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Substance abuse in trauma patients

Scott F Coffey, Julie A Schumacher, Elizabeth Nosen, Andrew K Littlefield, Amber M Henslee, Amy Lappen, Paul R Stasiewicz
To test whether a modified version of prolonged exposure (mPE) can effectively treat posttraumatic stress disorder (PTSD) in individuals with co-occurring PTSD and substance dependence, an efficacy trial was conducted in which substance dependent treatment-seekers with PTSD (N = 126, male = 54.0%, White = 79.4%) were randomly assigned to mPE, mPE + trauma-focused motivational enhancement session (mPE + MET-PTSD), or a health information-based control condition (HLS). All participants were multiply traumatized; the median number of reported traumas that satisfied DSM-IV Criterion A for PTSD was 8...
November 2016: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
Alfreda Holloway-Beth, Linda Forst, Julia Lippert, Sherry Brandt-Rauf, Sally Freels, Lee Friedman
BACKGROUND: Current research regarding injuries caused during interactions between police officers and civilians is conducted intermittently or on a very narrow sample frame which provides very little clinical information about the injuries suffered or the adverse outcomes. The aim of this study is to identify comorbid risk factors and describe acute outcomes of medically treated traumatic injuries occurring as a result of contact with law enforcement personnel. METHODS: For this retrospective study, patients injured as a result of contact with law enforcement personnel were identified using ICD-9 external cause of injury codes from medical record databases of patients treated in all hospitals and trauma units in Illinois between 2000 and 2009...
December 2016: Injury Epidemiology
Elham Shafiei, Esmaeil Fakharian, Abdollah Omidi, Hossein Akbari, Ali Delpisheh
BACKGROUND: It is well-known that severe brain injury can make people susceptible to psychological symptoms. However, mild traumatic brain injury (MTBI) is still open for discussion. OBJECTIVES: This study aimed to compare psychological symptoms of MTBI patients with those without MTBI considering demographic auxiliary variables. PATIENTS AND METHODS: This prospective cohort study was conducted on 50 MTBI patients and 50 healthy subjects aged 15 - 65 years...
June 2016: Archives of Trauma Research
Krishnaraj Mahendraraj, Diane M Durgan, Ronald S Chamberlain
BACKGROUND: Although burn patients with preexisting mood disorders have been shown to have diminished clinical recovery, acute mental disorders (AMD) are often unrecognized despite a link with post-traumatic stress disorder and social maladjustment later on. This study assessed the clinical profile of a large cohort of burn patients who developed AMD compared to those with chronic mental illness (CMI) and those without mental health problems to assess the impact of AMI on burn outcomes...
August 28, 2016: Burns: Journal of the International Society for Burn Injuries
Fernando Domingo, Elizabeth Dale, Cuilan Gao, Cynthia Groves, J Daniel Stanley, Robert A Maxwell, Jimmy L Waldrop
BACKGROUND: Mandibular fractures are common facial injuries and treatment may be complicated by post-operative infection. Risk of infection from contamination with oral flora is well established but no consensus exists regarding antibiotic prophylaxis. The purpose of this study is to assess risk factors and perioperative antibiotics on surgical site infection (SSI) rates following mandibular fracture surgery. METHODS: Retrospective medical record review was completed for trauma patients of any age surgically treated for mandibular fractures at a Level I Trauma Center from September 2006 to June 2012...
August 18, 2016: Journal of Trauma and Acute Care Surgery
Jeffrey Guina, Ramzi W Nahhas, Adam J Goldberg, Seth Farnsworth
BACKGROUND: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. METHODS: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions...
2016: Journal of Clinical Medicine
Joseph B Richardson, Christopher St Vil, Tanya Sharpe, Michael Wagner, Carnell Cooper
BACKGROUND: Black men are disproportionately overrepresented among victims of repeat violent injury. However, little is known about the risk factors that influence violent trauma recidivism among black men. We hypothesize that the following risk factors would be significant among black male victims of repeat violent injury: disrespect; being under the influence; being in a fight and using a weapon in the past year; and previous incarceration when comparing trauma recidivists versus nonrecidivists...
July 2016: Journal of Surgical Research
Gunjan Kamdar Tiyyagura, Marcie Gawel, Aimee Alphonso, Jeannette Koziel, Kyle Bilodeau, Kirsten Bechtel
BACKGROUND: Prehospital care providers are in a unique position to provide initial unadulterated information about the scene where a child is abusively injured or neglected. However, they receive minimal training with respect to detection of Child Abuse and Neglect (CAN) and make few reports of suspected CAN to child protective services. AIMS: To explore barriers and facilitators to the recognition and reporting of CAN by prehospital care providers. DESIGN/METHODS: Twenty-eight prehospital care providers participated in a simulated case of infant abusive head trauma prior to participating in one-on-one semi-structured qualitative debriefs...
July 19, 2016: Prehospital Emergency Care
Juliann C Koleszar, Benjamin R Childs, Heather A Vallier
The goals of this study were to determine the frequency of trauma recidivism and to identify risk factors. The authors hypothesized that substance abuse and mental illness would be associated with recidivism. They performed a retrospective review of 879 patients who were treated surgically for high-energy fractures over a period of 4 years. Recidivism was defined as presentation to the trauma center for a new, unrelated injury. A recurrent recidivist was a repeat patient who returned for more than 1 additional injury...
September 1, 2016: Orthopedics
L R Fortuna, K Álvarez, Z Ramos Ortiz, Y Wang, X Mozo Alegría, B L Cook, M Alegría
BACKGROUND: Immigration stress appears to augment the risk for suicide behaviors for Latinos. Yet, specific risk factors that contribute to suicidal ideation (SI) among diverse Latino immigrant populations are not well established. METHODS: Data were collected in Boston, Madrid and Barcelona using a screening battery assessing mental health, substance abuse risk, trauma exposure, demographics, and sociocultural factors. Prevalence rates of lifetime and 30-day SI were compared across sites...
August 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
Lisa K McIntyre, Saman Arbabi, Ellen F Robinson, Ronald V Maier
IMPORTANCE: Previous studies investigating patients at risk for hospital readmissions focus on medical services and have found chronic conditions as contributors. Little is known, however, of the characteristics of patients readmitted from surgical services. OBJECTIVE: Surgical patients readmitted within 30 days following discharge were analyzed to identify opportunities for intervention in a cohort that may differ from the medical population. DESIGN, SETTING, AND PARTICIPANTS: Medical record review of patients readmitted to any service within 30 days of discharge from the general surgery service to characterize index and readmission data between July 1, 2014, and June 30, 2015, at a Level I trauma center and safety-net hospital...
September 1, 2016: JAMA Surgery
Julia Holl, Sebastian Wolff, Maren Schumacher, Anja Höcker, Elisabeth A Arens, Gabriela Spindler, Malte Stopsack, Jonna Südhof, Philipp Hiller, Michael Klein, Ingo Schäfer, Sven Barnow
Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group)...
June 13, 2016: Development and Psychopathology
Judith Marcoux, Mohammad Alkutbi, Julie Lamoureux, Mitra Feyz, Rajeet S Saluja, Elaine de Guise
BACKGROUND: Patients who leave hospital against medical advice (AMA) may be at risk of adverse health outcomes, medical complications, and readmission. In this study, we examined the characteristics of patients who left AMA after traumatic brain injury (TBI), their rates of follow-up visits, and readmission. METHODS: We retrospectively studied 106 consecutive patients who left the tertiary trauma center AMA (1.8% of all admitted patients with a TBI). Preinjury health and social issues, mechanism of injury, computed tomography findings, and injury markers were collected...
May 26, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Arthur W Bloom
Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused on point-of-sale interventions for alcohol, as well as on family-unit interventions designed with subpopulation cultural values in mind...
2016: Alcohol Research: Current Reviews
Andrea Carter, Sonya Borrero, Charles Wessel, Donna L Washington, Bevanne Bean-Mayberry, Jennifer Corbelli
BACKGROUND: Women are a rapidly growing segment of patients who seek care in the Veterans Affairs (VA) Healthcare System, yet many questions regarding their health care experiences and outcomes remain unanswered. Racial and ethnic disparities have been well-documented in the general population and among veterans; however, prior disparities research conducted in the VA focused primarily on male veterans. We sought to characterize the findings and gaps in the literature on racial and ethnic disparities among women using the VA...
July 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Jenna A LoGiudice, Sherifa Douglas
BACKGROUND: One in five women will experience sexual violence in their lifetime. As a consequence of this violence, survivors face health care concerns such as depression, anxiety, substance abuse, and gynecologic problems. Nurses are at the forefront of health care delivery to survivors of sexual violence, yet literature about nursing curricula addressing sexual violence is scant. METHOD: A holistic, single-case study from a student survivor about the impact of sexual violence, being taught from a trauma-informed care perspective, is presented...
April 2016: Journal of Nursing Education
Jason M Matuszak, Jennifer McVige, Jacob McPherson, Barry Willer, John Leddy
CONTEXT: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. EVIDENCE ACQUISITION: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor...
March 28, 2016: Sports Health
Hilal Hocagil, Filiz Izci, Abdullah Cüneyt Hocagil, Ebru Findikli, Sevda Korkmaz, Merve Iris Koc
BACKGROUND: Here we aimed to investigate sociodemographic characteristics, psychiatric history, and association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic. METHODS: This study consists of 73 violence-exposed patients admitted to emergency clinic who were literate and agreed to participate in the study. A sociodemographic data form created by us to investigate alcohol-substance abuse, suicide attempt, previous history of trauma, self and family history of psychiatric disorders and Beck Anxiety Inventory was given to the patients...
2016: Neuropsychiatric Disease and Treatment
Douglas S Weinberg, Arvind S Narayanan, Kaeleen A Boden, Mary A Breslin, Heather A Vallier
BACKGROUND: Psychiatric disorders are common, and their functional consequences may be underappreciated by non-mental health-care providers. There exist limited data regarding the frequency of psychiatric illness in patients who sustain orthopaedic polytrauma. The purpose of this study was to describe the prevalence of psychiatric illness in patients with orthopaedic polytrauma, to determine whether psychiatric illnesses were identified and were accommodated by trauma providers, and, finally, to investigate any associations between postoperative complications and psychiatric illness...
March 2, 2016: Journal of Bone and Joint Surgery. American Volume
Liping Tong, Cole Erdmann, Marina Daldalian, Jing Li, Tina Esposito
BACKGROUND: This paper explores the importance of electronic medical records (EMR) for predicting 30-day all-cause non-elective readmission risk of patients and presents a comparison of prediction performance of commonly used methods. METHODS: The data are extracted from eight Advocate Health Care hospitals. Index admissions are excluded from the cohort if they are observation, inpatient admissions for psychiatry, skilled nursing, hospice, rehabilitation, maternal and newborn visits, or if the patient expires during the index admission...
2016: BMC Medical Research Methodology
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