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Adult Trauma

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https://www.readbyqxmd.com/read/27923267/sleep-and-processing-of-trauma-memories
#1
Ihori Kobayashi, Thomas A Mellman, Duaa Altaee, Mary Katherine Howell, Joseph Lavela
Sleep has been implicated in learning processes that appear to underlie recovery from posttraumatic stress disorder (PTSD). The importance of quality and timing of sleep following exposure-based therapies has been suggested. The present study evaluated relationships between sleep and adaptive emotional processing following written narrative exposure (WNE) to memories of traumatic events experienced by participants with clinically significant PTSD symptoms. Participants included 21 urban-residing nontreatment-seeking adults with full or subthreshold symptoms of PTSD who completed 4 sessions of 30-min WNE with the first session either in the evening or the morning...
December 2016: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/27923183/the-distal-consequences-of-physical-and-emotional-neglect-in-emerging-adults-a-person-centered-multi-wave-longitudinal-study
#2
Joseph R Cohen, Suvarna V Menon, Ryan C Shorey, Vi Donna Le, Jeff R Temple
Despite being the most prevalent form of child maltreatment, the correlates and consequences of neglect are poorly understood, particularly during early adulthood. The present multi-wave, longitudinal study sought to address this gap in this literature by examining physical and emotional neglect in emerging adults in a diverse community sample. 580 adolescents (AgeMean=18.25; AgeSD=0.59; 58.3% female; 31% Hispanic, 28.9% Caucasian; 26.2% African-American; 13.9% other) completed self-report measures for child maltreatment at baseline, and measures for depression, posttraumatic stress disorder, generalized anxiety disorder, and substance use every year for three years...
December 3, 2016: Child Abuse & Neglect
https://www.readbyqxmd.com/read/27921349/repeated-trauma-exposure-does-not-impair-distress-reduction-during-imaginal-exposure-for-posttraumatic-stress-disorder
#3
Alissa B Jerud, Frank J Farach, Michele Bedard-Gilligan, Hillary Smith, Lori A Zoellner, Norah C Feeny
BACKGROUND: Based on experimental research on threat extinction, individuals exposed to repeated traumatic events may have impaired outcome in exposure therapy compared to those who have experienced a single trauma (Lang & McTeague, ). This study examined whether repeated trauma exposure predicts smaller changes in self-reported distress during imaginal exposure and worse outcomes for patients with posttraumatic stress disorder (PTSD). METHODS: Adults (N = 116) with chronic PTSD received up to 10 sessions of prolonged exposure (PE) therapy...
December 6, 2016: Depression and Anxiety
https://www.readbyqxmd.com/read/27921020/epidemiology-of-cervical-spine-fractures
#4
Mahnaz Yadollahi, Shahram Paydar, Haleh Ghaem, Mohammad Ghorbani, Seyed Mohsen Mousavi, Ali Taheri Akerdi, Eimen Jalili, Mohammad Hadi Niakan, Hossein Ali Khalili, Ali Haghnegahdar, Shahram Bolandparvaz
BACKGROUND: Epidemiology of cervical spine fractures (CSfx) in trauma patients of general population is not yet exclusively known. OBJECTIVES: The purpose of this study was to evaluate the epidemiology of CSfx in trauma patients. PATIENTS AND METHODS: Data from trauma patients admitted in the emergency room (ER) of Shiraz Shahid Rajaei hospital during the 3.5 years period from September 22, 2009 to March 21, 2013, were gathered. All trauma patients with CSfx and/or spinal cord injuries were included in the study...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27918852/anomaly-detection-outperforms-logistic-regression-in-predicting-outcomes-in-trauma-patients
#5
Zachary D W Dezman, Chen Gao, Shiming Yang, Peter Hu, Li Yao, Hsiao-Chi Li, Chein-I Chang, Colin Mackenzie
OBJECTIVE: Recent advancements in trauma resuscitation have shown a great benefit of early identification and control of hemorrhage, which is the most common cause of death in injured patients. We introduce a new analytical approach, anomaly detection (AD), as an alternative method to the traditional logistic regression (LR) method in predicting which injured patients receive transfusions, intensive care, and other interventions. METHODS: We abstracted routinely collected prehospital vital sign data from patient records (adult patients who survived more than 15 minutes after being directly admitted to a level 1 trauma center)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918641/evaluation-of-the-biocompatibility-of-polypyrrole-implanted-subdurally-in-gaers
#6
Sebastien H Bauquier, Karen J McLean, Jonathan L Jiang, Ray C Boston, Alan Lai, Zhilian Yue, Simon E Moulton, Amy J Halliday, Gordon Wallace, Mark J Cook
This blinded controlled prospective randomized study investigates the biocompatibility of polypyrrole (PPy) polymer that will be used for intracranial triggered release of anti-epileptic drugs (AEDs). Three by three millimeters PPy are implanted subdurally in six adult female genetic absence epilepsy rats from Strasbourg. Each rat has a polymer implanted on one side of the cortex and a sham craniotomy performed on the other side. After a period of seven weeks, rats are euthanized and parallel series of coronal sections are cut throughout the implant site...
December 5, 2016: Macromolecular Bioscience
https://www.readbyqxmd.com/read/27917699/the-relation-of-dissociation-and-mind-wandering-to-unresolved-disorganized-attachment-an-experience-sampling-study
#7
David Marcusson-Clavertz, Sabina Gušić, Hans Bengtsson, Heidi Jacobsen, Etzel Cardeña
Individuals with unresolved/disorganized representations of childhood trauma (U/d attachment) report more psychological distress than others, but little is known about their everyday mentation. In the present study adults with childhood trauma (N = 45) completed the Berkeley-Leiden Adult Attachment Questionnaire-Unresolved (BLAAQ-U) and the Adult Attachment Interview (AAI), and reported everyday mentation during 5 days of experience sampling. The BLAAQ-U and the AAI showed a medium association with each other, but only the former significantly predicted negative affect, dissociation, and low control/awareness of mentation...
December 5, 2016: Attachment & Human Development
https://www.readbyqxmd.com/read/27916759/odour-as-a-determinant-of-persistent-symptoms-after-a-chemical-explosion-a-longitudinal-study
#8
Gro Tjalvin, Nils Magerøy, Magne Bråtveit, Stein Håkon Låstad Lygre, Bjørg Eli Hollund, Bente Elisabeth Moen
Foul-smelling environmental pollution was a major concern following a chemical workplace explosion. Malodorous pollution has previously been associated with aggravated physical and psychological health, and in persons affected by a trauma, an incidence-related odour can act as a traumatic reminder. Olfaction may even be of significance in the development and persistence of post-traumatic stress symptoms (PTSS). The present longitudinal study assessed whether perceived smell related to malodorous environmental pollution in the aftermath of the explosion was a determinant of subjective health complaints (SHC) and PTSS among gainfully employed adults, when the malodorous pollution was present, and after pollution clean-up...
December 2, 2016: Industrial Health
https://www.readbyqxmd.com/read/27916579/distal-patellar-tendon-avulsion-in-association-with-high-energy-knee-trauma-a-case-series-and-review-of-the-literature
#9
Brian Capogna, Eric Strauss, Sanjit Konda, Alan Dayan, Michael Alaia
BACKGROUND: Patellar tendon rupture is rare in the general population. Typically, failure occurs proximally or at the mid-substance. Distal avulsion from the tibial tubercle in adults is rare and not well described in the orthopedic literature. METHODS: We present the largest series of patients with distal patellar tendon injury with associated multi-ligamentous disruption of the knee. A series of six patients with distal patellar tendon avulsion were identified at a single institution...
December 1, 2016: Knee
https://www.readbyqxmd.com/read/27916443/extracorporeal-life-support-use-in-pediatric-trauma-a-review-of-the-national-trauma-data-bank
#10
Joshua A Watson, Brian R Englum, Jina Kim, Obinna O Adibe, Henry E Rice, Mark L Shapiro, Mani A Daneshmand, Elisabeth T Tracy
PURPOSE: As the role of extracorporeal life support (ECLS) continues to evolve in the adult and pediatric populations, smaller studies and case reports have described successful use of ECLS in specific groups of pediatric trauma patients. To further define the role of ECLS in pediatric trauma, we examined indications and outcomes for use of ECLS in injured children using a large national database. METHODS: All trauma patients ≤18years old were identified from the 2007 to 2011 National Trauma Data Bank...
October 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27916379/admission-hyperglycemia-is-associated-with-different-outcomes-after-blunt-versus-penetrating-trauma
#11
Jonathan P Meizoso, Juliet J Ray, Charles A Karcutskie, Laura F Teisch, Casey J Allen, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: Stress-induced hyperglycemia is associated with worse outcomes after trauma; however, the effect of mechanism of injury has not been studied. To fill this gap, we tested the hypothesis that blunt and penetrating trauma evoke different glycemic responses which are associated with different outcomes. MATERIALS AND METHODS: A retrospective cohort study comparing adults with blunt (n = 835) or penetrating trauma (n = 858) and admission glucose levels ≥ 106 mg/dL, ≥150 mg/dL, and ≥200 mg/dL at a level 1 trauma center from 02, 2011 to 08, 2013...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916349/pediatric-pyoderma-gangrenosum-is-it-just-big-wounds-on-little-adults
#12
Tahereh Soleimani, Sarah E Sasor, Leigh Spera, Barry E Eppley, Juan Socas, Michael W Chu, Sunil S Tholpady
BACKGROUND: Pyoderma gangrenosum (PG) is an uncommon, ulcerative, cutaneous condition, often caused by surgical trauma that can masquerade as a pyogenic disease process requiring debridement and antibiotics. Treatment is, however, medical, with delay leading to significant morbidity. In addition, medical workup for coincident disorders has been suggested. The purpose of this study was to test the hypothesis that pediatric PG has differing disease associations and therefore requires a differing medical workup...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916197/peak-creatinine-kinase-level-is-a-key-adjunct-in-the-evaluation-of-critically-ill-trauma-patients
#13
Saskya Byerly, Elizabeth Benjamin, Subarna Biswas, Jayun Cho, Eugene Wang, Monica D Wong, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Elevated creatinine kinase (CK) can indicate rhabdomyolysis, a risk factor for acute kidney injury (AKI). We investigated risk factors and clinical significance of peak CK levels. METHODS: Retrospective analysis, adult trauma patients. Logistic regression was used to identify risk factors for elevated CK and AKI. RESULTS: 3240 trauma patients were analyzed; median time to peak CK was 17 h and 347 patients had peak CK > 5000...
November 24, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#14
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27912035/failure-to-rescue-after-infectious-complications-in-a-statewide-trauma-system
#15
Elinore J Kaufman, Emily Earl-Royal, Philip S Barie, Daniel N Holena
BACKGROUND: The failure to rescue (FTR) rate, the rate of death after a complication, measures a center's ability to identify and manage complications by "rescuing" vulnerable patients. Infectious complications are common after trauma, but risk factors for death after infection are not established. We hypothesized that risk factors would differ for FTR after infectious complications, development of infections, and for development of and death after non-infectious complications. PATIENTS AND METHODS: We analyzed trauma registry data for adult patients admitted to all 30 level I and II Pennsylvania trauma centers, 2011-2014...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27910090/spinal-fractures-in-older-adult-patients-admitted-after-low-level-falls-10-year-incidence-and-outcomes
#16
Randeep S Jawa, Adam J Singer, Daniel N Rutigliano, Jane E McCormack, Emily C Huang, Marc J Shapiro, Suzanne D Fields, Brian N Morelli, James A Vosswinkel
OBJECTIVES: To evaluate the incidence of spinal fractures and their outcomes in the elderly who fall from low-levels in a suburban county. DESIGN: Retrospective county-wide trauma registry review from 2004 to 2013. SETTING: Suburban county with regionalized trauma care consisting of 11 hospitals. PARTICIPANTS: Adult trauma patients aged ≥65 years who were admitted after falling from <3 feet. MEASUREMENTS: Demographic characteristics, comorbidities, and outcomes...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27909627/recurrence-of-childhood-nephrogenic-adenoma-in-urinary-bladder-developed-four-years-after-previous-surgery-despite-intravesical-sodium-hyaluronate-therapy
#17
Burak Özçift, Ayper Kaçar, Hüseyin Tuğrul Tiryaki
Nephrogenic adenoma (NA) is a rarely seen benign metaplastic lesion of the urinary tract. Its etiology is uncertain, but induced by chronic inflammation, irritation, and trauma. NA is located in the urinary tract, most commonly in the bladder. NA usually presents with hematuria and lower urinary tract symptoms. In the literature it is mostly seen in adults but about 30 cases of NA's have been reported in children. Treatment of intravesical lesions consists of transurethral resection (TUR) and fulguration and rarely partial or total cystectomy may be required in ineffective TUR...
December 2016: Turkish Journal of Urology
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#18
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#19
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low molecular weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27906868/individual-clotting-factor-contributions-to-mortality-following-trauma
#20
Ryan C Kunitake, Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mitchell J Cohen, Rachael A Callcut
BACKGROUND: Acute traumatic coagulopathy (ATC) afflicts 20-30% of trauma patients, but the extensive collinearity of the coagulation cascade complicates attempts to clarify global clotting factor dysfunction. This study aims to characterize phenotypes of clotting factor dysfunction and their contributions to mortality after major trauma. METHODS: This prospective cohort study examines all adult trauma patients of the highest activation level presenting to San Francisco General Hospital between 2/2005 and 2/2015...
November 30, 2016: Journal of Trauma and Acute Care Surgery
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