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

Post Traumatic Stress Disorder: The Facts

DTIC Science & Technology

2007-02-22

Post Traumatic Stress Disorder ( PTSD ... PTSD treated? POST TRAUMATIC STRESS DISORDER : THE FACTS! He who did well in war, earns the right to begin doing well in peace. —Robert...Department of Veterans Affairs (VA), the National Center for Post Traumatic Stress Disorder (NC- PTSD ), the Walter Reed Army Medical Center (WRAMC),

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 ...

Increased visceral tissue perfusion with heated, humidified carbon dioxide insufflation during open abdominal surgery in a rodent model.

PubMed

Robson, Jonathan P; Kokhanenko, Pavlo; Marshall, Jean K; Phillips, Anthony R; van der Linden, Jan

2018-01-01

Tissue perfusion during surgery is important in reducing surgical site infections and promoting healing. This study aimed to determine if insufflation of the open abdomen with heated, humidified (HH) carbon dioxide (CO2) increased visceral tissue perfusion and core body temperature during open abdominal surgery in a rodent model. Using two different rodent models of open abdominal surgery, visceral perfusion and core temperature were measured. Visceral perfusion was investigated using a repeated measures crossover experiment with rodents receiving the same sequence of two alternating treatments: exposure to ambient air (no insufflation) and insufflation with HH CO2. Core body temperature was measured using an independent experimental design with three treatment groups: ambient air, HH CO2 and cold, dry (CD) CO2. Visceral perfusion was measured by laser speckle contrast analysis (LASCA) and core body temperature was measured with a rectal thermometer. Insufflation with HH CO2 into a rodent open abdominal cavity significantly increased visceral tissue perfusion (2.4 perfusion units (PU)/min (95% CI 1.23-3.58); p<0.0001) compared with ambient air, which significantly reduced visceral blood flow (-5.20 PU/min (95% CI -6.83- -3.58); p<0.0001). Insufflation of HH CO2 into the open abdominal cavity significantly increased core body temperature (+1.15 ± 0.14°C) compared with open cavities exposed to ambient air (-0.65 ± 0.52°C; p = 0.037), or cavities insufflated with CD CO2 (-0.73 ± 0.33°C; p = 0.006). Abdominal visceral temperatures also increased with HH CO2 insufflation compared with ambient air or CD CO2, as shown by infrared thermography. This study reports for the first time the use of LASCA to measure visceral perfusion in open abdominal surgery and shows that insufflation of open abdominal cavities with HH CO2 significantly increases visceral tissue perfusion and core body temperature.

Post-traumatic Stress Disorder Post Partum

PubMed Central

Schwab, W.; Marth, C.; Bergant, A. M.

2012-01-01

Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD), in some cases in a subsyndromal form. Until now, the possibility that postpartum psychological symptoms might be a continuum of a pre-existing disorder in pregnancy has rarely been considered. This study therefore aimed to evaluate the proportion of women who develop post-traumatic stress disorder as a result of childbirth. Materials and Methods: 56 multiparous women were recruited for the study. The diagnosis of PTSD was made according to the criteria for psychological disorders in the DSM-IV (Diagnostics and Statistical Manual of Mental Disorders). The data were collected in structured interviews in the 30th to 38th week of gestation and in the 6th week post partum. Results: Of the 56 women participating, 52 (93 %) completed the survey. Uncontrolled results showed that 21.15 % of the multiparous women met the full diagnostic PTSD criteria in the 6th week post partum. After the exclusion of all cases already characterised by all criteria or a subsyndromal form of PTSD caused by previous traumatisation, the PTSD rate was below 8 % at 6 weeks postpartum (= incidence rate of PTSD post partum). Conclusions: The present study is the first prospective longitudinal study to demonstrate the occurrence of full criteria PTSD in multiparous women as a result of childbirth after having excluded pre-existing PTSD. The results of our study show a high prevalence rate of PTSD during pregnancy. A number of women report all aspects of post-traumatic stress disorder as a result of childbirth. PMID:25253905

[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.

[A case of petrous ridge meningioma manifested as pneumocephalus followed by Eustachian tube insufflation].

PubMed

Yamaguchi, Shinya; Gi, Hidefuku; Uno, Jyunji; Ikai, Yoshiaki; Inoha, Satoshi; Nagaoka, Shintarou; Nishio, Shunji

2009-05-01

A 50-year-old female, who had a headache after Eustachian tube insufflation for her ear congestion, came to our hospital. CT and MRI revealed pneumocephalus and petrous ridge meningioma which destroyed petrous bone and air cells. Eustachian tube insufflation was considered to make the air coming into the middle ear, mastoid air cell and then into the intracranial space destroying the tumor. At surgery, there was subdural hematoma around the tumor. Total removal of the tumor and the hematoma membrane was performed. Histologically, the tumor was transitional meningioma and the cluster of meningioma cells were noted in the subdural hematoma membrane.

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 treat...

Post-Traumatic Cognition Mediates the Relationship between a History of Sexual Abuse and the Post-Traumatic Stress Symptoms in Sexual Assault Victims

PubMed Central

2017-01-01

More than half of all sexual assault victims report experiencing sexual victimization more than once. The aim of this paper was to determine the role post-traumatic cognition plays in the relationship between a history of sexual abuse and post-traumatic stress symptoms in sexual assault victims. The relationship between a history of sexual assault and the severity of post-traumatic stress symptoms was investigated retrospectively using data from a sexual assault crisis center in Korea. Data on psychological symptoms were collected in person at the initial assessment and by telephone 1 month later using the Post-traumatic Cognitions Inventory and the Post-traumatic Stress Disorder Symptoms Scale: Self-report Version. Of 105 women included in the analysis, 10 (9.5%) reported prior sexual abuse and were classified as sexually revictimized. Revictimized women had more post-traumatic negative cognition at initial assessment (t = −2.98; P = 0.004) and more post-traumatic symptoms at 1 month follow-up (t = −2.39; P = 0.019) than singly victimized women. At 1 month follow-up, the severity of post-traumatic stress symptoms had increased in revictimized women but had decreased slightly in singly victimized women. Negative post-traumatic cognition fully mediated the association between a history of sexual abuse and the severity of post-traumatic stress symptoms. Early detection of sexually revictimized women and tailored service and treatment intervention is needed to better serve this group of victims. Interventions targeted at preventing revictimization or post crime victimization may also help victims recover from the trauma and prevent future abuse. PMID:28875614

Client-centred therapy, post-traumatic stress disorder and post-traumatic growth: theoretical perspectives and practical implications.

PubMed

Joseph, Stephen

2004-03-01

In practice it is not unusual for client-centred therapists to work with people who have experienced traumatic events. However, client-centred therapy is not usually considered within texts on traumatic stress and questions have been raised over the appropriateness of client-centred therapy with trauma survivors. The present study shows how, although he was writing well before the introduction of the term 'post-traumatic stress disorder', Carl Rogers provided a theory of therapy and personality that contains an account of threat-related psychological processes largely consistent with contemporary trauma theory. Rogers' theory provides the conceptual underpinnings to the client-centred and experiential ways of working with traumatized people. Furthermore, Rogers' theory provides an understanding of post-traumatic growth processes, and encourages therapists to adopt a more positive psychological perspective to their understanding of how people adjust to traumatic events.

The longitudinal course of post-traumatic stress after childbirth.

PubMed

Söderquist, Johan; Wijma, Barbro; Wijma, Klaas

2006-06-01

Post-traumatic stress was assessed in early and late pregnancy, and 1, 4, 7, and 11 months postpartum by means of questionnaires among 1224 women. Thirty-seven women (3%) had post-traumatic stress (meeting criteria B, C, and D for PTSD) at least once within 1-11 months postpartum. In pregnancy, depression, severe fear of childbirth, 'pre'-traumatic stress, previous counseling related to pregnancy/childbirth, and self-reported previous psychological problems were associated with an increased risk of having post-traumatic stress within 1-11 months postpartum. Sum-scores of post-traumatic stress did not decrease over time among women who at least once had post-traumatic stress (criteria B, C, and D) within 1-11 months postpartum. Women with post-traumatic stress also showed a decrease in perceived social support over time postpartum.

Post-Traumatic Cognition Mediates the Relationship between a History of Sexual Abuse and the Post-Traumatic Stress Symptoms in Sexual Assault Victims.

PubMed

Shin, Kyoung Min; Chung, Young Ki; Shin, Yee Jin; Kim, Miran; Kim, Nam Hee; Kim, Kyoung Ah; Lee, Hanbyul; Chang, Hyoung Yoon

2017-10-01

More than half of all sexual assault victims report experiencing sexual victimization more than once. The aim of this paper was to determine the role post-traumatic cognition plays in the relationship between a history of sexual abuse and post-traumatic stress symptoms in sexual assault victims. The relationship between a history of sexual assault and the severity of post-traumatic stress symptoms was investigated retrospectively using data from a sexual assault crisis center in Korea. Data on psychological symptoms were collected in person at the initial assessment and by telephone 1 month later using the Post-traumatic Cognitions Inventory and the Post-traumatic Stress Disorder Symptoms Scale: Self-report Version. Of 105 women included in the analysis, 10 (9.5%) reported prior sexual abuse and were classified as sexually revictimized. Revictimized women had more post-traumatic negative cognition at initial assessment (t = -2.98; P = 0.004) and more post-traumatic symptoms at 1 month follow-up (t = -2.39; P = 0.019) than singly victimized women. At 1 month follow-up, the severity of post-traumatic stress symptoms had increased in revictimized women but had decreased slightly in singly victimized women. Negative post-traumatic cognition fully mediated the association between a history of sexual abuse and the severity of post-traumatic stress symptoms. Early detection of sexually revictimized women and tailored service and treatment intervention is needed to better serve this group of victims. Interventions targeted at preventing revictimization or post crime victimization may also help victims recover from the trauma and prevent future abuse. © 2017 The Korean Academy of Medical Sciences.

Post-traumatic psychiatric disorders: PTSD is not the only diagnosis.

PubMed

Auxéméry, Yann

2018-05-01

Traumatic events and their consequences are often hidden or minimised by patients for reasons linked to the post-traumatic stress disorder itself (inexpressibility, shame, depressive thoughts, fear of stigmatisation, etc.). Although post-traumatic stress disorder (PTSD) remains the most widely known disorder, chronic post-traumatic psychiatric disorders are many and varied. After a trauma, the practitioner has to check for the different clinical forms of post-traumatic psychological consequences: PTSD is not the only diagnosis. Based on our own clinical experience compared to the international literature, we think necessary to build a didactic classification describing chronic post-traumatic symptoms and syndromes. Post traumatic depressions and bereavement lead to high risk of suicidal crisis and self-harm behaviours. Re-experiencing are felt with anxiety, hyper arousal increases anxious reactivity, and avoidance strategies increase anticipatory anxiety, indicating post-traumatic anxiety disorders (agoraphobia, specific phobia, obsessive compulsive disorder, separation anxiety, social phobia). Characterising an often-severe clinical picture, the co-occurrence of post-traumatic and chronic psychotic symptoms is not unusual (post-traumatic schizophrenia, post-traumatic depression with mood-congruent psychotic features, non-schizophrenic post-traumatic psychotic disorder, and bipolar reaction to trauma). A physical injury occurring at the same time as a traumatic exposure increases the risk of developing post-traumatic stress disorder later which, in turn, afflicts the subjective perception of the physical health (development of somatoform and psychosomatic disorders, comorbidity with a post-concussion syndrome). The trauma may cause a rupture in the biography of a person, also in his/her internal physiological functioning as in his/her social activities (impacts of instinctive functions and behaviours, personality changes, and adjustment difficulties on professional

Post-traumatic growth among the UK veterans following treatment for post-traumatic stress disorder.

PubMed

Murphy, Dominic; Palmer, E; Lock, R; Busuttil, W

2017-04-01

The aim of this paper was to examine levels of post-traumatic growth (PTG) in a sample of the UK veterans who had received treatment for post-traumatic stress disorder (PTSD). The study followed-up 149 UK veterans after they had completed standardised treatment for PTSD provided by Combat Stress. Data had previously been collected on a range of mental health outcomes before treatment, and then repeated 6 months after the end of treatment. For the current study, participants completed the post-traumatic growth inventory (PTGI) measure. Analysis was conducted to explore levels of PTG and whether there were any relationships between pretreatment and post-treatment ratings of mental health and PTG. The mean score on the PTGI was 32.6. Evidence of a treatment effect on levels of PTG was observed. There appeared to be a relationship between improvements in symptoms of PTSD and depression and higher levels of PTG. This study observed the presence of PTG following exposure to traumatic events within a sample of the UK veterans following their treatment for PTSD. PTG scores were moderately low in comparison to similar studies in the USA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Towards a post-traumatic subtype of obsessive-compulsive disorder.

PubMed

Fontenelle, Leonardo F; Cocchi, Luca; Harrison, Ben J; Shavitt, Roseli G; do Rosário, Maria Conceição; Ferrão, Ygor A; de Mathis, Maria Alice; Cordioli, Aristides V; Yücel, Murat; Pantelis, Christos; Mari, Jair de Jesus; Miguel, Euripedes C; Torres, Albina R

2012-03-01

We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS. Copyright © 2011 Elsevier Ltd. All rights reserved.

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. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Comorbid Post-Traumatic Stress Disorder and Opioid Dependence.

PubMed

Patel, Rikinkumar S; Elmaadawi, Ahmed; Nasr, Suhayl; Haskin, John

2017-09-03

Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions. Since opioid withdrawal symptoms mimic hyper vigilance, this results in an exaggeration of the response of patients with post-traumatic stress disorder. This comorbidity is associated with worse health outcomes, as its pathophysiology involves a common neurobiological circuit. Opioid substitution therapy and psychotherapeutic medications in combination with evidence-based cognitive behavioral therapy devised for individuals with comorbid post-traumatic stress disorder and opioid dependence may improve treatment outcomes in this population. Therefore, we conclude that the screening for post-traumatic stress disorder in the opioid-abusing population is crucial. To understand the underlying mechanisms for this comorbidity and to improve the treatment response, further research should be encouraged.

Post-traumatic stress disorder and cardiovascular disease.

PubMed

Edmondson, Donald; von Känel, Roland

2017-04-01

In this paper, a first in a Series of two, we look at the evidence for an association of post-traumatic stress disorder with incident cardiovascular disease risk and the mechanisms that might cause this association, as well as the prevalence of post-traumatic stress disorder due to cardiovascular disease events and its associated prognostic risk. We discuss research done after the publication of previous relevant systematic reviews, and survey currently funded research from the two most active funders in the field: the National Institutes of Health and the US Veterans Administration. We conclude that post-traumatic stress disorder is a risk factor for incident cardiovascular disease, and a common psychiatric consequence of cardiovascular disease events that might worsen the prognosis of the cardiovascular disease. There are many candidate mechanisms for the link between post-traumatic stress disorder and cardiovascular disease, and several ongoing studies could soon point to the most important behavioural and physiological mechanisms to target in early phase intervention development. Similarly, targets are emerging for individual and environmental interventions that might offset the risk of post-traumatic stress disorder after cardiovascular disease events. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Morel-Lavallée syndrome and post-traumatic nodular fat necrosis: Two post-traumatic complications mimicking cellulitis].

PubMed

Moulin, C; Barthélémy, I; Emering, C; D'Incan, M

Dermal and subcutaneous inflammation following direct trauma is initially evocative of soft-tissue infection. However, two differential diagnoses must be considered: Morel-Lavallée syndrome and post-traumatic nodular fat necrosis. Case 1: a 51-year-old woman fell off her motorbike and had dermabrasions on her right and left tibial ridges that rapidly developed into dermo-hypodermitis of the entire limb. There was no improvement after 3 weeks of antibiotics. The patient was apyretic. She had a soft, non-inflammatory tumefaction on the inner aspect of her left knee. Ultrasound revealed subcutaneous collection in both legs. The surgeons confirmed a diagnosis of Morel-Lavallée syndrome and drained the two collections. Progress was good and the patient healed without major consequences. Case 2: following a fall on her stairs, a 40-year-old woman presented dermabrasions and haematomas on her left leg. Antibiotic therapy failed to prevent the progression of dermo-hypodermitis. The patient remained apyretic and there was no inflammatory syndrome. A CT scan showed thickening of a subcutaneous fat and fluid collection, resulting in diagnosis of post-traumatic nodular fat necrosis. Management was surgical and the outcome was good. These two cases show two post-traumatic cutaneous complications: Morel-Lavallée syndrome and post-traumatic nodular fat necrosis. Morel-Lavallée syndrome occurs after tangential trauma next to richly vascularized tissue. Post-traumatic nodular fat necrosis is defined as necrosis of adipocytes. In both cases, diagnosis is confirmed by imagery (Ultrasonography, tomography). Our two case reports show that inflammatory presentation of both Morel-Lavallée syndrome and post-traumatic nodular fat necrosis can lead to diagnostic and therapeutic errors while a surgical procedure is necessary since tissue necrosis can occur. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Subcutaneous emphysema, pneumomediastinum, pneumothorax, pneumoperitoneum, and pneumoretroperitoneum by insufflation of compressed air at the external genitalia in a child.

PubMed

Muramori, Katsumi; Takahashi, Yukiko; Handa, Noritoshi; Aikawa, Hisayuki

2009-04-01

A 7-year-old girl with concurrent subcutaneous emphysema, pneumomediastinum, pneumothorax, pneumoperitoneum, and pneumoretroperitoneum arrived at our facility. Compressed air at 5 atm of pressure was insufflated through the nozzle of a spray gun over her external genitalia. She was admitted for a small amount of genital bleeding and significant subcutaneous emphysema extending from the cheek to the upper body. Radiographic examination of the abdomen was suggestive of a visceral perforation, but she was managed conservatively and discharged in satisfactory condition without surgical intervention. The female genitalia possibly served as the entry point for air into the retroperitoneum and peritoneal cavity, with subsequent migration of air through the esophageal hiatus that resulted in pneumomediastinum, pneumothorax, and extensive subcutaneous emphysema.

Post-traumatic cervical pneumorrhachis--a rare entity.

PubMed

Gill, Maneet; Sreenivas, Mukkamala; Beniwal, Rajveer Singh

2011-02-01

Pneumorrhachis(PR) is a rare phenomenon and post traumatic PR even more so. Presentation can vary from asymptomatic to significant neurological deficit and so the management has to be individualised. We present a case of post-traumatic cervical PR.

Intra-Articular Therapeutic Delivery for Post Traumatic Osteoarthritis

DTIC Science & Technology

2015-10-01

AWARD NUMBER: W81XWH-14-2-0188 TITLE: Intra-Articular Therapeutic Delivery for Post-Traumatic Osteoarthritis PRINCIPAL INVESTIGATOR: Robert...Intra-Articular Therapeutic Delivery for Post-Traumatic Osteoarthritis 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-2-0188 5c. PROGRAM ELEMENT...are to test the ability of a novel therapeutic to hinder the progression of post-traumatic osteoarthritis . This debilitating joint condition more

An Analysis of Post-Traumatic Stress Symptoms in United States Air Force Drone Operators

DTIC Science & Technology

2014-05-17

war-time imagery (i.e., potential traumatic events). Ouma, Chappelle, and Salinas (2011) investigated self- reported stress and burnout among 296 USAF...related directly to operational factors (e.g., long work hours, disruptive shift schedules, daily balance of warfighter with domestic duties). Mental...Journal Article 3. DATES COVERED (From – To) Jan 2012 – Dec 2012 4. TITLE AND SUBTITLE An analysis of post-traumatic stress symptoms in United

Effect of Ergothioneine on Acute Lung Injury and Inflammation in Cytokine Insufflated Rats

PubMed Central

Repine, John E.; Elkins, Nancy D.

2012-01-01

Objective The Acute Respiratory Distress Syndrome (ARDS), the most severe form of Acute Lung Injury (ALI), is a highly-fatal, diffuse non-cardiogenic edematous lung disorder. The pathogenesis of ARDS is unknown but lung inflammation and lung oxidative stress are likely contributing factors. Since no specific pharmacologic intervention exists for ARDS, our objective was to determine the effect of treatment with ergothioneine---a safe agent with multiple anti-inflammatory and antioxidant properties on the development of lung injury and inflammation in rats insufflated with cytokines found in lung lavages of ARDS patients. Method Sprague-Dawley rats (3-10/group) were given 15 mg/kg or 150 mg/kg L-ergothioneine intravenously 1 hour before or 18 hours after cytokine (IL-1 and IFNγ) insufflation. Lung injury (lavage LDH levels) and lung inflammation (lavage neutrophil numbers) were measured 24 hours after cytokine insufflation. Results Ergothioneine pre- and post- treatment generally decreased lung injury and lung inflammation in cytokine insufflated rats. Conclusion Ergothioneine should be considered for additional testing as a potential therapy for treating and preventing ARDS. PMID:22197759

Compliance of the abdominal wall during laparoscopic insufflation.

PubMed

Becker, Chuck; Plymale, Margaret A; Wennergren, John; Totten, Crystal; Stigall, Kyle; Roth, J Scott

2017-04-01

To provide adequate workspace between the viscera and abdominal wall, insufflation with carbon dioxide is a common practice in laparoscopic surgeries. An insufflation pressure of 15 mmHg is considered to be safe in patients, but all insufflation pressures create perioperative and postoperative physiologic effects. As a composition of viscoelastic materials, the abdominal wall should distend in a predictable manner given the pressure of the pneumoperitoneum. The purpose of this study was to elucidate the relationship between degree of abdominal distention and the insufflation pressure, with the goal of determining factors which impact the compliance of the abdominal wall. A prospective, IRB-approved study was conducted to video record the abdomens of patients undergoing insufflation prior to a laparoscopic surgery. Photo samples were taken every 5 s, and the strain of the patient's abdomen in the sagittal plane was determined, as well as the insufflator pressure (stress) at bedside. Patients were insufflated to 15 mmHg. The relationship between the stress and strain was determined in each sample, and compliance of the patient's abdominal wall was calculated. Subcutaneous fat thickness and rectus abdominus muscle thickness were obtained from computed tomography scans. Correlations between abdominal wall compliances and subcutaneous fat and muscle content were determined. Twenty-five patients were evaluated. An increased fat thickness in the abdominal wall had a direct exponential relationship with abdominal wall compliance (R 2  = 0.59, p < 0.05). There was no correlation between muscle and fat thickness. All insufflation pressures create perioperative and postoperative complications. The compliance of patients' abdominal body walls differs, and subcutaneous fat thickness has a direct exponential relationship with abdominal wall compliance. Thus, insufflation pressures can be better tailored per the patient. Future studies are needed to demonstrate the

Effect of abdominal insufflation for laparoscopy on intracranial pressure.

PubMed

Kamine, Tovy Haber; Papavassiliou, Efstathios; Schneider, Benjamin E

2014-04-01

Increased abdominal pressure may have a negative effect on intracranial pressure (ICP). Human data on the effects of laparoscopy on ICP are lacking. We retrospectively reviewed laparoscopic operations for ventriculoperitoneal shunt placement to determine the effect of insufflation on ICP. Nine patients underwent insufflation with carbon dioxide (CO(2)) at pressures ranging from 8 to 15 mm Hg and ICP measured through a ventricular catheter. We used a paired t test to compare ICP with insufflation and desufflation. Linear regression correlated insufflation pressure with ICP. The mean ICP increase with 15-mm Hg insufflation is 7.2 (95% CI, 5.4-9.1 [P < .001]) cm H(2)O. The increase in ICP correlated with increasing insufflation pressure (P = .04). Maximum ICP recorded was 25 cm H(2)O. Intracranial pressure significantly increases with abdominal insufflation and correlates with laparoscopic insufflation pressure. The maximum ICP measured was a potentially dangerous 25 cm H(2)O. Laparoscopy should be used cautiously in patients with a baseline elevated ICP or head trauma.

Post-traumatic stress disorder due to childbirth: the aftermath.

PubMed

Beck, Cheryl Tatano

2004-01-01

Childbirth qualifies as an extreme traumatic stressor that can result in post-traumatic stress disorder. The reported prevalence of post-traumatic stress disorder after childbirth ranges from 1.5% to 6%. The aim of this phenomenologic study was to describe the essence of mothers' experiences of post-traumatic stress disorder after childbirth. The qualitative research design used for this study was descriptive phenomenology. The main recruitment approach was via the Internet through the help of Trauma and Birth Stress, a charitable trust in New Zealand. Purposive sampling was used and resulted in 38 mothers participating from the countries of New Zealand, the United States, Australia, and the United Kingdom. The participants were asked to describe their experiences with post-traumatic stress disorder after childbirth. Their stories were analyzed using Colaizzi's method of data analysis. Mothers with post-traumatic stress disorder attributable to childbirth struggle to survive each day while battling terrifying nightmares and flashbacks of the birth, anger, anxiety, depression, and painful isolation from the world of motherhood. This glimpse into the lives of mothers with post-traumatic stress disorder attributable to childbirth provides an impetus to increase research efforts in this neglected area.

Ketamine as a Rapid Treatment for Post-Traumatic Stress Disorder

DTIC Science & Technology

2011-10-01

Post - traumatic stress disorder ( PTSD ) is a debilitating anxiety disorder characterized by intrusive re-experiences of the traumatic events...08-1-0602 TITLE: Ketamine as a Rapid Treatment for Post - Traumatic Stress Disorder PRINCIPAL INVESTIGATOR: Dennis Charney...dissociative effects of ketamine but not have any sustained anxiolytic and antidepressant effects. Forty individuals diagnosed with post - traumatic

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

Biomarkers of Risk for Post-traumatic Stress Disorder (PTSD)

DTIC Science & Technology

2009-05-01

Post - traumatic Stress Disorder ( PTSD ) PRINCIPAL INVESTIGATOR: Audrey R. Tyrka, MD, PhD... Post - traumatic Stress Disorder ( PTSD ) 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-07-1-0269 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...1,087,938. 11. United States Department of Defense, “Biomarkers of risk for post - traumatic stress disorder ( PTSD ),” Principal Investigator,

Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review.

PubMed

de Graaff, Lisanne F; Honig, Adriaan; van Pampus, Mariëlle G; Stramrood, Claire A I

2018-06-01

Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a post-traumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related post-traumatic stress disorder. Major databases [Cochrane; Embase; PsycINFO; PubMed (Medline)] were searched using combinations of the key words and their synonyms. After screening titles and abstracts and reading 135 full-text articles, 13 studies were included. All evaluated secondary prevention, and none primary prevention. Interventions included debriefing, structured psychological interventions, expressive writing interventions, encouraging skin-to-skin contact with healthy newborns immediately postpartum and holding or seeing the newborn after stillbirth. The large heterogeneity of study characteristics precluded pooling of data. The writing interventions to express feelings appeared to be effective in prevention. A psychological intervention including elements of exposure and psycho-education seemed to lead to fewer post-traumatic stress disorder symptoms in women who delivered via emergency cesarean section. No research has been done on primary prevention of traumatic childbirth. Research on secondary prevention of traumatic childbirth and post-traumatic stress disorder following delivery provides insufficient evidence that the described interventions are effective in unselected groups of women. In certain subgroups, results are inhomogeneous. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

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. PMID:27635228

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

Neurotherapy of Traumatic Brain Injury/Post-Traumatic Stress Symptoms in Vietnam Veterans.

PubMed

Nelson, David V; Esty, Mary Lee

2015-10-01

Previous report suggested the beneficial effects of an adaptation of the Flexyx Neurotherapy System (FNS) for the amelioration of mixed traumatic brain injury/post-traumatic stress symptoms in veterans of the Afghanistan and Iraq wars. As a novel variant of electroencephalograph biofeedback, FNS falls within the bioenergy domain of complementary and alternative medicine. Rather than learning voluntary control over the production/inhibition of brain wave patterns, FNS involves offsetting stimulation of brain wave activity by means of an external energy source, specifically, the conduction of electromagnetic energy stimulation via the connecting electroencephalograph cables. Essentially, these procedures subliminally induce strategic distortion of ongoing brain wave activity to presumably facilitate resetting of more adaptive patterns of activity. Reported herein are two cases of Vietnam veterans with mixed traumatic brain injury/post-traumatic stress symptoms, each treated with FNS for 25 sessions. Comparisons of pre- and post-treatment questionnaire assessments revealed notable decreases for all symptoms, suggesting improvements across the broad domains of cognition, pain, sleep, fatigue, and mood/emotion, including post-traumatic stress symptoms, as well as for overall activity levels. Findings suggest FNS treatment may be of potential benefit for the partial amelioration of symptoms, even in some individuals for whom symptoms have been present for decades. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder.

PubMed

Phelps, Andrea J; Kanaan, Richard A A; Worsnop, Christopher; Redston, Suzy; Ralph, Naomi; Forbes, David

2018-01-01

This study used ambulatory polysomnography (PSG) to investigate post-traumatic nightmares of post-traumatic stress disorder (PTSD). The key research question was whether post-traumatic nightmares occur in both rapid eye movement (REM) and non-REM sleep, and if so, whether nightmares in each sleep stage differed in content, phenomenology, and heart rate response. Underlying sleep disorders were investigated in an exploratory way. Thirty-five treatment-seeking veterans, current serving military members, and emergency service personnel undertook full PSG using the Compumedics (Melbourne, Australia) SomtePSG V1 system, during an inpatient psychiatric admission. The PSG recording included an event button to be pressed when a nightmare occurred, allowing us to determine the stage of sleep, changes in heart rate, and associated sleep events. The content and phenomenological features of participants' nightmares were recorded. Of the 35 participants, 29 reported a nightmare during their sleep study, but only 21 pressed the event button and could recall the content of one or more nightmare. This yielded sleep and nightmare data for 24 nightmares. Of the 24, 10 nightmares arose from REM sleep and 14 from non-REM (stages N1 and N2). Seven were accurate trauma replays and 17 were non-replay or a mixture of replay and non-replay. Most nightmares were associated with respiratory or leg movement events and increase in heart rate on awakening. Post-traumatic nightmares of PTSD occur in both REM and non-REM sleep and are commonly associated with other sleep disturbances. These findings have important treatment implications. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Post-Traumatic Stress Disorder and the Military: A Selected Bibliography

DTIC Science & Technology

2005-11-11

Post - Traumatic Stress Disorder ( PTSD ) and its presentation in military personnel. This bibliography...Richard. "Psychopathology of Post - Traumatic Stress Disorder ( PTSD ): Boundaries of the Syndrome." In Torture and Its Consequences: Current Treatment...Wright. "Understanding and Treating Post - Traumatic Stress Disorder Symptoms in Female Partners of Veterans with PTSD ." Journal of Marital and

Catecholamines in Post-Traumatic Stress Disorder

DTIC Science & Technology

2012-07-01

could lead to memories that are too strong, contributing to the recurrent, intrusive retrieval of the traumatic events that occurs in PTSD. As a...emotionally arousing experiences are typically vivid and persistent. The recurrent, intrusive memories of traumatic events in post-traumatic stress disorder...signaling plays a critical role in the maintenance of waking and in the regulation of REM sleep. J Neurophysiol 92:2071–2082. Ouyang M, Zhang L, Zhu

VA Health Care: VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services

DTIC Science & Technology

2011-01-01

post - traumatic stress disorder ( PTSD ) and...Veterans Affairs (VA) Intramural Post - Traumatic Stress Disorder ( PTSD ) Research Funding and VA’s Medical and Prosthetic Research Appropriation...Table 6: Department of Veterans Affairs (VA) Research Centers and Programs That Conduct or Support Post - Traumatic Stress Disorder ( PTSD ) Research

Reintegration of National Guard Soldiers with Post-Traumatic Stress Disorder

DTIC Science & Technology

2010-03-01

Post - Traumatic Stress Disorder ( PTSD ). An alarming number of soldiers returning from our current wars in Iraq...veterans have been diagnosed with the invisible wounds of Post - Traumatic Stress Disorder ( PTSD ). An alarming number of soldiers returning from our current...returning veterans have been diagnosed with the invisible wounds of Post - Traumatic Stress Disorder ( PTSD ). These veterans’ coping skills have

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

Prevalence and risk factors of childbirth-related post-traumatic stress symptoms.

PubMed

Modarres, Maryam; Afrasiabi, Sedigheh; Rahnama, Parvin; Montazeri, Ali

2012-09-03

There is evidence that traumatic birth experiences are associated with psychological impairments. This study aimed to estimate the prevalence of childbirth-related post-traumatic stress symptoms and its obstetric and perinatal risk factors among a sample of Iranian women. This was a cross-sectional study carried out in Bushehr, Iran during a 3-months period from July to September 2009. Data were collected from all women attending eleven healthcare centers for postnatal care 6 to 8 weeks after childbirth. Those who had a traumatic delivery were identified and entered into the study. In order to assess childbirth-related post-traumatic stress, the Post-traumatic Symptom Scale-Interview (PSS-I) was administered. Data on demographic, obstetric and perinatal characteristics also were collected. Multivariate logistic regression was performed to examine the association between childbirth-related post-traumatic stress and demographic and obstetric and perinatal variables. In all, 400 women were initially evaluated. Of these, 218 women (54.5%) had a traumatic delivery and overall, 80 women (20%) were found to be suffering from post-partum post-traumatic stress disorder (PTSD). Multiple logistic regression analysis revealed that post-partum PTSD was associated with educational level, gestational age at delivery, number of prenatal care visits, pregnancy complications, pregnancy intervals, labor duration, and mode of delivery. The findings indicated that the prevalence of traumatic birth experiences and post-partum PTSD were relatively high among Iranian women. The findings also indicated that obstetric and perinatal variables were independently the most significant contributing factors to women's post-partum PTSD. It seems that a better perinatal care and supportive childbirth might help to reduce the burden of post-partum PTSD among this population.

Mission Connect Mild TBI Translational Research Consortium, Post Traumatic Hypopituitarism

DTIC Science & Technology

2010-08-01

10 Aug 2010 4. TITLE AND SUBTITLE The Mission Connect MTBI Translational Research Consortium 5a. CONTRACT NUMBER Post traumatic hypopituitarism 5b...distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The purpose of this project is to identify the incidence of post traumatic hypopituitarism ...June 21, 2010; however, none have reached the six month milestone for blood testing 15. SUBJECT TERMS post traumatic hypopituitarism 16. SECURITY

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

Post traumatic Headache and Psychological Health: Mindfulness Training for Mild TraumaticBrain Injury

DTIC Science & Technology

2015-10-01

Award Number: W81XWH-10-1-1021 TITLE: Post-traumatic Headache and Psychological Health: Mindfulness Training for Mild Traumatic Brain Injury...traumatic Headache and Psychological Health: Mindfulness Training for Mild Traumatic Brain Injury” 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR...health, and quality of life of our soldiers. This project addresses multiple FY09 TBI/PH topic areas by validating an evidence-based, mind -body approach

Post-traumatic Stress Disorder by Gender and Veteran Status.

PubMed

Lehavot, Keren; Katon, Jodie G; Chen, Jessica A; Fortney, John C; Simpson, Tracy L

2018-01-01

Population-based data on the prevalence, correlates, and treatment utilization of post-traumatic stress disorder by gender and veteran status are limited. With changes in post-traumatic stress disorder diagnostic criteria in 2013, current information from a uniform data source is needed. This was a secondary analysis of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, which consisted of in-person interviews that were conducted with a representative sample of U.S. adults. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version was used to assess past-year and lifetime post-traumatic stress disorder among veterans (n=3,119) and civilians (n=32,982). Data were analyzed from January to March 2017. Adjusting for age and race/ethnicity, women veterans reported the highest rates of lifetime and past-year post-traumatic stress disorder (13.4%, 95% CI=8.8%, 17.9%, and 11.7%, 95% CI=7.1%, 16.4%) compared with women civilians (8.0%, 95% CI=7.4%, 8.6%, and 6.0%, 95% CI=5.5%, 6.6%); men veterans (7.7%, 95% CI=6.5%, 8.8%, and 6.7%, 95% CI=5.7%, 7.8%); and men civilians (3.4%, 95% CI=3.0%, 3.9%, and 2.6%, 95% CI=2.2%, 2.9%). Traumatic event exposure, correlates of lifetime post-traumatic stress disorder, and treatment seeking varied across subgroups. Men and women veterans were more likely than civilians to use a variety of treatment sources, with men civilians being least likely to seek treatment and men veterans exhibiting the longest delay in seeking treatment. Post-traumatic stress disorder is a common mental health disorder that varies by gender and veteran status. Women veterans' high rates of post-traumatic stress disorder highlight a critical target for prevention and intervention, whereas understanding treatment barriers for men veterans and civilians is necessary. Published by Elsevier Inc.

Post-traumatic pseudomyopia.

PubMed

London, Richard; Wick, Bruce; Kirschen, David

2003-02-01

Many clinicians have noted that patients demonstrate a myopic refractive change following Traumatic Brain Injury (TBI). This apparent myopic shift disappears with cycloplegia, yet stubbornly reappears as soon as the pharmaceutical effect wears off. We propose that this shift is secondary to an irritative lesion that affects the parasympathetic innervation, resulting in ciliary body contracture. The dilemma for the clinician is whether to provide the immediate relief of clear distance vision by prescribing additional minus lenses, or to work toward attempting to re-establish the baseline refractive error. The natural history of post-traumatic pseudomyopia in our experience involves one of the following three courses: (1) a transient condition that will occasionally resolve; (2) the typical case, a recalcitrant condition that will resolve under cycloplegic intervention, but immediately return as the cycloplegic wears off; or (3) a less-common subgroup of patients who continue to show an increase in myopia over time. Our description of these cases demonstrates management strategies (including atropinization) to relax accommodative spasm, traditional vision therapy techniques aimed at loosening the accommodative system, and refractive corrections. Pseudomyopia is one of many ocular and behavioral sequelae following TBI. By understanding the natural course and potential management options for post-traumatic pseudomyopia, the clinician will be better prepared to deal with these challenging cases. Flexibility is required, since options that work with one patient may prove ineffective with another. Counseling the patient as to potential outcomes given the natural history of this condition helps establish more-realistic expectations by the patients being treated.

21 CFR 884.1300 - Uterotubal carbon dioxide insufflator and accessories.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Uterotubal carbon dioxide insufflator and... Gynecological Diagnostic Devices § 884.1300 Uterotubal carbon dioxide insufflator and accessories. (a) Identification. A uterotubal carbon dioxide insufflator and accessories is a device used to test the patency...

21 CFR 884.1300 - Uterotubal carbon dioxide insufflator and accessories.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Uterotubal carbon dioxide insufflator and... Gynecological Diagnostic Devices § 884.1300 Uterotubal carbon dioxide insufflator and accessories. (a) Identification. A uterotubal carbon dioxide insufflator and accessories is a device used to test the patency...

21 CFR 884.1300 - Uterotubal carbon dioxide insufflator and accessories.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Uterotubal carbon dioxide insufflator and... Gynecological Diagnostic Devices § 884.1300 Uterotubal carbon dioxide insufflator and accessories. (a) Identification. A uterotubal carbon dioxide insufflator and accessories is a device used to test the patency...

[Post-traumatic tics].

PubMed

Alegre, S; Chacón, J; Redondo, L; Navarro-Busto, C; Solana, B

1996-10-01

Secondary tics are those in which an aetiology justifying them can be found, as compared to idiopathic tics, which make up the majority, and the Gilles de la Tourette syndrome (SGT), which is, at the moment, of unknown origin. Of the possible aetiologies described as causing tics, craneo-encephalic trauma has been mentioned on very few occasions. We present a case of post-traumatic tics (verbal and neck) in a young man of 24, and review the published cases which can be considered to be of post-traumatic tics. We have found six cases of tics secondary to traumas, all craneo-encephalic, like ours (the one under study). The time interval between the blow and the appearance of the tic or tics varied between 2 weeks and 3 months. The absence of significant lesions seen in the complementary investigations make it impossible for us to discover the site of the lesion caused by the trauma. However, the presence in some cases of other tics before the trauma, and of family histories of tics, supports the idea of a genetic basis or predisposition to suffer this disorder.

Risk factors in pregnancy for post-traumatic stress and depression after childbirth.

PubMed

Söderquist, J; Wijma, B; Thorbert, G; Wijma, K

2009-04-01

The objective of this study was to find risk factors in pregnancy for post-traumatic stress and depression 1 month after childbirth. Furthermore, the relation between post-traumatic stress and depression was explored. A prospective longitudinal study. Pregnant women in Linköping and Kalmar, Sweden. A total of 1224 women were assessed in pregnancy, week 12-20 and 32, as well as 1 month postpartum. Post-traumatic stress and depression after delivery were assessed 1 month postpartum. Potential risk factors were assessed in early and late pregnancy. Variables measured during pregnancy were trait anxiety, depression, fear of childbirth, childbirth-related traumatic stress, stress coping capacity, social support, parity, educational level, age, gestation week, parity, educational level, civil status, previous psychological/psychiatric counselling, and previous experience of any traumatic events. Delivery mode was assessed from the medical records. Prevalence of post-traumatic stress (criteria A, B, C, D, E, and F according to DSM-IV) and depression (Beck's depression inventory). One month postpartum, 12 (1.3%) women had post-traumatic stress (met symptom criteria B, C, and D for post-traumatic stress disorder according to Diagnostic and statistical manual of mental disorders, 4th edition [DSM-IV]). The most important risk factors in pregnancy were depression in early pregnancy (OR=16.3), severe fear of childbirth (OR=6.2), and 'pre'-traumatic stress (in view of the forthcoming delivery) in late pregnancy (OR=12.5). The prevalence of depression was 5.6%. Post-traumatic stress and depression were positively related 1 month postpartum and were predicted by mainly the same factors. Risk factors for post-traumatic stress and depression after childbirth can be assessed in early pregnancy. Post-traumatic stress and depression also seem to share the same underlying vulnerability factors.

Intra-Articular Therapeutic Delivery for Post-Traumatic Osteoarthritis

DTIC Science & Technology

2017-10-01

takes about 10 years to develop. The goals of this work are to test the ability of a novel therapeutic to slow the progression of post -traumatic...frequency of delivery in well- established small and large animal models of post -traumatic OA. These hypotheses will be tested via three Specific Aims...group) to conduct further contrast agent pilot testing on non-healthy joints. Animals were euthanized at 3 weeks post -MMT surgery, and all limbs fixed

Post-traumatic stress disorder vs traumatic brain injury

PubMed Central

Bryant, Richard

2011-01-01

Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) often coexist because brain injuries are often sustained in traumatic experiences. This review outlines the significant overlap between PTSD and TBI by commencing with a critical outline of the overlapping symptoms and problems of differential diagnosis. The impact of TBI on PTSD is then described, with increasing evidence suggesting that mild TBI can increase risk for PTSD. Several explanations are offered for this enhanced risk. Recent evidence suggests that impairment secondary to mild TBI is largely attributable to stress reactions after TBI, which challenges the long-held belief that postconcussive symptoms are a function of neurological insult This recent evidence is pointing to new directions for treatment of postconcussive symptoms that acknowledge that treating stress factors following TBI may be the optimal means to manage the effects of many TBIs, PMID:22034252

Post-traumatic stress disorder: medicine and politics.

PubMed

Stein, Dan J; Seedat, Soraya; Iversen, Amy; Wessely, Simon

2007-01-13

Regrettably, exposure to trauma is common worldwide, and can have serious adverse psychological results. The introduction of the notion of post-traumatic stress disorder has led to increasing medicalisation of the problem. This awareness has helped popular acceptance of the reality of post-traumatic psychiatric sequelae, which has boosted research into the pathogenesis of the disorder, leading to improved pharmacological and psychological management. The subjective experience of trauma and subsequent expression of symptoms vary considerably over space and time, and we emphasise that not all psychological distress or psychiatric disorders after trauma should be termed post-traumatic stress disorder. There are limits to the medicalisation of distress and there is value in focusing on adaptive coping during and after traumas. Striking a balance between a focus on heroism and resilience versus victimhood and pathological change is a crucial and constant issue after trauma for both clinicians and society. In this Review we discuss the advantages and disadvantages of medicalising trauma response, using examples from South Africa, the Armed Services, and post-disaster, to draw attention to our argument.

Abdominal insufflation for laparoscopy increases intracranial and intrathoracic pressure in human subjects.

PubMed

Kamine, Tovy Haber; Elmadhun, Nassrene Y; Kasper, Ekkehard M; Papavassiliou, Efstathios; Schneider, Benjamin E

2016-09-01

Laparoscopy has emerged as an alternative to laparotomy in select trauma patients. In animal models, increasing abdominal pressure is associated with an increase in intrathoracic and intracranial pressures. We conducted a prospective trial of human subjects who underwent laparoscopic-assisted ventriculoperitoneal shunt placement (lap VPS) with intraoperative measurement of intrathoracic, intracranial and cerebral perfusion pressures. Ten patients undergoing lap VPS were recruited. Abdominal insufflation was performed using CO2 to 0, 8, 10, 12 and 15 mmHg. ICP was measured through the ventricular catheter simultaneously with insufflation and with desufflation using a manometer. Peak inspiratory pressures (PIP) were measured through the endotracheal tube. Blood pressure was measured using a noninvasive blood pressure cuff. End-tidal CO2 (ETCO2) was measured for each set of abdominal pressure level. Pressure measurements from all points of insufflation were compared using a two-way ANOVA with a post hoc Bonferroni test. Mean changes in pressures were compared using t test. ICP and PIP increased significantly with increasing abdominal pressure (both p < 0.01), whereas cerebral perfusion pressure (CPP) and mean arterial pressure did not significantly change with increasing abdominal pressure over the range tested. Higher abdominal pressure values were associated with decreased ETCO2 values. Increased ICP and PIP appear to be a direct result of increasing abdominal pressure, since ETCO2 did not increase. Though CPP did not change over the range tested, the ICP in some patients with 15 mmHg abdominal insufflation reached values as high as 32 cmH2O, which is considered above tolerance, regardless of the CPP. Laparoscopy should be used cautiously, in patients who present with baseline elevated ICP or head trauma as abdominal insufflation affects intracranial pressure.

Post-traumatic stress disorder in the perinatal period: A concept analysis.

PubMed

Vignato, Julie; Georges, Jane M; Bush, Ruth A; Connelly, Cynthia D

2017-12-01

To report an analysis of the concept of perinatal post-traumatic stress disorder. Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs. Concept analysis via Walker and Avant's approach. The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder. Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes. Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes. © 2017 John Wiley

Bereavement, post-traumatic stress and post-traumatic growth: through the lenses of positive psychology

PubMed Central

Thomadaki, Olga O.

2017-01-01

ABSTRACT Background: During the past decades we have learned a lot about the psychopathology that can be triggered from adversity, but our knowledge of the qualities developed and processes experienced by people who remain healthy despite having gone through trauma has been limited. A proposed area within positive psychology is the psychology of loss. Psychology of loss emphasizes the study of healthy individuals, the resources they use for adapting to loss, and the ways in which they can transform their losses into personal growth and strength. Under the theoretical umbrella of positive psychology, the construct of post-traumatic growth has also received increased scholarly attention in recent years. Post-traumatic growth is a concept and a construct that reflects the ‘positive psychological change experienced as a result of the struggle with highly challenging life circumstances’ (Tedeschi & Calhoun, 2004). Numerous empirical studies have described the phenomenon after various traumas, including traumatic bereavement, even among children and adolescents (Kilmer et al., 2009). Objective: The qualitative study presented was conducted in the UK, where eight women were interviewed after losing their first child perinatally. This type of bereavement constitutes a traumatic loss and although there is a plethora of research focusing on the resulting parental psychopathology, research on adaptive grief resolution and post-traumatic growth is scarce. Method: The research question was ‘How mothers experience personal growth after a perinatal loss’ and the research methodology employed was interpretative phenomenological analysis (Smith, Flowers, & Larkin, 2009). Results: The analysis revealed four superordinate themes. The first mainly presented the traumatic quality of this type of bereavement and included subthemes such as iatrogenic psychological trauma, while the second presented the multiple losses involved with emerging themes on the amputated object

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,…

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

Cancer.gov

Cancer-related post-traumatic stress can occur any time from diagnosis to after treatment ends. Shock, fear, helplessness, or horror can be felt by cancer patients and lead to cancer-related post-traumatic stress. Learn about the causes and ways doctors can help manage these symptoms of distress in this expert-reviewed summary.

Electric Field Stimulation Enhances Healing of Post-Traumatic Osteoarthritic Cartilage

DTIC Science & Technology

2015-10-01

AWARD NUMBER: W81XWH-14-1-0591 TITLE: Electric Field Stimulation Enhances Healing of Post-Traumatic Osteoarthritic Cartilage PRINCIPAL...DATES COVERED 30 Sep 2014 – 29 Sep 2015 4. TITLE AND SUBTITLE Electric Field Stimulation Enhances Healing of Post-Traumatic Osteoarthritic Cartilage...instability, among other traumatic affections of joints, and occupations or sports that subject joints to high levels of impact and torsional loading

Efficacy and tolerability of medical ozone gas insufflations in patients with osteonecrosis of the jaw treated with bisphosphonates-Preliminary data: Medical ozone gas insufflation in treating ONJ lesions.

PubMed

Ripamonti, C I; Maniezzo, M; Boldini, S; Pessi, M A; Mariani, L; Cislaghi, E

2012-12-01

Osteonecrosis of the Jaw (ONJ) is an adverse event reported especially in patients receiving cancer treatments regimen, bisphosphonates (BPs), and denosumab. We performed an open-label, prospective study in patients treated with zoledronic acid who developed ONJ lesions >2.5 cm, and had no benefit after the treatment with the standard therapy, to evaluate the efficacy and tolerability of medical ozone (O3) treatment delivered as gas insufflations on each ONJ lesions. Twenty-four patients (mean age 62.5, range 41-80; 12 female) with bone metastases due to breast (11), prostate (4)and lung (4)cancers, myeloma (2), or osteoporosis (3), previously treated with zoledronic acid and not underwent dental preventive measures and with ONJ lesions >2.5 cm, were observed and treated with topical O3 gas insufflation every third day for a minimum of 10 for each pathological area or till necrotic bone sequestrum or surgery. We used a special insufflation bell-shaped device adjusted to the specific characteristics of the patient, capable of eliminating any residue of O3 diffusion by degrading it and releasing O2 into the air. Azithromicin 500 mg/day was administered for 10 days in all patients before the first three gas insufflation although they had previously received various cycles of antibiotics. Ten patients required more than 10 O3 gas insufflations due to multiple lesions and/or purulent sovrainfections; one patient received two further O3 insufflations while waiting the day of surgery. Six of 24 patients interrupted the O3 gas therapy for oncological disease progression (five patients) and for fear of an experimental therapy (one patient). Six patients had the sequestrum and complete or partial (one patient) spontaneous expulsion of the necrotic bone followed by oral mucosa re-epithelization after a range of 4-27 of O3 gas insufflations. No patient reported adverse events. In 12 patients with the largest and deeper ONJ lesions, O3 gas therapy produced the sequestrum of

Post-traumatic stress disorder symptoms may explain poor mental health in patients with fibromyalgia.

PubMed

Toussaint, Loren L; Whipple, Mary O; Vincent, Ann

2017-05-01

Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.

Anxiety, Depression and Post-Traumatic Stress Disorder after Earthquake.

PubMed

Thapa, Prakash; Acharya, Lumeshor; Bhatta, Bhup Dev; Paneru, Suman Bhatta; Khattri, Jai Bahadur; Chakraborty, Prashant Kumar; Sharma, Rajasee

2018-03-13

Prevalence of anxiety, depression and post traumatic stress disorder is high after earthquake. The aim of the study is to study the prevalence and comorbidity of commonly occurring psychological symptoms in people exposed to Nepal mega earthquake in 2015 after a year of the event. A community based, cross sectional, descriptive study was carried out in Bhumlichaur area of Gorkha district, Nepal after around 14 months of the first major earthquake. We used self-reporting questionnaire 20, Post-traumatic stress disorder 8 and hospital anxiety and depression scale to screen for presence of symptoms of anxiety and depression or post-traumatic stress disorder in this population. The risk of having these disorders according to different socio-demographic variable was assessed by calculating odds ratio. All calculations were done using predictive and analytical software (PASW) version 16.0. A total of 198 participants were included in the final data analysis. The mean age of study participants was 35.13 years (SD=18.04). Borderline anxiety symptoms were found in 104 (52.5%) while significant anxiety symptoms were found in 40 (20%) of respondents. Borderline depressive symptoms were seen in 40 (20%) while significant depressive symptoms were seen in 16 (8%) of subjects. Around 27% (n= 53) of respondents were classified as having post-traumatic stress disorder. The prevalence of anxiety and depressive symptoms and post-traumatic stress disorder seems to be high even after one year in people exposed to earthquake.

Combat, Sexual Assault, and Post-Traumatic Stress in OIF/OEF Military Women

DTIC Science & Technology

2012-07-01

Traumatic Stress in OIF/OEF Military Women PRINCIPAL INVESTIGATOR: Anne G. Sadler, Ph.D., R.N. CONTRACTING ORGANIZATION: Iowa City VA...5a. CONTRACT NUMBER Combat, Sexual Assault, and Post-Traumatic Stress in OIF/OEF Military Women 5b. GRANT NUMBER W81XWH-08-2-0080 5c...complex relationship between these traumatic exposures and women’s health outcomes, such as post-traumatic stress disorder (PTSD) and traumatic

Terrorism, post-traumatic stress, coping strategies, and spiritual outcomes.

PubMed

Meisenhelder, Janice Bell; Marcum, John P

2009-03-01

This mail survey measured post-traumatic stress symptoms, spiritual and non-spiritual coping strategies, and positive spiritual outcomes following the tragedies of 9/11/01 in a national, random sample of 1,056 Presbyterians. Respondents reported mild to moderate degrees of re-experiencing and hyper-arousal symptoms of post-traumatic stress, unrelated to location or knowing someone involved. People experiencing high stress used greater frequency and variety of both spiritual and non-spiritual types of coping strategies. Positive spiritual outcomes were remarkably related to positive spiritual coping strategies, in contrast to no association with negative coping. This study illustrates the significant degree of post-traumatic stress experienced with vicarious exposure and a wide spectrum of coping strategies used following the major terrorist attacks.

Post-traumatic unilateral plantar hyperhidrosis.

PubMed

Eren, Y; Yavasoglu, N G; Comoglu, S S

2016-02-01

Localized unilateral hyperhidrosis is rare and poorly understood, sometimes stemming from trauma. Feet, quite vulnerable to trauma are affected by disease-mediated plantar hyperhidrosis, usually bilaterally. This report describes partial hyperhidrosis developing post-traumatically on the left plantar region of a 52-year-old male.

Electric Field Stimulation Enhances Healing of Post-Traumatic Osteoarthritic Cartilage

DTIC Science & Technology

2017-10-01

expected. Statistics: Comparisons were analyzed using ANOVA with Tukey’s post -hoc test (pɘ.05). RESULTS: In study 1, a proportion of synovial...AWARD NUMBER: W81XWH-14-1-0591 TITLE: Electric Field Stimulation Enhances Healing of Post -Traumatic Osteoarthritic Cartilage PRINCIPAL...2016 – 29 Sep 2017 4. TITLE AND SUBTITLE Cartilage 5a. CONTRACT NUMBER Electric Field Stimulation Enhances Healing of Post -Traumatic Osteoarthritic

The Root Cause of Post-traumatic and Developmental Stress Disorder

DTIC Science & Technology

2013-03-01

Post - traumatic and Developmental Stress Disorder PRINCIPAL INVESTIGATOR: Keith A...28 Feb 2013 4. TITLE AND SUBTITLE The Root Cause of Post - traumatic and Developmental Stress Disorder 5a. CONTRACT NUMBER W81XWH-­‐07-­‐1-­‐0244...goal of Project 1 is to describe the progression of post -deployment stress disorders ( PTSD , major depression, suicidality) in active duty troops

Pathomechanics of Post-Traumatic OA Development in the Military Following Articular Fracture

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-15-2-0087 TITLE: Pathomechanics of Post -Traumatic OA Development in the Military Following Articular Fracture PRINCIPAL...Sep 2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Pathomechanics of Post -Traumatic OA Development in the Military Following Articular Fracture 5b...develop new models for predicting the risk of post -traumatic osteoarthritis (PTOA) following intra-articular fracture (IAF). We have analyzed pre

Functional Neuro-Imaging and Post-Traumatic Olfactory Impairment

PubMed Central

Roberts, Richard J.; Sheehan, William; Thurber, Steven; Roberts, Mary Ann

2010-01-01

Objective: To evaluate via a research literature survey the anterior neurological significance of decreased olfactory functioning following traumatic brain injuries. Materials and Methods: A computer literature review was performed to locate all functional neuro-imaging studies on patients with post-traumatic anosmia and other olfactory deficits. Results: A convergence of findings from nine functional neuro-imaging studies indicating evidence for reduced metabolic activity at rest or relative hypo-perfusion during olfactory activations. Hypo-activation of the prefrontal regions was apparent in all nine post-traumatic samples, with three samples yielding evidence of reduced activity in the temporal regions as well. Conclusions: The practical ramifications include the reasonable hypothesis that a total anosmic head trauma patient likely has frontal lobe involvement. PMID:21716782

Post-traumatic hypopituitarism and fatigue.

PubMed

Masel, Brent E; Zgaljardic, Dennis J; Forman, Jack

2017-10-01

Post-traumatic hypopituitarism (PTH) associated with chronic cognitive, psychiatric, and/or behavioural sequelae is common following moderate to severe traumatic brain injury (TBI). More specifically, due to a cascade of hormonal deficiencies secondary to PTH, individuals with TBI may experience debilitating fatigue that can negatively impact functional recovery, as it can limit participation in brain injury rehabilitation services and lead to an increase in maladaptive lifestyle practices. While the mechanisms underlying fatigue and TBI are not entirely understood, the current review will address the specific anatomy and physiology of the pituitary gland, as well as the association between pituitary dysfunction and fatigue in individuals with TBI.

Restless 'rest': intrinsic sensory hyperactivity and disinhibition in post-traumatic stress disorder.

PubMed

Clancy, Kevin; Ding, Mingzhou; Bernat, Edward; Schmidt, Norman B; Li, Wen

2017-07-01

Post-traumatic stress disorder is characterized by exaggerated threat response, and theoretical accounts to date have focused on impaired threat processing and dysregulated prefrontal-cortex-amygdala circuitry. Nevertheless, evidence is accruing for broad, threat-neutral sensory hyperactivity in post-traumatic stress disorder. As low-level, sensory processing impacts higher-order operations, such sensory anomalies can contribute to widespread dysfunctions, presenting an additional aetiological mechanism for post-traumatic stress disorder. To elucidate a sensory pathology of post-traumatic stress disorder, we examined intrinsic visual cortical activity (based on posterior alpha oscillations) and bottom-up sensory-driven causal connectivity (Granger causality in the alpha band) during a resting state (eyes open) and a passive, serial picture viewing state. Compared to patients with generalized anxiety disorder (n = 24) and healthy control subjects (n = 20), patients with post-traumatic stress disorder (n = 25) demonstrated intrinsic sensory hyperactivity (suppressed posterior alpha power, source-localized to the visual cortex-cuneus and precuneus) and bottom-up inhibition deficits (reduced posterior→frontal Granger causality). As sensory input increased from resting to passive picture viewing, patients with post-traumatic stress disorder failed to demonstrate alpha adaptation, highlighting a rigid, set mode of sensory hyperactivity. Interestingly, patients with post-traumatic stress disorder also showed heightened frontal processing (augmented frontal gamma power, source-localized to the superior frontal gyrus and dorsal cingulate cortex), accompanied by attenuated top-down inhibition (reduced frontal→posterior causality). Importantly, not only did suppressed alpha power and bottom-up causality correlate with heightened frontal gamma power, they also correlated with increased severity of sensory and executive dysfunctions (i.e. hypervigilance and impulse control

Electric Field Stimulation Enhances Healing of Post-Traumatic Osteoarthritic Cartilage

DTIC Science & Technology

2016-10-01

analyzed using ANOVA with Tukey’s post -hoc test (pɘ.05). RESULTS: In study 1, a proportion of synovial fibroblasts migrated to a maximum depth of ~250...AWARD NUMBER: W81XWH-14-1-0591 TITLE: Electric Field Stimulation Enhances Healing of Post -Traumatic Osteoarthritic Cartilage PRINCIPAL...COVERED 30 Sep 2015 – 29 Sep 2016 4. TITLE AND SUBTITLE Cartilage 5a. CONTRACT NUMBER Electric Field Stimulation Enhances Healing of Post -Traumatic

The Effect of Post Traumatic Stress Disorder on Military Leadership: An Historical Perspective

DTIC Science & Technology

2011-05-19

Post Traumatic Stress Disorder ( PTSD ) on military leadership. For over twenty years, the United States Army has used the Be...Introduction Multiple deployment cycles to Iraq and Afghanistan combat zones and the increase in Post - Traumatic Stress Disorder ( PTSD ) have resulted...Approved for Public Release; Distribution is Unlimited The Effect of Post Traumatic Stress Disorder on Military Leadership: An

[Comparative studies of the quality of the esophageal voice following laryngectomy: the insufflation test and reverse speech audiometry].

PubMed

Böhme, G; Clasen, B

1989-09-01

We carried out a transnasal insufflation test according to Blom and Singer on 27 laryngectomy patients as well as a speech communications test with the help of reverse speech audiometry, i.e. the post laryngectomy telephone test according to Zenner and Pfrang. The combined evaluation of both tests provided basic information on the quality of the esophagus voice and functionability of the speech organs. Both tests can be carried out quickly and easily and allow a differentiated statement to be made on the application possibilities of a esophagus voice, electronic speech aids and voice prothesis. Three groups could be identified from our results: 1. Insufflation test and reverse speech test provided conformable good or very good results. The esophagus voice was well understood. 2. Complete failure in the insufflation and telephone tests calls for further examinations to exclude any spasm, stricture, divertical and scarred membrane stenosis as well as tumor relapse in the region of the pharyngo-esophageal segments. 3. Organic causes must be looked for in the area of the nozzle as well as cranial nerve failure and social-determined causes in the case of normal insufflation and considerably reduced speech communication in the telephone test.

Synovial osteochondromatosis involvement in post-traumatic ankle injury.

PubMed

Lee, Daniel K; Louk, Louis; Bell, Bryan L

2008-01-01

Ankle involvement by synovial chondromatosis is unusual. It is unknown whether a post-traumatic event to the ankle induces the formation and development of these lesions. Synovial osteochondromatosis associated with post-traumatic ankle events are rare but suggest trauma to the synovial tissues as being causative, although this has never been statistically confirmed owing to the lack of reports and frequency. We report a case of primary synovial osteochondromatosis involving the tibiotalar joint with painful symptoms after a history of ankle injury, including magnetic resonance imaging findings of this unusual condition.

Post-traumatic headache: the use of the sport concussion assessment tool (SCAT-3) as a predictor of post-concussion recovery.

PubMed

Begasse de Dhaem, Olivia; Barr, William B; Balcer, Laura J; Galetta, Steven L; Minen, Mia T

2017-12-01

Given that post-traumatic headache is one of the most prevalent and long-lasting post-concussion sequelae, causes significant morbidity, and might be associated with slower neurocognitive recovery, we sought to evaluate the use of concussion screening scores in a concussion clinic population to assess for post-traumatic headache. This is a retrospective cross-sectional study of 254 concussion patients from the New York University (NYU) Concussion Registry. Data on the headache characteristics, concussion mechanism, concussion screening scores were collected and analyzed. 72% of the patients had post-traumatic headache. About half (56.3%) were women. The mean age was 35 (SD 16.2). 90 (35%) patients suffered from sport-related concussions (SRC). Daily post-traumatic headache patients had higher Sport Concussion Assessment Tool (SCAT)-3 symptom severity scores than the non-daily post-traumatic headache and the headache-free patients (50.2 [SD 28.2] vs. 33.1 [SD 27.5] vs. 21.6 SD23], p < 0.001). Patients with SRC had lower headache intensity (4.47 [SD 2.5] vs. 6.24 [SD 2.28], p < 0.001) and SCAT symptom severity scores (33.9 [SD 27.4] vs. 51.4 [SD 27.7], p < 0.001) than the other patients, but there were no differences in post-traumatic headache prevalence, frequency, and Standardized Assessment of Concussion (SAC) scores. The presence and frequency of post-traumatic headache are associated with the SCAT-3 symptom severity score, which is the most important predictor for post-concussion recovery. The SCAT-3 symptom severity score might be a useful tool to help characterize patients' post-traumatic headache.

Combat, Sexual Assault, and Post-Traumatic Stress in OIF/OEF Military Women

DTIC Science & Technology

2013-01-01

Traumatic Stress in OIF/OEF Military Women PRINCIPAL INVESTIGATOR: Anne G. Sadler, R.N., Ph.D. CONTRACTING ORGANIZATION: Iowa City VA...NUMBER Combat, Sexual Assault, and Post-Traumatic Stress in OIF/OEF Military Women 5b. GRANT NUMBER W81XWH-08-2-0080 5c. PROGRAM ELEMENT NUMBER...endpoints (e.g., post-traumatic stress disorder, traumatic brain injury) in four subgroups: 1) women deployed to combat related regions once; 2) women

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…

Persistent post-traumatic headache vs. migraine: an MRI study demonstrating differences in brain structure.

PubMed

Schwedt, Todd J; Chong, Catherine D; Peplinski, Jacob; Ross, Katherine; Berisha, Visar

2017-08-22

The majority of individuals with post-traumatic headache have symptoms that are indistinguishable from migraine. The overlap in symptoms amongst these individuals raises the question as to whether post-traumatic headache has a unique pathophysiology or if head trauma triggers migraine. The objective of this study was to compare brain structure in individuals with persistent post-traumatic headache (i.e. headache lasting at least 3 months following a traumatic brain injury) attributed to mild traumatic brain injury to that of individuals with migraine. Twenty-eight individuals with persistent post-traumatic headache attributed to mild traumatic brain injury and 28 individuals with migraine underwent brain magnetic resonance imaging on a 3 T scanner. Regional volumes, cortical thickness, surface area and curvature measurements were calculated from T1-weighted sequences and compared between subject groups using ANCOVA. MRI data from 28 healthy control subjects were used to interpret the differences in brain structure between migraine and persistent post-traumatic headache. Differences in regional volumes, cortical thickness, surface area and brain curvature were identified when comparing the group of individuals with persistent post-traumatic headache to the group with migraine. Structure was different between groups for regions within the right lateral orbitofrontal lobe, left caudal middle frontal lobe, left superior frontal lobe, left precuneus and right supramarginal gyrus (p < .05). Considering these regions only, there were differences between individuals with persistent post-traumatic headache and healthy controls within the right lateral orbitofrontal lobe, right supramarginal gyrus, and left superior frontal lobe and no differences when comparing the migraine cohort to healthy controls. In conclusion, persistent post-traumatic headache and migraine are associated with differences in brain structure, perhaps suggesting differences in their underlying

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. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

[Rational Rehabilitation in the treatment of post-traumatic stress disorder (PTSD). A pilot study].

PubMed

Tomasoa, A T; Appelo, M T

2007-01-01

In a randomised controlled study, a type of cognitive behavior therapy known as Rational Rehabilitation proved effective in the treatment of patients with chronic mental symptoms. Post-traumatic stress disorder is a serious illness that occurs frequently and can last for many years. Rational Rehabilitation may also be an effective treatment for post-traumatic stress disorder. To investigate, via a pilot study, on the effect of Rational Rehabilitation in patients with post-traumatic stress disorder, whether a randomised controlled study is called for. Nineteen patients with post-traumatic stress disorder, who were awaiting regular treatment, opted to join the study. The effect of Rational Rehabilitation was studied in relation to: symptoms of post-traumatic stress disorder, degree of happiness experienced, autonomy, social support and need for further treatment. results Rational Rehabilitation seems to have a positive effect on all outcome measures, except flashbacks. A controlled study of the effect of Rational Rehabilitation in patients with post-traumatic stress disorder seems justified.

POST Traumatic Stress Disorder in Emergency Workers: Risk Factors and Treatment

NASA Astrophysics Data System (ADS)

Argentero, Piergiorgio; Dell'Olivo, Bianca; Setti, Ilaria

Post traumatic stress disorder (PTSD) are emergent phenomena resulting from exposure to a traumatic event that causes actual or threatened death or injury and produces intense fear, helplessness, or horror. In order to assess the role of different factors contributing to this kind of emergent phenomenon prevalence rates across gender, cultures, and samples exposed to different traumas are examined. Risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and post-trauma interventions are examined as well. Several characteristics of the trauma, related to cognitions, post-trauma social support and therapeutic interventions for PTSD are also considered. Further work is needed in order to analyze the inter-relationships among these factors and underlying mechanisms. The chaotic nature of traumatic processes, the multiple and interactive impacts on traumatic events require a comprehensive perspective aimed at planning effective interventions. Treatment outcome studies recommended the combined use of training and therapies as first-line treatment for PTSD.

Measuring a new facet of post traumatic growth: Development of a scale of physical post traumatic growth in men with prostate cancer.

PubMed

Walsh, Deirdre M J; Groarke, Ann Marie; Morrison, Todd G; Durkan, Garrett; Rogers, Eamonn; Sullivan, Francis J

2018-01-01

This study developed a measure of physical post traumatic growth (physical post traumatic growth inventory; P-PTGI) in men with prostate cancer. A pool of items was created from themes identified in a qualitative study. A quantitative study was then conducted to assess the psychometric properties of the P-PTGI in a sample of 693 prostate cancer survivors. Tests of dimensionality revealed that the 20-item P-PTGI contained two factors: Health Autonomy and Health Awareness. Results demonstrated that scale score reliability for the P-PTGI and its subscales was excellent. In support of the scale's convergent validity, scores on the P-PTGI correlated positively with mindfulness and quality of life, and correlated negatively with depression and anxiety. A statistically significant correlation between the P-PTGI and another robust indicator of post traumatic growth attests to its concurrent validity. While further investigation of the P-PTGI's psychometric properties is required, preliminary findings are promising.

Improved Therapeutic Regimens for Treatment of Post-Traumatic Ocular Infections

DTIC Science & Technology

2009-05-01

TITLE: Improved Therapeutic Regimens for Treatment of Post- Traumatic Ocular Infections PRINCIPAL INVESTIGATOR: Michelle C. Callegan, Ph.D...From - To) 15 APR 2008 - 14 APR 2009 4. TITLE AND SUBTITLE Improved Therapeutic Regimens for Treatment of Post-Traumatic 5a. CONTRACT NUMBER...delay between injury and adequate treatment . This proposal was designed to analyze the effectiveness of antibiotics, anti- inflammatory drugs, and non

Improved Therapeutic Regimens for Treatment of Post-Traumatic Ocular Infections

DTIC Science & Technology

2008-05-01

Treatment of Post-Traumatic Ocular Infections PRINCIPAL INVESTIGATOR: Michelle C. Callegan, Ph.D. CONTRACTING...NUMBER Improved Therapeutic Regimens for Treatment of Post-Traumatic Ocular Infections 5b. GRANT NUMBER W81XWH-07-1-0280 5c. PROGRAM ELEMENT NUMBER...in arid environments and the delay between time of injury and adequate treatment . This proposal was designed to analyze the effectiveness of

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.

Post-Traumatic Stress Disorder, Depression and Anxiety among North Korean Refugees: A Meta-Analysis.

PubMed

Taylor, Benjamin Eric; Chekaluk, Eugene; Bennett, Joanne

2017-09-01

Post-traumatic stress disorder is common among North Korean refugees who have fled their country for economic, financial and humanitarian reasons. Co-morbid depression and anxiety are also common among North Korean refugees, due to the difficulties they have faced within their country and during their escape journey. Depression and anxiety complicate treatment for post-traumatic stress disorder, and lead to poorer outcomes. Thus, the aim of the present study was to provide a meta-analysis of studies investigating post-traumatic stress disorder, depression, and anxiety among North Korean refugees. Selected articles were published in English, and included measures of post-traumatic stress, and/or depression and anxiety. 10 studies were included in the depression meta-analysis, and 6 in the anxiety meta-analysis. A random-effects model revealed strong, significant associations between post-traumatic stress and depression, r=0.63, 95% CI (0.51, 0.72), p<0.001, z=8.33, and anxiety, r=0.51, 95% CI (0.36, 0.63), p<0.001, z=6.07. The relationships between post-traumatic stress, depression and anxiety were higher among adults and those with more than five years outside of North Korea. Depression appears to be an important treatment focus for North Korean refugees with post-traumatic stress.

Memories of Vietnam: post-traumatic stress disorders in Australian veterans.

PubMed

Tennant, C; Streimer, J H; Temperly, H

1990-03-01

We compared a random sample of Australian Vietnam veteran inpatients suffering from Post Traumatic Stress Disorder (PTSD) (N = 13) with veteran inpatients with other neurotic diagnoses. Those with PTSD had experienced substantially higher levels of combat stress, were more likely to have manifested conduct disorder in childhood, and had poorer work adjustment. Only three had been diagnosed as having traumatic or war neuroses by their original treating psychiatrist in the Veterans Affairs Department. Post traumatic stress disorder (or war neurosis) has possibly been under-diagnosed by treating psychiatrists in the Veterans Affairs Department, especially in the pre-DSM-III era.

Post-traumatic subtalar osteoarthritis: which grading system should we use?

PubMed

de Muinck Keizer, Robert-Jan O; Backes, Manouk; Dingemans, Siem A; Goslings, J Carel; Schepers, Tim

2016-09-01

To assess and compare post-traumatic osteoarthritis following intra-articular calcaneal fractures, one must have a reliable grading system that consistently grades the post-traumatic changes of the joint. A reliable grading system aids in the communication between treating physicians and improves the interpretation of research. To date, there is no consensus on what grading system to use in the evaluation of post-traumatic subtalar osteoarthritis. The objective of this study was to determine and compare the inter- and intra-rater reliability of two grading systems for post-traumatic subtalar osteoarthritis. Four observers evaluated 50 calcaneal fractures at least one year after trauma on conventional oblique lateral, internally and externally rotated views, and graded post-traumatic subtalar osteoarthritis using the Kellgren and Lawrence Grading Scale (KLGS) and the Paley Grading System (PGS). Inter- and intra-rater reliability were calculated and compared. The inter-rater reliability showed an intra-class correlation (ICC) of 0.54 (95 % CI 0.40-0.67) for the KLGS and an ICC of 0.41 (95 % CI 0.26 - 0.57) for the PGS. This difference was not statistically significant. The intra-rater reliability showed a mean weighted kappa of 0.62 for both the KLGS and the PGS. There is no statistically significant difference in reliability between the Kellgren and Lawrence Grading System (KLGS) and the Paley Grading System (PGS). The PGS allows for an easy two-step approach making it easy for everyday clinical purposes. For research purposes however, the more detailed and widely used KLGS seems preferable.

Prospective effects of traumatic event re-exposure and post-traumatic stress disorder in syringe exchange participants.

PubMed

Peirce, Jessica M; Brooner, Robert K; Kolodner, Ken; Schacht, Rebecca L; Kidorf, Michael S

2013-01-01

Determine the effect of traumatic event re-exposure and post-traumatic stress disorder (PTSD) symptom severity on proximal drug use and drug abuse treatment-seeking in syringe exchange participants. Prospective longitudinal 16-month cohort study of new syringe exchange registrants enrolled in a parent study of methods to improve treatment engagement. Data were collected in a research van next to mobile syringe exchange distribution sites in Baltimore, Maryland. Male and female (n = 162) injecting drug users (IDUs) registered for syringe exchange. Traumatic event re-exposure was identified each month with the Traumatic Life Events Questionnaire. PTSD symptoms were measured with the Modified PTSD Symptom Scale-Revised, given every 4 months. Outcome measures collected monthly were days of drug use (heroin, cocaine) and drug abuse treatment-seeking behavior (interest, calls to obtain treatment, treatment participation). Each traumatic event re-exposure was associated with about 1 more day of cocaine use after accounting for the previous month's cocaine use [same month adjusted B, standard error = 1.16 (0.34); 1 month later: 0.99 (0.34)], while PTSD symptoms had no effect. Traumatic event re-exposure increased interest in drug abuse treatment [same month adjusted odds ratios with 95% confidence intervals = 1.34 (1.11-1.63)] and calling to obtain treatment [same month 1.58 (1.24-2.01); 1 month later 1.34 (1.03-1.75)]. Each 10% increase in PTSD symptom severity was associated with persistent increased interest in treatment [same month 1.25 (1.10-1.42); 1 month later 1.16 (1.02-1.32); 2 months later 1.16 (1.02-1.32)] and calling to obtain treatment [same month 1.16 (1.02-1.32)]. Neither traumatic events nor PTSD symptoms were associated with participants receiving treatment. Becoming exposed again to traumatic events among injecting drug users is associated with an increase in cocaine use up to 1 month later, but drug use is not related to post-traumatic stress disorder

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…

The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups.

PubMed

Jin, Yuchang; Xu, Jiuping; Liu, Dongyue

2014-12-01

This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4%. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. One year following the earthquake, 40.1 and 51.1% of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected.

Post-traumatic seizure susceptibility is attenuated by hypothermia therapy

PubMed Central

Atkins, Coleen M.; Truettner, Jessie S.; Lotocki, George; Sanchez-Molano, Juliana; Kang, Yuan; Alonso, Ofelia F.; Sick, Thomas J.; Dietrich, W. Dalton; Bramlett, Helen M.

2010-01-01

Traumatic brain injury (TBI) is a major risk factor for the subsequent development of epilepsy. Currently, chronic seizures after brain injury are often poorly controlled by available anti-epileptic drugs. Hypothermia treatment, a modest reduction in brain temperature, reduces inflammation, activates pro-survival signaling pathways, and improves cognitive outcome after TBI. Given the well-known effect of therapeutic hypothermia to ameliorate pathological changes in the brain after TBI, we hypothesized that hypothermia therapy may attenuate the development of post-traumatic epilepsy and some of the pathomechanisms that underlie seizure formation. To test this hypothesis, adult male Sprague Dawley rats received moderate parasagittal fluid-percussion brain injury, and then were maintained at normothermic or moderate hypothermic temperatures for 4 hr. At 12 weeks after recovery, seizure susceptibility was assessed by challenging the animals with pentylenetetrazole (PTZ), a GABAA receptor antagonist. PTZ elicited a significant increase in seizure frequency in TBI normothermic animals as compared to sham surgery animals and this was significantly reduced in TBI hypothermic animals. Early hypothermia treatment did not rescue chronic dentate hilar neuronal loss, nor did it improve loss of doublecortin-labeled cells in the dentate gyrus post-seizure. However, mossy fiber sprouting was significantly attenuated by hypothermia therapy. These findings demonstrate that reductions in seizure susceptibility after TBI are improved with post-traumatic hypothermia and provide a new therapeutic avenue for the treatment of post-traumatic epilepsy. PMID:21044182

Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report

PubMed Central

2009-01-01

A 25-year-old male military veteran presented with diagnoses of post concussion syndrome and post traumatic stress disorder three years after loss of consciousness from an explosion in combat. The patient underwent single photon emission computed tomography brain blood flow imaging before and after a block of thirty-nine 1.5 atmospheres absolute hyperbaric oxygen treatments. The patient experienced a permanent marked improvement in his post-concussive symptoms, physical exam findings, and brain blood flow. In addition, he experienced a complete resolution of post-traumatic stress disorder symptoms. After treatment he became and has remained employed for eight consecutive months. This case suggests a novel treatment for the combined diagnoses of blast-induced post-concussion syndrome and post-traumatic stress disorder. PMID:19829822

Anticonvulsants to treat post-traumatic stress disorder.

PubMed

Wang, Hee Ryung; Woo, Young Sup; Bahk, Won-Myong

2014-09-01

We reviewed the existing literature on the efficacy of anticonvulsants in treating post-traumatic stress disorder. We performed a literature search using PubMed, EMBASE and the Cochrane database on 30 September 2013. Randomized,controlled studies that investigated the efficacy of anticonvulsants for post-traumatic stress disorder were included in this review. Studies with retrospective designs, case reports and case series were excluded. A total of seven studies met the inclusion criteria for this review. Three studies used topiramate with negative findings regarding its efficacy. Two studies used divalproex, both of which failed to show superiority over placebo. One study used lamotrigine, with favourable results, and one study used tiagabine, with negative results. Future long-term studies with larger sample sizes are needed to investigate the clinical utility of anticonvulsants for posttraumatic stress disorder treatment.

Assessment of Biomarkers Associated with Joint Injury and Subsequent Post-Traumatic Arthritis

DTIC Science & Technology

2015-10-01

Post-traumatic arthritis, post-traumatic osteoarthritis, articular fracture, joint injury, trauma, biomarker, inflammation, MRI , knee, mouse model...will be collected prior to or at surgical intervention. MRI imaging of the injured knee will be obtained to assess the articular cartilage...and the development of PTA. We have successfully enrolled patients, collected and stored biosamples, obtained all post-operative MRI scans and are

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. © 2014 European Sleep Research Society.

Bioengineered Hydrogel to Inhibit Post-Traumatic Central Nervous System Scarring

DTIC Science & Technology

2016-10-01

AWARD NUMBER: W81XWH-14-1-0586 TITLE: Bioengineered Hydrogel to Inhibit Post-Traumatic Central Nervous System Scarring PRINCIPAL INVESTIGATOR...Bioengineered Hydrogel to Inhibit Post-Traumatic Central Nervous System Scarring 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH- 14-1-0586 5c. PROGRAM ELEMENT...cavitations that are not spontaneously repaired. Early after injury, blood enters the central nervous system (CNS) and directly kills brain cells but also

Bioengineered Hydrogel to Inhibit Post-Traumatic Central Nervous System Scarring

DTIC Science & Technology

2016-10-01

AWARD NUMBER: W81XWH-14-1-0586 TITLE: Bioengineered Hydrogel to Inhibit Post-Traumatic Central Nervous System Scarring PRINCIPAL...Hydrogel to Inhibit Post-Traumatic Central Nervous System Scarring 5a. CONTRACT NUMBER W81XWH-14-1-0586 5b. GRANT NUMBER W81XWH- 14-1-0586 5c...barriers that prevent the optimal delivery of biologics and cells to the injured nervous system . A significant problem is the formation of scar tissue

Incidence and Psychophysiology of Post-Traumatic Stress Disorder in Breast Cancer Victims and Witnesses

DTIC Science & Technology

1997-10-01

stressful events such as military combat or violent rape can and do produce post - traumatic stress disorder ( PTSD ), the ability of less acute...Psychophysiology of Post - Traumatic Stress Disorder in Breast Cancer Victims and Witnesses PRINCIPAL INVESTIGATOR: Roger K. Pitman, M.D. CONTRACTING ORGANIZATION...Psychophysiology of Post - Traumatic Stress Disorder in Breast Cancer Victims and Witnesses DAMD17-94-J-4365 6. AUTHOR(S) Roger

Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation

PubMed Central

Kroemeke, Aleksandra; Bargiel-Matusiewicz, Kamilla; Kalamarz, Magdalena

2017-01-01

Objectives: Post-traumatic growth (PTG) and its opposite—post-traumatic depreciation (PTD)—may be treated as important indicators of the patient quality of life. In the absence of studies on both, PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership. Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied. Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG (R2 = 0.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD (R2 = 0.14). Four groups of PTG × PTD symptoms were identified: high PTG low PTD group (52.4%), low PTG low PTD group (17.9%), high PTG high PTD group (15.5%), and low PTG high PTD group (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the high PTD low PTG group (R2 = 0.41). Conclusion: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women. PMID:28775703

Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation.

PubMed

Kroemeke, Aleksandra; Bargiel-Matusiewicz, Kamilla; Kalamarz, Magdalena

2017-01-01

Objectives: Post-traumatic growth (PTG) and its opposite-post-traumatic depreciation (PTD)-may be treated as important indicators of the patient quality of life. In the absence of studies on both, PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership. Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied. Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG ( R 2 = 0.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD ( R 2 = 0.14). Four groups of PTG × PTD symptoms were identified: high PTG low PTD group (52.4%), low PTG low PTD group (17.9%), high PTG high PTD group (15.5%), and low PTG high PTD group (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the high PTD low PTG group ( R 2 = 0.41). Conclusion: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women.

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.…

Traumatic stressors and post-traumatic stress disorder symptoms in headache patients.

PubMed

de Leeuw, Reny; Schmidt, John E; Carlson, Charles R

2005-01-01

The aim of this study was to assess the prevalence of significant traumatic stressors and post-traumatic stress disorder (PTSD) symptoms in a headache population. Several recent publications have emphasized the relationship between life stressors and/or daily hassles and recurrent headaches. However, little is known about the prevalence and impact of major traumatic stressors in patients with recurrent headaches. Eighty patients with either migraine or tension-type headache completed a PTSD checklist. Data were compared with those from patients with chronic masticatory muscle pain of similar intensity and duration. Almost 64% of the headache patients reported one or more major traumatic stressors. This percentage was not significantly different from that of the comparison group, and fell within the broad range reported for exposure to traumatic stressors in epidemiologic studies with nonpatient populations. One out of 6 patients in the total headache sample, and 1 out of 4 of those reporting a traumatic stressor, reported symptoms suggestive of current PTSD. The prevalence of current PTSD-like symptomatology reported by the headache patients was comparable to that of the comparison group of the present study, but higher than that reported for the general population in the available literature printed in English. Traumatic stressors most often reported were not related to direct physical trauma, but rather associated with loss or serious illness of a loved one. Exposure to traumatic events in patients with a primary diagnosis of recurrent headaches is similar to that reported for chronic masticatory muscle pain patients or nonpatient populations. However, symptoms consistent with a diagnosis of current PTSD appear to be more frequent in patients with recurrent headaches than reported in the scientific literature printed in English for nonpatient populations. Screening for PTSD symptomatology is recommended as part of the routine clinical evaluation of headache.

Unique relations between post-traumatic stress disorder symptoms and patient functioning in type 2 diabetes.

PubMed

Arigo, Danielle; Juth, Vanessa; Trief, Paula; Wallston, Kenneth; Ulbrecht, Jan; Smyth, Joshua M

2017-08-01

This study examined reported post-traumatic stress disorder symptoms in adults with poorly controlled type 2 diabetes who had no history of psychiatric diagnosis or treatment ( n = 184, M HbA1c  = 9.13%, standard deviation = 1.68). Participants reported moderate to severe intensity of post-traumatic stress disorder symptoms ( M = 19.17, SD = 17.58). Together, depressive and post-traumatic stress disorder symptoms accounted for 10-40 percent of the variance in type 2 diabetes outcomes; post-traumatic stress disorder symptoms were associated with elevated diabetes distress and more frequent exercise and self-blood glucose testing (unique R 2  ~ 3%). Post-traumatic stress disorder symptoms may be overlooked in type 2 diabetes among patients without formal psychiatric diagnoses, and warrant increased attention.

The impact of subjective birth experiences on post-traumatic stress symptoms: a longitudinal study.

PubMed

Garthus-Niegel, Susan; von Soest, Tilmann; Vollrath, Margarete E; Eberhard-Gran, Malin

2013-02-01

The aim of this prospective study was to examine the etiology of post-traumatic stress symptoms following childbirth within a transactional framework of stress. Participants were women (N = 1,499) from the Akershus Birth Cohort. These women were followed from pregnancy to 8 weeks postpartum. We modeled predisposing factors (e.g., fear of childbirth) and precipitating factors (subjective and objective birth experiences) as predictors of post-traumatic stress symptoms. Post-traumatic stress symptoms were measured by means of the Impact of Event Scale, objective birth experiences by means of birth journals, and subjective birth experiences by means of three questions. A structural equation model showed that subjective birth experiences had the highest association with post-traumatic stress symptoms. Moreover, they mediated the effect of predisposing factors and objective birth experiences. The results suggest that women's subjective birth experiences are the most important factor in the development of post-traumatic stress symptoms following childbirth.

Comparison Of Efficacy Of Phenytoin And Levetiracetam For Prevention Of Early Post Traumatic Seizures.

PubMed

Khan, Shahbaz Ali; Bhatti, Sajid Nazir; Khan, Aftab Alam; Khan Afridi, Ehtisham Ahmed; Muhammad, Gul; Gul, Nasim; Zadran, Khalid Khan; Alam, Sudhair; Aurangzeb, Ahsan

2016-01-01

The incidence of early post-traumatic seizures after civilian traumatic brain injury ranges 4-25%. The control of early post-traumatic seizure is mandatory because these acute insults may add secondary damage to the already damaged brain with poor outcome. Prophylactic use of anti-epileptic drugs have been found to be have variable efficacy against early post-traumatic seizures. The objective of this study was to compare the efficacy of Phenytion and Levetiracetam in prevention of early post-traumatic seizures in moderate to severe traumatic brain injury. This randomized controlled trial was conducted in department of Neurosurgery, Ayub Medical College, Abbottabad from March, 2012 to March 2013. The patients with moderate to severe head injury were randomly allocated in two groups. Patients in group A were given phenytoin and patients in group B were given Levetiracetam. Patients were followed for one week to detect efficacy of drug in terms of early post traumatic seizures. The 154 patients included in the study were equally divided into two groups. Out of 154 patients 115 (74.7%) were male while 29 (25.3%) were females. Age of patients ranges from 7-48 (24.15±9.56) years. Ninety one (59.1%) patients had moderate head injury while 63 (40.9%) patients had severe head injury. Phenytoin was effective in preventing early post traumatic seizures in 73 (94.8%) patients whereas Levetiracetam effectively controlled seizures in 70 (90.95%) cases (p-value of .348). There is no statistically significant difference in the efficacy of Phenytoin and Levetiracetam in prophylaxis of early posttraumatic seizures in cases of moderate to severe traumatic brain injury.

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

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.

[Labour factors associated with post-traumatic stress in uniformed workers in Medellín].

PubMed

González-Penagos, Catalina; Moreno-Bedoya, Juan P; Berbesi-Fernández, Dedsy Y; Segura-Cardona, Angela M

2013-01-01

Determining the labor factors associated with post-traumatic stress in uniformed workers in Medellin. A cross-sectional study was made of 124 uniformed workers aged 20 to 48 years-old. A survey was made using an adults' post-traumatic stress instrument which had been validated in Medellin. Statistical analysis was carried out. Post-traumatic stress disorder risk prevalence was 52.2 %. Multivariate analysis showed that the highest risk situations were those related to previous mental health diagnosis (PR=7.67), working schedule (4.24), violent episodes (PR=3.59) and community relationships (PR=2.73). A person's current labor situation seemed to be a risk factor for developing post-traumatic stress in the target population.

Cognitive-behaviour therapy for post-traumatic stress in schizophrenia. A randomized controlled trial.

PubMed

Steel, C; Hardy, A; Smith, B; Wykes, T; Rose, S; Enright, S; Hardcastle, M; Landau, S; Baksh, M F; Gottlieb, J D; Rose, D; Mueser, K T

2017-01-01

There is limited evidence for effective interventions in the treatment of post-traumatic stress symptoms within individuals diagnosed with schizophrenia. Clinicians have concerns about using exposure treatments with this patient group. The current trial was designed to evaluate a 16-session cognitive restructuring programme, without direct exposure, for the treatment of post-traumatic stress symptoms specifically within individuals diagnosed with schizophrenia. A multicentre randomized controlled single-blinded trial with assessments at 0 months, 6 months (post-treatment) and 12 months (follow-up) was conducted. A total of 61 participants diagnosed with schizophrenia and exhibiting post-traumatic stress symptoms were recruited. Those randomized to treatment were offered up to 16 sessions of cognitive-behaviour therapy (CBT, including psychoeducation, breathing training and cognitive restructuring) over a 6-month period, with the control group offered routine clinical services. The main outcome was blind rating of post-traumatic stress symptoms using the Clinician Administered PTSD Scale for Schizophrenia. Secondary outcomes were psychotic symptoms as measured by the Positive and Negative Symptom Scale and the Psychotic Symptom Rating Scale. Both the treatment and control groups experienced a significant decrease in post-traumatic stress symptoms over time but there was no effect of the addition of CBT on either the primary or secondary outcomes. The current trial did not demonstrate any effect in favour of CBT. Cognitive restructuring programmes may require further adaptation to promote emotional processing of traumatic memories within people diagnosed with a psychotic disorder.

Spontaneous regression of retro-odontoid post traumatic cicatrix following occipitocervical fixation.

PubMed

Sinha, Priyank; Lee, Ming-Te; Panbehchi, Sasan; Saxena, Ankur; Pal, Debasish

2017-01-01

This case report describes a patient who presented with myelopathy secondary to a large retro-odontoid post traumatic cicatrix. The objective of this study was to discuss the clinical presentation, pathogenesis, imaging, and surgical management of pseudoarthrosis tissue mass associated with odontoid nonunion. Atlantoaxial subluxation (AAS) has been widely reported in patients with rheumatoid arthritis. AAS leads to repeated cycles of partial tear and repair of ligaments around the altantoaxial complex, resulting in the formation of periodontoid mass (pseudotumor). It is thought that formation of retro-odontoid post traumatic mass (cicatrix), in certain cases of odontoid fracture, is because of similar pathology. This is a retrospective review of case note. Here, the patient underwent posterior decompression through a C1-C2 laminectomy and occipitocervical (C0-C4) fusion with instrumentation, which resulted in dramatic improvement in his symptoms and spontaneous regression of retro-odontoid post traumatic cicatrix. We have described an interesting and a rare case of a large pseudoarthrosis tissue mass associated with odontoid nonunion, which regressed following stand-alone posterior instrumentation. To the best of our knowledge, only a handful of such cases of spontaneous regression of retro-odontoid post traumatic cicatrix following occipitocervical fixation have been described in literature, and our case adds to the growing list of such cases and may help in understanding the natural history of the disease process one day. Although rare, post traumatic cicatrix should be considered as a differential diagnosis of enhancing retro-odontoid mass, especially if there is any history of cervical spine trauma.

Acute post-traumatic stress symptoms and age predict outcome in military blast concussion.

PubMed

Mac Donald, Christine L; Adam, Octavian R; Johnson, Ann M; Nelson, Elliot C; Werner, Nicole J; Rivet, Dennis J; Brody, David L

2015-05-01

High rates of adverse outcomes have been reported following blast-related concussive traumatic brain injury in US military personnel, but the extent to which such adverse outcomes can be predicted acutely after injury is unknown. We performed a prospective, observational study of US military personnel with blast-related concussive traumatic brain injury (n = 38) and controls (n = 34) enrolled between March and September 2012. Importantly all subjects returned to duty and did not require evacuation. Subjects were evaluated acutely 0-7 days after injury at two sites in Afghanistan and again 6-12 months later in the United States. Acute assessments revealed heightened post-concussive, post-traumatic stress, and depressive symptoms along with worse cognitive performance in subjects with traumatic brain injury. At 6-12 months follow-up, 63% of subjects with traumatic brain injury and 20% of controls had moderate overall disability. Subjects with traumatic brain injury showed more severe neurobehavioural, post-traumatic stress and depression symptoms along with more frequent cognitive performance deficits and more substantial headache impairment than control subjects. Logistic regression modelling using only acute measures identified that a diagnosis of traumatic brain injury, older age, and more severe post-traumatic stress symptoms provided a good prediction of later adverse global outcomes (area under the receiver-operating characteristic curve = 0.84). Thus, US military personnel with concussive blast-related traumatic brain injury in Afghanistan who returned to duty still fared quite poorly on many clinical outcome measures 6-12 months after injury. Poor global outcome seems to be largely driven by psychological health measures, age, and traumatic brain injury status. The effects of early interventions and longer term implications of these findings are unknown. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All

Pathomechanics of Post-Traumatic OA Development in the Military Following Articular Fracture

DTIC Science & Technology

2016-10-01

post -op CT) associated with IAFs, but more patient data are needed to make the risk models clinically useful. Prospective studies of PTOA...AWARD NUMBER: W81XWH-15-2-0087 TITLE: Pathomechanics of Post -Traumatic OA Development in the Military Following Articular Fracture PRINCIPAL...29 Sep 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Pathomechanics of Post -Traumatic OA Development in the Military Following Articular Fracture

Post-traumatic growth in parents after a child's admission to intensive care: maybe Nietzsche was right?

PubMed

Colville, Gillian; Cream, Penelope

2009-05-01

The aim of this prospective study was to establish the degree to which parents report post-traumatic growth after the intensive care treatment of their child. Prospective cross-sectional cohort study. Paediatric Intensive Care Unit (PICU). A total of 50 parents of children, admitted to PICU for >12 h. Parents provided stress ratings as their child was discharged from PICU and, 4 months later, completed postal questionnaires rating their anxiety, depression, post-traumatic stress and post-traumatic growth. As much as 44 parents (88%) indicated on the Posttraumatic Growth Inventory (PTGI) [1] that they had experienced a positive change to a great degree as a result of their experiences in PICU. Parents of children who were ventilated (P = 0.024) reported statistically higher post-traumatic growth as did parents of older children (P = 0.032). PTGI scores were positively correlated with post-traumatic stress scores at 4 months (P = 0.021), but on closer inspection this relationship was found to be curvilinear. Post-traumatic growth emerged as a salient concept for this population. It was more strongly associated with moderate levels of post-traumatic stress, than high or low levels.

Fetal blood gas values during fetoscopic myelomeningocele repair performed under carbon dioxide insufflation.

PubMed

Baschat, Ahmet A; Ahn, Edward S; Murphy, Jamie; Miller, Jena L

2018-05-10

Fetoscopic myelomeningocele (MMC) repair is performed with intrauterine carbon dioxide (CO 2 ) insufflation. While lamb experiments have shown significant fetal acidemia following CO 2 insufflation corresponding information for human pregnancies is not available. We performed umbilical venous cord blood sampling in three patients during fetoscopic MMC repair at 25+1, 25+3 and 24+1 weeks gestation. Fetal venous pH at the beginning of CO 2 insufflation were 7.36, 7.46 and 7.37; repeat values were 7.28, 7.35, 7.36 after 181, 159 and 149 minutes respectively. The partial pressure of oxygen and carbon dioxide was maintained in the normal range at these times and pH decrease was less in patient 3 receiving humidified CO2 insufflation. Our observations suggest that in contrast to sheep experiments, CO2 insufflation during fetoscopic myelomeningocele repair does not cause fetal acidemia. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

"In my before life": relationships, coping and post-traumatic growth in adolescent survivors of a traumatic brain injury.

PubMed

Di Battista, Ashley; Godfrey, Celia; Soo, Cheryl; Catroppa, Cathy; Anderson, Vicki

2014-11-01

Explore the individual, adolescent phenomeno-logy of quality of life after traumatic brain injury. Adolescent survivors of traumatic brain injury. Qualitative interviews with 10 adolescents, mean age at assessment 17.09 years (SD 1.81). Mean time since injury 4.62 years (SD 2.89). Data were analysed using a primarily interpretative phenomenological analysis approach. Two major findings: (1) perceived quality of life was not automatically impacted by a traumatic brain injury, but when it was, the directionality of impact (positive, negative) varied depending on the life-domain; (2) changes in ability post-traumatic brain injury were attributed to the injury (more often cognitive and physical changes) or to a sense of normal maturation processes (72% and 28%, respectively). Attribution processing permeated themes of personal and social discrepancies, which also yielded themes of: altered family and relationships, roles, responsibilities, independence, coping and post-traumatic growth. All participants reported a happy life at the time of interview. The adolescents' appraisal of their identity from pre- to post-injury life was related to their current sense of well-being. Most notably was the sense of balance; participants addressed the negative and positive consequences of brain injury to qualify their sense of wellbeing.

Patient Outcomes in Varying Length Post Traumatic Stress Disorder Programs at the Denver VA Medical Center

DTIC Science & Technology

1998-06-16

Post Traumatic Stress Disorder ( PTSD ...Outcomes 2 Abstract The Department of Veterans Affairs (DVA) has provided a number of treatment programs for Post Traumatic Stress Disorder ( PTSD ) including...D.C. Department of Veterans Affairs (1991). A Program Evaluation of the Department of Veterans Affairs Post Traumatic Stress Disorder ( PTSD )

Post-traumatic stress disorder in intensive care unit patients.

PubMed

Caiuby, Andrea Vannini Santesso; Andreoli, Paola Bruno de Araújo; Andreoli, Sergio Baxter

2010-03-01

Post-traumatic stress disorder has been detected in patients after treatment in intensive care unit. The main goal of this study is to review the psychological aspects and therapeutic interventions on those patients after their treatment on intensive care unit. Thirty eight articles have been included. The prevalence of post-traumatic stress disorder has varied from 17% up to 30% and the incidence from 14% to 24%. The risk factors were: previous anxiety historic, depression or panic, having delusional traumatic memories (derived from psychic formations as dreams and delirium), belief effects, depressive behavior, stressing experiences and mechanical ventilation. High doses of opiates, symptoms caused by sedation or analgesia reduction and the use of lorazepam were related with the increase of delirium and delusional memory. The disorder sintomatology can be reduced with hydrocortisone administration, with daily sedation interruption. No other effectiveness psychological intervention study was found.

NKCC1 up-regulation contributes to early post-traumatic seizures and increased post-traumatic seizure susceptibility.

PubMed

Wang, Fushun; Wang, Xiaowei; Shapiro, Lee A; Cotrina, Maria L; Liu, Weimin; Wang, Ernest W; Gu, Simeng; Wang, Wei; He, Xiaosheng; Nedergaard, Maiken; Huang, Jason H

2017-04-01

Traumatic brain injury (TBI) is not only a leading cause for morbidity and mortality in young adults (Bruns and Hauser, Epilepsia 44(Suppl 10):210, 2003), but also a leading cause of seizures. Understanding the seizure-inducing mechanisms of TBI is of the utmost importance, because these seizures are often resistant to traditional first- and second-line anti-seizure treatments. The early post-traumatic seizures, in turn, are a contributing factor to ongoing neuropathology, and it is critically important to control these seizures. Many of the available anti-seizure drugs target gamma-aminobutyric acid (GABA A ) receptors. The inhibitory activity of GABA A receptor activation depends on low intracellular Cl - , which is achieved by the opposing regulation of Na + -K + -Cl - cotransporter 1 (NKCC1) and K + -Cl - -cotransporter 2 (KCC2). Up-regulation of NKCC1 in neurons has been shown to be involved in neonatal seizures and in ammonia toxicity-induced seizures. Here, we report that TBI-induced up-regulation of NKCC1 and increased intracellular Cl - concentration. Genetic deletion of NKCC1 or pharmacological inhibition of NKCC1 with bumetanide suppresses TBI-induced seizures. TGFβ expression was also increased after TBI and competitive antagonism of TGFβ reduced NKKC1 expression, ameliorated reactive astrocytosis, and inhibited seizures. Thus, TGFβ might be an important pathway involved in NKCC1 up-regulation after TBI. Our findings identify neuronal up-regulation of NKCC1 and its mediation by TGFβ, as a potential and important mechanism in the early post-traumatic seizures, and demonstrate the therapeutic potential of blocking this pathway.

Heated insufflation with or without humidification for laparoscopic abdominal surgery.

PubMed

Birch, Daniel W; Dang, Jerry T; Switzer, Noah J; Manouchehri, Namdar; Shi, Xinzhe; Hadi, Ghassan; Karmali, Shahzeer

2016-10-19

Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible. Past studies on heated insufflation have shown inconclusive results with regards to maintenance of core temperature and reduction of postoperative pain and recovery times. To determine the effect of heated gas insufflation compared to cold gas insufflation on maintaining intraoperative normothermia as well as patient outcomes following laparoscopic abdominal surgery. We searched Cochrane Colorectal Cancer Specialised Register (September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, Issue 8), Ovid MEDLINE (1950 to September 2016), Ovid Embase (1974 to September 2016), International Pharmaceutical Abstracts (IPA) (September 2016), Web of Science (1985 to September 2016), Scopus, www.clinicaltrials.gov and the National Research Register (1956 to September 2016). We also searched grey literature and cross references. Searches were limited to human studies without language restriction. Only randomised controlled trials comparing heated (with or without humidification) with cold gas insufflation in adult and paediatric populations undergoing laparoscopic abdominal procedures were included. We assessed study quality in regards to relevance, design, sequence generation, allocation concealment, blinding, possibility of incomplete data and selective reporting. Two review authors independently selected studies for the review, with any disagreement resolved in consensus with a third co-author. Two review authors independently performed screening of eligible studies, data extraction and methodological quality assessment of the trials. We classified a study as low-risk of bias if all of the first six main

Clinical and electrophysiological features of post-traumatic Guillain-Barré syndrome.

PubMed

Li, Xiaowen; Xiao, Jinting; Ding, Yanan; Xu, Jing; Li, Chuanxia; He, Yating; Zhai, Hui; Xie, Bingdi; Hao, Junwei

2017-07-27

Post-traumatic Guillain-Barré syndrome (GBS) is a rarely described potentially life-threatening cause of weakness. We sought to elucidate the clinical features and electrophysiological patterns of post-traumatic GBS as an aid to diagnosis. We retrospectively studied six patients diagnosed with post-traumatic GBS between 2014 and 2016 at Tianjin Medical University General Hospital, China. Clinical features, serum analysis, lumbar puncture results, electrophysiological examinations, and prognosis were assessed. All six patients had different degrees of muscular atrophy at nadir and in two, respiratory muscles were involved. Five also had damaged cranial nerves and four of these had serum antibodies against gangliosides. The most common electrophysiological findings were relatively normal distal latency, prominent reduction of compound muscle action potential amplitude, and absence of F-waves, which are consistent with an axonal form of GBS. It is often overlooked that GBS can be triggered by non-infectious factors such as trauma and its short-term prognosis is poor. Therefore, it is important to analyze the clinical and electrophysiological features of GBS after trauma. Here we have shown that electrophysiological evaluations are helpful for diagnosing post-traumatic GBS. Early diagnosis may support appropriate treatment to help prevent morbidity and improve prognosis.

The Role of an Aggrecan 32mer Fragment in Post-Traumatic Osteoarthritis

DTIC Science & Technology

2017-10-01

Award Number: W81XWH-16-1-0706 TITLE: The Role of an Aggrecan 32mer Fragment in Post -Traumatic Osteoarthritis PRINCIPAL INVESTIGATOR: Professor...TITLE AND SUBTITLE The Role of an Aggrecan 32mer Fragment in Post - Traumatic Osteoarthritis 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-16-1-0706 5c...reduction in knee hyperalgesia, but not mechanical allodynia, in mice at 8 weeks post -surgery. This trend was not statistically significant, however, we are

Autobiographical integration of trauma memories and repressive coping predict post-traumatic stress symptoms in undergraduate students.

PubMed

Smeets, Tom; Giesbrecht, Timo; Raymaekers, Linsey; Shaw, Julia; Merckelbach, Harald

2010-01-01

What differentiates those who are able to adapt well to adverse life events (i.e., persons who are resilient) from those who are not (e.g., persons who develop post-traumatic stress symptoms)? Previous work suggests that enhanced autobiographical integration of trauma memories is associated with more severe post-traumatic stress symptoms. Extending this line of work, the present study looked at whether the integration of trauma memories, repressive coping and cognitive reactivity are related to post-traumatic stress symptomatology following negative life events among otherwise healthy young adults (N = 213). Results show that while enhanced integration of trauma memories and high levels of dissociation are related to elevated levels of post-traumatic stress, people who generally engage in repressive coping report fewer post-traumatic stress symptoms. Copyright (c) 2009 John Wiley & Sons, Ltd.

[Post-traumatic stress disorder and psychological debriefing: a controversial topic].

PubMed

Debabèche, C; Ansseau, M; Pitchot, W

2012-01-01

The last decades have demonstrated the value of early interventions after a traumatic event. The purpose of these interventions is to prevent the development of psychological consequences such as post-traumatic stress disorder. Psychological debriefing is clearly the most popular intervention. However, in the literature, it is subject to a real controversy. The objective of the present paper is to define the interest of psychological debriefing, but also alternative therapeutical strategies for people exposed to traumatic events.

Post-Traumatic Stress Disorder: MedlinePlus Health Topic

MedlinePlus

... of this page: https://medlineplus.gov/posttraumaticstressdisorder.html Post-Traumatic Stress Disorder Also called: PTSD On this page Basics Summary Start Here Diagnosis and Tests Treatments and Therapies Learn More Living With Related ...

JaK/STAT Inhibition to Prevent Post-Traumatic Epileptogenesis

DTIC Science & Technology

2014-09-01

NOTES 14. ABSTRACT Traumatic Brain Injury (TBI) is a well-established inducer of temporal lobe epilepsy (TLE), a frequently medically intractable... epilepsy syndrome. The controlled cortical impact (CCI) model of posttraumatic epilepsy in mice is a well established animal model of TBI that results...reduce development of post-traumatic epilepsy , and did not significantly improve memory function, but did enhance the motor recovery. These findings

Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder.

PubMed

Xi, Er-Ping; Zhu, Jian; Zhu, Shui-Bo; Yin, Gui-Lin; Liu, Yong; Dong, Yong-Qiang; Zhang, Yu; Xia, Feng

2012-11-01

Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder. We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs) of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen) Co., LTD, Guangdong, China) utilizing standard techniques. Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology. Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective.

Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder

PubMed Central

Xi, Er-Ping; Zhu, Jian; Zhu, Shui-Bo; Yin, Gui-Lin; Liu, Yong; Dong, Yong-Qiang; Zhang, Yu; Xia, Feng

2012-01-01

OBJECTIVE: Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder. METHODS: We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs) of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen) Co., LTD, Guangdong, China) utilizing standard techniques. RESULTS: Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology. CONCLUSION: Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective. PMID:23184204

The protective role of maternal post-traumatic growth and cognitive trauma processing in Palestinian mothers and infants: a longitudinal study.

PubMed

Diab, Safwat Y; Isosävi, Sanna; Qouta, Samir R; Kuittinen, Saija; Punamäki, Raija-Leena

2018-02-21

Women at pre partum and post partum are especially susceptible to war trauma because they struggle to protect their infants from danger. Trauma research suggests increased problems in maternal mental health and infant development. Yet many cognitive-emotional processes affect the trauma survivors' mental health, such as post-traumatic growth and post-traumatic cognition. The aim of this study was to examine whether a mother's high post-traumatic growth and optimal post-traumatic cognition could protect their own mental health and their infant's stress regulation from the effects of traumatic war experiences. This three-wave prospective study involved Palestinian women living in the Gaza Strip who were at the second trimester of pregnancy (T1), women with infants aged 4 months (T2), and women with children aged 12 months (T3) months. The participants reported their war experiences in a 30-item checklist of losses, destruction, and atrocities in the 2008-09, 2012, and 2014 military offensives. Post-traumatic growth was assessed by a 21-item scale and post-traumatic cognition by a 36-item scale. Maternal mental health was assessed by post-traumatic stress disorder (PTSD), depressive, anxiety, and dissociation symptoms at T1 and T3, and infants' stress regulation was assessed with the Infant Behaviour Questionnaire at T2 and T3. We included 511 women at T1, 481 women at T2, and 454 women at T3. High maternal post-traumatic growth and post-traumatic cognition had protective roles. Post-traumatic growth had a protective effect on maternal mental health since severe exposure to traumatic war experiences was not associated with maternal PTSD, depression, and dissociation if women showed high post-traumatic growth, as indicated by the significant interaction effect between post-traumatic growth and war trauma on each of the three symptoms. Post-traumatic cognition had a protective effect on infant development since severe exposure was not associated with dysfunctional

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

Longitudinal associations between post-traumatic distress and depressive symptoms following a traumatic event: a test of three models.

PubMed

Schindel-Allon, I; Aderka, I M; Shahar, G; Stein, M; Gilboa-Schechtman, E

2010-10-01

Symptoms of post-traumatic stress disorder (PTSD) and depression are highly co-morbid following a traumatic event. Nevertheless, decisive evidence regarding the direction of the relationship between these clinical entities is missing. The aim of the present study was to examine the nature of this relationship by comparing a synchronous change model (PTSD and depression are time synchronous, possibly stemming from a third common factor) with a demoralization model (i.e. PTSD symptoms causing depression) and a depressogenic model (i.e. depressive symptoms causing PTSD symptoms). Israeli adult victims of single-event traumas (n=156) were assessed on measures of PTSD and depression at 2, 4 and 12 weeks post-event. A cross-lagged structural equation modeling (SEM) analysis provided results consistent with the synchronous change model and the depressogenic model. Depressive symptoms may play an important role in the development of post-traumatic symptoms.

[Embolization as a treatment method in post-traumatic right hepatic artery pseudoaneurysm].

PubMed

Dobrowolska-Bak, Malgorzata; Brzegowy, Paweł; Urbanik, Andrzej

2012-01-01

A case of 42-year-old man with post-traumatic right hepatic artery pseudoaneurysm successfully treated by endovascular embolization with histoacrylate glue is presented. Despite coils are mostly used embolic material in pseudoaneurysm, embolization with histoacrylate glue can be highly effective and quick treatment modality for post-traumatic hepatic artery pseudoaneurysm, especially in cases when it is impossible to use standard materials.

Gene Therapy for Post-Traumatic Osteoarthritis

DTIC Science & Technology

2015-10-01

AD______________ AWARD NUMBER: W81XWH-14-1-0498 TITLE: Gene Therapy for Post-Traumatic Osteoarthritis PRINCIPAL INVESTIGATOR: Steven C...COVERED 30Sept 2014 - 29 Sept 2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Gene Therapy for Posttraumatic Osteoarthritis 5b. GRANT NUMBER...the research. 1. KEYWORDS: Provide a brief list of keywords (limit to 20 words). Osteoarthritis (OA) is a

Post-traumatic stress disorder in veterans.

PubMed

Charles, Janice; Harrison, Christopher; Britt, Helena

2014-11-01

Over 2000 general practice encounters per year (2.3%) in BEACH are with repatriation health card holders, referred to here as veterans. The patients are veterans of Australia's defence force or war widows, widowers or dependent children. We compared the rate at which post-traumatic stress disorder (PTSD) was managed among veterans and non-veterans from April 2009 to June 2014.

Exposure to workplace bullying and post-traumatic stress disorder symptomology: the role of protective psychological resources.

PubMed

Spence Laschinger, Heather K; Nosko, Amanda

2015-03-01

To examine the relationship between nurses' exposure to workplace bullying and Post-Traumatic Stress Disorder symptomology and the protective role of psychological capital (PsyCap). Workplace bullying has serious organisational and health effects in nursing. Few studies have examined the relation of workplace bullying to serious mental health outcomes, such as Post-Traumatic Stress Disorder. Even fewer have examined the effect of intrapersonal strengths on the health impact of workplace bullying. A survey of 1205 hospital nurses was conducted to test the hypothesized model. Nurses completed standardized measures of bullying, Post-Traumatic Stress Disorder and PsyCap. A moderated regression analysis revealed that more frequent exposure to workplace bullying was significantly related to Post-Traumatic Stress Disorder symptomology regardless of the PsyCap level. That is, PsyCap did not moderate the bullying/PTSD relationship in either group. Bullying exposure and PsyCap were significant independent predictors of Post-Traumatic Stress Disorder symptoms in both groups. Efficacy, a subdimension of PsyCap, moderated the bullying/Post-Traumatic Stress Disorder relationship only among experienced nurses. Workplace bullying appears to be predictive of Post-Traumatic Stress Disorder symptomology, a serious mental health outcome. Workplace bullying is a serious threat to nurses' health and calls for programmes that eliminate bullying and encourage greater levels of positive resources among nurses. © 2013 John Wiley & Sons Ltd.

Accidental overdose of insufflated colchicine.

PubMed

Baldwin, L R; Talbert, R L; Samples, R

1990-01-01

An accidental overdose of colchicine by nasal insufflation occurred when the colchicine was mistaken for methamphetamine. Colchicine insufflation is not believed to be a common practice among drug abusers; however, its physical appearance was similar enough to methamphetamine for it to be mistaken for that drug of abuse. In this case a 29-year-old White man presented to the emergency room 3 days after he 'snorted' approximately 200mg of colchicine powder. The colchicine was used as a 'root stimulator' in gardening by the patient's brother and stored in the same cabinet as the methamphetamine. Within 24 hours of exposure the patient began experiencing gastrointestinal distress and myalgia, which eventually prompted him to seek medical attention. The clinical course included hypocalcaemia (69 mg/L--day 5), hypophosphataemia (10 mg/L--day 5) and thrombocytopenia (19 X 10(3)/mm3 - day 8), all of which are consistent with colchicine toxicity. The patient improved with supportive care and electrolyte replacement, and was discharged after an 8-day hospitalisation.

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.

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

Post-traumatic stress disorder and head injury as a dual diagnosis: "islands" of memory as a mechanism.

PubMed

King, N S

1997-01-01

This case study describes post-traumatic stress disorder (PTSD) and head injury after a road traffic accident involving a pedestrian. Previous studies have proposed two mechanisms by which this dual diagnosis may occur: (1) when post-traumatic amnesia and retrograde amnesia are small or non-existent and (2) when non-declarative memory systems for the traumatic event are in operation. This case study demonstrates a third mechanism--"islands" of memory within post-traumatic amnesia.

Intra-Articular Lubricin Gene Therapy for Post-Traumatic Arthritis

DTIC Science & Technology

2017-09-01

and test non-viral substitutes for AAV before proceeding to a large animal model. 2. KEYWORDS: ACL transection, post -traumatic OA, PRG4, lubricin...16 weeks post ACLT (months 20-26, 4/15/16 – 11/14/16, completed April 2017); o Subtask 2: Drawer test immediately post -euthanasia (months 20-26, 4/15... testing device for measuring rabbit knee laxity post -ACLT. He aided in the continuation of the drawer testing (troubleshooting, analyzing drawer testing

Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief

PubMed Central

Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

2013-01-01

Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12th, 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors. PMID:25206499

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) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices...

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) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices...

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) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices...

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) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices...

Vibratory Stimuli: A Novel Rehabilitation Method for Preventing Post-Traumatic Knee Osteoarthritis

DTIC Science & Technology

2016-08-01

AWARD NUMBER: W81XWH-15-1-0287 TITLE: Vibratory Stimuli, A Novel Rehabilitation Method for Preventing Post – Traumatic Knee Osteoarthritis ...August 2015 – 31 July 2016 4. TITLE AND SUBTITLE Vibratory Stimuli, A Novel Rehabilitation Method for Preventing Post – Traumatic Knee Osteoarthritis ... osteoarthritis . While the specific aims will not be realized and cannot be analyzed until the study’s completion in Year 3 due to the single-blind

Pseudo-Acetabulum due to Heterotopic Ossification in a Child with Post Traumatic Neglected Posterior Hip Dislocation.

PubMed

Pathak, Aditya C; Patil, Atul K; Sheth, Binoti; Bansal, Rohan

2012-01-01

Traumatic neglected dislocations of hip in children are rare entity. Neglected traumatic dislocations of hip in children along with heterotopic ossification are still rare. Post traumatic neglected hip dislocations are to be diagnosed as early as possible and have to be treated with precision and aggression as the outcome of treatment for the same is not predictable. 5 year female with post-traumatic neglected hip dislocation with heterotopic ossification forming a pseudoacetabulum postero-superiorly in which femur head was lodged. The girl was operated by open reduction using Moore's Posterior approach and showed good results. Here is a mention of a rare case with a good 18 months follow up with no complication. Post-traumatic neglected posterior hip dislocation mostly requires open reduction and relocation of femoral head in original acetabulum with concentric reduction. Heterotopic ossification is a rare but known complication of traumatic dislocation of hip in children. Good results can be achieved in such cases and regular follow-up of patient is required post-operatively.

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

Biliary leakage due to a rapidly growing post-traumatic hepatic artery pseudoaneurysm: a case report.

PubMed

Hasegawa, Satoshi; Moriwaki, Yoshihiro; Uchida, Keiji; Kosuge, Takayuki; Yamamoto, Toshiro; Sugiyama, Mitsugi

2004-01-01

Post-traumatic hepatic pseudoaneurysms are rare. We report a very unusual case of bile duct injury complicated with an asymptomatic post-traumatic hepatic pseudoaneurysm. A previously healthy 17-year-old man sustained multiple traumas after a motorcycle accident. Post-traumatic hepatic pseudoaneurysms were detected after blunt liver injury. The rapid growth of the pseudoaneurysms in the hepatic hilus compressed the common hepatic bile duct and caused extrahepatic bile leakage at the lateral lobe. At first, the hepatic arterial pseudoaneurysms were embolized and bile leakage at the left lobe was treated conservatively. Finally, however, segment 2 and 3 partial liver resection should have been performed to stop the bile leakage. Post-traumatic pseudoaneurysm should be ruled out, in addition to the presence of biliary tract injury, if the intraperitoneal bile leakage appears after liver injury.

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.

Post-traumatic stress disorder and head injury as a dual diagnosis: "islands" of memory as a mechanism.

PubMed Central

King, N S

1997-01-01

This case study describes post-traumatic stress disorder (PTSD) and head injury after a road traffic accident involving a pedestrian. Previous studies have proposed two mechanisms by which this dual diagnosis may occur: (1) when post-traumatic amnesia and retrograde amnesia are small or non-existent and (2) when non-declarative memory systems for the traumatic event are in operation. This case study demonstrates a third mechanism--"islands" of memory within post-traumatic amnesia. PMID:9010405

The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study.

PubMed

Zhai, Yanxue; Liu, Kun; Zhang, Lin; Gao, Han; Chen, Zhuo; Du, Siyi; Zhang, Lili; Guo, Yu

2015-01-01

In China, a growing number of adolescents have experienced traumatic events that have resulted in PTSD (post-traumatic stress disorder). Post-traumatic symptoms are common psychological problems in adolescents who have experienced traumatic events. However, existing studies tend to focus on the factors influencing PTSD, such as the response styles and social support, and studies on the relationships between parenting style, resilience and post-traumatic symptoms are still rare. To analyze the relationships between parenting style, resilience and post-traumatic symptoms among adolescents in China. A cross-sectional survey was conducted from June to December 2013 in the Liaoning Province, China. N = 5765 adolescents (aged 12 to 18 years old) were ultimately chosen to participate. The Chinese version of the Essen Trauma Inventory for Kids and Juveniles (ETI-KJ), a modified version of the Parental Authority Questionnaire, and the Chinese Resilience Scale were used to estimate the post-traumatic symptoms, parenting style, and resilience, respectively. Pearson's correlations, multiple linear regression analyses and structural equation modeling (SEM) were applied to analyze the data. Of the adolescents, 39.76% (N = 2292) had been exposed to traumatic events during their lives. The prevalence of probable PTSD at the time of the interview (one-month-prevalence) was 12.65%. Parenting style and resilience were significantly associated with post-traumatic symptoms. According to the SEM, parenting style had a significant direct effect on resilience (0.70, P<0.01) and post-traumatic symptoms (-0.15, P<0.05), and resilience had a significant direct effect on the post-traumatic symptoms (-0.43, P<0.01). Furthermore, parenting style had a significant indirect effect (-0.43×0.70 = -0.30. P<0.01) on the post-traumatic symptoms through resilience. The SEM significantly explained 49% of the variance in resilience and 30% of the variance in post-traumatic symptoms. Parenting style and

The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study

PubMed Central

Zhai, Yanxue; Liu, Kun; Zhang, Lin; Gao, Han; Chen, Zhuo; Du, Siyi; Zhang, Lili; Guo, Yu

2015-01-01

Background In China, a growing number of adolescents have experienced traumatic events that have resulted in PTSD (post-traumatic stress disorder). Post-traumatic symptoms are common psychological problems in adolescents who have experienced traumatic events. However, existing studies tend to focus on the factors influencing PTSD, such as the response styles and social support, and studies on the relationships between parenting style, resilience and post-traumatic symptoms are still rare. Objectives To analyze the relationships between parenting style, resilience and post-traumatic symptoms among adolescents in China. Methods A cross-sectional survey was conducted from June to December 2013 in the Liaoning Province, China. N = 5765 adolescents (aged 12 to 18 years old) were ultimately chosen to participate. The Chinese version of the Essen Trauma Inventory for Kids and Juveniles (ETI-KJ), a modified version of the Parental Authority Questionnaire, and the Chinese Resilience Scale were used to estimate the post-traumatic symptoms, parenting style, and resilience, respectively. Pearson’s correlations, multiple linear regression analyses and structural equation modeling (SEM) were applied to analyze the data. Results Of the adolescents, 39.76% (N = 2292) had been exposed to traumatic events during their lives. The prevalence of probable PTSD at the time of the interview (one-month-prevalence) was 12.65%. Parenting style and resilience were significantly associated with post-traumatic symptoms. According to the SEM, parenting style had a significant direct effect on resilience (0.70, P<0.01) and post-traumatic symptoms (-0.15, P<0.05), and resilience had a significant direct effect on the post-traumatic symptoms (-0.43, P<0.01). Furthermore, parenting style had a significant indirect effect (-0.43×0.70 = -0.30. P<0.01) on the post-traumatic symptoms through resilience. The SEM significantly explained 49% of the variance in resilience and 30% of the variance in post-traumatic

How Thinking About the Donor Influences Post-traumatic Growth in Liver Transplant Recipients.

PubMed

Martín-Rodríguez, A; Pérez-San-Gregorio, M Á; Avargues-Navarro, M L; Borda-Mas, M; Pérez-Bernal, J; Gómez-Bravo, M Á

2018-03-01

The aim of this work was to find out whether thinking frequently about the donor influences post-traumatic growth of liver transplant recipients. The sample of 240 patients selected was made up of 185 men and 55 women with an overall mean age of 60.21 (SD 9.3) years. All of them had received liver transplants from cadaver donors. Transplant recipients were asked whether they thought frequently about the donor (yes or no) and filled out the Post-traumatic Growth Inventory. The t test for unpaired samples was applied to analyze how thinking frequently about the donor or not influenced post-traumatic growth. We also calculated the effect sizes by means of Cohen d or Cohen w depending on the nature of the variables analyzed (quantitative or qualitative). The liver transplant recipients who thought frequently about the donor, compared with those who did not, had higher total scores on post-traumatic growth (P = .000; d = 0.57; medium effect size). Furthermore, considering the effect sizes, the differences between the subgroups were more relevant on the following subscales: new possibilities (P = .000; d = 0.53; medium effect size), appreciation of life (P = .000; d = 0.60; medium effect size), and spiritual change (P = .000; d = 0.54; medium effect size). Patients who think frequently about the donor have more post-traumatic growth than those who do not. Copyright © 2017 Elsevier Inc. All rights reserved.

Delayed activation of the primary orbitofrontal cortex in post-traumatic anosmia.

PubMed

Lee, Vincent Kyu; Nardone, Raffaele; Wasco, Fern; Panigrahy, Ashok; Zuccoli, Giulio

2016-01-01

Functional magnetic resonance imaging may help in elucidating the pathophysiology of post-traumatic anosmia. Using an fMRI olfactory stimulus paradigm, this study compared BOLD activation of the brain in a 21-year old male research subject with post-traumatic anosmia and a 19-year old male normal healthy control participant. A delayed activation of the primary orbitofrontal cortex was found in the subject with traumatic anosmia, which may represent a crucial pathophysiological mechanism in the subject with traumatic anosmia due to axonal injury or traumatic transection at the lamina cribrosa level. In healthy subjects the activation of secondary cortical areas may be due to the habituation effect in the primary olfactory cortex. This raises the possibility that, in the absence of secondary activation areas-that may act as a feed-back habituation or desensitization in the patient-one of the primary response areas is activated over the longer period of stimulation. The failed activation of these secondary areas in the patient may cause a feed-back habituation or desensitization in the patient and could also play a role in the disturbed perception of odours.

Final Report: Continuation Study: A Systems Approach to Understanding Post-Traumatic Stress Disorder

DTIC Science & Technology

2017-01-31

Research Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 Post Traumatic Stress Disorder, HPA-Circadian-metabolic pathway, methylation...17150 remaining probes were located in coding regions. Linear additive models were used to test the interactions among the quantitative loci and...SECURITY CLASSIFICATION OF: Post -Traumatic Stress Disorder (PTSD) is a complex anxiety disorder affecting many combat-exposed soldiers. Current

Glutamate/glutamine concentrations in the dorsal anterior cingulate vary with Post-Traumatic Stress Disorder symptoms.

PubMed

Harnett, Nathaniel G; Wood, Kimberly H; Ference, Edward W; Reid, Meredith A; Lahti, Adrienne C; Knight, Amy J; Knight, David C

2017-08-01

Trauma and stress-related disorders (e.g., Acute Stress Disorder; ASD and Post-Traumatic Stress Disorder; PTSD) that develop following a traumatic event are characterized by cognitive-affective dysfunction. The cognitive and affective functions disrupted by stress disorder are mediated, in part, by glutamatergic neural systems. However, it remains unclear whether neural glutamate concentrations, measured acutely following trauma, vary with ASD symptoms and/or future PTSD symptom expression. Therefore, the current study utilized proton magnetic resonance spectroscopy ( 1 H-MRS) to investigate glutamate/glutamine (Glx) concentrations within the dorsal anterior cingulate cortex (ACC) of recently (i.e., within one month) traumatized individuals and non-traumatized controls. Although Glx concentrations within dorsal ACC did not differ between recently traumatized and non-traumatized control groups, a positive linear relationship was observed between Glx concentrations and current stress disorder symptoms in traumatized individuals. Further, Glx concentrations showed a positive linear relationship with future stress disorder symptoms (i.e., assessed 3 months post-trauma). The present results suggest glutamate concentrations may play a role in both acute and future post-traumatic stress symptoms following a traumatic experience. The current results expand our understanding of the neurobiology of stress disorder and suggest glutamate within the dorsal ACC plays an important role in cognitive-affective dysfunction following a traumatic experience. Copyright © 2017 Elsevier Ltd. All rights reserved.

Animal models of post-traumatic epilepsy.

PubMed

Ostergard, Thomas; Sweet, Jennifer; Kusyk, Dorian; Herring, Eric; Miller, Jonathan

2016-10-15

Post-traumatic epilepsy (PTE) is defined as the development of unprovoked seizures in a delayed fashion after traumatic brain injury (TBI). PTE lies at the intersection of two distinct fields of study, epilepsy and neurotrauma. TBI is associated with a myriad of both focal and diffuse anatomic injuries, and an ideal animal model of epilepsy after TBI must mimic the characteristics of human PTE. The three most commonly used models of TBI are lateral fluid percussion, controlled cortical injury, and weight drop. Much of what is known about PTE has resulted from use of these models. In this review, we describe the most commonly used animal models of TBI with special attention to their advantages and disadvantages with respect to their use as a model of PTE. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

[Clinical approach to post-traumatic stress disorders].

PubMed

Boussaud, Marie

2015-01-01

A confrontation with death can lead to acute reactions of stress, followed possibly, after a phase of latency, by post-traumatic stress disorder (PTSD). PTSD is characterised by the appearance of a repetition syndrome combining reliving, hypervigilance and avoidance; comorbidities frequently arise, increasingthe risk of suicide. Caregivers have an important role to play in identifying them.

Impact of valve-less vs. standard insufflation on pneumoperitoneum volume, inflammation, and peritoneal physiology in a laparoscopic sigmoid resection experimental model.

PubMed

Diana, Michele; Noll, Eric; Legnèr, Andras; Kong, Seong-Ho; Liu, Yu-Yin; Schiraldi, Luigi; Marchegiani, Francesco; Bano, Jordan; Geny, Bernard; Charles, Anne-Laure; Dallemagne, Bernard; Lindner, Véronique; Mutter, Didier; Diemunsch, Pierre; Marescaux, Jacques

2018-07-01

anterior posterior thickness was slightly, yet significantly higher in the valve-less group, on all post-insufflation CT scans. Valve-less insufflation achieved a slightly higher working space and a lower systemic and localized inflammatory response in this experimental setting.

Attitudes to emotional expression and personality in predicting post-traumatic stress disorder.

PubMed

Nightingale, J; Williams, R M

2000-09-01

To test hypotheses derived from a suggestion of Williams (1989) that negative attitudes towards emotional expression act as a predisposing or maintaining factor for post-traumatic stress reactions following a traumatic event. The study employed a prospective design in which attitudes to emotional expression, the 'Big Five' personality factors (Costa & McCrae, 1992a) and initial symptoms and injury severity within 1 week of a road traffic accident were used to predict the development of post-traumatic stress disorder 6 weeks post-accident. Sixty victims of road traffic accidents randomly selected from attenders at a large A&E department were assessed by questionnaire and interview. Measures comprised a 4-item scale relating to emotional expression, standardized scales for intrusion and avoidance features of traumatic experiences, and for anxiety and depression and the NEO-FFI Five Factor Personality Inventory. Forty-five of these participants responded to a postal questionnaire follow-up. In this survey the battery was repeated and also included a self-report diagnostic measure of post-traumatic stress disorder (PTSD). The percentage of the sample meeting DSM-IV diagnostic criteria for PTSD at 6 weeks post-trauma was 30.8%. A small but significant relationship was found for negative attitudes to emotional expression at 1 week to predict intrusive symptoms and diagnosis at 6 weeks, over and above the independent relationships of initial symptoms, initial injury severity, personality and coping. The emotional expression measure was largely stable between the two points of measurement. More negative attitudes to emotional expression were related to less openness, extraversion and agreeableness personality domains. Some support for the hypotheses was found in relation to the development of PTSD and for the status of attitudes to emotion as a stable trait related to personality factors. The potential importance of attitudes to emotional expression in therapy and other

[Transhepatic percutaneous embolisation of a post-traumatic pseudoaneurysm of hepatic artery].

PubMed

Marcheix, B; Dambrin, C; Cron, C; Sledzianowski, J F; Aguirre, J; Suc, B; Cerene, A; Rousseau, H

2004-12-01

Pseudoaneurysm of the hepatic artery is a rare complication of blunt abdominal trauma. We report a case of post-traumatic pseudoaneurysm diagnosed several months after the initial traumatism in a 18-year-old man who presented recurrent abdominal pain. This pseudoaneurysm was successfully treated by association of both classical endovascular treatment and transhepatic percutaneous embolization.

Cortical surface area reduction in identification of subjects at high risk for post-traumatic stress disorder: A pilot study.

PubMed

Hu, Hao; Sun, Yawen; Su, Shanshan; Wang, Yao; Qiu, Yongming; Yang, Xi; Zhou, Yan; Xiao, Zeping; Wang, Zhen

2018-01-01

Victims of motor vehicle accidents often develop post-traumatic stress disorder, which causes significant social function loss. For the difficulty in treating post-traumatic stress disorder, identification of subjects at high risk for post-traumatic stress disorder is essential for providing possible intervention. This paper aims to examine the cortical structural traits related to susceptibility to post-traumatic stress disorder. To address this issue, we performed structural magnetic resonance imaging study in motor vehicle accident victims within 48 hours from the accidents. A total of 70 victims, available for both clinical and magnetic resonance imaging data, enrolled in our study. Upon completion of 6-month follow-up, 29 of them developed post-traumatic stress disorder, while 41 of them didn't. At baseline, voxelwise comparisons of cortical thickness, cortical area and cortical volume were conducted between post-traumatic stress disorder group and trauma control group. As expected, several reduced cortical volume within frontal-temporal loop were observed in post-traumatic stress disorder. For cortical thickness, no between-group differences were observed. There were three clusters in left hemisphere and one cluster in right hemisphere showing decreased cortical area in post-traumatic stress disorder patients, compared with trauma controls. Peak voxels of the three clusters in left hemisphere were separately located in superior parietal cortex, insula and rostral anterior cingulate cortex. The finding of reduced surface area of left insula and left rostral anterior cingulate cortex suggests that shrinked surface area in motor vehicle accident victims could act as potential biomarker of subjects at high risk for post-traumatic stress disorder.

Targeted Alteration of Dietary Omega 3 and Omega 6 Fatty Acids for the Treatment of Post Traumatic Headaches

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-15-2-0059 TITLE: Targeted Alteration of Dietary Omega-3 and Omega-6 Fatty Acids for the Treatment of Post -Traumatic...Acids for the Treatment of Post - 5b. GRANT NUMBER Traumatic Headaches 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Kimbra Kenney, M.D...SUPPLEMENTARY NOTES 14. ABSTRACT Post -traumatic headache (PTH) is a common problem in military personnel due to their high rate of traumatic brain

Resilience, post-traumatic stress, and posttraumatic growth: Veterans' and active duty military members' coping trajectories following traumatic event exposure.

PubMed

Angel, Caroline M

2016-12-01

As part of the "Joining Forces" Initiative ("JFI"), the White House and nursing leaders announced nurses' commitment to recognize symptoms, provide care, and refer veterans and active duty military members for post-traumatic stress disorder ("PTSD"). The JFI is positioned to save lives through nursing education and raising PTSD awareness. Nurses should also be educated to recognize resilience (stable trajectory of healthy functioning across time following a traumatic event) and assess for post-traumatic growth ("PTG") (positive meaning making) alongside PTSD. In veterans who do develop PTSD, nearly three fourths of them with moderate PTSD will also experience PTG. Nurses' frontline contact with veterans in the VA, private sector healthcare settings, and community enable them to educate veterans and active duty military members about these coping trajectories. Copyright © 2016 Elsevier Ltd. All rights reserved.

Longitudinal cohort study of depression, post-traumatic stress, and alcohol use in South African women who attend alcohol serving venues.

PubMed

Abler, Laurie A; Sikkema, Kathleen J; Watt, Melissa H; Eaton, Lisa A; Choi, Karmel W; Kalichman, Seth C; Skinner, Donald; Pieterse, Desiree

2014-08-06

In South Africa, alcohol use poses a public health burden. Hazardous alcohol use often co-occurs with psychological distress (e.g., depression and post-traumatic stress). However, the majority of the research establishing the relationship between alcohol use and psychological distress has been cross-sectional, so the nature of co-occurring changes in psychological distress and alcohol use over time is not well characterized. The objective of this study is to examine the longitudinal relationship between psychological distress and alcohol use among South African women who attend alcohol serving venues. Four waves of data were collected over the course of a year from 560 women in a Cape Town township who attended drinking venues. At each assessment wave, participants reported depressive symptoms, post-traumatic stress symptoms, and alcohol use. Multilevel growth models were used to: 1) assess the patterns of alcohol use; 2) examine how depressive symptoms uniquely, post-traumatic stress symptoms uniquely, and depressive and post-traumatic stress symptoms together were associated with alcohol use; and 3) characterize the within person and between person associations of depressive symptoms and post-traumatic stress symptoms with alcohol use. Women reported high levels of alcohol use throughout the study period, which declined slightly over time. Post-traumatic stress symptoms were highly correlated with depressive symptoms. Modeled separately, both within person and between person depressive and post-traumatic stress symptoms were uniquely associated with alcohol use. When modeled together, significant between person effects indicated that women who typically have more post-traumatic stress symptoms, when controlling for depressive symptoms, are at risk for increased alcohol use; however, women with more depressive symptoms, controlling for post-traumatic stress symptoms, do not have differential risk for alcohol use. Significant within person effects indicated an

Post-Traumatic Stress Constrains the Dynamic Repertoire of Neural Activity.

PubMed

Mišić, Bratislav; Dunkley, Benjamin T; Sedge, Paul A; Da Costa, Leodante; Fatima, Zainab; Berman, Marc G; Doesburg, Sam M; McIntosh, Anthony R; Grodecki, Richard; Jetly, Rakesh; Pang, Elizabeth W; Taylor, Margot J

2016-01-13

Post-traumatic stress disorder (PTSD) is an anxiety disorder arising from exposure to a traumatic event. Although primarily defined in terms of behavioral symptoms, the global neurophysiological effects of traumatic stress are increasingly recognized as a critical facet of the human PTSD phenotype. Here we use magnetoencephalographic recordings to investigate two aspects of information processing: inter-regional communication (measured by functional connectivity) and the dynamic range of neural activity (measured in terms of local signal variability). We find that both measures differentiate soldiers diagnosed with PTSD from soldiers without PTSD, from healthy civilians, and from civilians with mild traumatic brain injury, which is commonly comorbid with PTSD. Specifically, soldiers with PTSD display inter-regional hypersynchrony at high frequencies (80-150 Hz), as well as a concomitant decrease in signal variability. The two patterns are spatially correlated and most pronounced in a left temporal subnetwork, including the hippocampus and amygdala. We hypothesize that the observed hypersynchrony may effectively constrain the expression of local dynamics, resulting in less variable activity and a reduced dynamic repertoire. Thus, the re-experiencing phenomena and affective sequelae in combat-related PTSD may result from functional networks becoming "stuck" in configurations reflecting memories, emotions, and thoughts originating from the traumatizing experience. The present study investigates the effects of post-traumatic stress disorder (PTSD) in combat-exposed soldiers. We find that soldiers with PTSD exhibit hypersynchrony in a circuit of temporal lobe areas associated with learning and memory function. This rigid functional architecture is associated with a decrease in signal variability in the same areas, suggesting that the observed hypersynchrony may constrain the expression of local dynamics, resulting in a reduced dynamic range. Our findings suggest that

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

PubMed Central

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

Adding a custom made pressure release valve during air enema for intussusception: A new technique.

PubMed

Ahmed, Hosni Morsi; Ahmed, Osama; Ahmed, Refaat Khodary

2015-01-01

Non-surgical reduction remains the first line treatment of choice for intussusception. The major complication of air enema reduction is bowel perforation. The authors developed a custom made pressure release valve to be added to portable insufflation devices, delivering air at pressures accepted as safe for effective reduction of intussusception in children under fluoroscopic guidance. The aim of this study was to develop a custom made pressure release valve that is suitable for the insufflation devices used for air enema reduction of intussusception and to put this valve into regular clinical practice. An adjustable, custom made pressure release valve was assembled by the authors using readily available components. The valve was coupled to a simple air enema insufflation device. The device was used for the trial of reduction of intussusception in a prospective study that included 132 patients. The success rate for air enema reduction with the new device was 88.2%. The mean pressure required to achieve complete reduction was 100 mmHg. The insufflation pressure never exceeded the preset value (120 mmHg). Of the successful cases, 58.3% were reduced from the first attempt while 36.1% required a second insufflation. Only 5.55% required a third insufflation to complete the reduction. In cases with unsuccessful pneumatic reduction attempt (18.1%), surgical treatment was required. Surgery ranged from simple reduction to resection with a primary end to end anastomosis. No complications from air enema were recorded. The authors recommend adding pressure release valves to ensure safety by avoiding pressure overshoot during the procedure.

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.

Post-traumatic stress symptoms 5 years after military deployment to Afghanistan: an observational cohort study.

PubMed

Eekhout, Iris; Reijnen, Alieke; Vermetten, Eric; Geuze, Elbert

2016-01-01

Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which participants are repeatedly measured over time, are warranted to assess the timing of an increase in symptoms to ultimately assess the timing of an increase in treatment demand after deployment. In this large observational cohort study, Dutch military personnel who were deployed to Afghanistan as part of the International Security Assistance Forces between March, 2005, and September, 2008, were assessed for post-traumatic stress symptoms with the Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP) questionnaire. Participants were assessed 1 month before deployment and followed up at 1 month, 6 months, 12 months, 2 years, and 5 years after deployment, with changes in SRIP scores compared with pre-deployment using a mixed model analysis. The primary outcome was the total score of post-traumatic stress symptoms measured with SRIP at pre-deployment and the five follow-up assessments, with a score of 38 used as the cutoff to indicate substantial post-traumatic stress symptoms. Between March, 2005, and September, 2008, 1007 participants were recruited to this study. The results show two important effects of deployment on post-traumatic stress symptoms. A short-term symptom increase within the first 6 months after deployment (symptom increase coefficient for SRIP score vs pre-deployment [β] 0·99, 95% CI 0·50-1·48); and a long-term symptom increase at 5 years after deployment (β 1·67, 1·14-2·20). This study underlines the importance of long-term monitoring of the psychological health of soldiers after deployment because early detection of symptoms is essential to early treatment, which is related to improved psychological health. Dutch Ministry of Defense. Copyright © 2016

Case control study: hyperbaric oxygen treatment of mild traumatic brain injury persistent post-concussion syndrome and post-traumatic stress disorder

PubMed Central

Harch, Paul G.; Andrews, Susan R.; Fogarty, Edward F.; Lucarini, Juliette; Van Meter, Keith W.

2017-01-01

Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim of this study is to assess safety, feasibility, and effectiveness of hyperbaric oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects aged 18–65 with PPCS with or without PTSD and from one or more blast-induced mild-moderate traumatic brain injuries that were a minimum of 1 year old and occurred after 9/11/2001 were studied. The measures included symptom lists, physical exam, neuropsychological and psychological testing on 29 subjects (1 dropout) and SPECT brain imaging pre and post HBOT. Comparison was made using SPECT imaging on 29 matched Controls. Side effects (30 subjects) experienced due to the HBOT: reversible middle ear barotrauma (n = 6), transient deterioration in symptoms (n = 7), reversible bronchospasm (n = 1), and increased anxiety (n = 2; not related to confinement); unrelated to HBOT: ureterolithiasis (n = 1), chest pain (n = 2). Significant improvement (29 subjects) was seen in neurological exam, symptoms, intelligence quotient, memory, measures of attention, dominant hand motor speed and dexterity, quality of life, general anxiety, PTSD, depression (including reduction in suicidal ideation), and reduced psychoactive medication usage. At 6-month follow-up subjects reported further symptomatic improvement. Compared to Controls the subjects' SPECT was significantly abnormal, significantly improved after 1 and 40 treatments, and became statistically indistinguishable from Controls in 75% of abnormal areas. HBOT was found to be safe and significantly effective for veterans with mild to moderate TBI PPCS with PTSD in all four outcome domains: clinical medicine, neuropsychology, psychology, and SPECT imaging. Veterans also experienced a significant reduction in suicidal ideation and reduction

Case control study: hyperbaric oxygen treatment of mild traumatic brain injury persistent post-concussion syndrome and post-traumatic stress disorder.

PubMed

Harch, Paul G; Andrews, Susan R; Fogarty, Edward F; Lucarini, Juliette; Van Meter, Keith W

2017-01-01

Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim of this study is to assess safety, feasibility, and effectiveness of hyperbaric oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects aged 18-65 with PPCS with or without PTSD and from one or more blast-induced mild-moderate traumatic brain injuries that were a minimum of 1 year old and occurred after 9/11/2001 were studied. The measures included symptom lists, physical exam, neuropsychological and psychological testing on 29 subjects (1 dropout) and SPECT brain imaging pre and post HBOT. Comparison was made using SPECT imaging on 29 matched Controls. Side effects (30 subjects) experienced due to the HBOT: reversible middle ear barotrauma ( n = 6), transient deterioration in symptoms ( n = 7), reversible bronchospasm ( n = 1), and increased anxiety ( n = 2; not related to confinement); unrelated to HBOT: ureterolithiasis ( n = 1), chest pain ( n = 2). Significant improvement (29 subjects) was seen in neurological exam, symptoms, intelligence quotient, memory, measures of attention, dominant hand motor speed and dexterity, quality of life, general anxiety, PTSD, depression (including reduction in suicidal ideation), and reduced psychoactive medication usage. At 6-month follow-up subjects reported further symptomatic improvement. Compared to Controls the subjects' SPECT was significantly abnormal, significantly improved after 1 and 40 treatments, and became statistically indistinguishable from Controls in 75% of abnormal areas. HBOT was found to be safe and significantly effective for veterans with mild to moderate TBI PPCS with PTSD in all four outcome domains: clinical medicine, neuropsychology, psychology, and SPECT imaging. Veterans also experienced a significant reduction in suicidal ideation and

A Model to Predict Psychological- and Health-Related Adjustment in Men with Prostate Cancer: The Role of Post Traumatic Growth, Physical Post Traumatic Growth, Resilience and Mindfulness.

PubMed

Walsh, Deirdre M J; Morrison, Todd G; Conway, Ronan J; Rogers, Eamonn; Sullivan, Francis J; Groarke, AnnMarie

2018-01-01

Background: Post traumatic growth (PTG) can be defined as positive change following a traumatic event. The current conceptualization of PTG encompasses five main dimensions, however, there is no dimension which accounts for the distinct effect of a physical trauma on PTG. The purpose of the present research was to test the role of PTG, physical post traumatic growth (PPTG), resilience and mindfulness in predicting psychological and health related adjustment. Method: Ethical approval was obtained from relevant institutional ethics committees. Participants ( N = 241), who were at least 1 year post prostate cancer treatment, were invited to complete a battery of questionnaires either through an online survey or a paper and pencil package received in the post The sample ranged in age from 44 to 88 years ( M = 64.02, SD = 7.76). Data were analysis using confirmatory factor analysis and structural equation modeling. Results: The physical post traumatic growth inventory (P-PTGI) was used to evaluate the role of PPTG in predicting adjustment using structural equation modeling. P-PTGI predicted lower distress and improvement of quality of life, whereas conversely, the traditional PTG measure was linked with poor adjustment. The relationship between resilience and adjustment was found to be mediated by P-PTGI. Conclusion: Findings suggest the central role of PTG in the prostate cancer survivorship experience is enhanced by the inclusion of PPTG. Adjusting to a physical trauma such as illness (internal transgressor) is unlike a trauma with an external transgressor as the physical trauma creates an entirely different framework for adjustment. The current study demonstrates the impact of PPTG on adjustment. This significantly adds to the theory of the development of PTG by highlighting the interplay of resilience with PTG, PPTG, and adjustment.

Predictors of post-traumatic stress symptoms in Oklahoma City: exposure, social support, peri-traumatic responses.

PubMed

Tucker, P; Pfefferbaum, B; Nixon, S J; Dickson, W

2000-11-01

Eighty-five adults seeking mental health assistance six months after the Oklahoma City bombing were assessed to determine which of three groups of variables (exposure, peri-traumatic responses, and social support) predicted development of post-traumatic stress disorder (PTSD) symptoms. Variables most highly associated with subsequent PTSD symptoms included having been injured (among exposure variables), feeling nervous or afraid (peri-traumatic responses), and responding that counseling helped (support variables). Combining primary predictors in the three areas, PTSD symptoms were more likely to occur in those reporting counseling to help and those feeling nervous or afraid at the time of the bombing. Implications of these findings are discussed for behavioral health administrators and clinicians planning service delivery to groups of victims seeking mental health intervention after terrorist attacks and other disasters.

An Herbal Derivative as the Basis for a New Approach to Treating Post-Traumatic Osteoarthritis

DTIC Science & Technology

2016-09-01

AWARD NUMBER: W81XWH-15-1-0397 TITLE: An Herbal Derivative as the Basis for a New Approach to Treating Post- Traumatic Osteoarthritis...SUBTITLE An Herbal Derivative as the Basis for a New Approach to Treating Post- Traumatic Osteoarthritis 5a. CONTRACT NUMBER 5b. GRANT NUMBER

Examining the relationship between post-traumatic stress disorder and social participation among Veterans with spinal cord injuries and disorders.

PubMed

Etingen, Bella; Locatelli, Sara M; Miskevics, Scott; LaVela, Sherri L

2017-07-26

The objectives of this study were to examine differences in social participation among Veterans with spinal cord injuries/disorders with and without post-traumatic stress disorder, and determine if lower social participation was independently associated with having post-traumatic stress disorder. A cross-sectional mailed national survey was sent to a national sample of Veterans with spinal cord injuries/disorders who received prior-year Veterans Affairs healthcare. Surveys provided data on: demographics, health conditions, injury characteristics, and social participation. Analyses included bivariate comparisons, and multivariate logistic regression to determine if lower social participation was independently associated with post-traumatic stress disorder. Veterans with (vs. without) post-traumatic stress disorder (n = 896) reported lower social participation (40.2 vs. 43.9, p < 0.0001). Multivariate analyses showed that longer duration of injury (OR = 0.98, 95% CI: 0.97-1.00, p = 0.04) and white race (OR = 0.62, 95% CI: 0.38-1.01, p = 0.05) were associated with lower odds of post-traumatic stress disorder, while a greater number of health conditions (OR = 1.43, 95% CI: 1.25-1.64, p < 0.0001) was associated with greater odds. When controlling for covariates, lower social participation was independently associated with post-traumatic stress disorder (OR = 0.94, 95% CI: 0.90-0.98, p = 0.003). Results indicate post-traumatic stress disorder is associated with lower social participation in Veterans with spinal cord injuries/disorders, independent of other factors that may impact participation. Efforts to screen for and treat post-traumatic stress disorder among persons with spinal cord injuries/disorders, regardless of injury-specific factors, are needed to improve participation. Implications for Rehabilitation Individuals with spinal cord injuries/disorders often have post-traumatic stress disorder; in Veterans with spinal cord

Post-traumatic external nasal pain syndrome (a trigeminal based pain disorder).

PubMed

Rozen, Todd

2009-09-01

Little has been written about persistent external nasal pain after injury to the nose in the neurologic or headache literature. In clinical practice, this can be a disabling and treatment refractory condition. The external portion of the nose is highly innervated by branches of the ophthalmic and maxillary divisions of the trigeminal nerve including the nasociliary nerve, external nasal nerve, infratrochlear nerve, anterior ethmoidal nerve, and infraorbital nerve. As these nerves are located on the external portion of the nose just deep enough to the skin they can be easily traumatized with any impact to the nose. Four patients with what is termed the post-traumatic external nasal pain syndrome are reported in this paper, describing the clinical presentation of the disorder and providing treatment options. Post-traumatic external nasal pain syndrome appears to be a novel form of trigeminal-based pain not previously reported in the neurologic literature.

Treating post-traumatic tremor with deep brain stimulation: report of five cases.

PubMed

Issar, Neil M; Hedera, Peter; Phibbs, Fenna T; Konrad, Peter E; Neimat, Joseph S

2013-12-01

Post-traumatic tremor is one of the most common movement disorders resulting from severe head trauma. However, literature regarding successful deep brain stimulation (DBS) treatment is scarce, resulting in ambiguity regarding the optimal lead location. Most cases support the ventral intermediate nucleus, but there is evidence to defend DBS of the zona incerta, ventral oralis anterior/posterior, and/or a combination of these targets. We report five patients with disabling post-traumatic tremor treated with DBS of the ventral intermediate nucleus and of the globus pallidus internus. Patients were referred to the Vanderbilt Movement Disorders Division, and surgical intervention was determined by a DBS Multidisciplinary Committee. Standard DBS procedure was followed. Patients 1-4 sustained severe diffuse axonal injuries. Patients 1-3 underwent unilateral ventral intermediate nucleus DBS for contralateral tremor, while Patient 4 underwent bilateral ventral intermediate nucleus DBS. Patients 1-3 experienced good tremor reduction, while Patient 4 experienced moderate tremor reduction with some dystonic posturing of the hands. Patient 5 had dystonic posturing of the right upper extremity with tremor of the left upper extremity. He was treated with bilateral DBS of the globus pallidus internus and showed good tremor reduction at follow-up. Unilateral or bilateral DBS of the ventral intermediate nucleus and bilateral DBS of the globus pallidus internus may be effective and safe treatment modalities for intractable post-traumatic tremor. Further studies are needed to clarify the optimal target for surgical treatment of post-traumatic tremor. Published by Elsevier Ltd.

An Herbal Derivative as the Basis for a New Approach to Treating Post Traumatic Osteoarthritis

DTIC Science & Technology

2016-09-01

AWARD NUMBER: W81XWH-15-1-0396 TITLE: An Herbal Derivative as the Basis for a New Approach to Treating Post- Traumatic Osteoarthritis...TITLE AND SUBTITLE An Herbal Derivative as the Basis for a New Approach to Treating Post- Traumatic Osteoarthritis 5a. CONTRACT NUMBER 5b. GRANT NUMBER

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…

Non-ablative fractional resurfacing of surgical and post-traumatic scars.

PubMed

Vasily, David B; Cerino, Mary E; Ziselman, Ethel M; Zeina, S Tannous

2009-11-01

Non-ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, the authors examined the efficacy and safety of the non-ablative 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. Clinical studies were conducted on a range of surgical and post-traumatic scars with a 1540 nm erbium:glass fractional laser varying energy, pulse widths, treatment passes, and number of treatments. A histological study was conducted on a postsurgical scar to follow the time course of healing post-treatment and the impact of the fractional treatment on normalization of scar tissue, as compared to baseline histology of the scar. Histologic findings demonstrated rapid re-epithelialization of the epidermis within 72 hours of treatment. Remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Clinical subjects, with Fitzpatrick skin types II-V, received three to seven treatments with microbeam energies up to 60 mJ/pb and five passes. Relative to baseline, 73% of treated scars improved 50% or more and 43% improved 75% or more. Side effects included mild swelling (95% of subjects), erythema (94%) and purpura (5%), which all resolved within two to three days. Downtime was minimal-to-none for all subjects. These data illustrate the safety and efficacy of the 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. Practitioners can vary energy and microbeam density in order to tailor the treatment to reflect the individual scar characteristics.

Factors associated with post-traumatic stress symptoms among adolescents exposed to the Sewol ferry disaster in Korea.

PubMed

Lee, Ju-Yeon; Kim, Sung-Wan; Bae, Kyung-Yeol; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang

2017-10-01

This study evaluated the factors associated with post-traumatic stress symptoms in Korean adolescents who lived in a disaster-affected community. A total of 1101 students attending secondary and high schools in Jindo, the location of the Sewol ferry disaster, were enrolled in a cross-sectional survey. The Child Report of Post-traumatic Symptoms (CROPS), the Center for Epidemiological Studies Depression Scale (CES-D), and the State Anxiety Inventory for Children (SAIC) were administered. Female gender, older children, poor academic achievement, and directly witnessing the rescue scene were associated with post-traumatic stress symptoms. The CES-D and SAIC scores of subjects with witness of the rescue were significantly higher than those of respondents without such experiences. The regression analysis revealed that directly witnessing the rescue scene was significantly associated with post-traumatic stress symptoms after adjusting for other variables. The results of this study suggest that witnessing the rescue scene following a disaster might be a risk factor for post-traumatic stress symptoms in adolescents in disaster-affected communities. Copyright © 2017 Elsevier B.V. All rights reserved.

Prospective Analysis of Risk Factors Related to Depression and Post Traumatic Stress Disorder in Deployed United States Navy Personnel

DTIC Science & Technology

2011-03-28

post traumatic stress disorder ( PTSD ) and depression (MDD) than...United States Several epidemiological studies have been conducted on the prevalence of post traumatic stress disorder ( PTSD ) and major depression in...forms contain the same 4-item screener for post - traumatic stress disorder ( PTSD ). This screener was developed by the National Center for PTSD and

Fear of childbirth and obstetrical events as predictors of postnatal symptoms of depression and post-traumatic stress disorder.

PubMed

Fairbrother, Nichole; Woody, Sheila R

2007-12-01

This prospective study examined psychological and obstetrical predictors of enduring postpartum symptoms of depression and post-traumatic stress disorder. Contrary to prediction, prenatal fear of childbirth did not significantly predict symptoms of depression or post-traumatic stress disorder at one month postpartum, but anxiety sensitivity was an unexpected predictor that merits further investigation. Several obstetrical and neonatal variables significantly predicted symptoms of post-traumatic disorder, but not depression.

The impact of post-traumatic stress disorder symptomatology on quality of life: The sentinel experience of anger, hypervigilance and restricted affect.

PubMed

Forbes, David; Nickerson, Angela; Bryant, Richard A; Creamer, Mark; Silove, Derrick; McFarlane, Alexander C; Van Hooff, Miranda; Phelps, Andrea; Felmingham, Kim L; Malhi, Gin S; Steel, Zachary; Fredrickson, Julia; Alkemade, Nathan; O'Donnell, Meaghan

2018-05-01

It is unclear which specific symptoms of post-traumatic stress disorder are related to poor perceived quality of life. To investigate the influence of post-traumatic stress disorder symptomatology on quality of life in traumatic injury survivors. Traumatic injury survivors completed questionnaires on post-traumatic stress disorder symptomatology and quality of life at 3 months ( n = 987), 12 months ( n = 862), 24 months ( n = 830) and 6 years ( n = 613) post trauma. Low quality of life was reported by 14.5% of injury survivors at 3 months and 8% at 6 years post event. The post-traumatic stress disorder symptom clusters that contributed most to poor perceived quality of life were numbing and arousal, the individual symptoms that contributed most were anger, hypervigilance and restricted affect. There was variability in the quality of life of traumatic injury survivors in the 6 years following trauma and a consistent proportion reported low quality of life. Early intervention to reduce anger, hypervigilance and restricted affect symptoms may provide a means to improving the quality of life of traumatic injury survivors.

Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles.

PubMed

Shannon, M P; Lonigan, C J; Finch, A J; Taylor, C M

1994-01-01

To determine the range and severity of post-traumatic stress disorder (PTSD) symptoms exhibited by children after exposure to a natural disaster. Three months after Hurricane Hugo struck Berkeley County, South Carolina, 5,687 school-aged children were surveyed about their experiences and reactions related to the storm. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index. Significant variation in the prevalence of PTSD symptoms was found across race, gender, and age groups. Self-reported symptoms were used to derive a post-traumatic stress syndrome classification according to DSM-III-R guidelines for the diagnosis of PTSD. More than 5% of the sample reported sufficient symptoms to be classified as exhibiting this post-traumatic stress syndrome. Females and younger children were more likely to receive this classification. At the symptom level, females reported more symptoms associated with emotional processing and emotional reaction to the trauma. Males were more likely to report symptoms related to cognitive and behavioral factors. Younger children were more likely to report symptoms overall. Children exposed to a high magnitude natural disaster report sufficient symptoms to establish a DSM-III-R derived classification of a PTSD syndrome. Differences between gender, age, and race groups appear to be related to differential risk of exposure, reporting biases, as well as a differential risk for developing post-traumatic symptoms.

The structure of post-traumatic stress disorder and complex post-traumatic stress disorder amongst West Papuan refugees.

PubMed

Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick

2015-05-07

The validity of applying the construct of post-traumatic stress disorder (PTSD) across cultures has been the subject of contention. Although PTSD symptoms have been identified across multiple cultures, questions remain whether the constellation represents a coherent construct with an interpretable factor structure across diverse populations, especially those naïve to western notions of mental disorder. An important additional question is whether a constellation of Complex-PTSD (C-PTSD) can be identified and if so, whether there are distinctions between that disorder and core PTSD in patterns of antecedent traumatic events. Our study amongst West Papuan refugees in Papua New Guinea (PNG) aimed to examine the factorial structure of PTSD based on the DSM-IV, DSM-5, ICD-10 and ICD-11 definitions, and C-PTSD according to proposed ICD-11 criteria. We also investigated domains of traumatic events (TEs) and broader psychosocial effects of conflict (sense of safety and injustice) associated with the factorial structures identified. Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), refugees' sense of safety and justice, and symptoms of PTSD and C-PTSD amongst 230 West Papuan refugees residing in Port Morseby, PNG. Confirmatory factor analysis (CFA) supported a unitary construct of both ICD-10 and ICD-11 PTSD, comprising the conventional symptom subdomains of intrusion, avoidance, and hyperarousal. In contrast, CFA did not identify a unitary construct underlying C-PTSD. The interaction of witnessing murders and sense of injustice was associated with both the intrusion and avoidance domains of PTSD, but not with the unique symptom clusters characterizing C-PTSD. Our findings support the ICD PTSD construct and its three-factor structure in this transcultural refugee population. Traumatic experiences of witnessing murder associated with a sense of injustice were specifically related to the intrusion and avoidance domains of

Post-War Research on Post-Traumatic Stress Disorder. Part I. Research before 1989.

PubMed

Rutkowski, Krzysztof; Dembińska, Edyta

2016-10-31

The paper presents the post-war history of post-traumatic research conducted at the Department of Psychiatry of the Jagiellonian University and the analysis of the main research approaches and selected publications. The time after World War II passed in Poland in two directions: coping with the finished war trauma and simultaneously the experience of communist persecution trauma. First scientific publications appeared in the fifties and were focused on the research of former concentration camps prisoners (KZ-Syndrome). Between 1962 and 1989 a special edition of Przegląd Lekarski, which concentrated entirely on war trauma research, was published. The journal was nominated for the Peace Nobel Prize twice. The research team from the Department of Psychiatry headed by Professor Antoni Kępiński made a very extensive description of KZ-Syndrome issues. The paper summarizes the most important contemporary research findings on psychopathology of KZ-Syndrome (Szymusik), reaction dynamics (Teutsch), after camp adjustment (Orwid), paroxysmal hypermnesia (Półtawska), somatic changes (Gatarski, Witusik). The result of the study was the basis for the development of a methodology and a new look at the classification of the consequences of post-traumatic stress disorder, as well as the development of ethical attitudes towards patients.

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2016-12-01

1 Award Number: W81XWH-12-2-0118 TITLE: Early Diagnosis and Intervention Strategies for Post -Traumatic Heterotopic Ossification in Severely...December 2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION...COVERED 30Sep2012 - 29Sep2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Early Diagnosis and Intervention Strategies for Post -Traumatic Heterotopic

Delayed-onset post-traumatic headache after a motor vehicle collision: a case report

PubMed Central

Stupar, Maja; Kim, Peter SY

2007-01-01

Introduction Headaches are common after a motor vehicle accident (MVA). Post-traumatic headaches share many clinical symptoms including the clinical course of primary headaches. Secondary headaches (including those resulting from a subdural hematoma) are not as common, but should be considered in cases of post-traumatic events particularly if clinical symptoms progress. Clinical Features A case of a patient with a post-traumatic subdural hematoma demonstrates the importance of carefully examining, properly diagnosing and managing patients that experience headaches after MVAs. This patient presented with uncomplicated low back pain, neck pain and headache which progressed at one month to include focal neurological deficits. Since clinical examination alone may not be sufficient to diagnose secondary headaches, immediate referral to the emergency department may be required. Conclusion Primary contact practitioners should be aware of the various causes of headaches that result after a MVA. Headaches, which do not respond or progress, should be followed aggressively to determine their source. PMID:17657301

An Herbal Derivative as the Basis for a New Approach to Treating Post-Traumatic Osteoarthritis

DTIC Science & Technology

2017-09-01

OA 3) A new ex vivo assay using intact joint cartilage to test ex vivo efficacy of EPRS inhibitors as therapeutics for OA. 15. SUBJECT TERMS Post ...AWARD NUMBER: W81XWH-15-1-0396 TITLE: An Herbal Derivative as the Basis for a New Approach to Treating Post - Traumatic Osteoarthritis...TITLE AND SUBTITLE An Herbal Derivative as the Basis for a New Approach to Treating Post - Traumatic Osteoarthritis 5a. CONTRACT NUMBER 5b. GRANT NUMBER

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

PubMed

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

2010-02-27

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.

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

Validation of the Child Post-Traumatic Cognitions Inventory in Korean survivors of sexual violence.

PubMed

Lee, Han Byul; Shin, Kyoung Min; Chung, Young Ki; Kim, Namhee; Shin, Yee Jin; Chung, Un-Sun; Bae, Seung Min; Hong, Minha; Chang, Hyoung Yoon

2018-01-01

Dysfunctional cognitions related to trauma is an important factor in the development and maintenance of post-traumatic stress disorder symptoms in children and adolescents. The Child Post-traumatic Cognitions Inventory (CPTCI) assesses such cognitions about trauma. We investigated the psychometric properties of the Korean version of CPTCI and its short form by surveying child and adolescent survivors of sexual violence. Children and adolescents aged 7-16 years ( N  = 237, M age  = 12.6, SD  = 2.3, 222 [93.7%] were female) who were exposed to sexual violence were included in this survey. We assessed the factor structure, internal consistency, and validity of the CPTCI and its short form through data analysis. Confirmatory factor analysis results supported the two-factor model presented in the original study. The total scale, its subscales, and the short form had good internal consistency (Cronbach's α = .96 for total scale and .91-.95 for the other scales). The CPTCI showed high correlations with scales measuring post-traumatic stress symptoms ( r  = .77-.80), anxiety ( r  = .69-.71), and depression ( r  = .74-.77); the correlation with post-traumatic stress symptoms was the highest. The differences in CPTCI scores per post-traumatic stress symptom levels were significant (all p  < .001) Sex differences in CPTCI scores were not significant ( p  > .05 for all comparisons); however, the scores exhibited differences per age group (all p  < .001). The results indicate that the Korean version of the CPTCI is a valid and reliable scale; therefore, it may be a valuable tool for assessing maladaptive cognitions related to trauma in research and clinical settings.

Cognitive activity limitations one year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury.

PubMed

Sommer, Jens Bak; Norup, Anne; Poulsen, Ingrid; Morgensen, Jesper

2013-09-01

To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. The study included 119 patients with severe traumatic brain injury admitted to centralized sub-acute rehabilitation in the Eastern part of Denmark during a 5-year period from 2005 to 2009. Level of consciousness was assessed consecutively during rehabilitation and at 1 year post-trauma. Severity of traumatic brain injury was classified according to duration of post-traumatic amnesia. The cognitive subscale of Functional Independence MeasureTM (Cog-FIM) was used to assess cognitive activity limitations. Multivariate logistic regression analyses were performed to identify predictors of an independent level of functioning. The majority of patients progressed to a post-confusional level of consciousness during the first year post-trauma. At follow-up 33-58% of patients had achieved functional independence within the cognitive domains on the Cog-FIM. Socio-economic status, duration of acute care and post-traumatic amnesia were significant predictors of outcome. Substantial recovery was documented among patients with severe traumatic brain injury during the first year post-trauma. The results of the current study suggest that absence of consciousness at discharge from acute care should not preclude patients from being referred to specialized sub-acute rehabilitation.

Developmental Timing of Childhood Physical and Sexual Maltreatment Predicts Adult Depression and Post-Traumatic Stress Symptoms.

PubMed

Jaye Capretto, Jessica

2017-04-01

Child physical and sexual maltreatment have emerged as documented risk factors for a wide range of health problems in adulthood, including depression and post-traumatic stress symptoms. Prior research focuses on generalized childhood adversities without accounting for how different critical details about the maltreatment may affect outcomes in adulthood. The present study examines the impact of two critical details, timing and type of child maltreatment, on depression and post-traumatic stress symptoms in adulthood. Participants ( N = 104) completed the Maltreatment and Abuse Chronology of Exposure scale (MACE) and the Inventory of Depression and Anxiety Scale-Second Version (IDAS-II). Hierarchical multiple regressions compared three different models of child maltreatment predictors and their differential utility for predicting depression and post-traumatic stress symptoms in adulthood: (a) number of child maltreatment experiences, (b) severity of child maltreatment, and (c) timing of child maltreatment. Results indicate that severity of child maltreatment and timing of child maltreatment are greater predictors for adult depression and post-traumatic stress symptoms than number of child maltreatment experiences. Compared with other developmental periods, early childhood sexual maltreatment experiences (5 years of age and below) and late childhood physical maltreatment experiences (13 years of age and above) were stronger predictors of adult depression and post-traumatic stress symptoms. Children maltreated during these age groups may be prioritized for prevention and intervention efforts, particularly when there are limited resources. Clinical interviews with maltreated children should also be expanded to include information about developmental timing and severity of maltreatment, which have ramifications for later health problems. Implications for assessment of maltreated children, prevention of adult depression and post-traumatic stress symptoms, and future

Predictors of birth-related post-traumatic stress symptoms: secondary analysis of a cohort study.

PubMed

Furuta, Marie; Sandall, Jane; Cooper, Derek; Bick, Debra

2016-12-01

This study aimed to identify factors associated with birth-related post-traumatic stress symptoms during the early postnatal period. Secondary analysis was conducted using data from a prospective cohort study of 1824 women who gave birth in one large hospital in England. Post-traumatic stress symptoms were measured by the Impact of Event Scale at 6 to 8 weeks postpartum. Zero-inflated negative binomial regression models were developed for analyses. Results showed that post-traumatic stress symptoms were more frequently observed in black women and in women who had a higher pre-pregnancy BMI compared to those with a lower BMI. Women who have a history of mental illness as well as those who gave birth before arriving at the hospital, underwent an emergency caesarean section or experienced severe maternal morbidity or neonatal complications also showed symptoms. Women's perceived control during labour and birth significantly reduced the effects of some risk factors. A higher level of perceived social support during the postnatal period also reduced the risk of post-traumatic stress symptoms. From the perspective of clinical practice, improving women's sense of control during labour and birth appears to be important, as does providing social support following the birth.

Transnasal Endoscopic Optic Nerve Decompression in Post Traumatic Optic Neuropathy.

PubMed

Gupta, Devang; Gadodia, Monica

2018-03-01

To quantify the successful outcome in patients following optic nerve decompression in post traumatic unilateral optic neuropathy in form of improvement in visual acuity. A prospective study was carried out over a period of 5 years (January 2011 to June 2016) at civil hospital Ahmedabad. Total 20 patients were selected with optic neuropathy including patients with direct and indirect trauma to unilateral optic nerve, not responding to conservative management, leading to optic neuropathy and subsequent impairment in vision and blindness. Decompression was done via Transnasal-Ethmo-sphenoidal route and outcome was assessed in form of post-operative visual acuity improvement at 1 month, 6 months and 1 year follow up. After surgical decompression complete recovery of visual acuity was achieved in 16 (80%) patients and partial recovery in 4 (20%). Endoscopic transnasal approach is beneficial in traumatic optic neuropathy not responding to steroid therapy and can prevent permanent disability if earlier intervention is done prior to irreversible damage to the nerve. Endoscopic optic nerve surgery can decompress the traumatic and oedematous optic nerve with proper exposure of orbital apex and optic canal without any major intracranial, intraorbital and transnasal complications.

Basal cerebral glucose distribution in long-term post-traumatic stress disorder.

PubMed

Molina, Mario Enrique; Isoardi, Roberto; Prado, Marcela Nathalie; Bentolila, Silvia

2010-03-01

The purpose of this investigation was to study basal cerebral glucose absorption patterns associated to long-term post-traumatic stress disorder. Fluorodeoxyglucose positron emission tomography (FDG-PET) and statistic parametric mapping (SPM) were used to compare regional cerebral glucose absorption between 15 war veterans (Hispanic men, aged 39-41 (M = 39.5, SD = 0.84)) diagnosed with post-traumatic stress disorder (PTSD) based on DSM-IV criteria, and a matching control group of six asymptomatic veterans. This study was conducted 20 years after the traumatic events. PTSD patients presented relatively diminished activity (P<0.005) in: cingulate gyri, precuneus, insula, hippocampus; frontal, pre-frontal and post-central regions; lingual, calcarine, occipital medial and superior gyri, and verbal and paraverbal areas. Relativeley augmented activity (P<0.005) was observed in PTSD patients in: fusiform, temporal superior, medial, and inferior gyri; occipital medial, inferior and lingual gyri; precuneus, and cerebellum. The amygdala and the thalamus showed normal metabolic activity. Various brain regions that showed diminished activity (limbic, frontal and prefrontal cortex, multimodal parieto-occipital areas and verbal and paraverbal areas) have evolved lately, and sub-serve highly complex cognitive and behavioural functions. Metabolic activity patterns are comparable to those observed in personality disorders of the borderline type.

Randomized trial of low versus high carbon dioxide insufflation pressures in posterior retroperitoneoscopic adrenalectomy.

PubMed

Fraser, Sheila; Norlén, Olov; Bender, Kyle; Davidson, Joanne; Bajenov, Sonya; Fahey, David; Li, Shawn; Sidhu, Stan; Sywak, Mark

2018-05-01

Posterior retroperitoneoscopic adrenalectomy has gained widespread acceptance for the removal of benign adrenal tumors. Higher insufflation pressures using carbon dioxide (CO 2 ) are required, although the ideal starting pressure is unclear. This prospective, randomized, single-blinded, study aims to compare physiologic differences with 2 different CO 2 insufflation pressures during posterior retroperitoneoscopic adrenalectomy. Participants were randomly assigned to a starting insufflation pressure of 20 mm Hg (low pressure) or 25 mm Hg (high pressure). The primary outcome measure was partial pressure of arterial CO 2 at 60 minutes. Secondary outcomes included end-tidal CO 2 , arterial pH, blood pressure, and peak airway pressure. Breaches of protocol to change insufflation pressure were permitted if required and were recorded. A prospective randomized trial including 31 patients (low pressure: n = 16; high pressure: n = 15) was undertaken. At 60 minutes, the high pressure group had greater mean partial pressure of arterial CO 2 (64 vs 50 mm Hg, P = .003) and end-tidal CO 2 (54 vs 45 mm Hg, P = .008) and a lesser pH (7.21 vs 7.29, P = .0005). There were no significant differences in base excess, peak airway pressure, operative time, or duration of hospital stay. Clinically indicated protocol breaches were more common in the low pressure than the high pressure group (8 vs 3, P = .03). In posterior retroperitoneoscopic adrenalectomy, greater insufflation pressures are associated with greater partial pressure of arterial CO 2 and end-tidal CO 2 and lesser pH at 60 minutes, be significant. Commencing with lesser CO 2 insufflation pressures decreases intraoperative acidosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Imagining What Could Have Happened: Types and Vividness of Counterfactual Thoughts and the Relationship With Post-traumatic Stress Reactions.

PubMed

Blix, Ines; Kanten, Alf Børre; Birkeland, Marianne Skogbrott; Thoresen, Siri

2018-01-01

A growing body of research suggests that counterfactual thinking after traumatic events is associated with post-traumatic stress reactions. In this study we explored frequency of upward and downward counterfactuals in trauma-exposed individuals, and how trauma-related counterfactuals were represented in terms of vividness. We examined the relationships between vividness and frequency of counterfactual thoughts and post-traumatic stress reactions in two groups who had experienced different types of traumatic exposure, namely survivors and bereaved from the fire on the ferry Scandinavian Star in 1990. Even after 26 years, both survivors and bereaved reported that they currently entertained thoughts about what could have happened during the fire on Scandinavian Star. Survivors reported more downward counterfactuals than the bereaved, whereas the bereaved reported more upward counterfactuals than the survivors did. Vividness of counterfactual thoughts, as well as reported frequency of upward and downward counterfactuals, were associated with post-traumatic stress reactions. Our results suggest that both upward and downward counterfactuals can be harmful, and that vivid counterfactuals about a traumatic event might play a similar role in post-traumatic stress as trauma memories. Therefore, traumatized individuals who entertain counterfactual thoughts may benefit from interventions that target these thoughts specifically.

White matter integrity in highly traumatized adults with and without post-traumatic stress disorder.

PubMed

Fani, Negar; King, Tricia Z; Jovanovic, Tanja; Glover, Ebony M; Bradley, Bekh; Choi, Kisueng; Ely, Timothy; Gutman, David A; Ressler, Kerry J

2012-11-01

Prior structural imaging studies of post-traumatic stress disorder (PTSD) have observed smaller volumes of the hippocampus and cingulate cortex, yet little is known about the integrity of white matter connections between these structures in PTSD samples. The few published studies using diffusion tensor imaging (DTI) to measure white matter integrity in PTSD have described individuals with focal trauma rather than chronically stressed individuals, which limits generalization of findings to this population; in addition, these studies have lacked traumatized comparison groups without PTSD. The present DTI study examined microstructural integrity of white matter tracts in a sample of highly traumatized African-American women with (n=25) and without (n=26) PTSD using a tract-based spatial statistical approach, with threshold-free cluster enhancement. Our findings indicated that, relative to comparably traumatized controls, decreased integrity (measured by fractional anisotropy) of the posterior cingulum was observed in participants with PTSD (p<0.05). These findings indicate that reduced microarchitectural integrity of the cingulum, a white matter fiber that connects the entorhinal and cingulate cortices, appears to be associated with PTSD symptomatology. The role of this pathway in problems that characterize PTSD, such as inadequate extinction of learned fear, as well as attention and explicit memory functions, are discussed.

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

Cancer.gov

Cancer-related post-traumatic stress (PTS) can occur any time from diagnosis until the end of treatment; treatment used in PTSD can be useful in reducing distress. Get comprehensive information on PTS in this summary for clinicians.

Workplace bullying and post-traumatic stress symptoms among family physicians in Lithuania: an occupation and region specific approach.

PubMed

Malinauskiene, Vilija; Einarsen, Staale

2014-12-01

The study investigated associations between workplace bullying and post-traumatic stress symptoms as compared to and controlled for associations between the latter and other psychosocial stress factors at work and in everyday life. The study employed a representative sample of Lithuanian family physicians, hence investigated a particularly resourceful occupational group in a geographical region earlier found to have a high risk context for exposure to bullying at work. With a response rate of 89.2%, a total of 323 family physicians filled in an anonymous questionnaire on workplace bullying, post-traumatic symptomatology (IES-R), other psychosocial stressors at work and in everyday life, personal health resources (sense of coherence), behavioral characteristics and demographic variables. The statistical software SPSS 14.0, Windows was used in the analysis. Associations were tested using a multivariate logistic regression analysis. A high prevalence of bullying was found among family physicians in Lithuania, with 13% of them experiencing severe workplace bullying and 17.3% experiencing more occasional incidents of bullying. The prevalence of post-traumatic stress symptoms was also high with 15.8% scoring above the standardized cut-off thresholds for post-traumatic stress disorder. The odds ratio (OR) of severe bullying for post-traumatic stress after adjustment for age and gender was 8.05 (95% confidence intervals (CI): 3.80-17.04). In the fully adjusted model it increased to 13.88 (95% CI: 4.68-41.13) indicating cumulative effects of all the investigated stressors. Workplace bullying is particularly prevalent among Lithuanian family physicians, as are the symptoms of post-traumatic distress. Strong associations between post-traumatic stress and exposure to severe bullying indicate that bullying is a significant source of mental health.

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

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.

Post-traumatic stress disorder symptoms in first-time myocardial infarction patients: roles of attachment and alexithymia.

PubMed

Gao, Wen; Zhao, Jing; Li, Yang; Cao, Feng-Lin

2015-11-01

To explore the roles of attachment and alexithymia in the severity of post-traumatic stress disorder symptoms and to specify the relationship between sub-dimensions of attachment, alexithymia and posttraumatic stress disorder symptoms in patients with first-time myocardial infarction in mainland China. Patients experiencing myocardial infarction have a risk of developing post-traumatic stress disorder symptoms. However, there have been few studies on the roles of attachment and alexithymia. A cross-sectional survey design. Ninety-seven patients participated in the assessment of post-traumatic stress disorder symptoms, attachment and alexithymia from June-December in 2012. To assess post-traumatic stress disorder symptoms and their correlates, we administered the Post-traumatic Stress Disorder Checklist-Civilian Version, the 20-item Toronto Alexithymia Scale and the Experiences in Close Relationships Scale 5-17 days after the remission of first myocardial infarction attack. Twenty-five (25·77%) patients met the criteria of posttraumatic stress disorder symptoms. Greater attachment anxiety and avoidance were associated with more severe posttraumatic stress disorder symptoms. Except for externally oriented thinking, all dimensions of alexithymia were significantly correlated with post-traumatic stress symptoms. In the regression model, attachment anxiety and difficulties identifying feelings were found to be predictive and the total regression equation explained 24·2% variance of posttraumatic stress disorder symptoms among myocardial infarction patients. First-time myocardial infarction patients were at risk of developing posttraumatic stress disorder symptoms. Attachment anxiety and difficulties identifying feelings were positively associated with posttraumatic stress disorder symptoms in the early stage of myocardial infarction rehabilitation. It is essential to evaluate the causal relationship between attachment, alexithymia and posttraumatic stress disorder

Combat veterans, mental health issues, and the death penalty: addressing the impact of post-traumatic stress disorder and traumatic brain injury.

PubMed

Giardino, Anthony E

2009-05-01

More than 1.5 million Americans have participated in combat operations in Iraq and Afghanistan over the past seven years. Some of these veterans have subsequently committed capital crimes and found themselves in our nation's criminal justice system. This Essay argues that combat veterans suffering from post-traumatic stress disorder or traumatic brain injury at the time of their offenses should not be subject to the death penalty.Offering mitigating evidence regarding military training, post-traumatic stress disorder, and traumatic brain injury presents one means that combat veterans may use to argue for their lives during the sentencing phase of their trials. Alternatively, Atkins v. Virginia and Roper v. Simmons offer a framework for establishing a legislatively or judicially created categorical exclusion for these offenders, exempting them from the death penalty as a matter of law. By understanding how combat service and service-related injuries affect the personal culpability of these offenders, the legal system can avoid the consequences of sentencing to death America's mentally wounded warriors, ensuring that only the worst offenders are subject to the ultimate punishment.

Psychological interventions for post-traumatic stress disorder in people living with HIV in Resource poor settings: a systematic review.

PubMed

Verhey, Ruth; Chibanda, Dixon; Brakarsh, Jonathan; Seedat, Soraya

2016-10-01

Post-traumatic stress disorder is pervasive in low- and middle-income countries. There is evidence to suggest that post-traumatic stress disorder is more common among people living with HIV than non-infected matched controls. We carried out a systematic review of interventions for adult post-traumatic stress disorder from resource poor settings with a focus on people living with HIV. We included all studies that investigated interventions for adult post-traumatic stress disorder from resource poor settings with a focus on interventions that were either randomised controlled trials or observational cohort studies carried out from 1980 to May 2015. Of the 25 articles that were identified for full review, two independent reviewers identified seven studies that met our study inclusion criteria. All randomised controlled trials (RCT) (n = 6) used cognitive behavioural therapy-based interventions and focused on people living with HIV in resource poor settings. There was only one study focusing on the use of lay counsellors to address post-traumatic stress disorder but core competencies were not described. There were no intervention studies from Africa, only an observational cohort study from Rwanda. Rigorously evaluated interventions for adult post-traumatic stress disorder in people living with HIV are rare. Most were undertaken in resource poor settings located in high-income countries. There is a need for research on the development and implementation of appropriate interventions for post-traumatic stress disorder in people living with HIV in low- and middle-income countries. © 2016 John Wiley & Sons Ltd.

Combat Stress Reaction and Post Traumatic Stress Disorder

DTIC Science & Technology

1990-01-01

CONDUCTED . PSYCHOLOGICAL, PHYSIOL..3ICAL S. AND ENVIRONMENTAL FACTORS ASSOCIATED WITH THE AETIO ..OGY OF BOTH DISORDERS WERE DISCUSSED, WITH A SPECIAL...reviewsof the Literature examining Combat Stress Reactions and Post-traumatic Stress Disorder s conducted . PsychotogicaL, physiotogicaL and environsmet...Journal of Clinical Psychology, 1987, 43, 1:, 44 - 53. Figley C.R. red] !,tress Disorders Among Vietnam Veterans: Theory , Research and Development

Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.

PubMed

Böttche, Maria; Kuwert, Philipp; Pietrzak, Robert H; Knaevelsrud, Christine

2016-03-01

The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to

Community Destruction and Traumatic Stress in Post-Tsunami Indonesia

ERIC Educational Resources Information Center

Frankenberg, Elizabeth; Nobles, Jenna; Sumantri, Cecep

2012-01-01

How are individuals affected when the communities they live in change for the worse? This question is central to understanding neighborhood effects, but few study designs generate estimates that can be interpreted causally. We address issues of inference through a natural experiment, examining post-traumatic stress at multiple time points in a…

Virtual Reality-Enhanced Extinction of Phobias and Post-Traumatic Stress.

PubMed

Maples-Keller, Jessica L; Yasinski, Carly; Manjin, Nicole; Rothbaum, Barbara Olasov

2017-07-01

Virtual reality (VR) refers to an advanced technological communication interface in which the user is actively participating in a computer-generated 3-dimensional virtual world that includes computer sensory input devices used to simulate real-world interactive experiences. VR has been used within psychiatric treatment for anxiety disorders, particularly specific phobias and post-traumatic stress disorder, given several advantages that VR provides for use within treatment for these disorders. Exposure therapy for anxiety disorder is grounded in fear-conditioning models, in which extinction learning involves the process through which conditioned fear responses decrease or are inhibited. The present review will provide an overview of extinction training and anxiety disorder treatment, advantages for using VR within extinction training, a review of the literature regarding the effectiveness of VR within exposure therapy for specific phobias and post-traumatic stress disorder, and limitations and future directions of the extant empirical literature.

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…

Post-traumatic epilepsy: current and emerging treatment options

PubMed Central

Szaflarski, Jerzy P; Nazzal, Yara; Dreer, Laura E

2014-01-01

Traumatic brain injury (TBI) leads to many undesired problems and complications, including immediate and long-term seizures/epilepsy, changes in mood, behavioral, and personality problems, cognitive and motor deficits, movement disorders, and sleep problems. Clinicians involved in the treatment of patients with acute TBI need to be aware of a number of issues, including the incidence and prevalence of early seizures and post-traumatic epilepsy (PTE), comorbidities associated with seizures and anticonvulsant therapies, and factors that can contribute to their emergence. While strong scientific evidence for early seizure prevention in TBI is available for phenytoin (PHT), other antiepileptic medications, eg, levetiracetam (LEV), are also being utilized in clinical settings. The use of PHT has its drawbacks, including cognitive side effects and effects on function recovery. Rates of recovery after TBI are expected to plateau after a certain period of time. Nevertheless, some patients continue to improve while others deteriorate without any clear contributing factors. Thus, one must ask, ‘Are there any actions that can be taken to decrease the chance of post-traumatic seizures and epilepsy while minimizing potential short- and long-term effects of anticonvulsants?’ While the answer is ‘probably,’ more evidence is needed to replace PHT with LEV on a permanent basis. Some have proposed studies to address this issue, while others look toward different options, including other anticonvulsants (eg, perampanel or other AMPA antagonists), or less established treatments (eg, ketamine). In this review, we focus on a comparison of the use of PHT versus LEV in the acute TBI setting and summarize the clinical aspects of seizure prevention in humans with appropriate, but general, references to the animal literature. PMID:25143737

Post-Traumatic Stress Symptoms in Pediatric Heart Transplant Recipients.

PubMed

Evan, Elana E; Patel, Payal A; Amegatcher, Alison; Halnon, Nancy

2014-04-26

Traumatic experiences are not unusual in pediatric heart transplant (HT) recipients before and after transplantation. Post-traumatic stress symptoms (PTSS) present at the time of transplant evaluation and developing afterward occur with an unknown frequency. We sought to determine the burden of these symptoms in heart transplant patients. We reviewed 51 consecutive HTs between 2003-2007, including 40 primary transplants and 11 re-transplants. Symptoms were present in 17 of the 51 patients (34%) at the time of orthotopic heart transplantation evaluation. None met the criteria for full post traumatic stress disorder. Transplant complications were examined. Nineteen subjects of the total sample had rejection in the first year following transplant. Rejection rates in the first year was 41% for those with PTSS (7 of 17 patients) and 36% for those without (12 of 33 patients) (P=n.s). Of those patients presenting for a second heart transplant, 55% had PTSS at the time of transplant evaluation and/or the peritransplant period; whereas, (28%) undergoing a primary transplant had PTSS. In addition to symptoms resulting from the disease process leading to HT and other prior experiences, the HT itself seems to present a large psychiatric burden on patients. All patients need to be followed before and after HT for signs and symptoms related to PTSS. Future studies should be undertaken to determine if preventative detection and treatment of patients with these PTSS symptoms early can lead to better outcomes.

Post-traumatic stress disorder in the context of terrorism and other civil conflict in Northern Ireland: randomised controlled trial

PubMed Central

Gillespie, Kate; Clark, David M

2007-01-01

Objective To evaluate the effectiveness of cognitive therapy for post-traumatic stress disorder related to terrorism and other civil conflict in Northern Ireland. Design Randomised controlled trial. Setting Community treatment centre, Northern Ireland. Participants 58 consecutive patients with chronic post-traumatic stress disorder (median 5.2 years, range 3 months to 32 years) mostly resulting from multiple traumas linked to terrorism and other civil conflict. Interventions Immediate cognitive therapy compared with a waiting list control condition for 12 weeks followed by treatment. Treatment comprised a mean of 5.9 sessions during 12 weeks and 2.0 sessions thereafter. Main outcome measures Primary outcome measures were patients' scores for post-traumatic stress disorder (post-traumatic stress diagnostic scale) and depression (Beck depression inventory). The secondary outcome measure was scores for occupational and social functioning (work related disability, social disability, and family related disability) on the Sheehan disability scale. Results At 12 weeks after randomisation, immediate cognitive therapy was associated with significantly greater improvement than the waiting list control group in the symptoms of post-traumatic stress disorder (mean difference 9.6, 95% confidence interval 3.6 to 15.6), depression (mean difference 10.1, 4.8 to 15.3), and self reported occupational and social functioning (mean difference 1.3, 0.3 to 2.5). Effect sizes from before to after treatment were large: post-traumatic stress disorder 1.25, depression 1.05, and occupational and social functioning 1.17. No change was observed in the control group. Conclusion Cognitive therapy is an effective treatment for post-traumatic stress disorder related to terrorism and other civil conflict. Trial registration Current Controlled Trials ISRCTN16228473. PMID:17495988

Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.

PubMed

Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J

2017-03-01

Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p < .01) of a pre-treatment depressive disorder predicted poor treatment response and explained 39% of the variance between individuals. Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may

Treating dysarthria following traumatic brain injury: investigating the benefits of commencing treatment during post-traumatic amnesia in two participants.

PubMed

McGhee, Hannah; Cornwell, Petrea; Addis, Paula; Jarman, Carly

2006-11-01

The aims of this preliminary study were to explore the suitability for and benefits of commencing dysarthria treatment for people with traumatic brain injury (TBI) while in post-traumatic amnesia (PTA). It was hypothesized that behaviours in PTA don't preclude participation and dysarthria characteristics would improve post-treatment. A series of comprehensive case analyses. Two participants with severe TBI received dysarthria treatment focused on motor speech deficits until emergence from PTA. A checklist of neurobehavioural sequelae of TBI was rated during therapy and perceptual and motor speech assessments were administered before and after therapy. Results revealed that certain behaviours affected the quality of therapy but didn't preclude the provision of therapy. Treatment resulted in physiological improvements in some speech sub-systems for both participants, with varying functional speech outcomes. These findings suggest that dysarthria treatment can begin and provide short-term benefits to speech production during the late stages of PTA post-TBI.

Predictors of cognitive and physical fatigue in post-acute mild-moderate traumatic brain injury.

PubMed

Schiehser, Dawn M; Delano-Wood, Lisa; Jak, Amy J; Hanson, Karen L; Sorg, Scott F; Orff, Henry; Clark, Alexandra L

2017-10-01

Post-traumatic fatigue (PTF) is a common, disabling, and often chronic symptom following traumatic brain injury (TBI). Yet, the impact of chronic cognitive and physical fatigue and their associations with psychiatric, sleep, cognitive, and psychosocial sequelae in mild-moderate TBI remain poorly understood. Sixty Veterans with a history of mild-moderate TBI and 40 Veteran controls (VC) were administered the Modified Fatigue Impact Scale, a validated measure of TBI-related cognitive and physical fatigue as well as measures of neuropsychiatric, psychosocial, sleep, and objective cognitive functioning. Compared to VC, TBI Veterans endorsed significantly greater levels of cognitive and physical fatigue. In TBI, psychiatric symptoms, sleep disturbance, and post-traumatic amnesia (PTA) were associated with both cognitive and physical fatigue, while loss of consciousness (LOC) and poor attention/processing speed were related to elevations in cognitive fatigue only. In regression analyses, anxiety, sleep disturbance, and LOC significantly predicted cognitive fatigue, while only post-traumatic stress symptoms and PTA contributed to physical fatigue. Cognitive and physical fatigue are problematic symptoms following mild-moderate TBI that are differentially associated with specific injury and psychiatric sequelae. Findings provide potential symptom targets for interventions aimed at ameliorating fatigue, and further underscore the importance of assessing and treating fatigue as a multi-dimensional symptom following TBI.

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…

A systematic review of midwife-led interventions to address post partum post-traumatic stress.

PubMed

Borg Cunen, Nicole; McNeill, Jenny; Murray, Karen

2014-02-01

to systematically identify interventions that midwives could introduce to address post-traumatic stress in women following childbirth. a search strategy was developed and relevant papers were identified from databases including Cinahl, Cochrane Library, EMBASE, Maternity and Infant Care, MEDLINE, PsycINFO, and Web of Science. Key search terms used were post-traumatic stress, post partum, intervention, controlled trial and review. Papers eligible for inclusion were primary studies and reviews of research published from 2002-2012, focusing on interventions which could be implemented by midwives for the prevention and/or management of PTSD. For primary studies, RCTs, controlled clinical trials, and cohort studies with a control group were eligible. Eligible reviews were those with a specified search strategy and inclusion/exclusion criteria. Methodological quality was assessed using recognised frameworks. six primary studies and eight reviews were eligible for inclusion. The majority of included studies or reviews focused on debriefing and/or counselling interventions; however the results were not consistent due to significant variation in methodological quality and use of dissimilar interventions. Two of the reviews considered the general management of post partum PTSD and one broadly covered anxiety during pregnancy and the post partum, incorporating a section on PTSD. The majority of women reported that the opportunity to discuss their childbirth experience was subjectively beneficial. no evidence-based midwifery interventions were identified from this systematic review that can be recommended for introduction into practice to address PTSD. It is recommended that future research in this area should incorporate standardised interventions with similar outcome measures to facilitate synthesis of results. Further research on interventions used in non-maternity populations is needed in order to confirm their usefulness in addressing post partum PTSD. © 2013 Elsevier

Post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the Yushu earthquake: a cross-sectional survey in China.

PubMed

Dongling, Liu; Hui, Chen; Ling, Ma; Wenqian, Bie; Zailiang, Liu; Changying, Chen

2017-04-01

To examine the prevalence of post-traumatic stress disorder symptoms and to explore the predictive factors of post-traumatic stress disorder symptoms among bereaved adolescents four years after the Yushu earthquake. On 14 April 2010, the 7·1-magnitude Yushu earthquake occurred in the high-altitude, hypoxia-prone regions primarily inhabited by ethnic minorities. Many adolescents lost their parents during the earthquake. This study examined post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the trauma in China. This was a cross-sectional descriptive study. This study used a cross-sectional design with 830 bereaved adolescents. Participant demographic data included gender, age and grade, and the earthquake exposure variables included the deceased relatives, whether they were buried, injured or amputated (non-life-threatening) and whether they witnessed a burial, injury or death. The post-traumatic stress disorder Checklist-Civilian version was used to assess the symptoms and prevalence of post-traumatic stress disorder, and the Coping Style Scale assessed coping styles. The results indicated that the prevalence of post-traumatic stress disorder was 19·3%. Individuals who were buried, injured or amputated (non-life-threatening), who witnessed a burial, injury or death, who suffered severe property loss during the earthquake and who had negative coping skills were the most likely individuals to have post-traumatic stress disorder symptoms. The presence of post-traumatic stress disorder was very prevalent among adolescents four years after the Yushu earthquake. Effective mental health services should be developed to facilitate postdisaster recovery for bereaved adolescents at high risk for post-traumatic stress disorder. The findings in this study improve our understanding of post-traumatic stress disorder and related risk factors in bereaved adolescents in non-Western communities, providing useful information for

Clinical evaluation of post-operative cerebral infarction in traumatic epidural haematoma.

PubMed

Zhang, Suojun; Wang, Sheng; Wan, Xueyan; Liu, Shengwen; Shu, Kai; Lei, Ting

2017-01-01

Patients with traumatic epidural haematoma, undergoing the prompt and correct treatment, usually have favourable outcomes. However, secondary cerebral infarction may be life-threatening condition, as it is difficult to be identified before neurological impairment occurs. To evaluate the clinical data of patients with traumatic EDH and assess potential risk factors for post-operative cerebral infarction. The clinical data of patients with traumatic EDH were collected and analysed retrospectively. The univariate analysis revealed 10 potential risk factors (the haematoma location, volume, the largest thickness and mid-line shift, basal cisterns compression, traumatic subarachnoid haemorrhage, pupil dilatation, pre-operative Glasgow Coma Scale score, ∆GCS and intraoperative brain pressure) for cerebral infarction with statistically significant difference. Of these factors, haematoma volume and basal cistern compression turned out to be the most significant risk factors through final multivariate logistic regression analysis. The findings of this study can provide predictive factors for development of cerebral infarction and information for clinical decision-making and future studies.

An Herbal Derivative as the Basis for a New Approach to Treating Post-Traumatic Osteoarthritis

DTIC Science & Technology

2017-09-01

AWARD NUMBER: W81XWH-15-1-0397 TITLE: An Herbal Derivative as the Basis for a New Approach to Treating Post - Traumatic Osteoarthritis...TITLE AND SUBTITLE An Herbal Derivative as the Basis for a New Approach to Treating Post - Traumatic Osteoarthritis 5a. CONTRACT NUMBER 5b. GRANT...responsible for charging tRNAs with the amino acid proline. The goal of this grant is to test the hypothesis that EPRS inhibitors will provide the basis

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. © 2010 Wiley Periodicals, Inc.

Assessment of Biomarkers Associated with Joint Injury and Subsequent Post-Traumatic Arthritis

DTIC Science & Technology

2016-12-01

models of the patella and patellar cartilage (Geomagic Studio, Research Triangle Park, NC). Changes in cartilage thickness between post -operative... quantitative scales, and "Assessment of Biomarkers Associated with Joint Injury and Subsequent Post -Traumatic Arthritis" Start date: 9/30/2012 PIs...Geomagic®). Positive and negative deviations of the bone surface were measured, and defined as the distance to a test surface ( post -fx bone surface

Post traumatic stress disorder following an electric shock.

PubMed

Premalatha, G D

1994-09-01

Post Traumatic Stress Disorder (PTSD) is still a diagnosis which is frequently missed even by psychiatric professionals. Each doctor needs to maintain a high level of awareness that patients may have experienced trauma; that PTSD can often occur for a variety of common symptoms; and that it may also be at the root of a persisting treatment-resistant depressive or anxiety state. This case demonstrates that occupational accidents may result in this condition.

Creating Safe Environments for Children with Post-Traumatic Stress Disorder.

ERIC Educational Resources Information Center

Demaree, Mary Ann

1995-01-01

Discusses development of Post-Traumatic Stress Disorder (PTSD) in children living in violent homes and communities. Discusses the role of teachers in creating classrooms that feel safe. Notes the importance of relearning safety to children who have PTSD. Describes strategies to create feeling of safety in the children. (BAC)

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…

Post Traumatic Stress, Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth

ERIC Educational Resources Information Center

Weems, Carl F.; Taylor, Leslie K.; Cannon, Melinda F.; Marino, Reshelle C.; Romano, Dawn M.; Scott, Brandon G.; Perry, Andre M.; Triplett, Vera

2010-01-01

This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n = 191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD…

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

PubMed

Riber, Karin

2016-01-01

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.

Screening for Post-Traumatic Stress Disorder in a Civilian Emergency Department Population with Traumatic Brain Injury.

PubMed

Haarbauer-Krupa, Juliet; Taylor, Christopher A; Yue, John K; Winkler, Ethan A; Pirracchio, Romain; Cooper, Shelly R; Burke, John F; Stein, Murray B; Manley, Geoffrey T

2017-01-01

Post-traumatic stress disorder (PTSD) is a condition associated with traumatic brain injury (TBI). While the importance of PTSD and TBI among military personnel is widely recognized, there is less awareness of PTSD associated with civilian TBI. We examined the incidence and factors associated with PTSD 6 months post-injury in a civilian emergency department population using measures from the National Institute of Neurological Disorders and Stroke TBI Common Data Elements Outcome Battery. Participants with mild TBI (mTBI) from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with complete 6-month outcome batteries (n = 280) were analyzed. Screening for PTSD symptoms was conducted using the PTSD Checklist-Civilian Version. Descriptive measures are summarized and predictors for PTSD were examined using logistic regression. Incidence of screening positive for PTSD was 26.8% at 6 months following mTBI. Screening positive for PTSD was significantly associated with concurrent functional disability, post-concussive and psychiatric symptomatology, decreased satisfaction with life, and decreased performance in visual processing and mental flexibility. Multi-variable regression showed injury mechanism of assault (odds ratio [OR] 3.59; 95% confidence interval [CI] 1.69-7.63; p = 0.001) and prior psychiatric history (OR 2.56; 95% CI 1.42-4.61; p = 0.002) remained significant predictors of screening positive for PTSD, while education (per year OR 0.88; 95% CI 0.79-0.98; p = 0.021) was associated with decreased odds of PTSD. Standardized data collection and review of pre-injury education, psychiatric history, and injury mechanism during initial hospital presentation can aid in identifying patients with mTBI at risk for developing PTSD symptoms who may benefit from closer follow-up after initial injury care.

Screening for Post-Traumatic Stress Disorder in a Civilian Emergency Department Population with Traumatic Brain Injury

PubMed Central

Haarbauer-Krupa, Juliet; Taylor, Christopher A.; Yue, John K.; Winkler, Ethan A.; Pirracchio, Romain; Cooper, Shelly R.; Burke, John F.; Stein, Murray B.

2017-01-01

Abstract Post-traumatic stress disorder (PTSD) is a condition associated with traumatic brain injury (TBI). While the importance of PTSD and TBI among military personnel is widely recognized, there is less awareness of PTSD associated with civilian TBI. We examined the incidence and factors associated with PTSD 6 months post-injury in a civilian emergency department population using measures from the National Institute of Neurological Disorders and Stroke TBI Common Data Elements Outcome Battery. Participants with mild TBI (mTBI) from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with complete 6-month outcome batteries (n = 280) were analyzed. Screening for PTSD symptoms was conducted using the PTSD Checklist-Civilian Version. Descriptive measures are summarized and predictors for PTSD were examined using logistic regression. Incidence of screening positive for PTSD was 26.8% at 6 months following mTBI. Screening positive for PTSD was significantly associated with concurrent functional disability, post-concussive and psychiatric symptomatology, decreased satisfaction with life, and decreased performance in visual processing and mental flexibility. Multi-variable regression showed injury mechanism of assault (odds ratio [OR] 3.59; 95% confidence interval [CI] 1.69–7.63; p = 0.001) and prior psychiatric history (OR 2.56; 95% CI 1.42–4.61; p = 0.002) remained significant predictors of screening positive for PTSD, while education (per year OR 0.88; 95% CI 0.79–0.98; p = 0.021) was associated with decreased odds of PTSD. Standardized data collection and review of pre-injury education, psychiatric history, and injury mechanism during initial hospital presentation can aid in identifying patients with mTBI at risk for developing PTSD symptoms who may benefit from closer follow-up after initial injury care. PMID:26936513

Facilitating post traumatic growth

PubMed Central

Turner, de Sales; Cox, Helen

2004-01-01

Background Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal care. All participants were injured through involvement in a motor vehicle accident, with the exception of one, who was injured through falling off the roof of a house. Methods In this qualitative study, we used an audio-taped in-depth interview with each participant as the means of data collection. Interviews were transcribed verbatim and analysed thematically to determine the participants' unique perspectives on the experience of recovery from traumatic injury. In reporting the findings, all participants' were given a pseudonym to assure their anonymity. Results Most participants indicated that their involvement in a traumatic occurrence was a springboard for growth that enabled them to develop new perspectives on life and living. Conclusion There are a number of contributions that health providers may make to the recovery of individuals who have been traumatically injured to assist them to develop new views of vulnerability and strength, make changes in relationships, and facilitate philosophical, physical and spiritual growth. PMID:15248894

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. © 2015 American Headache Society.

[Prevention and treatment of post-traumatic pancreatic necrosis in patients with blunt abdominal trauma].

PubMed

Cherdantsev, D V; Pervova, O V; Vinnik, Iu S; Kurbanov, D Sh

2016-01-01

High incidence of necrotic and suppurative complications is feature of acute post-traumatic pancreatitis. Severe trauma of the pancreas and post-traumatic pancreatitis lead to depressurization of ductal system that requires adequate drainage of damaged area and retroperitoneal fat. 95 patients in group 1 received standardized treatment. The victims of the 2nd group (44 patients) were treated using immunoreactive therapy (roncoleukin) and octreotide (the dose depended on the severity of pancreatitis) at early stages. The efficacy of treatment was assessed based on clinical, laboratory and instrumental parameters. Regardless severity of pancreatic injury overall mortality in groups 1 and 2 was 41% and 20.5% respectively. The main causes of adverse outcomes are severe destructive pancreatitis, postnecrotic suppurative complications. Adequacy rather radicalism of surgery should be preferred for blunt pancreatic trauma management. Minimally invasive surgical techniques and new methods of biological hemostasis may be applied. Timely use of anti-enzymatic and immunoactive therapy reduces the risk of severe post-traumatic pancreatitis, suppurative complications and improves outcomes in patients with blunt pancreatic trauma.

Chronic post-traumatic headache: clinical findings and possible mechanisms

PubMed Central

Defrin, Ruth

2014-01-01

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

Effectiveness of trauma-focused psychological therapies compared to usual postnatal care for treating post-traumatic stress symptoms in women following traumatic birth: a systematic review protocol.

PubMed

Furuta, Marie; Spain, Debbie; Bick, Debra; Ng, Edmond S W; Sin, Jacqueline

2016-11-24

Maternal mental health has been largely neglected in the literature. Women, however, may be vulnerable to developing post-traumatic stress symptoms or post-traumatic stress disorder (PTSD), following traumatic birth. In turn, this may affect their capacity for child rearing and ability to form a secure bond with their baby and impact on the wider family. Trauma-focused psychological therapies (TFPT) are widely regarded as effective and acceptable interventions for PTSD in general and clinical populations. Relatively little is known about the effectiveness of TFPT for women postpartum who have post-traumatic stress symptoms. We will conduct a review to assess the effectiveness of TFPT, compared with usual postpartum care, as a treatment for post-traumatic stress symptoms or PTSD for women following traumatic birth. Using a priori search criteria, we will search for randomised controlled trials (RCT) in four databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO and OpenGrey. We will use search terms that relate to the population, TFPT and comparators. Screening of search results and data extraction will be undertaken by two reviewers, independently. Risk of bias will be assessed in RCTs which meet the review criteria. Data will be analysed using the following methods, as appropriate: narrative synthesis; meta-analysis; subgroup analysis and meta-regression. As this work comprises a synthesis of existing studies, ethical approvals are not required. Results will be disseminated at conferences and in publications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Combat Post-Traumatic Stress Disorder, Alcoholism, and the Police Officer.

ERIC Educational Resources Information Center

Machell, David F.

This report describes the psychological profile of a police officer who suffers from three dimensions of emotional complication: combat post-traumatic stress disorder (CPTSD), alcoholism, and role immersion. Each of the three dimensions is discussed separately, followed by a discussion of their interaction and unification. It is noted that alcohol…

A pilot study of eye movement desensitisation and reprocessing treatment (EMDR) for post-traumatic stress after childbirth.

PubMed

Sandström, Marianne; Wiberg, Britt; Wikman, Marianne; Willman, Anna-Klara; Högberg, Ulf

2008-03-01

to explore the possibility of using eye movement desensitisation and reprocessing (EMDR) to treat women who have experienced post-traumatic stress after childbirth. the pilot study consisted of a 'before and after' treatment design combined with follow-up measurements 1-3 years after EMDR treatment. Quantitative data from questionnaires (Traumatic Event Scale [TES]) were collected. In addition, qualitative data from individual interviews with the participants were collected as well as data from the psychotherapist's treatment notes of the EMDR treatment sessions. the north of Sweden. four women with post-traumatic stress disorder (PTSD) after childbirth (one pregnant and three non-pregnant). all participants reported reduction of post-traumatic stress after treatment. After 1-3 years, the beneficial effects of EMDR treatment remained for three of the four women. Symptoms of intrusive thoughts and avoidance seemed most sensitive for treatment. EMDR might be a useful tool in the treatment of non-pregnant women severely traumatised by childbirth; however, further research is required.

An assessment by calorimetric calculations of the potential thermal benefit of warming and humidification of insufflated carbon dioxide.

PubMed

Roth, Jonathan V; Sea, Stephanie

2014-06-01

Heat transfer from a patient to warm and humidify insufflated carbon dioxide (CO2) during laparoscopic surgery may contribute to perioperative hypothermia. The magnitude of this effect was calculated using calorimetric calculations. Warming to 37°C and humidifying to 100%, each 100 L of insufflated CO2 would prevent a heat transfer of 3220 calories, which would result in a decrease of temperature by 0.06°C in a 70 kg patient after total body distribution of heat. We conclude that the thermal benefit of warming and humidifying insufflated CO2 is minor, particularly in comparison with other effective and inexpensive perioperative technologies, some of which are not always used out could easily be used. The decision to use heating and humidification of insufflated CO2 should be based on its other risks, benefits, and costs.

Post-traumatic stress disorder--best practice GP guidelines.

PubMed

Forbes, David; Wolfgang, Bronwyn; Cooper, John; Creamer, Mark; Barton, David

2009-03-01

Approximately 50-65% of Australians are exposed to a traumatic event during their lifetime. Approximately 250 000 Australians suffer from post-traumatic stress disorder (PTSD) at any given time, making it one of the most common anxiety disorders. In May 2007, the Australian guidelines for the treatment of adults with acute stress disorder and posttraumatic stress disorder was published. In order to facilitate translation of evidence regarding PTSD into busy clinical practice, and particularly for general practitioners, a more succinct version of the guidelines has been developed. This article describes a brief algorithm based on the Australian guidelines and outlines key recommendations. General practitioners are often the first point of contact with the health care system for someone who has experienced a traumatic event. Patients experiencing trauma within the past 2 weeks require psychological first aid, and monitoring and assessment for the development of acute stress disorder and symptoms of PTSD. If the patient wishes to talk about the event with you, support them in doing so. However, it is important not to push those who prefer not to talk about the event. Trauma focused psychological treatment is the first line of treatment for PTSD, although antidepressant medication may have an adjuvant role in some patients or in those with comorbidities.

Impact of prior urethral manipulation on outcome of anastomotic urethroplasty for post-traumatic urethral stricture.

PubMed

Singh, Bhupendra P; Andankar, Mukund G; Swain, Sanjaya K; Das, Krishanu; Dassi, Vimal; Kaswan, Harish K; Agrawal, Vipul; Pathak, Hemant R

2010-01-01

To determine the impact of earlier urethral interventions on the outcomes of anastomotic urethroplasty in post-traumatic stricture urethra. From October 1995 to March 2008, a total of 58 patients with post-traumatic posterior urethral stricture underwent anastomotic urethroplasty. Eighteen patients had earlier undergone urethral intervention in the form of urethrotomy (3), endoscopic realignment (7), or open urethroplasty (8). Success was defined as no obstructive urinary symptoms, maximum urine flow rate > or = 15 mL/s, normal urethral imaging and/or urethroscopy, and no need of any intervention in the follow-up period. Patients who met the above objective criteria after needing 1 urethrotomy following urethroplasty were defined to have satisfactory outcome and were included in satisfactory result rate along with patients who had a successful outcome. Results were analyzed using unpaired t test, chi-square test, binary logistic regression, Kaplan-Meier curves, and log rank test. Previous interventions in the form of endoscopic realignment or urethroplasty have significant adverse effect on the success rate of subsequent anastomotic urethroplasty for post-traumatic posterior urethral strictures (P <.05). Previous intervention in the form of visual internal urethrotomies (up to 2 times) did not affect the outcome of subsequent anastomotic urethroplasty. Length of stricture and age of patient did not predict the outcome in traumatic posterior urethral strictures in logistic regression analysis. Previous failed railroading or urethroplasty significantly decrease the success of subsequent anastomotic urethroplasty. Hence, a primary realignment or urethroplasty should be avoided in suboptimal conditions and the cases of post-traumatic urethral stricture should be referred to centers with such expertise. 2010 Elsevier Inc. All rights reserved.

Assessment of Cortical and Trabecular Bone Changes in Two Models of Post-Traumatic Osteoarthritis

PubMed Central

Pauly, Hannah M; Larson, Blair E; Coatney, Garrett A; Button, Keith D.; DeCamp, Charlie E; Fajardo, Ryan S; Haut, Roger C; Donahue, Tammy L Haut

2015-01-01

Subchondral bone is thought to play a significant role in the initiation and progression of the post-traumatic osteoarthritis. The goal of this study was to document changes in tibial and femoral subchondral bone that occur as a result of two lapine models of anterior cruciate ligament injury, a modified ACL transection model and a closed-joint traumatic compressive impact model. Twelve weeks post-injury bones were scanned via micro-computed tomography. The subchondral bone of injured limbs from both models showed decreases in bone volume and bone mineral density. Surgical transection animals showed significant bone changes primarily in the medial hemijoint of femurs and tibias, while significant changes were noted in both the medial and lateral hemijoints of both bones for traumatic impact animals. It is believed that subchondral bone changes in the medial hemijoint were likely caused by compromised soft tissue structures seen in both models. Subchondral bone changes in the lateral hemijoint of traumatic impact animals are thought to be due to transmission of the compressive impact force through the joint. The joint-wide bone changes shown in the traumatic impact model were similar to clinical findings from studies investigating the progression of osteoarthritis in humans. PMID:26147652

Trauma, post-traumatic stress disorder and psychiatric disorders in a middle-income setting: prevalence and comorbidity

PubMed Central

Dorrington, Sarah; Zavos, Helena; Ball, Harriet; McGuffin, Peter; Rijsdijk, Fruhling; Siribaddana, Sisira; Sumathipala, Athula; Hotopf, Matthew

2014-01-01

Background Most studies of post-traumatic stress disorder (PTSD) in low- and middle-income countries (LMICs) have focused on ‘high-risk’ populations defined by exposure to trauma. Aims To estimate the prevalence of post-traumatic stress disorder (PTSD) in a LMIC, the conditional probability of PTSD given a traumatic event and the strength of associations between traumatic events and other psychiatric disorders. Method Our sample contained a mix of 3995 twins and 2019 non-twins. We asked participants about nine different traumatic exposures, including the category ‘other’, but excluding sexual trauma. Results Traumatic events were reported by 36.3% of participants and lifetime PTSD was present in 2.0%. Prevalence of non-PTSD lifetime diagnosis was 19.1%. Of people who had experienced three or more traumatic events, 13.3% had lifetime PTSD and 40.4% had a non-PTSD psychiatric diagnosis. Conclusions Despite high rates of exposure to trauma, this population had lower rates of PTSD than high-income populations, although the prevalence might have been slightly affected by the exclusion of sexual trauma. There are high rates of non-PTSD diagnoses associated with trauma exposure that could be considered in interventions for trauma-exposed populations. Our findings suggest that there is no unique relationship between traumatic experiences and the specific symptomatology of PTSD. PMID:25257062

Perspectives on Creating Clinically Relevant Blast Models for Mild Traumatic Brain Injury and Post Traumatic Stress Disorder Symptoms

PubMed Central

Brenner, Lisa A.; Bahraini, Nazanin; Hernández, Theresa D.

2012-01-01

Military personnel are returning from Iraq and Afghanistan and reporting non-specific physical (somatic), behavioral, psychological, and cognitive symptoms. Many of these symptoms are frequently associated with mild traumatic brain injury (mTBI) and/or post traumatic stress disorder (PTSD). Despite significant attention and advances in assessment and intervention for these two conditions, challenges persist. To address this, clinically relevant blast models are essential in the full characterization of this type of injury, as well as in the testing and identification of potential treatment strategies. In this publication, existing diagnostic challenges and current treatment practices for mTBI and/or PTSD will be summarized, along with suggestions regarding how what has been learned from existing models of PTSD and traditional mechanism (e.g., non-blast) traumatic brain injury can be used to facilitate the development of clinically relevant blast models. PMID:22408635

Post-traumatic Stress Disorder Symptoms Resulting from Torture and Other Traumatic Events among Syrian Kurdish Refugees in Kurdistan Region, Iraq.

PubMed

Ibrahim, Hawkar; Hassan, Chiya Q

2017-01-01

Political violence is known to cause psychological distress. There is a large body of empirical studies drawing correlations between war trauma, torture, and post-traumatic stress disorder (PTSD). However, there are few studies on the effects of war-related trauma among Syrian refugees after events following the 'Arab Spring' uprisings between 2010 and 2012. This study examines the association of PTSD symptoms with torture and other traumatic events among Syrian Kurdish refugees living in Kurdistan Region, Iraq. The experiences and PTSD symptoms among 91 Syrian Kurdish refugees in the Arbat camp in the Sulaymaniyah Governorate of the Kurdistan Region of Iraq were assessed using the Harvard Trauma Questionnaire, sections I, IV, and V. Results showed that the estimated levels of PTSD symptoms were high: between 35 and 38%. There were no significant gender differences in the occurrence of PTSD symptoms. However, men reported more general traumatic experiences than women. There were significant positive correlations between PTSD symptoms with traumatic events and torture ( r = 0.500, r = 0.366, respectively). Examining the mental health impact of torture and other traumatic events among refugees has possible implications for organizations managing rehabilitation programs for individuals who have been exposed to traumatic events.

Reintegrating Troops with Mild Traumatic Brain Injury (mTBI) into their Communities: Understanding the Scope and Timeline of Post-Deployment Driving Problems

DTIC Science & Technology

2015-10-01

behaviors and anxieties among post- deployed SMs with and without traumatic brain injury (TBI), post-traumatic stress syndrome (PTSD) or TBI with...post- traumatic stress syndrome (TBI/PTSD). The goal was to compare SMs who were post-deployment to SMs who had not served in OEF/OIF/OND, however all...in situations when SM would typically drive (p=.02) with TBI/PTSD reporting this more common than TBI and 0Dx. • Move to middle of road or onto

Biomarkers of Risk for Post-Traumatic Stress Disorder (PTSD)

DTIC Science & Technology

2008-05-01

post - traumatic stress disorder ( PTSD ),” Principal Investigator, 4/07-4/10, $276,422. 12. R01 MH0687670-01 “DEX/CRH Response... Stress Disorder ( PTSD ) PRINCIPAL INVESTIGATOR: Audrey R. Tyrka, M.D., Ph.D. CONTRACTING ORGANIZATION: Butler Hospital... Stress Disorder ( PTSD ) 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-07-1-0269 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Audrey R.

Post-traumatic diaphragmatic hernias - importance of basic radiographic investigations.

PubMed

Mansoor, E

2013-05-03

This case presentation highlights important principles in the management of post-traumatic diaphragmatic hernia. A suggestive history should prompt early diagnosis even if the patient appears well. The chest radiograph, although not pathognomonic, is extremely useful in the detection of diaphragmatic hernia if accurately interpreted. Herniated bowel is at high risk of strangulation, especially in the presence of a 'ribbon sign'. Delayed operative intervention can prove fatal.

Prevention of the Post traumatic Fibrotic Response in Joints

DTIC Science & Technology

2016-12-01

researchers focusing on research associated with post -traumatic joint stiffness. This team has grown from a group of three initial Principal Investigators...The formation of the Translational Research Partnership ensured reaching the stated objective. Two Specific Aims were defined to test the...body weight of rabbits during the initial 8 weeks of the experimental study. During this time the rabbits were treated with tested and control

Systems Biology Approach to Understanding Post-traumatic Stress Disorder

DTIC Science & Technology

2015-01-14

Chemistry 2015 14. ABSTRACT Post-traumatic stress disorder (PTSD) is a psychological disorder a???ecting individuals that have experienced life-changing...functioning. Although PTSD is still categorized as a psychological disorder, recent years have witnessed a multi-directional research e???ort...Diagnostic Scale’’.4 These tests help diagnose whether or not a subject has PTSD with fairly good accuracy. However, these tests are not designed to

[Visual rehabilitation of patients with large post-traumatic defects of the anterior eye segment through iris-lens diaphragm implantation].

PubMed

Khodzhaev, N S; Sobolev, N P; Mushkova, I A; Izmaylova, S B; Karimova, A N

The diversity of methodological approaches and lack of pathogenetically reasonable tactics for patients with combined ocular injuries became the basis for the development and systematization of surgical rehabilitation stages of patients, in whom post-traumatic cataract is combined with post-traumatic aniridia and corneal scarring. to construct a visual rehabilitation approach to patients with post-traumatic defects of the anterior eye segment following optical-reconstructive surgery that involved implantation of an iris-lens diaphragm (ILD). We have analyzed 80 reconstructive cases with ILD implantation in patients with post-traumatic aniridia and corneal damage. These patients constituted the first study group (Group 1). We have also investigated 58 eyes with residual ametropy and stable visual function 1 year after ILD implantation before and after conducting a laser keratorefractive surgery. These patients were assigned to the second study group (Group 2). Rehabilitation approach to patients after anterior segment injuries that has been proposed allows to achieve high clinical and functional results and reduce the risk of intra- and postoperative complications. The proposed approach to patients after optical-reconstructive surgery with iris-lens diaphragm implantation followed by keratorefractive surgery is an effective method of visual rehabilitation of anterior eye segment post-traumatic defects.

Do South African former detainees experience post-traumatic stress? Circumventing the demand characteristics of psychological assessment.

PubMed

Kagee, Ashraf

2004-09-01

Most research on persons subjected to physical or psychological torture for political reasons has framed this experience as traumatic, with the sequelae approximating the diagnostic criteria of post-traumatic stress disorder (PTSD). Yet, critiques of the trauma model have called attention to the fact that PTSD represents a Western conceptualization of the concerns of persons who have survived stressful experiences. In order to determine whether symptoms of traumatization are salient psychiatric phenomena for South African former detainees, semi-structured qualitative interviews were conducted with 20 respondents who were detained and tortured for political reasons during the apartheid era. Interviews were transcribed and analysed for thematic content using a grounded theory approach. Results showed that although the main concerns expressed were unrelated to traumatization, participants also indicated that they experienced symptoms of post-traumatic stress. These data suggest that although too great a focus on traumatic responses may be misplaced, it remains important to consider the possibility that former detainees may exhibit symptoms of this nature. Consequently, critiques of the trauma discourse as a Western phenomenon need to be tempered with evidence of the lived reality of psychological sequelae experienced by this population.

Assessment of Biomarkers Associated with Joint Injury and Subsequent Post Traumatic Arthritis

DTIC Science & Technology

2015-10-01

arthritis, post-traumatic osteoarthritis, articular fracture, joint injury, trauma, biomarker, inflammation, MRI , knee, mouse model, translational...prior to or at surgical intervention. MRI imaging of the injured knee will be obtained to assess the articular cartilage. Degenerative changes in...development of PTA. We have successfully enrolled patients, collected and stored biosamples, obtained all post-operative MRI scans and are continuing to

A retrospective study of ketamine administration and the development of acute or post-traumatic stress disorder in 274 war-wounded soldiers.

PubMed

Mion, G; Le Masson, J; Granier, C; Hoffmann, C

2017-12-01

The objective of this study was to explore whether ketamine prevents or exacerbates acute or post-traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010-2012). The diagnosis of post-traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain. Covariables related to post-traumatic and acute stress disorders with a p ≤ 0.10 were included in a multivariable logistic regression model. The data from 450 soldiers were identified; 399 survived, of which 274 were analysed. Among these, 98 (36%) suffered from post-traumatic stress disorder and 89 (32%) had received ketamine. Fifty-four patients (55%) in the post-traumatic stress disorder group received ketamine vs. 35 (20%) in the no PTSD group (p < 0.001). The 89 injured soldiers who received ketamine had a median (IQR [range]) injury severity score of 5 (3-13 [1-26]) vs. 3 (2-4 [1-6] in the 185 patients who did not (p < 0.001). At multivariable analysis, only acute stress disorder and total number of surgical procedures were independently associated with the development of post-traumatic stress disorder. In this retrospective study, ketamine administration was not a risk factor for the development of post-traumatic stress disorder in the military trauma setting. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Depressive symptoms, post-traumatic stress symptoms and suicide risk among graduate students: The mediating influence of emotional regulatory self-efficacy.

PubMed

Zeng, Baoer; Zhao, Jiubo; Zou, Laiquan; Yang, Xueling; Zhang, Xiaoyuan; Wang, Wanjun; Zhao, Jingbo; Chen, Jie

2018-06-01

The current study was to examine the relationship among depressive symptoms, post-traumatic stress symptoms, emotion regulatory self-efficacy and suicide risk. A cross-sectional survey was conducted among 3257 graduate students from a medical college of China. Lifetime prevalence of suicidal ideation, plan and attempt were 25.7%, 1.6%, 1.1%, respectively, with one-year suicidal ideation showing at 6.3%. Structural equation modeling was employed to examine the relative contribution of depressive symptoms, post-traumatic stress symptoms and emotion regulatory self-efficacy on suicide risk. Structural equation model had a highly satisfactory fit [χ 2  = 7.782, df = 4, p = 0.096; RMSEA = 0.021; CFI = 0.992; GFI = 0.997]. Post-traumatic stress symptoms had a direct effect and an indirect effect on suicide risk via emotion regulatory self-efficacy. Depressive symptoms also had a direct effect and an indirect effect on suicide risk via emotion regulatory self-efficacy. The depressive and post-traumatic stress symptoms increased the risk of suicide risk, but the variable of emotion regulatory self-efficacy would be served as a buffering factor, decreasing the risk of suicide. The interaction term of depressive symptoms and post-traumatic stress symptoms had a direct effect on suicide risk. A significant interactive effect of depressive and post-traumatic stress symptoms on suicide risk was found. Copyright © 2018 Elsevier B.V. All rights reserved.

Post traumatic inferior vena cava thrombosis: A case report and review of literature.

PubMed

Chakroun, Amine; Nakhli, Mohamed Said; Kahloul, Mohamed; Harrathi, Mohamed Amine; Naija, Walid

2017-01-01

Post traumatic inferior vena cava (IVC) thrombosis is a rare and not well described entity with nonspecific clinical presentation. It remains a therapeutic challenge in traumatic context because of haemorrhagic risk due to anticoagulation. We report a case of IVC thrombosis in an 18 year-old man who presented with liver injury following a traffic crash. The thrombosis was incidentally diagnosed on admission by computed tomography. The patient was managed conservatively without anticoagulation initially considering the increasing haemorrhagic risk. IVC filter placing was not possible because of the unusual localization of the thrombus. Unfractionated heparin was started on the third day after CT scan control showing stability of hepatic lesions with occurrence of a pulmonary embolism. The final outcome was good. The management of post traumatic IVC thrombosis is not well described. Medical approach consists in conservative management with anticoagulation which requires the absence of active bleeding lesions. Surgical treatment is commonly based on thrombectomy under extracorporeal circulation. Interventional vascular techniques have become an important alternative approach for the treatment of many vessel lesions. Their main advantages are the relative ease and speed with which they can be performed. Post traumatic IVC thrombosis is a rare condition. Its management is not well defined. Early anticoagulation should be discussed on a case-by-case basis. Other alternatives such IVC filter or surgical thrombectomy may be used when the bleeding risk is increased. The most serious risk is pulmonary embolism. Outcome can be favorable even with non surgical approaches. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ultra-modified rapid sequence induction with transnasal humidified rapid insufflation ventilatory exchange: Challenging convention.

PubMed

Kulkarni, Ketan Sakharam; Dave, Nandini; Saran, Shriyam; Garasia, Madhu; Parelkar, Sandesh

2018-04-01

During positive pressure ventilation, gastric inflation and subsequent pulmonary aspiration can occur. Rapid sequence induction (RSI) technique is an age-old formula to prevent this. We adopted a novel approach of RSI for patients with high risk of aspiration and evaluated it further in patients undergoing laparoscopic surgeries. We believe that, in patients with risk of gastric insufflation and pulmonary aspiration, transnasal humidified rapid-insufflation ventilatory exchange can be useful in facilitating pre- and apnoeic oxygenation till tracheal isolation is achieved.

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

A microprocessor-controlled tracheal insufflation-assisted total liquid ventilation system.

PubMed

Parker, James Courtney; Sakla, Adel; Donovan, Francis M; Beam, David; Chekuri, Annu; Al-Khatib, Mohammad; Hamm, Charles R; Eyal, Fabien G

2009-09-01

A prototype time cycled, constant volume, closed circuit perfluorocarbon (PFC) total liquid ventilator system is described. The system utilizes microcontroller-driven display and master control boards, gear motor pumps, and three-way solenoid valves to direct flow. A constant tidal volume and functional residual capacity (FRC) are maintained with feedback control using end-expiratory and end-inspiratory stop-flow pressures. The system can also provide a unique continuous perfusion (bias flow, tracheal insufflation) through one lumen of a double-lumen endotracheal catheter to increase washout of dead space liquid. FRC and arterial blood gases were maintained during ventilation with Rimar 101 PFC over 2-3 h in normal piglets and piglets with simulated pulmonary edema induced by instillation of albumin solution. Addition of tracheal insufflation flow significantly improved the blood gases and enhanced clearance of instilled albumin solution during simulated edema.

Sudden post-traumatic sciatica caused by a thoracic spinal meningioma.

PubMed

Mariniello, Giuseppe; Malacario, Francesca; Dones, Flavia; Severino, Rocco; Ugga, Lorenzo; Russo, Camilla; Elefante, Andrea; Maiuri, Francesco

2016-10-01

Spinal meningiomas usually present with slowly progressive symptoms of cord and root compression, while a sudden clinical onset is very rare. A 35-year-old previously symptom-free woman presented sudden right sciatica and weakness of her right leg following a fall with impact to her left foot. A neurological examination showed paresis of the right quadriceps, tibial and sural muscles, increased bilateral knee and ankle reflexes and positive Babinski sign. Magnetic resonance imaging (MRI) revealed the presence of a spinal T11 meningioma in the left postero-lateral compartment of the spinal canal; at this level, the spinal cord was displaced to the contralateral side with the conus in the normal position. At surgery, a meningioma with dural attachment of the left postero-lateral dural surface was removed. The intervention resulted in rapid remission of both pain and neurological deficits. Spinal meningiomas may exceptionally present with sudden pain and neurological deficits as result of tumour bleeding or post-traumatic injury of the already compressed nervous structures, both in normal patients and in those with conus displacement or tethered cord. In this case, the traumatic impact of the left foot was transmitted to the spine, resulting in stretching of the already compressed cord and of the contralateral lombosacral roots. This case suggests that low thoracic cord compression should be suspected in patients with post-traumatic radicular leg pain with normal lumbar spine MRI. © The Author(s) 2016.

Air Quality Monitoring of the Post-Operative Recovery Room and Locations Surrounding Operating Theaters in a Medical Center in Taiwan

PubMed Central

Tang, Chin-Sheng; Wan, Gwo-Hwa

2013-01-01

To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers. PMID:23573296

Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

PubMed

Tang, Chin-Sheng; Wan, Gwo-Hwa

2013-01-01

To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

Health Care Utilization and the Cost of Post-Traumatic ARDS Care.

PubMed

Robles, Anamaria J; Kornblith, Lucy Z; Hendrickson, Carolyn M; Howard, Benjamin M; Conroy, Amanda S; Moazed, Farzad; Calfee, Carolyn S; Cohen, Mitchell J; Callcut, Rachael A

2018-04-02

Post-traumatic acute respiratory distress syndrome (ARDS) is associated with prolonged mechanical ventilation and longer hospitalizations. The relationship between post-traumatic ARDS severity and financial burden has not been previously studied. We hypothesized that increasing severity is associated with incrementally higher health care costs. Adults arriving as the highest level of trauma activation were enrolled in an ongoing prospective cohort study. Patients who survived ≥6 hours are included in the analysis. Blinded review of chest radiographs was performed by two independent physicians for any intubated patient with PaO2:FiO2 ratio (P/F) ≤300mgHg during the first 8 days of admission. The severity of ARDS was classified by the Berlin criteria. Hospital charge data was utilized to perform standard costing analysis. ARDS occurred in 13% (203/1586). The distribution of disease severity was 33% mild, 42% moderate, and 25% severe. Patients with ARDS were older (41 vs 35 years, p<0.01), had higher median ISS (30 vs 10, p<0.01), more chest injury (AIS≥3: 51% vs 21%, p<0.01), and blunt mechanisms (85% vs 53%, p<0.01). By ARDS severity, there was no significant difference in age, mechanism, or rate of traumatic brain injury. Increasing ARDS severity was associated with higher ISS and higher mortality rates. Standardized total hospital charges were four-fold higher for patients who developed ARDS compared to those who did not develop ARDS ($434K vs $96K, p<0.01). Furthermore, the daily hospital charges significantly increased across categories of worsening ARDS severity (mild $20,451; moderate $23,994; severe $33,316, p<0.01). The development of post-traumatic ARDS is associated with higher health care costs. Among trauma patients who develop ARDS, total hospital charges per day increase with worsening severity of disease. Prevention, early recognition, and treatment of ARDS after trauma are potentially important objectives for efforts to control health care

Family Caregivers of Liver Transplant Recipients: Coping Strategies Associated With Different Levels of Post-traumatic Growth.

PubMed

Pérez-San-Gregorio, M Á; Martín-Rodríguez, A; Borda-Mas, M; Avargues-Navarro, M L; Pérez-Bernal, J; Gómez-Bravo, M Á

2018-03-01

Analyze the influence of 2 variables (post-traumatic growth and time since liver transplantation) on coping strategies used by the transplant recipient's family members. In all, 218 family members who were their main caregivers of liver transplant recipients were selected. They were evaluated using the Posttraumatic Growth Inventory and the Brief COPE. A 3 × 3 factorial analysis of variance was used to analyze the influence that post-traumatic growth level (low, medium, and high) and time since transplantation (≤3.5 years, >3.5 to ≤9 years, and >9 years) exerted on caregiver coping strategies. No interactive effects between the two factors in the study were found. The only significant main effect was the influence of the post-traumatic growth factor on the following variables: instrumental support (P = .007), emotional support (P = .005), self-distraction (P = .006), positive reframing (P = .000), acceptance (P = .013), and religion (P = <.001). According to the most relevant effect sizes, low post-traumatic growth compared with medium growth was associated with less use of self-distraction (P = .006, d = -0.52, medium effect size), positive reframing (P = .001, d = -0.62, medium effect size), and religion (P = .000, d = -0.66, medium effect size), and in comparison with high growth, it was associated with less use of positive reframing (P = .002, d = -0.56, medium effect size) and religion (P = .000, d = 0.87, large effect size). Regardless of the time elapsed since the stressful life event (liver transplantation), family members with low post-traumatic growth usually use fewer coping strategies involving a positive, transcendent vision to deal with transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

Cumulative trauma and partner conflict predict post-traumatic stress disorder in postpartum African-American women.

PubMed

Hauff, Nancy J; Fry-McComish, Judith; Chiodo, Lisa M

2017-08-01

To describe relationships between cumulative trauma, partner conflict and post-traumatic stress in African-American postpartum women. Cumulative trauma exposure estimates for women in the USA range from 51-69%. During pregnancy, most trauma research has focused on physical injury to the mother. Post-traumatic stress disorder (PTSD) is associated with trauma and more prevalent in African-American women than women of other groups. Knowledge about both the rate and impact of cumulative trauma on pregnancy may contribute to our understanding of women seeking prenatal care, and disparities in infant morbidity and mortality. This retrospective, correlational, cross-sectional study took place on postpartum units of two Detroit hospitals. Participants were 150 African-American women aged between 18-45 who had given birth. Mothers completed the Cumulative Trauma Scale, Conflict Tactics Scale, Clinician Administered Post-traumatic Stress Scale, Edinburgh Postnatal Depression Scale and a Demographic Data form. Descriptive statistics, correlations and multiple regressions were used for data analysis. All participants reported at least one traumatic event in their lifetime. Cumulative trauma and partner conflict predicted PTSD, with the trauma of a life-threatening event for a loved one reported by 60% of the sample. Nearly, one-fourth of the women screened were at risk for PTSD. Increased cumulative trauma, increased partner conflict and lower level of education were related to higher rates of PTSD symptoms. Both cumulative trauma and partner conflict in the past year predict PTSD. Reasoning was used most often for partner conflict resolution. The results of this study offer additional knowledge regarding relationships between cumulative trauma, partner conflict and PTSD in African-American women. Healthcare providers need to be sensitive to patient life-threatening events, personal failures, abuse and other types of trauma. Current evidence supports the need to assess for

Post-traumatic stress disorder and its predictors in emergency medical service personnel: a cross-sectional study from Karachi, Pakistan.

PubMed

Kerai, Salima Mansoor; Khan, Uzma Rahim; Islam, Muhammad; Asad, Nargis; Razzak, Junaid; Pasha, Omrana

2017-08-29

Emergency medical service (EMS) personnel who work to provide emergency medical care at the scene and during transportation are exposed to various kinds of stressors and are particularly susceptible to developing stress-reactions. This study assesses symptoms of post-traumatic stress disorder and its predictors among the personnel of a selected EMS in Karachi, Pakistan. Data were gathered from 518 personnel working in an EMS setting from February to May 2014. Participants were screened for post-traumatic stress symptoms using the Impact of Event Scale-Revised (IES-R). Demographic and work-related characteristics, coping styles and the social support systems of the participants were assessed. Linear regression was used on the IES-R to identify predictors of post-traumatic stress symptoms. The mean score of the IES-R was 23.9 ± 12.1. EMS personnel with a dysfunctional coping style (β = 0.67 CI 0.39 - 0.95), anxiety, and depression (β = 0.64 CI 0.52 - 0.75) were more likely to have increased severity of post-traumatic stress symptoms. Age was found to have an inverse relationship with stress symptoms (β = -0.17 CI 0.33 - -0.023), indicating the susceptibility of younger EMS personnel to stress. The EMS personnel in this setting were found to have a moderate level of post-traumatic stress symptoms. The significant predictors of post-traumatic stress symptoms in this EMS population were age, coping style, and levels of anxiety and depression. These predicting factors can be a potential avenue for interventions to improve the mental health of these frontline workers.

Post-Traumatic Symptomatology and Compulsions as Potential Mediators of the Relation Between Child Sexual Abuse and Auditory Verbal Hallucinations.

PubMed

McCarthy-Jones, Simon

2018-05-01

Whilst evidence is mounting that childhood sexual abuse (CSA) can be a cause of auditory verbal hallucinations (AVH), it is unclear what factors mediate this relation. Recent evidence suggests that post-traumatic symptomatology may mediate the CSA-AVH relation in clinical populations, although this hypothesis has not yet been tested in the general population. There is also reason to believe that obsessive ideation could mediate the CSA-AVH relation. To test for evidence to falsify the hypotheses that post-traumatic symptomatology, obsessions, compulsions, anxiety and depression mediate the relation between CSA and AVH in a general population sample. Indirect effects of CSA on AVH via potential mediators were tested for, using a regression-based approach employing data from the 2007 Adult Psychiatric Morbidity Survey (n = 5788). After controlling for demographics, IQ and child physical abuse, it was found that CSA, IQ, post-traumatic symptomatology and compulsions predicted lifetime experience of AVH. Mediation analyses found significant indirect effects of CSA on AVH via post-traumatic symptomatology [odds ratio (OR): 1.11; 95% confidence interval (CI):1.00-1.29] and compulsions (OR: 1.10, 95% CI: 1.01-1.28). These findings offer further support for the hypothesis that post-traumatic symptomatology is a mediator of the CSA-AVH relation. Although no evidence was found for obsessional thoughts as a mediating variable, a potential mediating role for compulsions is theoretically intriguing. This study's findings reiterate the need to ask about experiences of childhood adversity and post-traumatic symptomology in people with AVH, as well as the likely therapeutic importance of trauma-informed and trauma-based interventions for this population.

Factors Associated with Post-traumatic Stress Symptoms in Students Who Survived 20 Months after the Sewol Ferry Disaster in Korea.

PubMed

Lee, So Hee; Kim, Eun Ji; Noh, Jin Won; Chae, Jeong Ho

2018-03-12

The Sewol ferry disaster caused national shock and grief in Korea. The present study examined the prevalence and associated factors of post-traumatic stress disorder (PTSD) symptoms among the surviving students 20 months after that disaster. This study was conducted using a cross-sectional design and a sample of 57 students (29 boys and 28 girls) who survived the Sewol ferry disaster. Data were collected using a questionnaire, including instruments that assessed psychological status. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with PTSD symptoms. The results showed that 26.3% of participants were classified in the clinical group by the Child Report of Post-traumatic Symptoms score. Based on a generalized linear model, Poisson distribution, and log link analyses, PTSD symptoms were positively correlated with the number of exposed traumatic events, peers and social support, peri-traumatic dissociation and post-traumatic negative beliefs, and emotional difficulties. On the other hand, PTSD symptoms were negatively correlated with psychological well-being, family cohesion, post-traumatic social support, receiving care at a psychiatry clinic, and female gender. This study uncovered risk and protective factors of PTSD in disaster-exposed adolescents. The implications of these findings are considered in relation to determining assessment and interventional strategies aimed at helping survivors following similar traumatic experiences. © 2018 The Korean Academy of Medical Sciences.

Factors Associated with Post-traumatic Stress Symptoms in Students Who Survived 20 Months after the Sewol Ferry Disaster in Korea

PubMed Central

2018-01-01

Background The Sewol ferry disaster caused national shock and grief in Korea. The present study examined the prevalence and associated factors of post-traumatic stress disorder (PTSD) symptoms among the surviving students 20 months after that disaster. Methods This study was conducted using a cross-sectional design and a sample of 57 students (29 boys and 28 girls) who survived the Sewol ferry disaster. Data were collected using a questionnaire, including instruments that assessed psychological status. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with PTSD symptoms. Results The results showed that 26.3% of participants were classified in the clinical group by the Child Report of Post-traumatic Symptoms score. Based on a generalized linear model, Poisson distribution, and log link analyses, PTSD symptoms were positively correlated with the number of exposed traumatic events, peers and social support, peri-traumatic dissociation and post-traumatic negative beliefs, and emotional difficulties. On the other hand, PTSD symptoms were negatively correlated with psychological well-being, family cohesion, post-traumatic social support, receiving care at a psychiatry clinic, and female gender. Conclusion This study uncovered risk and protective factors of PTSD in disaster-exposed adolescents. The implications of these findings are considered in relation to determining assessment and interventional strategies aimed at helping survivors following similar traumatic experiences. PMID:29495137

Post-Traumatic Stress in Sexually Abused, Physically Abused, and Nonabused Children.

ERIC Educational Resources Information Center

Deblinger, Esther; And Others

1989-01-01

This investigation compared rates of post-traumatic stress disorder symptoms across sexually abused (N=29), physically abused (N=20), and nonabused (N=29) psychiatrically hospitalized children. Overall rates were not significantly different across groups, but significant differences were found with respect to specific symptoms, especially in…

The Root Cause of Post-traumatic and Developmental Stress Disorder, Phase 2

DTIC Science & Technology

2013-10-01

have tested and validated. Project 2 will investigate post -mortem anatomy in subjects with major depression and/or PTSD. Both molecular and...Award Number: W81XWH-11-2-0166 TITLE: The Root Cause of Post -traumatic and Developmental Stress Disorder, Phase II PRINCIPAL INVESTIGATOR: Keith...construed as an official Department of the Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE

Post-Traumatic Stress Disorder (PTSD)

MedlinePlus

... as if it were happening again (flashbacks) Upsetting dreams or nightmares about the traumatic event Severe emotional ... aspects of the traumatic event through play Frightening dreams that may or may not include aspects of ...

Mitochondrial Based Treatments that Prevent Post Traumatic Osteoarthritis in a Translational Large Animal Intraarticular Fracture Survival Model

DTIC Science & Technology

2015-09-01

AWARD NUMBER: W81XWH-11-1-0583 TITLE: “Mitochondrial-Based Treatments that Prevent Post-Traumatic Osteoarthritis in a Translational Large... Osteoarthritis in a Translational Large Animal Intraarticular Fracture Survival Model” 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0583 5c. PROGRAM...upon completion of the 6- and 12- month time points. 15. SUBJECT TERMS Post-traumatic osteoarthritis , oxidative stress, mitochondria, animal model 16

Post-traumatic stress reactions before the advent of post-traumatic stress disorder: potential effects on the lives and legacies of Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale.

PubMed

Mackowiak, Philip A; Batten, Sonja V

2008-12-01

Evidence is presented that Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale each developed symptoms consistent with post-traumatic stress disorder in the aftermath of repeated potentially traumatizing events of differing character. Their case histories also varied with respect to background, premorbid personality style, risk factors, clinical presentation, and course of the illness, illustrating the pleomorphic character of the disorder, as well as the special problems in diagnosing it in historical figures.

Remembering Collective Violence: Broadening the Notion of Traumatic Memory in Post-Conflict Rehabilitation.

PubMed

Kevers, Ruth; Rober, Peter; Derluyn, Ilse; De Haene, Lucia

2016-12-01

In the aftermath of war and armed conflict, individuals and communities face the challenge of dealing with recollections of violence and atrocity. This article aims to contribute to a better understanding of processes of remembering and forgetting histories of violence in post-conflict communities and to reflect on related implications for trauma rehabilitation in post-conflict settings. Starting from the observation that memory operates at the core of PTSD symptomatology, we more closely explore how this notion of traumatic memory is conceptualized within PTSD-centered research and interventions. Subsequently, we aim to broaden this understanding of traumatic memory and post-trauma care by connecting to findings from social memory studies and transcultural trauma research. Drawing on an analysis of scholarly literature, this analysis develops into a perspective on memory that moves beyond a symptomatic framing toward an understanding of memory that emphasizes its relational, political, moral, and cultural nature. Post-conflict memory is presented as inextricably embedded in communal relations, involving ongoing trade-offs between individual and collective responses to trauma and a complex negotiation of speech and silence. In a concluding discussion, we develop implications of this broadened understanding for post-conflict trauma-focused rehabilitation.

Molecular Indicators of Stress-Induced Neuroinflammation in a Mouse Model Simulating Features of Post-Traumatic Stress Disorder (Open Access)

DTIC Science & Technology

2017-05-23

OPEN ORIGINAL ARTICLE Molecular indicators of stress-induced neuroinflammation in a mouse model simulating features of post -traumatic stress disorder... post -traumatic stress disorder (PTSD). The model involved exposure of an intruder (male C57BL/6) mouse to a resident aggressor (male SJL) mouse for 5...revealed that neurogenesis and synaptic plasticity pathways were activated during the early responses but were inhibited after the later post -trauma

Prevention of Post Traumatic Stress Disorder among Military Health Care Workers: A Systematic Review

DTIC Science & Technology

2012-01-01

Posttraumatic Stress Disorder (PTSD) is not uncommon among medical personnel serving in the military and that its prevention remains a significant...nonmedical personnel, the purpose for this paper is to perform a review of peer-reviewed and evidence- based literature for post-traumatic stress ...of traumatic stress , depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of

Child sexual abuse, post-traumatic stress disorder, and substance use: predictors of revictimization in adult sexual assault survivors.

PubMed

Ullman, Sarah E; Najdowski, Cynthia J; Filipas, Henrietta H

2009-01-01

This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N=555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Posttraumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.

Post-traumatic Stress Disorder Symptoms Resulting from Torture and Other Traumatic Events among Syrian Kurdish Refugees in Kurdistan Region, Iraq

PubMed Central

Ibrahim, Hawkar; Hassan, Chiya Q.

2017-01-01

Political violence is known to cause psychological distress. There is a large body of empirical studies drawing correlations between war trauma, torture, and post-traumatic stress disorder (PTSD). However, there are few studies on the effects of war-related trauma among Syrian refugees after events following the ‘Arab Spring’ uprisings between 2010 and 2012. This study examines the association of PTSD symptoms with torture and other traumatic events among Syrian Kurdish refugees living in Kurdistan Region, Iraq. The experiences and PTSD symptoms among 91 Syrian Kurdish refugees in the Arbat camp in the Sulaymaniyah Governorate of the Kurdistan Region of Iraq were assessed using the Harvard Trauma Questionnaire, sections I, IV, and V. Results showed that the estimated levels of PTSD symptoms were high: between 35 and 38%. There were no significant gender differences in the occurrence of PTSD symptoms. However, men reported more general traumatic experiences than women. There were significant positive correlations between PTSD symptoms with traumatic events and torture (r = 0.500, r = 0.366, respectively). Examining the mental health impact of torture and other traumatic events among refugees has possible implications for organizations managing rehabilitation programs for individuals who have been exposed to traumatic events. PMID:28265252

Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature.

PubMed

Brooks, Samantha; Amlôt, R; Rubin, G J; Greenberg, N

2018-02-02

As disasters become increasingly prevalent, and reported on, a wealth of literature on post-disaster mental health has been published. Most published evidence focuses on symptoms of mental health problems (such as post-traumatic stress disorder, depression and anxiety) and psychosocial factors increasing the risk of such symptoms. However, a recent shift in the literature has moved to exploring resilience and the absence of adverse lasting mental health effects following a disaster. This paper undertakes a qualitative review of the literature to explore factors affecting psychological resilience, as well as the potential positive impact of experiencing a disaster (post-traumatic growth) by examining the literature on employees in disaster-exposed organisations. We identify several protective factors: training, experience, and perceived (personal) competence; social support; and effective coping strategies. Post-traumatic growth frequently appeared to occur at both personal and professional levels for those rescue staff after a disaster, giving employees a greater appreciation of life and their relationships, enhancing their self-esteem and providing a sense of accomplishment and better understanding of their work. Implications, in terms of how to build a resilient workforce, are discussed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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…

Best practice intervention for post-traumatic stress disorder among transit workers.

PubMed

Bender, Ash; Eynan, Rahel; O'Grady, John; Nisenbaum, Rosane; Shah, Ravi; Links, Paul S

2016-03-09

Transportation industry workers are at high risk for exposure to traumatic incidents in the workplace. A considerable number of those exposed to such incidents will develop post-traumatic stress disorder (PTSD) symptoms, which leads to high rates of absenteeism and are costly to the public transit corporation and workplace safety compensation insurance. To determine whether the newly implemented Best Practice Intervention (BPI) provides superior outcomeswhen compared with Treatment-as-Usual (TAU) interventions in improving workers' rates of return to work (RTW), decreasing duration of time lost from work and overall reduction in severity of PTSD symptoms 6 months after exposure. A sequential mixed methods approach was used with qualitative analysis followed by a pre-post intervention design. Sixty-two participants were recruited to the (TAU) phase of the study and 79 to the (BPI) phase. Significant differences were observed between the TAU and BPI groups in number of lost work days (TAU: 20 days vs. BPI: 52 days, p = 0.02). PTSD symptoms decreased with time (MPPS score: 51.3 vs. 24.35; p < 0.001). One-fifth of the participants (21 %) did not return to work by the end of the 6 months follow-up period. The study demonstrated the value of workplace interventions in improving awareness of psychological symptoms after exposure to a traumatic incident and the value of screening for PTSD symptoms.

Community violence exposure and post-traumatic stress reactions among Gambian youth: the moderating role of positive school climate.

PubMed

O'Donnell, Deborah A; Roberts, William C; Schwab-Stone, Mary E

2011-01-01

Community violence exposure among youth can lead to various negative outcomes, including post-traumatic stress symptoms. Research in the Western world indicates that a number of social support factors may moderate the relation between violence exposure and internalizing symptoms. Little research has been carried out in non-Western countries. This study aimed to fill this gap by exploring the relations among violence exposure, parental warmth, positive school climate, and post-traumatic stress reactions among youth in The Republic of The Gambia, Africa. A school-based survey of youth behaviors, feelings, attitudes, and perceptions was administered to 653 students at senior secondary schools in four Gambian communities. Students reported high levels of exposure to violence. Over half of students reported witnessing someone threatened with serious physical harm, beaten up or mugged, attacked or stabbed with a knife/piece of glass, or seriously wounded in an incident of violence. Nearly half of students reported being beaten up or mugged during the past year, and nearly a quarter reported being threatened with serious physical harm. There were no sex differences in levels of exposure. Traumatic stress symptoms were common, especially among females. Both violence witnessing and violent victimization significantly predicted post-traumatic stress symptoms, and positive school climate moderated the relationship. Among youth victimized by violence, positive school climate was most strongly correlated with lower levels of post-traumatic stress at low levels of exposure. Among youth who had witnessed violence, positive school climate was most strongly correlated with lower levels of post-traumatic stress at high levels of exposure. Community-based programs that bring together parents, schools, and youth may play an important role in combating the negative effects of some types of violence exposure among Gambian youth. Youth experiencing high levels of violent victimization

Exploring Facilitators of Post-traumatic Growth in Patients with Spinal Cord Injury: A Qualitative Study

PubMed Central

Khanjani, Mohammad Saeed; Younesi, Seyed Jalal; Khankeh, Hamid Reza; Azkhosh, Manouchehr

2017-01-01

Introduction There is increasing evidence regarding people’s reactions to life stressors in which people also may show positive experiences following a traumatic event. The aim of the present study was to explain the facilitators of post-traumatic growth based on the experiences of patients with a spinal cord injury. Methods This was a qualitative study conducted on 16 Iranian patients with a spinal cord injury using semistructured, in-depth interviews, and content analysis in 2015. These participants, despite their spinal cord injury, were successful in their lives and were considered successful members of society. A purposive sampling method was used until reaching data saturation, and then the collected data were analyzed using a content analysis method. Results The study revealed several factors as facilitators of post-traumatic growth in the patients. The extracted facilitators were put into seven categories of main concepts, including existence of support resources, contact with spinal cord injury associations, spiritual beliefs, positive attitude toward injury, access to proper facilities, enhancement of knowledge and awareness, and active presence in society. Conclusion Different factors may facilitate post-traumatic growth in patients with a spinal cord injury. Understanding these facilitators may help us in designing educational, support, and consulting programs for patients and their families as well as to the correct the support programs. PMID:28243405

Post-traumatic stress symptoms and psychological functioning in children of parents with acquired brain injury.

PubMed

Kieffer-Kristensen, Rikke; Teasdale, Thomas W; Bilenberg, Niels

2011-01-01

The effect of parental brain injury on children has been relatively little investigated. This study examines post-traumatic stress symptoms (PSS) and psychological functioning in children with a parent with an acquired brain injury. The participants were 35 patients with acquired brain injury, their spouses and children aged 7-14 years recruited from out-patient brain injury rehabilitation units across Denmark. Children self-reported psychological functioning using the Becks Youth Inventory (BYI) and Child Impact of Events revised (CRIES) measuring PSS symptoms. Emotional and behavioural problems among the children were also identified by the parents using the Achenbach's Child Behaviour Checklist (CBCL). A matched control group, consisting of 20 children of parents suffering from diabetes, was recruited from the National Danish Diabetes Register. Post-traumatic stress symptoms above cut-off score (<30) were found (CRIES) in 46% of the children in the brain injury group compared to 10% in the diabetes group. The parents in the brain injury group reported more emotional and behavioural problems in their children when compared to published norms (CBCL). When parents have acquired brain injury, their children appear to be at a substantial risk for developing post-traumatic stress symptoms. These results indicate the need for a child-centred family support service to reduce the risk of children being traumatized by parental brain injury, with a special focus on the relational changes within the family.

A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents.

PubMed

Trickey, David; Siddaway, Andy P; Meiser-Stedman, Richard; Serpell, Lucy; Field, Andy P

2012-03-01

Post-traumatic stress disorder (PTSD) is a complex and chronic disorder that causes substantial distress and interferes with social and educational functioning. Consequently, identifying the risk factors that make a child more likely to experience traumatic distress is of academic, clinical and social importance. This meta-analysis estimated the population effect sizes of 25 potential risk factors for PTSD in children and adolescents aged 6-18 years across 64 studies (N=32,238). Medium to large effect sizes were shown for many factors relating to subjective experience of the event and post-trauma variables (low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, PTSD at time 1, and thought suppression); whereas pre-trauma variables and more objective measures of the assumed severity of the event generated small to medium effect sizes. This indicates that subjective peri-trauma factors and post-event factors are likely to have a major role in determining whether a child develops PTSD following exposure to a traumatic event. Such factors could potentially be assessed following a potentially traumatic event in order to screen for those most vulnerable to developing PTSD and target treatment efforts accordingly. The findings support the cognitive model of PTSD as a way of understanding its development and guiding interventions to reduce symptoms. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Post Traumatic Pseudoaneurysm of the Hepatic Artery - Clinical report].

PubMed

Rolim, Dalila; Sampaio, Sérgio; Almeida Pinto, João; Oliveira, Manuel

2014-01-01

Hepatic artery aneurysms are a rare condition that can be fatal if rupture happens. Often, they are incidentally identified in routine imaging. Intervention is indicated when symptomatic, if they reach 2cm or more of size, in patients presenting with multiple hepatic artery aneurysms and in all pseudoaneurysms. We describe the case of a 57 year-old female, to whom a post-traumatic hepatic artery aneurysm was diagnosed. Open surgical repair was successfully accomplished.

The military's approach to traumatic brain injury and post-traumatic stress disorder

NASA Astrophysics Data System (ADS)

Ling, Geoffrey S. F.; Grimes, Jamie; Ecklund, James M.

2014-06-01

Traumatic brain injury (TBI) and Post Traumatic Stress Disorder (PTSD) are common conditions. In Iraq and Afghanistan, explosive blast related TBI became prominent among US service members but the vast majority of TBI was still due to typical causes such as falls and sporting events. PTS has long been a focus of the US military mental health providers. Combat Stress Teams have been integral to forward deployed units since the beginning of the Global War on Terror. Military medical management of disease and injury follows standard of care clinical practice guidelines (CPG) established by civilian counterparts. However, when civilian CPGs do not exist or are not applicable to the military environment, new practice standards are created. Such is the case for mild TBI. In 2009, the VA-DoD CPG for management of mild TBI/concussion was published and a system-wide clinical care program for mild TBI/concussion was introduced. This was the first large scale effort on an entire medical care system to address all severities of TBI in a comprehensive organized way. In 2010, the VA-DoD CPG for management of PTSD was published. Nevertheless, both TBI and PTS are still incompletely understood. Investment in terms of money and effort has been committed by the DoD to their study. The Defense and Veterans Brain Injury Center, National Intrepid Center of Excellence and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury are prominent examples of this effort. These are just beginnings, a work in progress ready to leverage advances made scientifically and always striving to provide the very best care to its military beneficiaries.

High-frequency oscillation and tracheal gas insufflation in patients with severe acute respiratory distress syndrome and traumatic brain injury: an interventional physiological study

PubMed Central

2013-01-01

Introduction In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) improves gas exchange compared with conventional mechanical ventilation (CMV). We evaluated the effect of HFO-TGI on PaO2/fractional inspired O2 (FiO2) and PaCO2, systemic hemodynamics, intracranial pressure (ICP), and cerebral perfusion pressure (CPP) in patients with traumatic brain injury (TBI) and concurrent severe ARDS. Methods We studied 13 TBI/ARDS patients requiring anesthesia, hyperosmolar therapy, and ventilation with moderate-to-high CMV-tidal volumes for ICP control. Patients had PaO2/FiO2 <100 mm Hg at end-expiratory pressure ≥10 cm H2O. Patients received consecutive, daily, 12-hour rescue sessions of HFO-TGI interspersed with 12-hour periods of CMV. HFO-TGI was discontinued when the post-HFO-TGI PaO2/FiO2 exceeded 100 mm Hg for >12 hours. Arterial/central-venous blood gases, hemodynamics, and ICP were recorded before, during (every 4 hours), and after HFO-TGI, and were analyzed by using repeated measures analysis of variance. Respiratory mechanics were assessed before and after HFO-TGI. Results Each patient received three to four HFO-TGI sessions (total sessions, n = 43). Pre-HFO-TGI PaO2/FiO2 (mean ± standard deviation (SD): 83.2 ± 15.5 mm Hg) increased on average by approximately 130% to163% during HFO-TGI (P < 0.01) and remained improved by approximately 73% after HFO-TGI (P < 0.01). Pre-HFO-TGI CMV plateau pressure (30.4 ± 4.5 cm H2O) and respiratory compliance (37.8 ± 9.2 ml/cm H2O), respectively, improved on average by approximately 7.5% and 20% after HFO-TGI (P < 0.01 for both). During HFO-TGI, systemic hemodynamics remained unchanged. Transient improvements were observed after 4 hours of HFO-TGI versus pre-HFO-TGI CMV in PaCO2 (37.7 ± 9.9 versus 41.2 ± 10.8 mm Hg; P < 0.01), ICP (17.2 ± 5.4 versus 19.7 ± 5.9 mm Hg; P < 0.05), and CPP (77.2 ± 14.6 versus 71.9 ± 14.8 mm Hg; P < 0.05). Conclusions

Animal Models of Post-Traumatic Stress Disorder and Recent Neurobiological Insights

PubMed Central

Whitaker, Annie M.; Gilpin, Nicholas W.; Edwards, Scott

2014-01-01

Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to develop PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress- and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often observed combination of PTSD and co-morbid conditions such as alcohol use disorder (AUD). Future studies will continue to refine preclinical PTSD models in hopes of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders. PMID:25083568

Post-traumatic acute kidney injury: a cross-sectional study of trauma patients.

PubMed

Lai, Wei-Hung; Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Kuo, Pao-Jen; Hsu, Shiun-Yuan; Hsieh, Ching-Hua; Hsieh, Hsiao-Yun

2016-11-22

The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System. Patients with direct renal trauma were excluded from this study. Two-sided Fisher's exact or Pearson's chi-square tests were used to compare categorical data, unpaired Student's t-test was used to analyze normally distributed continuous data, and Mann-Whitney's U test was used to compare non-normally distributed data. Propensity score matching with a 1:1 ratio with logistic regression was used to evaluate the effect of shock on AKI. Patients with AKI presented with significantly older age, higher incidence rates of pre-existing comorbidities, higher odds of associated injures (subdural hematoma, intracerebral hematoma, intra-abdominal injury, and hepatic injury), and higher injury severity than patients without AKI. In addition, patients with AKI had a longer hospital stay (18.3 days vs. 9.8 days, respectively; P < 0.001) and intensive care unit (ICU) stay (18.8 days vs. 8.6 days, respectively; P < 0. 001), higher proportion of admission into the ICU (57.7% vs. 19.0%, respectively; P < 0.001), and a higher odds ratio (OR) of short-term mortality (OR 39.0; 95% confidence interval, 24.59-61.82; P < 0.001). However, logistic regression analysis of well-matched pairs after propensity score matching did not show a significant influence of shock on the occurrence of AKI. We believe that early and aggressive resuscitation, to avoid prolonged untreated shock, may help to prevent the occurrence

Post-War Research on Post-Traumatic Stress Disorder. Part II - 1989 onwards.

PubMed

Rutkowski, Krzysztof; Dembińska, Edyta

2016-10-31

The paper illustrates the research on post-traumatic disorders conducted in Kraków at the Department of Psychotherapy and the Department of Psychiatry of the Jagiellonian University Medical College after 1989. The political changes that occurred in Poland after 1989 allowed the research to be extended with new groups of survivors. Having conducted the research of the former concentration camp prisoners, the study started to be carried out in the two research teams: 1) the former prisoners of the Stalinist period, Siberian deportees, war veterans and others were examined at the former Social Pathology Institute of the Department of Psychiatry, Jagiellonian University Medical College and the work is continued at the Department of Psychotherapy, Jagiellonian University Medical College; 2) at the Child and Adolescent Psychiatric Clinic the research of the Holocaust survivors and their families has been carried on by the same team up to the present day. The paper outlines the historical background of persecution, its course and a typical impact it had on health of each of the group of survivors. All individuals suffer from widely understood post-traumatic disorders (F43.1 and F62.0). However, differences in the profile of symptoms can be noted. The manner in which the research was organised and its modifications are also presented. The aim of this paper is to familiarise the Reader with the presented concepts and contextualise them in a political and historical dimensions, and in the continuity of the previous research on KZ-Syndrome and war neuroses.

Impact of Extraperitoneal Dioxyde Carbon Insufflation on Respiratory Function in Anesthetized Adults: A Preliminary Study Using Electrical Impedance Tomography and Wash-out/Wash-in Technic

PubMed Central

Bordes, Julien; Mazzeo, Cecilia; Gourtobe, Philippe; Cungi, Pierre Julien; Antonini, Francois; Bourgoin, Stephane; Kaiser, Eric

2015-01-01

Background: Extraperitoneal laparoscopy has become a common technique for many surgical procedures, especially for inguinal hernia surgery. Investigations of physiological changes occurring during extraperitoneal carbon dioxide (CO2) insufflation mostly focused on blood gas changes. To date, the impact of extraperitoneal CO2 insufflation on respiratory mechanics remains unknown, whereas changes in respiratory mechanics have been extensively studied in intraperitoneal insufflation. Objectives: The aim of this study was to investigate the effects of extraperitoneal CO2 insufflation on respiratory mechanics. Patients and Methods: A prospective and observational study was performed on nine patients undergoing laparoscopic inguinal hernia repair. Anesthetic management and intraoperative care were standardized. All patients were mechanically ventilated with a tidal volume of 8 mL/kg using an Engström Carestation ventilator (GE Healthcare). Ventilation distribution was assessed by electrical impedance tomography (EIT). End-expiratory lung volume (EELV) was measured by a nitrogen wash-out/wash-in method. Ventilation distribution, EELV, ventilator pressures and hemodynamic parameters were assessed before extraperitoneal insufflation, and during insufflation with a PEEP of 0 cmH2O, 5 cmH20 and of 10 cmH20. Results: EELV and thoracopulmonary compliance were significantly decreased after extraperitoneal insufflation. Ventilation distribution was significantly higher in ventral lung regions during general anesthesia and was not modified after insufflation. A 10 cmH20 PEEP application resulted in a significant increase in EELV, and a shift of ventilation toward the dorsal lung regions. Conclusions: Extraperitoneal insufflation decreased EELV and thoracopulmonary compliance. Application of a 10 cmH20 PEEP increased EELV and homogenized ventilation distribution. This preliminary clinical study showed that extraperitoneal insufflation worsened respiratory mechanics, which may

[A case of incest with dissociative amnesia and post traumatic stress disorder].

PubMed

Erdinç, Işil Bilgin; Sengül, Ceyhan Balci; Dilbaz, Nesrin; Bozkurt, Songül

2004-01-01

Incest is a kind of sexual abuse that causes serious disorders during childhood and adulthood. In order to overcome the trauma, abuse victims frequently use dissociative defence mechanisms. Post traumatic stress disorder, dissociative disorders, major depression and borderline personality disorder can be seen in the victims of childhood sexual abuse. In this article we present an adolescent who was found and brought to our clinic by the Children's Police Department while she was wandering around aimlessly. She could not remember anything about her identity or personal history. She had no apparent physical disturbances, marks of beating or wounds which could be seen externally. Her physical and neurological examinations were both normal. In her laboratory tests, there was nothing abnormal. No sign of intoxication or infection was detected. EEG and CT were also normal. After the family was found, we learned about the sexual and physical abuse and the patient was diagnosed with dissociative amnesia. The psychometric evaluations also supported our diagnosis. When the dissociation began to disappear, post traumatic stress disorder symptoms became more apparent. After she described her traumatic memories, PTSD symptoms began to recede. Through this case presentation we would like to emphasize the relationship between childhood physical and sexual abuse and dissociative disorders.

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. Copyright © 2015 Elsevier Ltd. All rights reserved.

Primary closure versus delayed closure for non bite traumatic wounds within 24 hours post injury.

PubMed

Eliya-Masamba, Martha C; Banda, Grace W

2013-10-22

Acute traumatic wounds are one of the common reasons why people present to the emergency department. Primary closure has traditionally been reserved for traumatic wounds presenting within six hours of injury and considered 'clean' by the attending surgeon, with the rest undergoing delayed primary closure as a means of controlling wound infection. Primary closure has the potential benefit of rapid wound healing but poses the potential threat of increased wound infection. There is currently no evidence to guide clinical decision-making on the best timing for closure of traumatic wounds. To determine the effect on time to healing of primary closure versus delayed closure for non bite traumatic wounds presenting within 24 hours post injury. To explore the adverse effects of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours post injury. In May 2013, for this first update we searched the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. There were no restrictions with respect to language, date of publication or study setting. Randomised controlled trials comparing primary closure with delayed closure of non bite traumatic wounds. Two review authors independently evaluated the results of the searches against the inclusion criteria. No studies met the inclusion criteria for this review. Since no studies met the inclusion criteria, neither a meta-analysis nor a narrative description of studies was possible. There is currently no systematic evidence to guide clinical decision-making regarding the timing for closure of traumatic wounds. There is a need for robust research to investigate the effect of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours of injury.

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…

Combat stressors and post-traumatic stress in deployed military healthcare professionals: an integrative review.

PubMed

Gibbons, Susanne W; Hickling, Edward J; Watts, Dorraine D

2012-01-01

  While there has been a growing body of literature on the impact of combat stressors and post-traumatic stress on military service members involved in current conflicts, there has been little available information that directly examines the impact of these on healthcare providers. Aims for this integrative review included: (1) identifying exposures, experiences and other factors influencing stress responses in military healthcare providers previously engaged in a war effort and (2) describing the incidence of post-traumatic stress and related mental health problems in this population. Using Cooper's integrative review method, relevant documents were collected and analysed using content categories and a coding scheme to assist with identifying and recording data for units of analysis. Literature searches (including all years to present) were conducted using keywords for stress reaction, for healthcare provider and for military war effort involvement. Literature was obtained using the Cumulative Index to Nursing and Allied Health Literature, the National Library of Medicine and the American Psychological Association databases. Evidence suggests that similar to military combatants, military healthcare provider exposure to life-threatening situations will increase the probability of adverse psychological disorders following these traumatic experiences. The presence of a strong sense of meaning and purpose, within a supportive environment appear to help mediate the impact of these dangerous and stressful events. Results of this review and other supporting literature indicate the need for a systematic approach to studying combat stress and post-traumatic stress in deployed healthcare providers. © 2011 Blackwell Publishing Ltd.

Children exposed to disaster: II. Risk factors for the development of post-traumatic symptomatology.

PubMed

Lonigan, C J; Shannon, M P; Taylor, C M; Finch, A J; Sallee, F R

1994-01-01

To examine the influence of subject and exposure variables on the development of post-traumatic stress disorder (PTSD) symptoms and syndrome in children exposed to disaster. Three months after Hurricane Hugo, 5,687 school-aged children were surveyed about their experiences and reactions to the hurricane. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index. The presence of PTSD symptoms was strongly related to children's reported severity of the hurricane, degree of home damage sustained, and continued displacement; however, children's level of trait anxiety and their reported emotional reactivity during the hurricane were more strongly related to the presence of PTSD symptoms than were the exposure factors. Different sets of risk factors appeared to differentially influence the development of the three DSM-III-R PTSD symptom clusters. Little evidence for a differential effect of the risk factors between females and males and younger and older children was found. Level of trait anxiety appears to be the single strongest risk for the development of severe post-traumatic reactions. The higher rate of post-traumatic symptoms in females and younger children in combination with the absence of differential reaction to the risk factors suggests that females and younger children are more likely to develop posttraumatic reactions following a disaster.

Integrated Trauma-Focused Cognitive-Behavioural Therapy for Post-traumatic Stress and Psychotic Symptoms: A Case-Series Study Using Imaginal Reprocessing Strategies

PubMed Central

Keen, Nadine; Hunter, Elaine C. M.; Peters, Emmanuelle

2017-01-01

Despite high rates of trauma in individuals with psychotic symptoms, post-traumatic stress symptoms are frequently overlooked in clinical practice. There is also reluctance to treat post-traumatic symptoms in case the therapeutic procedure of reprocessing the trauma exacerbates psychotic symptoms. Recent evidence demonstrates that it is safe to use reprocessing strategies in this population. However, most published studies have been based on treating post-traumatic symptoms in isolation from psychotic symptoms. The aims of the current case series were to assess the acceptability, feasibility, and preliminary effectiveness of integrating cognitive-behavioural approaches for post-traumatic stress and psychotic symptoms into a single protocol. Nine participants reporting distressing psychotic and post-traumatic symptoms were recruited from a specialist psychological therapies service for psychosis. Clients were assessed at five time points (baseline, pre, mid, end of therapy, and at 6+ months of follow-up) by an independent assessor on measures of current symptoms of psychosis, post-traumatic stress, emotional problems, and well-being. Therapy was formulation based and individualised, depending on presenting symptoms and trauma type. It consisted of five broad, flexible phases, and included imaginal reprocessing strategies (reliving and/or rescripting). The intervention was well received, with positive post-therapy feedback and satisfaction ratings. Unusually for this population, no-one dropped out of therapy. Post therapy, all but one (88% of participants) achieved a reliable improvement compared to pre-therapy on at least one outcome measure: post-traumatic symptoms (63%), voices (25%), delusions (50%), depression (50%), anxiety (36%), and well-being (40%). Follow-up assessments were completed by 78% (n = 7) of whom 86% (n = 6) maintained at least one reliable improvement. Rates of improvements following therapy (average of 44% across measures post therapy

Post-traumatic myositis ossificans circumscripta: an unusually large example.

PubMed

Todd, William; Gianfortune, Philip J; Laughner, Todd

2007-01-01

A 66-year-old woman presented with painful gait and a large, firm, nonmobile mass in her right foot. She had undergone four previous surgeries to remove a recurring "calcified hematoma" that resulted from an injury sustained 3 decades previously. An unusually large ossific mass (7.0 x 7.0 x 2.0 cm) consistent with post-traumatic myositis ossificans circumscripta was excised. After 3 years of follow-up, there was no return of the symptoms or the mass.

[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.

A prospective randomized trial of postoperative pain following different insufflation pressures during gynecologic laparoscopy.

PubMed

Topçu, H O; Cavkaytar, S; Kokanalı, K; Guzel, A I; Islimye, M; Doganay, M

2014-11-01

To determine the effects of different intra-abdominal pressure values on visceral pain following gynecologic laparoscopic surgery in the Trendelenburg position. This randomized, controlled prospective trial was conducted at a tertiary education hospital and included 150 patients who underwent gynecologic laparoscopy with different abdominal insufflation pressures. There were 54 patients in the 8 mmHg low pressure group (LPG), 45 in the 12 mmHg standard pressure group (SPG), and 51 in the 15 mmHg high pressure group (HPG). We assessed mean age, body mass index (BMI), duration of surgery, analgesic consumption, length of hospital stay, amount of CO2 expended and volume of hemorrhage. Visceral pain and referred visceral pain were assessed 6, 12, and 24 h postoperatively using a visual analog scale (VAS). There was no significant difference in age, BMI, analgesic consumption or length of hospital stay among groups. The mean operative time and total CO2 expended during surgery were higher in the LPG compared with the SPG and HPG. The mean intensity of postoperative pain assessed by the VAS score at 6 and 12 h was less in the LPG than in the SPG and HPG and was reduced significantly at 12 h. VAS scores at 24 h in the LPG and SPG were lower than in the HPG. Pain is reduced by low insufflation pressure compared with standard and high insufflation pressure following gynecologic laparoscopic surgery in the Trendelenburg position. However, low insufflation pressure may result in longer operation times and increased hemorrhage. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Post-traumatic stress among rescue workers after terror attacks in Norway.

PubMed

Skogstad, L; Heir, T; Hauff, E; Ekeberg, Ø

2016-10-01

On 22 July 2011, Norway was struck by two terror attacks. Seventy-seven people were killed, and many injured. Rescue workers from five occupational groups and unaffiliated volunteers faced death and despair to assist victims. To investigate the level of, and associations between, demographic variables, exposure and work-related variables and post-traumatic stress symptoms (PTSS). A cross-sectional study of general and psychosocial health care personnel, police officers, firefighters, affiliated and unaffiliated volunteers were conducted ~10 months after the terror attacks. The respondents answered a self-reported questionnaire. Post-traumatic stress disorder (PTSD) Checklist - specific (PCL-S) assessed PTSS. There were 1790 participants; response rate was 61%. About 70% of the professional rescue workers had previous work experience with similar tasks or had participated in training or disaster drills. They assessed the rescue work as a success. Firefighters and unaffiliated volunteers reported more perceived threat compared with the other groups. Among the professional personnel, the prevalence of sub-threshold PTSD (PCL 35-49) was 2% and possible PTSD (PCL ≥ 50) 0.3%. The corresponding figures among the unaffiliated volunteers were 24% and 15%, respectively. In the multivariate analysis, female gender (β = 1.7), witnessing injured/dead (β = 2.0), perceived threat (β = 1.1), perceived obstruction in rescue work (β = 1.6), lower degree of previous training (β = -0. 9) and being unaffiliated volunteers (β = 8.3) were significantly associated with PTSS. In the aftermath of a terror attack, professional rescue workers appear to be largely protected from post-traumatic stress reactions, while unaffiliated volunteers seem to be at higher risk. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

In first-time mothers, post-partum depressive symptom prospectively predict symptoms of post-traumatic stress.

PubMed

Shahar, Golan; Herishanu-Gilutz, Shirley; Holcberg, Gershon; Kofman, Ora

2015-11-01

Symptoms of both depression and Post-Traumatic Stress Disorder (PTSD) are prevalent among first-time mothers following birth. However, the direction of the association between the two types of symptoms is unclear. Ninety six first-time mothers giving birth via vaginal delivery (N=38), emergency C-Section (N=27) and planned C-Section (N=21) were assessed for depression and PTSD twice: Six weeks post-partum and six-weeks later. Cross-lagged Structural Equation Modeling (SEM) analyses revealed a prospective effect of depressive symptoms on PTSD symptoms. No moderating factors were identified. A relatively modest sample size and only two assessment waves. An early detection and intervention with symptoms of post-partum depression might also prevent the development of PTSD symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.

Tracheal gas insufflation combined with high-frequency oscillatory ventilation.

PubMed

Dolan, S; Derdak, S; Solomon, D; Farmer, C; Johanningman, J; Gelineau, J; Smith, R B

1996-03-01

To determine the efficacy of tracheal insufflation delivered by two different catheter designs on CO2 elimination when used in conjunction with high-frequency oscillatory ventilation. A nonrandomized before and after trial. Each animal served as his own control. Ten mongrel dogs weighing 20.9 +/- 1.9 kg. Four animals were assigned to a normal lung group and six animals underwent lung injury by large volume saline lavage. Permissive hypercapnia was allowed to occur by selecting oscillator settings that would lead to alveolar hypoventilation. Proximal mean airway pressure was kept constant. Tracheal gas was insufflated at 1 cm above the carina for 30 min periods at gas flows of 5 to 15 L/min. Carinal pressure, hemodynamic parameters (cardiac output, mean arterial pressure, pulmonary artery occlusion pressure), and gas exchange parameters (PaCO2, PaO2, PaO2/FIO2, shunt fraction, D O2) were measured. For the normal dogs, at catheter flow of 15 L/min; the forward thrust catheter increased carinal pressure and Pao2/FIO2 BY 30% (p<.003) and 105% (p<.005), respectively. The forward thrust catheter reduced Paco2 by 40% (p<.04). The reverse thrust catheter increased PaO2/FIO2 by 102% (p<.001) and decreased pressure and PaCO2 by 44% (p<.001) and 34% (p<.003), respectively. For the injured dogs, at catheter flow rate of 15 L/min, the forward thrust catheter increased carinal pressure, PaO2, and PaO2/FIO2 by 6% (p<.001), 23% (p<.001), and 24% (p<.02), respectively. The forward thrust catheter reduced PaCO2 by 29% (p<.002). The reverse thrust catheter increased PaO2 and PaO2/FIO2 both by 11% (p<.02) and reduced carinal pressure and PaCO2 by 23% (p<.001) and 18% (p<.002), respectively. Tracheal gas insufflation is capable of improving oxygenation and ventilation in acute lung injury when combined with high-frequency oscillatory ventilation. The addition of this second gas flow at the level of the carina raises or lowers distal airway pressure, the magnitude of which is dependent

Costo-osteochondral graft for post-traumatic osteonecrosis of the radial head in an adolescent boy.

PubMed

Iwai, S; Sato, K; Nakamura, T; Okazaki, M; Itoh, Y; Toyama, Y; Ikegami, H

2011-01-01

We present a case of post-traumatic osteonecrosis of the radial head in a 13-year-old boy which was treated with costo-osteochondral grafts. A satisfactory outcome was seen at a follow-up of two years and ten months. Although costo-osteochondral grafting has been used in the treatment of defects in articular cartilage, especially in the hand and the elbow, the extension of the technique to manage post-traumatic osteonecrosis of the radial head in a child has not previously been reported in the English language literature. Complete relief of pain was obtained and an improvement in the range of movement was observed. The long-term results remain uncertain.

Perturbed threat monitoring following a traumatic event predicts risk for post-traumatic stress disorder.

PubMed

Naim, R; Wald, I; Lior, A; Pine, D S; Fox, N A; Sheppes, G; Halpern, P; Bar-Haim, Y

2014-07-01

Post-traumatic stress disorder (PTSD) is a chronic and difficult to treat psychiatric disorder. Objective, performance-based diagnostic markers that uniquely index risk for PTSD above and beyond subjective self-report markers could inform attempts to improve prevention and early intervention. We evaluated the predictive value of threat-related attention bias measured immediately after a potentially traumatic event, as a risk marker for PTSD at a 3-month follow-up. We measured the predictive contribution of attentional threat bias above and beyond that of the more established marker of risk for PTSD, self-reported psychological dissociation. Dissociation symptoms and threat-related attention bias were measured in 577 motor vehicle accident (MVA) survivors (mean age = 35.02 years, 356 males) within 24 h of admission to an emergency department (ED) of a large urban hospital. PTSD symptoms were assessed at a 3-month follow-up using the Clinician-Administered PTSD Scale (CAPS). Self-reported dissociation symptoms significantly accounted for 16% of the variance in PTSD at follow-up, and attention bias toward threat significantly accounted for an additional 4% of the variance in PTSD. Threat-related attention bias can be reliably measured in the context of a hospital ED and significantly predicts risk for later PTSD. Possible mechanisms underlying the association between threat bias following a potentially traumatic event and risk for PTSD are discussed. The potential application of an attention bias modification treatment (ABMT) tailored to reduce risk for PTSD is suggested.

A Pilot Study of the Effects of Mindfulness-Based Stress Reduction on Post-traumatic Stress Disorder Symptoms and Brain Response to Traumatic Reminders of Combat in Operation Enduring Freedom/Operation Iraqi Freedom Combat Veterans with Post-traumatic Stress Disorder.

PubMed

Bremner, James Douglas; Mishra, Sanskriti; Campanella, Carolina; Shah, Majid; Kasher, Nicole; Evans, Sarah; Fani, Negar; Shah, Amit Jasvant; Reiff, Collin; Davis, Lori L; Vaccarino, Viola; Carmody, James

2017-01-01

Brain imaging studies in patients with post-traumatic stress disorder (PTSD) have implicated a circuitry of brain regions including the medial prefrontal cortex, amygdala, hippocampus, parietal cortex, and insula. Pharmacological treatment studies have shown a reversal of medial prefrontal deficits in response to traumatic reminders. Mindfulness-based stress reduction (MBSR) is a promising non-pharmacologic approach to the treatment of anxiety and pain disorders. The purpose of this study was to assess the effects of MBSR on PTSD symptoms and brain response to traumatic reminders measured with positron-emission tomography (PET) in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) combat veterans with PTSD. We hypothesized that MBSR would show increased prefrontal response to stress and improved PTSD symptoms in veterans with PTSD. Twenty-six OEF/OIF combat veterans with PTSD who had recently returned from a combat zone were block randomized to receive eight sessions of MBSR or present-centered group therapy (PCGT). PTSD patients underwent assessment of PTSD symptoms with the Clinician-Administered PTSD Scale (CAPS), mindfulness with the Five Factor Mindfulness Questionnaire (FFMQ) and brain imaging using PET in conjunction with exposure to neutral and Iraq combat-related slides and sound before and after treatment. Nine patients in the MBSR group and 8 in the PCGT group completed all study procedures. Post-traumatic stress disorder patients treated with MBSR (but not PCGT) had an improvement in PTSD symptoms measured with the CAPS that persisted for 6 months after treatment. MBSR also resulted in an increase in mindfulness measured with the FFMQ. MBSR-treated patients had increased anterior cingulate and inferior parietal lobule and decreased insula and precuneus function in response to traumatic reminders compared to the PCGT group. This study shows that MBSR is a safe and effective treatment for PTSD. Furthermore, MBSR treatment is associated with

Age, cumulative trauma and stressful life events, and post-traumatic stress symptoms among older adults in prison: do subjective impressions matter?

PubMed

Maschi, Tina; Morgen, Keith; Zgoba, Kristen; Courtney, Deborah; Ristow, Jennifer

2011-10-01

The aging prison population in the United States presents a significant public health challenge with high rates of trauma and mental health issues that the correctional system alone is ill-prepared to address. The purpose of this study was to examine the relationship of age, objective, and subjective measures of trauma and stressful life events and post-traumatic stress symptoms among older adults in prison. Data were gathered from 334 prisoners (aged 55+) housed in the New Jersey Department of Corrections, as of September 2010. An anonymous self-report, self-administered survey was mailed to the total population of 1,000 prisoners aged 55 years and older. Objective and subjective trauma was measured using the Life Stressors Checklist-Revised (LSC-R), and post-traumatic stress symptoms were measured using the Civilian Version of the Post-traumatic Stress Scale. Results of a path analysis revealed that past year subjective impressions of traumatic and stressful life events had a positive and significant relationship to current post-traumatic stress symptoms. Age was found to have a significant and inverse relationship to subjective traumatic and stressful life events. That is, younger participants reported higher levels of cumulative traumatic and stressful life events and past year subjective ratings of being bothered by these past events. These findings have significance for interdisciplinary/interprofessional practice and appropriate institutional and community care, including reentry planning of older adults in the criminal justice system.

Depressive symptoms and symptoms of post-traumatic stress disorder in women after childbirth.

PubMed

Zaers, Stefanie; Waschke, Melanie; Ehlert, Ulrike

2008-03-01

This study examined the course of psychological problems in women from late pregnancy to six months postpartum, the rates of psychiatric, especially depressive and post-traumatic stress symptoms and possible related antecedent variables. During late pregnancy, one to three days postpartum, six weeks and six months postpartum, 47 of the 60 participating women completed a battery of questionnaires including the General Health Questionnaire, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, and the PTSD Symptom Scale. In general, most women recovered from psychiatric and somatic problems over the period of investigation. However, depressive and post-traumatic stress symptoms in particular were not found to decline significantly. Six weeks postpartum, 22% of the women had depressive symptoms, with this figure remaining at 21.3% six months postpartum. In addition, 6% of the women studied reported clinically significant PTSD symptoms at six weeks postpartum with 14.9% reporting such symptoms at six months postpartum. The most important predictor for depressive and post-traumatic stress symptoms was the block variable "anxiety in late pregnancy". Other predictors were the variables "psychiatric symptoms in late pregnancy", "critical life events" and the "experience of delivery". The results of our study show a high prevalence rate of psychiatric symptoms in women after childbirth and suggest, besides the experience of the delivery itself, a vulnerability or predisposing history that makes the development of psychiatric symptoms after childbirth more probable.

Reliability of classification for post-traumatic ankle osteoarthritis.

PubMed

Claessen, Femke M A P; Meijer, Diederik T; van den Bekerom, Michel P J; Gevers Deynoot, Barend D J; Mallee, Wouter H; Doornberg, Job N; van Dijk, C Niek

2016-04-01

The purpose of this study was to identify the most reliable classification system for clinical outcome studies to categorize post-traumatic-fracture-osteoarthritis. A total of 118 orthopaedic surgeons and residents-gathered in the Ankle Platform Study Collaborative Science of Variation Group-evaluated 128 anteroposterior and lateral radiographs of patients after a bi- or trimalleolar ankle fracture on a Web-based platform in order to rate post-traumatic osteoarthritis according to the classification systems coined by (1) van Dijk, (2) Kellgren, and (3) Takakura. Reliability was evaluated with the use of the Siegel and Castellan's multirater kappa measure. Differences between classification systems were compared using the two-sample Z-test. Interobserver agreement of surgeons who participated in the survey was fair for the van Dijk osteoarthritis scale (k = 0.24), and poor for the Takakura (k = 0.19) and the Kellgren systems (k = 0.18) according to the categorical rating of Landis and Koch. This difference in one categorical rating was found to be significant (p < 0.001, CI 0.046-0.053) with the high numbers of observers and cases available. This study documents fair interobserver agreement for the van Dijk osteoarthritis scale, and poor interobserver agreement for the Takakura and Kellgren osteoarthritis classification systems. Because of the low interobserver agreement for the van Dijk, Kellgren, and Takakura classification systems, those systems cannot be used for clinical decision-making. Development of diagnostic criteria on basis of consecutive patients, Level II.

In search of antiepileptogenic treatments for post-traumatic epilepsy.

PubMed

Saletti, Patricia G; Ali, Idrish; Casillas-Espinosa, Pablo M; Semple, Bridgette D; Lisgaras, Christos; Moshé, Solomon L; Galanopoulou, Aristea S

2018-06-21

Post-traumatic epilepsy (PTE) occurs in 20% of individuals with acquired epilepsy, and can impact significantly the quality of life due to the seizures and other functional or cognitive and behavioral outcomes of the traumatic brain injury (TBI) and PTE. There is no available antiepileptogenic or disease modifying treatment for PTE. Animal models of TBI and PTE have been developed, offering useful insights on the value of inflammatory, neurodegenerative pathways, hemorrhages and iron accumulation, calcium channels and other target pathways that could be used for treatment development. Most of the existing preclinical studies test efficacy towards pathologies of functional recovery after TBI, while a few studies are emerging testing the effects towards induced or spontaneous seizures. Here we review the existing preclinical trials testing new candidate treatments for TBI sequelae and PTE, and discuss future directions for efforts aiming at developing antiepileptogenic and disease-modifying treatments. Copyright © 2018. Published by Elsevier Inc.

Work-related post-traumatic stress reactions: the hidden dimension.

PubMed

Lawson, B Z

1987-01-01

A variety of occupational health hazards can cause employees to experience feelings of victimization and to develop work-related post-traumatic stress responses. The author presents assessment guidelines developed in work with people suffering from toxic exposures to help identify factors that can place employees at high risk for such stress responses. These guidelines can be adapted to evaluate employee reactions to any type of occupational injury. Clinicians also need to move beyond individual treatment approaches to address workplace and policy interventions.

21 CFR 884.1300 - Uterotubal carbon dioxide insufflator and accessories.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Uterotubal carbon dioxide insufflator and accessories. 884.1300 Section 884.1300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Diagnostic Devices § 884.1300...

21 CFR 884.1300 - Uterotubal carbon dioxide insufflator and accessories.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Uterotubal carbon dioxide insufflator and accessories. 884.1300 Section 884.1300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Diagnostic Devices § 884.1300...

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center.

PubMed

Kaimal, Girija; Walker, Melissa S; Herres, Joanna; French, Louis M; DeGraba, Thomas J

2018-06-11

The study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures. Observational study of correlations between clinical symptoms of post-traumatic stress, depression and anxiety and visual themes in mask imagery. The National Intrepid Center of Excellence at the Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Active-duty military SMs (n=370) with a history of traumatic brain injury, post-traumatic stress symptoms and related PH conditions. The masks used for analysis were created by the SMs during art therapy sessions in week 1 of a 4-week integrative treatment programme. Associations between scores on the PTSD Checklist-Military, Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale on visual themes in depictions of aspects of individual identity (psychological injury, military symbols, military identity and visual metaphors). Visual and clinical data comparisons indicate that SMs who depicted psychological injury had higher scores for post-traumatic stress and depression. The depiction of military unit identity, nature metaphors, sociocultural metaphors, and cultural and historical characters was associated with lower post-traumatic stress, depression and anxiety scores. Colour-related symbolism and fragmented military symbols were associated with higher anxiety

Single piece artificial urinary sphincter for secondary incontinence following successful repair of post traumatic urethral injury

PubMed Central

Kandpal, D. K.; Rawat, S. K.; Kanwar, S.; Baruha, A.; Chowdhary, S. K.

2013-01-01

Post traumatic urethral injury is uncommon in children. The management of this condition is dependent on the severity of injury. Initial suprapubic cystostomy with delayed repair is the conventional treatment. Successful reconstruction of urethral injury may be followed by urethral stricture, incontinence, impotence, and retrograde ejaculation. Successful repair of post traumatic urethral injury followed by secondary incontinence in children has not been well addressed in literature. We report the management of one such child, with satisfactory outcome with implantation of a new model of single piece artificial urinary sphincter in the bulbar urethra by perineal approach. PMID:24347870

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. © 2013 John Wiley & Sons, Ltd.

Post-traumatic stress disorder: the neurobiological impact of psychological trauma

PubMed Central

Sherin, Jonathan E.; Nemeroff, Charles B.

2011-01-01

The classic fight-or-flight response to perceived threat is a reflexive nervous phenomenon thai has obvious survival advantages in evolutionary terms. However, the systems that organize the constellation of reflexive survival behaviors following exposure to perceived threat can under some circumstances become dysregulated in the process. Chronic dysregulation of these systems can lead to functional impairment in certain individuals who become “psychologically traumatized” and suffer from post-traumatic stress disorder (PTSD), A body of data accumulated over several decades has demonstrated neurobiological abnormalities in PTSD patients. Some of these findings offer insight into the pathophysiology of PTSD as well as the biological vulnerability of certain populations to develop PTSD, Several pathological features found in PTSD patients overlap with features found in patients with traumatic brain injury paralleling the shared signs and symptoms of these clinical syndromes. PMID:22034143

Post-traumatic stress disorder diagnosis in children: challenges and promises

PubMed Central

Cohen, Judith A.; Scheeringa, Michael S.

2009-01-01

Children and adolescents experience high rates of potentially traumatic experiences. Many children subsequently develop mental health problems, including post-traumatic stress disorder (PTSD) symptoms. Accurately diagnosing PTSD in children is challenging. This paper reviews the following important issues: (i) the specificity of the PTSD diagnosis; (ii) children who are symptomatic and impaired but do not have enough symptoms for the diagnosis of PTSD; (iii) developmental considerations for preschool and schooi-age children; and (iv) a variety of assessment challenges that reflect the difficulty and complexity of interviewing children and caregivers about these symptoms. Despite these challenges, PTSD remains the best construct for clinical and research work with trauma survivors. Pediatric PTSD criteria are valuable for identifying children at risk and in need of treatment and can be even more helpful when developmentally modified in ways that are discussed. PMID:19432391

Single-port thoracoscopic surgery for pneumothorax under two-lung ventilation with carbon dioxide insufflation

PubMed Central

Han, Kook Nam; Lee, Hyun Joo; Lee, Dong Kyu; Kim, Heezoo; Lim, Sang Ho; Choi, Young Ho

2016-01-01

Background The development of single-port thoracoscopic surgery and two-lung ventilation reduced the invasiveness of minor thoracic surgery. This study aimed to evaluate the feasibility and safety of single-port thoracoscopic bleb resection for primary spontaneous pneumothorax using two-lung ventilation with carbon dioxide insufflation. Methods Between February 2009 and May 2014, 130 patients underwent single-port thoracoscopic bleb resection under two-lung ventilation with carbon dioxide insufflation. Access was gained using a commercial multiple-access single port through a 2.5-cm incision; carbon dioxide gas was insufflated through a port channel. A 5-mm thoracoscope, articulating endoscopic devices, and flexible endoscopic staplers were introduced through a multiple-access single port for bulla resection. Results The mean time from endotracheal intubation to incision was 29.2±7.8 minutes, the mean operative time was 30.9±8.2 minutes, and the mean total anesthetic time was 75.5±14.4 minutes. There were no anesthesia-related complications or wound problems. The chest drain was removed after a mean of 3.7±1.4 days and patients were discharged without complications 4.8±1.5 days from the operative day. During a mean 7.5±10.1 months of follow-up, there were five recurrences (3.8%) in operated thorax. Conclusions The anesthetic strategy of single-lumen intubation with carbon dioxide gas insufflation can be a safe and feasible option for single-port thoracoscopic bulla resection as it represents the least invasive surgical option with the potential advantages of reducing operative time and one-lung ventilation-related complications without diminishing surgical outcomes. PMID:27293823

Thoracoscopic evacuation of retained post-traumatic hemothorax.

PubMed

Ahmad, Tanveer; Ahmed, Syed Waqar; Soomro, Niaz Hussain; Sheikh, Khalil Ahmed

2013-03-01

Post-traumatic retained hemothorax is a major risk factor for empyema thoracis leading to prolonged hospitalization, entrapped lung and a need for decortication. VATS (Video Assisted Thoracoscopy) for retained hemothorax shortens the duration of chest tube drainage and length of stay. From December 2004 to July 2009, 110 consecutive patients underwent VATS for retained or clotted hemothoraces at the Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi. Majority of the patients were males (n = 91; 82.7%). Sixty-five patients (59.1%) underwent VATS within 6 days and 45 patients (40.9%) between 7 - 14 days of injury. In 8 patients (7.3%) VATS was abandoned for thoracotomy. Post VATS full lung expansion was achieved in 87 patients (79.0) with complete evacuation of hemothorax. Chest tubes were removed within the first week in 100 patients (90.9%). In hemodynamically stable patients, VATS is a safe, reliable and effective technique for the evacuation of retained hemothorax. Early intervention within 6 days of injury avoids the need for a thoracotomy and is associated with a better short and long-term outcome.

Post-traumatic anxiety associates with failure of the innate immune receptor TLR9 to evade the pro-inflammatory NFκB pathway.

PubMed

Zimmerman, G; Shaltiel, G; Barbash, S; Cohen, J; Gasho, C J; Shenhar-Tsarfaty, S; Shalev, H; Berliner, S A; Shelef, I; Shoham, S; Friedman, A; Cohen, H; Soreq, H

2012-02-21

Post-traumatic anxiety notably involves inflammation, but its causes and functional significance are yet unclear. Here, we report that failure of the innate immune system Toll-like receptor 9 (TLR9) to limit inflammation is causally involved with anxiety-associated inflammation and that peripheral administration of specific oligonucleotide activators of TLR9 may prevent post-traumatic consequences in stressed mice. Suggesting involvement of NFκB-mediated enhancement of inflammatory reactions in the post-traumatic phenotype, we found association of serum interleukin-1β increases with symptoms severity and volumetric brain changes in post-traumatic stress disorder patients. In predator scent-stressed mice, the moderate NFκB-activating oligonucleotides mEN101 and its human ortholog BL-7040, but not the canonic NFκB activator oligonucleotide ODN1826, induced anxiolytic effects. In stressed mice, peripherally administered mEN101 prevented delayed stress-inducible serum interleukin-1β increases while limiting stress-characteristic hippocampal transcript modifications and the anxiety-induced EGR1-mediated neuronal activation. Attesting to the TLR9 specificity of this response, BL-7040 suppressed NFκB-mediated luciferase in transfected cells co-expressing TLR9, but not other TLRs. Furthermore, TLR9-/- mice were mEN101 and BL-7040 resistant and presented unprovoked anxiety-like behavior and anxiety-characteristic hippocampal transcripts. Our findings demonstrate functional relevance of TLR9 in protecting stressed mammals from overreacting to traumatic experiences and suggest using oligonucleotide-mediated peripheral TLR9 activation to potentiate the innate immune system and prevent post-traumatic inflammation and anxiety.

Post-traumatic anxiety associates with failure of the innate immune receptor TLR9 to evade the pro-inflammatory NFκB pathway

PubMed Central

Zimmerman, G; Shaltiel, G; Barbash, S; Cohen, J; Gasho, C J; Shenhar-Tsarfaty, S; Shalev, H; Berliner, S A; Shelef, I; Shoham, S; Friedman, A; Cohen, H; Soreq, H

2012-01-01

Post-traumatic anxiety notably involves inflammation, but its causes and functional significance are yet unclear. Here, we report that failure of the innate immune system Toll-like receptor 9 (TLR9) to limit inflammation is causally involved with anxiety-associated inflammation and that peripheral administration of specific oligonucleotide activators of TLR9 may prevent post-traumatic consequences in stressed mice. Suggesting involvement of NFκB-mediated enhancement of inflammatory reactions in the post-traumatic phenotype, we found association of serum interleukin-1β increases with symptoms severity and volumetric brain changes in post-traumatic stress disorder patients. In predator scent-stressed mice, the moderate NFκB-activating oligonucleotides mEN101 and its human ortholog BL-7040, but not the canonic NFκB activator oligonucleotide ODN1826, induced anxiolytic effects. In stressed mice, peripherally administered mEN101 prevented delayed stress-inducible serum interleukin-1β increases while limiting stress-characteristic hippocampal transcript modifications and the anxiety-induced EGR1-mediated neuronal activation. Attesting to the TLR9 specificity of this response, BL-7040 suppressed NFκB-mediated luciferase in transfected cells co-expressing TLR9, but not other TLRs. Furthermore, TLR9−/− mice were mEN101 and BL-7040 resistant and presented unprovoked anxiety-like behavior and anxiety-characteristic hippocampal transcripts. Our findings demonstrate functional relevance of TLR9 in protecting stressed mammals from overreacting to traumatic experiences and suggest using oligonucleotide-mediated peripheral TLR9 activation to potentiate the innate immune system and prevent post-traumatic inflammation and anxiety. PMID:22832815

Post traumatic stress disorder among former child soldiers attending a rehabilitative service and primary school education in northern Uganda.

PubMed

Ovuga, Emilio; Oyok, Thomas O; Moro, E B

2008-09-01

This study was prompted by the psychiatric hospitalization of 12 former child soldiers of the Lord's Resistance Army (LRA) at a rehabilitation school in northern Uganda with a case of mass psychotic behavior. To report the prevalence of post-traumatic stress disorder, depressed mood, and associated risk factors. Data on post-traumatic stress disorder, depressed mood, physical disabilities, socio-demographic variables, and the children's war experiences were collected in face-to-face interviews using the Harvard Trauma Questionnaire (HTQ), a modified Hopkins Symptoms Check-List (HSCL), and a 15-item War Trauma Experience Check-list (WTECL-15). Data was analyzed with SPSS version 11.0. There were 58 girls and 44 boys. Eighty nine children (87.3%) reported having experienced ten or more war-related traumatic psychological events; 55.9% of the children suffered from symptoms of post-traumatic stress disorder, 88.2%, symptoms of depressed mood and 21.6% had various forms of physical disability. Nearly half of the children (42.2%) reported a positive family history of severe mental illness; 10.8%, a family history of suicide; 22.5%, a family history of suicide attempt; and 45.1%, a family history of alcohol abuse. Children who experienced 10 or more traumatic war events were more likely than the rest to experience depressed mood. Return through a reception center or through a cleansing ritual did not protect against depression. Post-traumatic stress disorder among former LRA child soldiers at a rehabilitation centre in northern Uganda is presented. The report highlights the huge unmet need for psychological services among former child soldiers of the LRA.

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.

Refugee Children in Sweden: Post-Traumatic Stress Disorder in Iranian Preschool Children Exposed to Organized Violence.

ERIC Educational Resources Information Center

Almqvist, Kjerstin; Brandell-Forsberg, Margareta

1997-01-01

Evaluation of the incidence of post-traumatic stress disorder (PTSD) in 50 preschool children from 47 Iranian families living as refugees in Sweden found a rise of PTSD from 2% to 21% in the 42 children with traumatic exposure through war and political persecution. Stability of prevalence was high in follow-up 2 and 2.5 years later. (Author/DB)

Heat loss during carbon dioxide insufflation: comparison of a nebulization based humidification device with a humidification and heating system.

PubMed

Noll, Eric; Schaeffer, Roland; Joshi, Girish; Diemunsch, Sophie; Koessler, Stefanie; Diemunsch, Pierre

2012-12-01

This study compared the heat loss observed with the use of MR860 AEA Humidifier™ system (Fisher & Paykel Healthcare, New Zealand), which humidifies and heats the insufflated CO(2), and the use of the AeronebPro™ device (Aerogen, Ireland), which humidifies but does not heat the insufflated CO(2). With institutional approval, 16 experiments were conducted in 4 pigs. Each animal, acting as its own control, was studied at 8-day intervals in randomized sequence with the following four conditions: (1) control (C) no pneumoperitoneum; (2) standard (S) insufflation with nonhumidified, nonheated CO(2); (3) Aeroneb™ (A): insufflation with humidified, nonheated CO(2); and (4) MR860 AEA humidifier™ (MR): insufflation with humidified and heated CO(2). The measured heat loss after 720L CO(2) insufflation during the 4 h was 1.03 ± 0.75 °C (mean ± SEM) in group C; 3.63 ± 0.31 °C in group S; 3.03 ± 0.39 °C in group A; and 1.98 ± 0.09 °C in group MR. The ANOVA showed a significant difference with time (p = 0.0001) and with the insufflation technique (p = 0.024). Heat loss in group C was less than in group S after 60 min (p = 0.03), less than in group A after 70 min (p = 0.03), and less than in group MR after 150 min (p = 0.03). The heat loss in group MR was less than in group S after 50 min (p = 0.04) and less than in group A after 70 min (p = 0.02). After 160 min, the heat loss in group S was greater than in group A (p = 0.03). As far as heat loss is concerned, for laparoscopic procedures of less than 60 min, there is no benefit of using any humidification with or without heating. However, for procedures greater than 60 min, use of heating along with humidification, is superior.

The moderation of resilience on the negative effect of pain on depression and post-traumatic growth in individuals with spinal cord injury.

PubMed

Min, Jung-Ah; Lee, Chang-Uk; Hwang, Sung-Il; Shin, Jung-In; Lee, Bum-Suk; Han, Sang-Hoon; Ju, Hye-In; Lee, Cha-Yeon; Lee, Chul; Chae, Jeong-Ho

2014-01-01

To determine the moderating effect of resilience on the negative effects of chronic pain on depression and post-traumatic growth. Community-dwelling individuals with SCI (n = 37) were recruited at short-term admission for yearly regular health examination. Participants completed self-rating standardized questionnaires measuring pain, resilience, depression and post-traumatic growth. Hierarchical linear regression analysis was performed to identify the moderating effect of resilience on the relationships of pain with depression and post-traumatic growth after controlling for relevant covariates. In the regression model of depression, the effect of pain severity on depression was decreased (β was changed from 0.47 to 0.33) after entering resilience into the model. In the final model, both pain and resilience were significant independent predictors for depression (β = 0.33, p = 0.038 and β = -0.47, p = 0.012, respectively). In the regression model of post-traumatic growth, the effect of pain severity became insignificant after entering resilience into the model. In the final model, resilience was a significant predictor (β = 0.51, p = 0.016). Resilience potentially mitigated the negative effects of pain. Moreover, it independently contributed to reduced depression and greater post-traumatic growth. Our findings suggest that resilience might provide a potential target for intervention in SCI individuals.

Simultaneous correction of post-traumatic aphakia and aniridia with the use of artificial iris and IOL implantation.

PubMed

Forlini, Cesare; Forlini, Matteo; Rejdak, Robert; Prokopiuk, Agata; Levkina, Oxana; Bratu, Adriana; Rossini, Paolo; Cagampang, Perfecto R; Cavallini, Gian Maria

2013-03-01

Combined post-traumatic aniridia and aphakia demand extensive and complex reconstructive surgery. We present our approach for simultaneous correction of this surgical situation with the use of the ArtificialIris (Dr. Schmidt Intraocularlinsen GmbH, Germany) with a foldable acrylic IOL Lentis L-313 (Oculentis, GmbH, Germany) sutured to its surface. The novelty (our first operation was on June 2010) of this surgical technique is based on the combined use of foldable (with closed haptics) IOL and Artificialiris to correct post-traumatic aniridia and aphakia. Four consecutive cases of combined post-traumatic lesions of iris and lens, corrected with complex device ArtificialIris and foldable IOL. In two cases, the compound implant was sutured to the sclera in sulcus during the penetrating keratoplasty; in another case, it was positioned through a corneal incision of about 5.0 mm with transscleral fixation, and in one patient with preserved capsular support and possibility of IOL in-the-bag implantation the ArtificialIris was placed in sulcus sutureless through a clear corneal tunnel. Maximal follow-up was 6 months. The complex device was placed firmly fixed within the sulcus, including in the eye implanted without sutures, and showed a stable and centered position without any tilt or torque. Management of post-traumatic aniridia combined with aphakia by haptic fixation of a foldable acrylic IOL on a foldable iris prosthesis appears to be a promising approach which gives the surgeon the possibility to correct a complex lesion with one procedure, which is less traumatic and faster. Existence of foldable materials, both iris and IOL, permits relatively small corneal incisions (4.0-5.0 mm). Moreover, the custom-tailored iris prosthesis gives a perfect aesthetic result.

The dissociative post-traumatic stress disorder (PTSD) subtype: A treatment outcome cohort study in veterans with PTSD.

PubMed

Haagen, Joris F G; van Rijn, Allison; Knipscheer, Jeroen W; van der Aa, Niels; Kleber, Rolf J

2018-06-01

Dissociation is a prevalent phenomenon among veterans with post-traumatic stress disorder (PTSD) that may interfere with the effectiveness of treatment. This study aimed to replicate findings of a dissociative PTSD subtype, to identify corresponding patterns in coping style, symptom type, and symptom severity, and to investigate its impact on post-traumatic symptom improvement. Latent profile analysis (LPA) was applied to baseline data from 330 predominantly (97%) male treatment-seeking veterans (mean age 39.5 years) with a probable PTSD. Multinomial logistic models were used to identify predictors of dissociative PTSD. Eighty veterans with PTSD that commenced with psychotherapy were invited for a follow-up measure after 6 months. The majority (n = 64, 80% response rate) completed the follow-up measure. Changes in post-traumatic stress between baseline and follow-up were explored as a continuous distal outcome. Latent profile analysis revealed four distinct patient profiles: 'low' (12.9%), 'moderate' (33.2%), 'severe' (45.1%), and 'dissociative' (8.8%) PTSD. The dissociative PTSD profile was characterized by more severe pathology levels, though not post-traumatic reactions symptom severity. Veterans with dissociative PTSD benefitted equally from PTSD treatment as veterans with non-dissociative PTSD with similar symptom severity. Within a sample of veterans with PTSD, a subsample of severely dissociative veterans was identified, characterized by elevated severity levels on pathology dimensions. The dissociative PTSD subtype did not negatively impact PTSD treatment. The present findings confirmed the existence of a distinct subgroup veterans that fit the description of dissociative PTSD. Patients with dissociative PTSD subtype symptoms uniquely differed from patients with non-dissociative PTSD in the severity of several psychopathology dimensions. Dissociative and non-dissociative PTSD patients with similar post-traumatic severity levels showed similar levels of

[Procalcitonin as a predictor of trauma severity and post-traumatic sepsis in children].

PubMed

Liu, Shao-Feng; Yuan, Gao-Pin; Yang, Jian; He, Tao-Zhen; Feng, Hai-Huan; Liu, Min

2012-09-01

To determine the association of procalcitonin (PCT) with trauma severity and post traumatic sepsis in children. The blood samples of 30 children with acute trauma in a Pediatric unit were collected for four consecutive days. The levels of PCT, IL-6, CRP and WBC were measured. The pediatric trauma score (PTS), length of stay in hospital, incidence of sepsis and clinical outcomes of the children were recorded. The value of PCT for predicting prognosis of children with trauma was compared with other inflammatory markers. Plasma PCT levels increased significantly in the patients in our study. Sepsis occurred in 23.33% of the patients. The patients with sepsis had higher levels of PCT than those with and without systemic inflammatory response syndrome (SIRS) and the healthy controls (P < 0.05). The peak level of PCT emerged on day 2 after trauma. The plasma PCT levels were positively correlated with trauma severity. The level of PCT on day 2 was an independent predictor for post-trauma sepsis and SIRS. Plasma PCT levels increase markedly in post trauma children. Plasma PCT of day 2 after trauma is an independent predictor of post-traumatic sepsis and SIRS complications. There is a significant correlation between the severity of injury and plasma PCT.

[Post-traumatic stress disorder in schoolchildren after the 2011 earthquake in Lorca (Spain)].

PubMed

López-García, Juan José; López-Soler, Concepción

2014-01-01

To determine the prevalence of post-traumatic stress disorder (PTSD) in children after the 2011 earthquake in Lorca (Spain). By using a cross-sequential design, children aged from 8 to 12 years (495 students at 1 month and 374 at 1 year) were assessed for full and partial PTSD using the Post-traumatic Children's Symptoms Stress Disorder Scale. The percentage of children with PTSD was 55.4% (65.6% of girls and 46.9% of boys) at 1 month and 40.1% (44.5% girls and 35.9% children) at 1 year. One in two young girls (8-10 years) had PTSD 1 year after the earthquake. A differential effect was observed due to gender and age, in which younger children, especially girls, were particularly at risk, even 1 year after the earthquake. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Trajectories and Risk Factors for Post-Traumatic Stress Symptoms following Pediatric Concussion.

PubMed

Truss, Katherine; Godfrey, Celia; Takagi, Michael; Babl, Franz E; Bressan, Silvia; Hearps, Stephen; Clarke, Cathriona; Dunne, Kevin; Anderson, Vicki

2017-07-15

A substantial minority of children experience post-traumatic stress symptoms (PTSS) following injury. Research indicates variation in the trajectory of PTSS following pediatric injury, but investigation of PTSS following concussion has assumed homogeneity. This study aimed to identify differential trajectories of PTSS following pediatric concussion and to investigate risk factors, including acute post-concussive symptoms (PCS), associated with these trajectories. A total of 120 children ages 8-18 years reported PTSS for 3 months following concussion diagnosis using the Child PTSD Symptom Scale, with a score of 16 or above indicating probable post-traumatic stress disorder diagnosis. Age, gender, injury mechanism, loss of consciousness, previous concussions, prior hospitalization, prior diagnosis of depression or anxiety, and acute PCS were assessed as risk factors. Data were analyzed using group-based trajectory modeling. Results revealed 16% of children had clinically significant PTSS 2 weeks post-concussion, declining to 10% at 1 month and 6% at 3 months post-injury. Group-based trajectory modeling identified three trajectories of PTSS post-concussion: "resilient" (70%); "recovering" (25%), in which children experienced elevated acute symptoms that declined over time; and "chronic symptomatology" (5%). Due to small size, the chronic group should be interpreted with caution. Higher acute PCS and prior diagnosis of depression or anxiety both significantly increased predicted probability of recovering trajectory group membership. These findings establish that most children are resilient to PTSS following concussion, but that PTSS do occur acutely in a substantial minority of children. The study indicates mental health factors, particularly PTSS, depression, and anxiety, should be considered integral to models of concussion management and treatment.

Psychosomatic treatment of phantom limb pain with post-traumatic stress disorder: a case report.

PubMed

Muraoka, M; Komiyama, H; Hosoi, M; Mine, K; Kubo, C

1996-08-01

The successful treatment of severe left lower limb phantom pain is reported. Hypnosis and antidepressant drugs were the basis for the treatment which controlled the phantom limb pain and an associated post-traumatic stress disorder.

The value of the identification of predisposing factors for post-traumatic amnesia in management of mild traumatic brain injury.

PubMed

Fotakopoulos, George; Makris, Demosthenes; Tsianaka, Eleni; Kotlia, Polikceni; Karakitsios, Paulos; Gatos, Charalabos; Tzannis, Alkiviadis; Fountas, Kostas

2018-01-01

To identify the risk factors for post-traumatic amnesia (PTA) and to document the incidence of PTA after mild traumatic brain injuries. This was a prospective study, affecting mild TBI (mTBI) (Glasgow Coma Scale 14-15) cases attending to the Emergency Department between January 2009 and April 2012 (40 months duration). Patients were divided into two groups (Group A: without PTA, and Group B: with PTA, and they were assessed according to the risk factors. A total of 1762 patients (males: 1002, 56.8%) were meeting study inclusion criteria [Group A: n = 1678 (83.8%), Group B: n = 84 (4.2%)]. Age, CT findings: (traumatic focal HCs in the frontal and temporal lobes or more diffuse punctate HCs, and skull base fractures), anticoagulation therapy and seizures were independent factors of PTA. There was no statistically significant correlation between PTA and sex, convexity fractures, stroke event, mechanism of mTBI (fall +/or beating), hypertension, coronary heart disease, chronic smokers and diabetes (p > 0.005). CT findings: (traumatic focal HCs in the frontal and temporal lobes or more diffuse punctate HCs and skull base fractures), age, seizures and anticoagulation/antiplatelet therapy, were independent factors of PTA and could be used as predictive factors after mTBI.

Aripiprazole for Post-traumatic Stress Disorder: A Systematic Review.

PubMed

Britnell, Sara R; Jackson, Anna D; Brown, Jamie N; Capehart, Bruce P

The aim of this study was to review the safety and efficacy of aripiprazole as monotherapy and adjunct therapy for the treatment of post-traumatic stress disorder (PTSD). A search of both MEDLINE (1956 to May 2017) and EMBASE (1957 to May 2017) was conducted using the terms "aripiprazole" and "post-traumatic stress disorder," "posttraumatic stress disorder," or "PTSD." Studies evaluating the primary endpoint of PTSD in patients taking aripiprazole as monotherapy or adjunct therapy were analyzed for relevance. Those that met the objective of this study were included for evaluation: 1 placebo-controlled trial; 4 open-label trials; and 1 retrospective chart review. In patients with a history of PTSD, aripiprazole resulted in significant improvements in the primary outcome, including Clinician-Administered PTSD Symptom Scale or PTSD Checklist-Military scores, in all but 1 study analyzed. Study durations ranged from 10 to 16 weeks. Initial doses of aripiprazole ranged from 2 to 15 mg daily that could be titrated up or down in the range of 2 to 30 mg daily based on efficacy and tolerability. Overall, aripiprazole was well tolerated with the most common treatment-related study discontinuations attributed to the adverse events of anxiety, insomnia, akathisia, asthenia, restlessness, and somnolence. Based on the reviewed literature, aripiprazole is a reasonable therapy option as monotherapy or adjunct therapy in patients with PTSD. Larger randomized controlled trials are needed to better understand the role of this atypical antipsychotic in patients with PTSD.

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

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.

Interventions to prevent post-traumatic stress disorder: a systematic review.

PubMed

Forneris, Catherine A; Gartlehner, Gerald; Brownley, Kimberly A; Gaynes, Bradley N; Sonis, Jeffrey; Coker-Schwimmer, Emmanuel; Jonas, Daniel E; Greenblatt, Amy; Wilkins, Tania M; Woodell, Carol L; Lohr, Kathleen N

2013-06-01

Traumatic events are prevalent worldwide; trauma victims seek help in numerous clinical and emergency settings. Using effective interventions to prevent post-traumatic stress disorder (PTSD) is increasingly important. This review assessed the efficacy, comparative effectiveness, and harms of psychological, pharmacologic, and emerging interventions to prevent PTSD. The following sources were searched for research on interventions to be included in the review: MEDLINE; Cochrane Library; CINAHL; EMBASE; PILOTS (Published International Literature on Traumatic Stress); International Pharmaceutical Abstracts; PsycINFO; Web of Science; reference lists of published literature; and unpublished literature (January 1, 1980 to July 30, 2012). Two reviewers independently selected studies, extracted data or checked accuracy, assessed study risk of bias, and graded strength of evidence. All data synthesis occurred between January and September 2012. Nineteen studies covered various populations, traumas, and interventions. In meta-analyses of three trials (from the same team) for people with acute stress disorder, brief trauma-focused cognitive behavioral therapy was more effective than supportive counseling in reducing the severity of PTSD symptoms (moderate-strength); these two interventions had similar results for incidence of PTSD (low-strength); depression severity (low-strength); and anxiety severity (moderate-strength). PTSD symptom severity after injury decreased more with collaborative care than usual care (single study; low-strength). Debriefing did not reduce incidence or severity of PTSD or psychological symptoms in civilian traumas (low-strength). Evidence about relevant outcomes was unavailable for many interventions or was insufficient owing to methodologic shortcomings. Evidence is very limited regarding best practices to treat trauma-exposed individuals. Brief cognitive behavioral therapy may reduce PTSD symptom severity in people with acute stress disorder

Risk factors for the development of post-traumatic stress disorder and coping strategies in mothers and fathers following infant hospitalisation in the neonatal intensive care unit.

PubMed

Aftyka, Anna; Rybojad, Beata; Rosa, Wojciech; Wróbel, Aleksandra; Karakuła-Juchnowicz, Hanna

2017-12-01

The aim of this study was to identify the potential risk factors for the development of post-traumatic stress disorder in mothers and fathers following infant hospitalisation in the neonatal intensive care unit. The development of neonatal intensive care units has increased the survival rate of infants. However, one of the major parental problems is post-traumatic stress disorder. An observational study covered 125 parents (72 mothers and 53 fathers) of infants aged 3-12 months who were hospitalised in the neonatal intensive care unit during the neonatal period. Third-referral neonatal intensive care unit. Several standardised and self-reported research tools were used to estimate the level of post-traumatic stress symptoms (Impact Event Scale-Revised), perceived stress (Perceived Stress Scale) and coping strategies (COPE Inventory). The respondents also completed a Parent and Infant Characteristic Questionnaire. The mothers and fathers did not differ in their parental and infant characteristics. Post-traumatic stress disorder was present in 60% of the mothers and 47% of the fathers. Compared to the fathers, the mothers felt greater stress (p = .020) and presented a higher severity of post-traumatic stress disorder (p < .001). Previous miscarriages (p = .023) and the presence of chronic diseases (p = .032) were risk factors for post-traumatic stress disorder in the mothers. In the fathers, an Apgar test at 1 min after birth (p = .030) and a partner's post-traumatic stress disorder (p = .038) were related to post-traumatic stress disorder. The mothers compared to the fathers were more likely to use strategies such as: positive reinterpretation and growth, focusing on and venting of emotions, instrumental social support, religious coping and acceptance. In the fathers, the predictors included an Apgar score at 1 min after birth, a lack of congenital anomalies in the child and mental disengagement. Risk factors for post-traumatic stress disorder, as

Hyperbaric Oxygen Therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury Post-Concussion Syndrome (PCS) and Post Traumatic Stress Disorder (PTSD)

DTIC Science & Technology

2016-10-01

Award Number: W81XWH-10-1-0962 TITLE: Hyperbaric Oxygen Therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury...164. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-10-1-0962 Hyperbaric Oxygen Therapy in the Treatment of Chronic Mild-Moderate Blast-Induced...month follow-up period post-hyperbaric oxygen treatment. 1 additional subject is scheduled to be screened in October 2016 and 3 are awaiting first

Post-traumatic stress disorder.

PubMed

Yehuda, Rachel; Hoge, Charles W; McFarlane, Alexander C; Vermetten, Eric; Lanius, Ruth A; Nievergelt, Caroline M; Hobfoll, Stevan E; Koenen, Karestan C; Neylan, Thomas C; Hyman, Steven E

2015-10-08

Post-traumatic stress disorder (PTSD) occurs in 5-10% of the population and is twice as common in women as in men. Although trauma exposure is the precipitating event for PTSD to develop, biological and psychosocial risk factors are increasingly viewed as predictors of symptom onset, severity and chronicity. PTSD affects multiple biological systems, such as brain circuitry and neurochemistry, and cellular, immune, endocrine and metabolic function. Treatment approaches involve a combination of medications and psychotherapy, with psychotherapy overall showing greatest efficacy. Studies of PTSD pathophysiology initially focused on the psychophysiology and neurobiology of stress responses, and the acquisition and the extinction of fear memories. However, increasing emphasis is being placed on identifying factors that explain individual differences in responses to trauma and promotion of resilience, such as genetic and social factors, brain developmental processes, cumulative biological and psychological effects of early childhood and other stressful lifetime events. The field of PTSD is currently challenged by fluctuations in diagnostic criteria, which have implications for epidemiological, biological, genetic and treatment studies. However, the advent of new biological methodologies offers the possibility of large-scale approaches to heterogeneous and genetically complex brain disorders, and provides optimism that individualized approaches to diagnosis and treatment will be discovered.

Rotator cuff strain: a post-traumatic mimicker of tendonitis on MRI.

PubMed

Anzilotti, K F; Schweitzer, M E; Oliveri, M; Marone, P J

1996-08-01

To determine whether there is a subset of young patients (< 35 years) with acute, post-traumatic insults to the rotator cuff which mimic the early stages of impingement. One hundred and ninety-seven consecutive shoulder MR images were retrospectively reviewed, and the results of 83 clinically correlated. Two observers independently evaluated the location of intra-tendon signal and adjacent bone marrow abnormalities on T1- and T2-weighted images. These findings were correlated with age, history of trauma, and surgical or clinical follow-ups. Patients younger than 35 years had signal intensity that was more localized in atypical locations (posterior aspect of the supraspinatus tendon), more commonly associated with marrow abnormalities (presumed bone bruise), and more often associated with trauma. Younger patients also were less likely to require surgery, especially if they showed bone bruises. This differentiated them from older patients (> 45 years), who demonstrated more widespread signal within the tendon, rare bone bruises, and more frequent surgery. Localized tendon signal in atypical locations of the supraspinatus tendon, particularly when associated with bone bruise and young age, suggests the possibility of a post-traumatic strain.

Post-traumatic female urethral reconstruction.

PubMed

Blaivas, Jerry G; Purohit, Rajveer S

2008-09-01

Post-traumatic urethral damage resulting in urethrovaginal fistulas or strictures, though rare, should be suspected in patients who have unexpected urinary incontinence or lower urinary tract symptoms after pelvic surgery, pelvic fracture, a long-term indwelling urethral catheter, or pelvic radiation. Careful physical examination and cystourethroscopy are critical to diagnose and assess the extent of the fistula. A concomitant vesicovaginal or ureterovaginal fistula should also be ruled out. The two main indications for reconstruction are sphincteric incontinence and urethral obstruction. Surgical correction intends to create a continent urethra that permits volitional, painless, and unobstructed passage of urine. An autologous pubovaginal sling, with or without a Martius flap at time of reconstruction, should be considered. The three approaches to urethral reconstruction are anterior bladder flaps, posterior bladder flaps, and vaginal wall flaps. We believe vaginal flaps are usually the best option. Options for vaginal repair of fistula include primary closure, peninsula flaps, bilateral labial pedicle flaps, and labial island flaps. Outcomes are optimized by using exacting surgical principles during repair and careful postoperative management by an experienced reconstructive surgeon.

Collective stories and well-being: using a dialogical narrative approach to understand peer relationships among combat veterans experiencing post-traumatic stress disorder.

PubMed

Caddick, Nick; Phoenix, Cassandra; Smith, Brett

2015-03-01

Using a dialogical narrative approach, this original research explored how combat veterans experiencing post-traumatic stress disorder made sense of peer relationships with other veterans and what effects these relationships had on their well-being. Interviews and participant observations were conducted with 15 male combat veterans (aged 27-60 years) and one member of the civilian emergency services, the majority of whom were diagnosed with post-traumatic stress disorder following traumatic exposure in a range of armed conflicts. All participants were part of a surfing charity for veterans experiencing post-traumatic stress disorder. Data were rigorously analysed using a dialogical narrative analysis (DNA). Findings revealed the collective story that veterans used to make sense of peer relationships within the group. This collective story worked for the veterans to shape their experiences of well-being by fostering camaraderie, stimulating deeper connections and countering the negative effects of post-traumatic stress disorder. Potential therapeutic effects of the collective story were also identified. This article extends previous knowledge on combat veterans and social relationships and advances the field of narrative health psychology through the empirical application of a sophisticated dialogical narrative approach. © The Author(s) 2015.

Suppressed acoustic startle response in traumatic brain injury masks post-traumatic stress disorder hyper-responsivity.

PubMed

Liska, Grant M; Lee, Jea-Young; Xu, Kaya; Sanberg, Paul R; Borlongan, Cesario V

2018-05-21

An exaggerated acoustic startle reflex (ASR) is a clinical indicator of anxiety disorders, such as post-traumatic stress disorder (PTSD). Given the prevalence of PTSD following traumatic brain injury (TBI), we studied the effects of TBI on ASR. Adult Sprague Dawley rats exposed to moderate controlled cortical impact injury model of TBI displayed suppression of ASR intensity and sensitivity. As patients with PTSD have been shown to display hyperactive startle responses, the present discrepant observation of TBI-induced suppression of ASR has clinical implications, in that the reduced, instead of elevated, startle response in patients with comorbid TBI/PTSD could be owing to a masking effect of TBI.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

Clinical correlates of plasma brain-derived neurotrophic factor in post-traumatic stress disorder spectrum after a natural disaster.

PubMed

Stratta, Paolo; Sanità, Patrizia; Bonanni, Roberto L; de Cataldo, Stefano; Angelucci, Adriano; Rossi, Rodolfo; Origlia, Nicola; Domenici, Luciano; Carmassi, Claudia; Piccinni, Armando; Dell'Osso, Liliana; Rossi, Alessandro

2016-10-30

Clinical correlates of plasma Brain-Derived Neurotrophic Factor (BDNF) have been investigated in a clinical population with Post Traumatic Stress Disorder (PTSD) symptoms and healthy control subjects who survived to the L'Aquila 2009 earthquake. Twenty-six outpatients and 14 control subjects were recruited. Assessments included: Structured Clinical Interview for DSM-IV Axis-I disorders Patient Version, Trauma and Loss Spectrum-Self Report (TALS-SR) for post-traumatic spectrum symptoms. Thirteen patients were diagnosed as Full PTSD and 13 as Partial PTSD. The subjects with full-blown PTSD showed lower BDNF level than subjects with partial PTSD and controls. Different relationship patterns of BDNF with post-traumatic stress spectrum symptoms have been reported in the three samples. Our findings add more insight on the mechanisms regulating BDNF levels in response to stress and further proofs of the utility of the distinction of PTSD into full and partial categories. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Media triggers of post-traumatic stress disorder 50 years after the Second World War.

PubMed

Hilton, C

1997-08-01

Post-traumatic stress disorder (PTSD) may present many years after the original trauma. Case studies of two elderly patients are described. Both had experienced life-threatening combat situations and witnessed intense suffering during the Second World War. Marked distress was triggered by the media commemorating the fiftieth anniversary of the end of the war. PTSD patients often avoid talking of their traumatic experiences because of associated distress. Without taking a military and trauma history from elderly patients the diagnosis is likely to be missed.

Challenges in treating post-traumatic stress disorder and attachment trauma.

PubMed

Allen, Jon G

2003-06-01

Treating women suffering from trauma poses significant challenges. The diagnostic prototype of post-traumatic stress disorder (PTSD) is based on single-event trauma, such as sexual assault in adulthood. Several effective cognitive- behavioral treatments for such traumas have been developed, although many treated patients continue to experience residual symptoms. Even more problematic is the complex developmental psychopathology stemming from a lifetime history of multiple traumas, often beginning with maltreatment in early attachment relationships. A history of attachment trauma undermines the development of capacities to regulate emotional distress and thereby complicates the treatment of acute trauma in adulthood. Such complex trauma requires a multifaceted treatment approach that must balance processing of traumatic memories with strategies to contain the intense emotions this processing evokes. Moreover, conducting such treatment places therapists at risk for secondary trauma such that trauma therapists also must process this stressful experience and implement strategies to regulate their own distress.

The feeling of discomfort during vaginal examination, history of abuse and sexual abuse and post-traumatic stress disorder in women.

PubMed

Güneş, Gizem; Karaçam, Zekiye

2017-08-01

To examine the feeling of discomfort during vaginal examinations, history of abuse and sexual abuse and post-traumatic stress disorder in women to determine the correlation between these variables. Women who have experienced abuse or sexual abuse may feel more discomfort during vaginal examinations and may perceive a sensation similar to what they experienced during sexual abuse. Cross-sectional. This study included 320 women receiving a vaginal examination. The data were collected using a questionnaire composed of items related to descriptive characteristics, vaginal examinations and violence, a visual analogue scale of discomfort, and the Post-Traumatic Stress Disorder Scale-civilian version. The mean score for the feeling of discomfort during vaginal examinations was 3·92 ± 3·34; 26·3% of the women described discomfort. Thirty-eight (12%) of the 320 women had experienced emotional violence, 25 (8%) had experienced physical violence, and 25 (8%) had been forced into sexual intercourse by their spouses. Of the women, 64·7% suffered from post-traumatic stress disorder, and physical, emotional and sexual violence were found to increase the possibility of this disorder. Exposure to emotional violence increased the possibility of discomfort during vaginal examinations by 4·5 (OR = 4·482; 95% CI = 1·421-14·134). Post-traumatic stress disorder (OR = 1·038; 95% CI = 1·009-1·066) was found to increase the possibility of discomfort during vaginal examinations; however, as the number of live births increases, women reported a reduction in their discomfort with vaginal examinations. This study revealed a positive correlation between discomfort during vaginal examinations and emotional violence and post-traumatic stress disorder but a negative correlation between discomfort during vaginal examinations and the number of live births. In addition, having a history of abuse and sexual abuse was found to increase post-traumatic stress disorder. Considering

Post-traumatic stress symptoms in pathological gambling: Potential evidence of anti-reward processes.

PubMed

Green, Cheryl L; Nahhas, Ramzi W; Scoglio, Arielle A; Elman, Igor

2017-03-01

Background Excessive gambling is considered to be a part of the addiction spectrum. Stress-like emotional states are a key feature both of pathological gambling (PG) and of substance addiction. In substance addiction, stress symptomatology has been attributed in part to "anti-reward" allostatic neuroadaptations, while a potential involvement of anti-reward processes in the course of PG has not yet been investigated. Methods To that end, individuals with PG (n = 22) and mentally healthy subjects (n = 13) were assessed for trauma exposure and post-traumatic stress symptomatology (PTSS) using the Life Events Checklist and the Civilian Mississippi Scale, respectively. Results In comparison with healthy subjects, individuals with PG had significantly greater PTSS scores including greater physiological arousal sub-scores. The number of traumatic events and their recency were not significantly different between the groups. In the PG group, greater gambling severity was associated with more PTSS, but neither with traumatic events exposure nor with their recency. Conclusions Our data replicate prior reports on the role of traumatic stress in the course of PG and extend those findings by suggesting that the link may be derived from the anti-reward-type neuroadaptation rather than from the traumatic stress exposure per se.

Post-traumatic stress symptoms in pathological gambling: Potential evidence of anti-reward processes

PubMed Central

Green, Cheryl L.; Nahhas, Ramzi W.; Scoglio, Arielle A.; Elman, Igor

2017-01-01

Background Excessive gambling is considered to be a part of the addiction spectrum. Stress-like emotional states are a key feature both of pathological gambling (PG) and of substance addiction. In substance addiction, stress symptomatology has been attributed in part to “anti-reward” allostatic neuroadaptations, while a potential involvement of anti-reward processes in the course of PG has not yet been investigated. Methods To that end, individuals with PG (n = 22) and mentally healthy subjects (n = 13) were assessed for trauma exposure and post-traumatic stress symptomatology (PTSS) using the Life Events Checklist and the Civilian Mississippi Scale, respectively. Results In comparison with healthy subjects, individuals with PG had significantly greater PTSS scores including greater physiological arousal sub-scores. The number of traumatic events and their recency were not significantly different between the groups. In the PG group, greater gambling severity was associated with more PTSS, but neither with traumatic events exposure nor with their recency. Conclusions Our data replicate prior reports on the role of traumatic stress in the course of PG and extend those findings by suggesting that the link may be derived from the anti-reward-type neuroadaptation rather than from the traumatic stress exposure per se. PMID:28274137

Hyperbaric oxygen ameliorates worsening signs and symptoms of post-traumatic stress disorder

PubMed Central

Eovaldi, Benjamin; Zanetti, Claude

2010-01-01

Hyperbaric oxygen therapy at 2.4 atmospheric pressure absolutes for 90 minutes per day ameliorated the signs and symptoms of agitation, confusion, and emotional distress in a 27-year-old male seven days following a traumatic accident. Hyperbaric oxygen was used to treat the patient’s crush injury and underlying nondisplaced pelvic fractures which were sustained in a bicycle versus automobile traffic accident. Its effect on the patient’s neuropsychiatric symptoms was surprising and obvious immediately following the initial hyperbaric oxygen treatment. Complete cognitive and psychiatric recovery was achieved by the seventh and final hyperbaric oxygen treatment. We propose that hyperbaric oxygen was effective in improving the patient’s neuropsychiatric symptoms by reducing cerebral oxidative stress, inflammation, vasogenic edema, and hippocampal neuronal apoptosis. Further investigation into the use of hyperbaric oxygen as a novel therapy for the secondary prevention of post-traumatic stress disorder that often accompanies post-concussive syndrome may be warranted. We acknowledge that hyperbaric oxygen therapy has been shown to have a strong placebo effect on neurologic and psychiatric diseases. PMID:21212826

Family Functioning and Children's Post-Traumatic Stress Symptoms in a Referred Sample Exposed to Interparental Violence.

PubMed

Telman, Machteld D; Overbeek, Mathilde M; de Schipper, J Clasien; Lamers-Winkelman, Francien; Finkenauer, Catrin; Schuengel, Carlo

This study examined the association between interparental violence (IPV), child abuse and neglect, other traumatic experiences, and children's post-traumatic stress (PTS) symptoms and explored the moderating role of family functioning in the aftermath of IPV. One hundred and twenty IPV-exposed children (53.3 % male, M age = 9.85) and parents who were referred to community mental health centers participated in the study. Combined, IPV, child abuse and neglect, and other traumatic experiences were associated with PTS symptoms. For family functioning, higher levels of parenting stress were associated with higher levels of PTS symptoms. No moderating effects were found. To understand the variability in PTS symptoms among children exposed to IPV, other traumatic and stressful experiences need to be taken into account.

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…

Risk factors for post-traumatic pneumonia in patients with retained haemothorax: results of a prospective, observational AAST study.

PubMed

Bradley, Matthew; Okoye, Obi; DuBose, Joseph; Inaba, Kenji; Demetriades, Demetrios; Scalea, Thomas; O'Connor, James; Menaker, Jay; Morales, Carlos; Shiflett, Tony; Brown, Carlos

2013-09-01

Retained haemothorax (RH) is a problematic sequela of thoracic trauma, reported in up to 20% of patients following chest injury. RH is associated with a higher severity of thoracic trauma and may portend the onset of other serious post-traumatic complications, including pneumonia. The development of pneumonia has previously been reported to be as high as 19.5% in the setting of traumatic RH. The purpose of this study was to identify risk factors for the development of pneumonia as a complication in RH. We utilized the American Association for the Surgery of Trauma Post-Traumatic Retained Haemothorax database. Patients with post-traumatic RH were prospectively enrolled from 2009 to 2011. Inclusion criteria were placement of a thoracostomy tube within 24h of admission for the evacuation of pneumothorax or haemothorax and subsequent chest computed tomography scan chest showing RH. Patients treated with thoracotomy before placement of tube thoracostomy were excluded. For univariate analysis, the Chi-square test with Yates correction was used for comparison of categorical risk factors and the Student's t-test or the Mann-Whitney test for comparison of continuous risk factors. To identify independent risk factors for the development of pneumonia, variables from the univariate analysis significant at p<0.2 were entered into a forward logistic regression model. Adjusted odds ratio and 95% confidence intervals (CI) were derived. 328 patients with post-traumatic RH from 20 United States centres were enrolled. After stepwise regression analysis, ISS>25 (adjusted OR: 7.1; 95% CI: 3.1, 16.4; p<0.001), blunt mechanism of injury (adjusted OR: 3.5; 95% CI: 1.7, 7.2; p=0.001), and failure to administer peri-procedural antibiotics on the initial thoracostomy tube placement (adjusted OR: 2.6; 95% CI: 1.30, 5.4; p=0.01) were found to be independent predictors of the pneumonia in patients with post-traumatic RH. To our knowledge, our current study is the largest attempt to identify the

Exposures to war-related traumatic events and post-traumatic stress disorder symptoms among displaced Darfuri female university students: an exploratory study.

PubMed

Badri, Alia; Crutzen, Rik; Van den Borne, H W

2012-08-03

With the deaths of hundreds of thousands and the displacement of up to three million Darfuris, the increasingly complex and on-going war in Darfur has warranted the need to investigate war-related severity and current mental health levels amongst its civilian population. The purpose of this study is to explore the association between war-related exposures and assess post-traumatic stress disorder (PTSD) symptoms amongst a sample of Darfuri female university students at Ahfad University for Women (AUW) in Omdurman city. An exploratory cross-sectional study among a representative sample of Darfuri female university students at AUW (N = 123) was conducted in February 2010. Using an adapted version of the Harvard Trauma Questionnaire (HTQ), war-related exposures and post-traumatic stress disorder (PTSD) symptoms were assessed. Means and standard deviations illustrated the experiential severity of war exposure dimensions and PTSD symptom sub-scales, while Pearson correlations tested for the strength of association between dimensions of war exposures and PTSD symptom sub-scales. Approximately 42 % of the Darfuri participants reported being displaced and 54 % have experienced war-related traumatic exposures either as victims or as witnesses (M = 28, SD = 14.24, range 0 - 40 events). Also, there was a strong association between the experiential dimension of war-related trauma exposures and the full symptom of PTSD. Moreover, the refugee-specific self-perception of functioning sub-scale within the PTSD measurement scored a mean of 3.2 (SD = .56), well above the 2.0 cut-off. This study provides evidence for a relationship between traumatic war-related exposures and symptom rates of PTSD among AUW Darfuri female students. Findings are discussed in terms of AUW counseling service improvement.

Childhood adversities and post-traumatic stress disorder: evidence for stress sensitisation in the World Mental Health Surveys.

PubMed

McLaughlin, Katie A; Koenen, Karestan C; Bromet, Evelyn J; Karam, Elie G; Liu, Howard; Petukhova, Maria; Ruscio, Ayelet Meron; Sampson, Nancy A; Stein, Dan J; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Borges, Guilherme; Demyttenaere, Koen; Dinolova, Rumyana V; Ferry, Finola; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Kawakami, Norito; Lee, Sing; Navarro-Mateu, Fernando; Piazza, Marina; Pennell, Beth-Ellen; Posada-Villa, José; Ten Have, Margreet; Viana, Maria Carmen; Kessler, Ronald C

2017-11-01

Background Although childhood adversities are known to predict increased risk of post-traumatic stress disorder (PTSD) after traumatic experiences, it is unclear whether this association varies by childhood adversity or traumatic experience types or by age. Aims To examine variation in associations of childhood adversities with PTSD according to childhood adversity types, traumatic experience types and life-course stage. Method Epidemiological data were analysed from the World Mental Health Surveys ( n = 27 017). Results Four childhood adversities (physical and sexual abuse, neglect, parent psychopathology) were associated with similarly increased odds of PTSD following traumatic experiences (odds ratio (OR) = 1.8), whereas the other eight childhood adversities assessed did not predict PTSD. Childhood adversity-PTSD associations did not vary across traumatic experience types, but were stronger in childhood-adolescence and early-middle adulthood than later adulthood. Conclusions Childhood adversities are differentially associated with PTSD, with the strongest associations in childhood-adolescence and early-middle adulthood. Consistency of associations across traumatic experience types suggests that childhood adversities are associated with generalised vulnerability to PTSD following traumatic experiences. © The Royal College of Psychiatrists 2017.

Deficient pain modulatory systems in patients with mild traumatic brain and chronic post-traumatic headache: implications for its mechanism.

PubMed

Defrin, Ruth; Riabinin, Miri; Feingold, Yelena; Schreiber, Shaul; Pick, Chaim G

2015-01-01

Although the prevalence rate of chronic post-traumatic headache (CPTHA) after mild traumatic brain injury (TBI) reaches up to 95%, its mechanism is unknown, and little is known about the characteristics of the pain system in this condition. Our aim was to investigate the capabilities of two pain modulatory systems among individuals with CPTHA and study their association with CPTHA, here for the first time. Forty-six subjects participated; 16 with TBI and CPTHA, 12 with TBI without CPTHA, and 18 healthy controls. Testing included the measurement of heat-pain (HPT) and pressure-pain (PPT) thresholds in the forehead and forearm, pain adaptation to tonic noxious heat, and conditioned pain modulation (CPM).The participants completed a post-traumatic stress disorder (PTSD) questionnaire. The two TBI groups did not differ in the TBI and background characteristics. However, TBI patients with CPTHA had significantly higher HPT and lower PPT in the cranium and higher PTSD symptomatology than TBI patients without CPTHA and healthy controls. Adaptation to pain and CPM were diminished in the CPTHA group compared with the two control groups. The intensity of CPTHA correlated negatively with cranial PPT, magnitude of pain adaptation, and CPM. CPTHA intensity correlated positively with PTSD symptomatology. CPTHA appears to be characterized by cranial hyperalgesia and dysfunctional pain modulation capabilities, which are associated with CPTHA magnitude. It is concluded that damage to pain modulatory systems along with chronic cranial sensitization underlies the development of CPTHA. PTSD may reinforce CPTHA and vice versa. Clinical implications are discussed.

Deficient Pain Modulatory Systems in Patients with Mild Traumatic Brain and Chronic Post-Traumatic Headache: Implications for its Mechanism

PubMed Central

Riabinin, Miri; Feingold, Yelena; Schreiber, Shaul; Pick, Chaim G.

2015-01-01

Abstract Although the prevalence rate of chronic post-traumatic headache (CPTHA) after mild traumatic brain injury (TBI) reaches up to 95%, its mechanism is unknown, and little is known about the characteristics of the pain system in this condition. Our aim was to investigate the capabilities of two pain modulatory systems among individuals with CPTHA and study their association with CPTHA, here for the first time. Forty-six subjects participated; 16 with TBI and CPTHA, 12 with TBI without CPTHA, and 18 healthy controls. Testing included the measurement of heat-pain (HPT) and pressure-pain (PPT) thresholds in the forehead and forearm, pain adaptation to tonic noxious heat, and conditioned pain modulation (CPM).The participants completed a post-traumatic stress disorder (PTSD) questionnaire. The two TBI groups did not differ in the TBI and background characteristics. However, TBI patients with CPTHA had significantly higher HPT and lower PPT in the cranium and higher PTSD symptomatology than TBI patients without CPTHA and healthy controls. Adaptation to pain and CPM were diminished in the CPTHA group compared with the two control groups. The intensity of CPTHA correlated negatively with cranial PPT, magnitude of pain adaptation, and CPM. CPTHA intensity correlated positively with PTSD symptomatology. CPTHA appears to be characterized by cranial hyperalgesia and dysfunctional pain modulation capabilities, which are associated with CPTHA magnitude. It is concluded that damage to pain modulatory systems along with chronic cranial sensitization underlies the development of CPTHA. PTSD may reinforce CPTHA and vice versa. Clinical implications are discussed. PMID:25068510

Contact network and satisfaction with contacts in children whose parents have post traumatic stress disorder.

PubMed

Selimbasic, Zihnet; Sinanovic, Osman; Avdibegovic, Esmina; Kravic, Nemina

2009-01-01

The aim was to analyse contacts network and satisfaction with contacts among children of parents with post traumatic stress disorder (PTSD). The sample consisted of 100 pupils (age 10 to 15) from two randomly chosen schools. Children were selected from general population, lived with both parents who have had war traumatic experiences. They agreed to participate in psychometric research. We divided them in two groups: observed (0) group of children (N=50) whose parents were showing symptoms of post traumatic stress disorder (PTSD) and control (C) group of children (N=50) whose parents did not show symptoms of PTSD (evaluated by Harvard trauma questionnaire-BiH version). Contact network was examined by a Map of Contact Network which includes contact and satisfaction with persons in close environment. In relation to gender representatives of fathers and mothers, sample was homogenous. The most important persons in children whose parents are showing symptoms of PTSD were schoolmates (88.0%), home mate (86.0%), mother (72.0%), and father (2.0%). At children whose parents did not show symptoms of PTSD, most important persons were schoolmate (94.0%), mother (80.0%), brother (6.0%), grandfather (8.0%), and father (14.0%). The most distinct disappointment in contacts in children with parents with PTSD symptoms were family, relatives and friends, in school and formal contacts (p < 0.001). Children of parents who have had symptoms of post traumatic stress disorder (PTSD), the most important persons that they communicate were schoolmates and they had problem in communicating with fathers and males. According to satisfaction children whose parents suffered from PTSD were showing distinction in contacts with their families, relatives, schoolmates and formal contacts.

Parental Post-traumatic Stress Disorder Symptoms Are Related to Successful Aging in Offspring of Holocaust Survivors

PubMed Central

Shrira, Amit; Ayalon, Liat; Bensimon, Moshe; Bodner, Ehud; Rosenbloom, Tova; Yadid, Gal

2017-01-01

A fascinating, yet underexplored, question is whether traumatic events experienced by previous generations affect the aging process of subsequent generations. This question is especially relevant for offspring of Holocaust survivors (OHS), who begin to face the aging process. Some preliminary findings point to greater physical dysfunction among middle-aged OHS, yet the mechanisms behind this dysfunction need further clarification. Therefore, the current studies assess aging OHS using the broad-scoped conceptualization of successful aging, while examining whether offspring successful aging relates to parental post-traumatic stress disorder (PTSD) symptoms and offspring’s secondary traumatization symptoms. In Study 1, 101 adult offspring (mean age = 62.31) completed measures of parental PTSD, secondary traumatization, as well as successful aging indices – objective (medical conditions, disability and somatic symptoms) and subjective (perceptions of one’s aging). Relative to comparisons and OHS who reported that none of their parents suffered from probable PTSD, OHS who reported that their parents suffered from probable PTSD had lower scores in objective and subjective measures of successful aging. Mediation analyses showed that higher level of secondary traumatization mediated the relationship between parental PTSD and less successful aging in the offspring. Study 2 included 154 dyads of parents (mean age = 81.86) and their adult offspring (mean age = 54.48). Parents reported PTSD symptoms and offspring reported secondary traumatization and completed measures of objective successful aging. Relative to comparisons, OHS whose parent had probable PTSD have aged less successfully. Once again, offspring secondary traumatization mediated the effect. The findings suggest that parental post-traumatic reactions assessed both by offspring (Study 1) and by parents themselves (Study 2) take part in shaping the aging of the subsequent generation via reactions of secondary

Post-traumatic seizure disorder following acquired brain injury.

PubMed

Teasell, Robert; Bayona, Nestor; Lippert, Corbin; Villamere, James; Hellings, Chelsea

2007-02-01

The present study aimed to evaluate the effectiveness of prophylactic anticonvulsant pharmacological strategies for the prevention of seizure disorders following acquired brain injury (ABI) to provide guidance for clinical practice based on the best available evidence. A systematic review of the literature from 1980-2005 was conducted focusing on treatment interventions available for post-traumatic seizures following ABI. The evidence for the efficacy of a given intervention was ranked as strong (supported by at least two randomized controlled trials (RCTs), moderate (supported by a single RCT), or limited (supported by other types of studies in the absence of RCTs). Based on a previous meta-analysis and the findings of this review, there is strong evidence that prophylactic anticonvulsant therapy decreases the occurrence of early seizures but only within the first week post-injury. Moreover, the evidence indicates that prophylactic anticonvulsant therapy does not decrease the incidence of seizure onset more than one week post-injury. In children, there is moderate evidence that prophylactic phenytoin does not reduce the incidence of early or late seizures. The efficacy of anticonvulsants after the development of seizures has not been specifically studied in ABI. Prophylactic anti-convulsants are effective in reducing seizures in the first week post-injury in adults. However, they do not reduce the occurrence of seizures after the first week.

No evidence for differential dose effects of hydrocortisone on intrusive memories in female patients with complex post-traumatic stress disorder--a randomized, double-blind, placebo-controlled, crossover study.

PubMed

Ludäscher, Petra; Schmahl, Christian; Feldmann, Robert E; Kleindienst, Nikolaus; Schneider, Miriam; Bohus, Martin

2015-10-01

Post-traumatic stress disorder is characterized by intrusive traumatic memories. Presently, a controversial debate is ongoing regarding whether reduced cortisol secretion in post-traumatic stress disorder promotes an automatic retrieval of trauma-associated memories. Hence, a pharmacological elevation of cortisol was proposed to decrease post-traumatic stress disorder symptoms, particularly intrusions. The present study investigated the impact of two different doses of hydrocortisone on automatic memory retrieval using a randomized, double-blind, placebo-controlled, crossover study in 30 inpatients with post-traumatic stress disorder. All participants were female and received various psychotropic medications. They were randomly assigned to one of two groups within a crossover design: they received either 1 week placebo followed by 1 week hydrocortisone 10/d, followed by 1 week placebo, followed by hydrocortisone 30 mg/d (15 participants) or 1 week hydrocortisone 30 mg/d, followed by 1 week placebo, followed by 1 week hydrocortisone 10 mg/d, followed by 1 week placebo (15 participants). The outcome measures were the frequency and the intensity of intrusions, the overall symptomatology of post-traumatic stress disorder and the general psychopathology. We did not find any differences in the frequency and the intensity of post-traumatic stress disorder-related intrusions between the 10 mg hydrocortisone, the 30 mg hydrocortisone and the placebo condition. All effect sizes for the hydrocortisone condition vs. placebo were very small. Additionally, the overall symptomatology of post-traumatic stress disorder and the general psychopathology did not differ between the hydrocortisone therapies and placebo. Our results do not show any effect of the hydrocortisone administration on intrusions in complex post-traumatic stress disorder. © The Author(s) 2015.

The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors.

PubMed

Gard, Tracy L; Hoover, Donald R; Shi, Qiuhu; Cohen, Mardge H; Mutimura, Eugene; Adedimeji, Adebola A; Anastos, Kathryn

2013-10-01

We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression. The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics. Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms. This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.

Peritoneal Tumorigenesis and Inflammation are Ameliorated by Humidified-Warm Carbon Dioxide Insufflation in the Mouse.

PubMed

Carpinteri, Sandra; Sampurno, Shienny; Bernardi, Maria-Pia; Germann, Markus; Malaterre, Jordane; Heriot, Alexander; Chambers, Brenton A; Mutsaers, Steven E; Lynch, Andrew C; Ramsay, Robert G

2015-12-01

Conventional laparoscopic surgery uses CO2 that is dry and cold, which can damage peritoneal surfaces. It is speculated that disseminated cancer cells may adhere to such damaged peritoneum and metastasize. We hypothesized that insufflation using humidified-warm CO2, which has been shown to reduce mesothelial damage, will also ameliorate peritoneal inflammation and tumor cell implantation compared to conventional dry-cold CO2. Laparoscopic insufflation was modeled in mice along with anesthesia and ventilation. Entry and exit ports were introduced to maintain insufflation using dry-cold or humidified-warm CO2 with a constant flow and pressure for 1 h; then 1000 or 1 million fluorescent-tagged murine colorectal cancer cells (CT26) were delivered into the peritoneal cavity. The peritoneum was collected at intervals up to 10 days after the procedure to measure inflammation, mesothelial damage, and tumor burden using fluorescent detection, immunohistochemistry, and scanning electron microscopy. Rapid temperature control was achieved only in the humidified-warm group. Port-site tumors were present in all mice. At 10 days, significantly fewer tumors on the peritoneum were counted in mice insufflated with humidified-warm compared to dry-cold CO2 (p < 0.03). The inflammatory marker COX-2 was significantly increased in the dry-cold compared to the humidified-warm cohort (p < 0.01), while VEGFA expression was suppressed only in the humidified-warm cohort. Significantly less mesothelial damage and tumor cell implantation was evident from 2 h after the procedure in the humidified-warm cohort. Mesothelial cell damage and inflammation are reduced by using humidified-warm CO2 for laparoscopic oncologic surgery and may translate to reduce patients' risk of developing peritoneal metastasis.

Post-traumatic Stress Symptoms in Post-ICU Family Members: Review and Methodological Challenges

PubMed Central

Petrinec, Amy B.; Daly, Barbara J.

2018-01-01

Family members of intensive care unit (ICU) patients are at risk for symptoms of post-traumatic stress disorder (PTSD) following ICU discharge. The aim of this systematic review is to examine the current literature regarding post-ICU family PTSD symptoms with an emphasis on methodological issues in conducting research on this challenging phenomenon. An extensive review of the literature was performed confining the search to English language studies reporting PTSD symptoms in adult family members of adult ICU patients. Ten studies were identified for review published from 2004–2012. Findings demonstrate a significant prevalence of family PTSD symptoms in the months following ICU hospitalization. However, there are several methodological challenges to the interpretation of existing studies and to the conduct of future research including differences in sampling, identification of risk factors and covariates of PTSD, and lack of consensus regarding the most appropriate PTSD symptom measurement tools and timing. PMID:25061017

Post-Traumatic Stress Symptoms in Post-ICU Family Members: Review and Methodological Challenges.

PubMed

Petrinec, Amy B; Daly, Barbara J

2016-01-01

Family members of intensive care unit (ICU) patients are at risk for symptoms of post-traumatic stress disorder (PTSD) following ICU discharge. The aim of this systematic review is to examine the current literature regarding post-ICU family PTSD symptoms with an emphasis on methodological issues in conducting research on this challenging phenomenon. An extensive review of the literature was performed confining the search to English language studies reporting PTSD symptoms in adult family members of adult ICU patients. Ten studies were identified for review published from 2004 to 2012. Findings demonstrate a significant prevalence of family PTSD symptoms in the months following ICU hospitalization. However, there are several methodological challenges to the interpretation of existing studies and to the conduct of future research including differences in sampling, identification of risk factors and covariates of PTSD, and lack of consensus regarding the most appropriate PTSD symptom measurement tools and timing. © The Author(s) 2014.

Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: a prospective analysis of low income adults.

PubMed

Dunn, Erin C; Solovieff, Nadia; Lowe, Sarah R; Gallagher, Patience J; Chaponis, Jonathan; Rosand, Jonathan; Koenen, Karestan C; Waters, Mary C; Rhodes, Jean E; Smoller, Jordan W

2014-01-01

There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context. We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina. We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing. Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva. To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations

Interaction Between Genetic Variants and Exposure to Hurricane Katrina on Post-Traumatic Stress and Post-Traumatic Growth: A Prospective Analysis of Low Income Adults

PubMed Central

Dunn, Erin C.; Solovieff, Nadia; Lowe, Sarah R.; Gallagher, Patience J.; Chaponis, Jonathan; Rosand, Jonathan; Koenen, Karestan C.; Waters, Mary; Rhodes, Jean; Smoller, Jordan W.

2013-01-01

Background There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context. Methods We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina. Results We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing. Limitations Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva. Conclusions To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological

Post-traumatic tricuspid insufficiency: a case report.

PubMed

Tütün, Ufuk; Aksöyek, Ayşen; Parlar, Ali Ihsan; Cobanoğlu, Adnan

2011-11-01

Post-traumatic tricuspid insufficiency is a rare complication of chest trauma. An 18-year-old male patient was injured in a bicycle accident from his abdominal and anterior chest wall. The tear on the inferior diaphragmatic surface of the heart was repaired with primary sutures by the attending surgeon. Eighteen years later, he was admitted to the hospital with severe tricuspid regurgitation (3+/4+). During the operation, the valve was determined unsuitable for repair and was replaced with a bioprosthesis. The hemodynamic aberrations relevant to an isolated tricuspid valve injury are very often well-tolerated. Reconstructive surgery may be possible in the early period. In the late cases, repair is sometimes not feasible due to degeneration of the valvular apparatus. Replacement with a biological prosthesis may give the best long-term results in longstanding cases.

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2016-12-01

the study for the presence or absence of ectopic bone formation at the indicated time points post injury (Table 1.). 8 Table 1. Incidence of HO...1 Award Number: W81XWH-12-2-0119 TITLE: Early Diagnosis and Intervention Strategies for Post -Traumatic Heterotopic Ossification in Severely...2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT

Prevalence of High Emotional Distress and Symptoms of Post-Traumatic Stress Disorder in U.S. Air Force Active Duty Remotely Piloted Aircraft Operators (2010 USAFSAM Survey Results)

DTIC Science & Technology

2012-12-01

distribution is unlimited. Case Number: 88ABW-2013-0436, 31 Jan 2013 8. Brasher KS, Dew AB , Kilminster SG, Bridger RS, “Occupational Stress in...Kritz- Silverstein D, et al., “New Onset and Persistent Symptoms of Post-Traumatic Stress Disorder Self Reported After Deployment and Combat Exposures

Conditioned Fear Extinction and Generalization in Post-Traumatic Stress Disorder

DTIC Science & Technology

2012-08-01

ORGANIZATION: Emory University Atlanta, GA 30322-1018 REPORT DATE: August 2012 TYPE OF REPORT: Annual Report PREPARED FOR: U.S...To) 1 August 2011–31 July 2012 4. TITLE AND SUBTITLE Conditioned Fear Extinction and Generalization in Post-Traumatic Stress Disorder...TT   100   RS4606   RGS2   CC   109   CG   88   GG   28   RS4680   COMT   AA   44   GA   99   GG   83   RS4875113

Post-Traumatic Stress Disorder and the Military: A Selected Bibliography

DTIC Science & Technology

2008-03-01

C55 2007) Friedman, Matthew J ., Terence M. Keane, and Patricia A. Resick, eds. Handbook of PTSD: Science and Practice. New York: Guilford Press...Vietnam Veterans Readjustment Study. New York: Brunner/Mazel, 1990. 322pp. (RC552 .P67T747 1990) Lewis, Steve. J . “Combat Stress Control: Putting Principle...Nation’s Veterans from Post-Traumatic Stress Disorder. Wheaton, IL: Quest Books, 2005. 329pp. (RC552 .P67T31 2005) 4 Tierney, Bonnie J . Locked in Time: I

Chronic post-operative iris prosthesis endophthalmitis in a patient with traumatic aniridia: a case report.

PubMed

Firl, Kevin C; Montezuma, Sandra R

2016-11-09

Post-operative endophthalmitis is a serious complication of intraocular surgery which may present acutely or chronically. Chronic post-operative endophthalmitis is characterized by decreased visual acuity, mild pain, and low-grade uveitis several weeks or months after intraocular surgery which may be responsive to corticosteroids, but recur upon tapering. Low virulence organisms such as Propionibacterium acnes are the most common culprit organisms, and treatment most often consists of both intravitreal antibiotic injections and surgery. Aniridia is a condition defined by total or partial loss of the iris and leads to decreased visual quality marked by glare and photophobia. Treatment of complex or severe cases of traumatic aniridia in which surgical repair is difficult may consist of implantation of iris prostheses, devices designed to reduce symptoms of aniridia. Though chronic, post-operative endophthalmitis has been associated with most intraocular surgeries including intraocular lens implantation after cataract removal, it has never been described in a patient with an iris prosthesis. In this case report, we describe the case of a 49 year old, male construction worker with traumatic aniridia who experienced chronic, recurrent low-grade intraocular inflammation and irritation for months after implantation of the Ophtec 311 prosthetic iris. Symptoms and signs of inflammation improved temporarily with sub-Tenon's capsule triamcinolone injections. Ultimately after more than 2 post-operative years, the iris prosthesis was explanted, and intravitreal cultures showed P. acnes growth after 5 days. Intravitreal antibiotics treated the infection successfully. To our knowledge, this is the first reported case of chronic, post-operative endophthalmitis in a patient with an iris prosthesis. Chronic, post-operative endophthalmitis may be a difficult to identify in the context of traumatic aniridia and iris prosthesis implantation due to other potential etiologies of

Carbon dioxide insufflation deflects airborne particles from an open surgical wound model.

PubMed

Kokhanenko, P; Papotti, G; Cater, J E; Lynch, A C; van der Linden, J A; Spence, C J T

2017-01-01

Surgical site infections remain a significant burden on healthcare systems and may benefit from new countermeasures. To assess the merits of open surgical wound CO 2 insufflation via a gas diffuser to reduce airborne contamination, and to determine the distribution of CO 2 in and over a wound. An experimental approach with engineers and clinical researchers was employed to measure the gas flow pattern and motion of airborne particles in a model of an open surgical wound in a simulated theatre setting. Laser-illuminated flow visualizations were performed and the degree of protection was quantified by collecting and characterizing particles deposited in and outside the wound cavity. The average number of particles entering the wound with a diameter of <5μm was reduced 1000-fold with 10L/min CO 2 insufflation. Larger and heavier particles had a greater penetration potential and were reduced by a factor of 20. The degree of protection was found to be unaffected by exaggerated movements of hands in and out of the wound cavity. The steady-state CO 2 concentration within the majority of the wound cavity was >95% and diminished rapidly above the wound to an atmospheric level (∼0%) at a height of 25mm. Airborne particles were deflected from entering the wound by the CO 2 in the cavity akin to a protective barrier. Insufflation of CO 2 may be an effective means of reducing intraoperative infection rates in open surgeries. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation

PubMed Central

Li, Suyun; Li, Zhi; Hua, Wenbin; Wang, Kun; Li, Shuai; Zhang, Yunkun; Ye, Zhewei; Shao, Zengwu; Wu, Xinghuo; Yang, Cao

2017-01-01

Abstract Rationale: Thoracic-lumbar vertebral fracture is very common in clinic, and late post-traumatic kyphosis is the main cause closely related to the patients’ life quality, which has evocated extensive concern for the surgical treatment of the disease. This study aimed to analyze the clinical outcomes and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation. Patient concerns: All patients presented back pain with kyphotic apex vertebrae between T12 and L3. According to Frankel classification grading system, among them, 3 patients were classified as grade D, with the ability to live independently. Diagnoses: A systematic review of 12 case series of post-traumatic kyphosis after failed thoracolumbar fracture operation was involved. Interventions: Wedge osteotomy was performed as indicated—posterior closing osteotomy correction in 5 patients and anterior open-posterior close correction in 7 patients.Postoperatively, thoracolumbar x-rays were obtained to evaluate the correction of kyphotic deformity, visual analog scales (VAS) and Frankel grading system were used for access the clinical outcomes. Outcomes: All the patients were followed up, with the average period of 38.5 months (range 24–56 months). The Kyphotic Cobb angle was improved from preoperative (28.65 ± 11.41) to postoperative (1.14 ± 2.79), with the correction rate of 96.02%. There was 1 case of intraoperative dural tear, without complications such as death, neurological injury, and wound infection. According to Frankel grading system, no patient suffered deteriorated neurological symptoms after surgery, and 2 patients (2/3) experienced significant relief after surgery. The main VAS score of back pain was improved from preoperative (4.41 ± 1.08) to postoperative (1.5 ± 0.91) at final follow-up, with an improvement rate of 65.89%. Lessons: Surgical treatment of late post-traumatic kyphosis after failed thoracolumbar fracture

Treatment of post-traumatic psychiatric disorders: A continuum of immediate, post-immediate and follow-up care mediated by specific psychotherapeutic principles. Clinical experience in French-speaking countries.

PubMed

Auxéméry, Yann

2018-06-07

People who witness a horrific event are at risk of suffering from acute psychological disorders, potentially leading to chronic post-traumatic symptoms and severe medico-psycho-social complications. Traumatised individuals suffer from psychological damage that is initially indescribable: they are often unable to ask for care in the immediate aftermath of an event. Afterwards, traumatic events and their post-traumatic consequences are still often hidden or minimised by patients for reasons linked to the disorder itself (inexpressibility, shame, depressive thoughts, fear of stigmatisation, etc.). The provision of the initial stage of care has a major impact on the long-term prognosis. Although official French recommendations remain vague, and scientific studies lack power, there is a developing professional consensus on practices, and developments in neurobiology are opening up new opportunities to validate them. Drawing upon our clinical experience and clinical principles provided by our mentors, our aim is to clarify the phases of psychotherapeutic treatment, and we describe three practices: immediate care ("defusing"), post-immediate care ("French debriefing" or "post-immediate psychotherapeutic intervention") and follow-up care ("deferred debriefing" and psychotherapy). Although the international literature considers these phases as separate, here we describe a continuity of talking therapies that support long-term remission. The effectiveness of the combination of immediate, post-immediate and follow-up care has been confirmed by events surrounding the recent Paris and Nice attacks. Specific psychotherapeutic principles are unrelated to a particular school of psychotherapy (notably cognitive and behavioural therapies, analytical therapies, various forms of hypnosis, and eye-movement therapies, etc.). Instead, they refer to specific principles that are effective in the treatment of post-traumatic psychiatric disorders. By helping the individual to verbalise their

Microbiologic progression of post-traumatic peritonitis.

PubMed

Nyström, P O; Skau, T; Johansson, L; Lennquist, S

1985-08-01

The natural course of post-traumatic peritonitis was studied in 17 pigs. Following a standardized missile wound to the abdomen the pigs were operated on and observed in continuous anesthesia for periods up to 3 days. Bacterial density was measured in peritoneal exudate, parietal peritoneum, laparotomy wound, and projectile entrance and exit wounds at this operation and also at relaparotomy, which terminated the experiments. The bacterial density showed significant perioperative fall, averaging X 1,905 in peritoneal exudate and X 40 in parietal peritoneum. From a low postoperative level (mean c. 10(2)/ml or /gm), bacterial density increased significantly in the observation period. In peritoneal exudate the increase was X 4,073 and in peritoneum X 2,630. In laparotomy and projectile entrance and exit wounds the corresponding figures were X 234, X 126, and X 15. The bacterial population's perioperative reduction and subsequent proliferation were interpreted as reflecting the host defense, which accordingly was limited in capacity and duration.

Applied psychophysiology, clinical biofeedback, and rehabilitation neuropsychology: a case study--mild traumatic brain injury and post-traumatic stress disorder.

PubMed

Ackerman, Rosalie J

2004-11-01

This article presents a case study of a 39-year-old European American married woman with a history of child and adolescent incest,marital rape, and physical abuse from her husband for more than 10 years. She was referred to a pain clinic for treatment of headaches and Tourette's syndrome. The client was evaluated with the Ackerman-Banks Neuropsychological Rehabilitation Battery to identify neuropsychological strengths and weaknesses. The Vulnerability to Stress Audit was used to identify life events that were positively and negatively influencing her life. The client was treated for mild traumatic brain injury, post-traumatic stress disorder,cognitive difficulties, impulsivity, confabulation, low frustration tolerance, and inability to evaluate and make decisions about socially appropriate behaviors. Treatment involved traditional psychotherapy, hypnosis, cognitive rehabilitation, biofeedback training, electromyography, finger temperature, and blood pressure.

Gastroduodenal artery aneurysm - Post traumatic pancreatic pseudocyst drainage - An interesting case.

PubMed

Zarin, Mohammad; Ali, Sajid; Majid, Abdul; Jan, ZakaUllah

2018-01-01

Pseudoaneurysms of the gastroduodenal artery (GDA) are rare and mostly associated with pancreatitis. However, they can occur as a possible complication following gastric or pancreatic surgery and thus prior recognition and prompt treatment is mandatory (Lee et al., 2009 [1]). We report a case of a ruptured GDA aneurysm in a patient who underwent roux-en-y-cystojejunostomy for traumatic pancreatic pseudocyst and this has rarely been reported in the literature. Our patient presented with melena one month post operatively. CT Angiogram showed pseudoaneurysm of the GDA and the origin of right gastroepiploic artery which was embolised. Our case highlights that GDA aneurysm must be considered in the differential for a patient who presents with melena following drainage of traumatic pancreatic pseudocyst and that it can be managed successfully with angioembolization. A young boy was operated for traumatic pancreatic pseudocyst. One month later, he presented with the complaints of melena. Patient was resuscitated initially and then CT Angiogram was planned that showed pseudo aneurysm of the GDA and the origin of right gastroepiploic artery. The aneurysm was embolised and patient was sent home later on. On two months follow up the patient was doing well and had no episode of melena. GDA aneurysm are rare and should be suspected in a patient with GI hemorrhage after surgery for traumatic pancreatic pseudocyst. The investigation of choice is CT Angiography and endovascular angioembolization is the treatment modality of choice. Copyright © 2017. Published by Elsevier Ltd.

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

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

PubMed Central

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.

2009-01-01

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

[The Influence of Subjective Health Status, Post-Traumatic Growth, and Social Support on Successful Aging in Middle-Aged Women].

PubMed

Lee, Seung Hee; Jang, Hyung Suk; Yang, Young Hee

2016-10-01

This study was done to investigate factors influencing successful aging in middle-aged women. A convenience sample of 103 middle-aged women was selected from the community. Data were collected using a structured questionnaire and analyzed using descriptive statistics, two-sample t-test, one-way ANOVA, Kruskal Wallis test, Pearson correlations, Spearman correlations and multiple regression analysis with the SPSS/WIN 22.0 program. Results of regression analysis showed that significant factors influencing successful aging were post-traumatic growth and social support. This regression model explained 48% of the variance in successful aging. Findings show that the concept 'post-traumatic growth' is an important factor influencing successful aging in middle-aged women. In addition, social support from friends/co-workers had greater influence on successful aging than social support from family. Thus, we need to consider the positive impact of post-traumatic growth and increase the chances of social participation in a successful aging program for middle-aged women.

Differential Symptom Pattern of Post-traumatic Stress Disorder (PTSD) in Maltreated Children with and without Concurrent Depression.

ERIC Educational Resources Information Center

Runyon, Melissa K.; Faust, Jan; Orvaschel, Helen

2002-01-01

A study examined differences in the Post-Traumatic Stress Disorder (PTSD) symptomalogy among 96 abused children with and without concurrent depression. Analysis revealed that three post-trauma symptoms, including psychological amnesia, flashbacks/reenactments, and sleep difficulties, discriminated among groups. Children with PTSD and depression…

Microsurgical Outcome of Post-traumatic Peripheral Nerve Injuries: An Experience of 23 Cases and Review of Literature.

PubMed

Garg, Kanwaljeet; Sinha, Sumit; Satyarthee, Guru Dutta; Agarwal, Deepak; Gupta, Deepak Kumar; Sharma, Bhawani; Mahapatra, Ashok Kumar

2016-01-01

The present study aimed to evaluate the microsurgical outcome in post-traumatic peripheral nerve injuries and its correlation with time since injury and the type of the operative procedure performed. All the patients admitted to our center with the diagnosis of post-traumatic peripheral nerve injury were included in the study. The data of all patients was retrospectively analysed from the computerized database of our hospital. The time period of the study was from January 2008 to March 2011. A total of 23 patients were included in the study. The interval between injury and surgery was 28.8 weeks (range: 1 day - 70 weeks). The most common mode of injury was road traffic accidents (39%, n=9). The mean follow up was 24.7 ± 11.3 months (range 9-45 months). Six (60%) patients had a good outcome. There was no statistically significant correlation between outcome and time since injury or type of operative procedure performed (p > 0.05). Post-traumatic peripheral nerve injury is a rare form of nerve injury. There is no correlation between the surgical outcome and time since injury. Some of the nerves have a better outcome as compared to others.

Lessons from the 2004 Asian tsunami: epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities.

PubMed

Rajkumar, A P; Mohan, T S P; Tharyan, P

2013-03-01

The nosological validity of post-traumatic stress disorder (PTSD) remains controversial in non-Western communities. After natural disasters, epidemiological studies often overlook these conceptual debates and assess post-traumatic stress symptoms (PTSS) by short screening instruments. Such PTSS estimates are reported as inflated prevalence rates of PTSD in post-disaster settings. To discuss the prevalence and determinants of PTSS within the context of pertinent epidemiological and nosological debates. We assessed PTSS and grief symptoms of 643 survivors from five Indian villages struck by the Asian tsunami using the Impact of Events Scale - Revised and Complicated Grief Assessment Scale. We adopted a case control design and employed complex sample multiple logistic regression statistics to study the determinants of PTSS. The prevalence of PTSS was 15.1% (95% CI 12.3%-17.9%). PTSS was significantly associated with traumatic grief, female gender, physical injury, death of children and financial losses, but not with functional disability (p = .91). Although PTSS were common in this population, elevating them to a psychiatric construct of PTSD is questionable, when functional impairment and avoidance behaviours were absent. Grief reactions, socio-economic burden, and poor support systems contribute towards PTSS. We highlight the important issues regarding the nosological validity and epidemiology of PTSD in non-Western communities.

Prolonged grief and post-traumatic growth after loss: Latent class analysis.

PubMed

Zhou, Ningning; Yu, Wei; Tang, Suqin; Wang, Jianping; Killikelly, Clare

2018-06-06

Bereavement may trigger different psychological outcomes, such as prolonged grief disorder or post-traumatic growth. The relationship between these two outcomes and potential precipitators remain unknown. The current study aimed to identify classes of Chinese bereaved individuals based on prolonged grief symptoms and post-traumatic growth and to examine predictors for these classes. We used data from 273 Chinese individuals who lost a relative due to disease (92.3%), accident (4.4%) and other reasons (1.8%). Latent class analysis revealed three classes: a resilient class, a growth class, and a combined grief/growth class. A higher level of functional impairment was found for the combined grief/growth class than for the other two classes. Membership in the combined grief/growth class was significantly predicted by the younger age of the deceased and the death of a parent, child or spouse. Subjective closeness with the deceased and gender were marginally significant predictors. When the four variables were included in the multinomial regression analysis, death of a parent, child or spouse significantly predicted the membership to the combined grief/growth class. These findings provide valuable information for the development of tailored interventions that may build on the bereaved individuals' personal strengths. Copyright © 2018. Published by Elsevier B.V.

Implant-supported fixed restoration of post-traumatic mandibular defect accompanied with skin grafting: A clinical report

PubMed Central

Noh, Kwantae; Choi, Woo-Jin

2013-01-01

Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with post-traumatic mandibular defect. A split-thickness skin graft was performed prior to implant placement and prefabricated acrylic stent was placed to hold the graft in place. The esthetic and functional demands of the patient were fulfilled by implant-supported screw-retained fixed prosthesis using CAD-CAM technology. PMID:23508120

Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL) in nursing staff at a forensic psychiatric security unit: a cross-sectional study.

PubMed

Lauvrud, Christian; Nonstad, Kåre; Palmstierna, Tom

2009-04-16

Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors.

Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL) in nursing staff at a forensic psychiatric security unit: a cross-sectional study

PubMed Central

Lauvrud, Christian; Nonstad, Kåre; Palmstierna, Tom

2009-01-01

Background Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Methods Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. Results The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Conclusion Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors. PMID:19371413

The influence of women's preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study.

PubMed

Garthus-Niegel, Susan; von Soest, Tilmann; Knoph, Cecilie; Simonsen, Tone Breines; Torgersen, Leila; Eberhard-Gran, Malin

2014-06-05

This study aimed to examine whether a mismatch between a woman's preferred and actual mode of delivery increases the risk of post-traumatic stress symptoms after childbirth. The study sample consisted of 1,700 women scheduled to give birth between 2009 and 2010 at Akershus University Hospital, Norway. Questionnaire data from pregnancy weeks 17 and 32 and from 8 weeks postpartum were used along with data obtained from hospital birth records. Post-traumatic stress symptoms were measured with the Impact of Event Scale. Based on the women's preferred and actual mode of delivery, four groups were established: Match 1 (no preference for cesarean section, no elective cesarean section, N = 1,493); Match 2 (preference for cesarean section, elective cesarean section, N = 53); Mismatch 1 (no preference for cesarean section, elective cesarean section, N = 42); and Mismatch 2 (preference for cesarean section, no elective cesarean section, N = 112). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were conducted to examine whether the level of post-traumatic stress symptoms differed significantly among these four groups. Examining differences for all four groups, ANOVA yielded significant overall group differences (F = 11.96, p < 0.001). However, Bonferroni post-hoc tests found significantly higher levels of post-traumatic stress symptoms only in Mismatch 2 compared to Match 1. This difference could be partly explained by a number of risk factors, particularly psychological risk factors such as fear of childbirth, depression, and anxiety. The results suggest increased post-traumatic stress symptoms in women who preferred delivery by cesarean section but delivered vaginally compared to women who both preferred vaginal delivery and delivered vaginally. In psychologically vulnerable women, such mismatch may threaten their physical integrity and, in turn, result in post-traumatic stress symptoms. These women, who often fear childbirth, may

Exposures to war-related traumatic events and post-traumatic stress disorder symptoms among displaced Darfuri female university students: an exploratory study

PubMed Central

2012-01-01

Background With the deaths of hundreds of thousands and the displacement of up to three million Darfuris, the increasingly complex and on-going war in Darfur has warranted the need to investigate war-related severity and current mental health levels amongst its civilian population. The purpose of this study is to explore the association between war-related exposures and assess post-traumatic stress disorder (PTSD) symptoms amongst a sample of Darfuri female university students at Ahfad University for Women (AUW) in Omdurman city. Methods An exploratory cross-sectional study among a representative sample of Darfuri female university students at AUW (N = 123) was conducted in February 2010. Using an adapted version of the Harvard Trauma Questionnaire (HTQ), war-related exposures and post-traumatic stress disorder (PTSD) symptoms were assessed. Means and standard deviations illustrated the experiential severity of war exposure dimensions and PTSD symptom sub-scales, while Pearson correlations tested for the strength of association between dimensions of war exposures and PTSD symptom sub-scales. Results Approximately 42 % of the Darfuri participants reported being displaced and 54 % have experienced war-related traumatic exposures either as victims or as witnesses (M = 28, SD = 14.24, range 0 – 40 events). Also, there was a strong association between the experiential dimension of war-related trauma exposures and the full symptom of PTSD. Moreover, the refugee-specific self-perception of functioning sub-scale within the PTSD measurement scored a mean of 3.2 (SD = .56), well above the 2.0 cut-off. Conclusions This study provides evidence for a relationship between traumatic war-related exposures and symptom rates of PTSD among AUW Darfuri female students. Findings are discussed in terms of AUW counseling service improvement. PMID:22863107

Intolerance of uncertainty as a predictor of post-traumatic stress symptoms following a traumatic event.

PubMed

Oglesby, Mary E; Boffa, Joseph W; Short, Nicole A; Raines, Amanda M; Schmidt, Norman B

2016-06-01

Intolerance of uncertainty (IU) has been associated with elevated post-traumatic stress symptoms (PTSS) in the extant literature. However, no research to date has investigated whether pre-trauma IU predicts PTSS following trauma exposure. The current study prospectively examined the relationship between IU and PTSS within a sample of individuals with various levels of exposure to a university campus shooting. We hypothesized that pre-trauma IU would predict elevated PTSS following a campus shooting, even after covarying for anxiety sensitivity (AS), a known correlate of PTSS. Participants included undergraduates (n=77) who completed a self-report battery in Introductory Psychology. After a campus shooting, they were invited to complete measures of PTSD symptoms and level of exposure to the shooting. As anticipated, results revealed pre-trauma IU as a significant predictor of elevated PTSS following the campus shooting. These results remained significant after covarying for pre-trauma levels of AS. Our results are the first to demonstrate that elevated pre-trauma levels of IU predict later PTSS following exposure to a traumatic event. This finding is discussed in terms of promising directions for future research and treatment strategies. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Impact of HIV Status, HIV Disease Progression and Post-Traumatic Stress Symptoms on the Health-Related Quality of Life of Rwandan Women Genocide Survivors

PubMed Central

Gard, Tracy L.; Hoover, Donald R.; Shi, Qiuhu; Cohen, Mardge H.; Mutimura, Eugene; Adedimeji, Adebola A.; Anastos, Kathryn

2014-01-01

Purpose We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression. Methods The Rwandan Women’s Interassociation Study and Assessment (RWISA) was a longitudinal prospective study of HIV-infected and uninfected women. At study entry 922 women (705 HIV+ and 217 HIV−) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical and behavioral characteristics. Results Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall QOL than did HIV− women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms. Conclusions This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL. PMID:23271207

Psychological treatment of post-traumatic stress disorder (PTSD).

PubMed

Bisson, J; Andrew, M

2005-04-18

Psychological interventions are widely used in the treatment of post-traumatic stress disorder (PTSD). To perform a systematic review of randomised controlled trials of all psychological treatments except eye movement desensitisation and reprocessing following the guidelines of the Cochrane Collaboration. Systematic searches of computerised databases, hand search of the Journal of Traumatic Stress, searches of reference lists, known websites and discussion fora, and personal communication with key workers. Types of studies - Any randomised controlled trial of a psychological treatment. Types of participants - Adults suffering from traumatic stress symptoms for three months or more. Types of interventions - Trauma-focused cognitive behavioural therapy/exposure therapy (TFCBT); stress management (SM); other therapies (supportive therapy, non-directive counselling, psychodynamic therapy and hypnotherapy); group cognitive behavioural therapy (group CBT). Types of outcomes - Severity of clinician rated traumatic stress symptoms. Secondary measures included self-reported traumatic stress symptoms, depressive symptoms, anxiety symptoms, adverse effects and dropouts. Data was entered using the Review Management software. Quality assessments were performed. The data were analysed for summary effects using the RevMan 4.2 programme. Twenty-nine studies were included in the review. With regards to reduction of clinician assessed PTSD symptoms TFCBT did significantly better than waitlist/usual care (standardised mean difference (SMD) = -1.36; 95% CI, -1.88 to -0.84; 13 studies; n = 609). There was no significant difference between TFCBT and SM (SMD = -0.27; 95% CI, -0.71 to 0.16; 6 studies; n = 239). TFCBT did significantly better than other therapies (SMD = -0.81; 95% CI, -1.19 to -0.42; 3 studies; n = 120). Stress management did significantly better than waitlist/usual care (SMD = -1.14; 95% CI, -1.62 to -0.67; 3 studies; n = 86) and than other therapies (SMD = -1.22; 95% CI

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…

Impact of traumatic loss on post-traumatic spectrum symptoms in high school students after the L'Aquila 2009 earthquake in Italy.

PubMed

Dell'OSso, L; Carmassi, C; Massimetti, G; Conversano, C; Daneluzzo, E; Riccardi, I; Stratta, P; Rossi, A

2011-11-01

On April 6th 2009, the town of L'Aquila, Italy, was struck by an earthquake (6.3 on the Richter scale) that lead large parts of the town to be destroyed and the death of 309 people. Significant losses in the framework of earthquakes have been reported as a major risk factor for PTSD development. Aim of this study was to investigate post-traumatic spectrum symptoms in a sample of adolescents exposed to the L'Aquila 2009 earthquake 21 months earlier, with particular attention to the impact of loss. 475 students (203 women and 272 men), attending the last year of High School in L'Aquila, were assessed by: Trauma and Loss Spectrum-Self Report (TALS-SR) and Impact of Event Scale (IES). The presence of full and partial PTSD was also assessed. 72 students (15.2%) reported the loss of a close friend or relative in the framework of the earthquake. Full PTSD was reported by 146 (30.7%) students and partial PTSD by 149 (31.4%) students. There was a significant difference reported in PTSD between bereaved and non bereaved subjects. Significantly higher post-traumatic symptom levels were reported by bereaved subjects. The lack of information on the relationship with the deceased and the number of losses experienced, besides the use of self report instruments are the limitations of this study. Our results show high rates of post-traumatic spectrum symptoms in adolescents who survived the L'Aquila earthquake. Having experienced the loss of a close friend or a relative in the framework of the earthquake seems to be related to higher PTSD rates and more severe symptomatology. These results highlight the need to carefully explore adolescents exposed to a significant loss as consequence of an earthquake. Copyright © 2011 Elsevier B.V. All rights reserved.

The endocannabinoid system and Post Traumatic Stress Disorder (PTSD): From preclinical findings to innovative therapeutic approaches in clinical settings.

PubMed

Berardi, Andrea; Schelling, Gustav; Campolongo, Patrizia

2016-09-01

Post-Traumatic Stress Disorder (PTSD) is a psychiatric chronic disease developing in individuals after the experience of an intense and life-threatening traumatic event. The post-traumatic symptomatology encompasses alterations in memory processes, mood, anxiety and arousal. There is now consensus in considering the disease as an aberrant adaptation to traumatic stress. Pharmacological research, aimed at the discovery of new potential effective treatments, has lately directed its attention towards the "so-called" cognitive enhancers. This class of substances, by modulating cognitive processes involved in the development and/or persistence of the post-traumatic symptomatology, could be of great help in improving the outcome of psychotherapies and patients' prognosis. In this perspective, drugs acting on the endocannabinoid system are receiving great attention due to their dual ability to modulate memory processes on one hand, and to reduce anxiety and depression on the other. The purpose of the present review is to offer a thorough overview of both animal and human studies investigating the effects of cannabinoids on memory processes. First, we will briefly describe the characteristics of the endocannabinoid system and the most commonly used animal models of learning and memory. Then, studies investigating cannabinoid modulatory influences on memory consolidation, retrieval and extinction will be separately presented, and the potential benefits associated with each approach will be discussed. In the final section, we will review literature data reporting beneficial effects of cannabinoid drugs in PTSD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

‘Everything just seems much more right in nature’: How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden

PubMed Central

Poulsen, Dorthe Varning; Stigsdotter, Ulrika K; Djernis, Dorthe; Sidenius, Ulrik

2016-01-01

Available evidence shows that an increasing number of soldiers are seeking help for post-traumatic stress disorder. The post-traumatic stress disorder condition has big emotional and psychological consequences for the individual, his/her family and the society. Little research has been done to explore the impact of nature-based therapy for veterans with post-traumatic stress disorder although there is a growing amount of evidence pointing towards positive outcome. This qualitative study aims to achieve a deeper understanding of this relationship from the veteran’s perspective. Eight Danish veterans participated in a 10-week nature-based therapy. Qualitative interviews were conducted and analysed using the interpretative phenomenological method. The results indicated that the veterans have achieved tools to use in stressful situations and experienced an improvement in their post-traumatic stress disorder symptoms. PMID:28070397

Recovery of components of memory in post-traumatic amnesia.

PubMed

Leach, Kathleen; Kinsella, Glynda; Jackson, Martin; Matyas, Tom

2006-11-01

Post-traumatic amnesia by definition indicates significant impairment of new learning ability, however very few studies have, examined the natural history and resolution of memory and new learning during PTA. Those studies which have, tended to examine orientation separately from the memory processes required to achieve orientation. Analysis of the order of recovery of the items of the Westmead PTA scale was used to examine recovery of memory and new learning capacity. The results of daily assessment of 34 patients with traumatic brain injury (TBI) on the Westmead PTA scale were analysed for order of recovery. The pattern of rank order of item recovery indicated that Date of Birth recovered consistently first. There was variability in the remaining items, however items reflecting long-term memory tended to recover second and items reflecting simple new learning followed. Recall of all three pictures reflecting complex new learning recovered last. The pattern of recovery of memory and new learning during PTA reflects a number of complex, inter-related variables including; the familiarity with the information, amount of rehearsal both before and since the accident and the number of cues available in the environment.

Post-traumatic stress disorder in adolescents after a hurricane.

PubMed

Garrison, C Z; Weinrich, M W; Hardin, S B; Weinrich, S; Wang, L

1993-10-01

A school-based study conducted in 1990, 1 year after Hurricane Hugo, investigated the frequency and correlates of post-traumatic stress disorder (PTSD) in 1,264 adolescents aged 11-17 years residing in selected South Carolina communities. Data were collected via a 174-item self-administered questionnaire that included a PTSD symptom scale. A computer algorithm that applied decision rules of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised to the symptoms reported was used to assign a diagnosis of PTSD and to designate the number of individuals who met the reexperiencing (20%), avoidance (9%), and arousal (18%) criteria. Rates of PTSD were lowest in black males (1.5%) and higher, but similar, in the remaining groups (3.8-6.2%). Results from a multivariable logistic model indicated that exposure to the hurricane (odds ratio (OR) = 1.26, 95% confidence interval 1.13-1.41), experiencing other violent traumatic events (OR = 2.46, 95% confidence interval 1.75-3.44), being white (OR = 2.03, 95% confidence interval 1.12-3.69) and being female (OR = 2.17, 95% confidence interval 1.15-4.10) were significant correlates of PTSD.

Pathophysiological Bases of Comorbidity: Traumatic Brain Injury and Post-Traumatic Stress Disorder.

PubMed

Kaplan, Gary B; Leite-Morris, Kimberly A; Wang, Lei; Rumbika, Kendra K; Heinrichs, Stephen C; Zeng, Xiang; Wu, Liquan; Arena, Danielle T; Teng, Yang D

2018-01-15

The high rates of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) diagnoses encountered in recent years by the United States Veterans Affairs Healthcare System have increased public awareness and research investigation into these conditions. In this review, we analyze the neural mechanisms underlying the TBI/PTSD comorbidity. TBI and PTSD present with common neuropsychiatric symptoms including anxiety, irritability, insomnia, personality changes, and memory problems, and this overlap complicates diagnostic differentiation. Interestingly, both TBI and PTSD can be produced by overlapping pathophysiological changes that disrupt neural connections termed the "connectome." The neural disruptions shared by PTSD and TBI and the comorbid condition include asymmetrical white matter tract abnormalities and gray matter changes in the basolateral amygdala, hippocampus, and prefrontal cortex. These neural circuitry dysfunctions result in behavioral changes that include executive function and memory impairments, fear retention, fear extinction deficiencies, and other disturbances. Pathophysiological etiologies can be identified using experimental models of TBI, such as fluid percussion or blast injuries, and for PTSD, using models of fear conditioning, retention, and extinction. In both TBI and PTSD, there are discernible signs of neuroinflammation, excitotoxicity, and oxidative damage. These disturbances produce neuronal death and degeneration, axonal injury, and dendritic spine dysregulation and changes in neuronal morphology. In laboratory studies, various forms of pharmacological or psychological treatments are capable of reversing these detrimental processes and promoting axonal repair, dendritic remodeling, and neurocircuitry reorganization, resulting in behavioral and cognitive functional enhancements. Based on these mechanisms, novel neurorestorative therapeutics using anti-inflammatory, antioxidant, and anticonvulsant agents may promote better

[Reliability and Validity of the Korean Version of the Perinatal Post-Traumatic Stress Disorder Questionnaire].

PubMed

Park, Yu Kyung; Ju, Hyeon Ok; Na, Hunjoo

2016-02-01

The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was designed to measure post-traumatic symptoms related to childbirth and symptoms during postnatal period. The purpose of this study was to develop a translated Korean version of the PPQ and to evaluate reliability and validity of the Korean PPQ. Participants were 196 mothers at one to 18 months after giving childbirth and data were collected through e-mails. The PPQ was translated into Korean using translation guideline from World Health Organization. For this study Cronbach's alpha and split-half reliability were used to evaluate the reliability of the PPQ. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and known-group validity were conducted to examine construct validity. Correlations of the PPQ with Impact of Event Scale (IES), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI) were used to test a criterion validity of the PPQ. Cronbach's alpha and Spearman-Brown split-half correlation coefficient were 0.91 and 0.77, respectively. EFA identified a 3-factor solution including arousal, avoidance, and intrusion factors and CFA revealed the strongest support for the 3-factor model. The correlations of the PPQ with IES, BDI-II, and BAI were .99, .60, and .72, respectively, pointing to criterion validity of a high level. The Korean version PPQ is a useful tool for screening and assessing mothers' experiencing emotional distress related to child birth and during the postnatal period. The PPQ also reflects Post Traumatic Stress Disorder's diagnostic standards well.

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…

Post-traumatic stress disorder in Polish stroke patients who survived Nazi concentration camps.

PubMed

Pachalska, Maria; Grochmal-Bach, Bozena; MacQueen, Bruce Duncan; Frańczuk, Bogusław

2006-04-01

Many persons who survived Nazi concentration camps are now in advanced age, so that rehabilitation centers in Poland are seeing increasing numbers of such patients, especially after strokes. In many cases, the process of rehabilitation is severely hampered by Post-Traumatic Stress Disorder (PTSD), while the neuropsychological consequences of the stroke itself often evoke traumatic memories and simultaneously disorganize or destroy the patient's previous coping mechanisms. The present study describes the program developed by the authors for concentration camp survivors in post-stroke rehabilitation, including the use of art therapy and specially prepared films to help the patients cope with PTSD. The experimental group (KL) consisted of 8 such patients (4 men, 4 women, average age 79.1+/-4.28) with mild post-stroke aphasia who went through the PTSD program, while the comparison group (C) included 8 post-stroke patients, matched for age and gender, who were not concentration camp survivors and showed no premorbid symptoms of PTSD. All subjects were tested at baseline and again 3 months later, using structured interview and observation, self-rating scales for three basic negative emotions (anger, anxiety and sadness) and the Frustration and Aggression Test for the Disabled. The results showed significant differences between the groups at baseline, while at follow-up the differences between groups had changed in both extent and distribution. Qualitative analysis of the results allows for some important observations about the etiology and course of PTSD in these persons.

Neuroinflammatory genes associated with post-traumatic stress disorder: implications for comorbidity.

PubMed

Zass, Lyndon J; Hart, Stephanie A; Seedat, Soraya; Hemmings, Sian M J; Malan-Müller, Stefanie

2017-02-01

Post-traumatic stress disorder (PTSD) is a debilitating condition that only occurs in the aftermath of traumatic event exposure and is characterized by an impaired stress response and chronic, low-grade inflammation. Dysregulation of the immune system may contribute towards central nervous system tissue damage and exacerbation of fear memories following trauma. Patients with PTSD often have comorbid psychiatric and somatic disorders that are of themselves associated with heightened inflammation. Several immune-related genes have been associated with PTSD and other co-occurring disorders. In this review, we propose that chronic inflammation, particularly neuroinflammation, is an important contributory factor towards PTSD comorbidity. Thus, novel treatments that target dysregulated inflammatory processes could provide symptomatic relief from PTSD and its comorbid disorders. This review investigates the intricate links between chronic stress, anxiety and neuroinflammation and the potential impact of increased neuroinflammation on PTSD pathology and comorbidity.

Selective transcatheter embolization for treatment of post-traumatic hepatic artery and portal vein pseudoaneurysms.

PubMed

Laopaiboon, Vallop; Aphinives, Chalida; Pugkem, Ake; Thummaroj, Jureerat; Puttharak, Warinthorn; Soommart, Yamuna

2006-02-01

The authors report a case of post-traumatic hepatic artery and portal vein pseudoaneurysms caused by blunt abdominal trauma, with multiple organ injuries including liver laceration. Abdominal spiral CT, CDS and DSA were performed to confirm the diagnosis. Both pseudoaneurysms were treated successfully with selective transcatheter embolization.

Identification of potential biomarkers for post-traumatic complications released after trauma-hemorrhage from murine Kupffer cells and its investigation in lung and liver.

PubMed

Schultze, Cornelia; Hildebrand, Frank; Noack, Sandra; Krettek, Christian; Zeckey, Christian; Neunaber, Claudia

2016-11-01

Early diagnosis of complications after severe trauma by specific biomarkers remains difficult. Identify potential new biomarkers for early diagnosis of post-traumatic complications. Mice underwent pressure-controlled hemorrhage or sham procedure. Four hours later, genome-wide expression of isolated Kupffer cells was compared with controls using Affymetrix-Genechip-Expression-Analysis and real-time-PCR. Expression analysis and real-time-PCR revealed a significant increase of gene expression of Cxcl10, Il4ra, Csf2rb2, Lcn2, and Gbp5. Cxcl10, Il4ra, Csf2rb2, Lcn2, and Gbp5 might represent new biomarkers for early diagnosis of post-traumatic complications, if they are linked to the development of post-traumatic complications.

Regional differences in post-traumatic stress symptoms among children after the 2011 tsunami in Higashi-Matsushima, Japan.

PubMed

Kuwabara, Hitoshi; Araki, Tsuyoshi; Yamasaki, Syudo; Ando, Shuntaro; Kano, Yukiko; Kasai, Kiyoto

2015-01-01

On 11 March 2011, a massive undersea earthquake, measuring 9.0 on the Richter scale, caused a tsunami that devastated the shoreline of east Japan. It is estimated that over 20,000 people lost their lives as a result. It is recommended that clinical effort after a tsunami disaster concentrate on a high-impact area rather than cover a large area. However, regional differences in post-traumatic stress symptoms among children after a tsunami disaster are not well clarified. This study evaluated post-traumatic stress symptoms and reported the findings of early-phase screening of 2259 students from Higashi-Matsushima City, Japan, 6 weeks after a tsunami hit the city. The sample was divided into two age groups: elementary school students (n=1102) and junior high school students (n=1157). Of these groups, 289 (26.2%) elementary school students and 123 (10.6%) junior high school students attended the four schools that were located in the area struck by the tsunami; the mortality rate of the area exceeded 4%. We referred to these students as the "high-impact group." The "lower-impact group" consisted of 813 (73.8%) elementary school students and 1034 (89.4%) junior high school students who attended the remaining ten schools. The severity of post-traumatic stress symptoms did not significantly differ between areas with relatively high and low impact. However, among the junior high school students, those attending the school in the highly impacted area showed higher post-traumatic symptoms scores than did the students of the less-impacted area. When planning a mass intervention after a disaster, especially in the early phase when the resources for intervention are not sufficient, it might be useful to consider the degree of age-dependent impact effect. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Mechanical Insufflation-Exsufflation Device Prescription for Outpatients With Tetraplegia

PubMed Central

Crew, James D; Svircev, Jelena N; Burns, Stephen P

2010-01-01

Background: Mechanical insufflation-exsufflation (MIE) is an option for secretion mobilization in outpatients with spinal cord injury (SCI) who lack an effective cough and are at high risk for developing pneumonia. Objective: To describe characteristics of persons with SCI who received MIE devices for outpatient use and compare respiratory hospitalizations before and after MIE prescription. Design: Retrospective cohort study of all persons who were prescribed MIE devices for outpatient use during 2000 to 2006 by a Veterans Affairs SCI service. Results: We identified 40 patients with tetraplegia (4.5% of population followed by the SCI service) who were prescribed MIE devices. Of these, 30 (75%) had neurologic levels of C5 or rostral, and 33 (83%) had motor-complete injuries. For chronically injured patients who were prescribed MIE for home use, there was a nonsignificant reduction in respiratory hospitalization rates by 34% (0.314/y before MIE vs 0.208/y after MIE; P  =  0.21). A posthoc subgroup analysis showed a significant decline in respiratory hospitalizations for patients with significant tobacco smoking histories. Conclusions: Mechanical insufflation-exsufflation was typically prescribed for people with motor-complete tetraplegia. Outpatient MIE usage may reduce respiratory hospitalizations in smokers with SCI. Further research of this alternative, noninvasive method is warranted in the outpatient SCI population. PMID:20486531

Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium

PubMed Central

2005-01-01

The stress that results from traumatic events precipitates a spectrum of psycho-emotional and physiopathological outcomes. Post-traumatic stress disorder (PTSD) is a psychiatric disorder that results from the experience or witnessing of traumatic or life-threatening events. PTSD has profound psychobiological correlates, which can impair the person's daily life and be life threatening. In light of current events (e.g. extended combat, terrorism, exposure to certain environmental toxins), a sharp rise in patients with PTSD diagnosis is expected in the next decade. PTSD is a serious public health concern, which compels the search for novel paradigms and theoretical models to deepen the understanding of the condition and to develop new and improved modes of treatment intervention. We review the current knowledge of PTSD and introduce the role of allostasis as a new perspective in fundamental PTSD research. We discuss the domain of evidence-based research in medicine, particularly in the context of complementary medical intervention for patients with PTSD. We present arguments in support of the notion that the future of clinical and translational research in PTSD lies in the systematic evaluation of the research evidence in treatment intervention in order to insure the most effective and efficacious treatment for the benefit of the patient. PMID:16322808

Successful Transarterial Guglielmi Detachable Coil Embolization of Post-Traumatic Fistula between a Posterior Communicating Artery Aneurysm and the Cavernous Sinus

PubMed Central

Chen, Y.; Jiang, D-Y.; Tan, H-Q.; Wang, L-H.; Chen, X-Y.; Sun, J-H.

2009-01-01

Summary We describe a case of a post-traumatic posterior communicating artery (PCoA) aneurysmcavernous sinus fistula, which is an extremely rare complication of craniocerebral trauma, successfully treated with endosaccular coil embolization via transarterial route. Endosaccular embolization with Guglielmi detachable coils via transarterial route appears to be a feasible, effective and minimally invasive option for the treatment of post-traumatic fistula between the PCoA aneurysm with a small ostia and the cavernous sinus in the subacute phase. PMID:20465883

Hypertonic Saline Resuscitation Restores Inflammatory Cytokine Balance in Post-Traumatic Hemorrhagic Shock Patients

DTIC Science & Technology

2004-08-01

immunocompetant cells experience bidirectional communication with hormones and cytokines [35,40]. Thus, despite compelling experimental findings, HSD has not...hypertonic saline with 6% dextran-70 (HSD) has been shown in experimental studies to reduce shock/resuscitation-induced inflammatory reactions and...alterations have been described in clinical and experimental investigations of post-traumatic hemorrhagic shock [13]. The initial immunological

Warming and humidification of insufflation carbon dioxide in laparoscopic colonic surgery: a double-blinded randomized controlled trial.

PubMed

Sammour, Tarik; Kahokehr, Arman; Hayes, Julian; Hulme-Moir, Mike; Hill, Andrew G

2010-06-01

We aimed to test the hypothesis that warming and humidification of insufflation CO2 would lead to reduced postoperative pain and improved recovery by reducing peritoneal inflammation in laparoscopic colonic surgery. Warming and humidification of insufflation gas is thought be beneficial in laparoscopic surgery, but evidence in prolonged laparoscopic procedures is lacking. We used a multicenter, double-blinded, randomized controlled design. The Study Group received warmed (37 degrees C), humidified (98% RH) insufflation carbon dioxide, and the Control Group received standard gas (19 degrees C, 0% RH). Anesthesia and analgesia were standardized. Intraoperative oesophageal temperature was measured at 15 minutes intervals. At the conclusion of surgery, the primary surgeon was asked to rate camera fogging on a Likert scale. Postoperative opiate usage was determined using Morphine Equivalent Daily Dose (MEDD), and pain was measured using visual analogue scores. Peritoneal and plasma cytokine concentrations were measured at 20 hours postoperatively. Postoperative recovery was measured using defined discharge and complication criteria, and the Surgical Recovery Score. Eighty-two patients were randomized, with 41 in each arm. Groups were well matched at baseline. Intraoperative core temperature was similar in both groups. Median camera fogging score was significantly worse in the Study group (4 vs. 2, P = 0.040). There were marginal differences in pain scores, but no significant differences were detected in MEDD usage, cytokine concentrations, or any recovery parameters measured. Warming and humidification of insufflation CO2 does not attenuate the early inflammatory cytokine response, and confers no clinically significant benefit in laparoscopic colonic surgery.

Screening, diagnosis, and treatment of post-traumatic stress disorder.

PubMed

Wisco, Blair E; Marx, Brian P; Keane, Terence M

2012-08-01

Post-traumatic stress disorder (PTSD) is a prevalent problem among military personnel and veterans. Identification of effective screening tools, diagnostic technologies, and treatments for PTSD is essential to ensure that all individuals in need of treatment are offered interventions with proven efficacy. Well-validated methods for screening and diagnosing PTSD are now available, and effective pharmacological and psychological treatments can be offered. Despite these advances, many military personnel and veterans do not receive evidence-based care. We review the literature on screening, diagnosis, and treatment of PTSD in military populations, and discuss the challenges to implementing the best evidence-based practices in clinical settings.

Genetic Advances in Post-traumatic Stress Disorder.

PubMed

Guillén-Burgos, Hernan Felipe; Gutiérrez-Ruiz, Karol

Post-traumatic stress disorder, or PTSD, is a condition that affects a subgroup of individuals that have suffered a previous traumatic event capable of generating changes at a psychological and behavioural level. These changes affect the personal, family, and social environment of those who suffer from this condition. Different genes have been identified as risk markers for development of this disorder. The population heterogeneity and individual differences (genetic and environmental) of each subject have made it difficult to identify valid markers in previous studies. For this reason, studies of Gene x Environment (G×E) have gathered importance in the last two decades, with the aim of identifying of the phenotypes of a particular disease. These studies have included genes such as SLC64A, FKBP5, and ADCYAP1R1, among others. Little is known about the interaction between the genes, pathways, and the molecular and neural circuitry that underlie PTSD. However their identification and association with stimuli and specific environments that stimulate the development of PTSD makes it focus of interest for identify genomic variations in this disorder. In turn, the epigenetic modifications that regulate the expression of genes involved in the hypothalamic-pituitary-adrenal (HPA) axis and the amygdala- hippocampal-medial prefrontal cortex circuits play a role in the identification of biomarkers and endophenotypes in PTSD. In this review, the advances in genetic and epigenetic that have occurred in the genomic era in PTSD are presented. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Post-traumatic syringomyelia refractory to surgical intervention: a series of cases on recurrent syringomyelia.

PubMed

Leahy, H P; Beckley, A A; Formal, C S; Fried, G W

2015-01-01

The objective of this study was to analyze a series of traumatic spinal cord injury (SCI) patients with a diagnosis of syrinx who had recurrence of symptomatic syrinx following surgical intervention. This is a patient series. The study was conducted in an acute inpatient rehabilitation facility. Participants included patients ( N =6) with post-traumatic syringomyelia (PTS) who had recurrent syrinx despite surgical repair. Not applicable. The main outcome measures were time period between injury and clinical manifestations of syringomyelia, time to recurrence and presenting symptoms. Among the six patients, there is great variability between time of the initial SCI and the development of syrinx. In terms of time periods between diagnosis of syrinx and recurrence of syrinx, there is also some variability (ranging from 6 to 936 weeks). The median length of time to recurrence was 104 weeks. In all cases, the presenting symptom was ultimately weakness, and in most cases it was associated with rising sensory deficits. Notably, all patients were male, aged 31-55 years, had suffered diffuse traumatic SCI and four of six patients lost the ability to ambulate because of syrinx formation. This series suggests that there may be risk factors for developing post-traumatic syringomyelia. We question whether there is a relationship between American Spinal Injury Association Impairment Scale grade and recurrence of PTS. We need to look closely at these patients to see whether there are modifiable risk factors that may minimize their chance of developing PTS. Once these are identified, there may be a role in routine screening of all patients and particularly those who may be at an increased risk for PTS to avoid loss of ambulatory function.

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…

Sivelestat sodium hydrate improves post-traumatic knee osteoarthritis through nuclear factor-κB in a rat model.

PubMed

Yu, Xiaofeng; Zhao, Lijun; Yu, Zhiping; Yu, Changzheng; Bi, Jianfei; Sun, Binglong; Cong, Haibo

2017-08-01

As a specific inhibitor of neutrophil elastase, sivelestat sodium hydrate has primarily been used in the treatment of acute lung injury caused by various factors since its approval in 2002. Sivelestat sodium hydrate also improves post-traumatic knee osteoarthritis (KOA), although its underlying mechanisms of action have yet to be elucidated. The aim of the current study was to determine if sivelestat sodium hydrate improves post-traumatic KOA through nuclear factor (NF)-κB in a rat model. Treatment with sivelestat sodium hydrate significantly inhibited the induction of structural changes and significantly increased the vertical episode count and ipsilateral static weight bearing of the joint in KOA rats (all P<0.01). Sivelestat sodium hydrate significantly inhibited tumor necrosis factor-α and interleukin-6 production, serum nitrite levels, inducible nitric oxide synthase protein expression and high mobility group box 1 (HMGB1) secretion in KOA rats compared with the model group (all P<0.01). Sivelestat sodium hydrate also significantly suppressed p50/p65 DNA binding activity and NF-κB and phosphorylated inhibitor of κB protein expression in the joints of KOA rats compared with the model group (all P<0.01). These results suggest that sivelestat sodium hydrate improves post-traumatic KOA through HMGB1 and NF-κB in rats.

The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study.

PubMed

Gökçe İsbir, Gözde; İnci, Figen; Önal, Hatice; Yıldız, Pelin Dıkmen

2016-11-01

Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Quasi-experimental study. The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared-an antenatal education intervention group (n=44), and a routine prenatal care control group (n=46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale-Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Compared to the control group, women who attended antenatal education had greater childbirth self-efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, p<0.05). Antenatal education appears to alleviate post-traumatic stress disorder symptoms after childbirth. Copyright © 2016 Elsevier Inc. All rights reserved.

Post-traumatic stress disorder.

PubMed

Bisson, Jonathan I

2010-02-03

Post-traumatic stress disorder (PTSD) may affect 10% of women and 5% of men at some stage, and symptoms may persist for several years. Risk factors include major trauma, lack of social support, peritraumatic dissociation, and previous psychiatric history or personality factors. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent PTSD? What are the effects of interventions to treat PTSD? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 46 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: affect management; antiepileptic drugs; antihypertensive drugs; benzodiazepines; brofaromine; CBT; drama therapy; eye movement desensitisation and reprocessing; fluoxetine; group therapy; hydrocortisone; hypnotherapy; inpatient treatment programmes; Internet-based psychotherapy; mirtazapine; multiple-session CBT; multiple-session collaborative trauma support; multiple-session education; nefazodone; olanzapine; paroxetine; phenelzine; psychodynamic psychotherapy; risperidone; SSRIs (versus other antidepressants); sertraline; single-session group debriefing; single-session individual debriefing; supportive psychotherapy; supportive counselling; temazepam; tricyclic antidepressants; and venlafaxine.

Post-traumatic stress disorder.

PubMed

Bisson, Jonathan I

2007-08-01

Post-traumatic stress disorder (PTSD) may affect 10% of women and 5% of men at some stage, and symptoms may persist for several years. Risk factors include major trauma, lack of social support, peritraumatic dissociation, and psychiatric or personality factors. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent; and to treat PTSD? We searched: Medline, Embase, The Cochrane Library and other important databases up to December 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 36 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: affect management, antiepileptic drugs, antihypertensive drugs, benzodiazepines, brofaromine, carbamazepine, CBT, drama therapy, eye movement desensitisation and reprocessing, fluoxetine, group therapy, hydrocortisone, hypnotherapy, inpatient treatment programmes, internet-based psychotherapy, mirtazepine, multiple-session CBT, multiple-session collaborative trauma support, multiple-session education, nefazodone, olanzapine, paroxetine, phenelzine, propranolol, psychodynamic psychotherapy, risperidone, SSRIss, sertraline, single-session group debriefing, single-session individual debriefing, supportive psychotherapy, supportive counselling, temazepam, tricyclic antidepressants, venlafaxine.

The emotional cost of distance: Geographic social network dispersion and post-traumatic stress among survivors of Hurricane Katrina.

PubMed

Morris, Katherine Ann; Deterding, Nicole M

2016-09-01

Social networks offer important emotional and instrumental support following natural disasters. However, displacement may geographically disperse network members, making it difficult to provide and receive support necessary for psychological recovery after trauma. We examine the association between distance to network members and post-traumatic stress using survey data, and identify potential mechanisms underlying this association using in-depth qualitative interviews. We use longitudinal, mixed-methods data from the Resilience in Survivors of Katrina (RISK) Project to capture the long-term effects of Hurricane Katrina on low-income mothers from New Orleans. Baseline surveys occurred approximately one year before the storm and follow-up surveys and in-depth interviews were conducted five years later. We use a sequential explanatory analytic design. With logistic regression, we estimate the association of geographic network dispersion with the likelihood of post-traumatic stress. With linear regressions, we estimate the association of network dispersion with the three post-traumatic stress sub-scales. Using maximal variation sampling, we use qualitative interview data to elaborate identified statistical associations. We find network dispersion is positively associated with the likelihood of post-traumatic stress, controlling for individual-level socio-demographic characteristics, exposure to hurricane-related trauma, perceived social support, and New Orleans residency. We identify two social-psychological mechanisms present in qualitative data: respondents with distant network members report a lack of deep belonging and a lack of mattering as they are unable to fulfill obligations to important distant ties. Results indicate the importance of physical proximity to emotionally-intimate network ties for long-term psychological recovery. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Combined inflating lung and insufflating calf pulmonary surfactant under general anesthesia in the treatment of postoperative intractable atelectasis].

PubMed

Lu, Ya-ping; Hu, Yi; Shi, Gu-ping; Yao, Ming; Huang, Bing; Zhou, Xu-yan; Sun, Jian-liang; DU, Jian-long; Xie, Guo-hao; Fang, Xiang-ming

2013-06-18

To explore the efficacy and safety of combined inflating lung and insufflating calf pulmonary surfactant under general anesthesia for treating postoperative intractable atelectasis. From August 2006 to January 2013, 15 patients with obstinate postoperative atelectasis receiving pressure control lung expansion were enrolled. The bronchial cannula was intubated into the affected side to assist the expanding of the lung, and the calf pulmonary surfactant was insufflated selectively. The chest auscultation and computed tomography (CT) scan was performed at 1 d and 5 d after the procedure respectively, to evaluation the effect. The airway pressure, mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and oxygen saturation (SpO2) were recorded before the treatment, during the treatment and after the treatment.Monitoring arterial blood gas before and after treatment. After the expansion of the lung and insufflation of calf pulmonary surfactants, the iconographic scan showed that collapsed alveolar was reinflated in 12 (80.0%) patients at 1 d after the treatment and in 14 patients(93.3%) at 5 d after the procedure.There were not notable vital sign change and complications during the treatment.At after the treatment, 1, 3, 5 and 7 d after the treatment, PaO2 was higher (P < 0.05), and there were not significantly difference in the PaCO2 and pH (P > 0.05) . Combined pressure control lung expansion with selectively insufflating calf pulmonary surfactant under general anesthesia may be an effective therapy for postoperative intractable atelectasis.

Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

PubMed

de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

2011-07-01

This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

Iatrogenic trigeminal post-traumatic neuropathy: a retrospective two-year cohort study.

PubMed

Klazen, Y; Van der Cruyssen, F; Vranckx, M; Van Vlierberghe, M; Politis, C; Renton, T; Jacobs, R

2018-06-01

With the growing demand for dental work, trigeminal nerve injuries are increasingly common. This retrospective cohort study examined 53 cases of iatrogenic trigeminal nerve injury seen at the Department of Oral and Maxillofacial Surgery, University Hospitals of Leuven between 2013 and 2014 (0.6% among 8845 new patient visits). Patient records were screened for post-traumatic trigeminal nerve neuropathy caused by nerve injury incurred during implant surgery, endodontic treatment, local anaesthesia, tooth extraction, or specifically third molar removal. The patients ranged in age from 15 to 80years (mean age 42.1years) and 68% were female. The referral delay ranged from 1day to 6.5years (average 10months). The inferior alveolar nerve (IAN) was most frequently injured (28 cases), followed by the lingual nerve (LN) (21 cases). Most nerve injuries were caused during third molar removal (24 cases), followed by implant placement (nine cases) and local anaesthesia injuries (nine cases). Pain symptoms were experienced by 54% of patients suffering IAN injury, compared to 10% of patients with LN injury. Persistent neurosensory disturbances were identified in 60% of patients. While prevention remains the key issue, timely referral seems to be a critical factor for the successful treatment of post-traumatic neuropathy. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Comparison of the recovery patterns of language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke.

PubMed

Vukovic, Mile; Vuksanovic, Jasmina; Vukovic, Irena

2008-01-01

In this study we investigated the recovery patterns of language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke. The correlation of specific language functions and cognitive functions was analyzed in the acute phase and 6 months later. Significant recovery of the tested functions was observed in both groups. However, in patients with post-traumatic language processing deficits the degree of recovery of most language functions and some cognitive functions was higher. A significantly greater correlation was revealed within language and cognitive functions, as well as between language functions and other aspects of cognition in patients with post-traumatic language processing deficits than in patients with aphasia following a stroke. Our results show that patients with post-traumatic language processing deficits have a different recovery pattern and a different pattern of correlation between language and cognitive functions compared to patients with aphasia following a stroke. (1) Better understanding of the differences in recovery of language and cognitive functions in patients who have suffered strokes and those who have experienced traumatic brain injury. (2) Better understanding of the relationship between language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke. (3) Better understanding of the factors influencing recovery.

The treatment of recalcitrant post-traumatic nightmares with autogenic training and autogenic abreaction: a case study.

PubMed

Sadigh, M R

1999-09-01

Recurrent and frightening dreams are commonly experienced by patients who suffer from post-traumatic stress disorder after a motor vehicle accident. Such nocturnal episodes, if left untreated, can result in the experience of severe distress with physical, emotional, and psychophysiological concomitant. The present single-case study investigated the effects of the standard autogenic exercises and autogenic abreaction in reducing the frequency and severity of post-traumatic nightmares in a survivor of a car crash. The patient was also instructed in two additional organ-specific formulas in order to improve her sleep. The results of the study showed that the interventions were successful in effectively treating the patient's distressing nightmares. Follow-up data suggested that the treatment effects persisted after the termination of therapy. Suggestions for future investigations are discussed.

Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors.

PubMed

Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

2013-03-01

Childbirth might be a traumatic event for some women. This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 women who were 6-8 weeks postpartum and had been undergone to this center for postpartum and child care. One hundred and three (17. 2%) women had symptoms of PTSD following childbirth based on the PTSD Symptom Scale (PSS). The results of logistic regression analysis revealed a significant correlation between maternal occupation (P = 0.01), depression level (P < 0.001) and anxiety level (P < 0.001) with PTSD following childbirth. PTSD from childbirth occurs in some women. Early identification of risk factors should lead to early therapeutic intervention in the mothers at risk of PTSD.

Effects of post-traumatic growth on the dorsolateral prefrontal cortex after a disaster

PubMed Central

Nakagawa, Seishu; Sugiura, Motoaki; Sekiguchi, Atsushi; Kotozaki, Yuka; Miyauchi, Carlos Makoto; Hanawa, Sugiko; Araki, Tsuyoshi; Takeuchi, Hikaru; Sakuma, Atsushi; Taki, Yasuyuki; Kawashima, Ryuta

2016-01-01

The relating to others factor of post-traumatic growth (PTG), which involves mutual help and a strong sense of connection with humanity, is important for young people who are coping with stress. The prefrontal cortex (PFC), especially the dorsolateral PFC (DLPFC), may play an important role in post-traumatic stress disorder (PTSD) with regard to coping and resilience. We hypothesized that the neural correlates of PTG may be responsible for resilience to the correlates of PTSD. Our study tested this hypothesis by examining whether measures of PTG, particularly the measures of relating to others after a disaster, were associated with increased regional grey matter volume (rGMV) in the PFC by assessing individuals who had experienced the East Japan Great Earthquake. We calculated the delta-rGMV by subtracting the rGMV obtained 3 months before the disaster from the rGMV obtained after this disaster using voxel-based morphometry. The magnetic resonance imaging data obtained from 26 subjects (M/F: 21/5; age: 21.2 ± 1.6 yrs.) showed that the total scores on a PTG inventory and the subscore for relating to others at the post-assessment were positively and significantly associated with the delta-rGMV in the right DLPFC. The DLPFC seems to be the main neural correlate of PTG. PMID:27670443

Understanding Traumatic Stress in Children

MedlinePlus

... here Home 22 Apr 2013 Report Understanding Traumatic Stress in Children Supporting Children and Families After Traumatic ... affiliate of AIR, developed a resource, Understanding Traumatic Stress in Children , to help. This guide describes the ...

The factorial and discriminant validity of the German version of the Post-traumatic Growth Inventory in stroke patients.

PubMed

Mack, Julian; Herrberg, Marlene; Hetzel, Andreas; Wallesch, Claus Werner; Bengel, Jürgen; Schulz, Moritz; Rohde, Nathalie; Schönberger, Michael

2015-01-01

Post-traumatic growth (PTG) is the experience of positive changes that can follow a traumatic event. The current study examined the factorial as well as the discriminant validity of the German version of the Post-traumatic Growth Inventory (PTGI-G) in stroke patients. A total of 188 adult stroke patients (63.3% male; median age 69 years) completed the PTGI-G and the German version of the Hospital Anxiety and Depression Scale (HADS-D) at the end of their inpatient rehabilitation. Confirmatory factor analyses indicate an acceptable model fit of both the original five-factor solution as well as a second-order factor model of the PTGI-G (CFI > .95; RMSEA < .01). Small and non-significant correlations between the PTGI-G subscales and the depression scale of the HADS-D support the discriminant validity of the PTGI-G. The PTGI-G appears to be a valid tool in the context of stroke research.

Pathways from Victimization to Substance Use: Post Traumatic Stress Disorder as a Mediator

PubMed Central

Yeon Lee, Jung; Brook, Judith S.; Finch, Stephen J.; Brook, David W.

2016-01-01

Traumatic events are linked with an array of adverse consequences such as substance use. Only a few individuals exposed to traumatic events, however, suffer from post traumatic stress disorder (PTSD) or substance use. The present longitudinal study examined the inter-relationship among victimization, PTSD, and substance use. 674 participants (53% African Americans, 47% Puerto Ricans) were surveyed over five time waves at mean ages 14, 19, 24, 29, and 36. Of the 674, 60% were females. We used Mplus to perform structural equation modeling. Victimization at ages 19, 24, and 29 was directly associated with substance use at age 36 and was also related to PTSD at age 36. PTSD, in turn, was related to substance use at age 36. This study indicates the importance of intervention for those who have been victimized with a focus on PTSD treatment. From a public health perspective, health providers should consider treatment and prevention programs for helping individuals cope with some of the consequences of victimization. This might ultimately reduce substance use. PMID:26832837

Achievements for Developing a Technology to Manage Post-Traumatic Pain With Ultrasound Neuromodulation

DTIC Science & Technology

2012-01-03

REPORT Phase 1 achievements for developing a technology to manage post-traumatic pain with ultrasound neuromodulation . 14. ABSTRACT 16. SECURITY...CLASSIFICATION OF: The objective of this effort is to demonstrate the feasibility of using ultrasound induced neuromodulation to manage pain. SynSonix, LLC...has been developing ultrasound neuromodulation (UNMOD) to noninvasively stimulate neural circuitry. Pain management for acute traumas is generally

Post-traumatic stress disorder after weaning from prolonged mechanical ventilation.

PubMed

Jubran, Amal; Lawm, Gerald; Duffner, Lisa A; Collins, Eileen G; Lanuza, Dorothy M; Hoffman, Leslie A; Tobin, Martin J

2010-12-01

Weaning from prolonged mechanical ventilation may be associated with mental discomfort. It is not known whether such discomfort is linked with the development of post-traumatic stress disorder (PTSD). Accordingly, we investigated whether PTSD occurs in patients after weaning from prolonged ventilation. We also determined whether administering a questionnaire would identify patients at risk for developing PTSD. A prospective longitudinal study of patients transferred to a long-term acute-care hospital for weaning from prolonged ventilation was undertaken: 72 patients were studied 1 week after weaning, and 41 patients were studied again 3 months later. An experienced psychologist conducted a structured clinical interview 3 months after weaning to establish a diagnosis of PTSD. To assess for the presence of PTSD-related symptoms, the post-traumatic stress syndrome (PTSS-10) questionnaire was administered 1 week after weaning and 3 months later. The psychologist diagnosed PTSD in 12% of patients 3 months after ventilator weaning. Patients who developed PTSD were more likely to have a previous history of psychiatric disorders (P < 0.02). A PTSS-10 score >20 one week after weaning reliably identified patients who were diagnosed with PTSD 3 months later: sensitivity 1.0; specificity 0.76; area under the receiver-operating characteristic curve 0.91. PTSD was diagnosed in 12% of patients who were weaned from prolonged ventilation. A PTSS-10 score >20 one week after weaning identified patients diagnosed with PTSD 3 months later. This finding suggests that a simple questionnaire administered before hospital discharge can identify patients at risk for developing PTSD.

Combat-related headache and traumatic brain injury.

PubMed

Waung, Maggie W; Abrams, Gary M

2012-12-01

Post-traumatic headache is a commonly described complication of traumatic brain injury. Recent studies highlight differences between headache features of combat veterans who suffered traumatic brain injury compared to civilians. Not surprisingly, there is a higher rate of associated PTSD and sleep disturbances among veterans. Factors of lower socioeconomic status, rank, and multiple head injuries appear to have a similar effect on post-traumatic headache in combat-related traumatic brain injury. Areas of discordance in the literature include the effect of prolonged loss of consciousness and the prevalence of specific headache phenotypes following head trauma. To date, there have been no randomized trials of treatment for post-traumatic headache. This may be related to the variability of headache features and uncertainty of pathophysiologic mechanisms. Given this lack of data, many practitioners follow treatment guidelines for primary headaches. Additionally, because of mounting data linking PTSD to post-traumatic headache in combat veterans, it may be crucial to choose multimodal agents and take a multidisciplinary approach to combat-related headache.

An exploration of post-traumatic stress disorder in emergency nurses following Hurricane Katrina.

PubMed

Battles, Elizabeth D

2007-08-01

As a result of Hurricane Katrina on August 29, 2005, ED nurses were faced with chaos during and after the storm. The purpose of this pilot study was to determine if emergency nurses have experienced signs and symptoms of post-traumatic stress disorder (PTSD) as a result of working in an emergency department of the New Orleans metropolitan area during and immediately after Hurricane Katrina. The research identifies if the nurses perceived satisfaction with measures administrators took to provide Critical Incident Stress Management (CISM). To combat burnout, absenteeism, emotional difficulties, and health problems in nurses, administration must offer adequate crisis management for those affected by a traumatic event in the workplace. Data were captured through a cross-sectional research design using self-reporting questionnaires. A questionnaire captured demographic information as well as information regarding satisfaction with CISM offered by management. The Post Traumatic Checklist (PCL) was utilized to assess PTSD symptoms in the nurse. An emergency department located approximately 40 miles north of downtown New Orleans, Louisiana, served as the setting for this study. The sample included 21 registered nurses who worked in the emergency department. Twenty percent of the nurses has symptoms of PTSD. In addition, 100% of the nurses reported that administrators did not offer CISM. To combat consequences of long-term effects of PTSD, hospital administrators must offer adequate treatment to employees. Further research is needed to expand the sample and gain a wider perspective on PTSD symptoms in nurses who worked during the Hurricane.

Patient-reported outcomes in post-traumatic stress disorder. Part II: focus on pharmacological treatment.

PubMed

Kapfhammer, Hans-Peter

2014-06-01

Post-traumatic stress disorder (PTSD) may be associated with long-lasting psychological suffering, distressing psychosocial disability, markedly reduced health-related quality of life, and increased morbidity and mortality in a subgroup of individuals in the aftermath of serious traumatic events. Both etiopathogenesis and treatment modalities of PTSD are best conceptualized within a biopsychosotial model. Pharmacotherapy may lay claim to a major role in the multimodal treatment approaches. Here we outline two different pharmacotherapeutic trends that aim to modify the encoding, consolidation, and rehearsal of traumatic memory in order to reduce the risk of PTSD immediately after trauma exposure on the one hand, and that endeavor to treat the clinical state of PTSD on the other. The theoretical rationales of both pharmacological strategies are the complex neurobiological underpinnings that characterize traumatic memory organization and clinical PTSD. Meanwhile, promising data from randomized controlled trials have been obtained for both approaches. Empirical evidence may inform clinicians in their clinical efforts for this special group of patients. The efficacy of several classes of drugs that have been investigated within a context of research should be evaluated critically and still have to stand the test of effectiveness in daily clinical practice. From a patient perspective, empirical results may serve as a psychoeducative guideline to what pharmacotherapeutic approaches may realistically achieve, what their risks and benefits are, and what their limits are in contributing to reducing the often major chronic suffering caused by serious traumatic events. Ethical issues have to be considered, particularly in the context of pharmacological strategies projected to prevent PTSD in the aftermath of traumatic exposure.