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Long-term outcomes in trauma patients

Racquel E Kohler, Jared Tomlinson, Tiyamike Eletima Chilunjika, Sven Young, Mina Hosseinipour, Clara N Lee
PURPOSE: Low- and middle-income countries face a disproportionate burden of death and disability from injuries, many of which are due to road traffic accidents or falls. Lower extremity injuries in particular have implications not only for physical disabilities affecting work and school performance, but also for quality of life (QOL) of the individual. This qualitative study explores the psychosocial impact and QOL changes due to lower extremity injuries among trauma patients in central Malawi...
October 22, 2016: Quality of Life Research
Preeti Patil-Chhablani, Krishnapriya Kothamasu, Ramesh Kekunnaya, Virender Sachdeva, Vivek Warkad
PURPOSE: To evaluate the surgical outcome of augmented superior rectus transposition (SRT) and medial rectus recession (MRc) in patients with abducens nerve palsy. METHODS: The medical records of consecutive patients with abducens nerve palsy who underwent unilateral or bilateral simultaneous SRT with MRc from January 2012 to December 2014. Patients with previous strabismus surgery or botulinum toxin injection were excluded. Primary outcome measures were esotropia in primary position and abduction deficit...
October 7, 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Ana Luiza Zaninotto, Jessica Elias Vicentini, Davi Jorge Fontoura Solla, Tatiana Tateishi Silva, Vinicius Monteiro de Paula Guirado, Fabrício Feltrin, Mara Cristina Souza de Lucia, Manoel Jacobsen Teixeira, Wellingson Silva Paiva
OBJECTIVE: Diffuse axonal injury (DAI) is prevalent in traumatic brain injury (TBI), and is often associated with poor outcomes and cognitive impairment, including memory deficits. Few studies have explored visual memory after TBI and its relationship to executive functioning. Executive functioning is crucial for remembering an object's location, operating devices, driving, and route finding. We compared visual memory performance via the Rey-Osterrieth Complex Figure (ROCF) test 6 and 12 months after DAI...
October 11, 2016: Acta Neuropsychiatrica
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
Ali Yeganeh, Mani Mahmodi, Hosein Farahini, Mehdi Moghtadaei
INTRODUCTION: Severe defects in long bones can be caused by several factors such as trauma that lead to open wound and secondary infections after surgery. Induced membrane technique is one of the therapeutic strategies that can be used for these patients. Due to importance of this method and lack of information about this technique in Iran. AIM: this study was performed to investigate technical strengths and weakness of induced membrane technique. MATERIAL AND METHODS: This case series study conducted on 21 patients with bone defects in the femur and tibia and metatarsal bones referred to orthopedic clinic of Rasoul Akram Hospital, Tehran, Iran, for induced membrane surgery in 2012-2015...
July 27, 2016: Medical Archives
S T Chan, P C B Khong, W Wang
AIM: To provide an overview of healthcare professionals' psychological responses, coping strategies and supporting needs in the aftermath of an adverse event, thus informing health policy implications and future research in this aspect. BACKGROUND: Trauma experienced by healthcare professionals as second victims potentially provokes intense emotional distress, detrimental professional outcomes and imposes harsh long-term effects. METHODS: A systematic literature review was performed to synthesize the experiences and needs of second victims who are healthcare professionals being traumatized by an unanticipated adverse event, medical error or patient-related injury...
September 28, 2016: International Nursing Review
Mathilde Chevignard, Leila Francillette, Hanna Toure, Dominique Brugel, Philippe Meyer, Anne Laurent Vannier, Marion Opatowski, Laurence Watier
OBJECTIVE: Childhood traumatic brain injury (TBI) is a leading cause of death and lifelong acquired disability. The aim of this study was to prospectively study intellectual ability following childhood severe TBI over 7-8years post-injury, and factors influencing outcome and change over time. MATERIAL/PATIENTS AND METHODS: Children (0-15years) consecutively admitted in a single trauma center for severe non-inflicted TBI over a 3-year period were included in a prospective longitudinal study...
September 2016: Annals of Physical and Rehabilitation Medicine
Erik Berg, Øystein A Haaland, Kristin B Feragen, Charles Filip, Hallvard A Vindenes, Dag Moster, Rolv T Lie, Åse Sivertsen
Importance: Parents regularly express concern about long-term health outcomes for children who are born with an oral cleft. Objective: To assess whether oral clefts affect the health and ability to work of young adults. Design, Setting, and Participants: A population-based cohort study was conducted on all individuals born in Norway between calendar years 1967 and 1992 (n = 1 490 401). All patients treated for clefts in Norway during the study period were invited to participate (n = 2860)...
September 26, 2016: JAMA Pediatrics
Michel Taylor, Wilma Hopman, Jeff Yach
BACKGROUND: In September 2011, Kingston General Hospital (KGH) opened a dedicated orthopedic weekend trauma room. Previously, 1 weekend operating room (OR) was used by all surgical services. We assessed the impact this dedicated weekend trauma room had on hospital length of stay (LOS), time to surgery and 30-day mortality for patients with hip fractures. METHODS: Patients admitted between Oct. 1, 2009, and Sept. 30, 2012, were identified through our trauma registry, representing the 2 years before and 1 year after the opening of the orthopedic weekend trauma room...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Jessica C Rivera, Paul F Pasquina
Recent military combat operations have resulted in a high burden of extremity-related long-term disability due to limb amputation and persistent deficits despite limb reconstruction. The US Army amputee care programs, established at focused centers with interdisciplinary care teams, have redefined the standard of how rehabilitation following limb loss is undertaken as the limb reconstruction is just one part of the entire patient's restoration of wellness and reintegration. Inspired by this approached, comprehensive rehabilitation programs designed for patients with limb reconstruction have also excelled rehabilitation following a spectrum of severe limb trauma...
October 2016: Journal of Orthopaedic Trauma
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Phillip A Efron, Alicia M Mohr
BACKGROUND: Despite the excellent negative predictive value of sterile respiratory cultures, antibiotics often are continued after negative endotracheal aspirate (ETA) or bronchoalveolar lavage (BAL) for critically ill trauma patients. We hypothesized that persistent elevation of the Clinical Pulmonary Infection Score (CPIS) would predict continued antibiotic therapy after a negative respiratory culture for intubated trauma patients, and that prolonged antibiotics would provide no benefit...
September 16, 2016: Surgical Infections
Andrea Danese, Stephanie Lewis
The brain and the immune system are not fully formed at birth but rather continue to mature in response to the postnatal environment. The two-way interaction between brain and immune system makes it possible for childhood psychosocial stressors to affect immune system development, which in turn can affect brain development and its long-term functioning. Drawing from experimental animal models and observational human studies, we propose that the psychoneuroimmunology of early-life stress can offer an innovative framework to understand and treat psychopathology linked to childhood trauma...
September 15, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Gianmarco De Donato, Giulia Mazzitelli, Umberto Ruzzi, Mariagnese Mele, Marco Tadiello, Giovanni Giannace, Francesco Setacci, Giuseppe Galzerano, Carlo Setacci
Data from randomized controlled trials (RCTs) demonstrated significant differences between carotid artery stenting (CAS) and carotid endarterectomy (CEA) in terms of early neurological outcomes (from 0 to 30 days), although mid- and long-term neurological results are indistinguishable. CAS in symptomatic standard risk patients is coupled with a higher risk of any stroke, and death or any stroke at 30 days, while the rates of disabling or major stroke do not vary remarkably between treatments. Since the micro-embolization through the stent struts is the primary suspected cause of suspected early postoperative neurological complications (i...
December 2016: Journal of Cardiovascular Surgery
Dan Huang, Xuelian Du, Huiting Liang, Wenjie Hu, Haijun Hu, Xing Cheng
PURPOSE: To compare the effectiveness between anterior corpectomy (CORP) and posterior laminoplasty (LAMP) for the treatment of multilevel cervical myelopathy. STUDY DESIGN: Systematic review and meta-analysis. METHODS: We searched MEDLINE, EMBASE, PubMed, OVID, Web of Science and the Cochrane Central Register of Controlled Trials databases for all relevant articles that compared the two operations for the treatment of multilevel cervical myelopathy...
September 10, 2016: International Journal of Surgery
Francesco Baino, Isabel Potestio
In the treatment of severe oculo-orbital traumas, intraocular malignancies or other life-threatening conditions it is sometimes necessary to surgically remove the patient's diseased eye. Following the removal of the eye, an orbital implant is inserted into the anophthalmic socket in order to provide satisfactory volume replacement and restore the aesthetic appearance of a normal eye. Over the last decades, the implant design and the criteria of materials selection evolved from simple non-porous polymeric sphere to devices with more complex shape and functionalities for ensuring better clinical outcomes in the long-term...
December 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
T Kyriss, U Lenz, G Friedel
This overview reviews the current literature to compare the functional results after surgical and conservative treatment of patients with flail chest and multiple rib fractures. Regarding functional aspects, patients in the early phase after a thoracic trauma are those that benefit most from the stabilisation of the chest wall by internal fixation of the ribs. Patients recover faster from restrictive respiratory disorders, have less pain and return to the workplace earlier after an operation compared with those that receive conservative treatment...
September 2016: Zentralblatt Für Chirurgie
David P G van den Berg, Berber M van der Vleugel, Paul A J M de Bont, Gwen Thijssen, Carlijn de Roos, Rianne de Kleine, Tamar Kraan, Helga Ising, Ad de Jongh, Agnes van Minnen, Mark van der Gaag
BACKGROUND: Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. OBJECTIVE: This feasibility study explores the impact of specialized training on therapists' beliefs about trauma-focused treatment within a randomized controlled trial. METHOD: Therapist-rated (n=16) credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up...
2016: European Journal of Psychotraumatology
Eric Peter Thelin, Emma Jeppsson, Arvid Frostell, Mikael Svensson, Stefania Mondello, Bo-Michael Bellander, David W Nelson
BACKGROUND: In order to improve assessment and outcome prediction in patients suffering from traumatic brain injury (TBI), cerebral protein levels in serum have been suggested as biomarkers of injury. However, despite much investigation, biomarkers have yet to reach broad clinical utility in TBI. This study is a 9-year follow-up and clinical experience of the two most studied proteins, neuron-specific enolase (NSE) and S100B, in a neuro-intensive care TBI population. Our aims were to investigate to what extent NSE and S100B, independently and in combination, could predict outcome, assess injury severity, and to investigate if the biomarker levels were influenced by extracranial factors...
September 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
Michael H Stone
Information concerning the longitudinal course of Borderline Personality Disorder (BPD) derives mainly from (a) long-term (10 to 25 year) retrospective follow-up studies, primarily those conducted during the 1980s/1990s, (b) brief (1 to 3 year) follow-up studies of recent randomized controlled trials (RCTs) of several different treatment approaches, and (c) prospective follow-up studies. The patients contacted in the retrospective studies had been treated mostly by psychoanalytically informed approaches or supportive...
2016: Psychodynamic Psychiatry
Audrey E Ertel, Bryce R H Robinson, Mark H Eckman
BACKGROUND: Recent guidelines from the Eastern Association for the Surgery of Trauma conditionally recommend cervical collar removal after a negative cervical computed tomography in obtunded adult blunt trauma patients. Although the rates of missed injury are extremely low, the impact of chronic care costs and litigation upon decision making remains unclear. We hypothesize that the cost-effectiveness of strategies that include additional imaging may contradict current guidelines. METHODS: A cost-effectiveness analysis was performed for a base-case 40-year-old, obtunded man with a negative computed tomography...
November 2016: Journal of Trauma and Acute Care Surgery
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