov (United States)

    Pickett, Gwynedd E; Campos-Benitez, Mauricio; Keller, Jana L; Duggal, Neil

    2006-04-01

    Retrospective review. To describe the incidence, clinical features, and treatment of traumatic spinal cord injury (SCI) treated at a Canadian tertiary care center. Understanding the current epidemiology of acute traumatic SCI is essential for public resource allocation and primary prevention. Recent reports suggest that the mean age of patients with SCI may be increasing. We retrospectively reviewed hospital records on all patients with traumatic SCI between January 1997 and June 2001 (n = 151). Variables assessed included age, gender, length of hospitalization, type and mechanism of injury, associated spinal fractures, neurologic deficit, and treatment. Annual age-adjusted incidence rates were 42.4 per million for adults aged 15-64 years, and 51.4 per million for those 65 years and older. Motor vehicle accidents accounted for 35% of SCI. Falls were responsible for 63% of SCI among patients older than 65 years and for 31% of injuries overall. Cervical SCI was most common, particularly in the elderly, and was associated with fracture in only 56% of cases. Thoracic and lumbar SCI were associated with spinal fractures in 100% and 85% of cases, respectively. In-hospital mortality was 8%. Mortality was significantly higher among the elderly. Treatment of thoracic and lumbar fractures associated with SCI was predominantly surgical, whereas cervical fractures were equally likely to be treated with external immobilization alone or with surgery. A large proportion of injuries was seen among older adults, predominantly as a result of falls. Prevention programs should expand their focus to include home safety and avoidance of falls in the elderly.

  8. Neuropathology and brain weight in traumatic-crush asphyxia.

    Science.gov (United States)

    Al-Sarraj, Safa; Laxton, Ross; Swift, Ben; Kolar, Alexander J; Chapman, Rob C; Fegan-Earl, Ashley W; Cary, Nat R B

    2017-11-01

    Traumatic (crush) asphyxia is a rare condition caused by severe compression of the chest and trunk leading to often extreme so-called asphyxial signs, including cyanosis in head and neck regions, multiple petechiae, and subconjunctival haemorrhage as well as neurological manifestations. To investigate the neuropathology and brain weight in traumatic asphyxia caused by different accidents such as industrial accidents and road traffic collision. Post mortem records of 20 cases of traumatic asphyxia (TA) resulting from different causes of which four brains are available for comprehensive neuropathological examination. The expected brain weights for given body height and associated 95% confidence range were calculated according to the following formula: baseline brain weight (BBW) + body height x rate (g/cm). The 95% confidence range was calculated by adding and subtracting the standard error (SE) x 1.96 (7-8). There was a trend for higher brain weight in the TA cohort but it was not significant (1494 g vs 1404 g, p = 0.1). The upper limits of the brain weight of 95% confidence was 1680 g vs 1660 g, p = 0.9. The neuropathological examination of four available brains from the TA cohort showed severe congestion of blood vessels, perivascular haemorrhages and occasional βAPP deposits consistent with early axonal disruption. Brain examination is informative as part of investigation of TA. Developing ischaemic changes and an increase in brain weight are the most likely indicators of a prolonged period of patient's survival. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  9. Early versus late traumatic cataract surgery and intraocular lens implantation.

    Science.gov (United States)

    Tabatabaei, S A; Rajabi, M B; Tabatabaei, S M; Soleimani, M; Rahimi, F; Yaseri, M

    2017-08-01

    PurposeTo determine the proper time for traumatic cataract surgery after open globe injuries.SettingFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.DesignRandomized clinical trial.Patients and methodsIn a randomized clinical trial, 30 eyes with traumatic cataract after open globe injury with IOL implantation underwent early (in the first week after the trauma) and 30 eyes underwent late cataract surgery (from the first to second month after the trauma). We excluded patients who were under 12-year-old. All patients were visited at 1 week, 4 weeks, 12 weeks, and 6 months after surgery. In each visit, patients were examined regarding visual acuity, intraocular pressure (IOP), anterior chamber inflammation, IOL position, and posterior synechiae. In addition, posterior segment evaluation and fundoscopy were performed. Intraoperative complication including posterior capsular rupture, anterior vitrectomy, and zonulysis as well as the site of IOL implantation were documented and post-operative complications including raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were listed.ResultsBest-corrected visual acuity 6 months after surgery was not different between the two groups. Also in early cataract surgery group, the rate of posterior capsular rupture was not significantly higher than the late surgery group (P=0.069). On the other hand, zonulysis was significantly higher in the late procedure group (P=0.039). Other complications including anterior vitrectomy, raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were not different in the two groups.ConclusionsEarly and late traumatic cataract surgery and IOL implantation after open globe injuries, have no significant difference regarding the post-surgical BCVA and prominent intraoperative and post-operative complications.

  10. A review of glutamate's role in traumatic brain injury mechanisms

    Science.gov (United States)

    Good, Cameron H.

    2013-05-01

    Glutamate is the primary excitatory neurotransmitter used by the central nervous system (CNS) for synaptic communication, and its extracellular concentration is tightly regulated by glutamate transporters located on nearby astrocytes. Both animal models and human clinical studies have demonstrated elevated glutamate levels immediately following a traumatic brain event, with the duration and severity of the rise corresponding to prognosis. This rise in extracellular glutamate likely results from a combination of excessive neurotransmitter release from damaged neurons and down regulation of uptake mechanisms in local astrocytes. The immediate results of a traumatic event can lead to necrotic tissue in severely injured regions, while prolonged increases in excitatory transmission can cause secondary excitotoxic injury through activation of delayed apoptotic pathways. Initial TBI animal studies utilized a variety of broad glutamate receptor antagonists to successfully combat secondary injury mechanisms, but unfortunately this same strategy has proven inconclusive in subsequent human trials due to deleterious side effects and heterogeneity of injuries. More recent treatment strategies have utilized specific glutamate receptor subunit antagonists in an effort to minimize side effects and have shown promising results. Future challenges will be detecting the concentration and kinetics of the glutamate rise following injury, determining which patient populations could benefit from antagonist treatment based on their extracellular glutamate concentrations and when drugs should be administered to maximize efficacy.

  11. Traumatic vs non-traumatic spinal cord lesions: comparison of neurological and functional outcome after in-patient rehabilitation.

    Science.gov (United States)

    Gupta, A; Taly, A B; Srivastava, A; Vishal, S; Murali, T

    2008-07-01

    Retrospective comparative study of 2 years duration. To compare neurological and functional outcome and length of stay of persons with traumatic vs non-traumatic spinal cord lesion (SCL) after in-patient rehabilitation. Neurological rehabilitation department of a tertiary research center in Bangalore, Karnataka, India. Seventy-six in-patients with spinal cord lesion: traumatic (38 patients, M/F=34:4) and non-traumatic (38 patients, M/F=16:22) were admitted for in-patient multidisciplinary neurorehabilitation. ASIA impairment scale, duration of stay (DOS), and admission and discharge--Barthel Index scores in both the groups were recorded, compared and analyzed. ASIA impairment scale scores were significantly higher in non-traumatic group both at admission and discharge (P=0.020 and 0.017), respectively, showing lesser impairment in non-traumatic group. DOS for rehabilitation was higher for traumatic group as compared to non-traumatic group (65.97+/-47.66 vs 60.68+/-45.69 days), although statistically not significant (P>0.05). Barthel Index scores were 28.68+/-17.15 vs 27.63+/-14.96 at admission and 54.21+/-25.10 vs 51.44+/-19.86 at discharge in traumatic and non-traumatic groups, respectively. All patients (n=76) showed significant improvement in Barthel Index (P=0.000), but no statistically significant difference (P>0.05) was recorded between the two groups, both at admission and at discharge. Orthoses was required significantly more frequently (P=0.043) in traumatic SCL group. The study showed that despite more impairment in persons with traumatic spinal cord lesion, there was statistically no significant difference in the length of stay and the functional outcome between persons with traumatic and non-traumatic spinal cord lesion after in-patient rehabilitation.

  12. Treatment of traumatized refugees with Sertraline versus Venlafaxine in combination with psychotherapy – study protocol for a randomized clinical trial

    Science.gov (United States)

    2013-01-01

    Background Sufficient evidence is lacking to draw final conclusions on the efficiency of medical and psychological treatments of traumatized refugees with PTSD. The pharmacological treatments of choice today for post-traumatic stress disorder are antidepressants from the subgroup selective serotonin reuptake inhibitors, especially Sertraline. The evidence for the use of selective serotonin reuptake inhibitors in the treatment of complex post-traumatic stress disorder in traumatized refugees is very limited. Venlafaxine is a dual-action antidepressant that works on several pathways in the brain. It influences areas in the brain which are responsible for the enhanced anxiety and hyper-arousal experienced by traumatized refugees and which some studies have found to be enlarged among patients suffering from post-traumatic stress disorder. Design This study will include approximately 150 patients, randomized into two different groups treated with either Sertraline or Venlafaxine. Patients in both groups will receive the same manual-based cognitive behavioral therapy, which has been especially adapted to this group of patients. The treatment period will be 6 to 7 months. The trial endpoints will be post-traumatic stress disorder and depressive symptoms and social functioning, all measured on validated ratings scales. Furthermore the study will examine the relation between a psycho-social resources and treatment outcome based on 15 different possible outcome predictors. Discussion This study is expected to bring forward new knowledge on treatment and clinical evaluation of traumatized refugees and the results are expected to be used in reference programs and clinical guidelines. Trial registration ClinicalTrials.gov NCT01569685 PMID:23663588

  13. Weaker lower extremity muscle strength predicts traumatic knee injury in youth female but not male athletes

    Science.gov (United States)

    Ryman Augustsson, Sofia; Ageberg, Eva

    2017-01-01

    Background The role of lower extremity (LE) muscle strength for predicting traumatic knee injury in youth athletes is largely unknown. Aims The aim was to investigate the influence of LE muscle strength on traumatic knee injury in youth female and male athletes. Methods 225 athletes (40% females) from sport senior high schools in Sweden were included in this case–control study. The athletes recorded any traumatic knee injury that had occurred during their high-school period in a web-based injury form. A one repetition maximum (1RM) barbell squat test was used to measure LE muscle strength. The 1RM was dichotomised to analyse ‘weak’ versus ‘strong’ athletes according to the median (weakmedian vs strongmedian). Results 63 traumatic knee injuries, including 18 ACL injuries, were registered. The majority of injured female athletes were in the weak group compared with the strong group (p=0.0001). The odds of sustaining a traumatic knee injury and an ACL injury was 9.5 times higher and 7 times higher, respectively, in the weakmedian group compared with the strongmedian group in females (p ≤0.011). A relative 1RM squat ≤1.05 kg (105% of bodyweight) was established as the best cut-off value to distinguish high versus low risk of injury in female athletes. No strength–injury relationships were observed for the male athletes (p ≥0.348). Conclusions Weaker LE muscle strength predicted traumatic knee injury in youth female athletes, but not in males. This suggests that LE muscle strength should be included in injury screening in youth female athletes. PMID:29259807

  14. Patient-reported outcomes in post-traumatic stress disorder Part II: Focus on pharmacological treatment

    Science.gov (United States)

    Kapfhammer, Hans-Peter

    2014-01-01

    Post-traumatic stress disorder (PTSD) may be associated with long-lasting psychological suffering, distressing psychosocial disability, markedly reduced health-related quality of life, and increased morbidity and mortality in a subgroup of individuals in the aftermath of serious traumatic events. Both etiopathogenesis and treatment modalities of PTSD are best conceptualized within a biopsychosotial model. Pharmacotherapy may lay claim to a major role in the multimodal treatment approaches. Here we outline two different pharmacotherapeutic trends that aim to modify the encoding, consolidation, and rehearsal of traumatic memory in order to reduce the risk of PTSD immediately after trauma exposure on the one hand, and that endeavor to treat the clinical state of PTSD on the other. The theoretical rationales of both pharmacological strategies are the complex neurobiological underpinnings that characterize traumatic memory organization and clinical PTSD. Meanwhile, promising data from randomized controlled trials have been obtained for both approaches. Empirical evidence may inform clinicians in their clinical efforts for this special group of patients. The efficacy of several classes of drugs that have been investigated within a context of research should be evaluated critically and still have to stand the test of effectiveness in daily clinical practice. From a patient perspective, empirical results may serve as a psychoeducative guideline to what pharmacotherapeutic approaches may realistically achieve, what their risks and benefits are, and what their limits are in contributing to reducing the often major chronic suffering caused by serious traumatic events. Ethical issues have to be considered, particularly in the context of pharmacological strategies projected to prevent PTSD in the aftermath of traumatic exposure. PMID:25152660

  15. Dialogical Exposure with Traumatically Bereaved Bosnian Women: Findings from a Controlled Trial.

    Science.gov (United States)

    Hagl, Maria; Powell, Steve; Rosner, Rita; Butollo, Willi

    2015-01-01

    In this trial, we compared the relative efficacy of dialogical exposure group treatment using Gestalt empty-chair method with a supportive group in the treatment of symptoms stemming from traumatic loss in a post-war society. One-hundred and nineteen women whose husbands were either killed or registered as missing during the war in Bosnia and Herzegovina were quasi-randomized to seven sessions of group treatment with dialogical exposure or to an active control condition. Both interventions resulted in significant improvement from baseline to post-treatment for both kinds of loss, in terms of post-traumatic symptoms, general mental health and grief reactions, with the exception of depression and traumatic grief in the control condition. Regarding mean effect sizes (Cohen's d), pre-treatment to post-treatment improvements were moderate (d = 0.56) for the dialogical exposure group and small (d = 0.34) for the supportive group. Treatment gains were maintained at least until the 1-year follow-up. In controlled comparisons, dialogical exposure was superior concerning traumatic grief (Cohen's d = 0.37) and post-traumatic avoidance (d = 0.73) at post-treatment. Results show that short-term dialogical exposure group treatment was moderately effective in treating traumatically bereaved women. Research attests to high levels of symptoms among post-war civil populations, in particular, when a loved one was killed, which can lead not only to trauma reactions but also to severe separation distress. Grieving the loss of a loved one is hampered if the death remains unconfirmed. Unconfirmed loss could be conceptualized as unfinished business in terms of Gestalt therapy, which offers empty-chair dialogue for resolving unfinished business and grief. Dialogical exposure therapy (DET) supports the client in gaining awareness of and expressing his or her inner dialogues concerning the traumatic event, using Gestalt empty-chair method. Short-term DET was effective in

  16. Analysis of traumatic ulcer healing time under the treatment of the Mauli banana (Musa acuminata 25% stem extract gel

    Directory of Open Access Journals (Sweden)

    Dewi Puspitasari

    2017-03-01

    Full Text Available ABSTRACT Introduction: Traumatic ulcer is one of oral disorders that often occur. The prevalence is quite high, between 3-24% of population. Therapy of traumatic ulcer is symptomatic. People usually use Aloe vera extract gel. Previous research showed that the Aloe vera gel is equivalent with ethanol extract of 25% Mauli banana (Musa acuminata stem in accelerating wound healing based on the number of macrophages and neovascular. The objective of the study is to find out the time difference of traumatic ulcer healing using 25% Musa acuminata stem extract gel compared to a gel containing Aloe vera extract. Methods: The research was post test design. Subjects were patients of Oral Medicine Installation in Gusti Hasan Aman Dental Hospital Banjarmasin with diagnosis of traumatic ulcer using completely random sampling method. Eight patients as samples were determined by the formula of Lemeshow. Results: there was no significant difference with p=0,724 (p>0,05 between healing time using Aloe vera gel and 25% Musa acuminata stem extract. Conclusion: At the concentration of 25% Musa acuminata stem extract gel concentration has the same healing time with Aloe vera gel, therefore can be recommended as a topical use for traumatic ulcer healing. Keywords: Musa acuminata stem, Healing time, Traumatic ulcer

  17. Mental Health Help Seeking Among Traumatized Individuals: A Systematic Review of Studies Assessing the Role of Substance Use and Abuse

    Science.gov (United States)

    van den Berk-Clark, Carissa; Patterson Silver Wolf, David

    2015-01-01

    Objective Prior research has suggested that competing neurobehavioral decision-making processes might affect health outcomes among traumatized populations. Regulatory imbalances to impulsive and executive decision systems are affected by high levels of stress, including stress resulting from traumatic events. Such regulatory imbalances have been associated with addictive behaviors. However, it is not well known whether addictive behavior increases or decreases the likelihood of utilization of behavioral health services among traumatized populations. The aim of this study is to systematically review mental health utilization studies targeting traumatized populations to determine the direction of association between substance use and behavioral health utilization. Method Databases of literature were searched in a systematic manner, and 37 relevant studies were recovered and analyzed. Findings Out of the 37 relevant studies that included addictive behaviors as a predictor of utilization, 16 showed a positive significant relationship and 6 showed a negative significant relationship. Studies showing a negative significant relationship used younger samples with more recent trauma exposure. Conclusions Studies have shown that for the most part, substance abuse increases the likelihood of utilization, except among younger populations with more recent trauma. Longitudinal studies that access how utilization evolves over time among traumatized populations and interacts with posttraumatic stress disorder (PTSD) and substance abuse severity are necessary to better understand how decision-making processes of traumatized individuals may increase the likelihood of chronic PTSD. PMID:26232295

  18. Non-traumatic perforation of the small bowel | Eid | African Health ...

    African Journals Online (AJOL)

    ... medical records of four patients who have presented with non-traumatic perforation of the small bowel and were treated at Al-Ain Hospital during the last 5 years were studied retrospectively. Results: The presenting symptoms of all patients were similar. Erect chest X-ray has shown free air under diaphragm in 3 patients.

  19. Traumatic abdominal wall hernia - four cases and a review of the ...

    African Journals Online (AJOL)

    Objective: To review blunt traumatic abdominal wall hernias (TAWHs) in our institution. Method: Retrospective review of blunt abdominal trauma cases over a 6-month period. Results: Four patients with TAWH were identified. The mean age was 36 years. Three had been involved in vehicular collisions, and 1 had been ...

  20. COMT Val 158 Met polymorphism is associated with nonverbal cognition following mild traumatic brain injury

    NARCIS (Netherlands)

    E.A. Winkler (Ethan A.); J.K. Yue (John); T.W. McAllister (Thomas W.); N.R. Temkin (Nancy); S.S. Oh (Sam S.); E.G. Burchard (Esteban); D. Hu (Donglei); A.R. Ferguson (Adam); H.F. Lingsma (Hester); J.F. Burke (John F.); M.D. Sorani (Marco); J. Rosand (Jonathan); E.L. Yuh (Esther); J. Barber (Jason); P.E. Tarapore (Phiroz E.); R.C. Gardner (Raquel C.); S. Sharma (Sourabh); G.G. Satris (Gabriela G.); C. Eng (Celeste); A.M. Puccio (Ava); K.K.W. Wang (Kevin K. W.); P. Mukherjee (Pratik); A.B. Valadka (Alex); D. Okonkwo (David); R. Diaz-Arrastia (Ramon); G. Manley (Geoffrey)

    2016-01-01

    textabstractMild traumatic brain injury (mTBI) results in variable clinical outcomes, which may be influenced by genetic variation. A single-nucleotide polymorphism in catechol-o-methyltransferase (COMT), an enzyme which degrades catecholamine neurotransmitters, may influence cognitive deficits

  1. Clinician-performed Beside Ultrasound for the Diagnosis of Traumatic Pneumothorax

    OpenAIRE

    Ku, Bon S.; Fields, J. Matthew; Carr, Brendan; Everett, Worth W.; Gracias, Vincent H.; Dean, Anthony J.

    2013-01-01

    Introduction: Prior studies have reported conflicting results regarding the utility of ultrasound in the diagnosis of traumatic pneumothorax (PTX) because they have used sonologists with extensive experience. This study evaluates the characteristics of ultrasound for PTX for a large cohort of trauma and emergency physicians. Methods: This was a prospective, observational study on a convenience sample of patients presenting to a trauma ...

  2. Acute Inflammatory Response in Rodent Brain and Blood Following a Blast Induced Traumatic Brain Injury

    Science.gov (United States)

    2014-11-01

    dehydrated with 30% sucrose before storing at -80 °C. Thirty micron coronal sections were stained with a primary antibody against microglia ...strongly Iba-1 stained cells as compared to controls. These results indicate blast exposure induces activation of microglia in the hippocampus... Neuroinflammation after traumatic brain injury: Opportunities for therapeutic intervention. Brain, behaviour and Immunity 26: 1191-1201. Loane, D. J

  3. Traumatic Brain Injury in Rats Induces Lung Injury and Systemic Immune Suppression

    NARCIS (Netherlands)

    Vermeij, Jan-Dirk; Aslami, Hamid; Fluiter, Kees; Roelofs, Joris J.; van den Bergh, Walter M.; Juffermans, Nicole P.; Schultz, Marcus J.; Van der Sluijs, Koen; van de Beek, Diederik; van Westerloo, David J.

    2013-01-01

    Traumatic brain injury (TBI) is frequently complicated by acute lung injury, which is predictive for poor outcome. However, it is unclear whether lung injury develops independently or as a result of mechanical ventilation after TBI. Further, TBI is strongly associated with the development of

  4. Treatment of sleep disturbances in refugees suffering from post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Sandahl, Hinuga; Vindbjerg, Erik; Carlsson, Jessica

    2017-01-01

    Sleep disturbances are often referred to as the hallmark of Post-Traumatic Stress Disorder (PTSD). Although PTSD is prevalent in refugees, studies on sleep disturbances in trauma-affected refugees are scarce. This article presents the results of two studies: a systematic review of the literature...

  5. Interventions for Secondary Traumatic Stress with Mental Health Workers: A Systematic Review

    Science.gov (United States)

    Bercier, Melissa L.; Maynard, Brandy R.

    2015-01-01

    Objective: A systematic review was conducted to examine effects of indicated interventions to reduce symptoms of secondary traumatic stress (STS) experienced by mental health workers. Method: Systematic review methods were employed to search, retrieve, select, and analyze studies that met study inclusion criteria. Results: Over 4,000 citations…

  6. Validity of 'post-traumatic stress disorder with secondary psychotic features': a review of the evidence

    NARCIS (Netherlands)

    Braakman, M. H.; Kortmann, F. A. M.; van den Brink, W.

    2009-01-01

    OBJECTIVE: To review the evidence from empirical studies regarding the validity of 'post-traumatic stress disorder with secondary psychotic features' (PTSD-SP) as a separate diagnostic entity. METHOD: The authors performed a review tracing publications between 1980 and January 2008. RESULTS:

  7. Traumatic dental injuries to permanent anterior teeth in 12 - 15 year ...

    African Journals Online (AJOL)

    Results: Among the 1382 children examined, 222(16.1%) had experienced traumatic dental injuries (TDIs). Males had experienced a significantly higher prevalence of trauma 126(18.8%) than females 96(13.5%) p=0.008. Falls were the leading cause of TDIs as reported by 78(35.1%) children. Amongst the, male children, ...

  8. Trauma in relationship – healing by religion : Restoring dignity and meaning after traumatic experiences

    NARCIS (Netherlands)

    Wulf, Mariéle

    2018-01-01

    Trauma in relationship, often experienced as micro-trauma, may affect spirituality, because spirituality is lived as and in a relationship to God. If a relationship is traumatizing, it affects all the dimensions of the human being, and deprives a person of his/her dignity. As a result of trauma a

  9. [Traumatic rupture of the aortic isthmus in a child, revealed by paraplegia].

    Science.gov (United States)

    Guibert, L; Frémond, B; Bourdelat, D; Bracq, H; Leguerrier, A; Guillou, L; Dormoy, D; Malledant, Y

    1985-01-01

    After a severe polytraumatism, a 14 year-old boy presents paraplegia without vertebral lesion. Angiocardiography showed rupture of aortic isthmus. Surgical treatment resulted in successful outcome. The authors insist on the rarity of traumatic rupture of aorta in children and or the particularity of the diagnosis revealed by paraplegia.

  10. Online Structured Writing Therapy for Post-traumatic Stress Disorder and Complicated Grief

    NARCIS (Netherlands)

    Ruwaard, J.; Lange, A.; Lindefors, N.; Andersson, G.

    2016-01-01

    Post-traumatic stress disorder (PTSD) and complicated grief are related disorders for which well-described and effective cognitive-behavioural therapeutic procedures exist that are firmly rooted in theoretical work. As a result, several research groups have been able to successfully translate these

  11. Measurement Differences from Rating Posttraumatic Stress Disorder Symptoms in Response to Differentially Distressing Traumatic Events

    Science.gov (United States)

    Elhai, Jon D.; Fine, Thomas H.

    2012-01-01

    The authors explored differences in posttraumatic stress disorder (PTSD) symptoms as a result of rating symptoms from two separate, differentially distressing traumatic events. In an initial sample of 400 nonclinical participants, the authors inquired through a web survey about previous psychological trauma, instructing participants to nominate…

  12. Molecular mechanisms of cognitive dysfunction following traumatic brain injury.

    Science.gov (United States)

    Walker, Kendall R; Tesco, Giuseppina

    2013-01-01

    Traumatic brain injury (TBI) results in significant disability due to cognitive deficits particularly in attention, learning and memory, and higher-order executive functions. The role of TBI in chronic neurodegeneration and the development of neurodegenerative diseases including Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic Lateral Sclerosis (ALS) and most recently chronic traumatic encephalopathy (CTE) is of particular importance. However, despite significant effort very few therapeutic options exist to prevent or reverse cognitive impairment following TBI. In this review, we present experimental evidence of the known secondary injury mechanisms which contribute to neuronal cell loss, axonal injury, and synaptic dysfunction and hence cognitive impairment both acutely and chronically following TBI. In particular we focus on the mechanisms linking TBI to the development of two forms of dementia: AD and CTE. We provide evidence of potential molecular mechanisms involved in modulating Aβ and Tau following TBI and provide evidence of the role of these mechanisms in AD pathology. Additionally we propose a mechanism by which Aβ generated as a direct result of TBI is capable of exacerbating secondary injury mechanisms thereby establishing a neurotoxic cascade that leads to chronic neurodegeneration.

  13. Post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the Yushu earthquake: a cross-sectional survey in China.

    Science.gov (United States)

    Dongling, Liu; Hui, Chen; Ling, Ma; Wenqian, Bie; Zailiang, Liu; Changying, Chen

    2017-04-01

    To examine the prevalence of post-traumatic stress disorder symptoms and to explore the predictive factors of post-traumatic stress disorder symptoms among bereaved adolescents four years after the Yushu earthquake. On 14 April 2010, the 7·1-magnitude Yushu earthquake occurred in the high-altitude, hypoxia-prone regions primarily inhabited by ethnic minorities. Many adolescents lost their parents during the earthquake. This study examined post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the trauma in China. This was a cross-sectional descriptive study. This study used a cross-sectional design with 830 bereaved adolescents. Participant demographic data included gender, age and grade, and the earthquake exposure variables included the deceased relatives, whether they were buried, injured or amputated (non-life-threatening) and whether they witnessed a burial, injury or death. The post-traumatic stress disorder Checklist-Civilian version was used to assess the symptoms and prevalence of post-traumatic stress disorder, and the Coping Style Scale assessed coping styles. The results indicated that the prevalence of post-traumatic stress disorder was 19·3%. Individuals who were buried, injured or amputated (non-life-threatening), who witnessed a burial, injury or death, who suffered severe property loss during the earthquake and who had negative coping skills were the most likely individuals to have post-traumatic stress disorder symptoms. The presence of post-traumatic stress disorder was very prevalent among adolescents four years after the Yushu earthquake. Effective mental health services should be developed to facilitate postdisaster recovery for bereaved adolescents at high risk for post-traumatic stress disorder. The findings in this study improve our understanding of post-traumatic stress disorder and related risk factors in bereaved adolescents in non-Western communities, providing useful information for

  14. Longitudinal changes of telomere length and epigenetic age related to traumatic stress and post-traumatic stress disorder.

    Science.gov (United States)

    Boks, Marco P; van Mierlo, Hans C; Rutten, Bart P F; Radstake, Timothy R D J; De Witte, Lot; Geuze, Elbert; Horvath, Steve; Schalkwyk, Leonard C; Vinkers, Christiaan H; Broen, Jasper C A; Vermetten, Eric

    2015-01-01

    Several studies have reported an association between traumatic stress and telomere length suggesting that traumatic stress has an impact on ageing at the cellular level. A newly derived tool provides an additional means to investigate cellular ageing by estimating epigenetic age based on DNA methylation profiles. We therefore hypothesise that in a longitudinal study of traumatic stress both indicators of cellular ageing will show increased ageing. We expect that particularly in individuals that developed symptoms of post-traumatic stress disorder (PTSD) increases in these ageing parameters would stand out. From an existing longitudinal cohort study, ninety-six male soldiers were selected based on trauma exposure and the presence of symptoms of PTSD. All military personnel were deployed in a combat zone in Afghanistan and assessed before and 6 months after deployment. The Self-Rating Inventory for PTSD was used to measure the presence of PTSD symptoms, while exposure to combat trauma during deployment was measured with a 19-item deployment experiences checklist. These groups did not differ for age, gender, alcohol consumption, cigarette smoking, military rank, length, weight, or medication use. In DNA from whole blood telomere length was measured and DNA methylation levels were assessed using the Illumina 450K DNA methylation arrays. Epigenetic ageing was estimated using the DNAm age estimator procedure. The association of trauma with telomere length was in the expected direction but not significant (B=-10.2, p=0.52). However, contrary to our expectations, development of PTSD symptoms was associated with the reverse process, telomere lengthening (B=1.91, p=0.018). In concordance, trauma significantly accelerated epigenetic ageing (B=1.97, p=0.032) and similar to the findings in telomeres, development of PTSD symptoms was inversely associated with epigenetic ageing (B=-0.10, p=0.044). Blood cell count, medication and premorbid early life trauma exposure did not

  15. Prevalence of traumatic events and PTSD symptoms among secondary school students in Baghdad

    Directory of Open Access Journals (Sweden)

    Ashraf Al-Hadethe

    2014-11-01

    Full Text Available Background: People in Iraq have been more or less continually exposed to war for more than three decades. Studies with Iraqi participants report high prevalence rates of posttraumatic stress disorder (PTSD and related problems. Methods: The aim of this study is to measure the prevalence of traumatic events and to screen the prevalence of PTSD symptoms among Iraqi secondary school students. Four self-report scales were administered to 403 secondary school students, aged 16–19 (61% male and 31% female. These scales were Baghdad Trauma History Screen, the Scale of Posttraumatic Stress Symptoms (SPTSS, Social Support Scale, and Scale of Religious Coping. Results: The results showed that 84% of participants experienced at least one traumatic event. Of these, 61% fully met the criteria for PTSD; 65% of the females and 58% of the males. PTSD symptoms were correlated with 20 positive religious coping but not with social support. Conclusions: It’s clear that traumatic events were speared widely among the participants and the result showed that the vast majority of participants were exposed to different types of traumatic events. In addition, many of the participants have met full PTSD criteria and others had partial PTSD.

  16. Traumatic and non-traumatic isolated horizontal meniscal tears of the knee in patients less than 40 years of age.

    Science.gov (United States)

    Kim, Jung-Ryul; Kim, Byung-Guk; Kim, Jin-Woo; Lee, Jin-Hyun; Kim, Jae-Hwa

    2013-07-01

    The aim of this study is to analyze the characteristics of isolated horizontal meniscal tears in young patients and compared traumatic and non-traumatic isolated horizontal meniscal tear without other type of meniscal tear. Forty patients who underwent partial meniscectomy with isolated horizontal meniscal tears and followed up for more than 2 years were divided into two groups according to the presence of distinct previous traumatic events (defined as contusion or sprain) to the knees. Analyzed variables included in this descriptive statistics were involved side of knee and location of meniscus, physical examinations (joint line tenderness and McMurray's testing), subjective International Knee Documentation Committee (IKDC) criteria, and Lysholm functional questionnaires. Twenty-two of the forty patients (55 %) had distinct previous traumatic events. Fourteen cases (63.6 %) in traumatic group and 14 cases (77.8 %) in non-traumatic group are involved non-dominant knees during locomotion or playing sports. Twenty patients (90.9 %) in traumatic group and eight patients (44.4 %) in non-traumatic group presented with tear in the midportion of the medial meniscus on arthroscopic findings (p knees and medial meniscus. Anterior aspect of medial meniscus was more frequently involved in traumatic group. Meniscal cysts were more frequently showed in non-traumatic group.

  17. Cognitive retraining in traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Diya Nangia

    2012-04-01

    Full Text Available Traumatic brain injury (TBI is often associated with cognitive impairments. The psychological sequelae of cognitive deficits and emotional problems contribute significantly to the disability in the patient and to the distress of the family. The study aimed to develop a cognitive retraining programme to enhance cognitive functioning in TBI. 25 years old male presenting with history of left temporal hemorrhagic contusion with cerebral edema underwent 2 months of a cognitive retaining programme, addressing executive functions impairment. A single case experimental design with pre- and post-assessment was adopted to evaluate changes in the patient in response to the intervention. Improvements were found in cognitive functioning, and in symptom reduction and behaviour. The 2 months hospital based cognitive retraining programme was found to be efficacious in ameliorating symptoms and improving cognitive, social and occupational functioning post traumatic brain injury.

  18. Simultaneous, Isolated Traumatic Bilateral Patella Fractures

    Science.gov (United States)

    Madi, Sandesh; Naik, Monappa; Rao, Sharath; Vijayan, Sandeep

    2016-01-01

    Introduction Isolated traumatic fractures of both Patellae, occurring at the same time, in an otherwise healthy person, are very rare. The Patella, as a subcutaneous and a cancellous bone, is vulnerable to injury. However, simultaneous injury to both Patellae without the involvement of any other bony injuries occurs infrequently, and only a few cases have been reported in the literature. Case Presentation We report a rare case of isolated, traumatic bilateral Patella fracture with unusual fracture patterns and briefly review the literature. Conclusions In simultaneous bilateral Patella fractures, good functional outcome can be expected following a stable surgical fixation and a structured rehabilitation regime. However, personality of the fracture determines salvage versus sacrifice of the Patella. PMID:27218047

  19. Life satisfaction in people with post-traumatic stress disorder.

    Science.gov (United States)

    Karatzias, Thanos; Chouliara, Zoë; Power, Kevin; Brown, Keith; Begum, Millia; McGoldrick, Therese; MacLean, Rory

    2013-12-01

    There is limited research on the association between post-traumatic stress disorder (PTSD) and life satisfaction in community samples. We set out to investigate levels of life satisfaction and its demographic, trauma related and clinical predictors in a sample of people with PTSD (n = 46). Participants completed a battery of standardised self-report measures including Satisfaction with Life Scale, the PTSD Checklist and The Hospital Anxiety and Depression Scale. Our results indicated that people with moderately severe PTSD in the community are likely to experience lower levels of life satisfaction compared with those with other psychiatric conditions or those without any diagnoses. Multivariate analysis revealed that marital status and trauma symptoms were the only significant predictors of life satisfaction. In specific, being married and presenting with less severe posttraumatic symptomatology were both significantly associated with higher levels of life satisfaction in people with PTSD. The strong association between traumatic symptomatology and life satisfaction may indicate that routine assessment for life satisfaction or similar positive constructs in people with PTSD, referred for psychological therapies might be useful. Information on positive psychology constructs may facilitate capitalising on clients' strengths and not just on pathology.

  20. Cerebral Infarction after Traumatic Brain Injury: Incidence and Risk Factors.

    Science.gov (United States)

    Bae, Dong-Hyeon; Choi, Kyu-Sun; Yi, Hyeong-Joong; Chun, Hyoung-Joon; Ko, Yong; Bak, Koang Hum

    2014-10-01

    Post-traumatic cerebral infarction (PTCI) is one of the most severe secondary insults after traumatic brain injury (TBI), and is known to be associated with poor outcome and high mortality rate. We assessed the practical incidence and risk factors for the development of PTCI. We conducted retrospective study on 986 consecutive patients with TBI from the period May 2005 to November 2012 at our institution. The definition of PTCI was made on non-enhanced CT scan based on a well-demarcated or fairly discernible region of low attenuation following specific vascular territory with normal initial CT. Clinical and radiological findings that related to patients' outcome were reviewed and statistically compared. PTCI was observed in 21 (2.1%) patients. Of various parameters, age (p=0.037), initial Glasgow coma scale score (paccident and PTCI, patterns of TBI and vascular territory of PTCI were not specific. The mortality rates were significantly higher in patients with PTCI than without PTCI. The development of PTCI is rare after TBI, but it usually results in serious outcome and high mortality. Early recognition for risks and aggressive managements is mandatory to prevent PTCI.

  1. Magnetic resonance imaging of fresh traumatic injuries of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Koji; Ojima, Tadao; Sato, Katsumi; Sato, Tetsuro; Komatsu, Tetsuro; Nobuta, Shingo; Inoue, Hisayoshi; Onuma, Hidezi; Murakami, Tadashi (Tohoku Rosai Hospital, Sendai (Japan))

    1993-11-01

    Taking advantages of its water density delineation, MR studies were carried out in 22 patients having traumatic hemarthrosis of the knee within 3 days of the incidents. Because of swelling and severe pain, exact physical examination of an injured knee is very difficult. However, MR imaging is a non-invasive examination that would facilitate morphological diagnosis of soft tissue injuries such as meniscal tears, ligamental tears, and even fracture. In the present studies, MRI findings were compared with those from arthroscopic investigations and MR reimaging more than one month later. The results were confirming most of the MRI findings. Seventeen cases of tears of the anterior cruciate ligaments, 1 case of tear to posterior cruciate ligaments, 2 cases of tear of medial collateral ligaments, 2 cases of tear of lateral collateral ligaments, 4 cases of tears of meniscal and 6 of fractures. False MRI findings were encountered in only two cases: normal cruciate ligament surrounded with hemarthrosis caused by the tear of anterior cruciate ligament, and the tear of the posteior horn of the lateral meniscus musked by hematoma in the burusa of the popliteus tendon. We concluded that MRI can definitely contribute to clinical diagnosis and treatment planning of fresh traumatic knee injuries buried in hemarthrosis. (author).

  2. Magnetic resonance imaging of fresh traumatic injuries of the knee

    International Nuclear Information System (INIS)

    Ishibashi, Koji; Ojima, Tadao; Sato, Katsumi; Sato, Tetsuro; Komatsu, Tetsuro; Nobuta, Shingo; Inoue, Hisayoshi; Onuma, Hidezi; Murakami, Tadashi

    1993-01-01

    Taking advantages of its water density delineation, MR studies were carried out in 22 patients having traumatic hemarthrosis of the knee within 3 days of the incidents. Because of swelling and severe pain, exact physical examination of an injured knee is very difficult. However, MR imaging is a non-invasive examination that would facilitate morphological diagnosis of soft tissue injuries such as meniscal tears, ligamental tears, and even fracture. In the present studies, MRI findings were compared with those from arthroscopic investigations and MR reimaging more than one month later. The results were confirming most of the MRI findings. Seventeen cases of tears of the anterior cruciate ligaments, 1 case of tear to posterior cruciate ligaments, 2 cases of tear of medial collateral ligaments, 2 cases of tear of lateral collateral ligaments, 4 cases of tears of meniscal and 6 of fractures. False MRI findings were encountered in only two cases: normal cruciate ligament surrounded with hemarthrosis caused by the tear of anterior cruciate ligament, and the tear of the posteior horn of the lateral meniscus musked by hematoma in the burusa of the popliteus tendon. We concluded that MRI can definitely contribute to clinical diagnosis and treatment planning of fresh traumatic knee injuries buried in hemarthrosis. (author)

  3. Chronic Traumatic Encephalopathy and Suicide: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Hal S. Wortzel

    2013-01-01

    Full Text Available Traumatic brain injury (TBI is a global health concern, and the recent literature reports that a single mild TBI can result in chronic traumatic encephalopathy (CTE. It has been suggested that CTE may lead to death by suicide, raising important prevention, treatment, and policy implications. Thus, we conducted a systematic review of the medical literature to answer the key question: What is the existing evidence in support of a relationship between CTE and suicide? Systematic searches of CTE and suicide yielded 85 unique abstracts. Seven articles were identified for full text review. Only two case series met inclusion criteria and included autopsies from 17 unique cases, 5 of whom died by suicide. Neither studies used blinding, control cases, or systematic data collection regarding TBI exposure and/or medical/neuropsychiatric history. The identified CTE literature revealed divergent opinions regarding neuropathological elements of CTE and heterogeneity regarding clinical manifestations. Overall quality of evidence regarding a relationship between CTE and suicide was rated as very low using Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE criteria. Further studies of higher quality and methodological rigor are needed to determine the existence and nature of any relationship between CTE and suicide.

  4. Traumatic brain injury: future assessment tools and treatment prospects

    Directory of Open Access Journals (Sweden)

    Steven R Flanagan

    2008-10-01

    Full Text Available Steven R Flanagan1, Joshua B Cantor2, Teresa A Ashman21New York University School of Medicine, The Rusk Institute of Rehabilitation, New York, NY, USA; 2Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USAAbstract: Traumatic brain injury (TBI is widespread and leads to death and disability in millions of individuals around the world each year. Overall incidence and prevalence of TBI are likely to increase in absolute terms in the future. Tackling the problem of treating TBI successfully will require improvements in the understanding of normal cerebral anatomy, physiology, and function throughout the lifespan, as well as the pathological and recuperative responses that result from trauma. New treatment approaches and combinations will need to be targeted to the heterogeneous needs of TBI populations. This article explores and evaluates the research evidence in areas that will likely lead to a reduction in TBI-related morbidity and improved outcomes. These include emerging assessment instruments and techniques in areas of structural/chemical and functional neuroimaging and neuropsychology, advances in the realms of cell-based therapies and genetics, promising cognitive rehabilitation techniques including cognitive remediation and the use of electronic technologies including assistive devices and virtual reality, and the emerging field of complementary and alternative medicine.Keywords: traumatic brain injury, assessments, treatments

  5. Current pre-hospital traumatic brain injury management in China

    Science.gov (United States)

    Kou, Kou; Hou, Xiang-yu; Sun, Jian-dong; Chu, Kevin

    2014-01-01

    BACKGROUND: Traumatic brain injury (TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, pre-hospital service can significantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China. DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure (CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identified articles. RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions. CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China. PMID:25548596

  6. The Impact of Traumatic Brain Injury on the Aging Brain.

    Science.gov (United States)

    Young, Jacob S; Hobbs, Jonathan G; Bailes, Julian E

    2016-09-01

    Traumatic brain injury (TBI) has come to the forefront of both the scientific and popular culture. Specifically, sports-related concussions or mild TBI (mTBI) has become the center of scientific scrutiny with a large amount of research focusing on the long-term sequela of this type of injury. As the populace continues to age, the impact of TBI on the aging brain will become clearer. Currently, reports have come to light that link TBI to neurodegenerative disorders such as Alzheimer's and Parkinson's diseases, as well as certain psychiatric diseases. Whether these associations are causations, however, is yet to be determined. Other long-term sequelae, such as chronic traumatic encephalopathy (CTE), appear to be associated with repetitive injuries. Going forward, as we gain better understanding of the pathophysiological process involved in TBI and subclinical head traumas, and individual traits that influence susceptibility to neurocognitive diseases, a clearer, more comprehensive understanding of the connection between brain injury and resultant disease processes in the aging brain will become evident.

  7. Isolated traumatic head injury in children: Analysis of 276 observations

    Directory of Open Access Journals (Sweden)

    Bahloul Mabrouk

    2011-01-01

    Full Text Available Background : To determine predictive factors of mortality among children after isolated traumatic brain injury. Materials and Methods : In this retrospective study, we included all consecutive children with isolated traumatic brain injury admitted to the 22-bed intensive care unit (ICU of Habib Bourguiba University Hospital (Sfax, Tunisia. Basic demographic, clinical, biochemical, and radiological data were recorded on admission and during ICU stay. Results : There were 276 patients with 196 boys (71% and 80 girls, with a mean age of 6.7 ± 3.8 years. The main cause of trauma was road traffic accident (58.3%. Mean Glasgow Coma Scale score was 8 ± 2, Mean Injury Severity Score (ISS was 23.3 ± 5.9, Mean Pediatric Trauma Score (PTS was 4.8 ± 2.3, and Mean Pediatric Risk of Mortality (PRISM was 10.8 ± 8. A total of 259 children required mechanical ventilation. Forty-eight children (17.4% died. Multivariate analysis showed that factors associated with a poor prognosis were PRISM > 24 (OR: 10.98, neurovegetative disorder (OR: 7.1, meningeal hemorrhage (OR: 2.74, and lesion type VI according to Marshall tomographic grading (OR: 13.26. Conclusion : In Tunisia, head injury is a frequent cause of hospital admission and is most often due to road traffic injuries. Short-term prognosis is influenced by demographic, clinical, radiological, and biochemical factors. The need to put preventive measures in place is underscored.

  8. Incidence and functional evolution of traumatic injuries of the spine

    Directory of Open Access Journals (Sweden)

    Francisco Alberto Trinidad Ovalle

    2014-09-01

    Full Text Available OBJECTIVE: To determine the incidence and functional outcome of traumatic injuries of the spine in the period from January 1, 2013 to December 31, 2013, at the General Hospital "Dr. Rafael Pascacio Gamboa", state of Chiapas, México. METHODS: A retrospective, cross-sectional, descriptive, observational study, where all patients seeking medical and surgical care in the emergency department and inpatient unit for a traumatic spinal injury were included, regardless of age or sex. RESULTS: A sample of 60 patients, of whom 43 were male (71.7% and 17 females (28.3%, with an average age of 35 was obtained. As for the cause of the injury, falls were the leading cause (61.7% followed by motor vehicle accidents (35% and finally, assaults (3.3%. In this sample, 21% had associated injuries being the most common (7.3% the thoracic trauma. The most common site of injury was the thoracic spine, followed by the lower cervical and finally the thoracolumbar ones. We found that 70% of patients had partial or complete neurological injury, with complete spinal cord transection (Frankel A being the most frequent lesion in 53%. CONCLUSION: The incidence in our series is similar that the reported in developing countries which have sociocultural problems similar to ours. The same applies to the etiology of these lesions, which is closely linked to social and economic activity in each country or region.

  9. Pathology and Treatment of Traumatic Cervical Spine Syndrome: Whiplash Injury

    Directory of Open Access Journals (Sweden)

    Nobuhiro Tanaka

    2018-01-01

    Full Text Available Traumatic cervical syndrome comprises the various symptoms that occur as a result of external force such as that of a traffic accident. In 1995, the Quebec Task Force on whiplash-associated disorders (WAD formulated the Quebec classification, with accompanying clinical practice guidelines. These guidelines were in accordance with the stated clinical isolated or combined symptoms of the syndrome: neck pain, headaches, dizziness, numbness of head or face, eye pain, vision loss, double vision, tinnitus, hearing loss, nausea, and numbness and/or weakness of extremities. In recent years, cerebrospinal fluid hypovolemia or fibromyalgia has been recognized as a major notable cause of a variety of symptoms, although many clinical questions remain regarding the pathology of this syndrome. Therefore, its diagnosis and treatment should be conducted extremely carefully. While the Quebec classification and its guidelines are very useful for the normalization and standardization of symptoms of traumatic cervical syndrome, in the future, we would like to see the emergence of new guidelines that better address the diversity of this disease.

  10. Post-traumatic endophthalmitis involving Clostridium tetani and Bacillus spp.

    Science.gov (United States)

    Iyer, M N; Kranias, G; Daun, M E

    2001-07-01

    To report a case of post-traumatic infectious endophthalmitis caused by Clostridium tetani and Bacillus spp. Case report. A 25-year-old man developed endophthalmitis after a traumatic corneoscleral laceration of his right eye by a concrete reinforcement bar. He underwent pars plana lensectomy and vitrectomy with aspiration of vitreous fluid and a conjunctival swab for cultures. Cultures from the conjunctival swab were negative for organisms. Cultures of the vitreous aspirate were positive for Bacillus species and C. tetani. He had received a tetanus toxoid booster at the emergency department. By the time the culture results became available, he had developed severe eye pain associated with marked orbital congestion, increased swelling and erythema of the lids, marked injection and chemosis of the conjunctiva, and subsequently underwent evisceration. The inflammation resolved after evisceration of the right eye, and he was discharged to home on doxycycline 100 mg orally two times daily for 10 days. We are unaware of previous reports of endophthalmitis involving C tetani and could find none in a computerized MEDLINE search. Patients with penetrating eye injury should be assessed for tetanus immunization status, and early intervention with tetanus toxoid booster and/or tetanus immune globulin should be considered if cultures are positive.

  11. Misconceptions about traumatic brain injuries among South African university students

    Directory of Open Access Journals (Sweden)

    Chrisma Pretorius

    2013-08-01

    Full Text Available Objective. To investigate the incidence and type of misconceptions about traumatic brain injuries (TBIs harboured by university students.  Method. A convenience sample of 705 university students were recruited and data were collected using an electronic survey. The link to the survey was sent via e-mail to all registered students at Stellenbosch University. The participants had to complete the Common Misconceptions about Traumatic Brain Injury (CM-TBI questionnaire.  Results. The findings of this study suggest that the students subscribe to misconceptions from each of the 7 categories of misconceptions about TBIs. The mean percentages of misconceptions about TBIs were calculated and the amnesia (mean 49.7% and unconsciousness (mean 46.1% categories were identified as the categories about which the respondents had the most misconceptions, while the mean percentages of misconceptions were lower for the categories of recovery (mean 27.6%, rehabilitation (mean 26.56%, prevention (mean 20.8%, brain injury sequelae (mean 18.7% and brain damage (mean 8.4%.  Conclusion. Generally, these findings appear to be in keeping with previous literature, which suggests that misconceptions about TBIs are common among the general population. This study’s identification of these misconceptions could help create awareness, provide a focus for information provision, and contribute to the development of educational intervention programmes tailored for the South African context.

  12. Second language acquisition after traumatic brain injury: a case study.

    Science.gov (United States)

    Połczyńska-Fiszer, M; Mazaux, J M

    2008-01-01

    Post-traumatic language and memory impairment, as well as a subsequent recovery in monolinguals have been widely documented in the literature, yet little is known about learning the second language after a severe head trauma followed by coma, as well as the relationship of this process with cognitive recovery, psychological status and quality of life. The present study investigates the relationship of learning the second language (English) in the process of rehabilitation, with quality of life in a Polish female university student who, as a result of a car accident, suffered a major closed-head injury and was comatose for a month. The subject was enrolled in an English learning program nine months after the trauma. The experiment lasted six months and comprised monthly meetings. The patient improved the major components of the second language, including vocabulary. Within the 6 months, the subject was gradually capable of learning additional and more complex lexical items. Learning the second language after traumatic brain injury may positively influence emotional well-being, self-esteem, and, perhaps, recovery of quality of life. A long-term beneficial effect of learning L2 was a consequential improvement of the patient's memory.

  13. Traumatic Pneumothorax Following Acupuncture: A Case Series

    Directory of Open Access Journals (Sweden)

    Felix Grusche

    2017-01-01

    Full Text Available Acupuncture and dry needling are used by a range of health professionals to treat conditions such as musculoskeletal pain. Treatment occurs both in an outpatient setting and in emergency departments (ED. Acupuncture and dry needling are considered to be relatively safe techniques with a low risk of serious adverse events. We report three cases of traumatic pneumothorax following acupuncture/dry needling that presented to our ED between 2014 and 2016.

  14. Managing traumatic brain injury secondary to explosions

    Directory of Open Access Journals (Sweden)

    Burgess Paula

    2010-01-01

    Full Text Available Explosions and bombings are the most common deliberate cause of disasters with large numbers of casualties. Despite this fact, disaster medical response training has traditionally focused on the management of injuries following natural disasters and terrorist attacks with biological, chemical, and nuclear agents. The following article is a clinical primer for physicians regarding traumatic brain injury (TBI caused by explosions and bombings. The history, physics, and treatment of TBI are outlined.

  15. Traumatic Brain Injury and Sleep Disorders

    OpenAIRE

    Viola-Saltzman, Mari; Watson, Nathaniel F.

    2012-01-01

    Sleep disturbance is common following traumatic brain injury (TBI), affecting 30–70% of individuals, many occurring after mild injuries. Insomnia, fatigue and sleepiness are the most frequent post-TBI sleep complaints with narcolepsy (with or without cataplexy), sleep apnea (obstructive and/or central), periodic limb movement disorder, and parasomnias occurring less commonly. In addition, depression, anxiety and pain are common TBI co-morbidities with substantial influence on sleep quality. T...

  16. Saturday Morning Palsy: Closed Traumatic Peripheral Neuropathy

    OpenAIRE

    NN Wazir

    2007-01-01

    Traumatic peripheral neuropathy can occur following fracture, dislocation, forceful reduction or direct compression. During the emergency medical relief mission for earthquake victims in Pakistan, between 30th Oct and 14th Nov 2005, four patients presented with wrist drop and two others with foot drop, all with no underlying fracture or dislocation. All of them were attended by medical teams two to three days for the first time due to difficult rescue work and hard terrain. They were seen in ...

  17. Traumatic Brain Injury: Caregivers’ Problems and Needs

    OpenAIRE

    syed tajjudin syed hassan; WF Khaw; AR Rosna; J Husna

    2011-01-01

    Traumatic brain injury (TBI) is an increasingly major world health problem. This short review using the most pertinent articles on TBI caregiving problems and needs highlights the pressing issues. Articles focusing on both TBI-caregivers’ problems and needs are rarely found, especially for developing countries. Most TBI-caregiving is done by family members, whose altered lives portend burden and stresses which add to the overwhelming demand of caring for the TBI-survivor. Lack of information,...

  18. Diabetes Insipidus after Traumatic Brain Injury

    Science.gov (United States)

    Capatina, Cristina; Paluzzi, Alessandro; Mitchell, Rosalid; Karavitaki, Niki

    2015-01-01

    Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in many age groups. Neuroendocrine dysfunction has been recognized as a consequence of TBI and consists of both anterior and posterior pituitary insufficiency; water and electrolyte abnormalities (diabetes insipidus (DI) and the syndrome of inappropriate antidiuretic hormone secretion (SIADH)) are amongst the most challenging sequelae. The acute head trauma can lead (directly or indirectly) to dysfunction of the hypothalamic neurons secreting antidiuretic hormone (ADH) or of the posterior pituitary gland causing post-traumatic DI (PTDI). PTDI is usually diagnosed in the first days after the trauma presenting with hypotonic polyuria. Frequently, the poor general status of most patients prevents adequate fluid intake to compensate the losses and severe dehydration and hypernatremia occur. Management consists of careful monitoring of fluid balance and hormonal replacement. PTDI is associated with high mortality, particularly when presenting very early following the injury. In many surviving patients, the PTDI is transient, lasting a few days to a few weeks and in a minority of cases, it is permanent requiring management similar to that offered to patients with non-traumatic central DI. PMID:26239685

  19. Secondary traumatisation and systemic traumatic stress.

    Science.gov (United States)

    Klarić, Miro; Kvesić, Ante; Mandić, Vjekoslav; Petrov, Božo; Frančišković, Tanja

    2013-06-01

    Traditionally, research has been focused on the development of symptoms in direct trauma survivors. However, during the last two decades researchers and clinicians have started exploring the way individual traumatic stress exposure affects trauma victims' spouses, children and professional caregivers. Studying trauma within the family is a part of what is called systemic traumatology, a study of groups, institutions and other human systems that show stress reactions directly caused by a traumatic event or series of events. The effect of an individual's traumatic stress on family members and on persons in direct contact is conceptualized as secondary traumatisation. In its narrow sense, secondary traumatisation involves a transfer of nightmares, intrusive thoughts, flashbacks and other Posttraumatic Stress Disorder symptoms, which are typically experienced by individuals suffering from PTSD, onto their immediate surroundings. In its broader sense, the term refers to any kind of distress transfer from a trauma victim to their immediate surroundings, and includes a broad spectrum of distress manifestation along with that resembling Posttraumatic Stress Disorder. Beyond that, a family member's PTSD is potentially transferable to subsequent generations, interfering with the psychological development of children.

  20. Endoscopic Surgery for Traumatic Acute Subdural Hematoma

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    Hiroyuki Kon

    2014-01-01

    Full Text Available Traumatic acute subdural hematoma (ASDH is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole endoscopic surgery. This 87-year-old woman had undergone coil embolization for a ruptured right middle-cerebral artery aneurysm and placement of a ventriculoperitoneal shunt for normal pressure hydrocephalus 5 years earlier. Upon admission, she manifested consciousness disturbance after suffering head trauma and right hemiplegia. Her Glasgow Coma Scale score was 8 (E2V2M4. Computed tomography (CT demonstrated a thick, left-frontotemporal ASDH. Due to her advanced age and poor condition, we performed endoscopic surgery rather than craniotomy to evacuate the ASDH. Under local anesthesia, we made a burr hole in her left forehead and increased its size to 15 mm in diameter. After introducing a transparent sheath into the hematoma cavity with a rigid endoscope, the clot was evacuated with a suction tube. The arterial bleeding point was electrically coagulated. A postoperative CT scan confirmed the reduction of the hematoma. There was neither brain compression nor brain swelling. Her consciousness disturbance and right hemiplegia improved immediately. Endoscopic surgery may represent a viable method to address traumatic intracranial hematomas in some patients.

  1. A retrospective evaluation of traumatic dental injury in children who ...

    African Journals Online (AJOL)

    Traumatic dental injury was observed more frequently in the 7.12 age groups: 52.5% in girls and 67.8% in boys. Falls are the major cause of traumatic dental injury in the age group 6.12 (51.4%). Sport activities are a common cause of traumatic dental injury in the 7.12 age group (34.2%). Patients visited a dentist within ...

  2. Traumatic Brain Injury: Are We Conducting Enough Resarch

    Science.gov (United States)

    2017-04-17

    FROM: 59 MDW/SGVU SUBJECT: Professional Presentation Approval 7 APR 2017 1. Your paper, entitled Traumatic Brain Injury: Are We Conducting Enough...review and approval.) NA - Pubmed searches w ere the only source of data 6. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED: Traumatic Brain Injury...Traumatic Brain Injury: Are We Conducting Enough Research? Capt Mariya Gusman MD, Lt Col Jonathan A Sosnov MD, Jeffrey T Howard PhD Background

  3. Traumatic Facial Diplegia and Horner Syndrome: Case Report.

    Science.gov (United States)

    Roth, Jonathan; Toaff, Jacob S; Margalit, Nevo; Salame, Khalil

    2007-08-01

    Traumatic facial diplegia is an uncommon pathology, and is usually associated with bitemporal bone fractures. Traumatic Horner syndrome is mostly associated with carotid artery dissection. We present a case with traumatic facial diplegia and a unilateral Horner syndrome where the mechanisms of injury were unusual. The patient had developed his neurological deficits 9 days following trauma. We discuss the mechanisms of the facial palsy and Horner syndrome and the importance of their diagnosis.

  4. Information Processing Bias in Post-traumatic Stress Disorder

    OpenAIRE

    Weber, Darren L

    2008-01-01

    This review considers theory and evidence for abnormal information processing in post-traumatic stress disorder (PTSD). Cognitive studies have indicated sensitivity in PTSD for traumatic information, more so than general emotional information. These findings were supported by neuroimaging studies that identify increased brain activity during traumatic cognition, especially in affective networks (including the amygdala, orbitofrontal and anterior cingulate cortex). In theory, it is proposed th...

  5. Biomarkers of Spontaneous Recovery from Traumatic Spinal Cord Injury

    Science.gov (United States)

    2017-10-01

    inflammation. 15. SUBJECT TERMS traumatic spinal cord injury, spinal cord , spontaneous recovery, functional recovery, inflammation, biomarkers, trauma 16...Award Number: W81XWH-15-1-0614 TITLE: Biomarkers of Spontaneous Recovery from Traumatic Spinal Cord Injury PRINCIPAL INVESTIGATOR: Ona Bloom...SUBTITLE 5a. CONTRACT NUMBER W81XWH-15-1-0614 W81XWH-15-1-0614 Biomarkers of Spontaneous Recovery from Traumatic Spinal Cord Injury 5b. GRANT NUMBER

  6. Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies

    Science.gov (United States)

    Knowles, Charles H; Whyte, Greg P

    2007-01-01

    Objective To evaluate the risk of chronic traumatic brain injury from amateur boxing. Setting Secondary research performed by combination of sport physicians and clinical academics. Design, data sources, and methods Systematic review of observational studies in which chronic traumatic brain injury was defined as any abnormality on clinical neurological examination, psychometric testing, neuroimaging studies, and electroencephalography. Studies were identified through database (1950 to date) and bibliographic searches without language restrictions. Two reviewers extracted study characteristics, quality, and data, with adherence to a protocol developed from a widely recommended method for systematic review of observational studies (MOOSE). Results 36 papers had relevant extractable data (from a detailed evaluation of 93 studies of 943 identified from the initial search). Quality of evidence was generally poor. The best quality studies were those with a cohort design and those that used psychometric tests. These yielded the most negative results: only four of 17 (24%) better quality studies found any indication of chronic traumatic brain injury in a minority of boxers studied. Conclusion There is no strong evidence to associate chronic traumatic brain injury with amateur boxing. PMID:17916811

  7. Albumin and fibrinogen levels’ relation with orthopedics traumatic patients’ outcome after massive transfusion

    Science.gov (United States)

    Bazavar, Mohammadreza; Tabrizi, Ali; Abedini, Naghi; Elmi, Asghar

    2014-01-01

    Background: Severe bleeding is common during limb trauma. It can lead to hemorrhagic shock required to massive blood transfusion. Coagulopathy is the major complication of massive transfusion-induced increased mortality rate. Aim of this study was evaluation of fibrinogen and albumin levels association with orthopedics traumatic patients’ outcome who received massive transfusion. Methods: In a cross sectional study, 23 patients with severe limb injury admitted to orthopedic emergency department were studied. All the patients received massive transfusion, that is, >10 unit blood. Albumin and fibrinogen levels are measured at admission and 24 h later, and compared according to final outcome. Results: Twenty-three traumatic patients with severe limb injuries were studied, out of which ten (43.2%) died and 13 (56.8%) were alive. There was significant difference between patients outcome in fibrinogen level after 24 h, but no difference was observed in albumin levels. Based on regression model, fibrinogen after 24 h had a significant role in determining the final outcome in traumatic patients who received massive transfusion (odds ratio 0.48, 95% confidence interval 0.15–0.92, P = 0.02). Conclusions: According to our results, fibrinogen level is the most important factor in determination of orthopedics traumatic patients when received massive transfusion. However, serum albumin does not play any role in patients’ outcome. PMID:24665235

  8. Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

    Directory of Open Access Journals (Sweden)

    Hwa Sung Sung

    2017-01-01

    Full Text Available Purpose The purpose of this study was to evaluate the ultrasonographic (US features of traumatic neuromas in breast cancer patients after mastectomy. Methods This study was performed with approval from our Institutional Review Board, and the requirement for informed consent was waived. Six traumatic neuromas in five patients were included in this study. The US findings of traumatic neuromas were evaluated retrospectively by two radiologists according to the Breast Imaging-Reporting and Data System (BI-RADS lexicon. The final assessment was also recorded. Results On US, all six lesions presented as a mass within the pectoralis muscle layer (mean size, 4.8 mm; range, 3.9 to 5.5 mm. Of the six masses, four had an oval shape with a circumscribed margin, and two had an irregular shape and an indistinct margin. They were all hypoechoic. Two lesions showed a non-parallel orientation. On color Doppler examinations, two lesions showed internal vascularity. Strain elastography was performed for four neuromas, resulting in scores of 1 (n=1, 4 (n=2, and 5 (n=1. The final assessment categories were BI-RADS 3 (n=2, 4A (n=2, and 4B (n=2. Conclusion On US, an oval shape, circumscribed margin, parallel orientation, and hypoechogenicity were the most frequent features of traumatic neuromas in breast cancer patients after mastectomy. Neuromas may show increased vascularity on color Doppler imaging and present as a hard mass on elastography.

  9. [Prognosis in pediatric traumatic brain injury. A dynamic cohort study].

    Science.gov (United States)

    Vázquez-Solís, María G; Villa-Manzano, Alberto I; Sánchez-Mosco, Dalia I; Vargas-Lares, José de Jesús; Plascencia-Fernández, Irma

    2013-01-01

    traumatic brain injury is a main cause of hospital admission and death in children. Our objective was to identify prognostic factors of pediatric traumatic brain injury. this was a dynamic cohort study of traumatic brain injury with 6 months follow-up. The exposition was: mild or moderate/severe traumatic brain injury, searching for prognosis (morbidity-mortality and decreased Glasgow scale). Relative risk and logistic regression was estimated for prognostic factors. we evaluated 440 patients with mild traumatic brain injury and 98 with moderate/severe traumatic brain injury. Morbidity for mild traumatic brain injury was 1 %; for moderate/severe traumatic brain injury, 5 %. There were no deaths. Prognostic factors for moderate/severe traumatic brain injury were associated injuries (RR = 133), fractures (RR = 60), street accidents (RR = 17), night time accidents (RR = 2.3) and weekend accidents (RR = 2). Decreased Glasgow scale was found in 9 %, having as prognostic factors: visible injuries (RR = 3), grown-up supervision (RR = 2.5) and time of progress (RR = 1.6). there should be a prognosis established based on kinetic energy of the injury and not only with Glasgow Scale.

  10. Client-centred therapy, post-traumatic stress disorder and post-traumatic growth: theoretical perspectives and practical implications.

    Science.gov (United States)

    Joseph, Stephen

    2004-03-01

    In practice it is not unusual for client-centred therapists to work with people who have experienced traumatic events. However, client-centred therapy is not usually considered within texts on traumatic stress and questions have been raised over the appropriateness of client-centred therapy with trauma survivors. The present study shows how, although he was writing well before the introduction of the term 'post-traumatic stress disorder', Carl Rogers provided a theory of therapy and personality that contains an account of threat-related psychological processes largely consistent with contemporary trauma theory. Rogers' theory provides the conceptual underpinnings to the client-centred and experiential ways of working with traumatized people. Furthermore, Rogers' theory provides an understanding of post-traumatic growth processes, and encourages therapists to adopt a more positive psychological perspective to their understanding of how people adjust to traumatic events.

  11. Utility of the Croatian translation of the community integration questionnaire-revised in a sample of adults with moderate to severe traumatic brain injury.

    Science.gov (United States)

    Tršinski, Dubravko; Tadinac, Meri; Bakran, Žarko; Klepo, Ivana

    2018-02-23

    To examine the utility of the Community Integration Questionnaire-Revised, translated into Croatian, in a sample of adults with moderate to severe traumatic brain injury. The Community Integration Questionnaire-Revised was administered to a sample of 88 adults with traumatic brain injury and to a control sample matched by gender, age and education. Participants with traumatic brain injury were divided into four subgroups according to injury severity. The internal consistency of the Community Integration Questionnaire-Revised was satisfactory. The differences between the group with traumatic brain injury and the control group were statistically significant for the overall Community Integration Questionnaire-Revised score, as well as for all the subscales apart from the Home Integration subscale. The community Integration Questionnaire-Revised score varied significantly for subgroups with different severity of traumatic brain injury. The results show that the Croatian translation of the Community Integration Questionnaire-Revised is useful in assessing participation in adults with traumatic brain injury and confirm previous findings that severity of injury predicts community integration. Results of the new Electronic Social Networking scale indicate that persons who are more active on electronic social networks report better results for other domains of community integration, especially social activities. Implications for rehabilitation The Croatian translation of the Community Integration Questionnaire-Revised is a valid tool for long-term assessment of participation in various domains in persons with moderate to severe traumatic brain injury Persons with traumatic brain injury who are more active in the use of electronic social networking are also more integrated into social and productivity domains. Targeted training in the use of new technologies could enhance participation after traumatic brain injury.

  12. Isolated traumatic brain injury and venous thromboembolism.

    Science.gov (United States)

    Van Gent, Jan-Michael; Bandle, Jesse; Calvo, Richard Y; Zander, Ashley L; Olson, Erik J; Shackford, Steven R; Peck, Kimberly A; Sise, C Beth; Sise, Michael J

    2014-08-01

    Traumatic brain injury (TBI) is considered an independent risk factor of venous thromboembolism (VTE). However, the role of TBI severity in VTE risk has not been determined. We hypothesized that increased severity of brain injury in patients with isolated TBI (iTBI) is associated with an increased incidence of VTE. The records of patients admitted from June 2006 to December 2011 were reviewed for injury data, VTE risk factors, results of lower extremity surveillance ultrasound, and severity of TBI. Patients were identified by DRG International Classification of Diseases-9th Rev. codes for TBI, and only those with a nonhead Abbreviated Injury Scale (AIS) score of 1 or lower, indicating minimal associated injury, were included. The association of iTBI and VTE was determined using a case-control design. Among iTBI patients, those diagnosed with VTE (cases) were matched for age, sex, and admission year to those without VTE (controls). Data were analyzed using conditional logistic regression. There were 345 iTBI patients: 41 cases (12%) and 304 controls (88%). A total of 151 controls could not be matched to an appropriate case and were excluded. Of the remaining 153 controls, 1 to 16 controls were matched to each of the 41 VTE cases. Compared with the controls, the cases had a higher mean head-AIS score (4.4 vs. 3.9, p = 0.001) and overall Injury Severity Score (20.4 vs. 16.8, p = 0.001). Following adjustment for all factors found to be associated with VTE (ventilator days, central line placement, operative time > 2 hours, chemoprophylaxis, history of VTE, and history of cancer), the cases were significantly more likely to have a greater head injury severity (head-AIS score ≥ 5; odds ratio, 5.25; 95% confidence interval, 1.59-17.30; p = 0.006). The incidence of VTE in iTBI patients was significantly associated with the severity of TBI. VTE surveillance protocols may be warranted in these high-risk patients, as early detection of VTE could guide subsequent therapy

  13. The Efficacy of Eye Movement Desensitization Reprocessing: autobiographical memory performance and problem solving skills in women with post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    kh sadeghi

    2015-07-01

    Conclusion: The result showed that elements of EMDR based on ALP Francis Shapiro, and trough having the influence on integration of traumatic event information and identifying the number of symptoms in patients having PTSD.

  14. Early Computed Tomography Frontal Abnormalities Predict Long-Term Neurobehavioral Problems But Not Affective Problems after Moderate to Severe Traumatic Brain Injury

    NARCIS (Netherlands)

    Spikman, Jacoba M.; Timmerman, Marieke E.; Coers, Annemieke; van der Naalt, Joukje

    2016-01-01

    Behavioral problems are serious consequences of moderate to severe traumatic brain injury (TBI) and have a negative impact on outcome. There may be two types: neurobehavioral problems, manifesting as inadequate social behavior resulting from prefrontal system damage, and affective behavioral

  15. Specificity of Cognitive and Behavioral Complaints in Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury

    OpenAIRE

    Pineau, H?l?ne; Marchand, Andr?; Guay, St?phane

    2015-01-01

    Characterization of cognitive and behavioral complaints is explored in Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (MTBI) samples according to the severity of PTSD, depression and general anxiety conditions. Self-reported questionnaires on cognitive and behavioral changes are administered to PTSD, MTBI, MTBI/PTSD and control groups. Confounding variables are controlled. All groups report more complaints since the traumatic event. PTSD and MTBI/PTSD groups report more...

  16. Understanding the importance of attachment in shame traumatic memory relation to depression: the impact of emotion regulation processes.

    Science.gov (United States)

    Matos, Marcela; Pinto-Gouveia, José; Costa, Vânia

    2013-01-01

    Early relationships are crucial to human brain maturation, well-being, affect regulation and self-other schema. Shame traumatic memories are related to psychopathology, and recent research has shown that the quality and type of attachment relationships may be crucial in shame traumatic memories in relation to psychopathology. The current study explores a mediator model of emotion regulation processes (rumination, thought suppression and dissociation) on the association between shame traumatic memory, with attachment figures and with others, and depressive symptoms. Ninety subjects from the general community population completed the Shame Experiences Interview (SEI), assessing shame experiences from childhood and adolescence, and a battery of self-report scales measuring shame traumatic memory, rumination, thought suppression, dissociation and depression. Mediator analyses show that emotion regulation processes, such as brooding, thought suppression and dissociation, mediate the association between shame traumatic memory with others and depression. In contrast, shame traumatic memory with attachment figures has a direct effect on depression, not mediated by emotion regulation processes, with only brooding partially mediating this relation. The current findings shed light on the importance of attachment figures on the structuring of shame traumatic memories and on their impact on psychopathological symptoms, adding to recent neuroscience research and Gilbert's approach on shame and compassion. In addition, our results emphasize the relevance of addressing shame memories, mainly those that involve attachment figures, particularly when working with patients suffering from depressive symptoms and/or that find compassion difficult or scary. The quality of attachment relationships is important in how shame memories are structured and in their relation to psychopathology. The relationship between shame traumatic memory with attachment figures and depressive symptoms is not

  17. The interaction of persistent pain and post-traumatic re-experiencing: a qualitative study in torture survivors.

    Science.gov (United States)

    Taylor, Bethany; Carswell, Kenneth; Williams, Amanda C de C

    2013-10-01

    There are limited studies and few theoretical models addressing the interaction between pain and symptoms of post-traumatic stress disorder, with none concerning this interaction in survivors of torture, who frequently report persistent pain. We aimed to explore the relationship between persistent pain and re-experiencing of traumatic events in survivors of torture. Nine torture survivors were interviewed about their experiences of pain and re-experiencing, and the results analyzed using interpretative phenomenological analysis. Levels of pain and post-traumatic stress were assessed. Four superordinate themes emerged, namely "pain is the enemy," "pain and intrusive memories are connected," "changed identity," and "resilience and resources." These themes showed a complex relationship between torture, pain, re-experiencing, and other aspects of individual experience, such as the multiple losses experienced by torture survivors. Both pain and post-traumatic stress disorder symptoms were shown to have profound impacts on the everyday lives of participants. The results suggest that the relationship between pain and re-experiencing requires a broad model that considers the impact of a range of individual, social, and environmental factors on the interaction between pain and traumatic stress symptoms in survivors of torture. The study has clinical implications, most notably the need to attempt more integrated treatment of pain and traumatic symptoms where they occur together, and to consider the meaning and impact of pain when treating survivors of torture. Further investigation of the relationship between pain and traumatic stress symptoms in torture survivors is needed, as are studies of combined treatment for pain and trauma. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  18. The mediating effect of depression between exposure to potentially traumatic events and PTSD in news journalists

    Directory of Open Access Journals (Sweden)

    Klas Backholm

    2012-08-01

    Full Text Available Background: News journalists are an occupational group with a unique task at the scene of an unfolding crisis—to collect information and inform the public about the event. By being on location, journalists put themselves at risk for being exposed to the potentially traumatic event. Objective: To compare potentially traumatic exposure during work assignments at a crisis scene and in personal life as predictors of the development of post-traumatic stress disorder (PTSD in news journalists. Further, to investigate the mediating effect of depression between the predictor and predicted variables. Method: With a web-based questionnaire, information from a sample of Finnish news journalists (n=407 was collected. The data collected included details on the range of potentially traumatic assignments (PTAs at the crisis scene during the past 12 months, lifetime potentially traumatic events (PTEs in personal life, PTSD symptoms, and level of depression. Results: Approximately 50% of the participants had worked with a PTA during the past 12 months. Depression had a significant indirect effect on the relationship between PTAs at the scene and symptoms of PTSD. A similar result was found regarding the relationship between personal life PTEs and PTSD. Depression had a complete indirect effect in the case of PTAs and a partial indirect effect in regard to PTE exposure in personal life. Conclusions: Exposure to PTAs is common within journalistic work. The results reflect the importance of understanding the underlying mechanisms of the measured symptoms (PTSD, depression in relation to trauma history. The main limitations of the study include the cross-sectional design and the nature of the instruments used for the collection of work-related trauma history.

  19. ECONOMIC LOSSES CAUSED BY TRAUMATIC BRAIN INJURY IN CHILDREN

    Directory of Open Access Journals (Sweden)

    S. A. Valiulina

    2015-01-01

    Full Text Available Background: Currently, analyzing the economic losses caused by health problems in population is of particular importance since it stipulates calculations of the volumes invested in healthcare systems in order to improve population’s health. Objective: The aim of our study was to find out economic losses caused by traumatic brain injury (TBI in children. Methods: The given work has utilized governmental statistical reports for Russia, for federal regions as well as for individual subjects. Direct medical expenses (medical services and indirect expenses (losses due to a temporary disability of parents having a sick child were calculated both in general and per patient. Results: Among all the direct medical costs of treatment of children with TBI inpatient care costs account for 85%. In the Central and Volga Federal District accounted for half of nationwide spending in general, brain injury and to provide certain kinds of healthcare. The structure of Russian costs as a result of the incidence of TBI children Moscow accounts for 20%. In Moscow, the cost of treating cases of traumatic brain injury in children is 3.2 times higher than the average for Russia. The resulting calculations of the value of health care costs attributable to a case of child head injury, behind the cost of treatment of the case of a child with head trauma, calculated according to the standards of Russia and the territories. This difference in the whole RF is 23%. Conclusion: The obtained findings have shown that in 2010 in Russia the magnitude of losses caused by TBI incidence in children amounted to 3 billion roubles or 0.008% of the gross product 1.2 billion roubles of which were direct expenses. However, this figure is considerably lower of the real amount; it becomes evident after the analysis of direct medical expenses per one case of pediatric TBI. Our calculations have shown that in Russia and in its regions the amount of expenses per one TBI patient is a quarter less

  20. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Hui-yan Sun

    2015-01-01

    Full Text Available Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury.

  1. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury.

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    Sun, Hui-Yan; Li, Qiang; Chen, Xi-Ping; Tao, Lu-Yang

    2015-04-01

    Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury.

  2. Post-traumatic stress and world assumptions: the effects of religious coping.

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    Zukerman, Gil; Korn, Liat

    2014-12-01

    Religiosity has been shown to moderate the negative effects of traumatic event experiences. The current study was designed to examine the relationship between post-traumatic stress (PTS) following traumatic event exposure; world assumptions defined as basic cognitive schemas regarding the world; and self and religious coping conceptualized as drawing on religious beliefs and practices for understanding and dealing with life stressors. This study examined 777 Israeli undergraduate students who completed several questionnaires which sampled individual world assumptions and religious coping in addition to measuring PTS, as manifested by the PTSD check list. Results indicate that positive religious coping was significantly associated with more positive world assumptions, while negative religious coping was significantly associated with more negative world assumptions. Additionally, negative world assumptions were significantly associated with more avoidance symptoms, while reporting higher rates of traumatic event exposure was significantly associated with more hyper-arousal. These findings suggest that religious-related cognitive schemas directly affect world assumptions by creating protective shields that may prevent the negative effects of confronting an extreme negative experience.

  3. The Effect of Relaxation Music Listening on Sleep Quality in Traumatized Refugees: A Pilot Study.

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    Jespersen, Kira Vibe; Vuust, Peter

    2012-01-01

    Traumatized refugees often suffer from severe sleep problems, with serious consequences in physiological and psychological areas of functioning. Recent research suggests that music may be a viable intervention to improve sleep quality. The aim of this pilot study was to investigate whether sleep quality of traumatized refugees could be improved by listening to relaxation music at bedtime, and whether such an improvement would affect the experience of trauma symptoms and well-being. This study used a two-group pretest/posttest design with repeated measures taken for sleep quality. Dependent variables included sleep quality measured by the Pittsburgh Sleep Quality Index, trauma symptoms as measured by the PTSD-8 and well-being measured by the "How Do You Feel?" questionnaire designed specifically for refugees. Fifteen traumatized refugees with sleep problems participated in the study. The intervention group received the music listening condition (relaxing music played at night through a music player nested in an ergonomic pillow); the control group received only the ergonomic pillow. Statistical comparisons showed a significant improvement of sleep quality in the music group, but not in the control group. A significant increase in well-being was found only in the intervention group, but there were no changes in trauma symptoms in either of the groups. These results support the use of relaxation music listening at bedtime to improve sleep quality in traumatized refugees.

  4. Comparison of Intact Knee Cartilage Thickness in Patients with Traumatic Lower Extremity Amputation and Nonimpaired Individuals.

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    Kesikburun, Serdar; Köroğlu, Özlem; Yaşar, Evren; Güzelküçük, Ümüt; Yazcoğlu, Kamil; Tan, Arif Kenan

    2015-08-01

    The aim of this study was to assess the femoral articular cartilage thickness of the intact knee in patients with traumatic lower extremity amputation compared with nonimpaired individuals. A total of 30 male patients with traumatic lower extremity amputation (mean [SD] age, 31.2 [6.3] yrs) and a random sample of 53 age-matched and body mass index-matched male nonimpaired individuals (mean [SD] age, 29.8 [6.3] yrs) participated in the study. Exclusion criteria were age younger than 18 yrs, history of significant knee injury, previous knee surgery, or rheumatic disease. The femoral articular cartilage thickness was measured using ultrasound at the midpoints of the medial condyle, the intercondylar notch, and the lateral condyle. Ultrasonographic cartilage measurement was performed on the intact side of the patients with amputation and on both sides of the nonimpaired individuals. The femoral articular cartilage thickness of the intact knees of the patients with amputation was significantly decreased at the lateral and medial condyles compared with the nonimpaired individuals (P amputation and the nonimpaired individuals (P > 0.05). There was a premature cartilage loss in the intact limb knee of the patients with traumatic amputation. This result supports the view that patients with traumatic lower extremity amputation are at increased risk for developing knee osteoarthritis in the intact limb.

  5. DIAGNOSIS AND CORRECTION OF COGNITIVE DISORDERS IN CHILDREN WITH TRAUMATIC BRAIN INJURY SEQUELAE

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    S. A. Nemkova

    2014-01-01

    Full Text Available The article is dedicated to the relevant aspects of complex diagnosis and treatment of cognitive disorders in children and adolescents with traumatic brain injury (TBI sequelae in the long term. Traumatic brain injury is one of the most important issues of the modern neuroscience due to high incidence rate and incapacitation severity. A steady increase in TBI sequelae, many of which are cognitive disorders (cerebro-asthenic and psychoorganic syndromes, post‑traumatic dementia accompanied by various symptoms of vegetative dysfunction syndrome, has been observed in children in the recent years. The factors affecting severity of TBI sequelae in children are severity of the injury, age at the injury, time elapsed since the injury and localization of the lesion. Disturbances of memory and attention (75%, hand-eye coordination, cerebro-asthenic disorders (88% and chronic headaches (95% are prevalent in the structure of cognitive disorders after a minor TBI. Severer cognitive dysfunctions accompanied by pathological neurological symptoms resulting in difficulties in learning, self‑service and negatively affecting social adaptation in general are observed in 94-100% of the children having suffered moderate or severe TBI. The article discusses the modern methods of complex diagnosis and pathogenetically substantiated techniques of drug therapy of cognitive disorders in patients with traumatic brain injury sequelae in detail.  

  6. Traumatic Events and Obsessive Compulsive Disorder in Children and Adolescents: Is There a Link?

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    Lafleur, Daniel L.; Petty, Carter; Mancuso, Elizabeth; McCarthy, Katherine; Biederman, Joseph; Faro, Alyssa; Levy, Hannah C.; Geller, Daniel A.

    2011-01-01

    Background The extant literature supports an association between psychological trauma and development of OCD in adults, and this link is a plausible mediator for environment gene interactions leading to phenotypic expression of OCD. Objective To explore the relationship between OCD and traumatic life events in children and adolescents. Methods We examined the prevalence of traumatic life events and PTSD in a large sample of systematically assessed children with OCD. OCD symptoms and severity were assessed using the Children’s Yale Brown Obsessive Compulsive Scale (CY-BOCS) in those with and without concurrent PTSD. Results Rate of PTSD and trauma exposure was higher in children with OCD than in a comparable control group of non-OCD youth matched for age, gender and SES. Children with concurrent PTSD had more intrusive fears and distress and less control over their rituals than children with OCD but without PTSD. Total CY-BOCS scores were higher in those with concurrent PTSD. Specific type of OCD symptoms was not altered by a PTSD diagnosis. Conclusions A history of psychologically traumatic events may be over-represented in children with OCD. Given the need to search for non-genetic factors that may lead to onset of OCD, better and more systematic methods to obtain and quantify psychologically traumatic life events are needed in clinical populations. PMID:21295942

  7. Delayed traumatic hematomas of the brain: the early manifestations of CT

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    Liu Shuyan; Tang Guangjian; Fu Jiazhen; Xu Bing; Yin Yanyu

    2002-01-01

    Objective: To study the CT manifestations of delayed traumatic hematomas of the brain and evaluate their diagnostic significance in predicting the delayed traumatic brain hematoma. Methods: The manifestations of initial CT studies and follow-up CT examinations of 31 delayed traumatic brain hematomas were analyzed. Another 50 CT studies of head trauma without delayed brain hematomas were included randomly as control. Results: The abnormal findings of CT studies of the 31 delayed traumatic brain hematomas included: (1) Decreased density of the local brain parenchyma and disappeared difference between gray and white matter of the same area in 18 cases; (2) Local subarachnoid space hemorrhage in 24 cases; (3) Slight mass effect of local brain parenchyma in 16 cases. (4) Subdural hematoma in 9 cases. The locations of the abnormalities were roughly the same with the delayed hematoma except one local subarachnoid space hemorrhage, which was in the opposite of the delayed hematoma. The appearing rate of those abnormal findings in the control group was low and the difference was statistically significant. Conclusion: The decrease of density of local brain parenchyma, the disappeared difference between the gray and white matter, local subarachnoid space hemorrhage, and local swollen of brain presented in the initial CT study of the patient with heat trauma should be taken as indicators of delayed hemorrhage of the same area of brain, and it is necessary to do follow-up CT studies to exclude it

  8. Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

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    Yun Mi Kim

    2011-02-01

    Full Text Available Traumatic ventricular septal defect (VSD resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

  9. Predictors of birth-related post-traumatic stress symptoms: secondary analysis of a cohort study.

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    Furuta, Marie; Sandall, Jane; Cooper, Derek; Bick, Debra

    2016-12-01

    This study aimed to identify factors associated with birth-related post-traumatic stress symptoms during the early postnatal period. Secondary analysis was conducted using data from a prospective cohort study of 1824 women who gave birth in one large hospital in England. Post-traumatic stress symptoms were measured by the Impact of Event Scale at 6 to 8 weeks postpartum. Zero-inflated negative binomial regression models were developed for analyses. Results showed that post-traumatic stress symptoms were more frequently observed in black women and in women who had a higher pre-pregnancy BMI compared to those with a lower BMI. Women who have a history of mental illness as well as those who gave birth before arriving at the hospital, underwent an emergency caesarean section or experienced severe maternal morbidity or neonatal complications also showed symptoms. Women's perceived control during labour and birth significantly reduced the effects of some risk factors. A higher level of perceived social support during the postnatal period also reduced the risk of post-traumatic stress symptoms. From the perspective of clinical practice, improving women's sense of control during labour and birth appears to be important, as does providing social support following the birth.

  10. Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes.

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    Swan, Sarah; Keen, Nadine; Reynolds, Nicola; Onwumere, Juliana

    2017-01-01

    Individuals with severe mental health problems, such as psychosis, are consistently shown to have experienced high levels of past traumatic events. They are also at an increased risk of further traumatisation through victimization events such as crime and assault. The experience of psychosis itself and psychiatric hospitalization have also been recognized to be sufficiently traumatic to lead to the development of post-traumatic stress (PTS) symptoms. Rates of post-traumatic stress disorder (PTSD) are elevated in people with psychosis compared to the general population. The current guidance for the treatment of PTSD is informed by an evidence base predominately limited to populations without co-morbid psychiatric disorders. The systematic review therefore sought to present the current available literature on the use of psychological treatments targeting PTS symptoms in a population with a primary diagnosis of a psychotic disorder. The review aimed to investigate the effect of these interventions on PTS symptoms and also the effect on secondary domains such as psychotic symptoms, affect and functioning. Fifteen studies were identified reporting on cognitive behavior therapy, prolonged exposure, eye movement desensitisation and reprocessing and written emotional disclosure. The review provides preliminary support for the safe use of trauma-focused psychological interventions in groups of people with severe mental health problems. Overall, the interventions were found to be effective in reducing PTS symptoms. Results were mixed with regard to secondary effects on additional domains. Further research including studies employing sufficiently powered methodologically rigorous designs is indicated.

  11. Implementing a screening programme for post-traumatic stress disorder following violent crime

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    Jonathan I. Bisson

    2010-12-01

    Full Text Available Background: The emergence of validated means to determine which individuals will develop post-traumatic stress disorder (PTSD following a traumatic event has raised the possibility of designing and implementing effective screening programmes following traumatic events. Objective: This study aimed to study the usefulness and implementation of a PTSD screening programme for victims of violent crime presenting to an emergency unit. Design: 3,349 individuals who presented to an emergency unit following a violent crime were asked to complete the Trauma Screening Questionnaire 2 weeks later. Those who scored above a standard cut-off were invited to attend a mental health assessment and subsequently offered treatment according to their needs. Results: Of the 3,349 individuals contacted, 572 (17.1% responded, 338 (10.1% screened positive, 26 (0.78% attended for assessment, and 9 (0.27% received treatment for PTSD. Conclusions: This simple screening programme was not as useful as was hoped raising questions regarding how best to develop screening programmes for PTSD following violent crime and other traumatic events.

  12. Factors prognosticating the outcome of decompressive craniectomy in severe traumatic brain injury: A Malaysian experience

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    Sharda, Priya; Haspani, Saffari; Idris, Zamzuri

    2014-01-01

    Objective: The objective of this prospective cohort study was to analyse the characteristics of severe Traumatic Brain Injury (TBI) in a regional trauma centre Hospital Kuala Lumpur (HKL) along with its impact of various prognostic factors post Decompressive Craniectomy (DC). Materials and Methods: Duration of the study was of 13 months in HKL. 110 consecutive patients undergoing DC and remained in our centre were recruited. They were then analysed categorically with standard analytical software. Results: Age group have highest range between 12-30 category with male preponderance. Common mechanism of injury was motor vehicle accident involving motorcyclist. Univariate analysis showed statistically significant in referral area (P = 0.006). In clinical evaluation statistically significant was the motor score (P = 0.040), pupillary state (P = 0.010), blood pressure stability (P = 0.013) and evidence of Diabetes Insipidus (P population, noted to be the largest series in severe TBI in this region. Severe head injury accounts for significant proportion of neurosurgical admissions, resources with its impact on socio-economic concerns to a growing population like Malaysia. This study concludes that the predictors of outcome in severe TBI post DC were postoperative hypoxia, unmaintained cerebral perfusion pressure and unstable blood pressure as independent predictors of poor outcome. Key words: Decompressive craniectomy, prognostication of decompressive craniectomy, prognostication of severe head injury, prognostication of traumatic brain injury, severe head injury, severe traumatic brain injury, traumatic brain injury. PMID:25685217

  13. Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

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    Sung, Hwa Sung; Kim, Young Seon [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2017-01-15

    The purpose of this study was to evaluate the ultrasonographic (US) features of traumatic neuromas in breast cancer patients after mastectomy. This study was performed with approval from our Institutional Review Board, and the requirement for informed consent was waived. Six traumatic neuromas in five patients were included in this study. The US findings of traumatic neuromas were evaluated retrospectively by two radiologists according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon. The final assessment was also recorded. On US, all six lesions presented as a mass within the pectoralis muscle layer (mean size, 4.8 mm; range, 3.9 to 5.5 mm). Of the six masses, four had an oval shape with a circumscribed margin, and two had an irregular shape and an indistinct margin. They were all hypoechoic. Two lesions showed a non-parallel orientation. On color Doppler examinations, two lesions showed internal vascularity. Strain elastography was performed for four neuromas, resulting in scores of 1 (n=1), 4 (n=2), and 5 (n=1). The final assessment categories were BI-RADS 3 (n=2), 4A (n=2), and 4B (n=2). On US, an oval shape, circumscribed margin, parallel orientation, and hypoechogenicity were the most frequent features of traumatic neuromas in breast cancer patients after mastectomy. Neuromas may show increased vascularity on color Doppler imaging and present as a hard mass on elastography.

  14. Tissue adhesives for simple traumatic lacerations.

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    Beam, Joel W

    2008-01-01

    Farion K, Osmond MH, Hartling L, et al. Tissue adhesives for traumatic lacerations in children and adults. Cochrane Database Syst Rev. 2001(4);CD003326. What is the clinical evidence base for tissue adhesives in the management of simple traumatic lacerations? Studies were identified by searches of the following databases: Cochrane Wounds Group Specialized Trials Register (September 2003), Cochrane Central Register of Controlled Trials (CENTRAL) (CDROM 2003, issue 3), MEDLINE (1966 to September 2003, week 1), EMBASE (1988 to 2003, week 36), Web of Science Science Citation Index (1975 to September 13, 2003) and various clinical trials registers (September 2003). Investigators and product manufacturers were contacted to identify additional eligible studies. The search terms included wounds and injuries, laceration, face injury, nose injury, tissue adhesives, and acrylates. Each study fulfilled the following criteria: (1) The study was a randomized controlled trial that compared tissue adhesives with standard wound closure (SWC) (sutures, staples, adhesive strips) or tissue adhesive with tissue adhesive. (2) The wounds were acute, linear lacerations less than 12 hours old, resulting from blunt or sharp trauma. (3) The wound length, width, and depth allowed for approximation of the edges with minimal tension after deep sutures were placed, if required. Studies were included with no language or publication status restriction, with participants of any age recruited in an emergency department, outpatient clinic, walk-in clinic, or other primary care setting. Studies were excluded if the wounds were stellate lacerations, puncture wounds, mammalian bites, infected, heavily contaminated or devitalized, crossing joints or mucocutaneous junctions, in hair-bearing areas, or in patients with keloid formation or chronic illness. The characteristics of the study and participants, interventions, outcome measures, and findings were extracted by one author and verified by a second

  15. Lifetime exposure to traumatic and other stressful life events and hair cortisol in a multi-racial/ethnic sample of pregnant women.

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    Schreier, Hannah M C; Enlow, Michelle Bosquet; Ritz, Thomas; Coull, Brent A; Gennings, Chris; Wright, Robert O; Wright, Rosalind J

    2016-01-01

    We examined whether lifetime exposure to stressful and traumatic events alters hypothalamic-pituitary-adrenal (HPA) axis functioning, as indexed by hair cortisol, regardless of associated psychopathology, among pregnant women of different racial/ethnic backgrounds. 180 women provided hair samples for measurement of integrated cortisol levels throughout pregnancy and information regarding their lifetime exposure to stressful and traumatic life events. Results indicate that increased lifetime exposure to traumatic events was associated with significantly greater hair cortisol over the course of pregnancy. Similarly, greater lifetime exposure to stressful and traumatic events weighted by reported negative impact (over the previous 12 months) was associated with significantly greater hair cortisol during pregnancy. All analyses controlled for maternal age, education, body mass index (BMI), use of inhaled corticosteroids, race/ethnicity, and post-traumatic stress disorder (PTSD) and depressive symptoms. Following stratification by race/ethnicity, associations between stressful and traumatic life events and hair cortisol were found among Black women only. This is the first study to consider associations between lifetime stress exposures and hair cortisol in a sociodemographically diverse sample of pregnant women. Increased exposure to stressful and traumatic events, independent of PTSD and depressive symptoms, was associated with higher cortisol production, particularly in Black women. Future research should investigate the influence of such increased cortisol exposure on developmental outcomes among offspring.

  16. Exposure to traumatic events, prevalence of posttraumatic stress disorder and alcohol abuse in Aboriginal communities.

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    Nadew, Gelaye T

    2012-10-01

    Generations of Aboriginal people have been exposed to strings of traumatic events with devastating psychosocial health consequences, including psychiatric morbidities and mortalities, and medical complications. Posttraumatic Stress Disorder (PTSD) is a psychiatric morbidity directly linked to traumatic events. Despite research findings indicating traumatic exposure and resultant PTSD in Indigenous communities, little attention has been given to this condition in mental healthcare delivery. Consequently, clinical and psychosocial interventions are misguided and failed to deliver positive outcomes. The objective of this study is to explore the relationship between exposure to traumatic events, prevalence of PTSD and alcohol abuse in remote Aboriginal communities in Western Australia. A combination of structured clinical interview and multiple survey questionnaires - Composite International Diagnostic Interview (CIDI), and Impact of Events Scale (IES), Alcohol Use Disorder Identification Test (AUDIT) and Indigenous Trauma Profile (ITP) - were administered to 221 Indigenous participants aged 18 to 65 years. The overwhelming majority, 97.3% (n=215) of participants were exposed to traumatic events. Analysis of CIDI results using DSM-IV diagnostic criteria shows a life time prevalence of 55.2% (n=122) for PTSD, 20% (n=44) for major depression (recurrent) and 2.3% (n=5) for a single episode. A total of 96% (n=212) participants reported consuming a drink containing alcohol and 73.8% (n=163) met diagnostic criteria for alcohol use related disorders, abuse and dependence. Of participants who met the PTSD diagnostic criteria, 91% (n=111) met diagnostic criteria for alcohol use related disorders. Other impacts of trauma such as other anxiety disorders, dysthymic disorder and substances abuses were also identified. The rate of exposure to traumatic events and prevalence of PTSD are disproportionately higher in the communities studied than the national average and one of the

  17. Traumatic grief in young people in Sub-Saharan Africa: a scoping review

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    Taggart H

    2015-07-01

    Full Text Available Holly Taggart,1 Sheila Greatrex-White,2 1Mental Health Commission, CentreForum, Westminster, UK; 2School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK Aim: To identify relevant and pertinent themes and interventions within the literature relating to childhood traumatic grief, in order to provide a sound background of evidence for further research and service development. Background: Childhood traumatic grief is caused when a significant person in a child's life dies under circumstances that they perceive to be traumatic. This can leave a child unable to return to the same level of physical and emotional functioning that he or she had prior to the death occurring. In Sub-Saharan Africa, there is an increased risk for childhood traumatic grief due to a high prevalence of orphanhood, environmental stressors, stigma, and abuse. This can have detrimental effects upon mental health. Methods: The review followed the York methodology: identifying the purpose and agreeing on the strategy beforehand; identifying relevant sources/studies; selecting the studies; charting the data; and collating, summarizing, and reporting results. Results and discussion: Interventions identified to prevent and/or manage traumatic grief included narrative exposure therapy, psychotherapy, mentoring, peer-group support, psychosocial support, a grief and loss therapy session, and memory boxes. Mental health remains neglected within service and policy development as well as in global health spending. The average amount expended on mental health services per person per year in low-income countries is less than $0.25. Only 36% of people in low income countries are covered by a mental health policy, compared with 92% in high income countries. Limitations: The sixth stage of the York methodology was omitted. Only papers written in English were included in the review. Conclusion: Childhood traumatic grief in young people is an important issue

  18. Traumatic pseudo-lipoma in 3-year-old child

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    Nilesh V Rathi

    2012-01-01

    Full Text Available The buccal fat pad is relatively large and prominent in neonates, infants and young children. The main function of this fat pad is considered as a cushioning tissue and sucking pad. A minor tear of buccal mucosa and buccinator muscle can result in herniation of large volume of fat into oral cavity that is termed as "pseudolipoma." The young children tend to be very playful while brushing their teeth. Improper brushing technique resulted in severe trauma to the buccal fat, including soft-tissue between buccinator and retromolar area. This article presents a case-report of a female child who developed traumatic pseudolipoma after faulty tooth brushing for long duration and its management along with its detail review of literature.

  19. Hemorrhage Detection and Segmentation in Traumatic Pelvic Injuries

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    Davuluri, Pavani; Wu, Jie; Tang, Yang; Cockrell, Charles H.; Ward, Kevin R.; Najarian, Kayvan; Hargraves, Rosalyn H.

    2012-01-01

    Automated hemorrhage detection and segmentation in traumatic pelvic injuries is vital for fast and accurate treatment decision making. Hemorrhage is the main cause of deaths in patients within first 24 hours after the injury. It is very time consuming for physicians to analyze all Computed Tomography (CT) images manually. As time is crucial in emergence medicine, analyzing medical images manually delays the decision-making process. Automated hemorrhage detection and segmentation can significantly help physicians to analyze these images and make fast and accurate decisions. Hemorrhage segmentation is a crucial step in the accurate diagnosis and treatment decision-making process. This paper presents a novel rule-based hemorrhage segmentation technique that utilizes pelvic anatomical information to segment hemorrhage accurately. An evaluation measure is used to quantify the accuracy of hemorrhage segmentation. The results show that the proposed method is able to segment hemorrhage very well, and the results are promising. PMID:22919433

  20. Traumatic Brain Injury and NADPH Oxidase: A Deep Relationship

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    Cristina Angeloni

    2015-01-01

    Full Text Available Traumatic brain injury (TBI represents one of the major causes of mortality and disability in the world. TBI is characterized by primary damage resulting from the mechanical forces applied to the head as a direct result of the trauma and by the subsequent secondary injury due to a complex cascade of biochemical events that eventually lead to neuronal cell death. Oxidative stress plays a pivotal role in the genesis of the delayed harmful effects contributing to permanent damage. NADPH oxidases (Nox, ubiquitary membrane multisubunit enzymes whose unique function is the production of reactive oxygen species (ROS, have been shown to be a major source of ROS in the brain and to be involved in several neurological diseases. Emerging evidence demonstrates that Nox is upregulated after TBI, suggesting Nox critical role in the onset and development of this pathology. In this review, we summarize the current evidence about the role of Nox enzymes in the pathophysiology of TBI.