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Quality of life after trauma

Chao Xiong, Zhiquan Zhang, Gurpreet S Baht, Niccolo Terrando
Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and significantly diminish the outcome. Indeed, after routine orthopedic surgery to repair a fracture, as many as 50% of elderly patients suffer from neurologic complications like delirium. Also, the capacity to heal and regenerate tissue after surgery decreases with age, and can impact the quality of fracture repair and even osseous integration of implants. Thus, a better understanding of mechanisms that drive these age-dependent changes could provide strategic targets to minimize risk for such complications and optimize outcomes...
February 27, 2018: Journal of Visualized Experiments: JoVE
Irmela Gnass, Michaela Ritschel, Silke Andrich, Silke Kuske, Kai Moschinski, Annegret Herrmann-Frank, Maria-Inti Metzendorf, Sascha Flohé, Johannes Sturm, Joachim Windolf, Andrea Icks
INTRODUCTION: Survivors of polytrauma experience long-term and short-term burden that influences their lives. The patients' view of relevant short-term and long-term outcomes should be captured in instruments that measure quality of life and other patient-reported outcomes (PROs) after a polytrauma. The aim of this systematic review is to (1) collect instruments that assess PROs (quality of life, social participation and activities of daily living) during follow-up after polytrauma, (2) describe the instruments' application (eg, duration of period of follow-up) and (3) investigate other relevant PROs that are also assessed in the included studies (pain, depression, anxiety and cognitive function)...
March 16, 2018: BMJ Open
Christoph Ihle, Christoph Weiß, Gunnar Blumenstock, Ulrich Stöckle, Björn Gunnar Ochs, Christian Bahrs, Andreas Nüssler, Anna Janine Schreiner
BACKGROUND: Being at risk for malnutrition can be observed among hospitalized patients of all medical specialties. There are only few studies in arthroplasty dealing with defining and assessing malnutrition as such a potentially risk. This study aims to identify the risk for malnutrition following primary (pAP) and revision arthroplasty (rAP) (1) using non-invasive interview based assessment tools and to analyze effects on clinical outcome (2) and quality of life (3). METHODS: A consecutive series of hospitalized patients of a Department of Arthroplasty at a Level 1 Trauma Center in Western Europe was observed between June 2014 and June 2016...
March 15, 2018: BMC Musculoskeletal Disorders
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
Kallio Hunnicutt-Ferguson, Katarzyna E Wyka, Melissa Peskin, Judith Cukor, Megan Olden, JoAnn Difede
Posttraumatic stress disorder (PTSD) is associated with functional deficits, poor physical health, and diminished quality of life. Limited research has examined PTSD symptom clusters and their associations with functioning and distress among disaster recovery workers, a population at high risk for PTSD due to potential for repeated trauma. The purpose of this study was to investigate associations between overall PTSD severity, as well as PTSD symptom clusters, and social and occupational functioning and subjective distress in World Trade Center (WTC) disaster workers after the terrorist attacks on September 11, 2001 (9/11)...
March 14, 2018: Journal of Traumatic Stress
Maria Lindqvist, Margareta Persson, Margareta Nilsson, Eva Uustal, Inger Lindberg
OBJECTIVE: this study explores women's experiences of the first two months after obstetric anal sphincter injury (OASIS) during childbirth with a focus on problematic recovery. METHODS: this qualitative study used inductive qualitative content analysis to investigate open-ended responses from 1248 women. The data consists of short and comprehensive written responses to open-ended questions focusing on recovery in the national quality register, the Perineal Laceration Register, two months after OASIS at childbirth...
February 20, 2018: Midwifery
Ho Jun Lee, Yong Ju Jang
Hypertrophic scars and keloids are fibroproliferative disorders that may arise after any deep cutaneous injury caused by trauma, burns, surgery, etc. Hypertrophic scars and keloids are cosmetically problematic, and in combination with functional problems such as contractures and subjective symptoms including pruritus, these significantly affect patients' quality of life. There have been many studies on hypertrophic scars and keloids; but the mechanisms underlying scar formation have not yet been well established, and prophylactic and treatment strategies remain unsatisfactory...
March 2, 2018: International Journal of Molecular Sciences
Stephanie Brooks Holliday, Tamara Dubowitz, Ann Haas, Bonnie Ghosh-Dastidar, Amy DeSantis, Wendy M Troxel
BACKGROUND: Research has demonstrated the adverse impact that discrimination has on physical and mental health. However, few studies have examined the association between discrimination and symptoms of posttraumatic stress disorder (PTSD). There is evidence that African Americans experience higher rates of PTSD and are more likely to develop PTSD following trauma exposure than Whites, and discrimination may be one reason for this disparity. PURPOSE: To examine the association between discrimination and PTSD among a cross-sectional sample largely comprising African American women, controlling for other psychosocial stressors (psychological distress, neighborhood safety, crime)...
February 28, 2018: Ethnicity & Health
Elizabeth A Evans, Dawn L Glover, Donna L Washington, Alison B Hamilton
BACKGROUND: Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. OBJECTIVES: We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. METHODS: Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015...
February 27, 2018: Substance Use & Misuse
Khuram Khan, Saqib Saeed, Alexius Ramcharan, Sanjiv Gray
INTRODUCTION: Traumatic brain injury (TBI) is one of the main causes of morbidity and mortality in young trauma patients with resultant multi-organ effects. Hypopituitarism following TBI can be debilitating and life threatening. TBI which causes hypopituitarism may be characterized by a single head injury, such as from a motor vehicle accident, or by chronic repetitive head trauma, as seen in combative supports including boxing, kick-boxing, and football. In the majority of cases, a diagnosis of hypopituitarism can be entirely missed resulting in severe neuro-endocrine dysfunction...
February 9, 2018: International Journal of Surgery Case Reports
Noortje I van Vliet, Rafaele J C Huntjens, Maarten K van Dijk, Ad de Jongh
BACKGROUND: The treatment of posttraumatic stress disorder (PTSD) related to a history of sexual and/or physical abuse in childhood is the subject of international debate, with some favouring a phase-based approach as their preferred treatment, while others argue for immediate trauma-focused treatment. A history of (chronic) traumatisation during childhood has been linked to the development of distinct symptoms that are often labelled as symptoms of complex PTSD. Many therapists associate the presence of symptoms of complex PTSD with a less favourable treatment prognosis...
February 22, 2018: Trials
Roi Anteby, Aya Barzelay, Adiel Barak
Purpose: To evaluate visual and surgical outcomes in very elderly patients (above 85 years of age) undergoing pars plana vitrectomy (PPV). Patients and methods: A single-center, retrospective study was carried out on the medical records of 82 patients aged 85 years and older who had undergone PPV from 2006 to 2013. Patients ranged in age from 86 to 99 years, with a mean age of 88.9 years (±2.88). Visual results and intraoperative and postoperative complications were the main outcome measures...
2018: Clinical Interventions in Aging
Stephen S Humble, Laura D Wilson, Li Wang, Drew A Long, Miya A Smith, Jonathan C Siktberg, Mina F Mirhoseini, Aashim Bhatia, Sumit Pruthi, Matthew A Day, Susanne Muehlschlegel, Mayur B Patel
BACKGROUND: Determine the prognostic impact of MRI-defined DAI after TBI on functional outcomes, quality of life, and 3-year mortality. METHODS: This retrospective single center cohort included adult trauma patients (age>17y) admitted from 2006-2012 with TBI. Inclusion criteria were positive head CT with brain MRI within 2 weeks of admission. Exclusion criteria included penetrating TBI or prior neurologic condition. Separate ordinal logistic models assessed DAI's prognostic value for following scores: 1)hospital-discharge Functional Independence Measure (FIM); 2)long-term Glasgow Outcome Scale-Extended (GOSE); and 3)long-term Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS)...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Fang-Gui Sun, De-Xin Wang, Yu-Tong Hu, Rong-Ming Xu
OBJECTIVE: To explore the curative effect and the recessive loss of blooding of PFNA for the treatment of intertrochanteric fractures of femur. METHODS: From January 2012 to January 2015, a total of 49 patients with intertrochanteric fractures of femur were treated with proximal femoral anti-rotation nail including 41 males and 8 females with an average age of 79 years old ranging from 65 to 91 years old. According to the modified Evans type, 1 case was type I, 12 cases were type II, 36 cases were type III...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Wen Xue, Xiao-Li Guan, Zeng-Ping Wang, Zhong-Yu Hao, Lin Liu, Yao-Wen Qian
OBJECTIVE: To investigate the clincial effects and feasibility of anterior thoracoscopically assisted surgery (TAS) with posterior one-stage total en block spondylectomy(TES) for thoracic spinal tumour. METHODS: From October 2014 to January 2016, 4 patients with thoracic spinal tumour were treated by anterior thoracoscopically assisted surgery with posterior one-stage total en block spondylectomy. There were 2 males and 2 females, aged 16, 35, 46, 60 years. Courses of disease were 1, 4, 6, 9 months...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mohammad Auais, Suzanne N Morin, Lois Finch, Sara Ahmed, Nancy Mayo
OBJECTIVES: To examine the course of recovery and resulting health-related quality of life (HRQL) after low-trauma hip fracture using two different definitions of recovery. DESIGN: Inception cohort with eight assessments over one year. SETTING: Participants were recruited from a tertiary-care hospital and followed in the community. INTERVENTION: Not applicable PARTICIPANTS: 47 (75% of all eligible) community-dwelling hip fracture patients (≥65 years)...
February 14, 2018: Archives of Physical Medicine and Rehabilitation
Melanie S Harned, Chelsey R Wilks, Sara C Schmidt, Trevor N Coyle
Although functional impairment typically improves during evidence-based psychotherapies (EBPs) for borderline personality disorder (BPD), functional levels often remain suboptimal after treatment. The present pilot study evaluated whether and how integrating PTSD treatment into an EBP for BPD would improve functional outcomes. Participants were 26 women with BPD, PTSD, and recent suicidal and/or self-injurious behavior who were randomized to receive one year of Dialectical Behavior Therapy (DBT) or DBT with the DBT Prolonged Exposure (DBT PE) protocol for PTSD...
February 6, 2018: Behaviour Research and Therapy
Kirsten Neckelmann, Rikke Hagelberg
Several patients suffer from rib fractures after traumas, and in severe cases it can be life-threatening. Until recently, attempts to perform surgical fixation in patients with instability have been unsuccessful. Chronic non-union causes persistent pain, disability and loss of quality of life. Implementation of surgical stabilization of rib fractures with tailored plates seems to improve pain relief, especially in cases of non-union but also in patients with instability of the chest wall after severe traumas, where advanced pain treatment (epidural catheter) is insufficient or weaning off fails...
February 5, 2018: Ugeskrift for Laeger
Ashley P Marek, Jean Dominique Morancy, Jeffrey G Chipman, Rachel M Nygaard, Robert M Roach, Michele M Loor
The incidence of thoracolumbar spine fractures in blunt trauma is 4 to 5 per cent. These fractures may lead to neurologic injury, chronic back pain, and disability. Most studies from United States trauma centers focus on neurologic sequelae and/or compare treatment modalities. However, most patients with spine fractures do not have a neurologic deficit. Our primary objective was to determine the long-term outcome of traumatic thoracolumbar spine fractures, specifically addressing quality of life, chronic pain, and employment using a validated patient outcome survey...
January 1, 2018: American Surgeon
Heura Llaquet Bayo, Sandra Montmany, Pere Rebasa, Miriam Secanella, Marta Alberich, Salvador Navarro
PURPOSE: Study objectives are to determine whether quality of life is recovered completely after major injury and to identify determinants associated with a worse quality of life. METHODS: Prospective 12-month follow-up of injured patients admitted to the intensive care unit in a Spanish level 1 trauma centre. The main outcome (quality of life) was measured using the EQ-5D-5L. The relationships between sociodemographic factors, injury severity and location, and quality of life scores were evaluated...
February 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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