Wounds and Injuries (Total 1474091 Papers Found)

BACKGROUND Excessive brain responsiveness to norepinephrine appears to contribute to post-traumatic stress disorder (PTSD), particularly at night. Prazosin, a brain active alpha-1 adrenergic receptor antagonist, significantly reduced trauma nightmares and sleep disturbance in 10 Vietnam War combat veterans in a previous placebo-controlled crossover study. The current parallel group trial in a larger sample of veterans evaluated prazosin effects on trauma nightmares, sleep quality, global clinica ...
Many individuals living with HIV have been exposed to some type of traumatic event during their lives and may be living with symptoms of post-traumatic stress disorder (PTSD). A substantial number of these individuals are also likely to show evidence of a co-morbid substance use disorder (SUD). There is reason to believe that the co-occurrence of HIV and PTSD or co-morbid PTSD and SUD (PTSD/SUD) may predict poorer health outcomes. There are several pathways through which PTSD or PTSD/SUD might a ...
From 1985 to 1991, 648 cases of assault-related penetrating ocular injury were reported to the National Eye Trauma System Registry. We examined the circumstances surrounding and initial clinical findings related to this case series of injuries. Eighty-three percent of the patients were male. The median age was 28 years; 77% were younger than age 40 years, and 17% were younger than age 20 years. The ocular injury was part of multiple trauma in 34% of cases. There was evidence of alcohol and illic ...
The traumatic wound response of families of white spruce, Picea glauca (Moench) Voss, resistant or susceptible to the white pine weevil, Pissodes strobi (Peck), were compared after simulated weevil damage. Leaders from 331 trees were wounded just below the apical bud in the spring, coinciding with the natural time of weevil oviposition. A portable 1-mm diameter drill was used to drill 24 holes per leader. Leaders were removed in the fall and examined for evidence of traumatic resin canal formati ...
Traumatic brain injury caused by explosive or blast events is currently divided into four phases: primary, secondary, tertiary, and quaternary blast injury. These phases of blast-induced traumatic brain injury (bTBI) are biomechanically distinct, and can be modeled in both in-vivo and in-vitro systems. The purpose of this review is to consider the mechanical phases of bTBI, how these phases are reproduced with in-vitro models, and to review findings from these models to assess how each phase of ...
This study compared 21 female adult psychiatric patients diagnosed with dissociative identity disorder (DID) with 21 female adult nondissociative psychiatric patients to determine whether DID patients exhibit a distinguishing set of clinical features, and perceptual, attentional, and cognitive processes. Participants were assessed with the Dissociative Disorders Interview Schedule to assess diagnostic status. Group scores on the Dissociative Experiences Scale, Tellegen Absorption Scale, Childhoo ...
After 1, 2, 4, 7, 14 and 21 days of ureteral occlusion, renal blood flow was measured on both sides by means of a dye-dilution method and the glomerular and tubular functions were evaluated by measuring the extraction of 51-Cr-EDTA and 125-I-Hippuran. The results showed an increase in the weight of the obstructed kidney parenchyma and indicated an incipient compensatory hypertrophy of the contralateral kidney after 14 days of occlusion. The blood flow to the occluded kidney was reduced on the fi ...
Young patients with vitreous, retinal and subvitreal haemorrhages without neovascularisation or prior trauma are a diagnostic challenge for the physician. In this case report, a patient is presented who developed unilateral, spontaneous, subvitreal, retinal and subretinal haemorrhages and was diagnosed with von Willebrand’s disease. A 33-year-old Caucasian woman presented at our clinic with unilateral subvitreal, retinal and subretinal haemorrhages. The haemorrhages occurred spontaneously with ...
We report a rare case of femoral nerve palsy secondary to hematoma compression of the iliacus. The patient presented with pain 2 days after performing a double kick in karate. The femoral nerve symptoms (numbness and weakness) did not begin until 3 to 4 days after the initial trauma. Magnetic resonance imaging (MRI) confirmed that there was a hematoma compressing the iliacus (and femoral nerve). This hematoma was subperiosteal, within the iliac fossa. This case is rare because the femoral nerve ...
Obwohl es ein stetig wachsendes Interesse am Einsatz viskoelastischer Testverfahren (ROTEM®/TEG®) zur Diagnostik und Therapiesteuerung beim blutenden Schwerverletzten gibt, fehlen bis dato in der Breite akzeptierte Leitlinien, wie diese Verfahren in die klinische Versorgung integriert werden können. Im September 2014 versammelten sich internationale Experten unterschiedlicher und an der Schwerverletztenversorgung beteiligter Fachdisziplinen zu einer zweitägigen Konsensuskonferenz in Philadel ...
BACKGROUND Chronic inflammation may be involved in combat-related post-traumatic stress disorder (PTSD) and may help explain comorbid physical diseases. However, the extent to which combat exposure per se, depression, or early life trauma, all of which are associated with combat PTSD, may confound the relationship between PTSD and inflammation is unclear. METHODS We quantified interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and C-reactive protein (CRP) in 51 co ...
This article reports two cases of fracture of the ceramic head component in total cementless hip arthroplasty. There was no history of difficulty prior to the component fracture, neither during the operation nor during daily use, and in one of the patients, no history of trauma was observed. ...
Poor mental health, manifesting as psychological distress, has become a leading problem recently; therefore, determining associated factors is important, especially in female-dominated occupations, as women are more prone to psychological distress than men, in part due to demands of both professional and domestic tasks. The objective of the present study was to investigate associations between leisure-time physical inactivity and psychological distress, accounting for the possible relation of ps ...
We compared the performance on test of language, apraxia, acalculia and intelligence of 32 children--age 5 to 16 years--and 31 adults, seen at our Aphasia Unit for the sequelae of a brain trauma. Logorrhea was never present among children who had nonfluent aphasia more frequently than adults. Apraxia and acalculia were equally present in the two groups. Twelve children and 15 adults of the first study were retested at variable distance from trauma. No group difference was found in the recovery o ...
BACKGROUND In an acute care setting, evaluation of traumatic brain injury (TBI) is often complicated by alcohol intoxication. The purpose of this study is to evaluate the clinical utility of the protein S100B as a biochemical marker for identifying brain injury in patients who are intoxicated at the time of injury. METHODS The study participants were 160 patients who presented to a large urban Level I Trauma Centre in Vancouver, Canada. Patients were classified into four clinical groups (medic ...
BACKGROUND Despite recent advances in arthroscopic soft tissue repair and reconstruction for shoulder instability, Latarjet procedure is continuously a method of choice for many cases of unstable shoulders. OBJECTIVES To evaluate the clinical results of minimally invasive modified Latarjet technique in recurrent, traumatic anterior shoulder instability associated with obvious Hill-Sachs and Bankart lesions. PATIENTS AND METHODS Between 2007 and 2013, 36 consequent patients with traumatic ant ...
The author takes as a point of departure that severe trauma, such as torture, is "unresolved" because it is not symbolized and is thus dissociated or existing as warded-off parts of the personality. Depending on the severity and character of the trauma, the depth of the regression experienced, and the age and life-circumstances of the patient at the moment of trauma, this can have more or less severe impact on the personality structure. The consequences may at worst be fragmentation and total la ...
In Ile-Ife, Nigeria, traumatic brain injuries are largely due to traffic accidents caused mainly by the bad maintenance of the roads and unsafe driving. Young men in the productive stage of their lives are those most affected. The resultant disabilities include quadriplegia (in more than half the patients) and paraplegia. The cost of treating and providing adequate facilities for these patients imposes a heavy economic burden upon developing countries. ...
OBJECTIVE To review our substantial favorable experience with oromandibular free tissue reconstruction in pediatric patients, emphasizing technical pearls, which seem to be associated with favorable long-term aesthetic and functional outcomes. METHODS Retrospective review of a consecutive series of all free tissue transfers performed from 1997 to 2010 by the senior author (Y.D.) in patients younger than 18 years. Demographic data, techniques used, and complications were examined. RESULTS A t ...
Almost all anatomical structures of the hand have been held responsible for non-traumatic, non-paralytic flexion deformity of the proximal interphalangeal joint. Together with Millesi and Flatt, we define camptodactyly as a disorder of flexor-extensor equilibrium in the PIP. This definition determined our therapeutic approach. 59 patients with one or several fingers affected by camptodactyly were followed between 1975 and 1989. In 3 cases, the anomaly was associated with another malformation of ...
Mesenchymal stem cell (MSC)-mediated tissue regeneration is a promising strategy to treat several neurodegenerative diseases and traumatic injuries of the central nervous system. Bone marrow MSCs have great potential as therapeutic agents, since they are easy to isolate and expand and are capable of producing various cell types, including neural cells. Recently we developed a highly efficient methodology to produce neural stem-like and neural precursor-like cells from mice bone marrow-derived MS ...
OBJECTIVE Placental abruption is a clinical term used when premature separation of the placenta from the uterine wall occurs prior to delivery of the fetus. Hypertension, substance abuse, smoking, intrauterine infection and recent trauma are risk factors for placental abruption. In this study, we sought for clinical factors that increase the risk for perinatal mortality in patients admitted to the hospital with the clinical diagnosis of placental abruption. MATERIALS AND METHODS We identified ...
The purpose of this study was to determine the incidence, features, and associated injuries of intraperitoneal (IP) and extraperitoneal (EP) bladder rupture (BR) resulting from blunt trauma. A retrospective study from September 2001 to August 2011 was performed for blunt traumatic BR in adults. Demographics, mean Injury Severity Score (ISS), mean length of stay (LOS), incidence, mortality, operative repair, and associated injuries were evaluated. Of 15,168 adult blunt trauma admissions over 10 y ...
The role of endothelial dysfunction in coronary vasospasm is controversial. We hypothesized that reactive oxygen species (ROS) and endothelin-1 (ET-1) are plausible candidates as the mediator of vasospasm is linked to endothelial dysfunction. In a pig model with repetitive endothelial injury in coronary arteries, intracoronary administration of serotonin induced a vasospasm at the endothelial injury site. The level of endothelin-converting enzyme was upregulated at that site where, upon exposure ...
Surgical labyrinthectomy in patients with Menière's disease produces unsatisfactory results in 10-70% of the cases. A pathological process in the vestibular nerve comprising an increase in connective tissue formation and the development of bony material within the nerve is possibly the reason for the pathological function of the vestibular system. This process may arise after a mechanical trauma to the labyrinth. Labyrinthectomy should be performed only for the treatment of Menière's disease i ...
This work intends to present aspects of clinical work in which the Ferenczian proposition of neo-catharsis, as re-emergence of repressed affective experience in the transference and countertransference presents itself as a challenge to the analyst, since a standard, classical technical approach results in repetition of past trauma with the analyst as perpetrator. A deviation from standard technique-free association, the principle of abstinence in transference, and interpretation-involving empath ...
The purpose of this three-year, prospective, follow-up study was to evaluate whether aggressive gap arthroplasty is essential in the management of ankylosis of the temporomandibular joint (TMJ). Fifteen patients were treated by the creation of a minimal gap of 5-8mm and insertion of an interpositional gap arthroplasty using the temporalis fascia. Eleven patients had unilateral coronoidectomy and 4 bilateral coronoidectomy based on Kaban's protocol. Preoperative assessment included recording of h ...
OBJECTIVE Perturbation of immune homeostasis is an important determinant for organ dysfunction following multiple injuries. The aim of this study was to investigate the ability of glycine to influence the immediate post-traumatic inflammatory environment and altered reactivity of circulating leucocytes. MATERIAL AND METHODS Twenty pigs were subjected to two standardized gunshots to the abdomen and thigh. Treatment was started immediately. The animals were randomized to receive either glycine 1 ...
Tip deformities as small as 10 mum on cannulae can cause unnecessary pain to patients. The only way of preventing these deformed cannulae from reaching patients is to test every cannula at the manufacturing stage. Clinical and laboratory tests carried out by the company compare handling and trauma caused by medical cannulae with technical parameters for manufacturing and testing. This article discusses the results of these tests, which the author found verified that the properties of medical ...
The microvascular endothelium and endothelial cells are primary targets during graft rejection. This study measured endothelial cell damage by assessing microvascular permeability, and evaluated the role of surgical trauma during the acute phase of transplant rejection. The authors developed an experimental model that allows for simultaneous measurement of leukocyte activation and albumin leakage to assess endothelial barrier function exposed to transplantation-induced trauma. Eighteen composite ...
In the search for ever earlier determinants of adult pathology many ignore the transformative impact of adolescence. The authors suggest that the reality of adolescent development creates a vulnerability to being overwhelmed. Through deferred action childhood experiences may interact with adolescent realities and omnipotent beliefs to traumatize the adolescent. The authors suggest that trauma in adolescence can be independent both of the intensity of current external exposure or of earlier traum ...
Despite considerable advances in treatment in the last 20 years, trauma continues to be the main cause of disability and death for people under the age of 40 years. The outcome after injury has been improved by the introduction of advanced prehospital life support, early transfer and the establishment of specialized programs. Trauma care is governed by two underlying principles: early definitive management and a continuum of treatment from the time of injury to the return to the activities of da ...
Hemorrhagic shock (HS) due to major trauma predisposes the host to the development of acute lung inflammation and injury. The lung vascular endothelium is an active organ that plays a central role in the development of acute lung injury through generating reactive oxygen species and synthesizing and releasing of a number of inflammatory mediators, including leukocyte adhesion molecules that regulate neutrophils emigration. Previous study from our laboratory has demonstrated that in a setting of ...
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; 7.0%). Of these, 47 (23.7%) had medical and 13 (6.5% ...
Primary cultures of confluent endothelial cells derived from human umbilical veins produce platelet-activating factor (PAF) (l -alkyl-2-acetyl-sn-glycero-3-phosphocholine) when stimulated with appropriate agonists. Highly purified human thrombin and calcium ionophore A23187 stimulate the incorporation of [3H] acetate into a lipid product that has been identified as PAF by its behavior in thin-layer chromatographic and high-performance liquid chromatographic systems, the presence of characteristi ...
The extensive empirical research generated by attachment theory is briefly reviewed, with special reference to transgenerational transmission of attachment patterns, internal working models, cross-cultural, and longitudinal studies. It is claimed that attachment theory and research support the alternative psychoanalytic approach initiated by Ferenczi, especially as regards the re-evaluation of real-life traumatic events, the occurrence of personality splits after childhood trauma, and the aggrav ...
BACKGROUND Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfu ...
Objective. To evaluate the use of routine MR imaging sequences in detecting and characterizing secondary reactive synovitis of the knee joint using arthroscopy as the standard of reference. Design and patients. Fifty consecutive patients with a history of knee pain who were referred for MR imaging and subsequently underwent arthroscopy of the knee comprised the study group. MR images were evaluated for the presence and appearance of synovitis reflected in synovial thickening and irregularity. Sy ...
Als Hautemphysem bezeichnet man eine aufsteigende oder sich ausbreitende Gasansammlung in der Subkutis nach spontaner oder verletzungsbedingter Kontinuitätsunterbrechung luftumschließender anatomischer Strukturen. Wir berichten über eine Patientin, die sich nach einer Zahnarztbehandlung mit einer unklaren einseitigen Gesichtsschwellung in der dermatologischen Ambulanz vorstellte. Es konnte unter Berücksichtigung der Anamnese, der Differenzialdiagnosen und des Untersuchungsbefundes die Diagno ...
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Simple excision of pterygium, although very simple, is associated with variable postoperative recurrence rate which is especially high with bare sclera technique [1,2]. Recurrence of pterygium could be attributed to episcleral fibroblasts proliferation and neovascularization secondary to the traumatic and inflammatory processes following pterygium surgery. Histologically, pterygium comprises a highly developed vascular neoformation network that lies in a body of hypertrophic and elastotic connec ...
We present a case of a successful repair of brachial artery after blunt trauma, almost five days after the injury. Autovenous graft (great saphenous vein) was used for the repair. The diagnosis was confirmed by angiography, and this method was indisposable in the postoperative course. Precise surgical technique is compulsory in obtaining optimal surgical revascularization. ...
From August 91 to December 94, 20 external fixators were used for severely injured patients (avg. ISS 25.2). The fractures were essentially open book with or without lateral compression and vertical lesions. The indication for fixation was treatment of shock and stabilization in 8 cases, stabilization alone in 9 cases, and in 3 cases as complementary fixation after internal fixation of posterior lesions. The fixation of the pelvis was effective on the amount of blood loss. One acetabulum fractur ...
Microsurgical techniques are vital for the treatment of many aspects of trauma in the child, both in initial management and later reconstructive surgery. The basic principles of microsurgery pertain to all patients, but there are nuances of technique and of the psycho-social and peri-operative aspects of treatment which are particularly important in the child. It is these distinctions that are examined in this paper. ...
The reported incidence of myocardial contusion after blunt chest trauma is 7-17%. Only one third of these patients present with significant morbidity. The polytrauma is generally dominated by hypovolemic and traumatic shock. Other causes of hypotension are less common, and may thus be ignored. The standard algorithm of care in multiple trauma care, however, leads to the diagnosis even in these cases, as illustrated by a case of prolonged shock induced by blunt myocardial trauma. ...
OBJECTIVE To determine if physical examination (PE) of the posterior pelvis in awake and alert trauma patients with known pelvic ring injuries can accurately predict a potentially unstable posterior ring injury and guide the use of computed tomography (CT) more effectively. DESIGN Patients with pelvic fracture noted on anteroposterior (AP) pelvic radiographs were prospectively evaluated over a 21-month period. AP, inlet, and outlet radiographs as well as CT scans were obtained on all patients. ...
A 52-yr-old woman was found wandering in the lobby of a hotel with an apparently isolated head trauma. Because of rapid deterioration of her neurologic status (Glasgow Coma Scale, 4; unilateral dilated pupil), the patient was intubated, sedated, and transferred to our trauma centre. Computed tomography (CT) examination of her head revealed an isolated acute subdural hematoma. Urgent surgical evacuation was performed uneventfully. Clinical examination revealed no other obvious traumatic lesions t ...
Surgical or traumatic losses of substances should preferably be made good by autografts, though "alloplastic implants" are a sound alternative. An account is given of the chemical and physical properties of intrinsic and manmade synthetic polymers. The best polymers for the preparation of endoprostheses are indicated, and reference is made to their more common indications in maxillofacial reconstructive surgery. ...
IN THIS ISSUE OF JAMA, BRODERICK AND COLLEAGUES 1 report results of their study of the association of vigorous sports with bleeding rate in 104 children and adolescents with moderate or severe hemophilia. Most participants were receiving prophylactic infusions of replacement clotting factor, which has been established as the standard of care for children and adolescents with hemophilia. Activities were scored as category 1, 2, or 3, depending on the expected trauma related to frequency and sever ...