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severe combined trauma

Melinda A Stanley, Nancy L Wilson, Srijana Shrestha, Amber B Amspoker, Paula Wagener, Jane Bavineau, Marla Turner, Terri L Fletcher, Jessica Freshour, Cynthia Kraus-Schuman, Mark E Kunik
OBJECTIVE: To determine whether Calmer Life (CL) improved worry, generalized anxiety disorder-related (GAD-related) symptoms, anxiety, depression, sleep, trauma-related symptoms, functional status, and quality of life better than Enhanced Community Care with Resource Counseling (ECC-RC) at 6 months and 9 months. METHODS: A randomized, controlled, comparative-effectiveness study involving underserved, low-income, mostly minority neighborhoods in Houston, Texas, looked at individuals ≥50 with significant worry and interest in psychosocial treatment...
August 7, 2018: American Journal of Geriatric Psychiatry
Olga Therese Ousdal, Anne Marita Milde, Alexander R Craven, Lars Ersland, Tor Endestad, Annika Melinder, Quentin J Huys, Kenneth Hugdahl
BACKGROUND: Neurobiological models of stress and stress-related mental illness, including post-traumatic stress disorder, converge on the amygdala and the prefrontal cortex (PFC). While a surge of research has reported altered structural and functional connectivity between amygdala and the medial PFC following severe stress, few have addressed the underlying neurochemistry. METHODS: We combined resting-state functional magnetic resonance imaging measures of amygdala connectivity with in vivo MR-spectroscopy (1H-MRS) measurements of glutamate in 26 survivors from the 2011 Norwegian terror attack and 34 control subjects...
September 18, 2018: Psychological Medicine
Ru Gao, Donghui Jia, Huimin Zhao, Zhang WeiWei, Wang Frank Yangming
Blunt traumatic diaphragmatic hernias are most commonly seen in combination with other injuries. Right diaphragmatic ruptures with serious pericardium ruptures are relatively rare. The diagnosis of diaphragmatic hernias is not difficult; however, prior to surgery, it is difficult to judge whether pericardium damage has occurred, particularly on the right side. This injury may occur in a critical pathological state in which cardiac tissue is outside the pericardium due to the pericardial defect. Severe hemodynamic disorders or even death may occur if the patient's condition is not diagnosed and treated in a timely manner...
September 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Hiroyuki Seki, Satoshi Ideno, Taiga Ishihara, Kota Watanabe, Morio Matsumoto, Hiroshi Morisaki
Posterior spinal fusion for adolescent idiopathic scoliosis is one of the most invasive surgical procedures performed in children and adolescents. Because of the extensive surgical incision and massive tissue trauma, posterior spinal fusion causes severe postoperative pain. Intravenous patient-controlled analgesia with opioids has been the mainstay of postoperative pain management in these patients. However, the use of systemic opioids is sometimes limited by opioid-related side effects, resulting in poor analgesia...
2018: Scoliosis and Spinal Disorders
Akhil P Verheyden, Ulrich J Spiegl, Helmut Ekkerlein, Erol Gercek, Stefan Hauck, Christoph Josten, Frank Kandziora, Sebastian Katscher, Philipp Kobbe, Christian Knop, Wolfgang Lehmann, Rainer H Meffert, Christian W Müller, Axel Partenheimer, Christian Schinkel, Philipp Schleicher, Matti Scholz, Christoph Ulrich, Alexander Hoelzl
Study Design: consensus paper with systematic literature review. Objective: The aim of this study was to establish recommendations for treatment of thoracolumbar spine fractures based on systematic review of current literature and consensus of several spine surgery experts. Methods: The project was initiated in September 2008 and published in Germany in 2011. It was redone in 2017 based on systematic literature review, including new AOSpine classification...
September 2018: Global Spine Journal
Jie Zeng
The aim of this study was to analyze the dynamic changes and predictive values of nuclear factor-κB (NF-κB) combined with interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in peripheral blood in multiple organ dysfunction syndrome (MODS) in patients with severe multiple trauma. Seventy patients diagnosed with severe multiple trauma in Emergency Department of Sichuan Provincial People's Hospital (Chengdu, China) from April 2014 to April 2016 were selected and retrospectively analyzed. The patients enrolled were divided into the MODS group (n=25) and the non-MODS group (n=45)...
September 2018: Experimental and Therapeutic Medicine
Tianlin Wen, Hao Meng, Fei Wang, Yunqiang Chen, Tiansheng Sun
AIM: To explore whether transplantation of bone marrow mesenchymal stem cells (BMSCs) would reduce the immune response and protect vital organs in a rat model of femur shaft fracture combined with craniocerebral injury. METHODS: The rats were divided into an experimental group (multiple traumas and receiving BMSCs injection, n = 25), a positive control group (only received the combination injuries, n = 25) and a negative group (n = 5). RESULTS: Compared with the positive control group, plasma IL-6 and IL-8 were significantly lower at the early stage, and IL-10 was higher at the late period in the experimental group (p < 0...
September 2018: Immunotherapy
Fabian Echterdiek, Daniel Kitterer, Vedat Schwenger, Jörg Latus
Bondage and discipline, dominance and submission, sadism and masochism (BDSM) refers to a variety of primarily erotic practices. Although safety is crucial for most BDSM practitioners, there are violent forms that may cause serious injury. We present the case of 61-year-old man with no history of chronic kidney disease who developed severe acute anuric kidney injury following violent BDSM play. He had been strapped tightly onto a wooden spanking bench and then received approximately 1000 vigorous hits onto his bare buttocks and thighs...
August 31, 2018: BMJ Case Reports
Ali Bani-Fatemi, Samia Tasmim, Kevin Z Wang, Jerry Warsh, Etienne Sibille, Vincenzo De Luca
BACKGROUND: Approximately 5% of patients with schizophrenia commit suicide, and 20% to 40% of them have at least one suicide attempt during their lifetime. Previous research has identified childhood trauma as a potential risk factor for suicide attempt in schizophrenia. The Psychiatric Genetics Consortium found 108 common genetic risk loci associated with schizophrenia. Moreover, familial, adoption, and twin studies suggested that suicidal behaviour is under genetic influence. OBJECTIVE: Our objective was to determine the effect of childhood trauma and schizophrenia polygenic risk in leading to suicide attempt, as well as to determine any interaction effect between the polygenic scores with childhood trauma...
August 25, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
Oliver Klein, Kristin Strohschein, Grit Nebrich, Michael Fuchs, Herbert Thiele, Patrick Giavalisco, Georg N Duda, Tobias Winkler, Jan Hendrik Kobarg, Dennis Trede, Sven Geissler
Pre-clinical and clinical studies are now beginning to demonstrate the high potential of cell therapies in enhancing muscle regeneration. We previously demonstrated functional benefit after the transplantation of autologous bone marrow mesenchymal stromal cells (MSC-TX) into a severe muscle crush trauma model. Despite our increasing understanding of the molecular and cellular mechanisms underlying MSC's regenerative function, little is known about the local molecular alterations and their spatial distribution within the tissue after MSC-TX...
August 23, 2018: Scientific Reports
Yan Zhang, Wen-Xiu Zhang, Yan-Jun Zhang, Ya-Dong Liu, Zong-Jian Liu, Qi-Chao Wu, Yun Guan, Xue-Ming Chen
Spinal cord injury (SCI) from trauma or disease severely impairs sensory and motor function. Neurorehabilitation after SCI is a complex medical process that focuses on improving neurologic function and repairing damaged connections in the central nervous system. An increasing number of preclinical studies suggest that melatonin may be useful for the treatment of SCI. Melatonin is an indolamine that is primarily secreted by the pineal gland and known to be regulated by photoperiodicity. However, it is also a versatile hormone with antioxidative, antiapoptotic, neuroprotective, and anti-inflammatory properties...
October 2018: Neural Regeneration Research
Eveline A J van Rein, Rogier van der Sluijs, Antoine M R Raaijmaakers, Luke P H Leenen, Mark van Heijl
BACKGROUND: Emergency medical services (EMS) providers must determine the injury severity on-scene, using a prehospital trauma triage protocol, and decide on the most appropriate hospital destination for the patient. Many severely injured patients are not transported to higher-level trauma centres. An accurate triage protocol is the base of prehospital trauma triage; however, ultimately the quality is dependent on the destination decision by the EMS provider. The aim of this systematic review is to describe compliance to triage protocols and evaluate compliance to the different categories of triage protocols...
August 2018: Injury
Qiuming Gao, Yun Xue, Peisheng Shi, Shungang Zhou, Xiaowen Deng, Rui Liu, Weiwei Shen, Qiang Huang, Chuangbing Li, Jie Shi
Objective: To investigate the effectiveness of wide fascial and doubly vascularized pedicle posterior cnemis flap in repair of the soft tissue defect of forefoot. Methods: Between March 2011 and March 2017, 18 cases with severe soft tissue defects of forefeet were repaired with the wide fascial and doubly vascularized pedicle posterior cnemis flaps. There were 13 males and 5 females with an average age of 33 years (range, 11-49 years). Of 18 cases, the defects were caused by trauma in 16 cases with an average disease duration of 15 hours (range, 3-72 hours), by infection after correction of spastic clubfoot in 1 case, and by infection after open fracture fixation in 1 case...
September 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Angela M Groves, Jacqueline P Williams, Eric Hernady, Christina Reed, Bruce Fenton, Tanzy Love, Jacob N Finkelstein, Carl J Johnston
Biomarkers could play an essential role during triage in the aftermath of a radiological event, where exposure to radiation will be heterogeneous and complicated by concurrent trauma. Used alongside biodosimetry, biomarkers can identify victims in need of treatment for acute radiation effects, and might also provide valuable information on later developing consequences that need to be addressed as part of a treatment strategy. Indeed, because the lung is particularly sensitive to radiation and resultant late effects not only affect quality of life, but can also lead to morbidity, the risk of developing downstream pulmonary complications in exposed individuals requires assessment...
August 17, 2018: Radiation Research
C Vahldieck, M Lindig, C Nau, M Hüppe
BACKGROUND: The intensity of postoperative pain is characterized by large interindividual variability. Furthermore, strong postoperative pain is known to influence physical recovery after surgery. High (preoperative) pain expectation and pre-existing pain, which are associated with pain-related disability (impairing pain) are risk factors for strong postoperative pain. They can be determined with the Lübeck Pain Risk Questionnaire used for the first time in this study. The aim of this study was to explore the hypothesis that patients with a combination of the characteristics (1) preoperative impairing pain and (2) high pain expectation are more likely to have strong postoperative pain...
August 13, 2018: Der Anaesthesist
Leonardo Toscano, Daniel Terra, Siul Salisbury
Bullet embolism is an uncommon complication from heart gunshot injuries because most of the patients die immediately after trauma. The low frequency of this complication combined with the possible absence of symptoms makes the condition a challenge for the surgeon, delaying diagnostics and leading to severe complications or death. In this case, a small calibre bullet entered the left ventricle and then impacted the femoris artery.
2018: Case Reports in Emergency Medicine
Eleanor Curtis, Kathleen Romanowski, Soman Sen, Ashley Hill, Christine Cocanour
BACKGROUND: Although many frailty scales exist, a single scale has not been agreed upon to define frailty. Herein, we determined whether the Canadian Study on Health and Aging Clinical Frailty Scale (CSHA CFS) can predict the risk of elderly patients for hospital mortality and discharge to skilled nursing facilities (SNFs) following traumatic injury. METHODS: Charts from trauma patients aged ≥65 y admitted from December 1, 2011 to December 31, 2013 were retrospectively examined...
October 2018: Journal of Surgical Research
N C Adams, T P Farrell, A O'Shea, A O'Hare, J Thornton, S Power, P Brennan, S Looby
Central or neurogenic diabetes insipidus (CDI) is due to deficient synthesis or secretion of antidiuretic hormone (ADH), also known as arginine vasopressin peptide (AVP). It is clinically characterised by polydipsia and polyuria (urine output > 30 mL/kg/day) of dilute urine (< 250 mOsm/L). It is the result of a defect in one of more sites involving the hypothalamic osmoreceptors, supraoptic or paraventricular nuclei of the hypothalamus, median eminence of the hypothalamus, infundibulum or the posterior pituitary gland...
October 2018: Neuroradiology
Ali Al Orf, Khawaja Bilal Waheed, Aftab Ahmed Baig, Khaled Saleh Mohammad, Mohamed Nasr El Sirafy, Muhammad Sohail Amin, Zechriah Jebakumar Arulanatham
BACKGROUND: Pan-scan (whole-body) computed tomography (CT) has a paramount role in the diagnosis of injuries in road traffic accidents (RTA). OBJECTIVE: Identify patterns of injuries on pan-CT scans. DESIGN: Retrospective medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: The records of all RTA patients who presented to the radiology department at King Fahad Military Medical Complex (KFMMC) in Dhahran for the 3-year period from July 2014 to July 2017 and underwent pan-CT were retrospectively reviewed...
July 2018: Annals of Saudi Medicine
Areg Grigorian, Jeffry Nahmias, Sebastian Schubl, Viktor Gabriel, Nicole Bernal, Victor Joe
Combined trauma in the burn patient has been previously shown to have higher mortality. With improved critical care and multidisciplinary approach, we hypothesized the risk of mortality in combined burn and trauma has decreased. A retrospective analysis of trauma, burn and combined burn-trauma patients in the National Trauma Data Bank was performed comparing years 2007-2015 to years 1994-2002. The impact of burn injuries on mortality in patients with minor trauma has decreased (OR 2.45, CI 2.26-2.66, p<0...
July 31, 2018: Burns: Journal of the International Society for Burn Injuries
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