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complex trauma

Shannon Dorsey, Katie A McLaughlin, Suzanne E U Kerns, Julie P Harrison, Hilary K Lambert, Ernestine C Briggs, Julia Revillion Cox, Lisa Amaya-Jackson
Child and adolescent trauma exposure is prevalent, with trauma exposure-related symptoms, including posttraumatic stress, depressive, and anxiety symptoms often causing substantial impairment. This article updates the evidence base on psychosocial treatments for child and adolescent trauma exposure completed for this journal by Silverman et al. (2008). For this review, we focus on 37 studies conducted during the seven years since the last review. Treatments are grouped by overall treatment family (e.g., cognitive behavioral therapy), treatment modality (e...
October 19, 2016: Journal of Clinical Child and Adolescent Psychology
Joel Wells, Jeffrey J Nepple, Karla Crook, James R Ross, Asheesh Bedi, Perry Schoenecker, John C Clohisy
BACKGROUND: Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation. QUESTIONS/PURPOSES: (1) Are there common proximal femoral characteristics in patients with symptomatic hip dysplasia undergoing periacetabular osteotomy (PAO)? (2) Where is the location of maximal femoral head and neck offset deformity in hip dysplasia? (3) Do certain subgroups of dysplastic hips more commonly have cam-type femoral morphology? (4) Is there a relationship between hip ROM as well as impingement testing and 3-D head and neck offset deformity? METHODS: Using our hip preservation database, 153 hips (148 patients) underwent PAO from October 2013 to July 2015...
October 17, 2016: Clinical Orthopaedics and related Research
F Bonnaire, M Goepel, P Bula
The requirements of the German statutory accident insurance (DGUV) for the new treatment procedure were presented on 1 January 2013 in a new catalogue. The implementation of the certification of hospitals for the very severe injury procedure (SAV) by the DGUV should have been completed by 2014. These requirements placed high demands on trauma-oriented hospitals because of the high structural and personnel prerequisites. The background to the new organization was the wish of the DGUV for quality improvement in patient treatment in hospitals for patients with very severe occupational and occupation-related trauma by placement in qualified centers with high case numbers...
October 17, 2016: Der Unfallchirurg
Ritesh Kumar, Syed Saeed Ahmed, Gulam Sarwar Hashmi, Md Kalim Ansari, Sajjad Abdur Rahman
AIM: The present study was planned to investigate the etiology of injuries and to analyze correlation between clinical and radiological findings in cases of craniomaxillofacial trauma. STUDY DESIGN: An 18 months cross-sectional study was done and 325 patients with maxillofacial fractures were analyzed from January 2013 to June 2014 who reported to the department of oral and maxillofacial surgery, Aligarh, Uttar Pradesh. Data was recorded in a preformed case sheet which included: patient's demographic data, cause of injury, type of injury, treatment plan...
September 2016: Journal of Maxillofacial and Oral Surgery
Amy E Lansing, Wendy Y Plante, Audrey N Beck
Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology...
October 6, 2016: Journal of Anxiety Disorders
Chase L Andreason, Timothy H Pohlman
The timely recognition of shock secondary to hemorrhage from severe facial trauma or as a complication of complex oral and maxillofacial surgery presents formidable challenges. Specific hemostatic disorders are induced by hemorrhage and several extreme homeostatic imbalances may appear during or after resuscitation. Damage control resuscitation has evolved from massive transfusion to a more complex therapeutic paradigm that includes hemodynamic resuscitation, hemostatic resuscitation, and homeostatic resuscitation...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
Thomas Broggini, Lisa Schnell, Ali Ghoochani, José María Mateos, Michael Buchfelder, Kurt Wiendieck, Michael K Schäfer, Ilker Y Eyupoglu, Nicolai E Savaskan
The Plasticity Related Gene family covers five, brain-specific, transmembrane proteins (PRG1-5, also termed LPPR1-5) that operate in neuronal plasticity during development, aging and brain trauma. Here we investigated the role of the PRG family on axonal and filopodia outgrowth. Comparative analysis revealed the strongest outgrowth induced by PRG3 (LPPR1). During development, PRG3 is ubiquitously located at the tip of neuronal processes and at the plasma membrane and declines with age. In utero electroporation of PRG3 induced dendritic protrusions and accelerated spine formations in cortical pyramidal neurons...
October 15, 2016: Aging
Carol A Keane, Christopher A Magee, Peter J Kelly
Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged individuals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study (N=1682), utilising a representative sample of individuals experiencing low housing stability...
October 13, 2016: Child Abuse & Neglect
Nasim Shahidi Hamedani, Heiko Rühl, Julia Janina Zimmermann, Tim Heiseler, Johannes Oldenburg, Günter Mayer, Bernd Pötzsch, Jens Müller
Activated protein C (APC) is a critical regulator of thrombin formation and thereby protects against thrombosis. On the other hand, overwhelming formation of APC increases the risk of bleeding such as in trauma-induced coagulopathy. Thus, pharmacological inhibition of APC activity may improve blood clottability in certain clinical situations. In this study, we demonstrate that the DNA aptamer HS02-52G binds with fast onset (1.118 ± 0.013 × 10(5) M(-1) s(-1)) to APC and possesses a long residence time of 13...
October 13, 2016: Nucleic Acid Therapeutics
Sara Bertilsson, Per Swärd, Anders Håkansson, Rafid Tofik, Bengt Rippe, Evangelos Kalaitzakis
BACKGROUND AND AIMS: The disease course of acute pancreatitis (AP) ranges from mild and self-limiting to severe inflammation, associated with significant morbidity and mortality. At present, there are no universally accepted and reliable predictors for severity. Microproteinuria has been associated with the presence of systemic inflammatory response syndrome as well as trauma, although its association with AP is not well understood. The aim of this study was to investigate the value of microproteinuria to predict development of organ failure in AP...
October 12, 2016: Digestive Diseases and Sciences
A Aprato, A Joeris, F Tosto, V Kalampoki, E Rometsch, M Favuto, A Stucchi, M Azi, A Massè
BACKGROUND: To test if complexity of acetabular fractures, pre-trauma health status, time from trauma to definitive surgery, severity of injury or job characteristics influence work resumption, return to the same professional position and time out of work. MATERIALS AND METHODS: We performed a retrospective study on patients with surgically treated acetabular fractures. Medical records were reviewed to analyse demographics, follow-up, diagnosis (Letournel classification), type of surgical treatment, co-morbidities, time from trauma to definitive surgery, American Society of Anesthesiologists physical status classification (ASA) and associated injuries...
October 12, 2016: Musculoskeletal Surgery
Julian D Ford, Andres R Schneeberger, Irina Komarovskaya, Kristina Muenzenmaier, Dorothy Castille, Lewis A Opler, Bruce Link
A new clinician rating measure, the Symptoms of Trauma Scale (SOTS) was administered to adult psychiatric outpatients (46 men, 47 women) with severe mental illness (SMI) who reported a history of trauma exposure and were recently discharged from inpatient psychiatric treatment. SOTS composite severity scores for DSM-IV and DSM-5 posttraumatic stress disorder (PTSD), complex PTSD (cPTSD), and total PTSD/cPTSD severity had acceptable internal consistency reliability. SOTS scores' construct and convergent validity was supported by correlations with self-report measures of childhood and adult trauma history, and PTSD, dissociation, and anger symptoms...
October 12, 2016: Journal of Trauma & Dissociation
Yaron Haviv, Avraham Zini, Yoni Etzioni, Valeri Klitinich, Alex Dobriyan, Yair Sharav, Rafael Benoliel, Galit Almoznino
OBJECTIVE: To identify patient and pain characteristics associated with negative impacts on daily life among patients with chronic orofacial pain (COFP). STUDY DESIGN: Medical records of 200 COFP patients were analyzed. RESULTS: Diagnostic categories included temporomandibular disorders (85; 42.7%), headaches (47; 23.6%), neuropathic pain (37; 18.5%), trigeminal neuralgia (16; 8.0%), and painful posttraumatic trigeminal neuropathy (PTTN) (14; 7...
August 27, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Udit Rawat, Jennifer L Pierce, Scott Evans, A Bobby Chhabra, Nicholas C Nacey
Despite having many unique anatomic features relative to the other digits, the thumb has received little attention in the radiology literature. The thumb, with its opposable and prehensile abilities, enables fine manual dexterity. However, most radiologists have little familiarity with the structures that allow these dynamic movements, other than their recognition of the role of the ulnar collateral ligament in the setting of gamekeeper injury. High-resolution magnetic resonance (MR) imaging allows optimal assessment of the intricate soft-tissue anatomy of the thumb, which enables thumb flexion, extension, abduction, and adduction...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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
Thanos Karatzias, Mark Shevlin, Claire Fyvie, Philip Hyland, Erifili Efthymiadou, Danielle Wilson, Neil Roberts, Jonathan I Bisson, Chris R Brewin, Marylene Cloitre
BACKGROUND: The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses following exposure to traumatic events; Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). We set out to explore whether the newly developed ICD-11 Trauma Questionnaire (ICD-TQ) can distinguish between classes of individuals according to the PTSD and CPTSD symptom profiles as per ICD-11 proposals based on latent class analysis. We also hypothesized that the CPTSD class would report more frequent and a greater number of different types of childhood trauma as well as higher levels of functional impairment...
September 28, 2016: Journal of Affective Disorders
T L Landsman, T Touchet, S M Hasan, C Smith, B Russell, J Rivera, D J Maitland, E Cosgriff-Hernandez
: Uncontrolled hemorrhage accounts for more than 30% of trauma deaths worldwide. Current hemostatic devices focus primarily on time to hemostasis, but prevention of bacterial infection is also critical for improving survival rates. In this study, we sought to improve on current devices used for hemorrhage control by combining the large volume-filling capabilities and rapid clotting of shape memory polymer (SMP) foams with the swelling capacity of hydrogels. In addition, a hydrogel composition was selected that readily complexes with elemental iodine to impart bactericidal properties to the device...
October 6, 2016: Acta Biomaterialia
Scott D Easton, Jooyoung Kong
Childhood sexual abuse (CSA) is a widely acknowledged trauma that affects a substantial number of boys/men and has the potential to undermine mental health across the lifespan. Despite the topic's importance, few studies have examined the long-term effects of CSA on mental health in middle and late life for men. Most empirical studies on the effects of CSA have been conducted with women, non-probability samples, and samples of young or emerging adults with inadequate control variables. Based on complex trauma theory, the current study investigated: a) the effect of CSA on mental health outcomes (depressive symptoms, somatic symptom severity, hostility) in late life for men, and b) the moderating effects of childhood adversities and masculine norms in the relationship between CSA and the three mental health outcomes...
October 5, 2016: Child Abuse & Neglect
Ching-Yan C Yeung, David F Holmes, Helen A Thomason, Christian Stephenson, Brian Derby, Matthew J Hardman
Pressure ulcers are complex wounds caused by pressure- and shear-induced trauma to skin and underlying tissues. Pressure-reducing devices, such as dressings, have been shown to successfully reduce pressure ulcer incidence, when used in adjunct to pressure ulcer preventative care. While pressure-reducing devices are available in a range of materials, with differing mechanical properties, understanding of how a material's mechanical properties will influence clinical efficacy remains limited. The aim of this study was to establish a standardised ex vivo model to allow comparison of the cell protection potential of two gel-like pressure-reducing devices with differing mechanical properties (elastic moduli of 77 kPa v 35 kPa)...
September 26, 2016: Wound Repair and Regeneration
André Struglics, Marcin Okroj, Per Swärd, Richard Frobell, Tore Saxne, L Stefan Lohmander, Anna M Blom
BACKGROUND: The complement system is suggested to be involved in the pathogenesis of osteoarthritis (OA), and proinflammatory cytokines may play a role in OA development by inducing proteases. The association between complement factors, cytokines and OA has not been investigated. The aim of the present study was to explore the involvement of the complement system after knee trauma and in OA. METHODS: C4d, C3bBbP and soluble terminal complement complex (sTCC) resulting from complement activation were immunoassayed in synovial fluid from subjects with healthy knees (reference), OA, rheumatoid arthritis (RA; positive control), pyrophosphate arthritis (PPA; positive control) and knee injury; other biomarkers were previously assessed...
October 6, 2016: Arthritis Research & Therapy
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