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Sample records for post-traumatic air insufflation

  1. Usefulness of computed tomography with air insufflation of the stomach prior to percutaneous endoscopic gastrostomy procedure

    PubMed Central

    Kawashima, Kousaku; Adachi, Kyoichi; Onishi, Koji; Fukuda, Kosuke; Kazumori, Hideaki; Ohno, Yasuhiko; Katoh, Takao; Sonoyama, Hiroki; Tada, Yasumasa; Kusunoki, Ryusaku; Oka, Akihiko; Fukuba, Nobuhiko; Oshima, Naoki; Yuki, Takafumi; Ishihara, Shunji; Kinoshita, Yoshikazu

    2016-01-01

    We examined the results of computed tomography (CT) with and without air insufflation of the stomach prior to performing percutaneous endoscopic gastrostomy (PEG). We retrospectively analyzed 366 patients who underwent PEG. CT images obtained with and without air insufflation were examined for the presence or absence of contact between the gastric anterior wall and abdominal wall. PEG outcome based on CT findings was also examined. CT with and without air insufflation was performed in 272 and 94 patients, respectively. Contact between the gastric anterior wall and abdominal wall was shown in 254 (93.4%) with and 45 (47.9%) without air insufflation, all of whom underwent a successful PEG procedure. In patients without contact between the gastric anterior wall and abdominal wall, PEG was not successful in 3 of 49 (6.1%) examined by CT without and 6 of 18 (33.3%) examined with air insufflation (p = 0.004). Values for diagnostic accuracy for contact between the gastric anterior wall and abdominal wall shown by CT with and without air insufflation in successful PEG cases were 0.96 and 0.51, respectively. In conclusion, CT with air insufflation more often revealed contact between the gastric anterior wall and abdominal wall as compared to CT without air insufflation, which may help to predict PEG procedure success. PMID:27257351

  2. Reassessment of psychological distress and post-traumatic stress disorder in United States Air Force Distributed Common Ground System operators.

    PubMed

    Prince, Lillian; Chappelle, Wayne L; McDonald, Kent D; Goodman, Tanya; Cowper, Sara; Thompson, William

    2015-03-01

    The goal of this study was to assess for the main sources of occupational stress, as well as self-reported symptoms of distress and post-traumatic stress disorder among U.S. Air Force (USAF) Distributed Common Ground System (DCGS) intelligence exploitation and support personnel. DCGS intelligence operators (n=1091) and nonintelligence personnel (n = 447) assigned to a USAF Intelligence, Surveillance, and Reconnaissance Wing responded to the web-based survey. The overall survey response rate was 31%. Study results revealed the most problematic stressors among DCGS intelligence personnel included high workload, low manning, as well as organizational leadership and shift work issues. Results also revealed 14.35% of DCGS intelligence operators' self-reported high levels of psychological distress (twice the rate of DCGS nonintelligence support personnel). Furthermore, 2.0% to 2.5% self-reported high levels of post-traumatic stress disorder symptoms, with no significant difference between groups. The implications of these findings are discussed along with recommendations for USAF medical and mental health providers, as well as operational leadership. PMID:25747649

  3. Symptoms of psychological distress and post-traumatic stress disorder in United States Air Force "drone" operators.

    PubMed

    Chappelle, Wayne L; McDonald, Kent D; Prince, Lillian; Goodman, Tanya; Ray-Sannerud, Bobbie N; Thompson, William

    2014-08-01

    The goal of this study is to repeat a survey administered in 2010 to assess for changes in mental health among United States Air Force aircrew operating Predator/Reaper remotely piloted aircraft, also commonly referred to as "drones." Participants were assessed for self-reported sources of occupational stress, levels of clinical distress using the Outcome Questionnaire-45.2, and symptoms of post-traumatic stress disorder (PTSD) using the PTSD Checklist-Military Version. A total of 1,094 aircrew responded to the web-based survey composed of the commercially available standardized instruments mentioned above. The survey also contained nonstandardized items asking participants to report the main sources of their occupational stress, as well as questions addressing demographics and work-related characteristics. The estimated response rate to the survey was 49%. Study results reveal the most problematic self-reported stressors are operational: low manning, extra duties/administrative tasks, rotating shift work, and long hours. The results also reveal 10.72% of operators self-reported experiencing high levels of distress and 1.57% reported high levels of PTSD symptomology. The results are lower than findings from the 2010 survey and from soldiers returning from Iraq and Afghanistan. Implications of the study and recommendations for United States Air Force line leadership and mental health providers are discussed. PMID:25102551

  4. An analysis of post-traumatic stress symptoms in United States Air Force drone operators.

    PubMed

    Chappelle, Wayne; Goodman, Tanya; Reardon, Laura; Thompson, William

    2014-06-01

    Remotely piloted aircraft (RPA), commonly referred to as "drones," have emerged over the past decade as an innovative warfighting tool. Given there is a paucity of empirical research assessing drone operators, the purpose of this study was to assess for the prevalence of PTSD symptoms among this cohort. Of the 1084 United States Air Force (USAF) drone operators that participated, a total of 4.3% endorsed a pattern of symptoms of moderate to extreme level of severity meeting criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders-4th edition. The incidence of PTSD among USAF drone operators in this study was lower than rates of PTSD (10-18%) among military personnel returning from deployment but higher than incidence rates (less than 1%) of USAF drone operators reported in electronic medical records. Although low PTSD rates may be promising, limitations to this study are discussed. PMID:24907535

  5. Comparison between air and carbon dioxide insufflation in the endoscopic submucosal excavation of gastrointestinal stromal tumors

    PubMed Central

    Shi, Wei-Bin; Wang, Zi-Hao; Qu, Chun-Ying; Zhang, Yi; Jiang, Han; Zhou, Min; Chen, Ying; Xu, Lei-Ming

    2012-01-01

    AIM: To evaluate the safety and efficacy of CO2 insufflation compared with air insufflation in the endoscopic submucosal excavation (ESE) of gastrointestinal stromal tumors. METHODS: Sixty patients were randomized to undergo endoscopic submucosal excavation, with the CO2 group (n = 30) and the air group (n = 30) undergoing CO2 insufflation and air insufflation in the ESE, respectively. The end-tidal CO2 level (pETCO2) was observed at 4 time points: at the beginning of ESE, at total removal of the tumors, at completed wound management, and 10 min after ESE. Additionally, the patients’ experience of pain at 1, 3, 6 and 24 h after the examination was registered using a visual analog scale (VAS). RESULTS: Both the CO2 group and air group were similar in mean age, sex, body mass index (all P > 0.05). There were no significant differences in PetCO2 values before and after the procedure (P > 0.05). However, the pain scores after the ESE at different time points in the CO2 group decreased significantly compared with the air group (1 h: 21.2 ± 3.4 vs 61.5 ± 1.7; 3 h: 8.5 ± 0.7 vs 42.9 ± 1.3; 6 h: 4.4 ± 1.6 vs 27.6 ± 1.2; 24 h: 2.3 ± 0.4 vs 21.4 ± 0.7, P < 0.05). Meanwhile, the percentage of VAS scores of 0 in the CO2 group after 1, 3, 6 and 24 h was significantly higher than that in the air group (60.7 ± 1.4 vs 18.9 ± 1.5, 81.5 ± 2.3 vs 20.6 ± 1.2, 89.2 ± 0.7 vs 36.8 ± 0.9, 91.3 ± 0.8 vs 63.8 ± 1.3, respectively, P < 0.05). Moreover, the condition of the CO2 group was better than that of the air group with respect to anal exsufflation. CONCLUSION: Insufflation of CO2 in the ESE of gastrointestinal stromal tumors will not cause CO2 retention and it may significantly reduce the level of pain, thus it is safe and effective. PMID:23326136

  6. Venous air embolism following insufflation of the urethra.

    PubMed

    Vanlinthout, L; Boghaert, A; Thienpont, L

    1986-01-01

    Venous air embolism following urethral inflation only scarcely documented: an extensive search of the literature yielded four papers relating to this subject. We report a new case of venous air embolism due to this uncommon etiology. Careful study revealed some common pathogenetic features with previously reported cases. Some important precautions can diminish the likelihood of gas embolism and reduce its fatal outcome in situations, similar to the kind mentioned. PMID:3564882

  7. Insufflation esophagoscopy.

    PubMed

    Edens, E T

    1978-01-01

    A new electroscope has been designed from the conventional Haslinger tubes. The new rigid scope combines the advantage of air insufflation in the flexible system with the therapeutic possibilities of the rigid tubes and is trustworthy in the following esophageal procedures; a) finding entrance of severe strictures; b) introducing nasogastric feeding tubes; c) extraction of foreign bodies; d) tumor coagulation/spur in hypopharyngeal diverticuli; e) washing and suction in cases with severe food retention; f)making tumor smears in patients with clotting disorders; g) taking substantial biopsies with an optical forceps, and h) objective photodocumentation of esophageal pathology. PMID:686602

  8. Post traumatic stress disorder.

    PubMed

    Tiller, J; Kyrios, M; Bennett, P

    1996-10-01

    Post traumatic stress disorder (PTSD) occurs after a person has been exposed to a traumatic event involving actual or threatened death, and has responded with intense fear or helplessness. The event is then persistently re-experienced. The person avoids stimuli associated with the trauma and experiences a numbing of general responsiveness. Symptoms of increased arousal can occur as well as depression and anxiety. PTSD causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The general practitioner is uniquely placed to identify PTSD and can have a key role in treatment. Cognitive behavioural treatment is a central therapeutic approach and can be carried out in general practice. The issues are to counteract the physiological components, expose the patient to the feared situation and help the patient to relearn that the stimuli are not necessarily associated with danger or threat. Repeated brief consultations over time can facilitate this process. PMID:8936738

  9. Post-Traumatic Stress Disorder

    MedlinePlus

    ... Physician September 01, 2000, http://www.aafp.org/afp/20000901/1035.html) Post-traumatic Stress Reactions Following ... Physician August 01, 1999, http://www.aafp.org/afp/990800ap/524.html) Written by familydoctor.org editorial ...

  10. Post-traumatic stress disorder

    MedlinePlus

    Post-traumatic stress disorder (PTSD) is a type of anxiety disorder . It can occur after you have gone through an extreme ... Normally, after the event, the body recovers. The stress hormones and chemicals the body releases due to ...

  11. Post-Traumatic Stress Disorder

    MedlinePlus

    ... PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. For Consumers General Information Post-Traumatic Stress Disorder ( NIMH ) Anxiety Information Stress Information Depression Information St. John's Wort Information See more Research ...

  12. Reconsidering Post-Traumatic Stress

    ERIC Educational Resources Information Center

    Berman, Dene S.; Davis-Berman, Jennifer

    2005-01-01

    This article serves to challenge the prevailing wisdom that suggests that most trauma is followed by post-traumatic stress disorder (PTSD), and is best treated with critical incident stress debriefing (CISD). Instead, recent evidence suggests that many individuals exposed to stress do not experience stress responses. Even those who do, however,…

  13. Post-Traumatic Stress Disorder (PDQ)

    MedlinePlus

    ... with post-traumatic stress need early treatment with methods that are used to treat other trauma victims. ... symptoms of post-traumatic stress. The crisis intervention method aims to relieve distress and help the patient ...

  14. AirSeal system insufflator to maintain a stable pneumorectum during TAMIS.

    PubMed

    Bislenghi, G; Wolthuis, A M; de Buck van Overstraeten, A; D'Hoore, A

    2015-01-01

    Transanal minimally invasive surgery (TAMIS) is typically used for treating intraluminal rectal tumors. Other applications have recently been described. We here present the use of TAMIS as a tool to treat a chronic anastomotic fistula after restorative rectal resection. A new insufflation device expected to solve the problem of maintaining a stable pneumorectum is described. PMID:25421704

  15. Post-Traumatic Visual Loss

    PubMed Central

    Atkins, Edward J.; Newman, Nancy J.; Biousse, Valérie

    2010-01-01

    Visual loss following head trauma is common, and the diagnosis can be challenging for the neurologist called to perform an emergency room assessment. The approach to the patient with post-traumatic visual loss is complicated by a wide range of potential ocular and brain injuries with varying pathophysiology. In addition to direct injuries of the eye and orbit, traumatic optic neuropathies, carotid cavernous fistulas, and damage to the intracranial visual pathways are classic causes of visual loss after head trauma. This review provides an update on the diagnosis and management of these conditions. PMID:18660739

  16. Delayed Post-Traumatic Anisocoria.

    PubMed

    Ergül, Dursun Fırat; Ekemen, Serdar; Özdemir, Özcan; Uzan, Çağdaş; Yelken, Birgül

    2015-06-01

    Post-traumatic carotid artery dissection is one of the major causes of ischemic stroke in young patients; its diagnosis remains a challenge for clinicians because of its variable clinical presentation. An otherwise healthy 37-year-old man was referred to the intensive care unit of our faculty for the management of multiple trauma because of a car accident. At 11 days from admission, his doctor noticed the advent of anisocoria. A prompt treatment was instituted with anti-platelet and-coagulant agents. The patient had a complete resolution of symptoms. The prognosis was good, and the patient achieved a complete clinical recovery. He was discharged without any sequelae. PMID:27366498

  17. [Post-traumatic stress disorder].

    PubMed

    Ponteva, Matti; Henriksson, Markus; Isoaho, Raimo; Laukkala, Tanja; Männikkö, Timo; Punamäki, Raija-Leena; Wahlbeck, Kristian

    2009-01-01

    Psychosocial support and careful monitoring are recommended for acute stress reaction (ASR) and acute stress disorder (ASD). If symptoms require, short focused cognitive-behavioural psychotherapy can be used for ASD. Medication is rarely necessary, but sleeping pills can be used for a short period. Trauma-focused psychotherapeutic interventions are first-line treatment for post-traumatic stress disorder. SSRI or SNRI antidepressant medication is also effective. There is less evidence on antipsychotic and antiepileptic medication. Psychotherapeutic interventions and medication can be, and often are, combined. Children, the elderly, and military and peacekeeping personnel need interventions that are tailored to their needs. PMID:19839195

  18. [Post-traumatic stress disorder after childbirth].

    PubMed

    Korábová, I; Masopustová, Z

    2016-01-01

    The aim of this paper is to introduce the issue of post-traumatic stress disorder after childbirth to health care professionals. The text focuses on the diagnostic definition of post-traumatic stress disorder after childbirth, symptoms, physiological background, prevalence, course, risk factors and consequences of post-traumatic stress disorder after childbirth for a woman, her child and her partner. Options for interventions and therapy are outlined as well. PMID:26982058

  19. Post-Traumatic Stress Disorder and Violence.

    ERIC Educational Resources Information Center

    French, Laurence

    This paper is a clinical discussion of post-traumatic stress disorder and violence, particularly as it applies to the Vietnam Post-Traumatic Stress Syndrome. In the first section, the syndrome is described as the sudden onset of explosive rage and unprovoked violence with little or no warning, accompanied by a drastic change in personality. It is…

  20. Interventional Treatment for Post-traumatic Headache.

    PubMed

    Conidi, Francis X

    2016-06-01

    Post-traumatic headache (migraine) is the most common symptom of concussion and traumatic brain injury. An expert opinion-based review along with a literature review (PubMed) was conducted looking at known interventional procedures for post-traumatic headache using the keywords post-traumatic headache, post-traumatic migraine headache, concussion, mild traumatic brain injury, and traumatic brain injury and the following categories: mechanism, pathophysiology, treatment, physical therapy, neurostimulation, Botox@/Onabotulinum toxin, and surgical intervention. The results returned a total of 181 articles of which 52 were selected. None of the articles included randomized placebo-controlled studies, and most were either prospective or retrospective case analysis and/or review articles or consensus opinion papers, with most studies yielding positive results. Despite a lack of hard evidence, interventional procedures, alone or in combination, appear to be an effective treatment for post-traumatic headaches. PMID:27130542

  1. Sterile post-traumatic immunosuppression.

    PubMed

    Islam, Md Nahidul; Bradley, Benjamin A; Ceredig, Rhodri

    2016-04-01

    After major trauma, the human immune system initiates a series of inflammatory events at the injury site that is later followed by suppression of local inflammation favoring the repair and remodeling of the damaged tissues. This local immune response involves complex interactions between resident cells such as macrophages and dendritic cells, soluble mediators such as cytokines and chemokines, and recruited cells such as neutrophils, monocytes and mesenchymal stromal cells. If of sufficient magnitude, these initial immune responses nevertheless have systemic consequences resulting in a state called post-traumatic immunosuppression (PTI). However, controversy exists regarding the exact immunological changes occurring in systemic compartments triggered by these local immune responses. PTI is one of the leading causes of post-surgical mortality and makes patients vulnerable to hospital-acquired infections, multiple organ failure and many other complications. In addition, hemorrhage, blood transfusion, immunesenescence and immunosuppressant drugs aggravate PTI. PTI has been intensively studied, but published results are frequently cloudy. The purpose of this review is to focus on the contributions made by different responsive modalities to immunosuppression following sterile trauma and to try to integrate these into an overall scheme of PTI. PMID:27195120

  2. Sterile post-traumatic immunosuppression

    PubMed Central

    Islam, Md Nahidul; Bradley, Benjamin A; Ceredig, Rhodri

    2016-01-01

    After major trauma, the human immune system initiates a series of inflammatory events at the injury site that is later followed by suppression of local inflammation favoring the repair and remodeling of the damaged tissues. This local immune response involves complex interactions between resident cells such as macrophages and dendritic cells, soluble mediators such as cytokines and chemokines, and recruited cells such as neutrophils, monocytes and mesenchymal stromal cells. If of sufficient magnitude, these initial immune responses nevertheless have systemic consequences resulting in a state called post-traumatic immunosuppression (PTI). However, controversy exists regarding the exact immunological changes occurring in systemic compartments triggered by these local immune responses. PTI is one of the leading causes of post-surgical mortality and makes patients vulnerable to hospital-acquired infections, multiple organ failure and many other complications. In addition, hemorrhage, blood transfusion, immunesenescence and immunosuppressant drugs aggravate PTI. PTI has been intensively studied, but published results are frequently cloudy. The purpose of this review is to focus on the contributions made by different responsive modalities to immunosuppression following sterile trauma and to try to integrate these into an overall scheme of PTI. PMID:27195120

  3. Post-traumatic Stress Disorder.

    PubMed

    Javidi, H; Yadollahie, M

    2012-01-01

    Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with

  4. Adolescent Post-Traumatic Stress Disorder

    ERIC Educational Resources Information Center

    Yule, William

    2003-01-01

    Based on over a decade of work in the area of PTSD, including a longitudinal study of PTSD among adolescents, Dr. Yule provides an introduction to post-traumatic stress disorder as it occurs in youth. This includes a look at the manifestations of stress reactions, the incidence and prevalence of PTSD, and the relationship between levels of…

  5. Post-traumatic elbow rotational stiffness

    PubMed Central

    Ling, Samuel KK; Faan, Yan Sui; Lui, Paulina WY; Ngai, Wai Kit

    2014-01-01

    Background The elbow is an important but complex structure, with movement in both the sagittal plane in flexion and extension, as well as the rotational plane in forearm supination and pronation. Trauma is a common cause of elbow stiffness, which significantly hampers daily function. There are currently no gold-standard management guidelines for post-traumatic elbow stiffness, and most of the published literature focuses solely on the sagittal plane of motion. Methods This is a retrospective case series reviewing all patients who underwent a surgical release for treatment of post-traumatic elbow stiffness during a 36-month period. Motion range and the shortened version of the Disabilities of the Arm, Shoulder and Hand scores were serially measured and analyzed. Results The results obtained showed that both the sagittal and rotational range of motion directly influenced upper limb function; however, the relationship between these two motion planes was weak, meaning that both sagittal and rotational motion in the elbow need be addressed individually. Post-traumatic elbow stiffness could be aptly managed by various surgical approaches, including arthroscopic-assisted procedures; these were all effective in increasing both the sagittal and rotational range of motion. More importantly, this gain in range translated to a statistically significant improvement in upper limb function. Conclusions Management of elbow stiffness needs to be tackled in both the sagittal and rotational motion planes.

  6. Südeck's post-traumatic osteodystrophy.

    PubMed

    Murariu, Isabella Cristina; Macovei, Luana

    2012-01-01

    The diversity that exists in the types of trauma, in the investigated anatomical structures, in the sites of trauma, in the outcomes of traumatic injuries, and in the general reaction of the body lead to a symptomatological polymorphism of post-traumatic sequelae. Therefore it is impossible to establish a well-defined nosological entity of these sequelae. The damaged tissues react under a very similar scheme, irrespective of the type of tissue, trauma or area, namely, through an inflammatory process, that causes various sequelae depending on certain parameters. Südeck post-traumatic osteodystrophy may be defined as a pathological entity based on some well-defined clinical features, on the development of its own therapy and on its more or less ubiquitous character. Südeck's post-traumatic osteodystrophy of the hand is rarely found isolated. This "acute bone atrophy" is usually included in the "pathological syndrome of the hand" and is caused by circulatory disorders that occur on a traumatized hand or on a hand with injury "at a distance", especially when nerve damage is involved. PMID:23700903

  7. Post Traumatic Endophthalmitis: Incidence and Risk Factors

    PubMed Central

    Dehghani, Ali Reza; Rezaei, Leila; Salam, Hasan; Mohammadi, Zahra; Mahboubi, Mohammad

    2014-01-01

    Post traumatic endophthalmitis is an uncommon but severe complication of ocular trauma. We aimed to identify the incidence of post traumatic endophthalmitis and its contributing risk factors in Feiz hospital (Isfahan, Iran) from 2006 until 2010. Medical records of 1042 patients with open globe injury were analyzed and data were collected including age, sex, location of being injured, visual acuity (VA), time from injury to hospitalization and to repair, site of ophthalmic injury and the presence of foreign body. The frequency of post-traumatic endophthalmitis was about 2.1% (N = 22) of all patients. Nine of 22 cases with endophthalmitis were under 8 years. The visual acuity at the time of admission was seen to be contributed to high rate of endophthalmitis. Intraocular foreign body was detected in 139 patients; and the rate of endophthalmitis was 5% among these patients. Statistical analysis showed significant relationship between presence of foreign body and higher rate of endophthalmitis. Also, duration of hospitalization was significantly different between two study groups (P = 0.019). There were no significant differences between two groups in terms of other studied variables. Patients with low age, low visual acuity at admission, presence of intraocular foreign body and long duration of hospital stay had a higher risk of endophthalmitis after the repair of the globe. Compared to the reports of other large institutions, we can attribute the low incidence rate of endophthalmitis in our institution to the early use of systemic antibiotics such as gentamycin and cephalosporins in the first hour of hospitalization until discharge. PMID:25363107

  8. What is post-traumatic stress disorder?

    PubMed Central

    Andreasen, Nancy C.

    2011-01-01

    Although post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) are categorized as separate and discrete disorders, the boundary between them is sometimes indistinct. Their separation is based on the assumption that PTSD results primarily from psychological stress, while TBI is the consequence of an identifiable injury to the brain. This distinction is based on an antiquated polarity between mind and brain, and the separation of the two disorders often becomes arbitrary in day-to-day psychiatric practice and research. PMID:22033951

  9. Post-traumatic headaches: a clinical overview.

    PubMed

    Russo, A; D'Onofrio, F; Conte, F; Petretta, V; Tedeschi, G; Tessitore, A

    2014-05-01

    Headache attributed to head and/or neck trauma or injury, the so-called post-traumatic headache (PTH), is the most common secondary headache disorder and one of the most controversial clinical entities in the headache field, due to its unclear pathophysiological mechanisms and the unsolved role of associated psychological and medico-legal aspects. PTH, as a significant cause of morbidity after traumatic brain injury, may occur as an isolated symptom or as one of a constellation of symptoms known as post-concussive syndrome. However, in many cases, PTH might also represent an accentuation of non-disabling, remote or infrequent pre-existing primary headaches rather than a new onset headache strictly related to the trauma. Recently, the International Classification of Headache Disorders attempted to classify PTH; however, many unsolved issues are still to be clarified. In this brief review, we will focus on PTH clinical aspects and diagnostic criteria. PMID:24867854

  10. Tribulin in post-traumatic stress disorder.

    PubMed

    Davidson, J; Glover, V; Clow, A; Kudler, H; Meador, K; Sandler, M

    1988-11-01

    Tribulin (endogenous monoamine oxidase inhibitor/benzodiazepine receptor binding inhibitor) output was measured in the urine of 18 patients with post-traumatic stress disorder (PTSD) and 13 controls. The level of the two inhibitory activities was highly significantly correlated in the group as a whole. There was no difference between output of either inhibitor in patients and controls. However, when the PTSD group was subdivided according to various psychometric ratings, a pattern of output did emerge. Levels of both inhibitory activities were higher in agitated compared with non-agitated subjects, and lower in extroverts compared with introverts. This finding supports the view that tribulin output is raised in conditions of greater arousal. PMID:3270828

  11. A Case of Post-Traumatic Meniere's Disease

    PubMed Central

    Chung, Juyong; Jung, Hahn Jin; Kim, Chong Sun

    2014-01-01

    There are only a few reports of post-traumatic Meniere's disease and there is few literature that contains detailed data associated with the disease. We report a case of post-traumatic Meniere's disease. He suffered from tinnitus, fluctuating sensorineural hearing loss, and recurrent vertigo. Symptomatic medical treatment was not helpful and neither was soft tissue plugging around the oval and round windows during exploratory tympanotomy. Three months after soft tissue plugging, endolymphatic sac decompression surgery was performed. The patient's symptoms improved markedly thereafter. The clinical significance of post-traumatic Meniere's disease is described and we present a brief review of the literature. PMID:24782951

  12. Post-traumatic subarachnoid hemorrhage: A review.

    PubMed

    Modi, Nikhilkumar J; Agrawal, Manish; Sinha, Virendra Deo

    2016-01-01

    Head injury has been the leading cause of death and disability in people younger than 40 years and the incidence is rising continuously. Anticipation of the pathological consequences of post-traumatic subarachnoid hemorrhage (tSAH) and an outcome-oriented management are very important in these cases. To encounter the complications pertaining to traumatic brain injury (TBI) and tSAH, various classifications have been proposed and goal-oriented screening strategies have been offered. The role of serial computed tomography (CT) scans, perfusion studies, transcranial Doppler, magnetic resonance imaging (MRI), and angiographic studies as diagnostic tools, has been described. Recently, MRI fluid-attenuated inversion recovery (FLAIR), gradient reversal echo (GRE), and susceptibility weighted imaging (SWI) have emerged as excellent complimentary MRI sequences, and the authors of this article have evaluated their role in the diagnosis and prognostication of patients with tSAH. Numerous studies have been conducted on the various complications associated with tSAH such as vasospasm, hydrocephalus, and electrolyte disturbances and their management. This article discusses these aspects of tSAH and their management nuances. PMID:26954974

  13. Post-traumatic stress disorder and vision.

    PubMed

    Trachtman, Joseph N

    2010-05-01

    Post-traumatic stress disorder (PTSD) can be defined as a memory linked with an unpleasant emotion that results in a spectrum of psychological and physical signs and symptoms. With the expectation of at least 300,000 postdeployment veterans from Iraq and Afghanistan having PTSD, optometrists will be faced with these patients' vision problems. Complicating the diagnosis of PTSD is some overlap with patients with traumatic brain injury (TBI). The estimated range of patients with TBI having PTSD varies from 17% to 40%, which has recently led the Federal government to fund research to better ascertain their relationship and differences. As a result of the sensory vision system's interconnections with the structures of the limbic system, blurry vision is a common symptom in PTSD patients. A detailed explanation is presented tracing the sensory vision pathways from the retina to the lateral geniculate body, visual cortex, fusiform gyrus, and the hypothalamus. The pathways from the superior colliculus and the limbic system to the eye are also described. Combining the understanding of the afferent and efferent fibers reveal both feedforward and feedback mechanisms mediated by nerve pathways and the neuropolypeptides. The role of the peptides in blurry vision is elaborated to provide an explanation as to the signs and symptoms of patients with PTSD. Although optometrists are not on the front line of mental health professionals to treat PTSD, they can provide the PTSD patients with an effective treatment for their vision disorders. PMID:20435270

  14. Relationships among Trait Resilience, Virtues, Post-traumatic Stress Disorder, and Post-traumatic Growth.

    PubMed

    Duan, Wenjie; Guo, Pengfei; Gan, Pei

    2015-01-01

    The present study aims to examine the relationship between trait resilience and virtues in the context of trauma. A total of 537 participants who attended the preliminary investigation and completed the Life Events Checklist were screened. Of these participants, 142 suffered from personal traumatic experiences in the past year; these individuals were qualified and invited to respond to online questionnaires to assess trait resilience, virtues (i.e., Conscientiousness, Vitality, and Relationship), post-traumatic stress disorder (PTSD) symptoms, and post-traumatic growth (PTG). The following questionnaires were used: Connor-Davidson Resilience Scale-Revised, Chinese Virtues Questionnaire, PTSD Checklist-Specific, and Post-traumatic Growth Inventory-Chinese. Only 95 participants who manifested self-reported PTSD symptoms and PTG were involved in the current analyses. Trauma was positively and significantly correlated with PTSD in the current sample. Results indicated that trait resilience was positively associated with virtues and PTG; by contrast, PTSD scores were negatively but not significantly related to most of these factors. The three virtues contributed to PTG to a greater extent than trait resilience in non-PTSD and PTSD groups. However, trait resilience remained a significant predictor in the PTSD group even when the three virtues were controlled. The relationship between trait resilience and PTG was moderated by PTSD type (non-PTSD group vs. PTSD group). Our results further suggested that trait resilience and virtues were conceptually related but functionally different constructs. Trait resilience and virtues are positively related; thus, these factors contributed variances to PTG in the context of trauma; however, trait resilience is only manifested when virtues are controlled and when individuals are diagnosed as PTSD. Furthermore, implications and limitations of this study are discussed. PMID:25932954

  15. Relationships among Trait Resilience, Virtues, Post-traumatic Stress Disorder, and Post-traumatic Growth

    PubMed Central

    Duan, Wenjie; Guo, Pengfei; Gan, Pei

    2015-01-01

    The present study aims to examine the relationship between trait resilience and virtues in the context of trauma. A total of 537 participants who attended the preliminary investigation and completed the Life Events Checklist were screened. Of these participants, 142 suffered from personal traumatic experiences in the past year; these individuals were qualified and invited to respond to online questionnaires to assess trait resilience, virtues (i.e., Conscientiousness, Vitality, and Relationship), post-traumatic stress disorder (PTSD) symptoms, and post-traumatic growth (PTG). The following questionnaires were used: Connor-Davidson Resilience Scale-Revised, Chinese Virtues Questionnaire, PTSD Checklist-Specific, and Post-traumatic Growth Inventory-Chinese. Only 95 participants who manifested self-reported PTSD symptoms and PTG were involved in the current analyses. Trauma was positively and significantly correlated with PTSD in the current sample. Results indicated that trait resilience was positively associated with virtues and PTG; by contrast, PTSD scores were negatively but not significantly related to most of these factors. The three virtues contributed to PTG to a greater extent than trait resilience in non-PTSD and PTSD groups. However, trait resilience remained a significant predictor in the PTSD group even when the three virtues were controlled. The relationship between trait resilience and PTG was moderated by PTSD type (non-PTSD group vs. PTSD group). Our results further suggested that trait resilience and virtues were conceptually related but functionally different constructs. Trait resilience and virtues are positively related; thus, these factors contributed variances to PTG in the context of trauma; however, trait resilience is only manifested when virtues are controlled and when individuals are diagnosed as PTSD. Furthermore, implications and limitations of this study are discussed. PMID:25932954

  16. Update on the management of post-traumatic stress disorder.

    PubMed

    Wallace, Duncan; Cooper, John

    2015-04-01

    Post-traumatic stress disorder occurs in people exposed to life-threatening trauma. GPs may be seeing more patients with post-traumatic stress disorder as military personnel return from overseas deployments. The condition can present in various ways. To reduce the likelihood of missed or delayed diagnosis GPs can screen at-risk populations. A comprehensive assessment is recommended. Specialist referral may be required, particularly if there are other mental health problems. Trauma-focused psychological therapies should be offered as the first line of treatment for post-traumatic stress disorder. Usually 8-12 sessions are needed for a therapeutic effect. If drug treatment is needed, selective serotonin reuptake inhibitors are the first line. Other drugs used in post-traumatic stress disorder include antipsychotics, anticonvulsants and prazosin. PMID:26648617

  17. Update on the management of post-traumatic stress disorder

    PubMed Central

    Wallace, Duncan; Cooper, John

    2015-01-01

    Summary Post-traumatic stress disorder occurs in people exposed to life-threatening trauma. GPs may be seeing more patients with post-traumatic stress disorder as military personnel return from overseas deployments. The condition can present in various ways. To reduce the likelihood of missed or delayed diagnosis GPs can screen at-risk populations. A comprehensive assessment is recommended. Specialist referral may be required, particularly if there are other mental health problems. Trauma-focused psychological therapies should be offered as the first line of treatment for post-traumatic stress disorder. Usually 8–12 sessions are needed for a therapeutic effect. If drug treatment is needed, selective serotonin reuptake inhibitors are the first line. Other drugs used in post-traumatic stress disorder include antipsychotics, anticonvulsants and prazosin. PMID:26648617

  18. EMDR for post-traumatic stress and other psychological trauma.

    PubMed

    Norgate, Kath

    Eye movement desensitisation and reprocessing (EMDR) is a powerful psychotherapy with well-researched benefits for adults and children who are experiencing post-traumatic stress and post-traumatic stress disorder. There is a wealth of research and practice-based evidence demonstrating the effectiveness of EMDR in many differing clinical presentations but the true potential of this extraordinarily beneficial therapeutic approach has not been fully embraced by the mental health nursing profession. PMID:23243806

  19. Post-traumatic stress disorder: evolutionary perspectives.

    PubMed

    Cantor, Chris

    2009-11-01

    Fear is the key emotion of post-traumatic stress disorder (PTSD). Fear's evolved function is motivating survival via defensive behaviours. Defensive behaviours have been highly conserved throughout mammalian species; hence much may be learned from ethology. Predation pressure drove the early evolution of defences, laying foundations in the more ancient brain structures. Conspecific (same species) pressure has been a more recent evolutionary influence, but along with environmental threats it has dominated PTSD research. Anti-predator responses involve both avoiding a predator's sensory field and avoiding detection if within it, as well as escape behaviours. More effective avoidance results in less need for escape behaviours, suggesting that avoidance is biologically distinct from flight. Recognizing the predation, environmental and conspecific origins of defence may result in clearer definition of PTSD phenomena. Defence can also be viewed in the stages of no threat, potential threat, encounter and circa strike. Specific defences are used sequentially and according to contexts, loosely in the order: avoidance, attentive immobility, withdrawal, aggressive defence, appeasement and tonic immobility. The DSM-IV criteria and PTSD research show substantial congruence with the model proposed: that PTSD is a disorder of heightened defence involving six key defences used in conjunction with vigilance and risk assessment according to contexts. Human research is reviewed in this respect with reference to laboratory and wild animal observations providing new insights. Understanding individual perceptual issues (e.g. predictability and controllability) relevant to these phenomena, combined with defence strategy recalibration and neuronal plasticity research goes some way to explaining why some traumatized individuals develop PTSD when others do not. PMID:20001399

  20. Mortality in late post-traumatic seizures.

    PubMed

    Englander, Jeffrey; Bushnik, Tamara; Wright, Jerry M; Jamison, Laura; Duong, Thao T

    2009-09-01

    The objective of this study was to examine the mortality rates in individuals with traumatic brain injury (TBI) who were classified as having experienced late post-traumatic seizures (LPTS) in the first 2 years post-TBI compared to those who were seizure-free (non-LPTS). Participants were a pooled sample (n = 508) from two studies which enrolled individuals with TBI who were injured between March 31, 1992 and December 20, 1999. The first sample was made up of individuals enrolled in a study of risk factors for LPTS development; the second sample was composed of individuals enrolled in the TBI National Database from a single rehabilitation center. Seventy-one (14%) participants had LPTS, of which 27% had died at 8-15 years post-injury, as compared to 10% of non-LPTS participants. Individuals with LPTS died at a younger age (54.1 versus 67.7 years; p = 0.01), but there were no statistically significant differences in either time from date of injury to death or highest GCS score in the first 24 h. Causes of death were variable and not specifically related to epilepsy. Of those with LPTS, risk factors for death include advanced age at time of injury and presence of subdural hematoma. The higher mortality rate and death at younger age with variable causes in TBI individuals with LPTS warrant close medical evaluation and monitoring of these individuals, particularly accessibility and compliance with ongoing general medical care, and education of primary care colleagues of the unique needs of this at-risk population. PMID:19508123

  1. Unpaired extinction: implications for treating post-traumatic stress disorder.

    PubMed

    Schreurs, Bernard G; Smith-Bell, Carrie A; Burhans, Lauren B

    2011-05-01

    Extinction of fear is important for treating stress-related conditions particularly post-traumatic stress disorder (PTSD). Although traditional extinction presents the feared stimulus by itself, there is evidence from both clinical and basic research that repeatedly presenting the feared stimulus by itself does not prevent fear from returning. This renewal or relapse can be "thwarted" by unpaired extinction-presentations of the feared stimulus and the event producing the fear. However, no matter how effective standard unpaired extinction may be in the laboratory, repeated presentation of a traumatic event is untenable. To make an unpaired extinction procedure more clinically relevant, we classically conditioned the rabbit nictitating membrane response using electrical stimulation or air puff as the unconditioned stimulus and then during unpaired extinction reduced both the intensity of the unconditioned stimulus and the days of unpaired stimulus presentations. We found unpaired extinction reduced conditioned and exaggerated unconditioned responding (an animal analog of PTSD called conditioning-specific reflex modification) and could be accomplished with a weak unconditioned stimulus as long as extended presentations were used. Surprisingly, brief presentations of a weak unconditioned stimulus or extended presentations of a strong one made the exaggerated responses stronger. One implication is that brief treatment may not just be ineffectual; it may heighten the symptoms of PTSD. Another implication is that using strong stimuli may also heighten those symptoms. PMID:21074779

  2. Samuel Pepys and post-traumatic stress disorder.

    PubMed

    Daly, R J

    1983-07-01

    Samuel Pepys's diary allows us an opportunity to see how a man of acknowledged ability and stability coped with the severe psychological trauma of being involved in the Great Fire of London in 1666. His self-monitoring provides an excellent record of the development of post-traumatic stress disorder and an account of his coping behaviour. Despite being one of the newest categories of mental disorder in the official nomenclature, post-traumatic stress disorder has obviously had a long existence. PMID:6349738

  3. Post-Traumatic Stress Symptoms and Post-Traumatic Growth: Evidence from a Longitudinal Study following an Earthquake Disaster

    PubMed Central

    Chen, Jieling; Zhou, Xiao; Zeng, Min; Wu, Xinchun

    2015-01-01

    Objective The current longitudinal study aims to examine the bidirectional relationship between post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG). Method One hundred twenty-two adults in the most severely affected area were investigated by self-report questionnaires at 12 months and 18 months after the Wenchuan Earthquake occurred in China. Results The autoregressive cross-lagged structure equation analysis revealed that PTG at 12 months post-earthquake could negatively predict PTSS at 18 months post-earthquake above and beyond PTSS stability, whereas PTSS at 12 months post-earthquake could not significantly predict subsequent PTG. Moreover, PTG at 12 months post-earthquake could predict fewer subsequent intrusions, numbing and hyper-arousal symptoms but not avoidance symptoms. Conclusion Growth can play a role in reducing long-term post-traumatic stress symptoms, and the implication of a positive perspective in post-trauma circumstance is discussed. PMID:26046912

  4. Post-traumatic osteolysis of the clavicle: MR features.

    PubMed

    Erickson, S J; Kneeland, J B; Komorowski, R A; Knudson, G J; Carrera, G F

    1990-01-01

    We present the magnetic resonance findings in a pathologically proven case of post-traumatic osteolysis of the distal clavicle. High signal intensity tissue centered on the acromioclavicular joint was seen on T2-weighted images, consistent with synovial proliferation. PMID:2398173

  5. MedlinePlus: Post-Traumatic Stress Disorder

    MedlinePlus

    ... traumatic stress disorder Traumatic events and children Related Health Topics Stress Veterans and Military Health National Institutes of Health ... Stress Disorder is the National Institute of Mental Health NIH MedlinePlus Magazine Post Traumatic Stress Disorder (PTSD): NIH Research to Results PTSD: A ...

  6. Post-Traumatic Pneumocele of the Frontal Sinus

    PubMed Central

    Calisir, Cuneyt; Adapinar, Baki

    2008-01-01

    A pneumocele is an abnormal dilatation of a paranasal sinus, most commonly affecting the frontal sinus. Although the etiology of pneumocele is not entirely known, several causative factors have been suggested including trauma, surgery, tumor and infection. We report here a case of post-traumatic pneumocele of the frontal sinus following a head trauma. PMID:18682678

  7. Pregabalin in post traumatic neuropathic pain: Case studies

    PubMed Central

    Singh, Rakesh Kumar; Sinha, Vijay Prakash; Pal, U. S.; Yadav, Sharad C.; Singh, Maneesh K.

    2012-01-01

    Pregabalin is effective in the treatment of peripheral and central neuropathic pain. This study evaluated the effectiveness of pregablin in management of post traumatic peripheral nerve injury facial pain not responding to other medication like analgesics. Pregabalin was well tolerated. The most common adverse effects were dizziness and tiredness. PMID:23251069

  8. Post-traumatic Lipoma of the Parotid gland

    PubMed Central

    Rehal, Satnam Singh; Alibhai, Mustansir; Perera, Esther

    2016-01-01

    Lipoma of the parotid gland is a rare entity. Trauma with soft tissue haematoma formation and subsequent lymphatic effusion, fat necrosis and lipoma formation have been postulated as an aetiological pathway. We report a case of a post-traumatic lipoma of the parotid gland to add to the available literature on this uncommon pathology. PMID:27106616

  9. The Relationship between Sexual Abuse and Post Traumatic Stress Disorder.

    ERIC Educational Resources Information Center

    Lawson, David Allen

    Post Traumatic Stress Disorder (PTSD) is a fairly recent inclusion in the literature as a psychiatric disorder. Currently, researchers are trying to relate PTSD to many different environmental and psychosocial stressors including physical abuse, emotional abuse, war trauma, and sexual abuse. This paper addresses research concerning the…

  10. Post-traumatic intracerebral pneumatocele: case report.

    PubMed

    Orebaugh, S L; Margolis, J H

    1990-12-01

    Pneumocephalus occurs in 0.5 to 1.0% of head trauma, but may also occur after neurologic surgery, or as a result of eroding infection or neoplasm. The pathophysiology involves the presence of craniodural fistula allowing ingress of air. A ball-valve mechanism may allow air to enter but not exit the cranium, or CSF leak permits air entrance as fluid leaves the intracranial space. While a "succession splash" is considered diagnostic of pneumocephalus, most patients have nonspecific signs and symptoms such as headache. Therefore, a high index of suspicion in a patient with recent head trauma is necessary. The diagnosis is made radiographically by CT scan. This is generally performed to rule out intracranial hematoma or cerebral contusion in head trauma, but will reveal even very small quantities of air to the unsuspecting physician. Therapy is often noninvasive, allowing the craniodural defect to heal spontaneously. Selected situations require immediate operative repair of the fistula. PMID:2258975

  11. An affective-cognitive processing model of post-traumatic growth.

    PubMed

    Joseph, Stephen; Murphy, David; Regel, Stephen

    2012-01-01

    A topic that has begun to attract interest from clinical psychologists and psychotherapists is post-traumatic growth. First, we provide a general overview of the field, setting out the historical development, main concepts, measurement issues and research findings. Second, we review evidence showing that the relationship between post-traumatic stress and post-traumatic growth is likely curvilinear. Third, a new affective-cognitive processing model of post-traumatic growth will be introduced in which post-traumatic stress is understood to be the engine of post-traumatic growth. Fourth, points of clinical intervention are described showing the ways in which therapists can facilitate post-traumatic growth. PMID:22610981

  12. Post-traumatic stress disorder after car accidents.

    PubMed

    Kuch, K; Swinson, R P; Kirby, M

    1985-10-01

    Survivors of car crashes often suffer from a post-traumatic fear of driving, generalized anxiety and depression. Unremitting pains are also common. As part of a pilot study 30 referred subjects were exposed to imagery of driving and accidents. Seventy-seven percent were phobic of driving. Fifty-three percent responded with increased anxiety to the imagery. Twelve treatment referrals received exposure therapy and six improved markedly. An additional four improved when a Benzodiazepine was added temporarily. Four out of eight subjects lost their unremitting pains along with their fears. When guided imagery evoked intense anxiety this seemed to predict a favourable outcome. A resumption of pleasure trips was a reliable criterion of recovery. The frequency of phobic symptomatology and it's importance to the understanding and management of post-traumatic anxiety states is discussed. PMID:4063939

  13. Post-Traumatic Headache Therapy in the Athlete.

    PubMed

    Seifert, Tad

    2016-06-01

    Post-traumatic headache can occur after any traumatic brain injury, regardless of severity. Headache is consistently the most common symptom following concussion and occurs in over 90 % of athletes with sports-related concussion. Despite this prevalence, the complaint of headache after a possible concussive injury is often dismissed. Even when sports-related concussion is accurately diagnosed, many athletes fall victim to mismanagement of this associated symptom by clinicians who are not well-versed in headache treatment. Furthermore, benign headaches may also occur incidentally in the context of head trauma. This complex, and often non-specific, nature of headaches provides a significant challenge in return to play decision-making. Post-traumatic headaches are generally categorized according to primary headache disorders in an attempt to guide treatment; however, there is minimal medical literature on headache management in the concussed athlete. There is clearly a continued need for prospective studies of existing treatments and new approaches. PMID:27184059

  14. Post-traumatic recto-spinal fistula.

    PubMed

    Lantsberg, L; Laufer, L; Greenberg, G; Hertzanu, Y

    2000-01-01

    Acquired recto-spinal fistula has been described elsewhere as a rare complication of colorectal malignancy and Crohn's enterocolitis. We treated a young man who developed a recto-spinal fistula as a result of a high fall injury. The patient presented with meningeal signs, sepsis and perianal laceration. Computerized axial tomography revealed air in the supersellar cistern. Gastrografin enema showed that contrast material was leaking from the rectum into the spinal canal. Surgical management included a diverting sigmoid colostomy, sacral bone curettage and wide presacral drainage. To the best of our knowledge, rectospinal fistula of traumatic origin has not been previously reported in the English literature. PMID:10663732

  15. Effects of carbon dioxide insufflation in balloon-assisted enteroscopy: A systematic review and meta-analysis

    PubMed Central

    Nishizawa, Toshihiro; Fujimoto, Ai; Ochiai, Yasutoshi; Kanai, Takanori; Naohisa, Yahagi

    2015-01-01

    Background and aim The efficacy of CO2 insufflation during balloon-assisted enteroscopy remains controversial. This study aimed to perform a systematic review with meta-analysis of randomized controlled trials (RCTs) in which CO2 insufflation was compared with air insufflation in balloon-assisted enteroscopy. Methods PubMed, the Cochrane library, and the Igaku-Chuo-Zasshi database were searched to identify RCTs eligible for inclusion in the systematic review. Data from the eligible studies were combined to calculate the pooled odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs). Results Four RCTs (461 patients) were identified. Compared with air insufflation, CO2 insufflation significantly increased intubation depth of oral enteroscopy (WMD: 55.2, 95% CI: 10.77–99.65, p = 0.015). However, there was significant heterogeneity. The intubation depth of anal enteroscopy showed no significant difference between the CO2 group and the air group. CO2 insufflation significantly reduced abdominal pain compared with air insufflation (WMD: −2.463, 95% CI: −4.452 to −0.474, p = 0.015), without significant heterogeneity. The PaCO2 or end-tidal CO2 level showed no significant difference between the CO2 group and air group. Conclusions Compared with air insufflation, CO2 insufflation during balloon-assisted enteroscopy caused less post-procedural pain without CO2 retention. PMID:26966518

  16. Post-traumatic osteolysis of the clavicle: a case report.

    PubMed

    Griffiths, C J; Glucksman, E

    1986-06-01

    A case of post-traumatic osteolysis of the clavicle occurring in a 25-year-old male is described. The condition should be suspected in anyone giving a history of persistent shoulder pain following trauma or intensive sporting activities. Characteristic resorption of the distal tip of the clavicle is found on X-ray. The condition usually responds within 2 years to conservative treatment. Previous reports of the condition are reviewed, and the possible pathogenesis and differential diagnosis discussed. PMID:3730078

  17. Post-traumatic osteolysis of the distal clavicle.

    PubMed

    Reber, P; Patel, A G; Hess, R; Noesberger, B

    1996-01-01

    We report a case of post-traumatic osteolysis of the distal clavicle of a 25-year-old man. The diagnosis was missed for several months, and the patient continued to have pain in his right shoulder. The pain continued in spite of intensive physiotherapy. When he was seen for the first time in our clinic 6 months after the accident, the radiographs showed an osteolysis of the distal clavicle. PMID:9063852

  18. Post-traumatic neurodegeneration and chronic traumatic encephalopathy.

    PubMed

    Daneshvar, Daniel H; Goldstein, Lee E; Kiernan, Patrick T; Stein, Thor D; McKee, Ann C

    2015-05-01

    Traumatic brain injury (TBI) is a leading cause of mortality and morbidity around the world. Concussive and subconcussive forms of closed-head injury due to impact or blast neurotrauma represent the most common types of TBI in civilian and military settings. It is becoming increasingly evident that TBI can lead to persistent, long-term debilitating effects, and in some cases, progressive neurodegeneration and chronic traumatic encephalopathy (CTE). The epidemiological literature suggests that a single moderate-to-severe TBI may be associated with accelerated neurodegeneration and increased risk of Alzheimer's disease, Parkinson's disease, or motor neuron disease. However, the pathologic phenotype of these post-traumatic neurodegenerations is largely unknown and there may be pathobiological differences between post-traumatic disease and the corresponding sporadic disorder. By contrast, the pathology of CTE is increasingly well known and is characterized by a distinctive pattern of progressive brain atrophy and accumulation of hyperphosphorylated tau neurofibrillary and glial tangles, dystrophic neurites, 43 kDa TAR DNA-binding protein (TDP-43) neuronal and glial aggregates, microvasculopathy, myelinated axonopathy, neuroinflammation, and white matter degeneration. Clinically, CTE is associated with behavioral changes, executive dysfunction, memory deficits, and cognitive impairments that begin insidiously and most often progress slowly over decades. Although research on the long-term effects of TBI is advancing quickly, the incidence and prevalence of post-traumatic neurodegeneration and CTE are unknown. Critical knowledge gaps include elucidation of pathogenic mechanisms, identification of genetic risk factors, and clarification of relevant variables-including age at exposure to trauma, history of prior and subsequent head trauma, substance use, gender, stress, and comorbidities-all of which may contribute to risk profiles and the development of post-traumatic

  19. Psychological Distress and Post-Traumatic Symptoms Following Occupational Accidents

    PubMed Central

    Ghisi, Marta; Novara, Caterina; Buodo, Giulia; Kimble, Matthew O.; Scozzari, Simona; Di Natale, Arianna; Sanavio, Ezio; Palomba, Daniela

    2013-01-01

    Depression and post-traumatic stress disorder frequently occur as a consequence of occupational accidents. To date, research has been primarily focused on high-risk workers, such as police officers or firefighters, and has rarely considered individuals whose occupational environment involves the risk of severe, but not necessarily life-threatening, injury. Therefore, the present study was aimed at assessing the psychological consequences of accidents occurring in several occupational settings (e.g., construction and industry). Thirty-eight victims of occupational accidents (injured workers) and 38 gender-, age-, and years of education-matched workers who never experienced a work accident (control group) were recruited. All participants underwent a semi-structured interview administered by a trained psychologist, and then were requested to fill in the questionnaires. Injured workers reported more severe anxious, post-traumatic and depressive symptoms, and poorer coping skills, as compared to controls. In the injured group low levels of resilience predicted post-traumatic symptomatology, whereas the degree of physical injury and the length of time since the accident did not play a predictive role. The results suggest that occupational accidents may result in a disabling psychopathological condition, and that a brief psychological evaluation should be included in the assessment of seriously injured workers. PMID:25379258

  20. Psychological distress and post-traumatic symptoms following occupational accidents.

    PubMed

    Ghisi, Marta; Novara, Caterina; Buodo, Giulia; Kimble, Matthew O; Scozzari, Simona; Di Natale, Arianna; Sanavio, Ezio; Palomba, Daniela

    2013-12-01

    Depression and post-traumatic stress disorder frequently occur as a consequence of occupational accidents. To date, research has been primarily focused on high-risk workers, such as police officers or firefighters, and has rarely considered individuals whose occupational environment involves the risk of severe, but not necessarily life-threatening, injury. Therefore, the present study was aimed at assessing the psychological consequences of accidents occurring in several occupational settings (e.g., construction and industry). Thirty-eight victims of occupational accidents (injured workers) and 38 gender-, age-, and years of education-matched workers who never experienced a work accident (control group) were recruited. All participants underwent a semi-structured interview administered by a trained psychologist, and then were requested to fill in the questionnaires. Injured workers reported more severe anxious, post-traumatic and depressive symptoms, and poorer coping skills, as compared to controls. In the injured group low levels of resilience predicted post-traumatic symptomatology, whereas the degree of physical injury and the length of time since the accident did not play a predictive role. The results suggest that occupational accidents may result in a disabling psychopathological condition, and that a brief psychological evaluation should be included in the assessment of seriously injured workers. PMID:25379258

  1. 21 CFR 884.1700 - Hysteroscopic insufflator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hysteroscopic insufflator. 884.1700 Section 884.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1700 Hysteroscopic insufflator. (a) Identification. A hysteroscopic insufflator is a...

  2. 21 CFR 884.5920 - Vaginal insufflator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Vaginal insufflator. 884.5920 Section 884.5920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5920 Vaginal insufflator. (a) Identification. A vaginal insufflator is a device used to...

  3. 21 CFR 884.1730 - Laparoscopic insufflator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Laparoscopic insufflator. 884.1730 Section 884.1730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1730 Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used...

  4. 21 CFR 884.1730 - Laparoscopic insufflator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Laparoscopic insufflator. 884.1730 Section 884.1730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1730 Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used...

  5. 21 CFR 884.5920 - Vaginal insufflator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Vaginal insufflator. 884.5920 Section 884.5920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5920 Vaginal insufflator. (a) Identification. A vaginal insufflator is a device used to...

  6. 21 CFR 884.1700 - Hysteroscopic insufflator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hysteroscopic insufflator. 884.1700 Section 884.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1700 Hysteroscopic insufflator. (a) Identification. A hysteroscopic insufflator is a...

  7. 21 CFR 884.5920 - Vaginal insufflator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Vaginal insufflator. 884.5920 Section 884.5920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5920 Vaginal insufflator. (a) Identification. A vaginal insufflator is a device used to...

  8. 21 CFR 884.1700 - Hysteroscopic insufflator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hysteroscopic insufflator. 884.1700 Section 884.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1700 Hysteroscopic insufflator. (a) Identification. A hysteroscopic insufflator is a...

  9. 21 CFR 884.5920 - Vaginal insufflator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vaginal insufflator. 884.5920 Section 884.5920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5920 Vaginal insufflator. (a) Identification. A vaginal insufflator is a device used to...

  10. 21 CFR 884.1730 - Laparoscopic insufflator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laparoscopic insufflator. 884.1730 Section 884.1730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1730 Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used...

  11. 21 CFR 884.5920 - Vaginal insufflator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Vaginal insufflator. 884.5920 Section 884.5920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5920 Vaginal insufflator. (a) Identification. A vaginal insufflator is a device used to...

  12. 21 CFR 884.1730 - Laparoscopic insufflator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Laparoscopic insufflator. 884.1730 Section 884.1730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1730 Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used...

  13. 21 CFR 884.1730 - Laparoscopic insufflator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Laparoscopic insufflator. 884.1730 Section 884.1730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1730 Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used...

  14. 21 CFR 884.1700 - Hysteroscopic insufflator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hysteroscopic insufflator. 884.1700 Section 884.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1700 Hysteroscopic insufflator. (a) Identification. A hysteroscopic insufflator is a...

  15. 21 CFR 884.1700 - Hysteroscopic insufflator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hysteroscopic insufflator. 884.1700 Section 884.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.1700 Hysteroscopic insufflator. (a) Identification. A hysteroscopic insufflator is a...

  16. Post-traumatic stress in Crohn's disease and its association with disease activity

    PubMed Central

    Cámara, Rafael J A; Gander, Marie-Louise; Begré, Stefan; von Känel, Roland

    2011-01-01

    Objective Violence, accidents and natural disasters are known to cause post-traumatic stress, which is typically accompanied by fear, suffering and impaired quality of life. Similar to chronic diseases, such events preoccupy the patient over longer periods. We hypothesised that post-traumatic stress could also be caused by Crohn's disease (CD), and that CD specific post-traumatic stress could be associated with an increased risk of disease exacerbation. Methods A cohort of CD patients was observed over 18 months in various types of locations providing gastroenterological treatment in Switzerland. The cohort included 597 consecutively recruited adults. At inclusion, CD specific post-traumatic stress was assessed using the Post-traumatic Diagnostic Scale (range 0–51 points). During follow-up, clinical aggravation was assessed by combining important outcome measures. Patients with post-traumatic stress levels suggestive of a post-traumatic stress disorder (≥ 15 points) were compared with patients with lower post-traumatic stress levels as well as with patients without post-traumatic stress. Also, the continuous relation between post-traumatic stress severity and risk of disease exacerbation was assessed. Results The 88 (19.1%) patients scoring ≥15 points had 4.3 times higher odds of exacerbation (95% CI 2.6 to 7.2) than the 372 (80.9%) patients scoring <15 points, and 13.0 times higher odds (95% CI 3.6 to 46.2) than the 45 (9.8%) patients scoring 0 points. The odds of exacerbation increased by 2.2 (95% CI 1.6 to 2.8) per standard deviation of post-traumatic stress. Conclusions CD specific post-traumatic stress is frequent and seems to be associated with exacerbation of CD. Thus gastroenterologists may want to ask about symptoms of post-traumatic stress and, where relevant, offer appropriate management according to current knowledge. PMID:24349679

  17. Post-traumatic osteolysis of the clavicle: a case report.

    PubMed Central

    Griffiths, C J; Glucksman, E

    1986-01-01

    A case of post-traumatic osteolysis of the clavicle occurring in a 25-year-old male is described. The condition should be suspected in anyone giving a history of persistent shoulder pain following trauma or intensive sporting activities. Characteristic resorption of the distal tip of the clavicle is found on X-ray. The condition usually responds within 2 years to conservative treatment. Previous reports of the condition are reviewed, and the possible pathogenesis and differential diagnosis discussed. Images Fig. 1 p130-b PMID:3730078

  18. Animal models of post-traumatic stress disorder: face validity

    PubMed Central

    Goswami, Sonal; Rodríguez-Sierra, Olga; Cascardi, Michele; Paré, Denis

    2013-01-01

    Post-traumatic stress disorder (PTSD) is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic) are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma. PMID:23754973

  19. Post-traumatic Stress Disorder and Magnetic Resonance Imaging.

    PubMed

    Moyer, Amanda

    2016-07-01

    Although post-traumatic stress disorder (PTSD) is not fully understood, considerable research has gone into studying anatomical changes in the brain that take place with this condition. Magnetic resonance (MR) imaging can demonstrate changes in the volume of numerous brain regions, and functional MR imaging shows changes in activation when subjects are exposed to trauma-related stimuli. This article reviews current research findings on PTSD-associated brain changes and behavioral effects and discusses how PTSD affects patients of different ages. PMID:27390232

  20. Animal models of post-traumatic stress disorder: face validity.

    PubMed

    Goswami, Sonal; Rodríguez-Sierra, Olga; Cascardi, Michele; Paré, Denis

    2013-01-01

    Post-traumatic stress disorder (PTSD) is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic) are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma. PMID:23754973

  1. [Post-traumatic aneurysm of the hand: 3 clinical cases].

    PubMed

    Carlesi, R; Casini, A; Bonalumi, F

    2000-01-01

    Three cases of ulnar post-traumatic aneurysms of the hand as a consequence of occupational injury are reported. In two cases arteriography examination confirmed the presence of ulnar aneurysm while in the third case we performed only Duplex-scanning. To avoid complications treatment was surgical, consisting of resection of the lesion with end-to-end anastomosis. Ulnar artery patency was confirmed by Duplex-scanning in the follow-up period and the patients were able to return to their jobs. PMID:10920623

  2. Functional neuroimaging studies of post-traumatic stress disorder

    PubMed Central

    Hughes, Katherine C; Shin, Lisa M

    2011-01-01

    Post-traumatic stress disorder (PTSD) is a significant problem that can affect individuals who have been exposed to a traumatic event or events, such as combat, violent crime or childhood abuse. Over the past several years, neuroimaging studies of PTSD have focused on elucidating the brain circuits that mediate this disorder. In this article, we will briefly introduce some of the methods used in functional neuroimaging studies of PTSD. We will then review functional neuroimaging studies that have reported significant findings in the amygdala, medial prefrontal cortex, hippocampus and insula. Finally, we will suggest future directions for research. PMID:21306214

  3. Post-traumatic segmental myoclonus associated with bilateral olivary hypertrophy.

    PubMed

    Birbamer, G; Gerstenbrand, F; Kofler, M; Buchberger, W; Felber, S; Aichner, F

    1993-06-01

    We present clinical and magnetic resonance (MR) findings in three patients with segmental myoclonia occurring 11-18 months after severe brainstem injury. Palatal myoclonus and vertical ocular myorhythmia were present in all three patients and synchronous involuntary movements of the upper extremities ("wing beating") in two patients. MR-imaging showed multiple post-traumatic lesions within the dentato-rubro-olivary pathway ("myoclonic triangle"), associated with bilateral enlargement and increased signal intensity of the inferior olives. The signal abnormality was more prominent on proton density weighted images than on T2-weighted images, suggesting underlying pathological changes different from typical gliosis. PMID:8356884

  4. [Update on Current Care Guidelines: Post-traumatic Stress Disorder].

    PubMed

    Ponteva, Matti; Henriksson, Markus; Isoaho, Raimo; Laukkala, Tanja; Punamäki, Leena; Wahlbeck, Kristian

    2015-01-01

    The updated Current Care Guidelines for ASD and PTSD recommend psychosocial support and careful monitoring for acute stress reaction (ASR) and acute stress disorder (ASD). If symptoms require, short focused cognitive-behavioral psychotherapy can be used for ASD. Medication is rarely necessary. Trauma-focused psychotherapeutic interventions are the first-line treatment for post-traumatic stress disorder (PTSD). Antidepressant medication is an effective second-line treatment. Psychotherapeutic interventions and medication should often be combined. Specific groups, such as children, the elderly, and military and peacekeeping personnel need tailored interventions. PMID:26237898

  5. Brain structure in post-traumatic stress disorder: A voxel-based morphometry analysis.

    PubMed

    Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui

    2013-09-15

    This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities. PMID:25206550

  6. Surgical Management of Post-Traumatic Iris Cyst

    PubMed Central

    Philip, Swetha Sara; John, Deepa Rebecca; Ninan, Fini; John, Sheeja Susan

    2015-01-01

    Purpose : Epithelial cysts of the iris may be primary or secondary. The management of secondary, posttraumatic iris cysts is often challenging. The purpose of this work is to report the successful surgical management of a post-traumatic iris cyst. Case Report: A 38 year-old man presented with an iris cyst associated with epithelial downgrowth and total cataract, six years after sustaining a penetrating injury to his right eye. The iris cyst was excised in toto with the epithelial downgrowth, and the procedure was combined with cataract extraction and intra ocular lens implantation. The patient had good post-operative visual recovery with minimal inflammatory reaction. Conclusion: Post-traumatic cysts of the iris can be associated with significant ocular morbidity. Many different modalities of treatment, with varying degrees of success, have been described for the treatment of iris cysts. Excision of the iris cyst in toto is a good surgical management option, which can result in an excellent functional outcome with minimal inflammatory complications. PMID:26862359

  7. IL-5 in post-traumatic eosinophilic pleural effusion.

    PubMed Central

    Schandené, L; Namias, B; Crusiaux, A; Lybin, M; Devos, R; Velu, T; Capel, P; Bellens, R; Goldman, M

    1993-01-01

    Thoracic trauma or pneumothorax can result in pleural fluid eosinophilia. In this study we investigated the role of the eosinophilopoietic cytokine IL-5 in three cases of post-traumatic eosinophilic pleural effusions (EPE). Using a specific immunoenzymatic assay, significant levels of IL-5 were found in EPE (range 100-3000 pg/ml), while IL-5 was undetectable (< 25 pg/ml) in corresponding serum samples and in non-eosinophilic pleural fluids. IL-5 present in pleural fluids was found bioactive in a proliferative assay using a mouse CTLL-2 cell line transfected with the cDNA corresponding to the alpha chain of the human IL-5 receptor. Using a reverse polymerase chain reaction (PCR) method, we found IL-5 mRNA expression within pleural mononuclear cells from patients with EPE, but not in corresponding peripheral blood mononuclear cells (PBMC), confirming that IL-5 is synthesized locally in the pleural cavity. In the two cases in which pleural CD4+ cells were purified, these cells were identified as the major source of IL-5. Taken together, these data indicate that the development of post-traumatic EPE is related to a local secretion of IL-5 by CD4+ cells present in the pleural cavity. Images Fig. 1 PMID:8100745

  8. Safety and efficacy of carbon dioxide insufflation during gastric endoscopic submucosal dissection

    PubMed Central

    Takada, Jun; Araki, Hiroshi; Onogi, Fumito; Nakanishi, Takayuki; Kubota, Masaya; Ibuka, Takashi; Shimizu, Masahito; Moriwaki, Hisataka

    2015-01-01

    AIM: To compare the safety and efficacy of carbon dioxide (CO2) and air insufflation during gastric endoscopic submucosal dissection (ESD). METHODS: This study involved 116 patients who underwent gastric ESD between January and December 2009. After eliminating 29 patients who fit the exclusion criteria, 87 patients, without known pulmonary dysfunction, were randomized into the CO2 insufflation (n = 36) or air insufflation (n = 51) groups. Standard ESD was performed with a CO2 regulation unit (constant rate of 1.4 L/min) used for patients undergoing CO2 insufflation. Patients received diazepam for conscious sedation and pentazocine for analgesia. Transcutaneous CO2 tension (PtcCO2) was recorded 15 min before, during, and after ESD with insufflation. PtcCO2, the correlation between PtcCO2 and procedure time, and ESD-related complications were compared between the two groups. Arterial blood gases were analyzed after ESD in the first 30 patients (12 with CO2 and 18 with air insufflation) to assess the correlation between arterial blood CO2 partial pressure (PaCO2) and PtcCO2. RESULTS: There were no differences in respiratory functions, median sedative doses, or median procedure times between the groups. Similarly, there was no significant difference in post-ESD blood gas parameters, including PaCO2, between the CO2 and air groups (44.6 mmHg vs 45 mmHg). Both groups demonstrated median pH values of 7.36, and none of the patients exhibited acidemia. No significant differences were observed between the CO2 and air groups with respect to baseline PtcCO2 (39 mmHg vs 40 mmHg), peak PtcCO2 during ESD (52 mmHg vs 51 mmHg), or median PtcCO2 after ESD (50 mmHg vs 50 mmHg). There was a strong correlation between PaCO2 and PtcCO2 (r = 0.66; P < 0.001). The incidence of Mallory-Weiss tears was significantly lower with CO2 insufflation than with air insufflation (0% vs 15.6%, P = 0.013). CO2 insufflation did not cause any adverse events, such as CO2 narcosis or gas embolisms

  9. Post-Traumatic Stress Disorder and People with Learning Disabilities: A Literature Based Discussion.

    ERIC Educational Resources Information Center

    Doyle, Colin; Mitchell, Duncan

    2003-01-01

    This article summarizes literature (1997-2001) from the MEDLINE data base concerning post-traumatic stress disorder in people with intellectual disabilities. It finds that these individuals may manifest emotional trauma primarily through challenging behavior. The article suggests that post-traumatic stress syndrome in this population frequently…

  10. The Mutual Prospective Influence of Child and Parental Post-Traumatic Stress Symptoms in Pediatric Patients

    ERIC Educational Resources Information Center

    Landolt, Markus A.; Ystrom, Eivind; Sennhauser, Felix H.; Gnehm, Hanspeter E.; Vollrath, Margarete E.

    2012-01-01

    Background: Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study…

  11. Post-Traumatic Growth in Mothers of Children with Autism: A Phenomenological Study

    ERIC Educational Resources Information Center

    Zhang, Wei; Yan, Ting Ting; Barriball, K. Louise; While, Alison E.; Liu, Xiao Hong

    2015-01-01

    While the adverse effects of raising a child with autism are well demonstrated, there have been few reports of the post-traumatic growth of mothers of children with autism. The purpose of this research was to explore dimensions of post-traumatic growth in this population in Mainland China and identify the factors facilitating post-traumatic…

  12. Post-traumatic Stress Disorder and Cardiovascular Disease.

    PubMed

    Burg, Matthew M; Soufer, Robert

    2016-10-01

    Post-traumatic stress disorder (PTSD) is a disabling condition that develops consequent to trauma exposure such as natural disasters, sexual assault, automobile accidents, and combat that independently increases risk for early incident cardiovascular disease (CVD) and cardiovascular (CV) mortality by over 50 % and incident hypertension risk by over 30 %. While the majority of research on PTSD and CVD has concerned initially healthy civilian and military veteran samples, emerging research is also demonstrating that PTSD consequent to the trauma of an acute cardiac event significantly increases risk for early recurrence and mortality and that patient experiences in the clinical pathway that are related to the emergency department environment may provide an opportunity to prevent PTSD onset and thus improve outcomes. Future directions for clinical and implementation science concern broad PTSD and trauma screening in the context of primary care medical environments and the testing of PTSD treatments with CVD-related surrogates and endpoints. PMID:27566327

  13. Be vigilant for post-traumatic stress reactions.

    PubMed

    Hull, Alastair M; Curran, Stephen A

    2016-05-01

    Most people experience at least one potentially traumatic event (PTE) during their life. Many will develop only transient distress and not a psychological illness. Even the most inherently horrific event does not invariably lead to the development of a psychological disorder while an individual with sufficient vulnerabilit may develop post-traumatic stress disorder (PTSD) after what appears be an event of low magnitude. The diagnosis of PTSD differs fro most psychiatric disorders as it includes an aetiological factor, the traumatic event, as a core criterion. The DSM 5 core symptoms of PTSD are grouped into four key symptom clusters: re-experiencing, avoidance, negative cognitions and mood, and arousal. Symptoms must be present for at least one month and cause functional impairment. PTSD patients can avoid engaging in treatment and assertive follow-up may be necessary. PMID:27382915

  14. Post-traumatic stress disorder: emerging concepts of pharmacotherapy.

    PubMed

    Baker, Dewleen G; Nievergelt, Caroline M; Risbrough, Victoria B

    2009-06-01

    Post-traumatic stress disorder (PTSD) can result from a traumatic experience that elicits emotions of fear, helpless or horror. Most individuals remain asymptomatic or symptoms quickly resolve, but in a minority intrusive imagery and nightmares, emotional numbing and avoidance, and hyperarousal persist for decades. PTSD is associated with psychiatric and medical co-morbidities, increased risk for suicide, and with poor social and occupational functioning. Psychotherapy and pharmacotherapy are common treatments. Whereas, research supports the efficacy of the cognitive behavioral psychotherapies, there is insufficient evidence to unequivocally support the efficacy of any specific pharmacotherapy. Proven effective pharmacologic agents are sorely needed to treat core and targeted PTSD symptoms, and for prevention. This review describes current and emerging pharmacotherapies that advance these goals. PMID:19453285

  15. Biological studies of post-traumatic stress disorder.

    PubMed

    Pitman, Roger K; Rasmusson, Ann M; Koenen, Karestan C; Shin, Lisa M; Orr, Scott P; Gilbertson, Mark W; Milad, Mohammed R; Liberzon, Israel

    2012-11-01

    Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models. PMID:23047775

  16. Clinical features, investigation and treatment of post-traumatic syringomyelia.

    PubMed Central

    Shannon, N; Symon, L; Logue, V; Cull, D; Kang, J; Kendall, B

    1981-01-01

    Thirteen patients who sustained spinal cord trauma causing persisting disability, developed new symptoms, the chief one of which was severe pain unrelieved by analgesics. The clinical diagnosis of post traumatic syringomyelia was confirmed in each case by means of myelography, as well as endomyelography in seven patients. In every case exploration of the spinal cord syrinx was performed. Ten patients were troubled by severe pain while three patients were mainly subject to altered sensation in the upper limbs. Of the six patients who had initially sustained complete cord transections, three were treated by cord transection and three were treated by syringostomy. The seven patients who sustained incomplete cord lesions were all treated by syringostomy. The patients who initially sustained incomplete sensory motor spinal cord damage had a better symptomatic response to surgery than hose who had sustained a complete spinal cord lesion. The ten patients whose main symptom was severe pain were completely relieved of their symptoms by surgery. Images PMID:7205304

  17. Post-traumatic stress disorder: some diagnostic and clinical issues.

    PubMed

    Creamer, M

    1989-12-01

    The development of post-traumatic stress disorder (PTSD) in a group of 42 individuals exposed to a multiple homicide was examined. A comparison of DSM-III and DSM-III-R indicated that 74% qualified for a diagnosis of PTSD using DSM-III, but only 33% met the criteria outlined in DSM-III-R. The most commonly reported symptoms were found to be intrusive recollections of the event and exaggerated startle response. In general, those symptoms that are new additions in the revised version were the least frequently reported, whilst guilt, which has been excluded from DSM-III-R, was experienced by 38% of the sample. It is suggested that the new criteria may not cluster with the core syndrome of PTSD. PMID:2610651

  18. Detecting Behavioral Deficits Post Traumatic Brain Injury in Rats.

    PubMed

    Awwad, Hibah O

    2016-01-01

    Traumatic brain injury (TBI), ranging from mild to severe, almost always elicits an array of behavioral deficits in injured subjects. Some of these TBI-induced behavioral deficits include cognitive and vestibulomotor deficits as well as anxiety and other consequences. Rodent models of TBI have been (and still are) fundamental in establishing many of the pathophysiological mechanisms of TBI. Animal models are also utilized in screening and testing pharmacological effects of potential therapeutic agents for brain injury treatment. This chapter details validated protocols for each of these behavioral deficits post traumatic brain injury in Sprague-Dawley male rats. The elevated plus maze (EPM) protocol is described for assessing anxiety-like behavior; the Morris water maze protocol for assessing cognitive deficits in learning memory and spatial working memory and the rotarod test for assessing vestibulomotor deficits. PMID:27604739

  19. Substance abuse and post-traumatic stress disorder comorbidity.

    PubMed

    Brown, P J; Wolfe, J

    1994-03-01

    This article reviews the extant literature on substance abusers with and without a comorbid diagnosis of post-traumatic stress disorder (PTSD) and reveals the discontinuity between clinical lore and empirical research. Included is an overview of PTSD-substance abuse theoretical models and comorbidity prevalence rates, as well as an evaluation of the comparative data on treatment outcome and psychosocial factors, such as coping skills, for PTSD versus non-PTSD substance abusers. In addition, we discuss the controversy surrounding sequential versus simultaneous treatment approaches for such 'dually-diagnosed' patients. We conclude by identifying gaps in current knowledge about the nature and impact of PTSD on substance abuse treatment outcome and outlining needs for future research. PMID:8082556

  20. Use of thioridazine in post-traumatic stress disorder.

    PubMed

    Dillard, M L; Bendfeldt, F; Jernigan, P

    1993-11-01

    Post-traumatic stress disorder is a condition that develops in persons who have experienced emotional or physical stress of sufficient magnitude to be extremely traumatic for virtually anyone. This may include natural catastrophes, combat experiences, rape, or other such horrifying events. The three major features of the disorder are reexperiencing the trauma through dreams, emotional numbing, and autonomic instability. To date, several treatment modalities have been used, usually consisting of a combination of psychotherapy and drug treatment. Although controversy exists, antidepressants and monoamine oxidase inhibitors are used most commonly, while other drugs such as lithium, carbamazepine, and antipsychotic drugs may be useful. We have reported a case involving a 44-year-old combat veteran who experienced severe flashbacks of his time spent in Vietnam. His symptoms and general state of mind improved significantly while taking the antipsychotic drug thioridazine. PMID:8235786

  1. Post-Traumatic Stress Disorder: A Psychiatric Defense

    PubMed Central

    Jordan, Harold W.; Howe, Gary L.; Gelsomino, Joe; Lockert, Edna W.

    1986-01-01

    Post-traumatic stress disorder (PTSD) is one of the anxiety disorders recently included in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III).1 The disorder refers to the psychological sequelae that may follow a significant stressor. The military has previously referred to PTSD as “war neurosis,” “shell shock,” and “combat neurosis.” PTSD has recently gained attention as a means of legal defense. As a defense, it may exist separately from “innocence by reason of insanity.” The authors review the literature, provide case vignettes exemplifying the clinical features, and present three additional cases that gained local and national notoriety because of their defense motions. The senior author served as an expert witness in these cases. Recommendations are given to readers who may in the future serve as expert witnesses or consultants in similar cases. PMID:3950984

  2. Chronic post-traumatic headache: clinical findings and possible mechanisms.

    PubMed

    Defrin, Ruth

    2014-02-01

    Chronic post-traumatic headache (CPTHA), the most frequent complaint after traumatic brain injury (TBI), dramatically affects quality of life and function. Despite its high prevalence and persistence, the mechanism of CPTHA is poorly understood. This literature review aimed to analyze the results of studies assessing the characteristics and sensory profile of CPTHA in order to shed light on its possible underlying mechanisms. The search for English language articles published between 1960 and 2013 was conducted in MEDLINE, CINAHL, and PubMed. Studies assessing clinical features of headache after TBI as well as studies conducting quantitative somatosensory testing (QST) in individuals with CPTHA and in individuals suffering from other types of pain were included. Studies on animal models of pain following damage to peripheral tissues and to the peripheral and central nervous system were also included. The clinical features of CPTHA resembled those of primary headache, especially tension-type and migraine headache. Positive and negative signs were prevalent among individuals with CPTHA, in both the head and in other body regions, suggesting the presence of local (cranial) mechanical hypersensitivity, together with generalized thermal hypoesthesia and hypoalgesia. Evidence of dysfunctional pain modulation was also observed. Chronic post-traumatic headache can result from damage to intra- and pericranial tissues that caused chronic sensitization of these tissues. Alternatively, although not mutually exclusive, CPTHA might possibly be a form of central pain due to damage to brain structures involved in pain processing. These, other possibilities, as well as risk factors for CPTHA are discussed at length. PMID:24976746

  3. Post-traumatic Stress Symptoms and Post-traumatic Growth in 223 Childhood Cancer Survivors: Predictive Risk Factors

    PubMed Central

    Tremolada, Marta; Bonichini, Sabrina; Basso, Giuseppe; Pillon, Marta

    2016-01-01

    With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder in young adult survivors of childhood cancer ranges from 6.2 to 22%; associated risk factors are young age at the assessment, female gender, low education level, and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA) survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSSs), and to identify the risk factors and the associated post-traumatic growth (PTG) index. Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman’s Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients’ mean age at the assessment was 19.33 years (SD = 3.01, 15–25), 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD = 4.17). Most (52.5%) had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD = 4.40). The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4%) and sub-clinical PTSS (6–8 symptoms: 11.2%), with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r = 0.24; p = 0.0001). A hierarchical regression model (R2 = 0.08; F = 1.46; p = 0.05) identified female gender (β = 0.16; p = 0.05) and less perceived social support (β = -0.43; p = 0.05) as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R2 = 0.36; F = 9.1; p = 0.0001), with

  4. Nursing students' post-traumatic growth, emotional intelligence and psychological resilience.

    PubMed

    Li, Y; Cao, F; Cao, D; Liu, J

    2015-06-01

    Nursing students in the present sample who have experienced childhood adversity have a certain level of post-traumatic growth. If introduced into nursing curricula, emotional intelligence interventions may increase emotional coping resources and enhance social skills for nurses, which may benefit their long-term occupational health. As researchers consider personal resilience a strategy for responding to workplace adversity in nurses, resilience building should be incorporated into nursing education. This is a preliminary study that may guide future investigations of the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the special sample of nursing students. Resilience, emotional intelligence and post-traumatic growth may benefit nursing students' careers and personal well-being in clinical work. Developing both their emotional intelligence and resilience may assist their individual post-traumatic growth and enhance their ability to cope with clinical stress. To investigate the relationships among post-traumatic growth, emotional intelligence and psychological resilience in vocational school nursing students who have experienced childhood adversities, a cross-sectional research design with anonymous questionnaires was conducted and self-report data were analysed. The Childhood Adversities Checklist (Chinese version), Posttraumatic Growth Inventory, Emotional Intelligence Scale and the 10-item Connor-Davidson Resilience Scale were used. Survey data were collected from 202 Chinese vocational school nursing students during 2011. Post-traumatic growth was associated with emotional intelligence and psychological resilience. Results indicated a curvilinear relationship between emotional intelligence and post-traumatic growth, and between psychological resilience and post-traumatic growth. Moderate-level emotional intelligence and psychological resilience were most associated with the greatest levels of growth

  5. Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder.

    PubMed

    Lipinska, Malgorzata; Timol, Ridwana; Kaminer, Debra; Thomas, Kevin G F

    2014-06-01

    Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder. PMID:24467663

  6. In vitro evaluation of the DP-4M PennCentury insufflator.

    PubMed

    Hoppentocht, M; Hoste, C; Hagedoorn, P; Frijlink, H W; de Boer, A H

    2014-09-01

    Dry powder formulations for inhalation have to be screened in animal studies for therapeutic efficacy and safety aspects and both are significantly affected by the dose and the particle size distribution (PSD) of the aerosol that is given. One of the most frequently used apparatus for pulmonary delivery of dry powder formulations in mice studies is the PennCentury DP-4M Dry Powder Insufflator. To make researchers of future preclinical animal studies with the DP-4M insufflator aware of the pitfalls regarding the conclusions to be drawn from their data, we investigated the dispersion behaviour by the DP-4M insufflator using two to three different powder preparation techniques for four different compounds. The primary PSDs of the different formulations were determined in duplicate by laser diffraction analysis. To measure the PSDs of the aerosols obtained with the DP-4M insufflator, the same diffractometer was used in combination with an in-house constructed adapter for the insufflator. The dispersion efficiency and delivered dose were highly affected by the amount of air available for dispersion; the 200 μL of air recommended for the type of insufflator used was insufficient for adequate dispersion. In contrast, the weighed dose did not have a profound effect on the dispersion behaviour and the delivered dose of the DP-4M insufflator. Also the physico-chemical powder properties and the applied particle preparation technique influenced the amount and PSD of the delivered aerosol only to a limited extend, with a few exceptions. We advise researchers to investigate the dispersion efficiency and delivered dose from the DP-4M insufflator with the formulation under investigation prior to in vivo studies and it may be necessary to optimise the formulation for administration to mice. PMID:24993307

  7. Post-traumatic stress disorder: a right temporal lobe syndrome?

    NASA Astrophysics Data System (ADS)

    Engdahl, B.; Leuthold, A. C.; Tan, H.-R. M.; Lewis, S. M.; Winskowski, A. M.; Dikel, T. N.; Georgopoulos, A. P.

    2010-12-01

    In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the magnetoencephalography (MEG)-based synchronous neural interactions (SNI) test to differentiate post-traumatic stress disorder (PTSD) subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with PTSD in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of PTSD and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.

  8. Post-traumatic stress disorder in Asian refugees.

    PubMed

    Ton-That, N

    1998-12-01

    This study profiles 127 cases of Vietnamese, Cambodian, Laotian and Chinese refugee outpatients diagnosed with post-traumatic stress disorder (PTSD). Traumatic etiologies included victims of wars such as political refugees, concentration camp prisoners and victims of rape, severe personal losses (property or human lives). These traumata were experienced by our subjects during the period between the end of the Vietnam war in April 1975 and recent times, when they finally arrived in the USA. Clinical symptoms of these subjects reflected many influences of their oriental culture background and are characterized by internalization that needs to be overcome for assessment as well as for therapy. Symptomatic treatment with psychopharmacology and supportive therapy are helpful while cultural approaches have been adopted by many patients to reach the inner self pathology that could be of both mental and organic in nature. These facts need to be taken into consideration in the future description of the PTSD clinical picture. Recommendations are made for future PTSD studies in Vietnam, Cambodia and Laos, and to promote a global movement for prevention of any socio-political situation that may generate PTSD. PMID:9895199

  9. Management of post-traumatic headaches in children and adolescents.

    PubMed

    Kacperski, Joanne; Arthur, Todd

    2016-01-01

    Traumatic brain injuries (TBI) occur in an estimated 475,000 children aged 0-14 each year. Worldwide, mild traumatic brain injuries (mTBI) represent around 75-90% of all hospital admissions for TBI. mTBI are a common occurrence in children and adolescents, particularly in those involved in athletic activities. An estimated 1.6-3.8 million sports-related TBIs occur each year, including those for which no medical care is sought. Headache is a common occurrence following TBI, reported in as many as 86% of high school and college athletes who have suffered from head trauma. As most clinicians who manage concussion and post-traumatic headaches (PTHs) can attest, these headaches may be difficult to treat. There are currently no established guidelines for the treatment of PTHs, especially when persistent, and practices can vary widely from one clinician to the next. Making medical management more challenging, there are currently no randomized controlled trials evaluating the efficacy of therapies for PTHs in children and adolescents. PMID:26688492

  10. The treatment of post-traumatic stiffness of the elbow.

    PubMed

    Pignatti, G; Ferrari, D; Tigani, D; Scardovi, M; Trentanti, P; Trentani, F; Giunti, A

    2000-01-01

    The authors present the results observed in 12 patients affected with post-traumatic stiffness of the elbow treated by an external fixator in distraction to obtain functional recovery of range of movement; in all of the cases anterior and posterior release and resection of the apex of the olecranon was carried out, while in 2 cases interposition arthroplasty with freeze-dried dura madre was associated. The series includes 12 cases with a long-term follow-up that ranges from 8 to 33 months after surgery. The mean arch of movement during the preoperative phase was 35 degrees (minimum 0 degree-maximum 90 degrees) in flexion extension and 80 degrees (minimum 0 degree-maximum 150 degrees) in pronosupination. Recovery of mean joint excursion in flexion-extension was 91 degrees and in pronosupination it was 127 degrees. Complications included loosening of the nails in 2 cases, breakage of the nails in 1 case, and transitory deficit of the ulnar nerve in 4 cases. A total of 11 patients (91.66%) declared that they were satisfied with the considerable improvement in their ability to do daily activities. The results of arthroplasty in distraction in the elbow are satisfactory even if much attention must be paid to the selection of the patients because of the intense collaboration that is required during postoperative rehabilitation. PMID:11569362

  11. Information Processing Bias in Post-traumatic Stress Disorder.

    PubMed

    Weber, Darren L

    2008-01-01

    This review considers theory and evidence for abnormal information processing in post-traumatic stress disorder (PTSD). Cognitive studies have indicated sensitivity in PTSD for traumatic information, more so than general emotional information. These findings were supported by neuroimaging studies that identify increased brain activity during traumatic cognition, especially in affective networks (including the amygdala, orbitofrontal and anterior cingulate cortex). In theory, it is proposed that traumatic cognition may interfere with neutral cognition and there is evidence of abnormal neutral stimulus processing in PTSD. Firstly, PTSD patients perform poorly on a variety of neuropsychology tasks that involve attention and memory for neutral information. The evidence from event-related potentials and functional neuroimaging also indicates abnormal results in PTSD during neutral stimulus processing. The research evidence generally provides support for theories of trauma sensitivity and abnormal neutral stimulus processing in PTSD. However, there is only tentative evidence that trauma cognition concurrently interferes with neutral cognition. There is even some evidence that traumatic or novelty arousal processes can increase the capacity for attentive processing, thereby enhancing cognition for neutral stimulus information. Research on this topic has not yet fully explored the mechanisms of interaction between traumatic and neutral content in the cognitive dynamics of PTSD. PMID:19639038

  12. An update on the management of post-traumatic headache.

    PubMed

    Obermann, Mark; Naegel, Steffen; Bosche, Bert; Holle, Dagny

    2015-11-01

    Recent studies from the UK give the debate about how to deal best with patients suffering from whiplash injury new impetus. Following whiplash injury, about 90% of patients complain about head and/or neck pain, as well as dizziness, sleep problems and anxiety. These symptoms are often referred to as whiplash-associated disorders. In the majority of cases, these complaints develop within a few days or weeks following the accident. However, 30-50% of patients experience prolonged symptoms for more than 6 months, with headache as the main complaint. In accordance with the bio-psycho-social model of chronic post-traumatic headache, the following treatment options have been suggested: (1) proper patient education with detailed explanation of the condition; (2) support of normal movement; (3) avoiding immobilization; (4) resumption of work; and (5) targeted physiotherapy. Based on current study data, intensified physiotherapy seems not to be superior to standard therapy with simple patient education and can therefore not be recommended considering cost-benefit aspects. PMID:26600874

  13. [Post-traumatic stress disorder: a problem for occupational medicine].

    PubMed

    Koniarek, J

    2000-01-01

    The impact of the mental stress on the human functioning and health has been evidenced in numerous studies. The majority of these studies focus on adverse effects of a long-term stress. Recently, a growing attention has been paid to the relationship between health and acute stress induced by sudden and short-lasting events or experiences characterised by particular intensity. A traumatic stress is one of the forms of the acute stress. It is some kind of reaction to an event in which life of an individual is directly threatened (serious injury, endangered physical integrity, etc.) or he/she witnesses sudden death, serious injury or life-threatening situation of other people. Traumatic experiences may lead among others to post-traumatic stress disorder (PTSD). The review of the studies, presented in this paper, indicates that the proportion of people with traumatic experiences ranges between 40 and 90% depending on the population. There are professions (rescue services, the police, etc.) with inherent traumatic experiences. About 10% of people with traumatic experiences develop PTSD. The author indicates factors responsible for the development of PTSD. The society, particularly people whose professions involve traumatic experiences, and those employed in various institutions responsible for health care should be aware of health problems related to this kind of experiences. PMID:11002473

  14. Post-traumatic trigeminal neuropathy. A study of 63 cases

    PubMed Central

    Peñarrocha, David; Bagán, José V.; Peñarrocha, Miguel

    2012-01-01

    Introduction. Trigeminal neuropathy is most often secondary to trauma. The present study explores the underlying causes and the factors that influence recovery. Material and methods. A retrospective case study was made involving 63 patients with trigeminal neuropathy of traumatologic origin, subjected to follow-up for at least 12 months. Results. Fifty-four percent of all cases were diagnosed after mandibular third molar surgery. In 37 and 19 patients the sensory defect was located in the territory innervated by the mental and lingual nerve, respectively. Pain was reported in 57% of the cases, and particularly among the older patients. Regarding patient disability, quality of life was not affected in three cases, while mild alterations were recorded in 25 subjects and severe alterations in 8. Partial or complete recovery was observed in 25 cases after 6 months, and in 32 after one year. There were few recoveries after this period of time. Recovery proved faster in the youngest patients, who moreover were the individuals with the least pain. Conclusion. Our patients with trigeminal neuropathy recovered particularly in the first 6 months and up to one year after injury. The older patients more often suffered pain associated to the sensory defect. On the other hand, their discomfort was more intense, and the patients with most pain and the poorest clinical scores also showed a comparatively poorer course. Key words:Post-traumatic trigeminal neuropathy. PMID:22143689

  15. Abnormal Functional Connectivity Density in Post-traumatic Stress Disorder.

    PubMed

    Zhang, Youxue; Xie, Bing; Chen, Heng; Li, Meiling; Liu, Feng; Chen, Huafu

    2016-05-01

    Post-traumatic stress disorder (PTSD) is a psychiatric disorder that occurs in individuals who have experienced life-threatening mental traumas. Previous neuroimaging studies have indicated that the pathology of PTSD may be associated with the abnormal functional integration among brain regions. In the current study, we used functional connectivity density (FCD) mapping, a novel voxel-wise data-driven approach based on graph theory, to explore aberrant FC through the resting-state functional magnetic resonance imaging of the PTSD. We calculated both short- and long-range FCD in PTSD patients and healthy controls (HCs). Compared with HCs, PTSD patients showed significantly increased long-range FCD in the left dorsolateral prefrontal cortex (DLPFC), but no abnormal short-range FCD was found in PTSD. Furthermore, seed-based FC analysis of the left DLPFC showed increased connectivity in the left superior parietal lobe and visual cortex of PTSD patients. The results suggested that PTSD patients experienced a disruption of intrinsic long-range functional connections in the fronto-parietal network and visual cortex, which are associated with attention control and visual information processing. PMID:26830769

  16. Suicidal behavior in adolescents with post-traumatic stress disorder.

    PubMed

    Ganz, D; Sher, L

    2010-08-01

    Recently, the prevalence of post-traumatic stress disorder (PTSD) in adolescence is higher than the prevalence of PTSD in adult populations. PTSD and suicidality are often found in populations of adolescents presenting with other emotional disorders (particularly mood disorders), traumatic grief, childhood abuse, and/or a family or peer history of suicide. The reasons and developments of the association between PTSD and suicidality in adolescence, however, remain unclear. Core psychobiological changes contributing to PTSD affect emotion, arousal, perception of the self and the world, irritability, impulsivity, anger, aggression and depression. There is evidence that the aforementioned factors, as well as alcohol and other drug use may act to moderate the influence of stressful life events and lead to eventual suicidality. Both PTSD and suicidality in adolescents have also been hypothesized to be a result of exposure to violence and negative coping styles. There are many treatment challenges for these populations, yet the most promising prevention and treatments include suicide risk screenings, suicide education, Dialectical Behavioral Therapy, addressing associated coping mechanisms and prescribing anti-depressant and anti-anxiety medications. However, when prescribing medications, physicians do need to be careful to consider the weaknesses and strengths of each of the pharmacological options as they apply to adolescents presenting with PTSD and suicidality. PMID:20940670

  17. Substance abuse, memory, and post-traumatic stress disorder

    PubMed Central

    Tipps, Megan E.; Raybuck, Jonathan D.; Lattal, K. Matthew

    2014-01-01

    A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD. PMID:24345414

  18. Information Processing Bias in Post-traumatic Stress Disorder

    PubMed Central

    Weber, Darren L

    2008-01-01

    This review considers theory and evidence for abnormal information processing in post-traumatic stress disorder (PTSD). Cognitive studies have indicated sensitivity in PTSD for traumatic information, more so than general emotional information. These findings were supported by neuroimaging studies that identify increased brain activity during traumatic cognition, especially in affective networks (including the amygdala, orbitofrontal and anterior cingulate cortex). In theory, it is proposed that traumatic cognition may interfere with neutral cognition and there is evidence of abnormal neutral stimulus processing in PTSD. Firstly, PTSD patients perform poorly on a variety of neuropsychology tasks that involve attention and memory for neutral information. The evidence from event-related potentials and functional neuroimaging also indicates abnormal results in PTSD during neutral stimulus processing. The research evidence generally provides support for theories of trauma sensitivity and abnormal neutral stimulus processing in PTSD. However, there is only tentative evidence that trauma cognition concurrently interferes with neutral cognition. There is even some evidence that traumatic or novelty arousal processes can increase the capacity for attentive processing, thereby enhancing cognition for neutral stimulus information. Research on this topic has not yet fully explored the mechanisms of interaction between traumatic and neutral content in the cognitive dynamics of PTSD. PMID:19639038

  19. Post-traumatic stress disorder following disasters: a systematic review

    PubMed Central

    Neria, Y.; Nandi, A.; Galea, S.

    2016-01-01

    Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed. PMID:17803838

  20. Cancer-Related Post-traumatic Stress (PDQ®)—Patient Version

    Cancer.gov

    Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

  1. Cancer-Related Post-traumatic Stress (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

  2. Post-traumatic stress disorder and opioid use disorder: A narrative review of conceptual models.

    PubMed

    Danovitch, Itai

    2016-01-01

    Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed. PMID:27010975

  3. The Accuracy of Gastric Insufflation in Testing for Gastroesophageal Perforations during Laparoscopic Nissen Fundoplication

    PubMed Central

    Bass, Robert C.

    1999-01-01

    Background: Laparoscopic Nissen fundoplication is an effective technique for the symptomatic relief of the manifestations of gastroesophageal reflux disorder but is associated with a 0.8-1% rate of gastroesophageal perforation. Early detection and repair of these injuries is critical to patient outcome, but occult injuries occur and may be missed. Gastric insufflation technique evaluates the integrity of the gastroesophageal wall after laparoscopic Nissen fundoplication. Gastric insufflation technique involves occlusion of the proximal stomach with a non-crushing bowel clamp while insufflating the submerged gastroesophageal junction. We conducted an animal study to assess the utility of gastric insufflation technique. Methods: Five pigs (mean weight, 40.4 kg) underwent testing of laparoscopic gastric insufflation technique. In four animals, laparoscopic Nissen fundoplication was performed and then gastroesophageal junction injuries were created (3-5 mm distraction-type wall injuries). Non-crushing bowel clamps provided occlusion of the pylorus and then the proximal stomach during gastroesophageal insufflation. The gastroesophageal junction was then submerged. In the fifth animal, gastric insufflation technique was repeated while calibrated injuries were created to determine the smallest detectable injury. An injury was considered detectable if rising air bubbles were noted from the submerged gastroesophageal structures. Maximal luminal pressures needed to detect injuries were recorded with an in-line manometer. Results: In all animals, 5-7 mm injuries of the gastroesophageal junction were easily detected using gastric insufflation technique when the proximal stomach was occluded. When the pylorus alone was occluded, detection of gastroesophageal injuries was inconsistent. Small injuries (lt;3 mm) of the esophagus were difficult to visualize with pyloric occlusion alone but were consistently detectable with proximal stomach occlusion at pressures less than 20 mm Hg

  4. Wireless Insufflation of the Gastrointestinal Tract

    PubMed Central

    Battaglia, Santina; Smith, Byron F.; Ciuti, Gastone; Gerding, Jason; Menciassi, Arianna; Obstein, Keith L.; Valdastri, Pietro; Webster, Robert J.

    2013-01-01

    Despite clear patient experience advantages, low specificity rates have thus far prevented swallowable capsule endoscopes from replacing traditional endoscopy for diagnosis of colon disease. One explanation for this is that capsule endoscopes lack the ability to provide insufflation, which traditional endoscopes use to distend the intestine for a clear view of the internal wall. To provide a means of insufflation from a wireless capsule platform, in this paper we use biocompatible effervescent chemical reactions to convert liquids and powders carried onboard a capsule into gas. We experimentally evaluate the quantity of gas needed to enhance capsule visualization and locomotion, and determine how much gas can be generated from a given volume of reactants. These experiments motivate the design of a wireless insufflation capsule, which is evaluated in ex vivo experiments. These experiments illustrate the feasibility of enhancing visualization and locomotion of endoscopic capsules through wireless insufflation. PMID:23212312

  5. Management of Post-traumatic Laryngotracheal Stenosis: Our Experience.

    PubMed

    Kandakure, Vinod T; Mishra, Swati; Lahane, Vaibhav J

    2015-09-01

    To describe our experience in management of post-traumatic laryngo-tracheal stenosis by study of various surgical methods. To compare our results with different studies. To find out best surgical procedure. Retrospective study. 13 patients of LTS were analyzed within the period of 2009-2013 highlighting the important causes of stenosis, management based on type and severity of stenosis and outcome following the treatment given. Cases were diagnosed in detail with help of flexible laryngoscopy. Finer details of stenosis like site, length, associated injuries were studied with help of CT scan. Various modalities of treatment were used and outcome was assessed. There were 13 patients 9 males and 4 females. Of these 54 % had iatrogenic stenosis and 46 % had traumatic stenosis. 46 % had true stenosis, remaining cases suffered from either soft stenosis or had associated injuries rendering the stenosis as a complex one. The patients underwent a combined surgical approach which included treatment modalities like T-tube insertion, endoscopic dilatation, laser, and open surgical intervention (tracheal resection and anastomosis). Of all the patient treated 69.2 % were successfully decannulated and recovered well with a satisfactory airway outcome, (23.07 %) cases remained T-tube dependent, 8 % case died due to septicemia. It was evident that prolonged intubation remained most common cause of tracheal stenosis and the management varied depending on the type of stenosis. Simple soft stenosis could be managed well by endoscopic dilatation and laser while complete, complex stenosis required surgical intervention in form of T-tube stenting or open surgical intervention. Tracheal stenosis is a life threatening complication and difficult to manage. It requires multiple approaches and the successful outcome is assessed by patent airway and voice quality. PMID:26405660

  6. Resolution of disorientation and amnesia during post-traumatic amnesia

    PubMed Central

    Tate, R.; Pfaff, A.; Jurjevic, L.

    2000-01-01

    OBJECTIVES—Despite the growing number of instruments for the prospective measurement of post-traumatic amnesia (PTA) after traumatic brain injury, fundamental issues about the natural history of its resolution and methods of examination remain unresolved. The aims of the present study were to: (1) examine the sequence of resolution of disorientation and amnesia, and (2) determine if the method of measuring the memory component affected the duration of PTA.
METHODS—The sample comprised 31 severely injured patients admitted to a brain injury rehabilitation unit who were examined daily until they emerged from PTA. They were administered a composite PTA scale, covering orientation and memory items from standard PTA scales. Patients were consecutively allocated to one of two groups according to the method of measuring the memory component. Each group was administered identical materials with a different procedure.
RESULTS—The most common sequence for resolution of disorientation in both groups was person, followed by place, then time. Overall, amnesia resolved before disorientation in 94% of cases. Correlation coefficients between return of components of orientation and memory were all highly significant, ranging from r=0.81 to 0.93. Significant variability occurred in the number of days to emerge from PTA according to the scale used. There was evidence that the method of measuring memory influenced the patient's capacity to consistently sustain criterion scores on the scale.
CONCLUSIONS—These results are contrary to findings in mildly injured patients, in whom orientation usually returns before memory. They also demonstrate that the duration of PTA will be dictated by the method used. These findings raise validity issues with respect to the prospective measurement of PTA, and in particular determining when an individual patient has emerged from PTA, which require further investigation.

 PMID:10644784

  7. Post-traumatic optic neuropathy: our surgical and medical protocol.

    PubMed

    Emanuelli, E; Bignami, M; Digilio, E; Fusetti, S; Volo, T; Castelnuovo, P

    2015-11-01

    Post-traumatic optic neuropathy (TON) is a rare, but very much feared event. It is a traumatic injury of the optic nerve at any level along its course (often inside the optic canal), with partial or total loss of visual acuity, temporarily or permanently. Until now, an univocal treatment strategy does not exist. The clinical records of 26 patients, treated from 2002 to 2013, were reviewed. The most frequent cause of injury was road traffic accident (63%), followed by iatrogenic damage, work injuries, sport or home accidents. All patients underwent pre-operative ophthalmological evaluation, neuro-imaging (angio-CT or angio-MRI scans) and systemic corticosteroid therapy. All patients required a surgical treatment, due to poor response to medical therapy; it consisted of an endonasal endoscopic decompression of the intracanalicular segment of the optic nerve, performed by removing the bony wall of the optical canal and releasing the perineural sheath. Improvement of visual acuity was reached in 65% of cases. No minor or major complication occurred intra- or post-operative, with a maximum follow-up time of 41 months. An improvement in visual acuity was achieved, although very limited in some cases, when surgery was performed as close as possible to the traumatic event. In the literature, there is no evidence-based data evaluating both of the two main treatment options (medical therapy versus surgical decompression), to state which is the gold standard in the treatment for TON. We discuss the pro and cons of our protocol: medical endovenous steroid treatment, within 8 h of injury, and endoscopic surgical decompression within 12-24 since the beginning of medical therapy, represent the best solution in terms of risk-benefit ratio for the patients. PMID:25472815

  8. High cervical epidural neurostimulation for post-traumatic headache management.

    PubMed

    Elahi, Foad; Reddy, Chandan

    2014-01-01

    Headache following head injuries has been reported for centuries. The majority of post-traumatic headache (PTH) patients will report resolution of their complaints within a few months from the time of the initial injury. PTHs can contribute to disability, lost productivity, and health care costs. In this article we discuss a 40-year-old male with a history of motor vehicle accident and basal skull fracture. The patient had no headache history prior to the accident. He presented with more than 3 years persistent daily headache. The patient described constant throbbing and stabbing quality headaches predominantly on the left hemicranium with constant facial pain. He denies having aura, nausea, or vomiting, but reported occasional neck tightness. An extensive workup was carried out under the direction of the patient's primary neurologist. Secondary to persistent intractable pain, the patient was referred to the pain clinic for further evaluation. As his headaches were resistant to all trialed strategies, we decided to turn our therapeutic focus toward electrical neuromodulation along with continuing multimodal medications and multidisciplinary approach. During 7 days of high cervical dorsal column electrical nerve stimulation trial, he reported almost 90% pain reduction and significant improvement on his quality of life. On 12 months follow-up after he underwent a permanent implant of high cervical dorsal column electrical nerve stimulation, he reported the same level of pain reduction along with 100% satisfaction rate. To the best of our knowledge, there have been no publications to date concerning the application of high cervical nerve stimulation for PTH. PMID:25054404

  9. Acute and chronic efficacy of Bumetanide in an in vitro model of post-traumatic epileptogenesis

    PubMed Central

    Dzhala, Volodymyr; Staley, Kevin

    2014-01-01

    Background Seizures triggered by acute injuries to the developing brain respond poorly to first-line medications that target the inhibitory chloride-permeable GABAA-receptor. Neuronal injury is associated with profound increases in cytoplasmic chloride ([Cl−]i) resulting in depolarizing GABA signaling, higher seizure propensity and limited efficacy of GABAergic anticonvulsants. The Na+-K+-2Cl− (NKCC1) co-transporter blocker bumetanide reduces [Cl−]i and causes more negative GABA equilibrium potential in injured neurons. We therefore tested both the acute and chronic efficacy of bumetanide on early post-traumatic ictal-like epileptiform discharges and epileptogenesis. Methods Acute hippocampal slices were used as a model of severe traumatic brain injury and post-traumatic epileptogenesis. Hippocampal slices were then incubated for three weeks. After a one week latent period slice cultures developed chronic spontaneous ictal-like discharges. The anticonvulsant and antiepileptogenic efficacy of bumetanide, phenobarbital and the combination of these drugs was studied. Results Bumetanide reduced the frequency and power of early post-traumatic ictal-like discharges in vitro and enhanced the anticonvulsant efficacy of phenobarbital. Continuous two-three week administration of bumetanide as well as phenobarbital in combination with bumetanide failed to prevent post-traumatic ictal-like discharges and epileptogenesis. Conclusions Our data demonstrate a persistent contribution of NKCC1 co-transport in post-traumatic ictal-like activity, presumably as a consequence of chronic alterations in neuronal chloride homeostasis and GABA-mediated inhibition. New strategies for more effective reduction in post-traumatic and seizure-induced [Cl−]i accumulation could provide the basis for effective treatments for post-traumatic epileptogenesis and the resultant seizures. PMID:25495911

  10. “Cat Scratch Colon” and Cecal Barotrauma perforation during colonoscopy using CO2 insufflation

    PubMed Central

    Cox, Kristen; Fang, John C

    2014-01-01

    Cecal perforation due to barotrauma is an increasingly recognized complication of colonoscopy when using room air for insufflation. CO2 is increasingly being utilized for insufflation due to more rapid absorption compared to ambient air and results in reduced post-procedural pain and flatulence. Use of CO2 is thought to protect against barotrauma injury, and use of CO2 during endoscopy has not previously been reported to cause barotrauma perforation during colonoscopy. We present a case of cecal perforation secondary to barotrauma during routine screening colonoscopy with CO2. PMID:27489654

  11. The influence of emergency contraception on post-traumatic stress symptoms following sexual assault.

    PubMed

    Ferree, Nikole K; Wheeler, Malinda; Cahill, Larry

    2012-09-01

    Conservative estimates indicate that 18-25% of women in the United States will be exposed to some form of sexual assault in their lifetime. A great number of these women will develop post-traumatic stress disorder (PTSD). The current study explores the relationship between emergency contraception (EC) administration and subsequent post-traumatic stress symptoms in female sexual assault (SA) survivors. In a study population of 111 participants, post-traumatic stress symptoms were assessed approximately six months after the SA. Women who were already taking hormonal contraception (HC) at the time of the SA and those who declined EC were compared to women who took either Ogestrel or Plan B following the SA. While the administration of traditional HC and both types of EC were associated with fewer intrusive symptoms, women who took Ogestrel reported significantly lower post-traumatic stress total symptom levels than did those who took Plan B or those who declined EC. The results suggest that the manipulation of sex hormone levels with HC and EC in the immediate aftermath of trauma may influence subsequent post-traumatic stress symptoms. The current results may be useful in guiding the choice of EC. PMID:22925127

  12. Nefazodone in the treatment of patients with post-traumatic stress disorder.

    PubMed

    Sharpe, Rachel H; Voris, John C

    2002-09-01

    Post-traumatic stress disorder occurs in patients who have undergone a traumatic experience and manifests itself through a cluster of symptoms, including re-experiencing, avoidance and hyperarousal. Post-traumatic stress disorder is commonly found among veterans of war and victims of sexual trauma, natural disasters and accidents. Nefazodone is a medication that has an FDA-approved indication for treating depression. Nefazodone has also been reported to be efficacious in treating post-traumatic stress disorder. Despite recent reports of hepatotoxicity, when used appropriately, nefazodone is generally as well-tolerated as the medications currently FDA-indicated for post-traumatic stress disorder, the selective serotonin reuptake inhibitors. Through its mechanism inhibiting neuronal uptake of serotonin and norepinephrine and as a potent postsynaptic serotonergic antagonist, nefazodone has proven to be effective in treating post-traumatic stress disorder in several open-label trials. The results of such trials warrant its study in larger, double-blind, placebo-controlled clinical trials. PMID:19810976

  13. Post-traumatic stress responses following liver transplantation in older children.

    PubMed

    Walker, A M; Harris, G; Baker, A; Kelly, D; Houghton, J

    1999-03-01

    Eighteen children aged between 7 and 16 years who had undergone a liver transplantation were interviewed using the Child Post-Traumatic Stress Reaction Index (CPTS-RI) to discover if they had post-traumatic stress symptoms. A case control design was used to define which factors were important for the development of post-traumatic stress. Results of a one-way analysis of variance (ANOVA), with post-traumatic stress symptom intensity as measured on the CPTS-RI as the dependent variable, revealed a significant difference between the liver transplantation group compared with children who had a chronic life-threatening illness or had undergone a routine surgical operation. A post hoc (Tukey's HSD test) statistical analysis was performed and significance at the .05 level was found between the liver transplantation group and both the chronic illness group and the routine surgical operation group. Our results indicate that the acute life-threat involved in the liver transplantation contributed to the development of post-traumatic stress. It was thought that dissociation may be important in preventing the resolution of the trauma. Additional investigations are needed with larger numbers in a longitudinal study beginning before the transplant to determine the course of the PTSD symptoms and the appropriate timing of interventions to reduce the harmful effects of these symptoms. PMID:10190338

  14. [Post-traumatic osteolysis of the distal clavicle. A case report and review of the literature

    PubMed

    Zdichavsky, M; Hüfner, T; Pape, H C; Rosenthal, H; Tscherne, H

    2000-12-01

    The post-traumatic osteolysis of the distal clavicle is very infrequent and the etiology and pathology is poorly understood. It is important to consider this possibility for differential diagnosis when continued pain in the acromio-clavicular joint (AC joint) follows blunt shoulder trauma. The course of the disease may result in a 3 cm loss of length of the distal clavicle. Months and years may pass until osteolysis becomes manifest, but the earliest radiological findings are present 4 weeks after trauma. The disease is self-limiting and usually does not leave residues. We report a case of a 35-year-old man with a post-traumatic osteolysis of the distal clavicle after blunt shoulder trauma. The diagnosis was determined several months after pain persisted in his shoulder. Using this case we discuss the possible pathogenic mechanism, differential diagnosis and treatment options for the post-traumatic osteolysis of the distal clavicle. PMID:11148909

  15. Assessment of cognitive functions in individuals with post-traumatic symptoms after work-related accidents.

    PubMed

    Buodo, Giulia; Ghisi, Marta; Novara, Caterina; Scozzari, Simona; Di Natale, Arianna; Sanavio, Ezio; Palomba, Daniela

    2011-01-01

    The investigation of cognitive functions in individuals who developed post-traumatic symptoms after occupational accidents has been overlooked in the relevant literature. The present study was aimed at assessing attention, memory and executive functions in individuals with post-traumatic symptoms after a workplace accident. Moreover, possible presence of emotional interference from trauma-related cues on attentional performance was evaluated. Results showed that injured workers exhibited deficits in perceptual-psychomotor skills, executive functions, attention and concentration abilities, and memory as compared with healthy controls. With regards to emotional interference on attention, injured workers were found to perform significantly worse than controls specifically when exposed to trauma-related pictures. Overall, these findings suggest that post-traumatic symptoms following a workplace accident are associated with several cognitive and emotional dysfunctions, that should be carefully evaluated to help reduce the frequency and the adverse consequences of occupational accidents. PMID:20813497

  16. The effects of different methods of emotional disclosure: differentiating post-traumatic growth from stress symptoms.

    PubMed

    Slavin-Spenny, Olga M; Cohen, Jay L; Oberleitner, Lindsay M; Lumley, Mark A

    2011-10-01

    Research on emotional disclosure should test the effects of different disclosure methods and whether symptoms are affected differently than post-traumatic growth. We randomized 214 participants with unresolved stressful experiences to four disclosure conditions (written, private spoken, talking to a passive listener, talking to an active facilitator) or two control conditions. All groups had one 30-minute session. After 6 weeks, disclosure groups reported more post-traumatic growth than controls, and disclosure conditions were similar in this effect. All groups decreased in stress symptoms (intrusions, avoidance, psychological and physical symptoms), but disclosure did not differ from control. We conclude that 30 minutes of disclosure leads to post-traumatic growth but not necessarily symptom reduction, and various disclosure methods have similar effects. Research on the effects of disclosure should focus on the benefits of growth as well as symptom reduction. PMID:21905025

  17. Post-traumatic stress disorder, dissociation, and neuropsychological performance in Latina victims of childhood sexual abuse.

    PubMed

    Rivera-Vélez, Giselle M; González-Viruet, Maribella; Martínez-Taboas, Alfonso; Pérez-Mojica, Deborah

    2014-01-01

    This study compared the memory, attention/concentration, and executive functioning of 12 women with histories of child sexual abuse with a control group of 12 women without childhood abuse. Participants completed a neuropsychological test battery and various instruments assessing post-traumatic stress disorder and dissociation. The child sexual abuse group had lower performance than the control group on long- and short-term visual and verbal memory and presented more limited performance on executive functioning tasks. Functioning in these areas showed a negative correlation with post-traumatic stress disorder and dissociative symptoms. These findings suggest that child sexual abuse is associated with memory and executive functioning deficits and supports the idea that people with trauma histories and increased post-traumatic stress disorder and dissociation symptoms may have alterations in neuropsychological functioning. PMID:24393090

  18. Treatment of Sleep Disturbances in Post-Traumatic Stress Disorder: A Review of the Literature.

    PubMed

    Brownlow, Janeese A; Harb, Gerlinde C; Ross, Richard J

    2015-06-01

    Sleep disturbances are among the most commonly endorsed symptoms of post-traumatic stress disorder (PTSD). Treatment modalities that are effective for the waking symptoms of PTSD may have limited efficacy for post-traumatic sleep problems. The aim of this review is to summarize the evidence for empirically supported and/or utilized psychotherapeutic and pharmacological treatments for post-traumatic nightmares and insomnia. While there are few controlled studies of the applicability of general sleep-focused interventions to the management of the sleep disturbances in PTSD, evidence is growing to support several psychotherapeutic and pharmacological treatments. Future investigations should include trials that combine treatments focused on sleep with treatments effective in managing the waking symptoms of PTSD. PMID:25894359

  19. Carbon dioxide insufflation during screening unsedated colonoscopy: a randomised clinical trial

    PubMed Central

    Szura, Miroslaw; Matyja, Andrzej; Kulig, Jan

    2015-01-01

    One of the methods used to reduce pain and discomfort during colonoscopy is insufflation of carbon dioxide instead of air. However, the actual benefit of carbon dioxide insufflation is not unequivocally proven. The aim of the study was to evaluate the advantages of carbon dioxide insufflation during screening colonoscopy. A total of 200 patients undergoing screening colonoscopy between 2010 and 2011 were included in the prospective, randomized study carried out in a surgical referral center. Screening unsedated colonoscopy with either air or carbon dioxide insufflation was performed; patients were randomly assigned to air or carbon dioxide group by means of computer-generated randomization lists. All examinations were performed in an ambulatory setting with standard videocolonoscopes. The main outcomes analyzed were (a) duration of the entire procedure, (b) cecal intubation time, and (c) pain severity immediately, 15, and 60 min after the procedure. Group I included 59 women and 41 men and group II included 51 women and 49 men. The duration of the procedure was circa 10 min in both groups. Pain score values immediately and 15 min after the procedure were similar in both groups (P=0.624 and 0.305, respectively). A lower pain score was observed only after 60 min in patients insufflated with carbon dioxide (1.28 vs. 1.54, P=0.008). No pain reduction was observed in women and in obese patients (BMI>30). Carbon dioxide insufflation during unsedated screening colonoscopy does not decrease the duration of the procedure and appears to reduce pain intensity at 60 min after examination to an extent without clinical significance. The study was registered at ClinicalTrials.gov, number NCT01461564. PMID:24915135

  20. A Longitudinal Study of Post-Traumatic Growth and Psychological Distress in Colorectal Cancer Survivors.

    PubMed

    Occhipinti, Stefano; Chambers, Suzanne K; Lepore, Stephen; Aitken, Joanne; Dunn, Jeff

    2015-01-01

    The stability of post-traumatic growth over time and the relationship between post-traumatic growth and traditional distress outcomes remains unclear. We tracked post-traumatic growth in a population-based sample of colorectal cancer patients from soon after diagnosis to five years subsequently to assess the heterogeneity of a post-traumatic growth response to cancer over time and describe the simultaneous and longitudinal relationships between post-traumatic growth and psychological distress. 1966 colorectal patients who were five months post diagnosis were assessed six times over a five year period. There was considerable heterogeneity associated with both psychological distress and benefit finding scores over time. However, both for benefit finding and psychological distress, the variation in individual scores suggested an underlying positive linear trend and both lagged and lagged change components. Specifically, benefit finding and psychological distress are mutual leading indicators of each other. First, benefit finding served as a leading indicator of distress, in that increases in reported benefit finding from year to year predicted higher future increases in psychological distress. As well, in an inverse relationship, psychological distress served as a leading indicator of benefit finding, such that increases in reported distress from year to year predicted lower future increases in benefit finding. Post-traumatic growth may reflect patients coping efforts to enhance perceptions of wellbeing in response to escalating cancer-related threats, acting as harbinger of increasing trajectories of psychological distress. This explanation is consistent with a cognitive dissonance response in which threats to the integrity of the self then lead to a tendency to accentuate positive aspects of the self. PMID:26418357

  1. A Longitudinal Study of Post-Traumatic Growth and Psychological Distress in Colorectal Cancer Survivors

    PubMed Central

    Occhipinti, Stefano; Chambers, Suzanne K.; Lepore, Stephen; Aitken, Joanne; Dunn, Jeff

    2015-01-01

    The stability of post-traumatic growth over time and the relationship between post-traumatic growth and traditional distress outcomes remains unclear. We tracked post-traumatic growth in a population-based sample of colorectal cancer patients from soon after diagnosis to five years subsequently to assess the heterogeneity of a post-traumatic growth response to cancer over time and describe the simultaneous and longitudinal relationships between post-traumatic growth and psychological distress. 1966 colorectal patients who were five months post diagnosis were assessed six times over a five year period. There was considerable heterogeneity associated with both psychological distress and benefit finding scores over time. However, both for benefit finding and psychological distress, the variation in individual scores suggested an underlying positive linear trend and both lagged and lagged change components. Specifically, benefit finding and psychological distress are mutual leading indicators of each other. First, benefit finding served as a leading indicator of distress, in that increases in reported benefit finding from year to year predicted higher future increases in psychological distress. As well, in an inverse relationship, psychological distress served as a leading indicator of benefit finding, such that increases in reported distress from year to year predicted lower future increases in benefit finding. Post-traumatic growth may reflect patients coping efforts to enhance perceptions of wellbeing in response to escalating cancer–related threats, acting as harbinger of increasing trajectories of psychological distress. This explanation is consistent with a cognitive dissonance response in which threats to the integrity of the self then lead to a tendency to accentuate positive aspects of the self. PMID:26418357

  2. Predicting post-traumatic stress and health anxiety following a venous thrombotic embolism.

    PubMed

    Bennett, Paul; Patterson, Katie; Noble, Simon

    2016-05-01

    This research identified psychosocial factors associated with post-traumatic stress and health anxiety following a venous thrombotic embolism. In all, 158 participants, largely registered with a venous thrombotic embolism information website (Lifeblood: The Thrombosis Charity), completed an online survey. Post-traumatic symptom scores were linked to health threat, and not moderated by perceived control over risk for further venous thrombotic embolism. Health anxiety was associated with continuing symptoms and a negative emotional response to the venous thrombotic embolism. There is a need to intervene to reduce both short- and long-term distress in this population, ideally using a stepped-care model. PMID:25030797

  3. Post-traumatic hepatic artery pseudoaneurysm treated with endovascular embolization and thrombin injection

    PubMed Central

    Francisco, Lloret Estañ; Asunción, López Conesa; Antonio, Capel Alemán; Ricardo, Robles Campos; Manuel, Reus Pintado; Caridad, Marín Hernández

    2010-01-01

    Post-traumatic hepatic artery pseudoaneurysm is uncommon, appearing in approximately 1% of hepatic trauma cases. Most are extrahepatic (80%) and have a late onset. Although they are usually asymptomatic, they should always be treated becasue of the high risk of complications, especially breakage. Currently the treatment of choice is endovascular embolization with coils or the exclusion of the pseudoaneurysm using other intravascular devices. Recently there have been accounts of a treatment that combines embolization with coils and image-guided percutaneous human thrombin injection. We present a case of post-traumatic hepatic artery pseudoaneurysm that was successfully treated using this combined technique. PMID:21160978

  4. Efficacy of cardiopulmonary resuscitation using intratracheal insufflation.

    PubMed

    Brochard, L; Boussignac, G; Adnot, S; Bertrand, C; Isabey, D; Harf, A

    1996-11-01

    The effects of constant-flow insufflation (CFI) of air in the trachea at the distal end of a modified endotracheal tube as the sole mode of ventilation during cardiopulmonary resuscitation (CPR) were studied in pigs. The ventilatory effect of CFI (15 +/- 2 L/min) generating a positive pressure of about 10 cm H2O with concomitant chest compression was studied first. In nine sedated, paralyzed animals disconnected from the ventilator, CFI alone did not significantly alter the decrease in PaO2 and the rise in PaCO2 observed during apnea. By contrast, the combination of precordial compression and CFI (CFI-CPR) maintained arterial blood gases over a 4-min period at the level obtained during mechanical ventilation. In the second part of the study, ventricular fibrillation was induced and CFI-CPR was compared with standard CPR using conventional mechanical ventilation during two successive 4-min periods, in random order. Ventilatory parameters were identical in the two situations, whereas hemodynamic parameters were similar or better with CFI-CPR than with standard CPR. Significant differences were observed between standard CPR and CFI-CPR for systolic aortic pressure (72 +/- 22 versus 82 +/- 27 mm Hg, respectively; p < 0.02) and for systolic (322 +/- 216 versus 431 +/- 237 ml/s; p < 0.01) and mean (116 +/- 106 versus 143 +/- 108 ml/s; p < 0.01) common carotid blood flows. The ease of use of CFI together with its beneficial hemodynamic effects suggests that CFI deserves to be investigated further as a mode of ventilation during CPR. PMID:8912743

  5. Juvenile Male Rape Victims: Is the Level of Post-Traumatic Stress Related to Personality and Parenting?

    ERIC Educational Resources Information Center

    Ruchkin, Vladislav V.; Eisemann, Martin; Hagglof, Bruno

    1998-01-01

    A study of 15 Russian juvenile male rape victims found their level of post-traumatic stress correlated with the temperament dimensions of harm avoidance and reward dependence. The total level of post-traumatic stress reaction was negatively correlated with parental emotional warmth and positively with paternal rejection. (Author/CR)

  6. Long-term effects of trauma: post-traumatic stress among civilian internees of the Japanese during World War II.

    PubMed

    Potts, M K

    1994-09-01

    This study examined predictors and health-related effects of post-traumatic stress among 129 civilian internees of the Japanese during World War II. Post-traumatic stress disorder was noted in 36.7% within the 6 months after their release and in 15.0% within the most recent 6 months. Women were more likely than men to indicate post-traumatic stress disorder within the 6 months after their release. Higher incomes were associated with lower levels of post-traumatic stress within the most recent 6 months. After controlling for demographic and internment-related factors, higher levels of post-traumatic stress were associated with poorer physical health. This association was stronger among older internees than among their younger counterparts. Implications of the findings for clinical gerontology are discussed. PMID:7806644

  7. Potential Mediators of Post-Traumatic Stress Disorder in Child Witnesses to Domestic Violence.

    ERIC Educational Resources Information Center

    Kilpatrick, Kym L.; Williams, L. M.

    1998-01-01

    A study examined variables that might mediate the incidence of Post-Traumatic Stress Disorder (PTSD) in 20 Australian child witnesses (ages 6-12) to domestic violence. Results found PTSD was not mediated by maternal emotional well-being, age and gender of the child, or the child's style of coping with parental conflict. (Author/CR)

  8. Social ecology interventions for post-traumatic stress disorder: what can we learn from child soldiers?

    PubMed

    Kohrt, Brandon

    2013-09-01

    Research with child soldiers is crucial to improving mental health services after war. This research also can illuminate innovative approaches to treating post-traumatic stress disorder (PTSD) among adult soldiers, veterans and other trauma survivors in high-income countries. A key contribution is the role of social ecology for trauma-healing interventions. PMID:23999478

  9. Post-traumatic osteolysis of the distal clavicle, pubis and ischium in 7 patients.

    PubMed

    Tao, Hui-min; Chen, Jie; Ji, Ying-yao; Yang, Di-sheng

    2004-08-01

    Post-traumatic osteolysis (PTOL) is a very rare disease occurring after acute trauma or repetitive micro-trauma, which is characterized by persistent pain in the injured site. In this study, we reported 7 patients, in whom osteolysis developed in the distal clavicle, pubis and ischium. PMID:15294106

  10. Acute Stress Disorder as a Predictor of Post-Traumatic Stress Disorder in Physical Assault Victims

    ERIC Educational Resources Information Center

    Elklit, Ask; Brink, Ole

    2004-01-01

    The authors' objective was to examine the ability of acute stress disorder (ASD) and other trauma-related factors in a group of physical assault victims in predicting post-traumatic stress disorder (PTSD) 6 months later. Subjects included 214 victims of violence who completed a questionnaire 1 to 2 weeks after the assault, with 128 participating…

  11. Recognition of Facial Emotions among Maltreated Children with High Rates of Post-Traumatic Stress Disorder

    ERIC Educational Resources Information Center

    Masten, Carrie L.; Guyer, Amanda E.; Hodgdon, Hilary B.; McClure, Erin B.; Charney, Dennis S.; Ernst, Monique; Kaufman, Joan; Pine, Daniel S.; Monk, Christopher S.

    2008-01-01

    Objective: The purpose of this study is to examine processing of facial emotions in a sample of maltreated children showing high rates of post-traumatic stress disorder (PTSD). Maltreatment during childhood has been associated independently with both atypical processing of emotion and the development of PTSD. However, research has provided little…

  12. Gender Differences in Traumatic Events and Rates of Post-Traumatic Stress Disorder among Homeless Youth

    ERIC Educational Resources Information Center

    Gwadz, Marya Viorst; Nish, David; Leonard, Noelle R.; Strauss, Shiela M.

    2007-01-01

    In the present report we describe patterns of traumatic events and Post-traumatic Stress Disorder (PTSD), both partial and full, among homeless youth and those at risk for homelessness, with an emphasis on gender differences. Participants were 85 homeless and at-risk youth (49% female) recruited from a drop-in center in New York City in 2000.…

  13. Post-Traumatic Stress Disorder and Group Leadership Instruction for Rehabilitation Counselors-in-Training

    ERIC Educational Resources Information Center

    Moore, Nykeisha; Wadsworth, John; Cory, James

    2009-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety syndrome that can develop after exposure to a traumatic event in which harm occurred or was threatened. PTSD is often treated with group therapy. Rehabilitation counselors need to be aware of the group treatments for PTSD because counselors may be leaders of group therapy, may work with consumers…

  14. The Relationship between Peer Victimization and Post-Traumatic Stress Symptomatology in a Rural Sample

    ERIC Educational Resources Information Center

    Crosby, James W.; Oehler, Judy; Capaccioli, Kristen

    2010-01-01

    Peer victimization (PV) has been associated with a number of negative psychological sequelae. Few studies, however, have examined the relationship between PV and the symptomatology of post-traumatic stress disorder, and no studies to date have examined this relationship in a rural sample. Adapted versions of the SEQ-SR and the TSCC were used to…

  15. Who Drops Out of Treatment for Post-Traumatic Stress Disorder?

    ERIC Educational Resources Information Center

    Bryant, Richard A.; Moulds, Michelle L.; Mastrodomenico, Julie; Hopwood, Sally; Felmingham, Kim; Nixon, Reginald D. V.

    2007-01-01

    Significant proportions of participants drop out of cognitive behaviour therapy for post-traumatic stress disorder (PTSD). This study indexed the pretreatment characteristics of civilian trauma survivors who remained in (n = 95) and dropped out (n = 33) of therapy for chronic PTSD. Therapy involved either cognitive behaviour therapy or supportive…

  16. Post Traumatic Stress Disorder: A Diagnosis for Youth from Violent, Impoverished Communities

    ERIC Educational Resources Information Center

    Bertram, Rosalyn M.; Dartt, Jennifer L.

    2009-01-01

    We examine the historical development and use of the diagnosis of post-traumatic stress disorder that has been primarily applied to war veterans. We explore how study of this population and refinement of this diagnosis were influenced by changing paradigms and the emergence of new theory. From this context, we then explore similarities and…

  17. Patterns of attention and experiences of post-traumatic stress symptoms following childbirth: an experimental study.

    PubMed

    Dale-Hewitt, Vanessa; Slade, Pauline; Wright, Ingram; Cree, Michelle; Tully, Chris

    2012-08-01

    Childbirth for some women can be experienced as a traumatic event whereby it is appraised as threatening to life and associated with feelings of fear, helplessness or horror. These women may develop symptoms consistent with post-traumatic stress disorder or its sub-clinical symptoms (post-traumatic stress, PTS). Cognitive processes such as attentional biases have been identified in individuals with PTS exposed to other traumatic events. This study used an experimental design (the modified Stroop task) to investigate the relationship between attentional biases and PTS symptoms in 50 women who experienced their labour and delivery as stressful and responded with fear, helplessness and horror. Attentional biases away from childbirth words were significantly associated with both symptoms of post-traumatic stress and more negative experiences of childbirth. A negative experience was also associated with more severe symptoms of PTS. Positive experiences were unassociated with attentional biases or symptoms. Post-traumatic stress responses, in this population, may be associated with avoidance, and through influencing cognitive processing, acting as a maintaining factor of distress. PMID:22688919

  18. Simple and Complex Post-Traumatic Stress Disorder: Strategies for Comprehensive Treatment in Clinical Practice.

    ERIC Educational Resources Information Center

    Williams, Mary Beth; Sommer, John F., Jr.

    This book delivers state-of-the-art techniques and information for practitioners to help individuals, groups, families, and communities suffering from post-traumatic stress disorder (PTSD). It addresses concerns about the efficacy of critical incident stress debriefing, examines the value of a variety of innovative treatment methods, and explores…

  19. Implications of Neuroscientific Evidence for the Cognitive Models of Post-Traumatic Stress Disorder

    ERIC Educational Resources Information Center

    Cruwys, Tegan; O'Kearney, Richard

    2008-01-01

    Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of…

  20. Post-Traumatic Stress Disorder in Maltreated Youth: A Study of Diagnostic Comorbidity and Child Factors

    ERIC Educational Resources Information Center

    Linning, Lisa M.; Kearney, Christopher A.

    2004-01-01

    The study of post-traumatic stress disorder (PTSD) in maltreated youth has received increased attention, though extensive comparisons to maltreated youth without PTSD and administrations of anxiety-based structured diagnostic interviews remain needed. We examined maltreated youth with or without PTSD using structured diagnostic interviews and…

  1. Is Post-Traumatic Stress Disorder a Helpful Concept for Adults with Intellectual Disability?

    ERIC Educational Resources Information Center

    Mitchell, A.; Clegg, J.

    2005-01-01

    Research using the concept of Post-Traumatic Stress Disorder (PTSD) with adults with intellectual disability (ID)assumes they perceive and react to traumatic events in a similar way to non-disabled adults. Reactions to trauma displayed by children may be relevant to adults with ID as well. Two focus groups were held with professionals and…

  2. Post-Traumatic Stress Disorder in Young People with Intellectual Disability

    ERIC Educational Resources Information Center

    Turk, J.; Robbins, I.; Woodhead, M.

    2005-01-01

    Background: Post-traumatic stress disorder (PTSD) is common and treatable. There is extensive research on people of average intelligence yet little on individuals with developmental disabilities. Methods: We report two people with intellectual disability (ID) who experienced PTSD. The relevance of their developmental difficulties, social and…

  3. Toward a Psychotherapy Integration Approach for Complex Post Traumatic Stress Disorder: A Critical Literature Review

    ERIC Educational Resources Information Center

    Confer, Jacob Russell

    2013-01-01

    The symptoms, assessment, and treatments of Post Traumatic Stress Disorder (PTSD) have been empirically investigated to the extent that there is a breadth of valid and reliable instruments investigating this psychopathological syndrome. There, too, exists a substantial evidence base for various treatment models demonstrating effectiveness in…

  4. Post Concussive and Post Traumatic Stress Disorders: Two Mutually Exclusive Syndromes.

    ERIC Educational Resources Information Center

    Sbordone, Robert J.

    Much confusion exists between post-concussive syndrome (PCS) and post-traumatic stress disorder (PTSD). This study evaluates the symptoms of both disorders, with the goal of illustrating their unique characteristics. A clinical neuropsychologist interviewed 41 males and 29 females who had previously received the diagnosis of PCS or PTSD. Each…

  5. Classroom Strategies for Teaching Veterans with Post-Traumatic Stress Disorder and Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Sinski, Jennifer Blevins

    2012-01-01

    Postsecondary institutions currently face the largest influx of veteran students since World War II. As the number of veteran students who may experience learning problems caused by Post-Traumatic Stress Disorder and/or Traumatic Brain Injury continues to rise, the need for instructional strategies that address their needs increases. Educators may…

  6. The Materiality of Virtual War: Post-Traumatic Stress Disorder and the Disabling Effects of Imperialism

    ERIC Educational Resources Information Center

    Jaffee, Laura Jordan

    2016-01-01

    A slew of recent news coverage has reported favorably on the use of virtual reality video games as a treatment for post-traumatic stress disorder (PTSD) in U.S. soldiers returning from Iraq and Afghanistan. Drawing on critical disability studies work, this paper argues that such depictions (re)produce a depoliticized framework for understanding…

  7. Sudden post-traumatic sensorineural hearing loss reverted to normal by sneezing

    PubMed Central

    2014-01-01

    An 11-year-old child with sudden post-traumatic sensorineural hearing loss regained his hearing functions after sneezing. This case report is a first in medical literature in describing recovery from hearing loss by sneezing. The therapeutic implications of this rare case deserve further investigation. PMID:27489670

  8. Development and Validation of the Child Post-Traumatic Cognitions Inventory (CPTCI)

    ERIC Educational Resources Information Center

    Meiser-Stedman, Richard; Smith, Patrick; Bryant, Richard; Salmon, Karen; Yule, William; Dalgleish, Tim; Nixon, Reginald D. V.

    2009-01-01

    Background: Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with…

  9. The MMPI and the Post-Traumatic Stress Syndrome in Vietnam Era Veterans.

    ERIC Educational Resources Information Center

    Burke, Henry R.; Mayer, Stuart

    1985-01-01

    Minnesota Multiphasic Personality Inventory profiles of Post-traumatic Stress Syndrome outpatients (N=30) and newly admitted random psychiatric inpatient veterans (N=30) were found to be practically identical and were consistent with diagnosis of schizophrenia, indicating the severity of delayed response to stress in Vietnam veterans. (NRB)

  10. Adaptive and Defensive Strategies in Post-Traumatic Play of Young Children Exposed to Violent Attacks

    ERIC Educational Resources Information Center

    Chazan, Saralea; Cohen, Esther

    2010-01-01

    Twenty-three children, aged four to eight years, who had been exposed to violent attacks, were videotaped in individual 40-minute play sessions. These play narratives were recorded by a student researcher trained in narrative analysis and play therapy. She then sorted these play vignettes into three patterns of post-traumatic play, defined in the…

  11. Post-Traumatic Stress Disorder and Quality of Life in Sexually Abused Australian Children

    ERIC Educational Resources Information Center

    Gospodarevskaya, Elena

    2013-01-01

    The study used publicly available data on post-traumatic stress disorder in a sample of the Australian population with a history of sexual abuse to demonstrate how this evidence can inform economic analyses. The 2007 Australian Mental Health Survey revealed that 8.3% of 993 adolescents experienced childhood sexual abuse, of which 40.2% were…

  12. Children and Post Traumatic Stress Disorder: What Classroom Teachers Should Know. ERIC Digest.

    ERIC Educational Resources Information Center

    Grosse, Susan J.

    Children may be exposed to trauma in their personal lives or at school. Teachers can prepare children to cope with trauma by understanding the nature of trauma, teaching skills for responding to emergencies, and learning how to mitigate the after-effects of trauma. Post traumatic stress disorder (PTSD) has specific characteristics and…

  13. The Assessment of Post-Traumatic Stress Disorder among Minority Vietnam Veterans.

    ERIC Educational Resources Information Center

    LaDue, Robin A.

    Vietnam veterans from racial or ethnic minority groups have a "double minority" status; clinicians treating these veterans should distinguish between behaviors resulting from experiences in Vietnam and those due to experiences as members of minority groups. Post-Traumatic Stress Disorder (PTSD) affects an estimated 20% of all Vietnam veterans and…

  14. Risk factors for Post Traumatic Stress Disorder amongst United Kingdom Armed Forces personnel

    PubMed Central

    Iversen, Amy C; Fear, Nicola T; Ehlers, Anke; Hughes, Jamie Hacker; Hull, Lisa; Earnshaw, Mark; Greenberg, Neil; Rona, Roberto; Wessely, Simon; Hotopf, Matthew

    2013-01-01

    Background Understanding the factors which increase the risk of PTSD for military personnel is important. This study aims to investigate the relative contribution of pre-deployment, peri-deployment, and post deployment variables to the prevalence of post traumatic stress symptoms in UK Armed Forces personnel who have been deployed in Iraq since 2003. Method Data are drawn from stage 1 of a retrospective cohort study comparing a random sample of UK military personnel deployed to the 2003 Iraq War with a control group who were not deployed to the initial phase of war fighting (response rate 61%). The analyses are limited to 4762 regular service individuals who responded and who deployed to Iraq since 2003. Results Post traumatic stress symptoms were associated with lower rank, being unmarried, low educational attainment and a history of childhood adversity. Exposure to potentially traumatising events was associated with post traumatic stress symptoms. Appraisals of the experience as involving threat to life or that work in theatre was above an individual’s trade and experience were strongly associated with post traumatic stress symptoms Low morale, poor social support within the unit and non-receipt of a homecoming brief were associated with greater risk of post traumatic stress symptoms. Conclusions These results support that there are modifiable occupational factors which may influence an individual’s risk of PTSD. Personal appraisal of threat to life during the trauma emerged as the strongest predictor of symptoms, and therefore interventions focused on reinstating a sense of control are an important focus for treatment. PMID:18226287

  15. Association of Genotyping of Bacillus cereus with Clinical Features of Post-Traumatic Endophthalmitis

    PubMed Central

    Hong, Meng; Wang, Qian; Tang, Zhide; Wang, Youpei; Gu, Yunfeng; Lou, Yongliang; Zheng, Meiqin

    2016-01-01

    Bacillus cereus is the second most frequent cause of post-traumatic bacterial endophthalmitis. Although genotyping of B. cereus associated with gastrointestinal infections has been reported, little is known about the B. cereus clinical isolates associated with post-traumatic endophthalmitis. This is largely due to the limited number of clinical strains available isolated from infected tissues of patients with post-traumatic endophthalmitis. In this study, we report successful isolation of twenty-four B. cereus strains from individual patients with different disease severity of post-traumatic endophthalmitis. Phylogenetic analysis showed that all strains could be categorized into three genotypes (GTI, GTII and GTIII) and the clinical score showed significant differences among these groups. We then further performed genotyping using the vrrA gene, and evaluated possible correlation of genotype with the clinical features of B. cereus–caused post-traumatic endophthalmitis, and with the prognosis of infection by conducting follow-up with patients for up to 2 months. We found that the disease of onset and final vision acuity were significantly different among the three groups. These results suggested that the vrrA gene may play a significant role in the pathogenesis of endophthalmitis, and genotyping of B. cereus has the potential for predicting clinical manifestation and prognosis of endophthalmitis. To the best of our knowledge, this is the first report of isolation of large numbers of clinical isolates of B. cereus from patients with endophthalmitis. This work sets the foundation for future investigation of the pathogenesis endophthalmitis caused by B. cereus infection. PMID:26886446

  16. Sex differences in objective measures of sleep in post-traumatic stress disorder and healthy control subjects.

    PubMed

    Richards, Anne; Metzler, Thomas J; Ruoff, Leslie M; Inslicht, Sabra S; Rao, Madhu; Talbot, Lisa S; Neylan, Thomas C

    2013-12-01

    A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82)  = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82)  = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82)  = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82)  = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82)  = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post-traumatic

  17. Carbon dioxide insufflation in esophageal endoscopic submucosal dissection reduces mediastinal emphysema: A randomized, double-blind, controlled trial

    PubMed Central

    Maeda, Yuki; Hirasawa, Dai; Fujita, Naotaka; Ohira, Tetsuya; Harada, Yoshihiro; Yamagata, Taku; Koike, Yoshiki; Suzuki, Kenjirou

    2016-01-01

    AIM To assess the efficacy of CO2 insufflation for reduction of mediastinal emphysema (ME) immediately after endoscopic submucosal dissection (ESD). METHODS A total of 46 patients who were to undergo esophageal ESD were randomly assigned to receive either CO2 insufflation (CO2 group, n = 24) or air insufflation (Air group, n = 22). Computed tomography (CT) was carried out immediately after ESD and the next morning. Pain and abdominal distention were chronologically recorded using a 100-mm visual analogue scale (VAS). The volume of residual gas in the digestive tract was measured using CT imaging. RESULTS The incidence of ME immediately after ESD in the CO2 group was significantly lower than that in the Air group (17% vs 55%, P = 0.012). The incidence of ME the next morning was 8.3% vs 32% respectively (P = 0.066). There were no differences in pain scores or distention scores at any post-procedure time points. The volume of residual gas in the digestive tract immediately after ESD was significantly smaller in the CO2 group than that in the Air group (808 mL vs 1173 mL, P = 0.013). CONCLUSION CO2 insufflation during esophageal ESD significantly reduced postprocedural ME. CO2 insufflation also reduced the volume of residual gas in the digestive tract immediately after ESD, but not the VAS scores of pain and distention. PMID:27621583

  18. A diagnostic dilemma between psychosis and post-traumatic stress disorder: a case report and review of the literature

    PubMed Central

    2011-01-01

    Introduction Post-traumatic stress disorder is defined as a mental disorder that arises from the experience of traumatic life events. Research has shown a high incidence of co-morbidity between post-traumatic stress disorder and psychosis. Case presentation We report the case of a 32-year-old black African woman with a history of both post-traumatic stress disorder and psychosis. Two years ago she presented to mental health services with auditory and visual hallucinations, persecutory delusions, suicidal ideation, recurring nightmares, hyper-arousal, and initial and middle insomnia. She was prescribed trifluoperazine (5 mg/day) and began cognitive-behavioral therapy for psychosis. Her psychotic symptoms gradually resolved over a period of three weeks; however, she continues to experience ongoing symptoms of post-traumatic stress disorder. In our case report, we review both the diagnostic and treatment issues regarding post-traumatic stress disorder with psychotic symptoms. Conclusions There are many factors responsible for the symptoms that occur in response to a traumatic event, including cognitive, affective and environmental factors. These factors may predispose both to the development of post-traumatic stress disorder and/or psychotic disorders. The independent diagnosis of post-traumatic stress disorder with psychotic features remains an open issue. A psychological formulation is essential regarding the appropriate treatment in a clinical setting. PMID:21392392

  19. [Post-traumatic osteolysis of the distal extremity of the clavicle. Anatomopathological study of 2 cases].

    PubMed

    Jeandel, P; Garbe, L; Dischino, M; Martet, G; Chouc, P Y; Dufour, M

    1992-03-01

    Two patients with post-traumatic osteolysis of the distal end of the clavicle undergoing surgery 5 months and 22 months respectively after the initial trauma were evaluated histopathologically. The lysed zone was replaced by tissue of fibrous appearance, with little blood supply and non-inflammatory, the presence of which could be suspected by magnetic resonance. The synovial membrane, non-inflammatory but hypervascularised, participated in the process but did not appear to be directly responsible for the osteolysis. The osseous tissue of the patient, operated upon early, showed signs of osteoclastic resorption but there was neither stasis, vasodilatation nor signs of osteogenesis. These various findings suggest that post-traumatic osteolysis of the distal end of the clavicle does not result from local ischemic events. These appearances seem identical to those described in multifocal primary osteolysis, the cause of which also remains unknown. PMID:1609239

  20. First metatarsophalangeal arthroscopy in patients with post-traumatic hallux valgus.

    PubMed

    Lui, T H

    2015-12-01

    Post-traumatic hallux valgus is relatively rare and has been reported after rupture of the medial collateral ligament of the first metatarsophalangeal (MTP-1) joint; Lisfranc joint injury; turf toe injury; medial plantar nerve entrapment secondary to tibial fracture or first metatarsal fracture. Post-traumatic hallux valgus after medial collateral ligament injury has a high incidence of MTP-1 pathology. Detailed history and clinical examination can facilitate differentiation of the source(s) of the patient's symptoms and assist accurate formulation of the surgical plan. First, MTP arthroscopy is a feasible diagnostic and therapeutic tool to manage the MTP-1 joint pain in hallux valgus following injury to the MTP-1 joint. PMID:26362238

  1. Pathophysiological links between traumatic brain injury and post-traumatic headaches

    PubMed Central

    Ruff, Robert L.; Blake, Kayla

    2016-01-01

    This article reviews possible ways that traumatic brain injury (TBI) can induce migraine-type post-traumatic headaches (PTHs) in children, adults, civilians, and military personnel. Several cerebral alterations resulting from TBI can foster the development of PTH, including neuroinflammation that can activate neural systems associated with migraine. TBI can also compromise the intrinsic pain modulation system and this would increase the level of perceived pain associated with PTH. Depression and anxiety disorders, especially post-traumatic stress disorder (PTSD), are associated with TBI and these psychological conditions can directly intensify PTH. Additionally, depression and PTSD alter sleep and this will increase headache severity and foster the genesis of PTH. This article also reviews the anatomic loci of injury associated with TBI and notes the overlap between areas of injury associated with TBI and PTSD.

  2. Attachment organization in Arabic-speaking refugees with post traumatic stress disorder.

    PubMed

    Riber, Karin

    2016-04-01

    As a part of an ongoing clinical study of refugees with post traumatic stress disorder (PTSD), the primary objective of the current study was to examine and describe the distribution of adult attachment patterns as assessed by the Adult Attachment Interview (AAI) in Arabic-speaking refugees. A total of 43 adult male and female refugees with Iraqi and Palestinian backgrounds completed the AAI. Sixty-seven percent of the sample was classified as Unresolved with respect to loss or trauma and a substantial proportion of insecure attachment representations (14% Secure-Autonomous, 39% Dismissing, 42% Preoccupied, 5% Cannot Classify) was found, in addition to high intake levels of post traumatic stress symptoms and comorbidity. Findings are compared with AAI studies of other PTSD or trauma samples, and the paper elaborates upon the methodological challenges in administering the AAI in a context of simultaneous translation. PMID:26673983

  3. Nothing new under the sun: post-traumatic stress disorders in the ancient world.

    PubMed

    Abdul-Hamid, Walid Khalid; Hughes, Jamie Hacker

    2014-01-01

    Herodotus' account of the Athenian spear carrier Epizelus' psychogenic mutism following the Marathon Wars is usually cited as the first documented account of post-traumatic stress disorders in historical literature. This paper describes much earlier accounts of post combat disorders that were recorded as occurring in Mesopotamia (present day Iraq) during the Assyrian dynasty (1300-609 BC). The descriptions in this paper include many symptoms of what we would now identify in current diagnostic classification systems as post-traumatic stress disorders; including flashbacks, sleep disturbance and low mood. The Mesopotamians explain the disorder in terms of spirit affliction; the spirit of those enemies whom the patient had killed during battle causing the symptoms. PMID:25577928

  4. [Clinical and psychometric study of post-traumatic stress disorders following acts of violence].

    PubMed

    De Mol, J

    1994-01-01

    Fifty victims of assaults and hold-ups underwent a medical and psychological examination in order to assess the semiological and psychometric features of post-traumatic stress disorder: 27 males and 23 females with a mean age of 41 years were examined 18 months after the traumatic event. The following semiology was observed: excitability, phobic avoidance, distrust, recurrent traumatic nightmares, difficulties in concentration, impaired memory, dysphoric mood, hyperfatigability, recurrent recollection of the traumatic event, headache, middle and terminal sleep disturbances and neurovegetative hyperreactivity. Testing demonstrated anxious and depressive troubles and moderate cognitive disturbances. Statistical study showed no correlation between type of aggression (psychological trauma with or without concomitant physical component) and cognitive and psycho-affective variables. Most of the cognitive disturbances were correlated with the severity of anxiety and depression. Post-traumatic stress disorder also perturbed the work capacity: only 8 patients resumed previous activities after a lapse of time of 1-54 months. PMID:8066356

  5. Post-traumatic Stress Disorder (PTSD) in Children of Conflict Region of Kashmir (India): A Review

    PubMed Central

    Shah, Tabindah; Mushtaq, Sahil

    2016-01-01

    Post-traumatic stress disorder (PTSD) occurs due to traumatic events. The last two decades have seen various traumatic events in Kashmiri population, which has led to psychological impact on all population, especially children. PTSD is one of the psychiatric disorders occurring after witnessing of traumatic events. A review of literature regarding PTSD in children of Kashmir (India) has been done to assess the prevalence, causes, neurobiology, risk factors and psychiatric co morbidity associated with it. PMID:26894159

  6. Transiliac Osteotomy in Surgical Management of Pelvic Post-Traumatic Malunions: A Retrospective Study.

    PubMed

    Lu, Shun; Wu, Junwei; Fu, Baisheng; Dong, Jinlei; Yang, Yongliang; Xin, Maoyuan; Wang, Guodong; He, Tong-Chuan; Zhou, Dongsheng

    2016-03-01

    While uncommon, post-traumatic pelvic malunions present reconstructive challenges and are associated with significant disability and financial burden. A transiliac osteotomy is a surgical technique useful to correct certain types of pelvic fracture malunions, and is only used when the correction of a limb-length discrepancy is the primary goal. This study aims to present our experience with this technique in the treatment of post-traumatic pelvic malunions. Eight patients who underwent transiliac osteotomies for post-traumatic pelvic malunions at our department from 2006 to 2011 were included in this study. We reviewed the clinical and radiographic results of these patients. By the time of their last follow-up, all osteotomy sites and iliac bone graft had healed with no evidence of internal fixation failure. Of the 3 patients who complained of preoperative posterior pain, 2 reported an improvement. All 8 patients noted the resolution of their lower back pain. At the time of their final follow-up, 4 patients could walk normally, 2 had a slight limp without a cane, 1 patient used a cane to help with standing and walking, and the final felt limited during ambulation with a cane. Limb-lengthening relative to preoperative measurements was 2.86 cm (2.2-3.0 cm) at the time of the last follow-up. Two patients were able to return to their previous jobs, 4 patients changed their jobs or engaged in light manual labor while the final 2 were able to perform activities of daily living but were unable to participate in work or labor. Three patients reported being "extremely satisfied" with their outcomes, 3 were "satisfied," and 2 were "unsatisfied." A transiliac osteotomy can be used to manage selected cases of post-traumatic pelvic malunions that are unable to be corrected with a traditional release and osteotomy. However, in these cases the correction of limb-length discrepancies should be the primary reconstructive goal. PMID:27043674

  7. Women of valor: post-traumatic stress disorder in the dental practice.

    PubMed

    Kloeffler, G Davis

    2015-01-01

    Dental professionals can intervene in head, neck and facial pain found in female patients who suffer from post-traumatic stress disorder (PTSD). There are three theories for why women are predisposed to pain: hormonal differences, nervous system rewiring and sympathetic issues. This article includes case studies of three patients who are representative of these theories. A rapid, nonintrusive intervention will also be described. PMID:25632516

  8. [Management of stressing events and prevention of post-traumatic stress in the railroad setting].

    PubMed

    del Nord, P

    2012-01-01

    The paper addresses the proper management of events that can lead to post traumatic stress, that are the situations where: the person experienced or witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. This document results from a collation of the knowledge acquired by railway undertakings and infrastructure managers on the management and prevention of post-traumatic stress. Having surveyed the various strategies for the management of post-traumatic stress as these are applied in the participating countries, a number of recommendations and best practices were identified and these are presented in this guide. This guide comprises two parts: * A theoretical document comprising several parts: Part one deals with the fundamental notions involved in post-traumatic stress and potentially traumatic events; Part two deals with a strategy for managing potentially traumatic events and sets out a reference framework to this end. This strategy is broken down into five key phases: risk assessment, preparation and prevention, intervention, post-intervention and follow-up, appraisal, including reports from experience. Practical "check sheets" stating the key messages to be understood and/or the specific actions to be taken before, during or after a potentially traumatic event. These sheets are intended for operational staff, managers, directors and support workers. This guide was prepared by a working group under the supervision of the UIC Safety Platform's Occupational Health and Safety Group (OHSG). The working group brought together psychologists, occupational physicians, ergonomists, safety experts, managers and safety directors. It is the fruit of interdisciplinary collaboration, marrying the concerns, needs and knowledge of railway undertakings and infrastructure managers from a variety of European countries. PMID:23405657

  9. Modification effects of coping on post-traumatic morbidity among earthquake rescuers.

    PubMed

    Chang, Chia-Ming; Lee, Li-Ching; Connor, Kathryn M; Davidson, Jonathan R T; Lai, Te-Jen

    2008-03-15

    This study aims to investigate the modification effects of coping strategies on the relationships between rescue effort and psychiatric morbidity (i.e. general psychiatric morbidity and post-traumatic morbidity) in earthquake rescue workers. Firefighters (n=193) who were involved in the rescue effort after the Taiwan Chi-Chi earthquake were invited to complete a questionnaire which contained questions on demographics, exposure to rescue work, general psychiatric morbidity, post-traumatic morbidity, and coping strategies. Multivariate regression models with interaction terms were carried out to investigate the modification effect of coping strategies on the relationships between rescue effort and psychiatric morbidities. Older age and longer job experiences (>3 years) were associated with both general psychiatric and post-traumatic morbidities. Coping strategies such as confrontive coping, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem solving, and positive appraisal significantly modified the effect of exposure to dead bodies on general psychiatric morbidity. Furthermore, confrontive coping, distancing, and planned problem solving significantly modified the effect of exposure to direct rescue involvement on general psychiatric morbidity. However, coping strategies were not observed to buffer the effect of rescue involvement or contact with dead bodies on post-traumatic morbidity. More frequent use of coping strategies could reduce the effect that exposure to rescue efforts has on the incidence of general psychiatric morbidity in rescue workers. However, coping strategies do not seem to reduce the influence of such exposure on trauma-related morbidities. This suggests that coping strategies can be used to prevent general psychiatric morbidity but not trauma-related morbidities. PMID:18258306

  10. Induced membrane technique for the treatment of bone defects due to post-traumatic osteomyelitis

    PubMed Central

    Wang, X.; Luo, F.; Huang, K.

    2016-01-01

    Objectives Induced membrane technique is a relatively new technique in the reconstruction of large bone defects. It involves the implantation of polymethylmethacrylate (PMMA) cement in the bone defects to induce the formation of membranes after radical debridement and reconstruction of bone defects using an autologous cancellous bone graft in a span of four to eight weeks. The purpose of this study was to explore the clinical outcomes of the induced membrane technique for the treatment of post-traumatic osteomyelitis in 32 patients. Methods A total of 32 cases of post-traumatic osteomyelitis were admitted to our department between August 2011 and October 2012. This retrospective study included 22 men and ten women, with a mean age of 40 years (19 to 70). Within this group there were 20 tibias and 12 femurs with a mean defect of 5 cm (1.5 to 12.5). Antibiotic-loaded PMMA cement was inserted into the defects after radical debridement. After approximately eight weeks, the defects were implanted with bone graft. Results The patients were followed for 27.5 months (24 to 32). Radiographic bone union occurred at six months for 26 cases (81%) and clinical healing occurred in 29 cases (90%) at ten months. A total of six cases had a second debridement before bone grafting because of recurrence of infection and one patient required a third debridement. No cases of osteomyelitis had recurred at the time of the last follow-up visit. Conclusion The induced membrane technique for the treatment of post-traumatic osteomyelitis is a simple, reliable method, with good early results. However, there are many challenges in determining the scope of the debridement, type of limb fixation and source of bone graft to be used. Cite this article: Dr Z. Xie. Induced membrane technique for the treatment of bone defects due to post-traumatic osteomyelitis. Bone Joint Res 2016;5:101–105. DOI: 10.1302/2046-3758.53.2000487. PMID:27033845

  11. Endoscopic management of post-traumatic prostatic and supraprostatic strictures using Neodymium-YAG laser.

    PubMed

    Nabi, Ghulam; Dogra, Prem Nath

    2002-12-01

    We assessed the feasibility, efficacy and long-term results of endoscopic management using Neodymium-YAG (Nd-YAG) laser as a day care procedure in patients with post-traumatic supraprostatic and prostatic strictures. Three patients with post-traumatic prostatic and supraprostatic obliterative strictures underwent Nd-YAG laser core through urethrotomy as a day care procedure. Patient age ranged between 12 and 14 years. Mean duration of injury was 16 months. The length of stricture was assessed by bi-directional endoscopy prior to the procedure in all cases. Core through procedure was carried out using Nd-YAG laser under the guidance of a cystoscope placed antegradely. Patients were discharged on the same day with urethral catheter. Foley catheters were removed at 6 weeks. Nd-YAG laser core through procedure was carried out successfully in all cases with negligible blood loss in a mean time of 48 min. There were no intraoperative or postoperative complications. Patients were discharged on the same day. Follow-up cystogram was conducted at 6 weeks and urethroscopy at months. At a mean follow-up of 23 months, patients were asymptomatic and voiding well. Nd-YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post-traumatic prostatic and supraprostatic strictures. It can be carried out as a day care procedure in carefully selected patients and has no complications. PMID:12492959

  12. The impact of forensic investigations following assisted suicide on post-traumatic stress disorder.

    PubMed

    Wagner, Birgit; Boucsein, Valerie; Maercker, Andreas

    2011-01-01

    In Switzerland, all deaths through assisted suicide are reported as unnatural deaths and investigated by a forensic team (police, medical examiner, and state attorney). However, there is limited knowledge concerning the impact these forensic investigations have on the development of post-traumatic stress disorder, complicated grief, or depression in those who have lost a loved one. A cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. The Impact of Event Scale, Inventory of Complicated Grief, and Brief Symptom Inventory were used to assess mental health. The newly developed Forensic Investigation Experience Scale measured the emotional experience of the legal investigation at the death scene. The data suggest that the diagnosis of post-traumatic stress disorder is significantly related to having experienced the forensic investigation as emotionally difficult. Thus, the way the forensic investigation is conducted immediately after an unnatural death is evidently associated with the development of post-traumatic stress. It is recommended that a protocol be developed establishing a standardised response to cases of assisted suicide and that specific training be provided for the legal professionals involved. PMID:22012547

  13. Psychotrauma and effective treatment of post-traumatic stress disorder in soldiers and peacekeepers.

    PubMed

    Vitzthum, Karin; Mache, Stefanie; Joachim, Ricarda; Quarcoo, David; Groneberg, David A

    2009-01-01

    Psychotrauma occurs as a result to a traumatic event, which may involve witnessing someone's actual death or personally experiencing serious physical injury, assault, rape and sexual abuse, being held as a hostage, or a threat to physical or psychological integrity. Post-traumatic stress disorder (PTSD) is an anxiety disorder and was defined in the past as railway spine, traumatic war neurosis, stress syndrome, shell shock, battle fatigue, combat fatigue, or post-traumatic stress syndrome (PTSS). If untreated, post-traumatic stress disorder can impair relationships of those affected and strain their families and society. Deployed soldiers are especially at a high risk to be affected by PTSD but often receive inadequate treatment. Reviews to date have focused only on a single type of treatment or groups of soldiers from only one country. The aim of the current review was to evaluate characteristics of therapeutic methods used internationally to treat male soldiers' PTSD after peacekeeping operations in South Eastern Europe and the Gulf wars.This systematic literature review returned results pertaining to the symptoms, diagnosis, timing and effectiveness of treatment. Sample groups and controls were relatively small and, therefore, the results lack generalizability. Further research is needed to understand the influence and unique psychological requirements of each specific military operation on the internationally deployed soldiers. PMID:19643016

  14. Post-traumatic flexion contractures of the elbow: Operative treatment via the limited lateral approach

    PubMed Central

    Brinsden, Mark D; Carr, Andrew J; Rees, Jonathan L

    2008-01-01

    Varying surgical techniques, patient groups and results have been described regards the surgical treatment of post traumatic flexion contracture of the elbow. We present our experience using the limited lateral approach on patients with carefully defined contracture types. Surgical release of post-traumatic flexion contracture of the elbow was performed in 23 patients via a limited lateral approach. All patients had an established flexion contracture with significant functional deficit. Contracture types were classified as either extrinsic if the contracture was not associated with damage to the joint surface or as intrinsic if it was. Overall, the mean pre-operative deformity was 55 degrees (95%CI 48 – 61) which was corrected at the time of surgery to 17 degrees (95%CI 12 – 22). At short-term follow-up (7.5 months) the mean residual deformity was 25 degrees (95%CI 19 – 30) and at medium-term follow-up (43 months) it was 32 degrees (95%CI 25 – 39). This deformity correction was significant (p < 0.01). One patient suffered a post-operative complication with transient dysaesthesia in the distribution of the ulnar nerve, which had resolved at six weeks. Sixteen patients had an extrinsic contracture and seven an intrinsic. Although all patients were satisfied with the results of their surgery, patients with an extrinsic contracture had significantly (p = 0.02) better results than those with an intrinsic contracture. (28 degrees compared to 48 degrees at medium term follow up). Surgical release of post-traumatic flexion contracture of the elbow via a limited lateral approach is a safe technique, which reliably improves extension especially for extrinsic contractures. In this series all patients with an extrinsic contracture regained a functional range of movement and were satisfied with their surgery. PMID:18783605

  15. [Post-traumatic osteolysis of the distal extremity of the clavicle].

    PubMed

    Buchon, R; Naudinat, E; Schoenenberger, P; Hélie, O; Flageat, J

    1992-01-01

    Post-traumatic osteolysis of the acromial extremity of the clavicle is a rare condition, usually occurring sometime after an injury to the shoulder. Three cases of PTOAC and one case of athlete's osteolysis are reported. The semiology is summed up, as well as the differential diagnoses and the associated forms. This is a benign disease, which should be suggested by the clinical findings and diagnosed on the radiographs, which demonstrate early signs of osteolysis. The treatment is mainly based on immobilization. PMID:1474519

  16. [Post-traumatic osteolysis of the distal end of the clavicle. Contribution of MRI].

    PubMed

    Di Schino, M; Jeandel, P; Dufour, M; Martet, G; Guillot, D; Merrien, Y

    1991-01-01

    The authors describe a case of post-traumatic osteolysis of the clavicle. The clinical and roentgenographic aspects are well known. But regarding the lytic X ray aspect, another diagnosis, particularly a tumor may be evoked. Scintigraphy and computed tomograms can take a part in the diagnosis. But scanograms are uneasy to do in this region. The MRI allows to delimit the lesion, and the hypointense signal in T1 and T2 weighted sequences directs to a fibrosis in the area between the end of the clavicle and the acromion. In this case report, the relation between the MRI findings and the pathological aspects was good. PMID:1836891

  17. Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations

    PubMed Central

    Flory, Janine D.; Yehuda, Rachel

    2015-01-01

    Approximately half of people with post-traumatic stress disorder (PTSD) also suffer from Major Depressive Disorder (MDD). The current paper examines evidence for two explanations of this comorbidity. First, that the comorbidity reflects overlapping symptoms in the two disorders. Second, that the co-occurrence of PTSD and MDD is not an artifact, but represents a trauma-related phenotype, possibly a subtype of PTSD. Support for the latter explanation is inferred from literature that examines risk and biological correlates of PTSD and MDD, including molecular processes. Treatment implications of the comorbidity are considered. PMID:26246789

  18. [Prophylaxis and therapy of post-traumatic stress disorder with propranolol: evidence and ethical analysis].

    PubMed

    Kühlmeyer, K; Jox, R J

    2013-10-01

    The beta-antagonistic agent propranolol is increasingly being used in clinical trials for the prophylaxis and treatment of post-traumatic stress disorder (PTSD). This article discusses the evidence for the effectiveness of propranolol in the prophylaxis and treatment of PTSD and the ethical implications of research on these treatment approaches. The efficacy of a prophylactic or therapeutic use could not be shown during the last decade. Both treatment approaches raise ethical questions that should already be addressed during the clinical trials. PMID:24036701

  19. Post-traumatic stress symptoms and structure among orphan and vulnerable children and adolescents in Zambia

    PubMed Central

    Familiar, Itziar; Murray, Laura; Gross, Alden; Skavenski, Stephanie; Jere, Elizabeth; Bass, Judith

    2014-01-01

    Background Scant information exists on PTSD symptoms and structure in youth from developing countries. Methods We describe the symptom profile and exposure to trauma experiences among 343 orphan and vulnerable children and adolescents from Zambia. We distinguished profiles of post-traumatic stress symptoms using latent class analysis. Results Average number of trauma-related symptoms (21.6; range 0-38) was similar across sex and age. Latent class model suggested 3 classes varying by level of severity: low (31% of the sample), medium (45% of the sample), and high (24% of the sample) symptomatology. Conclusions Results suggest that PTSD is a continuously distributed latent trait. PMID:25382359

  20. Massachusetts' post-traumatic stress disorder program: a public health treatment model for Vietnam veterans.

    PubMed Central

    Forman, S I; Havas, S

    1990-01-01

    Post-traumatic stress disorder (PTSD) can be a serious aftermath of catastrophic events such as war. The incidence of PTSD appears to be high among Vietnam veterans. PTSD can be extremely disruptive to a person's physical and mental well-being, family life, social relationships, and employment status. Yet, for a variety of reasons, many Vietnam veterans suffering from PTSD have remained undiagnosed or insufficiently treated. The Massachusetts Department of Public Health, in cooperation with the Massachusetts Department of Veterans Services, initiated a hospital-based treatment and rehabilitation program for Vietnam veterans who have PTSD. As of November 1989, 150 Vietnam veterans had been admitted to this program. PMID:2108464

  1. Transposition of the tendo calcaneus for post-traumatic bone defects of the tibia.

    PubMed

    Ger, R

    1978-04-01

    Certain post-traumatic defects of the lower extremity present difficult problems in therapy and current methods of management do not offer satisfactory solutions. One such defect is an ulcerative lesion of the lower limb eroding the tibia and forming a chronic, rigid-walled cavity. We describe an operation in which the bone cavity is filled by viable tissue which acts as a bed for a skin graft. In chronic stasis ulcers it has been established that the tendo calcaneus will accept a skin graft, provided the paratenon is left undisturbred. PMID:348707

  2. Post-traumatic Stress in Children and Adolescents Exposed to Family Violence: I. Overview and Issues

    PubMed Central

    Margolin, Gayla; Vickerman, Katrina A.

    2010-01-01

    Exposure to child physical abuse and parents’ domestic violence can subject youth to pervasive traumatic stress and lead to Post-traumatic Stress Disorder (PTSD). The often repeating and ongoing nature of family violence exposure may result in youth exhibiting problems in multiple domains of functioning and meeting criteria for multiple disorders in addition to PTSD. These characteristics as well as unique factors related to children’s developmental level and symptom presentation complicate a PTSD diagnosis. This paper describes evolving conceptualizations in the burgeoning field of trauma related to family violence exposure, and reviews considerations that inform assessment and treatment planning for this population. PMID:20107623

  3. Post-Traumatic Stress Disorder in pre-schoolers: A report of two cases.

    PubMed

    Sowmya Bhaskaran T S; Gaikwad, Achla Dagdu; Chandrakanth, Chaithra; Seshadri, Shekhar P

    2016-04-01

    Post-Traumatic Stress Disorder (PTSD) presents unique challenges in toddlers and pre-schoolers as there are difficulties in assessment and overshadowing by comorbid illnesses. We present case descriptions of two pre-schoolers with developmental manifestations of the PTSD symptoms of intrusion, avoidance and alteration in arousal and reactivity following penetrative sexual abuse. These symptoms caused significant impairment and required a combination of pharmacological and psychotherapeutic intervention. This case report facilitates recognition of the disorder in preverbal and early verbal children and suggestions on management of PTSD in pre-schoolers are provided. PMID:27025472

  4. [Post-traumatic cubitus varus in children. Apropos of 8 cases in African children].

    PubMed

    Ribault, L; Latouche, J C; Badiane, C; Diagne, A L

    1990-01-01

    The authors relate their experience with 8 cases of management of post-traumatic cubitus varus in the Africa child. In this series the mean varus angle, sense stricto, irrespective of the physiological valgus, was 24 degrees with extreme values ranging 10 degrees-45 degrees. Indication for surgery has always rested with the true varus value and with the degree of resulting esthetic and functional prejudice. Resection of an external bone wedge combined with synthesis using two crossed rods yielded good results, and rehabilitation was started as early as the first month after surgery. PMID:2081368

  5. Bereavement and transformation: a psycho-spiritual and post-traumatic growth perspective.

    PubMed

    Bray, Peter

    2013-09-01

    In the aftermath of loss, it is not uncommon for individuals to disclose psycho-spiritual experiences that lead to personal changes and psychological growth. This article argues for and outlines a broad conceptual framework that captures and acknowledges the significance of these subjective experiences. The model synthesises and integrates two approaches to healthy growth: Lawrence Calhoun and Richard Tedeschi's post-traumatic growth model and Stanislav and Christina Grof's model of psycho-spiritual transformation. A rationale for a broader model and underpinning theory is briefly discussed, and their shared understandings about the human potential for growth in the struggle through loss are explored. PMID:21948147

  6. Transiliac Osteotomy in Surgical Management of Pelvic Post-Traumatic Malunions

    PubMed Central

    Lu, Shun; Wu, Junwei; Fu, Baisheng; Dong, Jinlei; Yang, Yongliang; Xin, Maoyuan; Wang, Guodong; He, Tong-Chuan; Zhou, Dongsheng

    2016-01-01

    Abstract While uncommon, post-traumatic pelvic malunions present reconstructive challenges and are associated with significant disability and financial burden. A transiliac osteotomy is a surgical technique useful to correct certain types of pelvic fracture malunions, and is only used when the correction of a limb-length discrepancy is the primary goal. This study aims to present our experience with this technique in the treatment of post-traumatic pelvic malunions. Eight patients who underwent transiliac osteotomies for post-traumatic pelvic malunions at our department from 2006 to 2011 were included in this study. We reviewed the clinical and radiographic results of these patients. By the time of their last follow-up, all osteotomy sites and iliac bone graft had healed with no evidence of internal fixation failure. Of the 3 patients who complained of preoperative posterior pain, 2 reported an improvement. All 8 patients noted the resolution of their lower back pain. At the time of their final follow-up, 4 patients could walk normally, 2 had a slight limp without a cane, 1 patient used a cane to help with standing and walking, and the final felt limited during ambulation with a cane. Limb-lengthening relative to preoperative measurements was 2.86 cm (2.2–3.0 cm) at the time of the last follow-up. Two patients were able to return to their previous jobs, 4 patients changed their jobs or engaged in light manual labor while the final 2 were able to perform activities of daily living but were unable to participate in work or labor. Three patients reported being “extremely satisfied” with their outcomes, 3 were “satisfied,” and 2 were “unsatisfied.” A transiliac osteotomy can be used to manage selected cases of post-traumatic pelvic malunions that are unable to be corrected with a traditional release and osteotomy. However, in these cases the correction of limb-length discrepancies should be the primary reconstructive goal. PMID:27043674

  7. Ultrasound guided greater occipital nerve blocks for post-traumatic occipital neuralgia.

    PubMed

    Walker, Jeremie; Howell, Stephen

    2014-01-01

    Chronic headaches can be debilitating for many patients. They often have a nebulous etiology, unpredictable course, and can be difficult to manage. We describe a post-traumatic headache that began after a motor vehicle collision. The patient sustained multiple injuries including a scalp laceration and bilateral occipital condyle fractures. Oral agents were unable to quell this patient's headaches. The diagnosis of occipital neuralgia was suspected based on history and presentation. Our patient received dramatic relief after ultrasound guided bilateral greater occipital nerve blocks. PMID:24902462

  8. Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

    PubMed Central

    Aslan, Ahmet; Konya, Mehmet Nuri; Sargin, Serdar

    2013-01-01

    Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Series: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2x3 cms. Intraoperatively the mass was seen to arise from medial nerve and careful excision was done protecting the nerve. At one year follow up the patient is relived of her symptoms with no sensorimotor deficit. Conclusion: Post traumatic neuroma present as unrelieved pain and progressive swelling. A high index of suspicion should be kept in cases of wound that are primarily sutured over an area with superficial nerves. Careful excision of the lesion is very effective in relieving patients symptoms PMID:27298917

  9. Post-traumatic inflammatory response: perhaps a succession of phases with a nutritional purpose.

    PubMed

    Aller, Maria-Angeles; Arias, Jorge-Luis; Arias, Jaime

    2004-01-01

    Post-traumatic inflammatory response, whether this be local or systemic, is considered to be the succession of three functional phases called nervous, immune and endocrine, that could have a nutritional significance. In the nervous phase, ischemia-reperfusion, which causes interstitial and cellular edema, is produced. Both types of edema could represent an ancestral mechanism to feed the cells by diffusion. During the immune phase, the tissues are infiltrated by inflammatory cells and bacteria. Then, extracellular digestion, by enzyme release (fermentation), and intracellular digestion by phagocytosis could be associated with a hypothetical trophic capacity for the neighbouring cells. Finally, in the late or endocrine phase nutrition mediated by the blood capillaries is established. In these three successive phases the inflammatory response goes on from an anaerobic metabolism (ischemia) through a metabolism characterized by a defective oxygen use (reperfusion, oxidative burst and heat hyperproduction) to an oxidative metabolism (oxidative phosphorilation) with a correct use of oxygen to produce usable energy. This type of metabolism is characterized by a large production of ATP, which is used to drive specialized multiple cellular processes. Since the nervous, immune and endocrine phases of the inflammatory response go from ischemia to the development of an oxidative metabolism, It is also tempting to speculate on whether the body reproduces the successive stages by which life passes from its origin without oxygen until it develops an effective, although costly, system for the use of oxygen every time we suffer post-traumatic acute inflammation. PMID:15193345

  10. Post-traumatic cervical spondyloptosis: A rare entity with multiple management options.

    PubMed

    Padwal, A; Shukla, D; Bhat, D I; Somanna, S; Devi, B I

    2016-06-01

    Post-traumatic cervical spondyloptosis is a rare condition associated with high energy injuries, and to our knowledge only case reports are available. There are no universally accepted treatment paradigms for these cases and management is individualised according to the case and surgeon preference. We retrospectively analysed our management and clinical outcomes of this condition. From January 2007 to August 2014 we treated eight patients with cervical spondyloptosis at our institute. Only two patients had no neurological deficits; all the remaining patients had partial cord injury. Seven were treated surgically with preoperative traction followed by anterior cervical discectomy and fusion with fixation in three patients, and combined anterior and posterior fusion and fixation in four. Depending on the presence of anterior compression by a disc an anterior first or posterior first approach was advocated. All four combined anterior and posterior fusion and fixation patients needed to be turned more than once (540°). There was no neurological deterioration in any of the patients, as they either improved or remained stable neurologically. Post-traumatic cervical spondyloptosis is a challenging entity to manage. Surgery can be done safely with good clinical and radiological outcome and needs to be tailored to the individual patient. PMID:26922508

  11. POST-TRAUMATIC OSTEOARTHRITIS: IMPROVED UNDERSTANDING AND OPPORTUNITIES FOR EARLY INTERVENTION†

    PubMed Central

    Anderson, Donald D.; Chubinskaya, Susan; Guilak, Farshid; Martin, James A.; Oegema, Theodore R.; Olson, Steven A.; Buckwalter, Joseph A.

    2011-01-01

    Even with current treatments of acute joint injuries, more than 40% of people who suffer significant ligament or meniscus tears, or articular surface injuries, will develop osteoarthritis. Correspondingly, 12% or more of all patients with lower extremity osteoarthritis have a history of joint injury. Recent research suggests that acute joint damage that occurs at the time of an injury initiates a sequence of events that can lead to progressive articular surface damage. New molecular interventions, combined with evolving surgical methods, aim to minimize or prevent progressive tissue damage triggered by joint injury. Seizing the potential for progress in the treatment of joint injuries to forestall OA will depend on advances in: (1) quantitative methods of assessing the injury severity, including both structural damage and biologic responses, (2) understanding of the pathogenesis of post-traumatic OA, taking into account potential interactions among the different tissues and the role of post-traumatic incongruity and instability, and (3) application of engineering and molecular research to develop new methods of treating injured joints. This paper highlights recent advances in understanding of the structural damage and the acute biological response following joint injury, and it identifies important directions for future research. PMID:21520254

  12. Coping behaviours and post-traumatic stress in war-affected eastern Congolese adolescents.

    PubMed

    Mels, Cindy; Derluyn, Ilse; Broekaert, Eric; García-Pérez, Coral

    2015-02-01

    This study explores coping strategies used by war-affected eastern Congolese adolescents across age and sex, and the association between post-traumatic stress symptoms and engagement and disengagement coping. Cross-sectional data were collected in 11 secondary schools across four areas in the Ituri province, Democratic Republic of Congo. A total of 952 pupils (45.3% girls, 54.7% boys) aged 13-21 years (M = 15.83, standard deviation = 1.81) participated in self-report assessment, using instruments that were either specifically developed (Adolescent Complex Emergency Exposure Scale, assessing traumatic exposure), validated (Impact of Event Scale Revised, assessing post-traumatic stress symptoms) or reviewed (Kidcope, assessing coping strategies) for the study population. Reported coping strategies varied with age, and boys more frequently reported problem solving and resignation as compared with girls. Disengagement coping was associated with lower symptom scores in younger adolescent girls, as was the interaction effect between engagement and disengagement coping. We conclude that disengagement coping is not necessarily a maladaptive reaction to stressful events in war-affected situations and that future research should aim to better understand the heterogeneous patterns of stress and coping responses, including the role of factors such as the nature and appraisal of stressors, available resources for coping and cultural preferences. PMID:24130163

  13. Neural involvement in post-traumatic osteopenia: an experimental study in the rat.

    PubMed

    Madsen, J E; Aune, A K; Falch, J A; Hukkanen, M; Konttinen, Y T; Santavirta, S; Nordsletten, L

    1996-05-01

    The effect of sciatic nerve resection on post-traumatic bone loss and mechanical strength of the ipsilateral (IL) and contralateral (CL) femoral shafts and necks was studied 25 days after a tibial fracture. We subjected 45 male rats to a standardized tibial fracture, stabilized it with a modular intramedullary nail and then randomly allocated the animals to two groups: right sciatic nerve resection (SNR group) or sham operation (sham group). All of the operated hindlimbs were further immobilized in a plaster cast to avoid unequal loadbearing between the two groups. After 25 days of healing, 85Sr incorporation in the IL femora was 10% lower in the SNR group compared to the sham group, indicating a lower bone mineralization after sciatic nerve resection. The bone mineral content was 15% higher in the SNR group ipsilaterally. Accordingly, the bending moment and energy absorption in the femoral midshaft were higher in the SNR group compared to the sham group. The sciatic nerve resection protected the femoral shaft against the normally occurring post-traumatic bone loss after a tibial fracture. This protective effect of the neurectomy also occurred in the femoral neck, but not to the same extent. A protective effect was also present in the CL femur, suggesting additional systemic effects of the sciatic nerve resection. PMID:8739898

  14. Treatment of post-traumatic myositis ossificans of the anterior thigh with extracorporeal shock wave therapy

    PubMed Central

    Torrance, David Allen; deGraauw, Christopher

    2011-01-01

    Objective This case study demonstrates the effectiveness of a novel approach to the treatment of post-traumatic myositis ossificans with extracorporeal shockwave therapy in an elite athlete. Clinical Features A 20 year-old male semi-professional rugby player presented with progressive pain and loss of range of motion after sustaining a severe, right quadriceps contusion nine weeks earlier. The differential diagnosis of myositis ossificans was suspected and confirmed on radiographic examination. Intervention and Outcome A two week treatment protocol was undertaken consisting of three sessions of extracorporeal shockwave therapy and an unsupervised exercise program consisting of active and passive range of motion, gradual strengthening and balance exercises. The patient experienced appreciable improvements in pain and range of motion in two weeks and was able to participate in sport specific activity four weeks after presentation. Summary This case illustrates the successful conservative management of post-traumatic myositis ossificans of the anterior thigh with extracorporeal shockwave therapy and a primarily unsupervised graded exercise program within a condensed treatment time frame of 2 weeks. PMID:22131560

  15. [Fundamentals of comprehensive prevention of the post-traumatic fat embolism syndrome].

    PubMed

    Kroupa, J

    1993-01-01

    Urgent top standard provisions implemented as soon as possible after serious injuries with the aim to prevent the development of shock or treat incipient and developing shock are among the most important aspects of prophylaxis of the traumatic fat embolism syndrome (FE). These provisions comprise quantitative and qualitative replacement of blood losses, prevention of spasms of the peripheral blood vessels, restoration of the microcirculation, maintenance of the acid-base equilibrium and a normal state of coagulation, normalization of fluctuations of the post-traumatic metabolic and humoral response, blocking of pathological impulses from the site of the fracture incl. settling of the long bones; suppression of hypoxia, in particular also by artificial pulmonary ventilation; a high caloric intake to prevent excessive development of lipolysis. Surgical operations with the exception of urgent ones which form part of urgent intensive care must be postponed to the time when clinical manifestations of traumatic shock have completely subsided. The group of comprehensive prophylactic provisions comprises also pharmacological measures/drugs and substances which influence the pathogenetic basis associated with the genesis and development of the FE syndrome and the more general syndrome of post-traumatic dyslipidaemic coagulopathy resp. PMID:8498119

  16. Post Traumatic Pseudoaneurysm Arising from V4 Segment of Vertebral Artery: A Case Report.

    PubMed

    Huh, Chae Wook; Nam, Kyoung Hyup; Choi, Chang Hwa; Lee, Jae Il

    2015-10-01

    This case report describes a traumatic pseudoaneurysm arising from the right V4 segment of the vertebral artery, near the origin of the posterior inferior cerebellar artery. Post-traumatic vertebral artery pseudoaneurysm is rare, but associated with a high mortality rate. We report on an extremely rare case of post-traumatic pseudoaneurysm of the vertebral artery with delayed manifestation. A 9-year-old child was admitted to the emergency room after a pedestrian car accident. A computed tomography (CT) scan showed subarachnoid hemorrhage with intraventricular hemorrhage (IVH), multiple facial bones, and temporal bone fracture. External ventricular drainage and decompressive suboccipital craniectomy were performed for acute hydrocephalus and posterior fossa swelling. The patient's clinical condition became suddenly aggravated on the 15th hospital day, and brain CT confirmed appearance of a new 4th ventricle IVH. Digital subtraction angiography revealed a ruptured pseudoaneurysm arising from the right V4 segment of the vertebral artery. Parent artery occlusion using detachable coils was achieved. Despite intensive care, the patient's clinical condition showed continuous deterioration and the patient died of respiratory complications on the 52nd hospital day. PMID:27169084

  17. Evaluation of early endoscopic realignment of post-traumatic complete posterior urethral rupture

    PubMed Central

    Abdelsalam, Yaser M; Abdalla, Medhat A; Safwat, Ahmad S; ElGanainy, Ehab O

    2013-01-01

    Introduction: to report our experience with 41 patients treated by early endoscopic realignment of complete post-traumatic rupture urethra. Materials and Methods: The study includes patients presented to our institute, between May 2004 and April 2009, with post-traumatic complete posterior urethral disruption. Preoperative retrograde urethrography, voiding cystourethrography and abdominopelvic CT were performed to evaluate the urethral defect length, the bladder neck competence, the prostate position, and the extent of the pelvic hematoma. Within the first week after trauma, antegrade and retrograde urethroscopy were performed to identify both urethral ends and insert urethral catheter. Patients were followed up by pericatheter retrograde urethrogram monthly postoperatively till catheter removal on disappearance of extravasation. Retrograde urethrography, voiding cystourethrography and urethroscopy were performed 1 month after the removal of the catheter. Follow-up abdominal ultrasound and uroflowmetry monthly till 6 months, bimonthly till 1 year, and every 3 months thereafter were encouraged. Urinary continence and postoperative erectile dysfunction were assessed by direct patient interview. Results: Forty one patients in the age group 17-61 years (mean 37.9) were treated. Patients were followed up for Conclusions: Early endoscopic realignment for complete posterior urethral rupture is a feasible technique with no or minimal intraoperative complications. The technique is successful as the definitive line of therapy in reasonable number of patients and seems to render further future interventions for inevitable urethral stricture easier. PMID:24082438

  18. Glossopharyngeal insufflation induces cardioinhibitory syncope in apnea divers.

    PubMed

    Dzamonja, Gordan; Tank, Jens; Heusser, Karsten; Palada, Ivan; Valic, Zoran; Bakovic, Darija; Obad, Ante; Ivancev, Vladimir; Breskovic, Toni; Diedrich, André; Luft, Friedrich C; Dujic, Zeljko; Jordan, Jens

    2010-12-01

    Apnea divers increase intrathoracic pressure voluntarily by taking a deep breath followed by glossopharyngeal insufflation. Because apnea divers sometimes experience hypotension and syncope during the maneuver, they may serve as a model to study the mechanisms of syncope. We recorded changes in hemodynamics and sympathetic vasomotor tone with microneurography during breath holding with glossopharyngeal insufflation. Five men became hypotensive and fainted during breath holding with glossopharyngeal insufflation within the first minute. In four divers, heart rate dropped suddenly to a minimum of 38 ± 4 beats/min. Therefore, cardioinhibitory syncope was more common than low cardiac output syncope. PMID:20623312

  19. Guilt, shame and need for a container: a study of post-traumatic stress among ambulance personnel.

    PubMed

    Jonsson, Anders; Segesten, Kerstin

    2004-10-01

    Post-traumatic stress symptoms among ambulance personnel are regarded as a natural behaviour and reaction to working with the severely injured, suicides, injured children and dead people. The findings show that post-traumatic stress symptoms, guilt, shame and self-reproach are common after duty-related traumatic events. To handle these overwhelming feelings it is necessary to talk about them with fellow workers, friends or family members. By using another person as a container it is possible to internalise the traumatic experience. Poor and un-emphatic behaviour towards a patient and their relatives can have its origin in untreated traumatic experiences. Personnel in ambulance organisations who perform defusing, debriefing and counselling have to be informed of the importance that the roll of guilt and shame may play in the developing of post-traumatic stress symptoms. PMID:15474346

  20. Post-traumatic stress disorder managed successfully with hypnosis and the rewind technique: two cases in obstetric patients.

    PubMed

    Slater, P M

    2015-08-01

    Two obstetric patients presenting with post-traumatic stress disorder in the antenatal period are discussed. The first patient had previously had an unexpected stillborn delivered by emergency caesarean section under general anaesthesia. She developed post-traumatic stress disorder and presented for repeat caesarean section in her subsequent pregnancy, suffering flashbacks and severe anxiety. Following antenatal preparation with hypnosis and a psychological method called the rewind technique, she had a repeat caesarean section under spinal anaesthesia, successfully managing her anxiety. The second patient suffered post-traumatic stress disorder symptoms after developing puerperal psychosis during the birth of her first child. Before the birth of her second child, she was taught self-hypnosis, which she used during labour in which she had an uneventful water birth. These cases illustrate the potential value of hypnosis and alternative psychological approaches in managing women with severe antenatal anxiety. PMID:26162981

  1. Insufflation with carbon dioxide reduces pneumoperitoneum after percutaneous endoscopic gastrostomy (PEG): a randomized controlled trial

    PubMed Central

    Murphy, Christopher J.; Adler, Douglas G.; Cox, Kristen; Sommers, Daniel N.; Fang, John C.

    2016-01-01

    Background and study aims: Pneumoperitoneum following PEG placement has been reported in up to 60 % of cases, and while usually benign and self-limited, it can lead to evaluation for suspected perforation. This study was designed to determine whether using CO2 compared to ambient air for insufflation during PEG reduces post-procedure pneumoperitoneum. Patients and Methods: Prospective, double-blind, randomized trial of 35 consecutive patients undergoing PEG at a single academic medical center. Patients were randomized to insufflation with CO2 or ambient air. The primary outcome was pneumoperitoneum determined by left-lateral decubitus abdominal x-rays 30 minutes after PEG placement. Secondary endpoints included abdominal distention, pain, and bloating. Results: PEG was successfully placed in 17 patients using CO2 and 18 patients using ambient air. Three patients in each arm were unable or declined to have x-rays completed and were excluded. Pneumoperitoneum was identified in 2/14 (14.3 %) using CO2 and 8/15 (53.3 %) using ambient air (P = 0.05). There was no significant difference in abdominal distention, visual analog scale (VAS) scores for pain or bloating between CO2 and ambient air. Conclusion: Utilizing CO2 significantly reduces the frequency of post-procedural pneumoperitoneum compared to use of ambient air during PEG placement, with no difference in waist circumference, pain or bloating between CO2 and ambient air. CO2 appears to be safe and effective for use and may be the insufflation agent of choice during PEG. PMID:27004246

  2. Post-traumatic hypoxia exacerbates brain tissue damage: analysis of axonal injury and glial responses.

    PubMed

    Hellewell, Sarah C; Yan, Edwin B; Agyapomaa, Doreen A; Bye, Nicole; Morganti-Kossmann, M Cristina

    2010-11-01

    Traumatic brain injury (TBI) resulting in poor neurological outcome is predominantly associated with diffuse brain damage and secondary hypoxic insults. Post-traumatic hypoxia is known to exacerbate primary brain injury; however, the underlying pathological mechanisms require further elucidation. Using a rat model of diffuse traumatic axonal injury (TAI) followed by a post-traumatic hypoxic insult, we characterized axonal pathology, macrophage/microglia accumulation, and astrocyte responses over 14 days. Rats underwent TAI alone, TAI followed by 30 min of hypoxia (TAI + Hx), hypoxia alone, or sham-operation (n = 6/group). Systemic hypoxia was induced by ventilating rats with 12% oxygen in nitrogen, resulting in a ∼ 50% reduction in arterial blood oxygen saturation. Brains were assessed for axonal damage, macrophage/microglia accumulation, and astrocyte activation at 1, 7, and 14 days post-treatment. Immunohistochemistry with axonal damage markers (β-amyloid precursor protein [β-APP] and neurofilament) showed strong positive staining in TAI + Hx rats, which was most prominent in the corpus callosum (retraction bulbs 69.8 ± 18.67; swollen axons 14.2 ± 5.25), and brainstem (retraction bulbs 294 ± 118.3; swollen axons 50.3 ± 20.45) at 1 day post-injury. Extensive microglia/macrophage accumulation detected with the CD68 antibody was maximal at 14 days post-injury in the corpus callosum (macrophages 157.5 ± 55.48; microglia 72.71 ± 20.75), and coincided with regions of axonal damage. Astrocytosis assessed with glial fibrillary acidic protein (GFAP) antibody was also abundant in the corpus callosum and maximal at 14 days, with a trend toward an increase in TAI + Hx animals (18.99 ± 2.45 versus 13.56 ± 0.81; p = 0.0617). This study demonstrates for the first time that a hypoxic insult following TAI perpetuates axonal pathology and cellular inflammation, which may account for the poor neurological outcomes seen in TBI patients who experience post-traumatic

  3. A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder

    PubMed Central

    2012-01-01

    Background The incidence of severe maternal morbidity is increasing in high-income countries as a consequence, in part, of increased obstetric intervention and increasingly complex medical needs of women who become pregnant. Access to emergency obstetric care means that for the majority of women in these countries, an experience of severe maternal morbidity is unlikely to result in loss of life. However, little is known about the subsequent impact on postnatal psychological health resulting in an evidence gap to support provision of appropriate care for these women. There has recently been increasing recognition that childbirth can be a cause of post-traumatic stress disorder (PTSD). The combination of experiencing a life-threatening complication and its management may culminate in psychological trauma. This systematic review examined the association between women’s experience of severe maternal morbidity during labour, at the time of giving birth or within the first week following birth, and PTSD and its symptoms. Methods Relevant literature was identified through multiple databases, including MEDLINE, PsycINFO, EMBASE, CINAHL, British Nursing Index, Web of Science, Cochrane library and the British Library, using predetermined search strategies. The search terms included "post-traumatic stress disorder", "PTSD", "stress disorders, post-traumatic", "maternal morbidity", “pregnancy complications” “puerperal disorders”, "obstetric labo(u)r complication", "postpartum h(a)emorrhage", "eclampsia”. Studies identified were categorised according to pre-defined inclusion and exclusion criteria. The quality of included studies was assessed using the relevant CASP appraisal tools. Results Eleven primary studies met review criteria. Evidence of a relationship between severe maternal morbidity and PTSD/PTSD symptoms was inconsistent and findings varied between studies. Nevertheless, there is some evidence that severe pre-eclampsia is a risk factor for PTSD and its

  4. Functional definition of seizure provides new insight into post-traumatic epileptogenesis.

    PubMed

    D'Ambrosio, Raimondo; Hakimian, Shahin; Stewart, Tessandra; Verley, Derek R; Fender, Jason S; Eastman, Clifford L; Sheerin, Aaron H; Gupta, Puneet; Diaz-Arrastia, Ramon; Ojemann, Jeffrey; Miller, John W

    2009-10-01

    Experimental animals' seizures are often defined arbitrarily based on duration, which may lead to misjudgement of the syndrome and failure to develop a cure. We employed a functional definition of seizures based on the clinical practice of observing epileptiform electrocorticography and simultaneous ictal behaviour, and examined post-traumatic epilepsy induced in rats by rostral parasagittal fluid percussion injury and epilepsy patients evaluated with invasive monitoring. We showed previously that rostral parasagittal fluid percussion injury induces different types of chronic recurrent spontaneous partial seizures that worsen in frequency and duration over the months post injury. However, a remarkable feature of rostral parasagittal fluid percussion injury is the occurrence, in the early months post injury, of brief (<2 s) focal, recurrent and spontaneous epileptiform electrocorticography events (EEEs) that are never observed in sham-injured animals and have electrographic appearance similar to the onset of obvious chronic recurrent spontaneous partial seizures. Simultaneous epidural-electrocorticography and scalp-electroencephalography recordings in the rat demonstrated that these short EEEs are undetectable by scalp electrocorticography. Behavioural analysis performed blinded to the electrocorticography revealed that (i) brief EEEs lasting 0.8-2 s occur simultaneously with behavioural arrest; and (ii) while behavioural arrest is part of the rat's behavioural repertoire, the probability of behavioural arrest is greatly elevated during EEEs. Moreover, spectral analysis showed that EEEs lasting 0.8-2 s occurring during periods of active behaviour with dominant theta activity are immediately followed by loss of such theta activity. We thus conclude that EEEs lasting 0.8-2 s are ictal in the rat. We demonstrate that the assessment of the time course of fluid percussion injury-induced epileptogenesis is dramatically biased by the definition of seizure employed, with

  5. Exploring the Content of Post-Traumatic Stress Symptoms among Parents after Paediatric Stem Cell Transplant

    PubMed Central

    Forinder, Ulla; Claesson, Lovisa; Szybek, Katharina; Lindahl Norberg, Annika

    2015-01-01

    In the present study the aim was to explore the content in a trauma reported in a self-report questionnaire by parents of children with a life threatening illness. Semi-structured interviews were performed, with the aim to explore the specific cognitive and behavioral content of the trauma related symptoms reported by the individual informant. The transcripts of the interviews were analyzed with content analysis using a direct approach with a-priori categories according to the B and C categories of the DSM-IV diagnostic criteria for PTSD. The results give us the picture of a complex situation, where the self-report instrument PCL captured a spectrum of qualitatively different cognitions. The parents described traumatic thoughts and images relating not only to experiences in the past (i.e., truly post-traumatic), but also to current stressors and expected future events. PMID:25965909

  6. Focal brain damage protects against post-traumatic stress disorder in combat veterans.

    PubMed

    Koenigs, Michael; Huey, Edward D; Raymont, Vanessa; Cheon, Bobby; Solomon, Jeffrey; Wassermann, Eric M; Grafman, Jordan

    2008-02-01

    Post-traumatic stress disorder (PTSD) is an often debilitating mental illness that is characterized by recurrent distressing memories of traumatic events. PTSD is associated with hypoactivity in the ventromedial prefrontal cortex (vmPFC), hyperactivity in the amygdala and reduced volume in the hippocampus, but it is unknown whether these neuroimaging findings reflect the underlying cause or a secondary effect of the disorder. To investigate the causal contribution of specific brain areas to PTSD symptoms, we studied a unique sample of Vietnam War veterans who suffered brain injury and emotionally traumatic events. We found a substantially reduced occurrence of PTSD among those individuals with damage to one of two regions of the brain: the vmPFC and an anterior temporal area that included the amygdala. These results suggest that the vmPFC and amygdala are critically involved in the pathogenesis of PTSD. PMID:18157125

  7. Morel-Lavallee seroma (post-traumatic pseudocyst) of back: a rarity with management conundrum.

    PubMed

    Singh, Anshuman; Anand, Akshay; Mittal, Sanchit; Sonkar, Abhinav Arun

    2016-01-01

    Morel-Lavallee seroma (MLS) or post-traumatic pseudocyst is a soft tissue seroma developing due to closed degloving injury by a shearing force that causes separation of subcutaneous fatty layer from the deeper muscular fascia resulting in collection of fluid in the created space. Presentation is usually fluctuant swelling following history of injury. More frequently described in orthopaedic literature, it occurs more commonly over gluteal and trochanteric regions, knee and flanks with occurrence over back, thorax being a rare entity. Despite mimicking several other similar presenting conditions, diagnosis of MLS can be made by meticulous history and physical examination with classical findings on ultrasonography, CT scan and MRI. Treatment modality may vary from conservative management to open surgical debridement of the wound with percutaneous aspiration and sclerodhesis forming useful adjuncts to conservative management. PMID:27435850

  8. Interplay between neuroimmunoendocrine systems during post-traumatic stress disorder: a minireview.

    PubMed

    Bauer, Moisés E; Wieck, Andréa; Lopes, Rodrigo P; Teixeira, Antonio L; Grassi-Oliveira, Rodrigo

    2010-01-01

    Early life stress has been suggested to mediate vulnerability to affective disorders. Traumatic events experienced in childhood such as sexual abuse and/or physical neglect may lead to psychiatric diseases in adult life, including post-traumatic stress disorder (PTSD). Previous studies have focused on adult traumatic events and very little is known regarding the long-term physiological effects of early life stress. Here, we review the complex interplay between most important cognitive, neuroendocrine and immunological changes reported in PTSD, focusing on long-term implications of childhood maltreatment. PTSD has been associated with significant biological changes related to impaired cognitive functions, attenuated hypothalamic-pituitary-adrenal (HPA) axis function (hypocortisolism) and activation of innate immune responses (low-grade inflammation). PMID:20134200

  9. Recent Progress in Understanding the Pathophysiology of Post-Traumatic Stress Disorder

    PubMed Central

    Bailey, Christopher R.; Cordell, Elisabeth; Sobin, Sean M.; Neumeister, Alexander

    2013-01-01

    Post-traumatic stress disorder (PTSD) is a common and chronic anxiety disorder that can result after exposure to a traumatic event. Though our understanding of the aetiology of PTSD is incomplete, several neurobiological systems have been implicated in the pathophysiology and vulnerability towards developing PTSD after trauma exposure. We aimed to provide a concise review of benchmark findings in important neurobiological systems related to the aetiology and maintenance of PTSD symptomology. Specifically, we discuss functional aetiologies in the noradrenergic, serotonergic, endogenous cannabinoid and opioid systems as well as the hypothalamic-pituitary adrenal (HPA) axis. This article provides a succinct framework to appreciate the current understanding of neurobiological mechanisms related to the pathophysiology of PTSD and how these findings may impact the development of future, targeted pharmacological treatments for this debilitating disorder. PMID:23483368

  10. Implications of memory modulation for post-traumatic stress and fear disorders

    PubMed Central

    Parsons, Ryan G; Ressler, Kerry J

    2013-01-01

    Post-traumatic stress disorder, panic disorder and phobia manifest in ways that are consistent with an uncontrollable state of fear. Their development involves heredity, previous sensitizing experiences, association of aversive events with previous neutral stimuli, and inability to inhibit or extinguish fear after it is chronic and disabling. We highlight recent progress in fear learning and memory, differential susceptibility to disorders of fear, and how these findings are being applied to the understanding, treatment and possible prevention of fear disorders. Promising advances are being translated from basic science to the clinic, including approaches to distinguish risk versus resilience before trauma exposure, methods to interfere with fear development during memory consolidation after a trauma, and techniques to inhibit fear reconsolidation and to enhance extinction of chronic fear. It is hoped that this new knowledge will translate to more successful, neuroscientifically informed and rationally designed approaches to disorders of fear regulation. PMID:23354388

  11. Work potential of road accident survivors with post-traumatic stress disorder.

    PubMed

    Matthews, Lynda R

    2005-04-01

    Work potential in adult survivors of road accidents with and without post-traumatic stress disorder (PTSD) was examined at a mean of 8.6 months (SD = 3.77) post-accident. All participants were working prior to their accident. Results showed that survivors with PTSD had significantly less work potential post-accident than survivors without PTSD. Specific barriers to employability for survivors with PTSD identified by this study included high levels of depression, reduced time-management ability, and an over-concern or anxiety with physical injuries. Respondents with PTSD, however, reported significantly greater extrinsic motivation to work than those without PTSD. Early intervention and referral to occupational rehabilitation programs that: (1) help address these barriers to employability and stimulate the existing motivation to return to work, and (2) work alongside clinical treatment programs, may assist in the reduction of poor work outcomes that people with PTSD following road accidents often experience. PMID:15701358

  12. A Case of Post-Traumatic Pseudocyst in the Spleen Successfully Treated with Alcohol Sclerotherapy

    PubMed Central

    Mun, Sang Wook; Lim, Taek-Jin; Hwang, Eun Ha; Lee, Yeoun Joo; Jeon, Ung Bae

    2015-01-01

    This report details a case of post-traumatic pseudocyst in the spleen that was successfully treated with sclerotherapy using ethanol. A sixteen-year-old boy visited our hospital for a follow-up examination of a splenic cyst. He had experienced blunt trauma to the abdomen three years prior to presentation. An abdominal computed tomography scan revealed a large cyst of the lower pole of the spleen. The cyst was 6.8×9.5×7.0 cm and conservative management was tried. A follow-up ultrasonographic examination three years later revealed that the size of the cyst was unchanged and another treatment was needed to prevent complications. One session of sclerosis with ethanol (90 mL of 99% ethanol) percutaneously was applied to the cyst. A follow-up after four months revealed that the cyst had completely resolved. PMID:26770903

  13. Histone-acetylation: a link between Alzheimer's disease and post-traumatic stress disorder?

    PubMed Central

    Bahari-Javan, Sanaz; Sananbenesi, Farahnaz; Fischer, Andre

    2014-01-01

    The orchestration of gene-expression programs is essential for cellular homeostasis. Epigenetic processes provide to the cell a key mechanism that allows the regulation of gene-expression networks in response to environmental stimuli. Recently epigenetic mechanisms such as histone-modifications have been implicated with cognitive function and altered epigenome plasticity has been linked to the pathogenesis of neurodegenerative and neuropsychiatric diseases. Thus, key regulators of epigenetic gene-expression have emerged as novel drug targets for brain diseases. Numerous recent review articles discuss in detail the current findings of epigenetic processes in brain diseases. The aim of this article is not to give yet another comprehensive overview of the field but to specifically address the question why the same epigenetic therapies that target histone-acetylation may be suitable to treat seemingly different diseases such as Alzheimer's disease and post-traumatic stress disorder. PMID:25009454

  14. A pilot DTI analysis in patients with recent onset post-traumatic stress disorder

    NASA Astrophysics Data System (ADS)

    Liu, Yang; Li, Liang; Li, Baojuan; Zhang, Xi; Lu, Hongbing

    2016-03-01

    To explore the alteration in white matter between survivors with recent onset post-traumatic stress disorder (PTSD) and without PTSD, who survived from the same coal mine flood disaster, the diffusion tensor imaging (DTI) sequences were analyzed using DTI studio and statistical parametric mapping (SPM) packages in this paper. From DTI sequence, the fractional anisotropy (FA) value describes the degree of anisotropy of a diffusion process, while the apparent diffusion coefficient (ADC) value reflects the magnitude of water diffusion. The DTI analyses between PTSD and non-PTSD indicate lower FA values in the right caudate nucleus, right middle temporal gyrus, right fusiform gyrus, and right superior temporal gyrus, and higher ADC values in the right superior temporal gyrus and right corpus callosum of the subjects with PTSD. These results are partly in line with our previous volume and cortical thickness analyses, indicating the importance of multi-modality analysis for PTSD.

  15. The nurse as a survivor: delayed post-traumatic stress reaction and cumulative trauma in nursing.

    PubMed

    Davidson, P; Jackson, C

    1985-01-01

    As opposed to studies on the immediate psychological impact of traumatic nursing experiences, little attention has been directed to the persistence of certain long-standing hidden symptoms of trauma in some nurses. Since psychological reactions to trauma are claimed to be similar, irrespective of the source of trauma, it is postulated that findings from recent studies on delayed post-traumatic stress reaction in Vietnam veterans, victims of natural disaster, and survivors of the holocaust, delineate symptoms which are also found in stress-prone nurses utilizing maladaptive coping strategies in response to hospital-related traumatic episodes. While some observations are conjectural and speculative, an integrated review is presented of areas of research hitherto unrelated, which serves to deepen our understanding of trauma and its impact upon the mental health of nurses. PMID:3844380

  16. Neglect of the complex: why psychotherapy for post-traumatic clinical presentations is often ineffective†

    PubMed Central

    Corrigan, Frank M.; Hull, Alastair M.

    2015-01-01

    Evidence of efficacy in studies of post-traumatic conditions is largely derived from studies in which variables are kept to a minimum. Extrapolation of treatments from uncomplicated disorders to complex conditions may therefore be called evidence-based without being evidenced. Complex conditions with polysymptomatic presentations and extensive comorbidity are being denied proper evaluation, and patients most severely traumatised from the early stages of their development are not provided with rigorously evaluated psychotherapies because they are more difficult to study in the manner approved by research protocols. Such evidence as there is suggests that the simple extension of treatments for uncomplicated disorders is seriously inadequate. This has significant implications for health services responsible for the provision of the most efficacious treatments to those whose disorders arise from severe trauma, often very early in their life. PMID:26191439

  17. Autologous staged fat tissue transfer in post-traumatic lower extremity reconstruction

    PubMed Central

    Benjamin, Martin A.; Schwarzman, Garrett; Eivazi, Mariet; Zachary, Lawrence

    2015-01-01

    Autologous fat tissue transfer for aesthetic reconstruction has been described in the literature for soft tissue damage as early as 1893. One area that has yet to be described is the role of fat grafting in post-traumatic lower extremity injuries. In this case report, we present a patient who had significant injury to her right lower extremity and presented for reconstruction. The patient is a 52-year-old female who presented to clinic after a right lower extremity traumatic injury that required multiple re-operations, which lead to dense scarring and volume loss along the extremity inferior to the knee joint. The patient received two staged autologous fat injections and reported positive outcomes. Our case report demonstrates the utility of fat transfer in reconstruction of the lower extremity in staged fashion. Further research in the refinement of this technique and patient follow-up will lead to better graft survival and reconstructive outcomes. PMID:26572154

  18. A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities.

    PubMed

    Admon, Roee; Milad, Mohammed R; Hendler, Talma

    2013-07-01

    Discriminating neural abnormalities into the causes versus consequences of psychopathology would enhance the translation of neuroimaging findings into clinical practice. By regarding the traumatic encounter as a reference point for disease onset, neuroimaging studies of post-traumatic stress disorder (PTSD) can potentially allocate PTSD neural abnormalities to either predisposing (pre-exposure) or acquired (post-exposure) factors. Based on novel research strategies in PTSD neuroimaging, including genetic, environmental, twin, and prospective studies, we provide a causal model that accounts for neural abnormalities in PTSD, and outline its clinical implications. Current data suggest that abnormalities within the amygdala and dorsal anterior cingulate cortex represent predisposing risk factors for developing PTSD, whereas dysfunctional hippocampal-ventromedial prefrontal cortex (vmPFC) interactions may become evident only after having developed the disorder. PMID:23768722

  19. Autologous staged fat tissue transfer in post-traumatic lower extremity reconstruction.

    PubMed

    Benjamin, Martin A; Schwarzman, Garrett; Eivazi, Mariet; Zachary, Lawrence

    2015-01-01

    Autologous fat tissue transfer for aesthetic reconstruction has been described in the literature for soft tissue damage as early as 1893. One area that has yet to be described is the role of fat grafting in post-traumatic lower extremity injuries. In this case report, we present a patient who had significant injury to her right lower extremity and presented for reconstruction. The patient is a 52-year-old female who presented to clinic after a right lower extremity traumatic injury that required multiple re-operations, which lead to dense scarring and volume loss along the extremity inferior to the knee joint. The patient received two staged autologous fat injections and reported positive outcomes. Our case report demonstrates the utility of fat transfer in reconstruction of the lower extremity in staged fashion. Further research in the refinement of this technique and patient follow-up will lead to better graft survival and reconstructive outcomes. PMID:26572154

  20. The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans.

    PubMed

    Combs, Hannah L; Berry, David T R; Pape, Theresa; Babcock-Parziale, Judith; Smith, Bridget; Schleenbaker, Randal; Shandera-Ochsner, Anne; Harp, Jordan P; High, Walter M

    2015-07-01

    United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment. PMID:25350012

  1. The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans

    PubMed Central

    Combs, Hannah L.; Berry, David T. R.; Pape, Theresa; Babcock-Parziale, Judith; Smith, Bridget; Schleenbaker, Randal; Shandera-Ochsner, Anne; Harp, Jordan P.

    2015-01-01

    Abstract United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment. PMID:25350012

  2. Cold and post-traumatic pain: modeling of the peripheral nerve message.

    PubMed

    de Medinaceli, L; Hurpeau, J; Merle, M; Begorre, H

    1997-01-01

    Hypersensitivity to cold is a relatively frequent sequel of peripheral nerve injuries but its mechanism is not well understood. We suggested that incomplete recovery of diameter of regenerated fibers is one of the factors involved in cold intolerance after nerve damage. Conduction velocity is correlated to fiber diameter, and is slowed down by cold. In normal subjects, cold does not desynchronize the volleys of sensory impulses sufficiently to change the intelligibility of the peripheral 'messages'. Sensory perceptions remain accurate although they acquire a characteristic numbness. On the other hand, post-traumatic reduction in fiber diameters causes a permanent distortion of the messages. We considered that when the distortion is severe, the resulting messages may be perceived by the centers as containing nociceptive components. We further hypothesized that, even in cases of moderate permanent distortion, cold acts by increasing the post-traumatic abnormalities of impulse synchronization. In winter, decompensation is observed when a threshold of desynchronization is reached. We constructed a model of peripheral nerve messages in an attempt to represent and quantitate the desynchronizations produced by cold and crush damage lesions in peripheral nerve messages. A number of parameters concerning fiber anatomy, exposure to cold, and type of nerve damage were taken into consideration. Four elementary types of desynchronization could be recognized by considering the times of arrival of pairs of impulses at the nervous centers. The difference between a normal and a distorted message could be expressed by eight variables. Thus, although our model was quite simple, a large amount of data was obtained and a preliminary statistical study was necessary in order to orient the final analysis. Then, we used factor analysis in an attempt to obtain a satisfactory interpretation of the data. The results indicated that peripheral desynchronization might explain, at least in part

  3. Racial discrimination, post traumatic stress, and gambling problems among urban Aboriginal adults in Canada.

    PubMed

    Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul; Parlee, Brenda

    2013-09-01

    Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events. PMID:22730152

  4. Post-Traumatic Seizures Exacerbate Histopathological Damage after Fluid-Percussion Brain Injury

    PubMed Central

    Bao, Ying-hui; Bramlett, Helen M.; Atkins, Coleen M.; Truettner, Jessie S.; Lotocki, George; Alonso, Ofelia F.

    2011-01-01

    Abstract The purpose of this study was to investigate the effects of an induced period of post-traumatic epilepsy (PTE) on the histopathological damage caused by traumatic brain injury (TBI). Male Sprague Dawley rats were given a moderate parasagittal fluid-percussion brain injury (1.9–2.1 atm) or sham surgery. At 2 weeks after surgery, seizures were induced by administration of a GABAA receptor antagonist, pentylenetetrazole (PTZ, 30 mg/kg). Seizures were then assessed over a 1-h period using the Racine clinical rating scale. To evaluate whether TBI-induced pathology was exacerbated by the seizures, contusion volume and cortical and hippocampal CA3 neuronal cell loss were measured 3 days after seizures. Nearly all TBI rats showed clinical signs of PTE following the decrease in inhibitory activity. In contrast, clinically evident seizures were not observed in TBI rats given saline or sham-operated rats given PTZ. Contusions in TBI-PTZ-treated rats were significantly increased compared to the TBI-saline-treated group (p < 0.001). In addition, the TBI-PTZ rats showed less NeuN-immunoreactive cells within the ipsilateral parietal cerebral cortex (p < 0.05) and there was a trend for decreased hippocampal CA3 neurons in TBI-PTZ rats compared with TBI-saline or sham-operated rats. These results demonstrate that an induced period of post-traumatic seizures significantly exacerbates the structural damage caused by TBI. These findings emphasize the need to control seizures after TBI to limit even further damage to the injured brain. PMID:20836615

  5. The Evolution of Post-Traumatic Stress Disorder following Moderate-to-Severe Traumatic Brain Injury.

    PubMed

    Alway, Yvette; Gould, Kate Rachel; McKay, Adam; Johnston, Lisa; Ponsford, Jennie

    2016-05-01

    Increasing evidence indicates that post-traumatic stress disorder (PTSD) may develop following traumatic brain injury (TBI), despite most patients having no conscious memory of their accident. This prospective study examined the frequency, timing of onset, symptom profile, and trajectory of PTSD and its psychiatric comorbidities during the first 4 years following moderate-to-severe TBI. Participants were 85 individuals (78.8% male) with moderate or severe TBI recruited following admission to acute rehabilitation between 2005 and 2010. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders (SCID-I), participants were evaluated for pre- and post-injury PTSD soon after injury and reassessed at 6 months, 12 months, 2 years, 3 years, and 4 years post-injury. Over the first 4 years post-injury, 17.6% developed injury-related PTSD, none of whom had PTSD prior to injury. PTSD onset peaked between 6 and 12 months post-injury. The majority of PTSD cases (66.7%) had a delayed-onset, which for a third was preceded by subsyndromal symptoms in the first 6 months post-injury. PTSD frequency increased over the first year post-injury, remained stable during the second year, and gradually declined thereafter. The majority of subjects with PTSD experienced a chronic symptom course and all developed one or more than one comorbid psychiatric disorder, with mood, other anxiety, and substance-use disorders being the most common. Despite event-related amnesia, post-traumatic stress symptoms, including vivid re-experiencing phenomena, may develop following moderate-to-severe TBI. Onset is typically delayed and symptoms may persist for several years post-injury. PMID:26176500

  6. Base deficit and serum lactate concentration in patients with post traumatic convulsion

    PubMed Central

    Afifi, Ibrahim; Parchani, Ashok; Al-Thani, Hassan; El-Menyar, Ayman; Alajaj, Raghad; Elazzazy, Shereen; Latifi, Rifat

    2016-01-01

    Introduction: Traumatic brain injury is a major cause of morbidity and mortality worldwide, and has been reported to be one of the risk factors for epileptic seizures. Abnormal blood lactate (LAC) and base deficit (BD) reflects hypoperfusion and could be used as metabolic markers to predict the outcome. The aim of this study is to assess the prognostic value of BD and LAC levels for post traumatic convulsion (PTC) in head injury patients. Materials and Methods: All head injury patients with PTC were studied for the demographics profile, mechanism of injury, initial vital signs, and injury severity score (ISS), respiratory rates, CT scan findings, and other laboratory investigations. The data were obtained from the trauma registry and medical records. Statistical analysis was done using SPSS software. Results: Amongst 3082 trauma patients, 1584 were admitted to the hospital. Of them, 401 patients had head injury. PTC was observed in 5.4% (22/401) patients. Out of the 22 head injury patients, 10 were presented with the head injury alone, whereas 12 patients had other associated injuries. The average age of the patients was 25 years, comprising predominantly of male patients (77%). Neither glasgow coma scale nor ISS had correlation with BD or LAC in the study groups. The mean level of BD and LAC was not statistically different in PTC group compared to controls. However, BD was significantly higher in patients with associated injuries than the isolated head injury group. Furthermore, there was no significant correlation amongst the two groups as far as LAC levels are concerned. Conclusion: Base deficit but not lactic acid concentration was significantly higher in head injury patients with associated injuries. Early resuscitation by pre-hospital personnel and in the trauma room might have impact in minimizing the effect of post traumatic convulsion on BD and LAC. PMID:27057221

  7. An Update on the Clinical Utility of the Children's Post-Traumatic Cognitions Inventory.

    PubMed

    McKinnon, Anna; Smith, Patrick; Bryant, Richard; Salmon, Karen; Yule, William; Dalgleish, Tim; Dixon, Clare; Nixon, Reginald D V; Meiser-Stedman, Richard

    2016-06-01

    The Children's Post-Traumatic Cognitions Inventory (CPTCI) is a self-report questionnaire that measures maladaptive cognitions in children and young people following exposure to trauma. In this study, the psychometric properties of the CPTCI were examined in further detail with the objective of furthering its utility as a clinical tool. Specifically, we investigated the CPTCI's discriminant validity, test-retest reliability, and the potential for the development of a short form of the measure. Three samples (London, East Anglia, Australia) of children and young people exposed to trauma (N = 535; 7-17 years old) completed the CPTCI and a structured clinical interview to measure posttraumatic stress disorder (PTSD) symptoms between 1 and 6 months following trauma. Test-retest reliability was investigated in a subsample of 203 cases. The results showed that a score in the range of 46 to 48 on the CPTCI was indicative of clinically significant appraisals as determined by the presence of PTSD. The measure also had moderate-to-high test-retest reliability (r = .78) over a 2-month period. The Children's Post-Traumatic Cognitions Inventory-Short Form (CPTCI-S) had excellent internal consistency (α = .92), and moderate-to-high test-retest reliability (r = .78). The examination of construct validity showed the model had an excellent fitting factor structure (Comparative Fit index = 0.95, Tucker-Lewis index = 0.91, Root Mean Square Error of Approximation = .07). A score ranging from 16 to 18 was the best cutoff point on the CPTCI-S, in that it was indicative of clinically significant appraisals as determined by the presence of PTSD. Based on these results, we concluded that the CPTCI is a useful tool to support the practice of clinicians and that the CPTCI-S has excellent psychometric properties. PMID:27191657

  8. Long-term prevalence of post-traumatic stress disorder symptoms in patients after secondary peritonitis

    PubMed Central

    Boer, Kimberly R; Mahler, Cecilia W; Unlu, Cagdas; Lamme, Bas; Vroom, Margreeth B; Sprangers, Mirjam A; Gouma, Dirk J; Reitsma, Johannes B; De Borgie, Corianne A; Boermeester, Marja A

    2007-01-01

    Introduction The aim of this study was to determine the long-term prevalence of post-traumatic stress disorder (PTSD) symptomology in patients following secondary peritonitis and to determine whether the prevalence of PTSD-related symptoms differed between patients admitted to the intensive care unit (ICU) and patients admitted only to the surgical ward. Method A retrospective cohort of consecutive patients treated for secondary peritonitis was sent a postal survey containing a self-report questionnaire, namely the Post-traumatic Stress Syndrome 10-question inventory (PTSS-10). From a database of 278 patients undergoing surgery for secondary peritonitis between 1994 and 2000, 131 patients were long-term survivors (follow-up period at least four years) and were eligible for inclusion in our study, conducted at a tertiary referral hospital in Amsterdam, The Netherlands. Results The response rate was 86%, yielding a cohort of 100 patients; 61% of these patients had been admitted to the ICU. PTSD-related symptoms were found in 24% (95% confidence interval 17% to 33%) of patients when a PTSS-10 score of 35 was chosen as the cutoff, whereas the prevalence of PTSD symptomology when borderline patients scoring 27 points or more were included was 38% (95% confidence interval 29% to 48%). In a multivariate analyses controlling for age, sex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, number of relaparotomies and length of hospital stay, the likelihood of ICU-admitted patients having PTSD symptomology was 4.3 times higher (95% confidence interval 1.11 to 16.5) than patients not admitted to the ICU, using a PTSS-10 score cutoff of 35 or greater. Older patients and males were less likely to report PTSD symptoms. Conclusion Nearly a quarter of patients receiving surgical treatment for secondary peritonitis developed PTSD symptoms. Patients admitted to the ICU were at significantly greater risk for having PTSD symptoms after adjusting for baseline

  9. Post-Traumatic Stress: What Some Indian Youth and Vietnam Veterans Have in Common. How Can We Help?

    ERIC Educational Resources Information Center

    Native American Development Corp., Washington, DC.

    Stress can make a person more apt to abuse alcohol and drugs. Based on interviews with Phil Tingley, president of the National Indian Social Workers Association, this booklet suggests that some Native American youth are victims of a special kind of stress--post-traumatic stress (PTS). PTS symptoms are delayed mental and physical responses to…

  10. Comparison of Symptom Distress between World War II Ex-POWs and Vietnam Combat Veterans with Post Traumatic Stress Disorder.

    ERIC Educational Resources Information Center

    Miller, David J.; And Others

    It has been documented that exposure to severe and prolonged stress can result in emotional disturbances which may last for decades. Research has focused on the diagnosis of Post-traumatic Stress Disorder (PTSD), symptoms of which include flashbacks, increased startle response, interpersonal withdrawal, suspiciousness, impulsivity, and…