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Sample records for abusive abdominal trauma

  1. Epidemiology of Abusive Abdominal Trauma Hospitalizations in United States Children

    ERIC Educational Resources Information Center

    Lane, Wendy Gwirtzman; Dubowitz, Howard; Langenberg, Patricia; Dischinger, Patricia

    2012-01-01

    Objectives: (1) To estimate the incidence of abusive abdominal trauma (AAT) hospitalizations among US children age 0-9 years. (2) To identify demographic characteristics of children at highest risk for AAT. Design: Secondary data analysis of a cross-sectional, national hospitalization database. Setting: Hospitalization data from the 2003 and 2006…

  2. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  3. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  4. Substance Abuse and Trauma.

    PubMed

    Simmons, Shannon; Suárez, Liza

    2016-10-01

    There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD. PMID:27613348

  5. Skeletal trauma in child abuse.

    PubMed

    Swoboda, Sara L; Feldman, Kenneth W

    2013-11-01

    Fractures and other skeletal injuries are common in childhood. Most are the result of falls, motor vehicle accidents, and other forms of accidental trauma. However, skeletal trauma is present in a significant number of abused children. Age and developmental abilities are key components in raising clinical suspicion for child abuse. Children who are unable to provide their own history because of age or developmental delay require increased attention. Younger children are more likely to have abusive fractures, whereas accidental fractures increase with age and developmental abilities. The consequences of missing abuse are high because children returned to their homes without intervention are likely to face further abuse and have an increased mortality risk. Because of the potentially high cost of undiagnosed child abuse, diagnosis of a skeletal injury is incomplete without diagnosing its etiology. All health providers for children should be able to recognize patterns of skeletal injury secondary to abusive trauma and understand the process for initiating Child Protective Services (CPS) investigations when necessary. Although they can occur accidentally, fractures in nonmobile children should always increase the clinician's concern for abusive trauma. In light of the significant consequences for children when abuse is missed by a primary care provider, abuse should be on the differential diagnosis for all presenting childhood injuries.

  6. Aspects of abuse: abusive head trauma.

    PubMed

    Hinds, Tanya; Shalaby-Rana, Eglal; Jackson, Allison M; Khademian, Zarir

    2015-03-01

    Abusive Head Trauma (AHT) is a form of child physical abuse that involves inflicted injury to the brain and its associated structures. Abusive Head Trauma, colloquially called Shaken Baby Syndrome, is the most common cause of serious or fatal brain injuries in children aged 2 years and younger. The American Academy of Pediatrics recommends the term Abusive Head Trauma, as opposed to Shaken Baby Syndrome, as the former term encompasses multiple forms of inflicted head injury (inertial, contact, and hypoxic-ischemic) and a range of clinical presentations and radiologic findings and their sequelae. Children diagnosed with AHT are 5 times more likely to die compared with accidentally head-injured children, yet signs and symptoms are not always obvious, and therefore the diagnosis can be overlooked. Therefore, the American Academy of Pediatrics has tasked pediatricians with knowing how and when to begin an evaluation of children with signs and symptoms that could possibly be due to AHT. Overall, a detailed history of present illness and medical history, recognition of physical and radiological findings, and careful interpretation of retinal pathology are important aspects of formulating the differential diagnoses and increasing or decreasing the index of suspicion for AHT.

  7. Addressing Trauma in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

    2016-01-01

    Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

  8. Combined Gastric and Duodenal Perforation Through Blunt Abdominal Trauma

    PubMed Central

    Kaur, Adarshpal; Singla, Archan Lal; Kumar, Ashwani; Yadav, Manish

    2015-01-01

    Blunt abdominal traumas are uncommonly encountered despite their high prevalence, and injuries to the organ like duodenum are relatively uncommon (occurring in only 3%-5% of abdominal injuries) because of its retroperitoneal location. Duodenal injury combined with gastric perforation from a single abdominal trauma impact is rarely heard. The aim of this case report is to present a rare case of blunt abdominal trauma with combined gastric and duodenal injuries. PMID:25738037

  9. [Role of surgery in closed abdominal trauma].

    PubMed

    Panis, Y; Charbit, L; Valleur, P

    1997-05-01

    Over the past twenty years, nonoperative management has increasingly been recommended for the care of patients with blunt abdominal trauma. Emergency laparotomy remains the rule in patients with hemodynamic instability or in those with peritonitis due to intestinal perforation. Surgical treatment of liver and splenic lesions tends to be more conservative. After assessment of the lesions by computed tomography, nonoperative management in intensive care unit is allowed in the majority of patients. PMID:9208689

  10. [Pheochromocytoma with retroperitoneal hemorrhage after abdominal trauma].

    PubMed

    Hayashi, Takuji; Nin, Mikio; Yamamoto, Yoshiyuki; Kamoto, Akihito; Ujike, Takeshi; Nishimura, Kensaku; Miyoshi, Susumu

    2009-11-01

    A 35-year-old man was delivered to the emergency room complaining of right flank pain because of blunt abdominal trauma sustained while playing baseball. Enhanced computed tomography (CT) revealed a right adrenal mass and fluid collection around the mass. We diagnosed the mass as pheochromocytoma by endocrinological examination and radioisotopical imaging test. After absorption of the hematoma three months after the injury, laparoscopic right adrenalectomy was performed. He had an uncomplicated postoperative course without supplementation of catecholamine. Pathological findings were compatible with pheochromocytoma. Eight months after the operation, he had no evidence of recurrence.

  11. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-01-01

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended. PMID:26698210

  12. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-12-23

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended.

  13. International issues in abusive head trauma.

    PubMed

    Frasier, Lori D; Kelly, Patrick; Al-Eissa, Majid; Otterman, Gabriel J

    2014-12-01

    In the decades since Dr. John Caffey described a series of children with chronic subdural hematoma and long bone fractures, there has been a substantial increase in the medical recognition of various forms child abuse. In the United States, the term shaken baby syndrome was coined to explain a constellation of injuries assumed to be the result of violent shaking of infants. After improved understanding of the variety of mechanisms that occur when children are abused, abusive head trauma (AHT) has become the recommended terminology. AHT is a more comprehensive term that reflects the brain injuries that children suffer as the result of abuse. AHT continues to include shaking as a mechanism of injury as well as shaking with impact, impact alone, crushing injuries or combinations of several mechanisms. The medical community in the United States has led the way in developing new terminology and research to describe this unique and devastating form of abuse. The globalization of medicine and rapid information transfer has resulted in AHT becoming well-recognized internationally as a form of serious and fatal child abuse. This paper will review the historical basis in the United States for the diagnosis of AHT. We will also review some of the current international issue in epidemiology, diagnosis, legal processes and outcomes in selected countries/regions where child abuse physicians are actively involved in the evaluation of AHT. PMID:25501737

  14. Abusive head trauma: two case reports

    PubMed Central

    Kanık, Ali; İnce, Osman Tolga; Yeşiloğlu, Şehriban; Eliaçık, Kayı; Bakiler, Ali Rahmi

    2015-01-01

    Abusive head trauma is a serious form of child abuse and mostly seen in infants below the age of two years as a result of a strong shaking by the caregiver who aims to stop the infant’s crying. Characteristic symptoms include subdural hematomas, encephalopathy, retinal hemorrhages and fractures of the long bones. When physically examined, there are generally no externally visible signs. For this reason, it can be underdiagnosed, if it is not considered in the differential diagnosis. When the information provided from the parents is inconsistent and contradictory with the clinical picture of the patient, this form of abuse must be suspected and retinal hemorrhages should be searched. In this article, two patients who were admitted to our emergency department and diagnosed with physical child abuse are reported. One of these patients had a history of minor head trauma after falling down from the sofa and the other one had a history of breathlessness and loss of consciousness as a result of excessive crying. PMID:26568695

  15. The neonatal nurse's role in preventing abusive head trauma.

    PubMed

    Allen, Kimberly A

    2014-10-01

    Abusive head trauma in infants occurs in 24.6 to 39.8 per 100,000 infants in developed countries. Abusive head trauma refers to any type of intentional head trauma an infant sustains, as a result of an injury to the skull or intracranial contents from a blunt force and/or violent shaking. The clinical question was: what evidence-based interventions have been implemented by neonatal nurses to prevent abusive head trauma in infants? PubMed was searched to obtain English language publications from 2005 to May 2014 for interventions focused on preventing abusive head trauma using the key term "shaken baby syndrome." A total of 10 studies were identified that met the inclusion criteria. All of the interventions targeted prevention of abusive head trauma with information about abusive head trauma/shaken baby syndrome and the "normal" infant crying behaviors. Interventions taught parents why infants cried, how to calm the infants, ways to cope with inconsolable infants, and how to develop a plan for what to do if they could not cope anymore. Parents who participated in the interventions were consistently able to explain the information and tell others about the dangers of shaking infants compared to the control parents. Only 2 studies calculated the preintervention abusive head trauma rate and the postintervention frequency of abusive head trauma. Each found significant differences in abusive head trauma.

  16. Bowel and mesenteric injuries from blunt abdominal trauma: a review.

    PubMed

    Iaselli, Francesco; Mazzei, Maria Antonietta; Firetto, Cristina; D'Elia, Domenico; Squitieri, Nevada Cioffi; Biondetti, Pietro Raimondo; Danza, Francesco Maria; Scaglione, Mariano

    2015-01-01

    The bowel and the mesentery represent the third most frequently involved structures in blunt abdominal trauma after the liver and the spleen. Clinical assessment alone in patients with suspected intestinal and/or mesenteric injury from blunt abdominal trauma is associated with unacceptable diagnostic delays. Multi-detector computed tomography, thanks to its high spatial, time and contrast resolutions, allows a prompt identification and proper classification of such conditions. The radiologist, in fact, is asked not only to identify the signs of trauma but also to provide an indication of their clinical significance, suggesting the chance of conservative treatment in the cases of mild and moderate, non-complicated or self-limiting injuries and focusing on life-threatening conditions which may benefit from immediate surgical or interventional procedures. Specific and non-specific CT signs of bowel and mesenteric injuries from blunt abdominal trauma are reviewed in this paper.

  17. Diagnostic imaging of blunt abdominal trauma in pediatric patients.

    PubMed

    Miele, Vittorio; Piccolo, Claudia Lucia; Trinci, Margherita; Galluzzo, Michele; Ianniello, Stefania; Brunese, Luca

    2016-05-01

    Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements. The liver is the most common organ injured in blunt abdominal trauma followed by the spleen. Renal, pancreatic, and bowel injuries are quite rare. In this review we present various imaging findings of blunt abdominal trauma in children.

  18. Alcohol abusive use increases facial trauma?

    PubMed Central

    Soares-Carneiro, Suzana-Célia-de-Aguiar; Matos da-Silva, Gessyca-Suielly-Melo; de-Barros-Caldas, Luciano-Cruz; Porto, Gabriela-Granja; Leal, Jefferson-Figueiredo; Catunda, Ivson

    2016-01-01

    Background Trauma is among the main death causes and morbidity in the world and is often related to the use of alcohol and its abuse has reached massive proportions, no matter if the country is developed or not, being considered as public health problem. Since there are very few randomized and prospective studies in literature about the association of facial trauma and the use of alcohol, this study aims to investigate the impact of alcohol use in facial trauma. Material and Methods This was a prospective and cross sectional study, involving facial trauma patients attended at Oral Maxillofacial Surgery Division of a State Hospital. Variables included patient´s profile, trauma etiology, facial region involved, type of injury and treatment and days of hospitalization. AUDIT test was applied to identify risks and damages of alcohol use and chemical dependence. Absolute distribution, uni and mutilvaried percentages were made for data evaluation. Pearson´s qui-squared and Fisher´s Exact tests were also used. Results One hundred patients were evaluated. The patient´s mean age was 33.50 years-old, 48% had between 17 and 29 years old, 28% had 30 to 39, and 24% 40 or more. Most of them were male (86%). The most frequent etiology was traffic accident (57%), the extraoral area was most committed (62%), the most frequent type of injury was fractures (78%) and the most affected bone was the mandible (36%). More than half of the patients (53%) had surgical treatment. 38% had their discharge from hospital right after the first attendance. The AUDIT most frequent answer was “moderate use” (46%) and use at risk (39%). There was significant difference between the use of alcohol (AUDIT) and hematoma (0.003) and number of days of hospitalization (p=0.005). Conclusions In this study it was not observed association between alcohol consumption using the AUDIT and trauma etiology, but patient victims of traffic accidents were classified as with risk in the scale. Most of the

  19. [Adrenal injury in blunt abdominal trauma].

    PubMed

    Abakumov, M M; Smoliar, A N; Barmina, T G; Boĭko, A V; Shalimova, I G

    2009-01-01

    10 patients with adrenal damage were observed during 2.5 years. It amounted 0.93% of all patients with closed abdominal injuries. The right adrenal gland was traumatized in all cases evidently due to it's compression between right lobe of liver and vertebral column. Adrenal damage is observed quite often in combination with injuries of right liver lobe, right kidney and retroperitoneal hematoma formation. 5 patients underwent laparotomy on account of intra-abdominal bleeding, but adrenal damage was never revealed. Ultrasound and tomographic semiotics of adrenal damage was worked out, which allowed ascertaining diagnosis in 80% on application of ultrasound study and in 100% at computer tomography. Injury of one adrenal gland was not accompanied by adrenal failure and did not require hormonal replacement therapy.

  20. Combination therapy that targets secondary pulmonary changes after abdominal trauma.

    PubMed

    Davis, K A; Fabian, T C; Ragsdale, D N; Trenthem, L L; Croce, M A; Proctor, K G

    2001-06-01

    After abdominal trauma, the lung is susceptible to secondary injury caused by acute neutrophil (PMN) sequestration and alveolar capillary membrane disruption. Adenosine is an endogenous anti-inflammatory metabolite that decreases PMN activation. AICAR ([5-amino-1-[beta-D-ribofuranosyl]imidazole-4-carboxamide]riboside) is the prototype of a novel class of anti-inflammatory drugs that increase endogenous adenosine. After trauma, AICAR administration has been shown to decrease secondary lung injury in models of hemorrhagic shock with delayed lipopolysaccharide challenge and pulmonary contusion. However, early suppression of PMN activation could worsen outcomes after penetrating abdominal trauma. We hypothesized that, after penetrating abdominal trauma, the ideal resuscitation strategy would involve early, short-lived suppression of PMN activation to minimize secondary lung injury, followed by later enhancement of PMN chemotaxis and phagocytosis [using granulocyte colony-stimulating factor (G-CSF)] to lessen late septic complications. G-CSF has not been shown to potentiate PMN mediated pulmonary reperfusion injury. Swine were subjected to cecal ligation/incision and hemorrhagic shock (trauma), followed by resuscitation with shed blood, crystalloid, and either G-CSF, a combination of G-CSF and AICAR, or 0.9% normal saline. At 72 h, bronchoalveolar lavage (BAL) leukocyte counts and protein concentration were determined, and lung tissue analysed for myeloperoxidase (MPO, a measure of PMN infiltration) and microscopic pathology. Analysis of BALs revealed a significant increase protein concentrations and in white blood cell and PMN infiltration (P< 0.05) following trauma. These acute changes were not exacerbated by G-CSF, but were reversed by combined AICAR + G-CSF, which implicates a physiologic role for adenosine. This suggests that combination therapy may have beneficial effects on the lung after trauma.

  1. Spleen volume on CT and the effect of abdominal trauma.

    PubMed

    Cruz-Romero, Cinthia; Agarwal, Sheela; Abujudeh, Hani H; Thrall, James; Hahn, Peter F

    2016-08-01

    The aim of this study is to determine the magnitude of change in spleen volume on CT in subjects sustaining blunt abdominal trauma without hemorrhage relative to patients without disease and how the spleen volumes are distributed. Sixty-seven subjects with blunt abdominal trauma and 101 control subjects were included in this retrospective single-center, IRB-approved, and HIPAA-compliant study. Patients with an injured spleen were excluded. Using a semiautomatic segmentation program, two readers computed spleen volumes from CT. Spleen volume distribution in male and female trauma and control cohorts were compared nonparametrically. Spleen volume plotted against height, weight, and age were analyzed by linear regression. The number of females and males are, respectively, 35 and 32 in trauma subjects and 69 and 32 among controls. Female trauma patients (49.6 years) were older than males (39.8 years) (p = 0.02). Distributions of spleen volume were not normal, skewed above their means, requiring a nonparametric comparison. Spleen volumes in trauma patients were smaller than those in controls with medians of 230 vs 294 mL in males(p < 0.006) and 163 vs 191 mL in females(p < 0.04). Spleen volume correlated positively with weight in females and with height in male controls, and negatively with age in male controls (p < 0.01). Variation in reproducibility and repeatability was acceptable at 1.5 and 4.9 %, respectively. Reader variation was 1.7 and 4.6 % for readers 1 and 2, respectively. The mean spleen volume in controls was 245 mL, the largest ever reported. Spleen volume decreases in response to blunt abdominal trauma. Spleen volumes are not normally distributed. Our population has the largest spleen volume reported in the literature, perhaps a consequence of the obesity epidemic. PMID:27166964

  2. Spleen volume on CT and the effect of abdominal trauma.

    PubMed

    Cruz-Romero, Cinthia; Agarwal, Sheela; Abujudeh, Hani H; Thrall, James; Hahn, Peter F

    2016-08-01

    The aim of this study is to determine the magnitude of change in spleen volume on CT in subjects sustaining blunt abdominal trauma without hemorrhage relative to patients without disease and how the spleen volumes are distributed. Sixty-seven subjects with blunt abdominal trauma and 101 control subjects were included in this retrospective single-center, IRB-approved, and HIPAA-compliant study. Patients with an injured spleen were excluded. Using a semiautomatic segmentation program, two readers computed spleen volumes from CT. Spleen volume distribution in male and female trauma and control cohorts were compared nonparametrically. Spleen volume plotted against height, weight, and age were analyzed by linear regression. The number of females and males are, respectively, 35 and 32 in trauma subjects and 69 and 32 among controls. Female trauma patients (49.6 years) were older than males (39.8 years) (p = 0.02). Distributions of spleen volume were not normal, skewed above their means, requiring a nonparametric comparison. Spleen volumes in trauma patients were smaller than those in controls with medians of 230 vs 294 mL in males(p < 0.006) and 163 vs 191 mL in females(p < 0.04). Spleen volume correlated positively with weight in females and with height in male controls, and negatively with age in male controls (p < 0.01). Variation in reproducibility and repeatability was acceptable at 1.5 and 4.9 %, respectively. Reader variation was 1.7 and 4.6 % for readers 1 and 2, respectively. The mean spleen volume in controls was 245 mL, the largest ever reported. Spleen volume decreases in response to blunt abdominal trauma. Spleen volumes are not normally distributed. Our population has the largest spleen volume reported in the literature, perhaps a consequence of the obesity epidemic.

  3. [Rupture of hepatic echinococcal cyst by minimal blunt abdominal trauma].

    PubMed

    Shapira, O; Simon, D; Rothstein, H; Pfeffermann, R

    1992-01-15

    Hepatic echinococcosis is endemic in Israel, with about 90 new cases diagnosed each year. Although many are asymptomatic for years, 40% develop complications. We describe a man of 37 and women aged 22 and 35, respectively, in whom rupture of an echinococcal cyst followed minimal, blunt abdominal trauma. In each patient the rupture led to complications consisting of massive intra-abdominal bleeding in 1, diffuse peritonitis in another and cystocutaneous fistula with ureteral obstruction due to reactive retroperitoneal fibrosis in the third. All 3 underwent surgery to resolve the immediate complication, with no mortality. A striking feature was the disproportion between the stormy clinical presentation and the relatively innocent nature of the trauma. In only 1 of our cases was the correct preoperative diagnosis made, which in this condition depends primarily on a high index of suspicion.

  4. The Impact of Learning About Child Abuse Trauma.

    ERIC Educational Resources Information Center

    Jones, Karyn Dayle

    2002-01-01

    Many counselors attend graduate courses and seminars on the treatment of child abuse and neglect. Educators and trainers need to focus on the feelings and reactions elicited from exposure to the content of these courses. This article provides information on the impact of learning about the trauma of child abuse. (Author)

  5. Intra-abdominal hypertension and abdominal compartment syndrome in pancreatitis, paediatrics, and trauma.

    PubMed

    De Waele, Jan J; Ejike, Janeth C; Leppäniemi, Ari; De Keulenaer, Bart L; De Laet, Inneke; Kirkpatrick, Andrew W; Roberts, Derek J; Kimball, Edward; Ivatury, Rao; Malbrain, Manu L N G

    2015-01-01

    Intra-abdominal hypertension (IAH) is an important contributor to early organ dysfunction among patients with trauma and sepsis. However, the impact of increased intra-abdominal pressure (IAP) among pediatric, pregnant, non-septic medical patients, and those with severe acute pancreatitis (SAP), obesity, and burns has been studied less extensively. The aim of this review is to outline the pathophysiologic implications and treatment options for IAH and abdominal compartment syndrome (ACS) for the above patient populations. We searched MEDLINE and PubMed to identify relevant studies. There is an increasing awareness of IAH in general medicine. The incidence of IAH and, to a lesser extent, ACS is high among patients with SAP. IAH should always be suspected and IAP measured routinely. In children, normal IAP in mechanically ventilated patients is approximately 7 ± 3 mm Hg. As an IAP of 10-15 mm Hg has been associated with organ damage in children, an IAP greater than 10 mm Hg should be considered IAH in these patients. Moreover, as ACS may occur in children at an IAP lower than 20 mm Hg, any elevation in IAP higher than 10 mm Hg associated with new organ dysfunction should be considered ACS in children until proven otherwise. Monitor IAP trends and be aware that specific interventions may need to be instituted at lower IAP than the current ACS definitions accommodate. Finally, IAH and ACS can occur both in abdominal trauma and extra-abdominal trauma patients. Early mechanical hemorrhage control and the avoidance of excessive fluid resuscitation are key elements in preventing IAH in trauma patients. IAH and ACS have been associated with many conditions beyond the general ICU patient. In adults and in children, the focus should be on the early recognition of IAH and the prevention of ACS. Patients at risk for IAH should be identified early during their treatment (with a low threshold to initiate IAP monitoring). Appropriate actions should be taken when IAP increases

  6. A rare consequence of blunt abdominal trauma: bilateral renal infarction.

    PubMed

    Saritas, Ayhan; Kandis, Hayati; Gunes, Harun; Kayikci, Ali; Baltaci, Davut; Buyukkaya, Ramazan; Ozaydinli, Ismet

    2014-05-01

    A 28-year-old man was admitted to the emergency department with lumbar pain owing to a motorbike accident. On clinical examination, abdominal tenderness, pelvic and left cruris pains were present. Erythrocytes, leucocytes and protein was found to be positive in urine analysis. Abdominal computed tomography with intravenous contrast solution showed contrast enhancement in 80% of right kidney, and 30% of left kidney; some intra-abdominal free fluid was also seen. Conservative management was planned for bilateral renal infarction. Urine output was 1.1 L per day. He was discharged on the seventh day of the hospital stay. The patient had not got any problems on the sixth month follow-up. Urine output is a very important parameter for multiple trauma patients. Any decrease in urine output may not be seen inspite of the presence of bilateral renal damage as in the case of the patient, and this situation does not allow ruling out renal injury completely. Hence, emergency physician should still be careful about the risk of renal injury.

  7. A 10-year restrospective evaluation of ultrasound in pregnant abdominal trauma patients.

    PubMed

    Meisinger, Quinn C; Brown, Michele A; Dehqanzada, Zia A; Doucet, Jay; Coimbra, Raul; Casola, Giovanna

    2016-04-01

    The pregnant abdominal trauma patient presents a unique diagnostic challenge. This study aimed to evaluate the accuracy of abdominal sonography for the detection of clinically important injuries in pregnant abdominal trauma patients. A retrospective review was performed of a trauma center database from 2001 to 2011. Medical records were reviewed to determine initial abdominal imaging test results and clinical course. Sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound for detection of traumatic injury were calculated. Of 19,128 patients with suspected abdominal trauma, 385 (2 %) were pregnant. Of these, 372 (97 %) received ultrasound as the initial abdominal imaging test. All 13 pregnant patients who did not receive ultrasound received abdominal CT. Seven pregnant patients underwent both ultrasound and CT. Seven ultrasound examinations were positive, leading to one therapeutic Cesarean section and one laparotomy. One ultrasound was considered false positive (no injury was seen on subsequent CT). There were 365 negative ultrasound examinations. Of these, 364 were true negative (no abdominal injury subsequently found). One ultrasound was considered false negative (a large fetal subchorionic hemorrhage seen on subsequent dedicated obstetrical ultrasound). Sensitivity and positive predictive value were 85.7 %. Specificity and negative predictive value were 99.7 %. Abdominal sonography is an effective and sufficient imaging examination in pregnant abdominal trauma patients. When performed as part of the initial assessment using an abbreviated trauma protocol with brief modifications for pregnancy, ultrasound minimizes diagnostic delay, obviates radiation risk, and provides high sensitivity for injury in the pregnant population.

  8. Contrast-enhanced ultrasound (CEUS) in blunt abdominal trauma.

    PubMed

    Miele, Vittorio; Piccolo, Claudia Lucia; Galluzzo, Michele; Ianniello, Stefania; Sessa, Barbara; Trinci, Margherita

    2016-01-01

    Baseline ultrasound is essential in the early assessment of patients with a huge haemoperitoneum undergoing an immediate abdominal surgery; nevertheless, even with a highly experienced operator, it is not sufficient to exclude parenchymal injuries. More recently, a new ultrasound technique using second generation contrast agents, named contrast-enhanced ultrasound (CEUS) has been developed. This technique allows all the vascular phase to be performed in real time, increasing ultrasound capability to detect parenchymal injuries, enhancing some qualitative findings, such as lesion extension, margins and its relationship with capsule and vessels. CEUS has been demonstrated to be almost as sensitive as contrast-enhanced CT in the detection of traumatic injuries in patients with low-energy isolated abdominal trauma, with levels of sensitivity and specificity up to 95%. Several studies demonstrated its ability to detect lesions occurring in the liver, spleen, pancreas and kidneys and also to recognize active bleeding as hyperechoic bands appearing as round or oval spots of variable size. Its role seems to be really relevant in paediatric patients, thus avoiding a routine exposure to ionizing radiation. Nevertheless, CEUS is strongly operator dependent, and it has some limitations, such as the cost of contrast media, lack of panoramicity, the difficulty to explore some deep regions and the poor ability to detect injuries to the urinary tract. On the other hand, it is timesaving, and it has several advantages, such as its portability, the safety of contrast agent, the lack to ionizing radiation exposure and therefore its repeatability, which allows follow-up of those traumas managed conservatively, especially in cases of fertile females and paediatric patients. PMID:26607647

  9. Evaluating blunt abdominal trauma with sonography: a cost analysis.

    PubMed

    McKenney, M G; McKenney, K L; Hong, J J; Compton, R; Cohn, S M; Kirton, O C; Shatz, D V; Sleeman, D; Byers, P M; Ginzburg, E; Augenstein, J

    2001-10-01

    Ultrasonography (US) is becoming increasingly utilized in the United States for the evaluation of blunt abdominal trauma (BAT). The objective of this study was to assess the cost impact of utilizing US in the evaluation of patients with BAT in a major trauma center. All patients sustaining BAT during a 6-month period before US was used at our institution (Jan-Jun 1993) were compared to BAT patients from a recent period in which US has been utilized (Jan-Jun 1995). The numbers of US, computed tomography (CT), and diagnostic peritoneal lavage (DPL) were tabulated for each group. Financial cost for each of these procedures as determined by our finance department were as follows: US $96, CT $494, DPL $137. These numbers are representative of actual hospital expenditures exclusive of physician fees as calculated in 1994 U.S. dollars. Cost analysis was performed with t test and chi squared test, and significance was defined as P < 0.05. There were 890 BAT admissions in the 1993 study period and 1033 admissions in the 1995 study period. During the 1993 period, 642 procedures were performed on the 890 patients to evaluate the abdomen: 0 US, 466 CT, and 176 DPL (see table) [table: see text]. This compares to 801 procedures on the 1,033 patients in 1995: 552 US, 228 CT, and 21 DPL. Total cost was $254,316 for the 1993 group and $168,501 for the 1995 group. Extrapolated to a 1-year period, a significant (P < 0.05) cost savings of $171,630 would be realized. Cost per patient evaluated was significantly reduced from $285.75 in 1993 to $163.12 in 1995 (P < 0.05). This represents a 43 per cent reduction in per patient expenditure for evaluating the abdomen. By effectively utilizing ultrasonography in the evaluation of patients with blunt abdominal trauma, a significant cost savings can be realized. This effect results chiefly from an eight-fold reduction in the use of DPL, and a two-fold reduction in the use of CT. PMID:11603547

  10. Retroclival collections associated with abusive head trauma in children.

    PubMed

    Silvera, V Michelle; Danehy, Amy R; Newton, Alice W; Stamoulis, Catherine; Carducci, Chiara; Grant, P Ellen; Wilson, Celeste R; Kleinman, Paul K

    2014-12-01

    Retroclival collections are rare lesions reported almost exclusively in children and strongly associated with trauma. We examine the incidence and imaging characteristics of retroclival collections in young children with abusive head trauma. We conducted a database search to identify children with abusive head trauma ≤ 3 years of age with brain imaging performed between 2007 and 2013. Clinical data and brain images of 65 children were analyzed. Retroclival collections were identified in 21 of 65 (32%) children. Ten (48%) were subdural, 3 (14%) epidural, 2 (10%) both, and 6 (28%) indeterminate. Only 8 of 21 retroclival collections were identifiable on CT and most were low or intermediate in attenuation. Eighteen of 21 retroclival collections were identifiable on MRI: 3 followed cerebral spinal fluid in signal intensity and 15 were bloody/proteinaceous. Additionally, 2 retroclival collections demonstrated a fluid-fluid level and 2 enhanced in the 5 children who received contrast material. Sagittal T1-weighted images, sagittal fluid-sensitive sequences, and axial FLAIR (fluid-attenuated inversion recovery) images showed the retroclival collections best. Retroclival collections were significantly correlated with supratentorial and posterior fossa subdural hematomas and were not statistically correlated with skull fracture or parenchymal brain injury. Retroclival collections, previously considered rare lesions strongly associated with accidental injury, were commonly identified in this cohort of children with abusive head trauma, suggesting that retroclival collections are an important component of the imaging spectrum in abusive head trauma. Retroclival collections were better demonstrated on MRI than CT, were commonly identified in conjunction with intracranial subdural hematomas, and were not significantly correlated with the severity of brain injury or with skull fractures.

  11. Treating women drug abusers: action therapy and trauma assessment.

    PubMed

    Uhler, Ann S; Parker, Olga V

    2002-07-01

    The authors suggest that action therapy, a group of techniques including psychodrama, drama therapy, and role training, warrants research attention to determine whether it is well suited to the special characteristics and needs of women clients. In addition, the authors call on researchers to develop a new standardized tool for counselors to use during initial interviews to determine whether women presenting for drug abuse treatment also have significant issues related to trauma. The authors believe the use of unassisted clinical judgment for trauma assessment in first interviews may drive patients away by probing for painful information that clients are not yet ready to confront or divulge.

  12. Diagnostic accuracy of emergency-performed focused assessment with sonography for trauma (FAST) in blunt abdominal trauma

    PubMed Central

    Ghafouri, Hamed Basir; Zare, Morteza; Bazrafshan, Azam; Modirian, Ehsan; Farahmand, Shervin; Abazarian, Niloofar

    2016-01-01

    Introduction Intra-abdominal hemorrhage due to blunt abdominal trauma is a major cause of trauma-related mortality. Therefore, any action taken for facilitating the diagnosis of intra-abdominal hemorrhage could save the lives of patients more effectively. The aim of this study was to determine the accuracy of focused assessment with sonography for trauma (FAST) performed by emergency physicians. Methods In this cross-sectional study from February 2011 to January 2012 at 7th Tir Hospital in Tehran (Iran), 120 patients with abdominal blunt trauma were chosen and evaluated for abdominal fluid. FAST sonography was performed for all the subjects by emergency residents and radiologists while they were blind to the other tests. Abdominal CTs, which is the gold standard, were done for all of the cases. SPSS 20.0 was used to analyze the results. Results During the study, 120 patients with abdominal blunt trauma were evaluated; the mean age of the patients was 33.0 ± 16.6 and the gender ratio was 3/1 (M/F). The results of FAST sonography by emergency physicians showed free fluid in the abdomen or pelvic spaces in 33 patients (27.5%), but this was not observed by the results of CT scans of six patients; sensitivity and specificity were 93.1 and 93.4%, respectively. As for tests performed by radiology residents, sensitivity was a bit higher (96.5%) with lower specificity (92.3%). Conclusion The results suggested that emergency physicians can use ultrasonography as a safe and reliable method in evaluating blunt abdominal trauma. PMID:27790349

  13. Splenic injury after blunt abdominal trauma during a soccer (football) game.

    PubMed

    Padlipsky, Patricia S; Brindis, Seth; Young, Kelly D

    2014-10-01

    The spleen is the most commonly injured abdominal organ in children who sustain blunt abdominal trauma, and pediatric splenic injury may result from minor mechanisms of injury, including sports participation. We present 2 cases of splenic injury in soccer goalies because of blunt abdominal trauma sustained during game play. Although abdominal organ injuries are uncommon in soccer, emergency medicine and primary care physicians must be aware of the possibility. A high index of suspicion and careful physical examination are key in making the diagnosis.

  14. Frequency, causes and pattern of abdominal trauma: A 4-year descriptive analysis

    PubMed Central

    Arumugam, Suresh; Al-Hassani, Ammar; El-Menyar, Ayman; Abdelrahman, Husham; Parchani, Ashok; Peralta, Ruben; Zarour, Ahmad; Al-Thani, Hassan

    2015-01-01

    Background: The incidence of abdominal trauma is still underreported from the Arab Middle-East. We aimed to evaluate the incidence, causes, clinical presentation, and outcome of the abdominal trauma patients in a newly established trauma center. Materials and Methods: A retrospective analysis was conducted at the only level I trauma center in Qatar for the patients admitted with abdominal trauma (2008-2011). Patients demographics, mechanism of injury, pattern of organ injuries, associated extra-abdominal injuries, Injury Severity Score (ISS), Abbreviated Injury Scale, complications, length of Intensive Care Unit, and hospital stay, and mortality were reviewed. Results: A total of 6888 trauma patients were admitted to the hospital, of which 1036 (15%) had abdominal trauma. The mean age was 30.6 ± 13 years and the majority was males (93%). Road traffic accidents (61%) were the most frequent mechanism of injury followed by fall from height (25%) and fall of heavy object (7%). The mean ISS was 17.9 ± 10. Liver (36%), spleen (32%) and kidney (18%) were most common injured organs. The common associated extra-abdominal injuries included chest (35%), musculoskeletal (32%), and head injury (24%). Wound infection (3.8%), pneumonia (3%), and urinary tract infection (1.4%) were the frequently observed complications. The overall mortality was 8.3% and late mortality was observed in 2.3% cases mainly due to severe head injury and sepsis. The predictors of mortality were head injury, ISS, need for blood transfusion, and serum lactate. Conclusion: Abdominal trauma is a frequent diagnosis in multiple trauma and the presence of extra-abdominal injuries and sepsis has a significant impact on the outcome. PMID:26604524

  15. [Trauma repetition and revictimization following physical and sexual abuse].

    PubMed

    Wöller, W

    2005-02-01

    The tendency of victims of physical or sexual childhood abuse to become revictimized in later life has well been documented empirically. Moreover, there is a high stability of violent and abusive relationships. The aim of this paper was to summarize perspectives from psychodynamic theory, attachment theory, and posttraumatic stress research to explain revictimization phenomena. The term repetition compulsion has little explanatory value without additional theoretical assumptions. Within the psychodynamic framework, an ego-psychological view conceives trauma repetition as an attempt to master traumatic experience, while in the object relations perspective, revictimization is explained by the influence of traumatic introjects. Negative cognitions of being worthless, bad and guilty can endorse the conviction that abuse is justified and reduce the capacity of self-care. Negative learning experiences from traumatic helplessness and powerlessness account for low self-efficacy expectations and prevent the establishment of self-boundaries. Trauma repetition can also be understood as an enactment in the service of affect regulation. Research in the field of attachment theory identified attachment styles predisposing to revictimization. Research dealing with posttraumatic stress disorder emphasizes the importance of traumatic affects recurring in daily life and, consequently, the tendency of abuse victims to actively produce dangerous situations in order to cope with these affects, furthermore, the role of dissociation in missing warning signals of impending traumatization. For therapeutically addressing revictimization, a detailed analysis of underlying phenomena is required. PMID:15685492

  16. [Trauma repetition and revictimization following physical and sexual abuse].

    PubMed

    Wöller, W

    2005-02-01

    The tendency of victims of physical or sexual childhood abuse to become revictimized in later life has well been documented empirically. Moreover, there is a high stability of violent and abusive relationships. The aim of this paper was to summarize perspectives from psychodynamic theory, attachment theory, and posttraumatic stress research to explain revictimization phenomena. The term repetition compulsion has little explanatory value without additional theoretical assumptions. Within the psychodynamic framework, an ego-psychological view conceives trauma repetition as an attempt to master traumatic experience, while in the object relations perspective, revictimization is explained by the influence of traumatic introjects. Negative cognitions of being worthless, bad and guilty can endorse the conviction that abuse is justified and reduce the capacity of self-care. Negative learning experiences from traumatic helplessness and powerlessness account for low self-efficacy expectations and prevent the establishment of self-boundaries. Trauma repetition can also be understood as an enactment in the service of affect regulation. Research in the field of attachment theory identified attachment styles predisposing to revictimization. Research dealing with posttraumatic stress disorder emphasizes the importance of traumatic affects recurring in daily life and, consequently, the tendency of abuse victims to actively produce dangerous situations in order to cope with these affects, furthermore, the role of dissociation in missing warning signals of impending traumatization. For therapeutically addressing revictimization, a detailed analysis of underlying phenomena is required.

  17. Do Trauma Symptoms Mediate the Relationship between Childhood Physical Abuse and Adult Child Abuse Risk?

    ERIC Educational Resources Information Center

    Milner, Joel S.; Thomsen, Cynthia J.; Crouch, Julie L.; Rabenhorst, Mandy M.; Martens, Patricia M.; Dyslin, Christopher W.; Guimond, Jennifer M.; Stander, Valerie A.; Merrill, Lex L.

    2010-01-01

    Objective: Although the intergenerational transmission of family violence has been well documented, the mechanisms responsible for this effect have not been fully determined. The present study examined whether trauma symptoms mediate the relationship between a childhood history of child physical abuse (CPA) and adult CPA risk, and whether any such…

  18. Seat Belt Use and its Effect on Abdominal Trauma: A National Trauma Databank Study.

    PubMed

    Nash, Nick A; Okoye, Obi; Albuz, Ozgur; Vogt, Kelly N; Karamanos, Efstathios; Inaba, Kenji; Demetriades, Demetrios

    2016-02-01

    We sought to use the National Trauma Databank to determine the demographics, injury distribution, associated abdominal injuries, and outcomes of those patients who are restrained versus unrestrained. All victims of motor vehicle collisions (MVCs) were identified from the National Trauma Databank and stratified into subpopulations depending on the use of seat belts. A total of 150,161 MVC victims were included in this study, 72,394 (48%) were belted. Young, male passengers were the least likely to be wearing a seat belt. Restrained victims were less likely to have severe injury as measured by Injury Severity Score and Abbreviated Injury Score. Restrained victims were also less likely to suffer solid organ injuries (9.7% vs 12%, P < 0.001), but more likely to have hollow viscous injuries (1.9% vs 1.3%, P < 0.001). The hospital and intensive care unit length of stay were significantly shorter in belted victims with adjusted mean difference: -1.36 (-1.45, -1.27) and -0.96 (-1.02, -0.90), respectively. Seat belt use was associated with a significantly lower crude mortality than unrestrained victims (1.9% vs 3.3%, P < 0.001), and after adjusting for differences in age, gender, position in vehicle, and deployment of air bags, the protective effect remained (adjusted odds ratio for mortality 0.50, 95% confidence interval 0.47, 0.54). In conclusion, MVC victims wearing seat belts have a significant reduction in the severity of injuries in all body areas, lower mortality, a shorter hospital stay, and decreased length of stay in the intensive care unit. The nature of abdominal injuries, however, was significantly different, with a higher incidence of hollow viscous injury in those wearing seat belts.

  19. Conservative versus operative management in stable patients with penetrating abdominal trauma: the experience of a Canadian level 1 trauma centre

    PubMed Central

    Bennett, Sean; Amath, Aysah; Knight, Heather; Lampron, Jacinthe

    2016-01-01

    Background The goal of conservative management (CM) of penetrating abdominal trauma is to avoid nontherapeutic laparotomies while identifying injuries early. Factors that may predict CM failure are not well established, and the experience of CM has not been well described in the Canadian context. Methods We searched a Canadian level 1 trauma centre database for all penetrating abdominal traumas treated between 2004 and 2014. Hemodynamically stable patients without peritonitis and without clear indications for immediate surgery were considered potential candidates for CM, and were included in the study. We compared those who were managed with CM with those who underwent immediate operative management (OM). Outcomes included mortality and length of stay (LOS). Further analysis was performed to identify predictors of CM failure. Results A total of 72 patients with penetrating abdominal trauma were classified as potential candidates for CM. Ten patients were managed with OM, and 62 with CM, with 9 (14.5%) ultimately failing CM and requiring laparotomy. The OM and CM groups were similar in terms of age, sex, injury severity, mechanism and number of injuries. There were no deaths in either group. The LOS in the intensive care (ICU)/trauma unit was 4.8 ± 3.2 days in the OM group and 2.9 ± 2.6 days in the CM group (p = 0.039). The only predictor for CM failure was intra-abdominal fluid on computed tomography (CT) scan (odds ratio 5.3, 95% confidence interval 1.01–28.19). Conclusion In select patients with penetrating abdominal trauma, CM is safe and results in a reduced LOS in the ICU/trauma unit of 1.9 days. Fluid on CT scan is a predictor for failure. PMID:27668329

  20. Systematic review of blunt abdominal trauma as a cause of acute appendicitis

    PubMed Central

    Toumi, Zaher; Chan, Anthony; Hadfield, Matthew B; Hulton, Neil R

    2010-01-01

    INTRODUCTION Acute appendicitis commonly presents as an acute abdomen. Cases of acute appendicitis caused by blunt abdominal trauma are rare. We present a systematic review of appendicitis following blunt abdominal trauma. The aim of this review was to collate and report the clinical presentations and experience of such cases. SUBJECTS AND METHODS A literature review was performed using PubMed, Embase and Medline and the keywords ‘appendicitis’, ‘abdominal’ and ‘trauma’. RESULTS The initial search returned 381 papers, of which 17 articles were included. We found 28 cases of acute appendicitis secondary to blunt abdominal trauma reported in the literature between 1991 and 2009. Mechanisms of injury included road-traffic accidents, falls, assaults and accidents. Presenting symptoms invariably included abdominal pain, but also nausea, vomiting and anorexia. Only 12 patients had computed tomography scans and 10 patients had ultrasonography. All reported treatment was surgical and positive for appendicitis. CONCLUSIONS Although rare, the diagnosis of acute appendicitis must be considered following direct abdominal trauma especially if the patient complains of abdominal right lower quadrant pain, nausea and anorexia. Haemodynamically stable patients who present shortly after blunt abdominal trauma with right lower quadrant pain and tenderness should undergo urgent imaging with a plan to proceed to appendicectomy if the imaging suggested an inflammatory process within the right iliac fossa. PMID:20513274

  1. Air reduction of intussusception after abdominal blunt trauma and a literature review

    PubMed Central

    Kwon, So Ra; Ha, Sang Ook; Oh, Young Taeck; Sohn, You Dong

    2016-01-01

    The typical presentation of intussusception includes intermittent severe abdominal pain, vomiting, rectal bleeding, and the presence of an abdominal mass. We present a case of intussusception after abdominal blunt trauma along with a literature review. A 4-year-old girl was admitted to the emergency department after a bicycle accident. She complained of progressively worsening abdominal pain, but there was no vomiting, fever, bloody stool, or abdominal mass. She was finally diagnosed with traumatic intussusception by ultrasonography and treated with air reduction. Because the typical symptoms are unusual in traumatic intussusception, close attention must be paid to avoid a delayed diagnosis. PMID:27752618

  2. The Anesthesiologist's Role in Treating Abusive Head Trauma.

    PubMed

    Lee, Jennifer K; Brady, Ken M; Deutsch, Nina

    2016-06-01

    Abusive head trauma (AHT) is the most common cause of severe traumatic brain injury (TBI) in infants and the leading cause of child abuse-related deaths. For reasons that remain unclear, mortality rates after moderate AHT rival those of severe nonintentional TBI. The vulnerability of the developing brain to injury may be partially responsible for the poor outcomes observed after AHT. AHT is mechanistically more complex than nonintentional TBI. The acute-on-chronic nature of the trauma along with synergistic injury mechanisms that include rapid rotation of the brain, diffuse axonal injury, blunt force trauma, and hypoxia-ischemia make AHT challenging to treat. The anesthesiologist must understand the complex injury mechanisms inherent to AHT, as well as the pediatric TBI treatment guidelines, to decrease the risk of persistent neurologic disability and death. In this review, we discuss the epidemiology of AHT, differences between AHT and nonintentional TBI, the severe pediatric TBI treatment guidelines in the context of AHT, anesthetic considerations, and ethical and legal reporting requirements. PMID:27195639

  3. The Role of Prothrombotic Factors in the Ocular Manifestations of Abusive and Non-Abusive Head Trauma: A Feasibility Study

    ERIC Educational Resources Information Center

    Yu, Anna; Stephens, Derek; Feldman, Brian M.; Parkin, Patricia C.; Kahr, Walter H. A.; Brandao, Leonardo R.; Shouldice, Michelle; Levin, Alex V.

    2012-01-01

    Objectives: Retinal hemorrhage is a cardinal manifestation of abusive head injury. Thrombophilia is relatively common in the general population and in adults can be associated with retinal hemorrhage. The specificity of retinal hemorrhage for abusive head trauma in the presence of prothrombotic factors, in particular following non-abusive head…

  4. Specific Radiological Findings of Traumatic Gastrointestinal Tract Injuries in Patients With Blunt Chest and Abdominal Trauma.

    PubMed

    Kokabi, Nima; Harmouche, Elie; Xing, Minzhi; Shuaib, Waqas; Mittal, Pardeep K; Wilson, Kenneth; Johnson, Jamlik-Omari; Nicolaou, Savvas; Khosa, Faisal

    2015-05-01

    Gastrointestinal hollow viscus injury after blunt chest and abdominal trauma is uncommon and complicates 0.6%-1.2% of all cases of trauma. Early recognition of such injuries significantly decreases morbidity and mortality. Since physical examination is not accurate in detecting such injuries, contrast-enhanced computed tomography has been the mainstay for diagnosis in many emergency departments. This pictorial essay aims to review the incidence, mechanisms, and signs of gastrointestinal hollow viscus injuries in the setting of blunt chest and abdominal trauma.

  5. False-positive focused abdominal sonography in trauma in a hypotensive child: case report.

    PubMed

    Imamedjian, Isabelle; Baird, Robert; Dubrovsky, Alexander Sasha

    2015-06-01

    We report a case of a false-positive focused abdominal sonography in trauma (FAST) examination in a persistently hypotensive pediatric trauma patient, performed 12 hours after the trauma, suspected to be caused by massive fluid resuscitation leading to ascites. While a positive FAST in a hypotensive trauma patient usually indicates hemoperitoneum, this case illustrates that the timing of the FAST examination relative to the injury, as well as clinical evolution including the volume of fluid resuscitation, need to be considered when interpreting the results of serial and/or late FAST examinations. PMID:26035503

  6. Abusive Head Trauma in Young Children: Characteristics and Medical Charges in a Hospitalized Population

    ERIC Educational Resources Information Center

    Ettaro, L.; Berger, R. P.; Songer, T.

    2004-01-01

    Objective: To describe the presenting characteristics, hospital course, and hospital charges associated with hospital admissions for head trauma in young children at a regional pediatric trauma center, and to examine whether these factors differ among abused and non-abused subjects. Method: Comparative case series study involving a retrospective…

  7. Primary Prevention of Pediatric Abusive Head Trauma: A Cost Audit and Cost-Utility Analysis

    ERIC Educational Resources Information Center

    Friedman, Joshua; Reed, Peter; Sharplin, Peter; Kelly, Patrick

    2012-01-01

    Objectives: To obtain comprehensive, reliable data on the direct cost of pediatric abusive head trauma in New Zealand, and to use this data to evaluate the possible cost-benefit of a national primary prevention program. Methods: A 5 year cohort of infants with abusive head trauma admitted to hospital in Auckland, New Zealand was reviewed. We…

  8. The eye in child abuse: key points on retinal hemorrhages and abusive head trauma.

    PubMed

    Binenbaum, Gil; Forbes, Brian J

    2014-12-01

    This review presents an up-to-date overview of ocular injuries resulting from child abuse, with a spotlight on abusive head trauma. Retinal hemorrhage is a principle finding of inflicted head trauma. The specific pattern of hemorrhages holds valuable diagnostic information, which can help to guide multidisciplinary assessments of the likelihood of abuse. Indirect ophthalmoscopy through dilated pupils by an ophthalmologist is necessary for adequate examination and documentation of retinal findings. Initial pediatrician evaluation of the eye and indications for ophthalmological consultation are reviewed. Focus is then placed upon understanding retinal hemorrhage patterns, their diagnostic significance and likely pathophysiological mechanisms. The differential diagnosis of retinal hemorrhage in young children is discussed, highlighting key distinctions among retinal hemorrhage patterns, severity and frequencies, as well as other ocular findings. The most common cause of retinal hemorrhage in an infant is trauma, and most other causes can be identified by considering the hemorrhage pattern, ocular or systemic signs and the results of laboratory and imaging tests, when indicated. PMID:25501729

  9. Pericardio-diaphragmatic rupture following blunt abdominal trauma: Case report and review of literature

    PubMed Central

    Abou Hussein, Bassem; Khammas, Ali; Kaiyasah, Hadiel; Swaleh, Abeer; Al Rifai, Nazim; Al-Mazrouei, Alya; Badri, Faisal

    2015-01-01

    Introduction Traumatic diaphragmatic rupture (TDR) occurs in 0–5% of patients with major blunt thoraco-abdominal trauma, in most of them on the left side, and an early correct diagnosis is made in less than half of the cases (Meyers and McCabe, 1993; Ball et al., 1982). Presentation of the case We report a case of a forty-eight years old man who had a pericardio-diaphragmatic rupture after a high-velocity blunt abdominal trauma that was diagnosed and treated successfully. Discussion Pericardio-diaphragmatic rupture (PDR) is an uncommon problem that poses a diagnostic challenge to surgeons. The incidence of PDR is between 0.2% and 3.3% of cases with TDR (Sharma, 1999 [3]). Conclusion PDR should be suspected in any patient with high velocity thoraco-abdominal trauma. Early diagnosis is essential and needs a high index of suspicion. Early Management is important in decreasing morbidity and mortality. PMID:26773877

  10. AAST grade III pancreatic injury following blunt abdominal trauma.

    PubMed

    Laing, G L; Jeetoo, S D; Oosthuizen, G; Clarke, D

    2012-08-01

    Isolated pancreatic trauma with major pancreatic duct disruption is a rare finding; it can present with equivocal clinical signs. Serum amylase levels and diagnostic contrast-enhanced computed tomography can facilitate the diagnostic process.

  11. Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings

    PubMed Central

    Behboodi, Firooz; Mohtasham-Amiri, Zahra; Masjedi, Navid; Shojaie, Reza; Sadri, Peyman

    2016-01-01

    Introduction: Focused assessment with sonography for trauma (FAST) is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. Methods: The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT) scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. Results: 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male). FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9%) cases. Finally, 12 (6.6%) patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006). Higher grading of spleen (p = 0.001) and hepatic (p = 0.038) ruptures increased the probability of need for laparotomy. Conclusion: 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy. PMID:27299142

  12. Long-term outcome of abusive head trauma.

    PubMed

    Chevignard, Mathilde P; Lind, Katia

    2014-12-01

    Abusive head trauma is a severe inflicted traumatic brain injury, occurring under the age of 2 years, defined by an acute brain injury (mostly subdural or subarachnoidal haemorrhage), where no history or no compatible history with the clinical presentation is given. The mortality rate is estimated at 20-25% and outcome is extremely poor. High rates of impairments are reported in a number of domains, such as delayed psychomotor development; motor deficits (spastic hemiplegia or quadriplegia in 15-64%); epilepsy, often intractable (11-32%); microcephaly with corticosubcortical atrophy (61-100%); visual impairment (18-48%); language disorders (37-64%), and cognitive, behavioral and sleep disorders, including intellectual deficits, agitation, aggression, tantrums, attention deficits, memory, inhibition or initiation deficits (23-59%). Those combined deficits have obvious consequences on academic achievement, with high rates of special education in the long term. Factors associated with worse outcome include demographic factors (lower parental socioeconomic status), initial severe presentation (e.g., presence of a coma, seizures, extent of retinal hemorrhages, presence of an associated cranial fracture, extent of brain lesions, cerebral oedema and atrophy). Given the high risk of severe outcome, long-term comprehensive follow-up should be systematically performed to monitor development, detect any problem and implement timely adequate rehabilitation interventions, special education and/or support when necessary. Interventions should focus on children as well as families, providing help in dealing with the child's impairment and support with psychosocial issues. Unfortunately, follow-up of children with abusive head trauma has repeatedly been reported to be challenging, with very high attrition rates. PMID:25501726

  13. Head kinematics during shaking associated with abusive head trauma.

    PubMed

    Lintern, T O; Puhulwelle Gamage, N T; Bloomfield, F H; Kelly, P; Finch, M C; Taberner, A J; Nash, M P; Nielsen, P M F

    2015-09-18

    Abusive head trauma (AHT) is a potentially fatal result of child abuse but the mechanisms of injury are controversial. To address the hypothesis that shaking alone is sufficient to elicit the injuries observed, effective computational and experimental models are necessary. This paper investigates the use of a coupled rigid-body computational modelling framework to reproduce in vivo shaking kinematics in AHT. A sagittal plane OpenSim computational model of a lamb was developed and used to interpret biomechanical data from in vivo shaking experiments. The acceleration of the head during shaking was used to provide in vivo validation of the associated computational model. Results of this study demonstrated that peak accelerations occurred when the head impacted the torso and produced acceleration magnitudes exceeding 200ms(-)(2). The computational model demonstrated good agreement with the experimental measurements and was shown to be able to reproduce the high accelerations that occur during impact. The biomechanical results obtained with the computational model demonstrate the utility of using a coupled rigid-body modelling framework to describe infant head kinematics in AHT.

  14. Abdominal aortic rupture from an impaling osteophyte following blunt trauma.

    PubMed

    Vernon, Seth A; Murphy, William R C; Murphy, Todd W; Haan, James M

    2014-04-01

    Blunt injury of the abdominal aorta is highly fatal. We present an unusual case of an osteophyte impaling the abdominal aorta treated by endovascular repair. A 77-year-old man sustained a thoracolumbar fracture-dislocation with posterior aortic rupture between his celiac and superior mesenteric artery origins. His aortic injury was treated with a stent graft, excluding the celiac origin. He was dismissed on postoperative day 6. At 6 months, he had returned to most preinjury activities, and at 2-year follow-up, he continues to have good functional outcome. Endovascular repair may be successfully employed in select aortic injuries in hemodynamically stable patients.

  15. [Surgical accesses to retroperitoneal organs and anatomic structures in case of abdominal trauma].

    PubMed

    Smoliar, A N; Abakumov, M M

    2015-01-01

    It is presented the detailed description with illustrations of 3 surgical accesses which are used by authors to dissect retroperitoneal organs and anatomic structures in victims with closed trauma and abdominal injury. We reported clinical observations of successful use of developed accesses.

  16. Ischemic jejunal stenosis and blind loop syndrome after blunt abdominal trauma.

    PubMed

    Isaacs, P; Rendall, M; Hoskins, E O; Missen, G A; Sladen, G E

    1987-02-01

    One month after suffering blunt abdominal trauma a patient developed severe steatorrhea and profound weight loss in association with an ischemic distal jejunal stricture and blind loop syndrome. Evidence for a partial mesenteric tear was found at resection of the stricture, which resulted in complete cure.

  17. Ureteral rupture after blunt abdominal trauma in a child with unknown horseshoe kidney.

    PubMed

    Mariotto, Arianna; Zampieri, Nicola; Cecchetto, Mariangela; Camoglio, Francesco Saverio

    2015-01-01

    More than 90% of renal injuries in children result from blunt abdominal trauma. A 10-year-old female had a blunt abdominal trauma with macro-hematuria. The computed tomography scan revealed the presence of a horseshoe kidney and a 3rd grade renal lesion and contrast leakage from the right ureter. The ureteral rupture was confirmed by cystoscopy and ascendant pyelography and than a double J-stent was implanted. The stent was removed one month later. Non-surgical management has become the standard of care for both ureteral and renal lesions in children. Non-surgical treatment is a safe procedure for renal trauma with ureteral rupture in children. PMID:26429120

  18. Clinical predictors of injuries not identified by focused abdominal sonogram for trauma (FAST) examinations.

    PubMed

    Hoffman, Lance; Pierce, Daniel; Puumala, Susan

    2009-04-01

    This study's objective was to identify clinical characteristics of patients with a blunt traumatic injury that increased the risk of peritoneal or pericardial fluid collections and abdominal organ injuries not identified by a bedside focused abdominal sonogram for trauma (FAST) examination. This observational study used a retrospective chart review of a cohort of patients identified through a query of the University of Nebraska Medical Center's trauma registry, a tertiary referral center for portions of Nebraska, Iowa, and Missouri. Adult patients presenting to the Emergency Department (ED) for an evaluation of blunt traumatic injury from September 1996 to December 2002 were eligible if their ED course included admission to the trauma service after completion of a bedside FAST examination (US) and a confirmatory study (Conf) such as an abdominopelvic computed tomography scan or exploratory laparotomy within 12 h of completion of the ED FAST examination. The medical records of those patients with a US+/Conf+ or US-/Conf+ examination were reviewed. Clinical characteristics were recorded on a standard data collection form. Statistically significant predictors of a US-/Conf+ examination were found using a stepwise logistic regression procedure. A query of the trauma registry for the study period revealed 1453 adult individuals with blunt abdominal trauma, with 458 patients meeting the inclusion criteria. The clinical characteristics of the 79 US+/Conf+ examinations were compared to those of the 53 US-/Conf+ examinations. The presence of a radiographically proven pelvic fracture (odds ratio 3.459; 95% confidence interval of 1.308-9.157) and a radiographically or operatively proven renal injury (odds ratio 3.667; 95% confidence interval of 1.013-13.275) were found to be significant predictors. The presence of a pelvic fracture or renal injury in adult victims of blunt abdominal trauma increases the likelihood of a US-/Conf+ examination. Patients with a negative FAST

  19. The efficacy of serial physical examination in penetrating abdominal trauma.

    PubMed

    van Haarst, E P; van Bezooijen, B P; Coene, P P; Luitse, J S

    1999-11-01

    Over a 10-year period we reviewed the records of 370 consecutive patients with potentially penetrating abdominal wounds (48 gunshot and 322 stab wounds). Selective non-operative management for abdominal stab wounds was introduced, guided by serial physical examination. In our study the terms therapeutic and non-therapeutic laparotomies were used, the latter comprising negative as well as insignificant findings. Initially diagnostic peritoneal lavage and local wound exploration were used, but these methods were later abandoned. Mortality was 10.2% and morbidity 25% in the group of gunshot wounds and 1.2% and 8.6% in the group of stab wounds. During this period the rate of laparotomies for stab wounds decreased from 55% to 30%, while the rate of non-therapeutic laparotomies decreased from 24% to 0% in the last year. Delayed laparotomy did not cause death or increase morbidity. Our results support the concept of selective non-operative management of abdominal stab wounds using repeated physical examination. Peritoneal perforation and haemoperitoneum should not be an indication for routine laparotomy.

  20. The development of a sexual abuse severity score: characteristics of childhood sexual abuse associated with trauma symptomatology, somatization, and alcohol abuse.

    PubMed

    Zink, Therese; Klesges, Lisa; Stevens, Susanna; Decker, Paul

    2009-03-01

    Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with self-reported trauma, somatization, and alcohol use. Characteristics included age of first sexual abuse, more than one perpetrator, degree of coercion, severity of abuse (i.e., attempted intercourse is more severe than fondling), and the number of occurrences. This is one of the few reports to develop a risk summary that quantifies the severity of CSA.

  1. Use of abdominal computed tomography in blunt trauma: Do we scan too much?

    PubMed Central

    Garber, Bryan G.; Bigelow, Eric; Yelle, Jean-Denis; Pagliarello, Guiseppe

    2000-01-01

    Objectives To determine what proportion of abdominal computed tomography (CT) scans ordered after blunt trauma are positive and the applicability and accuracy of existing clinical prediction rules for obtaining a CT scan of the abdomen in this setting. Setting A leading trauma hospital, affiliated with the University of Ottawa. Design A retrospective cohort study. Patients and methods All patients with blunt trauma admitted to hospital over a 1-year period having an Injury Severity Score (ISS) greater than 12 who underwent CT of the abdomen during the initial assessment. Recorded data included age, sex, Glasgow Coma Scale (GCS) score, ISS, type of injuries, number of abdominal CT scans ordered, and scan results. Two clinical prediction rules were found in the literature that identify patients likely to have intra-abdominal injuries. These rules were applied retrospectively to the cohort. The predicted proportion of positive CT scans was compared with the observed proportion, and the sensitivity, specificity, and accuracy were estimated. Results Of the 297 patients entered in the study, 109 underwent abdominal CT. The median age was 32 years, 71% were male and the median ISS was 24. In only 36.7% (40 of 109) of scans were findings suggestive of intra-abdominal injuries. Application of one of the clinical prediction rules gave a sensitivity of 93.8% and specificity of 25.5% but excluded 23% of patients because of a GCS score less than 11. The second prediction rule tested could be applied to all patients and was highly sensitive (92.5%) and specific (100.0%). Conclusions The assessment of the abdomen in blunt trauma remains a challenge. Accuracy in predicting positive scans in equivocal cases is poor. Retrospective application of an existing clinical prediction rule was found to be highly accurate in identifying patients with positive CT findings. Prospective use of such a rule could reduce the number of CT scans ordered without missing significant injuries. PMID

  2. Abusive head trauma in Spanish language medical literature.

    PubMed

    Cooper, M Townsend; Szyld, Edgardo; Darden, Paul M

    2016-08-01

    Anecdotal experiences raise concerns that abusive head trauma (AHT) is significantly underdiagnosed and perhaps poorly recognized in Latin American settings. With increasing interest in international collaboration in pediatrics, differences in perspectives regarding complex diagnoses should be explored to facilitate a productive exchange of knowledge and ideas. The purpose of this study was to describe the medical literature pertaining to AHT available to physicians who read only in Spanish. In this review, LILACS, SciELO (major Spanish language databases) and Pubmed were searched with appropriate terms and filters in English, Spanish, and Portuguese for Spanish language articles on AHT. Identified articles' reference lists were then examined for possible additional articles on AHT. All relevant articles were sorted by country and examined for article type and content. Thirty-four unique articles were located for review from 8 of 21 countries. Most of the articles identified were case reports, case series, or educational, and there were no studies regarding overall incidence or prevalence of AHT. Some scientific information contained in the articles varied considerably from that in the English language literature in the areas of etiology and preventive strategies. This survey highlights that the Spanish language literature regarding AHT is sparse and variable. This must be considered when working collaboratively in a global setting. Additionally, identification of this gap presents an opportunity for education and information exchange among global medical communities. PMID:27434224

  3. Abusive head trauma in Spanish language medical literature.

    PubMed

    Cooper, M Townsend; Szyld, Edgardo; Darden, Paul M

    2016-08-01

    Anecdotal experiences raise concerns that abusive head trauma (AHT) is significantly underdiagnosed and perhaps poorly recognized in Latin American settings. With increasing interest in international collaboration in pediatrics, differences in perspectives regarding complex diagnoses should be explored to facilitate a productive exchange of knowledge and ideas. The purpose of this study was to describe the medical literature pertaining to AHT available to physicians who read only in Spanish. In this review, LILACS, SciELO (major Spanish language databases) and Pubmed were searched with appropriate terms and filters in English, Spanish, and Portuguese for Spanish language articles on AHT. Identified articles' reference lists were then examined for possible additional articles on AHT. All relevant articles were sorted by country and examined for article type and content. Thirty-four unique articles were located for review from 8 of 21 countries. Most of the articles identified were case reports, case series, or educational, and there were no studies regarding overall incidence or prevalence of AHT. Some scientific information contained in the articles varied considerably from that in the English language literature in the areas of etiology and preventive strategies. This survey highlights that the Spanish language literature regarding AHT is sparse and variable. This must be considered when working collaboratively in a global setting. Additionally, identification of this gap presents an opportunity for education and information exchange among global medical communities.

  4. Childhood Sexual Abuse, Attachment, and Trauma Symptoms in College Females: The Moderating Role of Attachment

    ERIC Educational Resources Information Center

    Aspelmeier, Jeffery E.; Elliott, Ann N.; Smith, Christopher H.

    2007-01-01

    Objective: The present study tests a model linking attachment, childhood sexual abuse (CSA), and adult psychological functioning. It expands on previous work by assessing the degree to which attachment security moderates the relationship between a history of child sexual abuse and trauma-related symptoms in college females. Method: Self-reports of…

  5. Vicarious Trauma: A Comparison of Clinicians Who Treat Survivors of Sexual Abuse and Sexual Offenders

    ERIC Educational Resources Information Center

    Way, Ineke; VanDeusen, Karen M.; Martin, Gail; Applegate, Brooks; Jandle, Deborah

    2004-01-01

    This study compared vicarious trauma in a random sample of male and female clinicians who treat survivors (n=95) and those who treat offenders (n=252). A national survey was conducted with members of the Association for the Treatment of Sexual Abusers (ATSA) and the American Professional Society on the Abuse of Children (APSAC). These data were…

  6. Rebooting the Brain: Using Early Childhood Education to Heal Trauma from Abuse and Neglect

    ERIC Educational Resources Information Center

    McLintock, Ben

    2011-01-01

    Abused and neglected children live in a world that usually includes some sort of violence, chaos, and tremendous physical and mental stress. This toxic environment wreaks havoc on a child's developing brain. This article discusses how to use early childhood education to heal trauma from abuse and neglect. It shares the story of two children, Bryce…

  7. Isolated hepatic artery injury in blunt abdominal trauma presenting as upper gastrointestinal bleeding: treatment with transcatheter embolisation.

    PubMed

    Taslakian, Bedros; Ghaith, Ola; Al-Kutoubi, Aghiad

    2012-11-15

    Liver injury in blunt abdominal trauma is common. However, not often does blunt trauma cause injury to the anatomical structures of the porta hepatis. Isolated injury of the hepatic artery has been rarely reported in the literature. Such injury may be lethal and requires immediate diagnosis and management. This report describes an unusual case of blunt abdominal trauma resulting in hepatic and gastroduodenal artery dissection, with pseudoaneurysm formation complicated by active upper gastrointestinal bleeding. The injury was managed by transcatheter embolisation. Awareness of this diagnosis should facilitate management of similar trauma cases.

  8. Isolated hepatic artery injury in blunt abdominal trauma presenting as upper gastrointestinal bleeding: treatment with transcatheter embolisation

    PubMed Central

    Taslakian, Bedros; Ghaith, Ola; Al-Kutoubi, Aghiad

    2012-01-01

    Liver injury in blunt abdominal trauma is common. However, not often does blunt trauma cause injury to the anatomical structures of the porta hepatis. Isolated injury of the hepatic artery has been rarely reported in the literature. Such injury may be lethal and requires immediate diagnosis and management. This report describes an unusual case of blunt abdominal trauma resulting in hepatic and gastroduodenal artery dissection, with pseudoaneurysm formation complicated by active upper gastrointestinal bleeding. The injury was managed by transcatheter embolisation. Awareness of this diagnosis should facilitate management of similar trauma cases. PMID:23162032

  9. Acute Subdural Hematoma in Infants with Abusive Head Trauma: A Literature Review.

    PubMed

    Karibe, Hiroshi; Kameyama, Motonobu; Hayashi, Toshiaki; Narisawa, Ayumi; Tominaga, Teiji

    2016-05-15

    The number of cases with child abuse is increasing in Japan, and abusive head trauma (AHT) is a major cause of death in abused children. Child abuse has been recognized by the late 19th century, and widely accepted as battered child syndrome in the middle of the 20th century. As terms, there had been considerable mechanistic controversies between shaken-baby and -impact syndrome until the beginning of the 21st century. In recent years, AHT has been utilized as a less mechanistic term. Most of the characteristics of AHT in Japan have been similar to those in the United States as follows: infant is the most common victim, acute subdural hematoma (SDH) is the most common intracranial lesion, and retinal hemorrhage is often complicated. On the other hand, several characteristics have been different as follows: mother is the most common perpetrators, impact is a more common mechanism of trauma than shaking, and external trauma is more common reflecting the existence of impact. Since AHT as well as child abuse is a social pathological phenomenon influenced by victims, perpetrators, socioeconomic circumstances, and so on, various aspects of AHT as well as child abuse can be changed with times. Actually, a recent paper suggests such changes in infants with acute SDH due to AHT. In this review article, AHT, abusive infantile acute SDH in particular, are reviewed from the aspect of neurosurgical perspectives, including its mechanisms of trauma, biomechanics, clinical features, management, and prognosis, to update the trend in Japan. PMID:26960448

  10. Acute Subdural Hematoma in Infants with Abusive Head Trauma: A Literature Review

    PubMed Central

    KARIBE, Hiroshi; KAMEYAMA, Motonobu; HAYASHI, Toshiaki; NARISAWA, Ayumi; TOMINAGA, Teiji

    2016-01-01

    The number of cases with child abuse is increasing in Japan, and abusive head trauma (AHT) is a major cause of death in abused children. Child abuse has been recognized by the late 19th century, and widely accepted as battered child syndrome in the middle of the 20th century. As terms, there had been considerable mechanistic controversies between shaken-baby and -impact syndrome until the beginning of the 21st century. In recent years, AHT has been utilized as a less mechanistic term. Most of the characteristics of AHT in Japan have been similar to those in the United States as follows: infant is the most common victim, acute subdural hematoma (SDH) is the most common intracranial lesion, and retinal hemorrhage is often complicated. On the other hand, several characteristics have been different as follows: mother is the most common perpetrators, impact is a more common mechanism of trauma than shaking, and external trauma is more common reflecting the existence of impact. Since AHT as well as child abuse is a social pathological phenomenon influenced by victims, perpetrators, socioeconomic circumstances, and so on, various aspects of AHT as well as child abuse can be changed with times. Actually, a recent paper suggests such changes in infants with acute SDH due to AHT. In this review article, AHT, abusive infantile acute SDH in particular, are reviewed from the aspect of neurosurgical perspectives, including its mechanisms of trauma, biomechanics, clinical features, management, and prognosis, to update the trend in Japan. PMID:26960448

  11. Barriers Against Implementing Blunt Abdominal Trauma Guidelines in a Hospital: A Qualitative Study

    PubMed Central

    Zaboli, Rouhollah; Tofighi, Shahram; Aghighi, Ali; Shokouh, Seyyed Javad Hosaini; Naraghi, Nader; Goodarzi, Hassan

    2016-01-01

    Introduction Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital. Methods This study was conducted as a qualitative and phenomenology study in the Family Hospital in Tehran (Iran) in 2015. The research population included eight experts and key people in the area of blunt abdominal trauma clinical practice guidelines. Sampling was based on purposive and nonrandom methods. A semistructured interview was done for the data collection. A framework method was applied for the data analysis by using Atlas.ti software. Results After framework analyzing and various reviewing and deleting and combining the codes from 251 codes obtained, 15 families and five super families were extracted, including technical knowledge barriers, economical barriers, barriers related to deployment and monitoring, political will barriers, and managing barriers. Conclusion Structural reform is needed for eliminating the defects available in the healthcare system. As with most of the codes, subconcepts and concepts are classified into the field of human resources; it seems that the education and knowledge will be more important than other resources such as capital and equipment. PMID:27757191

  12. Trauma and posttraumatic stress disorder symptomatology: patterns among American Indian adolescents in substance abuse treatment.

    PubMed

    Deters, Pamela B; Novins, Douglas K; Fickenscher, Alexandra; Beals, Jan

    2006-07-01

    In this study the authors examined the prevalence and correlates of posttraumatic stress disorder (PTSD) and trauma symptomatology among a sample of 89 American Indian adolescents in a residential substance abuse treatment program. These youths reported an average of 4.1 lifetime traumas, with threat of injury and witnessing injury being most common; molestation, rape, and sexual attack were least common. Approximately 10% of participants met the Diagnostic and Statistical Manual IV Text Revision (DSM-IV-TR) criteria for full PTSD, and about 14% met the criteria for subthreshold PTSD. Molestation (including rape and sexual attack), experiencing 6 or more traumas, and a diagnosis of abuse of or dependence on stimulants were significantly associated with PTSD. Findings indicated that trauma was a pervasive phenomenon among this population, with sexual traumas being particularly stigmatizing, resulting in high rates of posttraumatic symptomatology, specifically PTSD.

  13. Examining the Associations Between Sex Trade Involvement, Rape, and Symptomatology of Sexual Abuse Trauma

    PubMed Central

    Lutnick, Alexandra; Harris, Jennie; Lorvick, Jennifer; Cheng, Helen; Wenger, Lynn D.; Bourgois, Philippe; Kral, Alex H.

    2015-01-01

    The high prevalence of rape and sexual trauma symptomatology among women involved in street-based sex trades is well-established. Because prior research has lacked appropriate, non-sex trade involved comparison groups, it is unknown whether differences exist among similarly situated women who do and do not trade sex. This article explores experiences of childhood and adult rape and symptomatology of sexual abuse trauma among a community-based sample of 322 women who use methamphetamine in San Francisco, California, 61% of whom were involved in the sex trade. Study participants were recruited via respondent-driven sampling and eligible if they were cisgender women, aged 18 or older, current methamphetamine users, and sexually active with at least one cisgender man in the past 6 months. The dependent variable was sexual abuse trauma symptomatology, as measured by the Sexual Abuse Trauma Index (SATI) subscale of the Trauma Symptom Checklist–40 (TSC-40), and the explanatory variable was sex trade involvement. Potential covariates were age, current homelessness, methamphetamine dependence, and experiences of childhood and adult rape. Sixty-one percent of participants had a SATI subscale score suggestive of sexual abuse trauma. The overall prevalence of rape in childhood and adulthood was 52% and 73%, respectively. In bivariate analysis, sex trade involvement and all of the potential covariates except for homelessness and age were associated with a SATI score suggestive of sexual abuse trauma. In multivariate models controlling for significant covariates, there was no longer a statistically significant association between sex trade involvement or childhood rape and an elevated SATI score. Elevated levels of psychological dependence on methamphetamine and experiences of rape as an adult were still associated with a high SATI score. These findings highlight that urban poor women, regardless of sex trade involvement, suffer high levels of rape and related trauma

  14. Examining the associations between sex trade involvement, rape, and symptomatology of sexual abuse trauma.

    PubMed

    Lutnick, Alexandra; Harris, Jennie; Lorvick, Jennifer; Cheng, Helen; Wenger, Lynn D; Bourgois, Philippe; Kral, Alex H

    2015-07-01

    The high prevalence of rape and sexual trauma symptomatology among women involved in street-based sex trades is well-established. Because prior research has lacked appropriate, non-sex trade involved comparison groups, it is unknown whether differences exist among similarly situated women who do and do not trade sex. This article explores experiences of childhood and adult rape and symptomatology of sexual abuse trauma among a community-based sample of 322 women who use methamphetamine in San Francisco, California, 61% of whom were involved in the sex trade. Study participants were recruited via respondent-driven sampling and eligible if they were cisgender women, aged 18 or older, current methamphetamine users, and sexually active with at least one cisgender man in the past 6 months. The dependent variable was sexual abuse trauma symptomatology, as measured by the Sexual Abuse Trauma Index (SATI) subscale of the Trauma Symptom Checklist-40 (TSC-40), and the explanatory variable was sex trade involvement. Potential covariates were age, current homelessness, methamphetamine dependence, and experiences of childhood and adult rape. Sixty-one percent of participants had a SATI subscale score suggestive of sexual abuse trauma. The overall prevalence of rape in childhood and adulthood was 52% and 73%, respectively. In bivariate analysis, sex trade involvement and all of the potential covariates except for homelessness and age were associated with a SATI score suggestive of sexual abuse trauma. In multivariate models controlling for significant covariates, there was no longer a statistically significant association between sex trade involvement or childhood rape and an elevated SATI score. Elevated levels of psychological dependence on methamphetamine and experiences of rape as an adult were still associated with a high SATI score. These findings highlight that urban poor women, regardless of sex trade involvement, suffer high levels of rape and related trauma

  15. Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes

    PubMed Central

    Shaheen, Aisha W.; Crandall, Marie L.; Nicolson, Norman G.; Smith-Singares, Eduardo; Merlotti, Gary J.; Jalundhwala, Yash; Issa, Nabil M.

    2016-01-01

    Context: Abdominal compartment syndrome (ACS) is associated with high morbidity and mortality among trauma patients. Several clinical and laboratory findings have been suggested as markers for ACS, and these may point to different types of ACS and complications. Aims: This study aims to identify the strength of association of clinical and laboratory variables with specific adverse outcomes in trauma patients with ACS. Settings and Design: A 5-year retrospective chart review was conducted at three Level I Trauma Centers in the City of Chicago, IL, USA. Subjects and Methods: A complete set of demographic, pre-, intra- and post-operative variables were collected from 28 patient charts. Statistical Analysis: Pearson's correlation coefficient was used to determine the strength of association between 29 studied variables and eight end outcomes. Results: Thirty-day mortality was associated strongly with the finding of an initial intra-abdominal pressure >20 mmHg and moderately with blunt injury mechanism. A lactic acid >5 mmol/L on admission was moderately associated with increased blood transfusion requirements and with acute renal failure during the hospitalization. Developing ACS within 48 h of admission was moderately associated with increased length of stay in the Intensive Care Unit (ICU), more ventilator days, and longer hospital stay. Initial operative intervention lasting more than 2 h was moderately associated with risk of developing multi-organ failure. Hemoglobin level <10 g/dL on admission, ongoing mechanical ventilation, and ICU stay >7 days were moderately associated with a disposition to long-term support facility. Conclusions: Clinical and lab variables can predict specific adverse outcomes in trauma patients with ACS. These findings may be used to guide patient management, improve resource utilization, and build capacity within trauma centers. PMID:27162436

  16. Childhood betrayal trauma and self-blame appraisals among survivors of intimate partner abuse.

    PubMed

    Babcock, Rebecca L; DePrince, Anne P

    2012-01-01

    Child abuse perpetrated by a close other, such as a parent, is linked to a wide range of detrimental effects, including an increased risk of self-blame. The current study evaluated whether experiences of childhood betrayal trauma were linked to self-blame following victimization in adulthood. A diverse sample of women (n = 230) from an urban city were recruited based on having experienced an incident of intimate partner abuse (IPA) reported to the local police. Women reported on their trauma histories and levels of self-blame for the target IPA incident. Results showed that a history of childhood betrayal trauma exposure predicted the degree of self-blame for the IPA incident. Women who experienced severe IPA during the target incident also indicated higher levels of self-blame. Findings from this study suggest that it may be important to target self-blame appraisals in interventions with adults exposed to abuse in childhood. PMID:22989241

  17. Complications following repair of extrahepatic bile duct injuries after blunt abdominal trauma.

    PubMed

    Rodriguez-Montes, J A; Rojo, E; Martín, L G

    2001-10-01

    Extrahepatic bile duct traumatic injuries are extremely rare and their treatment is difficult and with several controversies. The aim of this study was to offer some more clinical information on their surgical repair and outcome. We present seven patients with extrahepatic biliary tract lesions after blunt abdominal trauma, (isolated gallbladder lesions were excluded) four males and three females from 23 to 51 years of age (mean age 35.1 years). All patients had suffered high-energy blunt abdominal trauma and presented associated injuries, mostly liver trauma and lung contusions. Six gallbladder lesions and six common bile duct injures were identified; a right hepatic duct laceration and a left hepatic duct transection were also present. Injuries were treated either with primary repair or with duct-jejunal anastomoses with Roux-en-Y reconstruction. Principal complications were postoperative anastomotic leakage (1 case) and recurrent cholangitis (3 cases) with or without stricture. Not-diagnosed injuries caused substantial morbidity. We prefer and recommend the use of primary repair in partial ruptures with no significant tissue loss and biliary-enteric anastomoses in large injuries and complete transections because they offer the best long-term drainage with less risk of stricture formation than end-to-end anastomoses. We defend the use of long duration (6 to 9 months) transanastomotic stents. PMID:11596896

  18. Blunt abdominal trauma. A 5-year analysis of 870 patients requiring celiotomy.

    PubMed Central

    Cox, E F

    1984-01-01

    This study represents the experience with blunt trauma to the abdomen of patients from a major regional trauma center. Eight hundred and seventy patients with blunt abdominal trauma are reviewed, representing 12.89% of the total admissions over a 5-year period. The motor vehicle continues to be the major cause (89.5%) of injury to these patients. Thirty per cent had positive blood alcohol. Intra-abdominal injuries in this group necessitating operative intervention were based on the use of peritoneal lavage. Negative celiotomies occurred in 10.2% of these patients. Of the injuries incurred, the spleen was involved 42%, the liver 35.6%, the serosa, diaphragm, bowel, and blood vessels were involved to a lesser extent. Only 0.4% of the patients suffered direct injury to the stomach, duodenum, and pancreas, data which should preclude routine exploration of retroperitoneal structures unless by obvious retroperitoneal injury is noted. Additional surgical intervention for associated injuries was seen in 50.54% of this patient group. PMID:6712323

  19. Effects of Trauma Intervention on HIV Sexual Risk Behaviors among Women with Co-Occurring Disorders in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Larson, Mary Jo; Zhang, Annie; Acevedo, Andrea; Dai, Jianyu; Matsumoto, Atsushi

    2007-01-01

    Women in substance abuse treatment often have co-occurring mental health disorders and a history of trauma; they are also at high risk for HIV infection and other sexually transmitted diseases via unprotected sex. A quasi-experimental study evaluated the effectiveness of trauma-enhanced substance abuse treatment combined with HIV/AIDS prevention…

  20. A Behavioral Perspective of Childhood Trauma and Attachment Issues: Toward Alternative Treatment Approaches for Children with a History of Abuse

    ERIC Educational Resources Information Center

    Prather, Walter; Golden, Jeannie A.

    2009-01-01

    Attachment theory provides a useful conceptual framework for understanding trauma and the treatment of children who have been abused. This article examines childhood trauma and attachment issues from the perspective of behavior analysis, and provides a theoretical basis for two alternative treatment models for previously abused children and their…

  1. Assessing trauma, substance abuse, and mental health in a sample of homeless men.

    PubMed

    Kim, Mimi M; Ford, Julian D; Howard, Daniel L; Bradford, Daniel W

    2010-02-01

    This study examined the impact of physical and sexual trauma on a sample of 239 homeless men. Study participants completed a self-administered survey that collected data on demographics, exposure to psychological trauma, physical health and mental health problems, and substance use or misuse. Binomial logistic regression analyses were used to examine the relative significance of demographic factors and the four types of trauma exposure associated with three outcomes: mental health, substance abuse, and physical health problems. The authors found that trauma history was significantly associated with more mental health problems but was not associated with substance abuse problems for homeless men. This study reinforces service providers' perceptions that because many homeless men experience the long-term, deleterious effects of not only current stressors, but also abuse and victimization that often begin in childhood, homeless men are a subpopulation in need of proactive prevention services that emphasize long-term continuity of care rather than sporadic crisis-based services. Study findings suggest that mentally ill, homeless men need proactive services that address the sequelae of abuse with care that is specialized and distinctly different from care for homeless adults with substance abuse or physical health care issues.

  2. Blunt abdominal trauma in children: epidemiology, management, and management problems in a developing country.

    PubMed

    Ameh, E A; Chirdan, L B; Nmadu, P T

    2000-01-01

    Trauma is the leading cause of death in children in developed countries. In tropical Africa, it is only beginning to assume importance as infections and malnutrition are controlled. In developed countries, the availability of advanced imaging modalities has now reduced the necessity for laparotomy to less than 10% following blunt abdominal trauma (BAT) in children. This report reviews the epidemiology, management, and unnecessary laparotomies for pediatric BAT in a developing country in a retrospective review of 57 children aged 15 years or less at the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria over 12 years. The average age was 9 years and the male-female ratio 3.8:1. Seventy-four percent (74%) of abdominal injuries in children were due to blunt trauma. The commonest causes of injury were road traffic accidents (RTA) (57%), 88% in pedestrians and 59% in children aged 5-9 years. Falls were the cause of trauma in 36%, 60% of them aged 10-15 years. Other causes of injury were sports in 5% and animals in 2%. Diagnosis was clinical, supported by diagnostic peritoneal lavage or paracentesis. Two patients had ultrasonography, and none had computed tomography. Fifty-three patients had a laparotomy, 2 died before surgery, 1 was managed nonoperatively, and in 1 surgery was declined. There were 34 splenic injuries, 20 treated by splenic preservation, splenectomy in 13, and non-operative in 1. Fourteen gastrointestinal injuries were treated in 12 patients. Of 9 hepatic injuries, 4 were minor and were left untreated, 3 were repaired, 1 was packed to arrest hemorrhage, and a lacerated accessory liver was excised. Four injuries to the urinary tract (bladder contusion 2, bladder rupture 1, ruptured hydronephrotic kidney 1) were treated accordingly. There were 4 retroperitoneal hematomas associated with other intra-abdominal injuries and 2 pancreatic contusions. One lacerated gallbladder was treated by cholecystectomy and a ruptured left hemidiaphragm was repaired

  3. Characteristics of Hollow Viscus Injury following Blunt Abdominal Trauma; a Single Centre Experience from Eastern India

    PubMed Central

    Jha, Nawal Kishore; Yadav, Sanjay Kumar; Sharma, Rajshekhar; Sinha, Dipendra Kumar; Kumar, Sandip; Kerketta, Marshal Daud; Sinha, Mini; Anand, Abhinav; Gandhi, Anjana; Ranjan, Satish Kumar; Yadav, Jitin

    2014-01-01

    Objective: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma. Methods: This  was  a  retrospective  cross-ecnal  study  including  patients  with  blunt  abdominal  trauma leading to HVI admitted at Rajendra Institute of Medical Sciences, Ranchi, over a period of 4.5 years (January 2009 to July 2014). Data were retrieved from patients’ medical records. Total 173 patients with HVI due to blunt abdominal trauma, who underwent laparotomy at our institute, were reviewed. Data regarding clinical presentation, anatomical distribution, management and outcome were recorded and analysed. Results: Out of 173 patients 87.1% were men and 12.9% were women. Mean age of patients was 29±14.02 years. The most common site of injury was ileum (46.2%) followed by jejunum (44.5%). There were 5 gastric perforations (2.9%), 2 (1.15%) duodenal, 2 (1.15%) colonic, 2 (1.15%) sigmoidal and 2 (1.15%) rectal injuries. One caecal injury was also recorded. Road traffic accident was the most common mechanism of injury (57.2%) followed by fall from height (36.4%) and assault (6.4%). Free gas under diaphragm on erect abdomen radiography was seen in 85.5% of cases while preoperative CT Abdomen was done in 11.6% of cases. Treatment consisted of simple closure of the perforation (66.5%), resection and anastomosis (11.0%) and stoma (22.5%). Major complication was anastamotic leak which was recorded in 6.4% cases and 15.6% patients developed burst abdomen. Average hospital stay was 13±6 days. Overall mortality rate was 12.7%. Conclusion: Although early recognition of intestinal injuries from blunt abdominal trauma may be difficult in all cases, it is very important due to its tremendous life threatening potential. Age of the patient, anatomical site and time of presentation are probably main prognostic factors. PMID:27162889

  4. Successful Kidney and Lung Transplantation From a Deceased Donor With Blunt Abdominal Trauma and Intestinal Perforation.

    PubMed

    van Smaalen, Tim C; Krikke, Christina; Haveman, Jan Willem; van Heurn, L W Ernest

    2016-01-01

    The number of organ donors is limited by many contraindications for donation and poor quality of potential organ donors. Abdominal infection is a generally accepted contraindication for donation of abdominal organs. We present a 43-year-old man with lethal brain injury, blunt abdominal trauma, and intestinal perforation. After withdrawal of life-sustaining treatment and circulatory arrest, a minilaparotomy confirmed abdominal contamination with intestinal content. After closure of the abdomen, organs were preserved with in situ preservation with an aortic cannula inserted via the femoral artery. Thereafter, the kidneys were procured via bilateral lumbotomy to reduce the risk of direct bacterial contamination; lungs were retrieved following a standard practice. There was no bacterial or fungal growth in the machine preservation fluid of both kidneys. All organs were successfully transplanted, without postoperative infection, and functioned well after 6 months. We hereby show that direct contamination of organs can be avoided with the use of in situ preservation and retroperitoneal procurement. Intestinal perforation is not an absolute contraindication for donation, although the risk of bacterial or fungal transmission has to be evaluated per case. PMID:27500248

  5. Severity of Child Sexual Abuse and Revictimization: The Mediating Role of Coping and Trauma Symptoms

    ERIC Educational Resources Information Center

    Fortier, Michelle A.; DiLillo, David; Messman-Moore, Terri L.; Peugh, James; DeNardi, Kathleen A.; Gaffey, Kathryn J.

    2009-01-01

    Child sexual abuse (CSA) has consistently been associated with the use of avoidant coping; these coping methods have been associated with increased trauma symptoms, which have, in turn, been linked to increased risk for adult sexual revictimization. Given these previous findings, the purpose of the current study was to test a model that…

  6. Does Integrated Trauma-Informed Substance Abuse Treatment Increase Treatment Retention?

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Chernoff, Miriam; Brown, Vivian; Arevalo, Sandra; Gatz, Margaret

    2007-01-01

    This article presents findings from a quasi-experimental, nonrandomized group design study that explored whether trauma-enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment-as-usual. We used a subsample (N = 461) of participants in the Women, Co-Occurring Disorders and…

  7. The Measurement of Psychological Maltreatment: Early Data on the Child Abuse and Trauma Scale.

    ERIC Educational Resources Information Center

    Sanders, Barbara; Becker-Lausen, Evvie

    1995-01-01

    The Child Abuse and Trauma Scale, a self-report measure yielding a quantitative index of the frequency and extent of negative experiences in childhood and adolescence, was administered to 1,198 college students and 17 subjects with Multiple Personality Disorder. Results revealed the scale's strong internal consistency, test-retest reliability, and…

  8. Perpetrator Accounts in Infant Abusive Head Trauma Brought about by a Shaking Event

    ERIC Educational Resources Information Center

    Biron, Dean; Shelton, Doug

    2005-01-01

    Objective: To analyze perpetrator and medical evidence collected during investigations of infant abusive head trauma (IAHT), with a view to (a) identifying cases where injuries were induced by shaking in the absence of any impact and (b) documenting the response of infant victims to a violent shaking event. Method: A retrospective study was…

  9. Jogging the Cogs: Trauma-Focused Art Therapy and Cognitive Behavioral Therapy with Sexually Abused Children

    ERIC Educational Resources Information Center

    Pifalo, Terry

    2007-01-01

    Art therapy in conjunction with cognitive behavioral therapy reduces symptoms and enhances the potential for positive outcomes for sexually abused children in trauma-focused treatment. This article presents a treatment model that utilizes specific art therapy interventions to facilitate treatment, based on research on the effectiveness of combined…

  10. Abusive Head Trauma at a Tertiary Care Children's Hospital in Mexico City. A Preliminary Study

    ERIC Educational Resources Information Center

    Diaz-Olavarrieta, Claudia; Garcia-Pina, Corina A.; Loredo-Abdala, Arturo; Paz, Francisco; Garcia, Sandra G.; Schilmann, Astrid

    2011-01-01

    Objectives: Determine the prevalence, clinical signs and symptoms, and demographic and family characteristics of children attending a tertiary care hospital in Mexico City, Mexico, to illustrate the characteristics of abusive head trauma among this population. Methods: This is a cross-sectional descriptive study of infants and children under 5,…

  11. Trauma Adapted Family Connections: Reducing Developmental and Complex Trauma Symptomatology to Prevent Child Abuse and Neglect

    ERIC Educational Resources Information Center

    Collins, Kathryn S.; Strieder, Frederick H.; DePanfilis, Diane; Tabor, Maureen; Clarkson Freeman, Pamela A.; Linde, Linnea; Greenberg, Patty

    2011-01-01

    Families living in urban poverty, enduring chronic and complex traumatic stress, and having difficulty meeting their children's basic needs have significant child maltreatment risk factors. There is a paucity of family focused, trauma-informed evidence-based interventions aimed to alleviate trauma symptomatology, strengthen family functioning, and…

  12. Subdural hygromas in abusive head trauma: pathogenesis, diagnosis, and forensic implications.

    PubMed

    Wittschieber, D; Karger, B; Niederstadt, T; Pfeiffer, H; Hahnemann, M L

    2015-03-01

    Are subdural hygromas the result of abusive head trauma? CT and MR imaging represent important tools for the diagnosis of abusive head trauma in living infants. In addition, in-depth understanding of the pathogenesis of subdural hygromas is increasingly required by neuroradiologists, pediatricians, and forensic physicians. Therefore, the current knowledge on subdural hygromas is summarized and forensic conclusions are drawn. The most important diagnostic pitfalls, benign enlargement of the subarachnoid space, and chronic subdural hematoma, are discussed in detail. Illustrative cases from forensic practice are presented. Literature analysis indicates that subdural hygromas can occur immediately or be delayed. If other infrequent reasons can be excluded, the presence of subdural hygromas strongly suggests a posttraumatic state and should prompt the physician to search for other signs of abuse. To differentiate subdural hygromas from other pathologies, additional MR imaging of the infant's head is indispensable after initial CT scan. PMID:24948499

  13. The Use of Ophthalmic Ultrasonography to Identify Retinal Injuries Associated With Abusive Head Trauma.

    PubMed

    Riggs, Becky J; Trimboli-Heidler, Carmelina; Spaeder, Michael C; Miller, Marijean M; Dean, Nathan P; Cohen, Joanna S

    2016-05-01

    Abusive head trauma includes any nonaccidental injury inflicted to a child's head and body. It is often characterized by, but not limited to, the repetitive acceleration-deceleration forces with or without blunt head impact. It has a mortality rate of 30%, and 80% of survivors experience permanent neurologic damage. In this case series, we hypothesize that bedside ultrasonography can be useful in the identification of retinal injuries that are consistent with abusive head trauma. Ocular manifestations of abusive head trauma are identified by dilated ophthalmic examination showing retinal hemorrhages that are too numerous to count, multilayered, and extending to the periphery. Traumatic retinoschisis, splitting of the retinal layers with or without blood accumulating in the intervening space, is exclusive for abusive head trauma in infants without a history of significant cerebral crush injury. Direct visualization of intraocular structures is difficult when the eyelids are swollen shut or when dilatation must be delayed. We present a series of 11 patients with brain injuries who underwent ophthalmic point-of-care ultrasonography that revealed traumatic retinoschisis on average 60 hours earlier than direct ophthalmic visualization. Dilated ophthalmic examinations and autopsy reports confirmed retinoschisis and other forms of retinal hemorrhages that were too numerous to count, multilayered, and extending to the periphery in all 11 patients. One patient did not have a dilated ophthalmic examination; however, traumatic retinoschisis and retinal hemorrhages were confirmed on autopsy. Ocular point-of-care ultrasonography is a promising tool to investigate abusive head trauma through the identification of traumatic retinoschisis and retinal hemorrhages when pupillary dilatation and direct ophthalmic examination is delayed.

  14. People who Expect to Enter Psychotherapy are Prone to Believing that They Have Forgotten Memories of Childhood Trauma and Abuse

    PubMed Central

    Rubin, David C.; Boals, Adriel

    2010-01-01

    We asked 1004 undergraduates to estimate both the probability that they would enter therapy and the probability that they experienced but could not remember incidents of potentially life threatening childhood traumas or physical and sexual abuse. We found a linear relation between the expectation of entering therapy and the belief that one had, but cannot now remember, childhood trauma and abuse. Thus, individuals who are prone to seek psychotherapy are also prone to accept a suggested memory of childhood trauma or abuse as fitting their expectations. In multiple regressions predicting the probability of forgotten memories of childhood traumas and abuse, the expectation of entering therapy remained as a substantial predictor when self-report measures of mood, anxiety, posttraumatic stress disorder symptom severity, and trauma exposure were included. PMID:20623421

  15. Partner's Stake in Conformity and Abused Wives' Psychological Trauma

    ERIC Educational Resources Information Center

    DeMaris, Alfred; Kaukinen, Catherine

    2008-01-01

    This study investigates the potential buffering effect of help-seeking in the association between intimate partner assault and women's psychological trauma, and how this, in turn, may depend on the partner's stake in conformity. The sample consists of 374 women reporting the experience of domestic violence from a current intimate partner, drawn…

  16. Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers.

    PubMed

    Barr, Ronald G

    2012-10-16

    Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.

  17. Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

    PubMed Central

    Barr, Ronald G.

    2012-01-01

    Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant’s caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant–caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally. PMID:23045677

  18. Directed forgetting of trauma cues in adults reporting repressed or recovered memories of childhood sexual abuse.

    PubMed

    McNally, R J; Clancy, S A; Schacter, D L

    2001-02-01

    An item-cuing directed forgetting task was used to investigate whether women reporting repressed (n = 13) or recovered (n = 13) memories of childhood sexual abuse (CSA) exhibit an avoidant encoding style (and resultant impaired memory) for trauma cues relative to women reporting no CSA experience (n = 15). All participants viewed intermixed trauma (e.g., molested), positive (e.g., confident), and categorized neutral (e.g., mailbox) words on a computer screen and were instructed either to remember or to forget each word. The results provided no support for the hypothesis that people reporting either repressed or recovered memories of CSA are especially adept at forgetting words related to trauma. These groups recalled words they were instructed to remember more often than words they were instructed to forget regardless of whether they were trauma related.

  19. The historical trauma response among natives and its relationship with substance abuse: a Lakota illustration.

    PubMed

    Brave Heart, Maria Yellow Horse

    2003-01-01

    Historical trauma (HT) is cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma experiences; the historical trauma response (HTR) is the constellation of features in reaction to this trauma. The HTR often includes depression, self-destructive behavior, suicidal thoughts and gestures, anxiety, low self-esteem, anger, and difficulty recognizing and expressing emotions. It may include substance abuse, often an attempt to avoid painful feelings through self-medication. Historical unresolved grief is the associated affect that accompanies HTR; this grief may be considered fixated, impaired, delayed, and/or disenfranchised. This article will explain HT theory and the HTR, delineate the features of the HTR and its grounding in the literature, offer specific Native examples of HT and HTR, and will suggest ways to incorporate HT theory in treatment, research and evaluation. The article will conclude with implications for all massively traumatized populations.

  20. Sexual revictimization: the impact of attachment anxiety, accumulated trauma, and response to childhood sexual abuse disclosure.

    PubMed

    Brenner, Inbal; Ben-Amitay, Galit

    2015-01-01

    It has been proposed that a complexity of personal, interpersonal, and environmental factors is related to sexual revictimization among childhood sexual abuse survivors. In this study, we investigated the relations between attachment dimensions, exposure to accumulated childhood traumas, reaction to childhood sexual abuse disclosure, and adult sexual revictimization. Participants were 60 Israeli women with histories of childhood sexual abuse. Seventy percent of the women reported adult sexual revictimization. Revictimization was related to higher attachment anxiety but not to higher attachment avoidance. Revictimization was also related to emotional and physical child abuse but not to emotional and physical child neglect. Revictimization rates were higher among women who had received negative environmental responses following childhood sexual abuse disclosure than among women who had received supportive reactions and those who had not disclosed childhood sexual abuse at all. Findings were significant even after controlling for severity of childhood sexual abuse. The findings emphasize the role of various contextual-interpersonal factors on revictimization vulnerability among the survivors of childhood sexual abuse.

  1. The use of contrast-enhanced ultrasound in blunt abdominal trauma: advantages and limitations.

    PubMed

    Pinto, Fabio; Miele, Vittorio; Scaglione, Mariano; Pinto, Antonio

    2014-09-01

    Computed tomography (CT) is the imaging method of choice in the assessment of multiple trauma patients. However, in patients who suffered from low-energy abdominal trauma, the use of CT is controversial, since the probability of injury is low and therefore most of the studies are normal. Thus, conventional US imaging has increasingly been employed as the initial imaging modality in the work-up of minor traumatic emergency condition. More recently, the introduction of a new contrast-enhanced ultrasound (CEUS) technique, using second-generation ultrasound contrast agents, has led to a notable increase in the diagnostic accuracy of US in many organs. Therefore, in trauma patients, following assessment with conventional US imaging, a CEUS exam can be performed, to provide a more reliable assessment of solid organ injuries. CEUS has the potential to detect active bleeding from a variety of traumatic origins. Similar to CT, active extravasation is considered when there is evidence of contrast agent collection with echogenicity similar to that of an adjacent vessel. On the other hand, at least some drawbacks have to be addressed, including operator competence and reduced panoramic view. Moreover, CEUS, like conventional US imaging, cannot depict some lesions, such as diaphragmatic ruptures, bowel, and mesenteric traumatic injuries. This technique represents a non-invasive and repeatable method that can be performed at patient's bedside and is therefore extremely helpful for the follow-up of solid organs traumas managed conservatively, especially in pediatric patients and women of fertile age. Moreover, it may reduce the number of CT scans and expedite patient discharge.

  2. Recent Progress and Future Issues in the Management of Abusive Head Trauma

    PubMed Central

    NISHIMOTO, Hiroshi

    2015-01-01

    Head trauma is the leading cause of death in child abuse cases and one of the important issues in the care of abused children. Since the Child Abuse Prevention Law was enforced in 2000 in Japan, various measures have been taken to prevent child abuse over the following decade. Accordingly, medical research on abusive head trauma (AHT) has advanced, leading to significant progress in the medical diagnosis of AHT. This progress has been brought about by (1) the widespread establishment of child protection teams (CPTs) at core hospitals, (2) the progress in neuroradiological imaging and ophthalmoscopic technologies, and (3) the introduction of postmortem imaging. However, the pathological condition of patients with AHT, particularly that of the diffuse brain swelling type, still remains poorly understood. As a result, no clear treatment strategies for AHT have been developed and no treatment outcomes have been improved to date. The development of new treatment strategies for AHT and the construction of a comprehensive database that supports clinical studies are required in the future. PMID:25797781

  3. Damage control surgery in patient with delayed rupture of pseudoaneurysm after blunt abdominal trauma.

    PubMed

    Park, Chan Yong; Ju, Jae Kyun; Kim, Jung Chul

    2012-08-01

    Delayed rupture of post-traumatic pseudoaneurysms of the visceral arteries, especially the pancreaticoduodenal artery, is uncommon. Here, we describe a 55-year-old man hemorrhaging from a pseudoaneurysm of the inferior pancreaticoduodenal artery (IPDA). Computed tomography of the abdomen showed active bleeding in the IPDA and large amounts of hemoperitoneum and hemoretroperitoneum. Selective mesenteric angiography showed that the pseudoaneurysm arose from the IPDA, and treatment by angioembolization failed because the involved artery was too tortuous to fit with a catheter. Damage control surgery with surgical ligation and pad packing was successfully performed. The patient had an uncomplicated postoperative course and was discharged 19 days after the operation. To our knowledge, this is the first report of ruptured pseudoaneurysm of an IPDA after blunt abdominal trauma from Korea. PMID:22880189

  4. Abdominal wall hernia and aortic injury secondary to blunt trauma: Case report and review of the literature

    PubMed Central

    Ballard, David H.; Kaskas, Nadine M.; Hamidian Jahromi, Alireza; Skweres, Justin; Youssef, Asser M.

    2014-01-01

    INTRODUCTION Traumatic abdominal wall hernia (TAWH) and traumatic abdominal aortic injury (TAAI) are two uncommon complications secondary to blunt trauma. In both TAWH and TAAI, reported cases are often associated with poly-trauma. TAWH may be initially missed if more pressing issues are identified during the patient's primary survey. TAAI may be an incidental finding on imaging or, if severe, a cause of an acute abdomen and hemodynamic abnormality. PRESENTATION OF CASE A 54-year-old white male suffered a TAWH and TAAI (pseudoaneurysm) due to severe blunt trauma. TAWH was apparent on physical exam and the TAAI was suspected on computed tomography (CT). The patient's TAWH was managed with a series of abdominal explorations and the TAAI was repaired with endovascular stenting. DISCUSSION TAWH and TAAI are commonly due to severe blunt trauma from motor vehicle collisions. Diagnosis is made through physical exam, imaging studies, or surgical exploration. A variety of surgical techniques achieve technical success. CONCLUSION The patient with blunt trauma to the abdomen is at risk for TAWH and TAAI, which are often associated with other injuries. Investigations should include thorough clinical exam through secondary survey and radiologic imaging in the hemodynamically normal patient. PMID:25437685

  5. The influence of clinicians' previous trauma exposure on their assessment of child abuse risk.

    PubMed

    Regehr, Cheryl; LeBlanc, Vicki; Shlonsky, Aron; Bogo, Marion

    2010-09-01

    Research has identified high levels of trauma exposure and PTSD in professionals responsible for assessing children at risk for abuse. An important question arising is the influence of stress and trauma on professional judgment. This study examined the association between critical incident exposure, PTSD and workers' judgments of child risk. Ninety-six child protection workers participated in 2 simulated clinical interviews and subsequently completed standardized risk assessment measures. Workers reported high levels of exposure to critical events in the workplace and high levels of traumatic stress symptoms. Number of prior critical events encountered was negatively associated with assessment of risk. Level of traumatic stress symptoms was negatively associated with risk on one, but not other measures of risk. It is concluded that standardized measures for assessing a child's risk of abuse may be influenced by previous exposure to critical workplace events and levels of traumatic stress in workers. PMID:20823721

  6. Nonconvulsive Electrographic Seizures are Common in Children With Abusive Head Trauma*

    PubMed Central

    Hasbani, Daphne M.; Topjian, Alexis A.; Friess, Stuart H.; Kilbaugh, Todd J.; Berg, Robert A.; Christian, Cindy W.; Dlugos, Dennis J.; Huh, Jimmy; Abend, Nicholas S.

    2014-01-01

    Objective To determine the prevalence of nonconvulsive seizures in children with abusive head trauma. Design Retrospective study of children with abusive head trauma undergoing clinically indicated continuous electroencephalographic monitoring. Setting PICU of a tertiary care hospital. Subjects Children less than or equal to 2 years old with evidence of abusive head trauma determined by neuroimaging, physical examination, and determination of abuse by the Child Protection Team. Interventions None. Measurements and Main Results Thirty-two children with abusive head trauma were identified with a median age of 4 months (interquartile range 3, 5.5 months). Twenty-one of 32 children (66%) underwent electroencephalographic monitoring. Those monitored were more likely to have a lower admission Glasgow Coma Scale (8 vs 15, p = 0.05) and be intubated (16 vs 2, p = 0.002). Electrographic seizures occurred in 12 of 21 children (57%) and constituted electrographic status epilepticus in 8 of 12 children (67%). Electrographic seizures were entirely nonconvulsive in 8 of 12 children (67%). Electroencephalographic background category (discontinuous and slow-disorganized) (p = 0.02) and neuroimaging evidence of ischemia were associated with the presence of electrographic seizures (p = 0.05). Subjects who had electrographic seizures were no more likely to have clinical seizures at admission (67% electrographic seizures vs 33% none, p = 0.6), parenchymal imaging abnormalities (61% electrographic seizures vs 39% none, p = 0.40), or extra-axial imaging abnormalities (56% electrographic seizures vs 44% none, p = 0.72). Four of 21 (19%) children died prior to discharge; none had electrographic seizures, but all had attenuated-featureless electroencephalographic backgrounds. Follow-up outcome data were available for 16 of 17 survivors at a median duration of 9.5 months following PICU admission, and the presence of electrographic seizures or electrographic status epilepticus was not

  7. Homeless, mentally ill and addicted: the need for abuse and trauma services.

    PubMed

    Christensen, Richard C; Hodgkins, Candace C; Garces, Lorrie K; Estlund, Kathleen L; Miller, M David; Touchton, Reginald

    2005-11-01

    This paper examines an empirical investigation of the lifetime prevalence of trauma (defined as sexual and/or physical abuse) in a cohort of adults enrolled in a federally funded initiative that provides treatment for homeless persons suffering the effects of comorbid substance use and serious mental illness, and considers the impact of this information on clinical programming. Data collected from homeless individuals with co-occurring disorders admitted to the Seeking Treatment and Recovery (STAR) Program during a one year period (n=78) were analyzed for a history of trauma events. Of those individuals evaluated, 79.5% (62/78) acknowledged a history of either physical and/or sexual abuse at some time in their lifetimes. Of this population, 100% of the homeless women (27/27) with co-occurring disorders had experienced a life-altering traumatic event while 68.6% (35/51) of the homeless men also reported trauma histories. We describe the trauma-based interventions made in the STAR Program that have the potential for replication in other initiatives committed to serving homeless individuals with co-occurring disorders. PMID:16311487

  8. Shaken baby syndrome as a form of abusive head trauma.

    PubMed

    Al-Saadoon, Muna; Elnour, Ibtisam B; Ganesh, Anuradha

    2011-08-01

    Shaken baby syndrome (SBS) is a form of abuse that is characterised by brain injury. Because of the subtle and yet debilitating neurobehavioural impairment which ensues, SBS represents a diagnostic dilemma for attending clinicians. The situation is made worse by the young age of the affected child who may not be capable of explaining what happened. SBS has been reported in many parts of the world. To our knowledge, there is a dearth of literature on the topic from Arab/Islamic countries. This article attempts to shed light on the syndrome by reviewing information on the aetiology of SBS, as well as on its diagnosis and the reasons for delayed diagnosis. The central aim of this review is to increase awareness of SBS so that enlightened policies for prevention and intervention could be developed in the region and particularly in Oman.

  9. Neonatal skeletal fractures. Birth trauma or child abuse?

    PubMed

    Cumming, W A

    1979-03-01

    When a fracture is discovered in a newborn infant, it is important to decide whether it occurred at birth or after birth. Calcification around the fracture site gives a useful estimate of the age of the fracture. We reviewed films of 23 patients with fractures resulting from delivery. The fractures occurred at three different sites: the clavicle, the humerus, and the femur. Calcification could be seen as early as seven days after birth and was absent for as long as 11 days after birth. Six of seven femoral fractures occurred in infants with neuromuscular problems. Fracture at an unusual site or absence of calcification after 11 days should alert the radiologist to the possibility of abuse.

  10. Trauma and Sexuality: The Effects of Childhood Sexual, Physical, and Emotional Abuse on Sexual Identity and Behavior.

    ERIC Educational Resources Information Center

    Chu, James A., Ed.; Bowman, Elizabeth S., Ed.

    This book examines the effects of childhood trauma--including sexual abuse--on sexual orientation and behavior. It is directed at helping counselors expand their sensitivity and expertise in a critically important way: by providing a nonjudgmental look at the profound effects of long-standing early abuse on the sexual identities, orientation,…

  11. Using Sleep Dysfunction To Explore the Nature of Resilience in Adult Survivors of Childhood Abuse or Trauma.

    ERIC Educational Resources Information Center

    Chambers, Elisha; Belicki, Kathy

    1998-01-01

    A study of 97 adults found that 53 reported experiencing one or more types of trauma or abuse in childhood. As a group they scored more negatively than those reporting no abuse on measures of sleep dysfunction. Resilient characteristics were only related to measures of social-behavioral functioning, not well-being. (Author/CR)

  12. The "Wall of Fear": The Bridge between the Traumatic Event and Trauma Resolution Therapy for Childhood Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    Oz, Sheri

    2005-01-01

    A multitude of published books and papers on child sexual abuse (CSA) describe symptoms, long-term effects, and therapy for survivors of abuse. However, the parallels between the nature of the sexual trauma event(s) as originally experienced by the victim and the therapeutic process into which the survivor later becomes engaged have not been…

  13. Trauma Characteristics and Posttraumatic Stress Disorder among Adolescent Survivors of Childhood Sexual Abuse

    PubMed Central

    McLean, Carmen P.; Morris, Sarah Herrick; Conklin, Phoebe; Jayawickreme, Nuwan; Foa, Edna B.

    2014-01-01

    This study examined the relationship between the characteristics of childhood sexual abuse (CSA) and the severity of consequent posttraumatic stress disorder (PTSD), depression, suicidal ideation, and substance use in a sample of 83 female adolescents aged 13-18 years seeking treatment for PTSD. Nearly two-thirds of the sample (60.7%, n = 51) reported the perpetrator of the CSA was a relative. A large portion (40.5%, n = 34) of the sample reported being victimized once, while almost a quarter of the sample reported chronic victimization (23.8%, n = 20). PTSD and depression scores were in the clinical range, whereas reported levels of suicidal ideation and substance use were low. The frequency of victimizations was associated with suicidal ideation. Contrary to expectation, CSA characteristics including trauma type, perpetrator relationship, and duration of abuse were unrelated to PTSD severity, depressive symptoms, or substance abuse. PMID:25089075

  14. Trauma Characteristics and Posttraumatic Stress Disorder among Adolescent Survivors of Childhood Sexual Abuse.

    PubMed

    McLean, Carmen P; Morris, Sarah Herrick; Conklin, Phoebe; Jayawickreme, Nuwan; Foa, Edna B

    2014-07-01

    This study examined the relationship between the characteristics of childhood sexual abuse (CSA) and the severity of consequent posttraumatic stress disorder (PTSD), depression, suicidal ideation, and substance use in a sample of 83 female adolescents aged 13-18 years seeking treatment for PTSD. Nearly two-thirds of the sample (60.7%, n = 51) reported the perpetrator of the CSA was a relative. A large portion (40.5%, n = 34) of the sample reported being victimized once, while almost a quarter of the sample reported chronic victimization (23.8%, n = 20). PTSD and depression scores were in the clinical range, whereas reported levels of suicidal ideation and substance use were low. The frequency of victimizations was associated with suicidal ideation. Contrary to expectation, CSA characteristics including trauma type, perpetrator relationship, and duration of abuse were unrelated to PTSD severity, depressive symptoms, or substance abuse.

  15. A response to Mimics of child abuse: Can choking explain abusive head trauma? [35 (2015) 33-37].

    PubMed

    Galaznik, John G

    2016-04-01

    In the recently published article in this journal, "Mimics of Child Abuse: Can Choking Explain Abusive Head Trauma?",(1) the author chose to revisit a discussion prompted by a case report from 5 years ago which was inappropriate in his opinion. He went further to suggest that bringing an unvalidated mechanism of injury into the legal setting "obstructs justice", is a "further victimization of the child", and is a "travesty of justice".(1) Given the "Shaken Baby Syndrome: Rotational Cranial Injuries" has always been only an unvalidated hypothesis lacking experimental confirmation, the exploring of alternative injury mechanisms should be entirely appropriate. In 2010, the post publication discussion ended with a challenge to the American Academy of Pediatrics Committee on Child Abuse and Neglect (AAP COCAN) to either support the pure shaking mechanism with quality EBMS or eliminate any positive support for it from any official policy statement until the exact nature of each injury that pure abusive shaking has the potential to cause is clearly defined and supported with quality experimental research.(4) Since this is an area of acknowledged controversy by the AAP, it is appropriate to examine the evidence based experimental literature that has emerged over the last five years that is relevant to the abusive shaking hypothesis and the hypothesis of any primary brain-lethal hypoxic event leading to the findings of retinal hemorrhages, extra-axial bleeding, and brain injury when an infant presents to medical attention after an Acute/Apparent Life Threatening Event. In that light, this review was undertaken. PMID:26828828

  16. A case of thoracic splenosis in a post-splenectomy patient following abdominal trauma: Hello Howell-Jolly.

    PubMed

    Viviers, Petrus J

    2014-08-01

    Seeding of splenic tissue to extra-abdominal sites is a relatively infrequent consequence of open abdominal trauma. Immunological function of these small foci of ectopic splenic tissue is unknown and their use in determining the splenic function may be limited. In this case report, a patient is described who had previously undergone an emergency splenectomy. The absence of Howell-Jolly bodies on the blood smear in a patient who had previously undergone surgical splenectomy raised the suspicion of splenosis. The immunological features as well as non-invasive evaluation of these ill-defined splenic tissue sites are discussed. PMID:25988041

  17. A case of thoracic splenosis in a post-splenectomy patient following abdominal trauma: Hello Howell-Jolly.

    PubMed

    Viviers, Petrus J

    2014-08-01

    Seeding of splenic tissue to extra-abdominal sites is a relatively infrequent consequence of open abdominal trauma. Immunological function of these small foci of ectopic splenic tissue is unknown and their use in determining the splenic function may be limited. In this case report, a patient is described who had previously undergone an emergency splenectomy. The absence of Howell-Jolly bodies on the blood smear in a patient who had previously undergone surgical splenectomy raised the suspicion of splenosis. The immunological features as well as non-invasive evaluation of these ill-defined splenic tissue sites are discussed.

  18. Detection of necrosis of the gastric fundus after blunt abdominal trauma by PET-CT.

    PubMed

    Hofer, A; Kratochwill, H; Pentsch, A; Gabriel, M

    2015-02-01

    Positron emission tomography with [(18)F]-fluorodeoxyglucose provides functional and anatomic information by visualising the uptake of radiolabelled glucose in tumour and inflammatory cells. We report delayed diagnosis of necrosis of the gastric fundus after blunt abdominal trauma in a 73-year-old man. After a car accident with head-on collision, the patient was stabilised in our emergency room. His femur was treated by internal fixation, his ellbow was stabilised by a fixateur externe. During surgery his status deteriorated. The patient was in need of high dosage of inotrops during the following days. He had a biventricular pacemaker implanted because of ischemic myocardiopathy, and he suffered from renal insufficiency. Over the next days, his haemodynamics improved. A central venous line had to be removed because of ensuing septic fever. The patient complained of upper abdominal pain and nausea. A sonography and computer tomography without contrast medium were performed with negative result. Because of contamination of the central venous line with Staphylococcus epidermidis the pacemaker was evaluated for infection by transoesophageal echocardiography, again without any findings. Because of ongoing fever and positive inflammatory markers a positron emission tomography was indicated, as a contrast examination and a magnetic resonance examination were not feasible because of the renal insufficiency and the pacemaker, respectively. Prophylactic removal of the pacemaker would have been a substantial risk for the patient due to his underlying myocardiopathy. Positron emission tomography showed an increased tracer uptake in the gastric fundus, which turned out to be necrotic by endoscopy. A laparoscopic resection followed, and drainage of an abscess, which had evolved subsequently between stomach and spleen stopped the inflammatory process. This case report demonstrates that positron emission tomography may be an alternative to computer tomography with contrast medium

  19. Earthquake-related Crush Injury versus Non-Earthquake Injury in Abdominal Trauma Patients on Emergency Multidetector Computed Tomography: A Comparative Study

    PubMed Central

    Chen, Tian-wu; Dong, Zhi-hui; Chu, Zhi-gang; Tang, Si-shi; Deng, Wen

    2011-01-01

    The aim of this study was to investigate features of abdominal earthquake-related crush traumas in comparison with non-earthquake injury. A cross sectional survey was conducted with 51 survivors with abdominal crush injury in the 2008 Sichuan earthquake, and 41 with abdominal non-earthquake injury, undergoing non-enhanced computed tomography (CT) scans, serving as earthquake trauma and control group, respectively. Data were analyzed between groups focusing on CT appearance. We found that injury of abdominal-wall soft tissue and fractures of lumbar vertebrae were more common in earthquake trauma group than in control group (28 vs 13 victims, and 24 vs 9, respectively; all P < 0.05); and fractures were predominantly in transverse process of 1-2 vertebrae among L1-3 vertebrae. Retroperitoneal injury in the kidney occurred more frequently in earthquake trauma group than in control group (29 vs 14 victims, P < 0.05). Abdominal injury in combination with thoracic and pelvic injury occurred more frequently in earthquake trauma group than in control group (43 vs 29 victims, P < 0.05). In conclusion, abdominal earthquake-related crush injury might be characteristic of high incidence in injury of abdominal-wall soft tissue, fractures of lumbar vertebrae in transverse process of 1-2 vertebrae among L1-3 vertebrae, retroperitoneal injury in the kidney, and in combination with injury in the thorax and pelvis. PMID:21394315

  20. Is there a Role for Planned Serial Chest Radiographs and Abdominal Ultrasound Scans in the Resuscitation Room Following Trauma?

    PubMed Central

    Gales, Hannah; Perry, Michael

    2006-01-01

    INTRODUCTION Despite advances in trauma care, significant morbidity and mortality exists which could be reduced if all injuries were immediately identified. Two treatable factors are hypoxia and hypovolaemia which may occur secondary to haemorrhage into the chest and abdomen. Pneumothorax is also a frequent cause of preventable trauma death. Clinical examination is limited and we often rely on imaging. Anecdotally, it seemed some patients were investigated too quickly because their injuries had not evolved sufficiently enough to become detectable. In these patients, repeated assessments and imaging would, therefore, be necessary. PATIENTS AND METHODS This was a retrospective study looking at all patients over a 15-month period with significant chest and abdominal injuries. Patients with a chest or abdominal Abbreviated Injury Score (AIS) of 3 or above were identified. As a cross reference, those patients who required at least one chest drain, or a laparotomy within 24 h of admission were also identified. Case notes and films were reviewed with particular attention to the presence of initial ‘normal’ imaging. RESULTS A total of 1036 patients were eligible for entry into the trauma database; of these, 170 patients had chest and/or abdominal injuries coded as AIS 3 or more. We were able to identify 7 cases (4%) where initial clinical examination and imaging failed to detect either bleeding (pleural space or abdomen) or a pneumothorax. A further 5 cases were potential missed injuries, but the data were incomplete making confident inclusion in this group impossible. CONCLUSIONS Occult injuries are reported to have an incidence of around 2–5%. Serial imaging in the resuscitation room may enable early identification of chest and abdominal injuries. However, only 12 cases were identified making interpretation of suitable candidates for repeat imaging difficult. The question is which group of patients would benefit from planned repeat imaging before leaving the

  1. Characterization of indeterminate spleen lesions in primary CT after blunt abdominal trauma: potential role of MR imaging.

    PubMed

    Gordic, Sonja; Alkadhi, Hatem; Simmen, Hans-Peter; Wanner, Guido; Cadosch, Dieter

    2014-10-01

    The purpose of this study was to determine the value of magnetic resonance imaging (MRI) for characterization of indeterminate spleen lesions in primary computed tomography (CT) of patients with blunt abdominal trauma. Twenty-five consecutive patients (8 female, 17 male, mean age 51.6 ± 22.4 years) with an indeterminate spleen lesion diagnosed at CT after blunt abdominal trauma underwent MRI with T2- and T1-weighted images pre- and post-contrast material administration. MRI studies were reviewed by two radiologists. Age, gender, injury mechanism, injury severity score (ISS), management of patients, time interval between CT and MRI, and length of hospital stay were included into the analysis. Patient history, clinical history, imaging, and 2-month clinical outcome including review of medical records and telephone interviews served as reference standard. From the 25 indeterminate spleen lesions in CT, 11 (44 %) were traumatic; nine (36 %) were non-traumatic (pseudocysts, n=5; hemangioma, n=4) and five proven to represent artifacts in CT. The ISS (P<0.001) and the length of hospital stay (P=0.03) were significantly higher in patients with spleen lesions as compared with those without. All other parameters were similar among groups (all, P>0.05). The MRI features ill-defined lesion borders, variable signal intensity on T1- and T2-weighted images depending on the age of the hematoma, focal contrast enhancement indicating traumatic pseudoaneurysm, perilesional contrast enhancement, and edema were most indicative for traumatic spleen lesions. As compared with CT (2/25), MRI (5/25) better depicted thin subcapsular hematomas as indicator of traumatic spleen injury. In conclusion, MRI shows value for characterizing indeterminate spleen lesions in primary CT after blunt abdominal trauma.

  2. What Influences Believing Child Sexual Abuse Disclosures? The Roles of Depicted Memory Persistence, Participant Gender, Trauma History, and Sexism

    ERIC Educational Resources Information Center

    DeMarni Cromer, Lisa; Freyd, Jennifer J.

    2007-01-01

    This vignette study investigated factors that influence believing child sexual abuse disclosures. College student participants (N = 318) in a university human subject pool completed measures about their own trauma history and responded to questions about sexist attitudes. Participants then read vignettes in which an adult disclosed a history of…

  3. Vicarious Trauma: An Exploratory Study of the Impact of Providing Sexual Abuse Treatment on Clinicians' Trust and Intimacy

    ERIC Educational Resources Information Center

    VanDeusen, Karen M.; Way, Ineke

    2006-01-01

    This study examined vicarious trauma effects in male and female clinicians who treat sexual abuse survivors (n = 111) and sexual offenders (n = 272). The national survey was conducted using a random sample of clinical members of two professional organizations. Analyses tested the relationships between demographic variables, maltreatment history,…

  4. Update on injury mechanisms in abusive head trauma--shaken baby syndrome.

    PubMed

    Nadarasa, Jeyendran; Deck, Caroline; Meyer, Franck; Willinger, Rémy; Raul, Jean-Sébastien

    2014-12-01

    Violently shaking a baby leads to clinical presentations ranging from seizures to cardiopulmonary arrest. The main injuries sustained are retinal hemorrhages, subdural hemorrhages, and sometimes fractures and spine injury. It is important to have a global view of the injuries sustained by the infant to correctly discuss the biomechanical aspects of abusive head trauma. Recent works based on finite element models have shown that whiplash-shaking alone is enough to generate vitreo-retinal traction leading to retinal hemorrhage and to cause the rupture of bridging veins leading to subdural hemorrhage. We will review the main papers dealing with the mechanisms of shaken baby syndrome and present the most relevant hypothesis concerning the biomechanical aspects of injuries related to shaken baby syndrome.

  5. Annual Cost of U.S. Hospital Visits for Pediatric Abusive Head Trauma

    PubMed Central

    Peterson, Cora; Xu, Likang; Florence, Curtis; Parks, Sharyn E.

    2015-01-01

    We estimated the frequency and direct medical cost from the provider perspective of U.S. hospital visits for pediatric abusive head trauma (AHT). We identified treat-and-release hospital emergency department (ED) visits and admissions for AHT among patients aged 0–4 years in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS), 2006–2011. We applied cost-to-charge ratios and estimated professional fee ratios from Truven Health MarketScan® to estimate per-visit and total population costs of AHT ED visits and admissions. Regression models assessed cost differences associated with selected patient and hospital characteristics. AHT was diagnosed during 6,827 (95% confidence interval [CI] [6,072, 7,582]) ED visits and 12,533 (95% CI [10,395, 14,671]) admissions (28% originating in the same hospital’s ED) nationwide over the study period. The average medical cost per ED visit and admission were US$2,612 (error bound: 1,644–3,581) and US$31,901 (error bound: 29,266–34,536), respectively (2012 USD). The average total annual nationwide medical cost of AHT hospital visits was US$69.6 million (error bound: 56.9–82.3 million) over the study period. Factors associated with higher per-visit costs included patient age <1 year, males, coexisting chronic conditions, discharge to another facility, death, higher household income, public insurance payer, hospital trauma level, and teaching hospitals in urban locations. Study findings emphasize the importance of focused interventions to reduce this type of high-cost child abuse. PMID:25911437

  6. Annual Cost of U.S. Hospital Visits for Pediatric Abusive Head Trauma.

    PubMed

    Peterson, Cora; Xu, Likang; Florence, Curtis; Parks, Sharyn E

    2015-08-01

    We estimated the frequency and direct medical cost from the provider perspective of U.S. hospital visits for pediatric abusive head trauma (AHT). We identified treat-and-release hospital emergency department (ED) visits and admissions for AHT among patients aged 0-4 years in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS), 2006-2011. We applied cost-to-charge ratios and estimated professional fee ratios from Truven Health MarketScan(®) to estimate per-visit and total population costs of AHT ED visits and admissions. Regression models assessed cost differences associated with selected patient and hospital characteristics. AHT was diagnosed during 6,827 (95% confidence interval [CI] [6,072, 7,582]) ED visits and 12,533 (95% CI [10,395, 14,671]) admissions (28% originating in the same hospital's ED) nationwide over the study period. The average medical cost per ED visit and admission were US$2,612 (error bound: 1,644-3,581) and US$31,901 (error bound: 29,266-34,536), respectively (2012 USD). The average total annual nationwide medical cost of AHT hospital visits was US$69.6 million (error bound: 56.9-82.3 million) over the study period. Factors associated with higher per-visit costs included patient age <1 year, males, coexisting chronic conditions, discharge to another facility, death, higher household income, public insurance payer, hospital trauma level, and teaching hospitals in urban locations. Study findings emphasize the importance of focused interventions to reduce this type of high-cost child abuse.

  7. [The characteristics of the abdominal symptoms in craniocerebral trauma sustained in a state of alcoholic intoxication].

    PubMed

    Pedachenko, Ie H; Udod, S V

    1997-01-01

    This paper focuses on 63 cases of syndrome of nonprimary acute abdomen (SNPAA) in craniocerebral injury (CCI) sustained in the state of alcoholic intoxication, and 59 observations connected with cranio-abdominal injuries (CAI). In the presence of cerebral injuries, one of the specific characteristics of alcohol was that it entailed changes in the abdominal symptomatology either concealing manifestations of severe damage to the abdominal organs or potentiating SNPAA. In all the observations the abdominal symptomatology was less pronounced that in those victims who do not take alcoholic drinks. There have been identified four variants of SNPAA course. In 12.7% of cases manifestations of the above syndrome were related to the CCI pattern only, being associated with origination of pseudodefense of "truncal" genesis. It is advisable that instrumental methods of study into abdominal organs should come to be more widely used in those settings where there is alcohol intoxication with suspected CAI.

  8. Parents' behavior in response to infant crying: abusive head trauma education.

    PubMed

    Simonnet, Hina; Laurent-Vannier, Anne; Yuan, Wenlun; Hully, Marie; Valimahomed, Sakil; Bourennane, Malek; Chevignard, Mathilde

    2014-12-01

    Abusive head trauma (AHT) is still too common, and probably underestimated. It is the leading cause of death from child abuse. Crying is thought to contribute to the act of shaking. Objectives of this study were to (a) assess parents' knowledge about infant crying, their ability to manage crying, and their knowledge about AHT; and (b) assess the feasibility and the impact of a simple educational intervention about crying and AHT with parents shortly after their child's birth. A short questionnaire was completed orally by the parents of 190 consecutive newborns in a maternity hospital at day 2 of life. Then, during the routine examination of the child, the pediatrician gave parents a short talk about infant crying and AHT, and a pamphlet. Finally, parents were contacted by phone at 6 weeks for the post-intervention questionnaire assessing their knowledge about crying and AHT. Among 202 consecutive births, parents of 190 children were included (266 parents; 70% mothers) over a 1-month period and answered the pre-intervention questionnaire. The intervention was feasible and easy to provide. Twenty-seven percent of mothers and 36% of fathers had never heard of AHT. At 6 weeks, 183 parents (68% of the sample; 80% mothers) answered the post-intervention questionnaire. Parents' knowledge improved significantly post-intervention. Parents found the intervention acceptable and useful. Health care professionals such as pediatricians or nurses could easily provide this brief talk to all parents during systematic newborn examination. PMID:25043922

  9. Parents' behavior in response to infant crying: abusive head trauma education.

    PubMed

    Simonnet, Hina; Laurent-Vannier, Anne; Yuan, Wenlun; Hully, Marie; Valimahomed, Sakil; Bourennane, Malek; Chevignard, Mathilde

    2014-12-01

    Abusive head trauma (AHT) is still too common, and probably underestimated. It is the leading cause of death from child abuse. Crying is thought to contribute to the act of shaking. Objectives of this study were to (a) assess parents' knowledge about infant crying, their ability to manage crying, and their knowledge about AHT; and (b) assess the feasibility and the impact of a simple educational intervention about crying and AHT with parents shortly after their child's birth. A short questionnaire was completed orally by the parents of 190 consecutive newborns in a maternity hospital at day 2 of life. Then, during the routine examination of the child, the pediatrician gave parents a short talk about infant crying and AHT, and a pamphlet. Finally, parents were contacted by phone at 6 weeks for the post-intervention questionnaire assessing their knowledge about crying and AHT. Among 202 consecutive births, parents of 190 children were included (266 parents; 70% mothers) over a 1-month period and answered the pre-intervention questionnaire. The intervention was feasible and easy to provide. Twenty-seven percent of mothers and 36% of fathers had never heard of AHT. At 6 weeks, 183 parents (68% of the sample; 80% mothers) answered the post-intervention questionnaire. Parents' knowledge improved significantly post-intervention. Parents found the intervention acceptable and useful. Health care professionals such as pediatricians or nurses could easily provide this brief talk to all parents during systematic newborn examination.

  10. Directed forgetting of trauma cues in adult survivors of childhood sexual abuse with and without posttraumatic stress disorder.

    PubMed

    McNally, R J; Metzger, L J; Lasko, N B; Clancy, S A; Pitman, R K

    1998-11-01

    The authors used a directed-forgetting task to investigate whether psychiatrically impaired adult survivors of childhood sexual abuse exhibit an avoidant encoding style and impaired memory for trauma cues. The authors tested women with abuse histories, either with or without posttraumatic stress disorder (PTSD), and women with neither abuse histories nor PTSD. The women saw intermixed trauma words (e.g., molested), positive words (e.g., confident), and categorized neutral words (e.g., mailbox) on a computer screen and were instructed either to remember or to forget each word. Relative to the other groups, the PTSD group did not exhibit recall deficits for trauma-related to-be-remembered words, nor did they recall fewer trauma-related to-be-forgotten words than other words. Instead, they exhibited recall deficits for positive and neutral words they were supposed to remember. These data are inconsistent with the hypothesis that impaired survivors exhibit avoidant encoding and impaired memory for traumatic information.

  11. [The diagnosis of the types of automobile-caused trauma by the nature of the injuries to the internal abdominal organs].

    PubMed

    Solokhin, A A; Tkhakakhov, A A

    1996-01-01

    A total of 307 cases of fatal car injuries with traumas of the abdominal organs are analyzed. There were three types of injuries: those caused by collision of a pedestrian with a moving car (96 cases) injuries inflicted inside a car cabin (n = 157), and inflicted by a car wheel crossing the body (n = 54). Differences in the injuries inflicted in different types of car traumas are described. The authors demonstrate the possibility of differential diagnosis of these types of traumas in cases when the circumstances of the accident are unknown. They offer a differential diagnostic table for practical use, based on their findings.

  12. Relationships between Trauma, Posttraumatic Stress Disorder Symptoms, Dissociative Symptoms, and Lifetime Heroin Use among Individuals Who Abuse Substances in Residential Treatment

    ERIC Educational Resources Information Center

    Horton, E. Gail; Diaz, Naelys; Peluso, Paul R.; Mullaney, Donald; Weiner, Michael; McIlveen, John W.

    2009-01-01

    This study explored the relationships between trauma, posttraumatic stress disorder symptoms, dissociation, and lifetime heroin use among inpatient clients who abused substances. Results indicate important implications for practice and directions for future research. (Contains 1 figure and 1 table.)

  13. Acquired port-wine stain with superimposed eczema following penetrating abdominal trauma.

    PubMed

    Langenhan, Jamie; Novoa, Roberto A; Pappas-Taffer, Lisa

    2015-12-01

    Port-wine stains (PWSs), or capillary malformations, are common congenital lesions, but acquired lesions rarely present in the setting of trauma. We present the case of an 18-year-old man who developed a PWS and associated localized eczema following penetrating trauma to the left abdomen. The diagnoses were confirmed on biopsy. The patient's eczema improved with topical steroids. Magnetic resonance imaging of PWSs is recommended in order to rule out deeper arteriovenous malformations. More research is needed to elucidate the connection between PWS pathophysiology and the development of eczema.

  14. Practice-Informed Approaches to Addressing Substance Abuse and Trauma Exposure in Urban Native Families Involved with Child Welfare.

    PubMed

    Lucero, Nancy M; Bussey, Marian

    2015-01-01

    Similar to families from other groups, urban-based American Indian and Alaska Native ("Native") family members involved with the child welfare system due to substance abuse issues are also often challenged by untreated trauma exposure. The link between these conditions and the history of genocidal policies aimed at destroying Native family ties, as well as experiences of ongoing discrimination, bring added dimensions for consideration when pro- viding services to these families. Practice-based evidence indicates that the trauma-informed and culturally responsive model developed by the Denver Indian Family Resource Center (DIFRC) shows promise in reducing out-of-home placements and re-referrals in urban Native families with substance abuse and child welfare concerns, while also increasing caregiver capabilities, family safety, and child well-being. This article provides strategies from the DIFRC approach that non-Native caseworkers and supervisors can utilize to create an environment in their own agencies that supports culturally based practice with Native families while incorporating a trauma-informed understanding of service needs of these families. Casework consistent with this approach demonstrates actions that meet the Active Efforts requirement of the Indian Child Welfare Act (ICWA) as well as sound clinical practice. Intensive and proactive case management designed specifically for families with high levels of service needs is a key strategy when combined with utilizing a caseworker brief screening tool for trauma exposure; training caseworkers to recognize trauma symptoms, making timely referrals to trauma treatment by behavioral health specialists experienced in working with Native clients, and providing a consistent service environment that focuses on client safety and worker trustworthiness. Finally, suggestions are put forth for agencies seeking to enhance their cultural responsiveness and include increasing workers' understanding of cultural values

  15. Practice-Informed Approaches to Addressing Substance Abuse and Trauma Exposure in Urban Native Families Involved with Child Welfare.

    PubMed

    Lucero, Nancy M; Bussey, Marian

    2015-01-01

    Similar to families from other groups, urban-based American Indian and Alaska Native ("Native") family members involved with the child welfare system due to substance abuse issues are also often challenged by untreated trauma exposure. The link between these conditions and the history of genocidal policies aimed at destroying Native family ties, as well as experiences of ongoing discrimination, bring added dimensions for consideration when pro- viding services to these families. Practice-based evidence indicates that the trauma-informed and culturally responsive model developed by the Denver Indian Family Resource Center (DIFRC) shows promise in reducing out-of-home placements and re-referrals in urban Native families with substance abuse and child welfare concerns, while also increasing caregiver capabilities, family safety, and child well-being. This article provides strategies from the DIFRC approach that non-Native caseworkers and supervisors can utilize to create an environment in their own agencies that supports culturally based practice with Native families while incorporating a trauma-informed understanding of service needs of these families. Casework consistent with this approach demonstrates actions that meet the Active Efforts requirement of the Indian Child Welfare Act (ICWA) as well as sound clinical practice. Intensive and proactive case management designed specifically for families with high levels of service needs is a key strategy when combined with utilizing a caseworker brief screening tool for trauma exposure; training caseworkers to recognize trauma symptoms, making timely referrals to trauma treatment by behavioral health specialists experienced in working with Native clients, and providing a consistent service environment that focuses on client safety and worker trustworthiness. Finally, suggestions are put forth for agencies seeking to enhance their cultural responsiveness and include increasing workers' understanding of cultural values

  16. The impact of an educational intervention on knowledge about infant crying and abusive head trauma

    PubMed Central

    Ornstein, Amy E; Fitzpatrick, Eleanor; Hatchette, Jill; Woolcott, Christy G; Dodds, Linda

    2016-01-01

    BACKGROUND: Infants follow a predictable trajectory of increased early crying. Frustration with crying is reported to be a trigger for abusive head trauma (AHT). OBJECTIVE: To evaluate the impact of postpartum delivery of the educational program, the Period of PURPLE Crying (PURPLE), in a group of first-time mothers. The primary objective was to determine whether there was a change in knowledge about infant crying and shaking after exposure to PURPLE. Factors associated with change in knowledge were also examined. METHOD: A total of 93 participants were recruited over a four-month period at a tertiary care hospital in Nova Scotia. Pre- and postintervention data were collected. RESULTS: Knowledge about infant crying increased significantly after program delivery (P=0.001). Low baseline crying knowledge was a significant predictor of increased knowledge about infant crying (P≤0.01). There was an insignificant decrease in shaking knowledge (P=0.5), which may have been the consequence of high baseline knowledge. CONCLUSION: An educational program for new parents appears to be warranted, especially with respect to improving knowledge about infant crying. This may have a positive benefit in AHT prevention. Additional studies are required to evaluate the impact of the program on other caregivers and on rates of AHT. PMID:27095881

  17. Risk factors associated with retinal hemorrhage in suspected abusive head trauma

    PubMed Central

    Burkhart, Zachary N.; Thurber, Clinton J.; Chuang, Alice Z.; Kumar, Kartik S.; Davis, Garvin H.; Kellaway, Judianne

    2015-01-01

    Purpose To determine risk factors associated with retinal hemorrhage (RH) in pediatric abusive head trauma (AHT) suspects. Methods Records of children aged 0–3 years hospitalized for suspected AHT from January 2007 to November 2011 were retrospectively reviewed in this case–control study. Children were classified into case and control groups based on RH presence. Medical history, presenting symptoms, reasons, and characteristics of injury were recorded. Logistic regression analysis was performed to identify risk factors. Results A total of 168 children (104 males) were included. Of these, 103 were classified as cases and 65 as controls. The mean age (with standard deviation) was 9.3 ± 8.3 months (range, 1 day-36 months). Of the 103 cases, 22 (21%) had subretinal hemorrhage, 9 (9%) had retinoschisis, and 1 (1%) had vitreous hemorrhage. Children presenting with lethargy or altered mental status (P < 0.0001), subdural hemorrhage (P < 0.0001), and other radiologic findings (eg, cerebral ischemia, diffuse axonal injury, hydrocephalus, or solid organ injury; P = 0.01546) were likely to have RH. All 23 children with skull or nonskull fracture without intracranial hemorrhage did not have RH (P < 0.0001 both categories). Conclusions Retinal hemorrhages were almost never found in the absence of intracranial hemorrhage and not found in the setting of fracture without intracranial hemorrhage. PMID:25828822

  18. National, Regional, and State Abusive Head Trauma: Application of the CDC Algorithm

    PubMed Central

    Zolotor, Adam J.; Parrish, Jared W.; Barr, Ronald G.; Runyan, Desmond K.

    2013-01-01

    OBJECTIVE: To examine national, regional, and state abusive head trauma (AHT) trends using child hospital discharge data by applying a new coding algorithm developed by the Centers for Disease Control and Prevention (CDC). METHODS: Data from 4 waves of the Kids’ Inpatient Database and annual discharge data from North Carolina were used to determine trends in AHT incidence among children <1 year of age between 2000 and 2009. National, regional, and state incidence rates were calculated. Poisson regression analyses were used to examine national, regional, and state AHT trends. RESULTS: The CDC narrow and broad algorithms identified 5437 and 6317 cases, respectively, in the 4 years of KID weighted data. This yielded average annual incidences of 33.4 and 38.8 cases per 100 000 children <1 year of age. There was no statistically significant change in national rates. There were variations by region of the country, with significantly different trends in the Midwest and West. State data for North Carolina showed wide annual variation in rates, with no significant trend. CONCLUSIONS: The new coding algorithm resulted in the highest AHT rates reported to date. At the same time, we found large but statistically insignificant annual variations in AHT rates in 1 large state. This suggests that caution should be used in interpreting AHT trends and attributing changes in rates as being caused by changes in policies, programs, or the economy. PMID:24276842

  19. Pneumobilia After Penetrating Trauma Abdominal Wall with no Injury to the Biliary Tree- A Case Report.

    PubMed

    Sandhu, Sartaj Singh; Sampley, Sunil K; Chhabra, Kapil

    2013-06-01

    Pneumobilia denotes an abnormal connection between the gastrointestinal and the biliary tracts. In the absence of surgically created anastomosis between the bowel and the bile duct, the common causes for pneumobilia are gallstone obstruction, endoscopic interventions or emphysematous cholecystitis. We present the case of a young male with traumatic pneumobilia with gastric perforation and a tear in the mesentery of the small gut following penetrating trauma in the form of stab in the abdomen.

  20. [Ruptured retroperitoneal bile duct cyst. An extremely rare injury after blunt abdominal trauma].

    PubMed

    Sándor, L; Bali, I; Bozo, A; Farkas, G

    1991-07-01

    Management of a retroperitoneal extrahepatic bile duct cystenteric tear at a cystenteric malformation of the intra- and extrahepatic ducts (Todani IV-A) discovered during an emergency surgical procedure following an accident is presented and the problems associated with bile duct cysts are discussed. It is pointed out that acute treatment with a simple and safe method (external Kehr-T drainage) can be successful when injuries are present, although most trauma surgeon are seldom, and many never, directly confronted with injuries attributable to these extremely rare malformations.

  1. Superior mesenteric artery syndrome after blunt abdominal trauma: a case report.

    PubMed

    Falcone, John L; Garrett, Kevin O

    2010-07-01

    Superior mesenteric artery (SMA) syndrome is a rare cause of bowel obstruction. It is characterized anatomically by a narrowed aortomesenteric angle, causing a mechanical obstruction at the third portion of the duodenum. Patients usually present after prolonged confinement in the supine position, significant acute weight loss, application of body casts, and severe burns with symptoms of a small bowel obstruction. We present the case of a healthy 22-year-old male athlete with SMA syndrome that occurred after blunt abdominal injury in the setting of mild chronic weight loss; he was treated nonoperatively.

  2. An Abdominal CT may be Safe in Selected Hypotensive Trauma Patients with Positive FAST Exam

    PubMed Central

    Cook, Mackenzie R.; Holcomb, John B.; Rahbar, Mohammad H.; Alarcon, Louis H.; Bulger, Eileen M.; Brasel, Karen J.; Schreiber, Martin A.

    2016-01-01

    Background Positive Focused Assessment with Sonography in Trauma (FAST) and hypotension often indicates urgent surgery. An abdomen/pelvis CT (apCT) may allow less invasive management but the delay may be associated with adverse outcomes. Methods Patients in the Prospective Observational Multicenter Major Trauma Transfusion study with hypotension and a positive FAST (HF+) who underwent a CT (apCT+) were compared to those who did not. Results Of the 92 HF+ identified, 32(35%) underwent apCT during initial evaluation and apCT was associated with decreased odds of an emergency operation, OR 0.11 95% CI (0.001–0.116) and increased odds of angiographic intervention, OR 14.3 95% CI (1.5–135). There was no significant difference in 30 day mortality or need for dialysis. Conclusion An apCt in HF+ patients is associated with reduced odds of emergency surgery, but not mortality. Select HF+ patients can safely undergo apCT to obtain clinically useful information. PMID:25805456

  3. Factors Associated with Hemispheric Hypodensity after Subdural Hematoma following Abusive Head Trauma in Children

    PubMed Central

    Recker, Matthew J.; Lee, Philip S.; Bell, Michael J.; Tyler-Kabara, Elizabeth C.

    2014-01-01

    Abstract Abusive head trauma (AHT) is a unique form of pediatric TBI with increased mortality and neurologic sequelae. Hemispheric hypodensity (HH) in association with subdural blood after AHT has been described. Though risk factors for HH are not understood, we hypothesized that risk factors could be identified. We retrospectively enrolled children under 5 years with TBI secondary to AHT (child advocacy diagnosis) who had undergone initial and interval brain imaging. Records were interrogated for prearrival and in-hospital physiologic and radiographic findings. HH was determined by a blinded observer. Twenty-four children were enrolled and 13 developed HH. HH was not significantly associated with age, initial Glascow Coma Scale, or mortality. Pediatric Intensity Level of Therapy (PILOT) scores (p=0.01) and daily maximal intracranial pressure (ICPmax; p=0.037) were higher in HH. Hypoxia, hypotension, cardiopulmonary arrest, need for blood transfusion, and daily blood glucoses tended to be greater in HH. Whereas all children with HH had acute subdural hematoma (SBH), many children without HH also had subdural blood; the presence of skull fracture was more likely in the children who did not develop HH (p=0.04), but no other intracranial radiographic pattern of injury was associated with HH. Surgical intervention did not appear to protect against development of HH. A variety of insults associated with ischemia, including intracranial hypertension, ICP-directed therapies, hypoxia, hypotension, and cardiac arrest, occurred in the children who developed HH. Given the morbidity and mortality of this condition, larger studies to identify mechanisms leading to the development of HH and mitigating clinical approaches are warranted. PMID:24693985

  4. The Development of a Sexual Abuse Severity Score: Characteristics of Childhood Sexual Abuse Associated with Trauma Symptomatology, Somatization, and Alcohol Abuse

    ERIC Educational Resources Information Center

    Zink, Therese; Klesges, Lisa; Stevens, Susanna; Decker, Paul

    2009-01-01

    Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with…

  5. Sexual Abuse: Somatic and Emotional Reactions.

    ERIC Educational Resources Information Center

    Rimza, Mary Ellen; And Others

    1988-01-01

    Chart reviews and telephone interviews with 72 sexual abuse victims found that 48 of the children had symptoms similar to the "rape trauma" syndrome. Two-thirds of victims commonly had somatic complaints (such as abdominal pain) and emotional/behavioral problems (runaway behavior, suicide attempts). (DB)

  6. [Pancreatic injury in abdominal trauma in children: difficult to diagnose and treat].

    PubMed

    Fennema, Eelco M; Nellensteijn, David R; Nieuwenhuijs, Vincent B; van Rheenen, Patrick F; ten Duis, Henk-Jan; Hulscher, Jan B F

    2011-01-01

    Traumatic injury of the pancreas is rare in children. It is often difficult to diagnose due to the lack of signs and symptoms, and shortly after trauma laboratory values may be normal. In addition, ultrasound and CT are often not specific. The treatment of grade 1 and 2 injury is non-operative. Although there seems to be a shift towards non-operative management of grade 3-5 injuries (with injury of the pancreatic duct), this is still a matter of debate. We describe 3 children, a girl of 2.5 years-old and a boy of 7 years-old, with grade 3 pancreatic injuries and an 8-year-old boy with a grade 2 injury. We demonstrate that the diagnosis is hard to establish, while the consequences of this injury can be serious. Thinking of pancreatic injury is most important to its diagnosis. We advocate referral to or consultation of specialized centres in these cases.

  7. A case of gallbladder perforation detected by sonography after a blunt abdominal trauma.

    PubMed

    Hongo, Maiko; Ishida, Hideaki; Naganuma, Hiroko; Yoshioka, Hiroshi; Kasuya, Takamitu; Niwa, Makoto

    2014-06-01

    Gallbladder (GB) perforation is a very rare posttraumatic abdominal injury. It is potentially life-threatening, and good outcome requires early diagnosis. We present a case of isolated posttraumatic GB perforation in which the precise sonographic (US) diagnosis led us to apply proper management. Color Doppler US showed a clear to-and-fro flow signal passing through the perforation site, and contrast-enhanced US confirmed the presence of a small defect in the GB wall. When examining posttraumatic patients, the possibility of GB perforation must be kept in mind. Color Doppler US and contrast-enhanced US are the examinations of choice to detect the perforation site and show bile movement through the perforation.

  8. Dissection of the Abdominal Aorta in Blunt Trauma: Management by Percutaneous Stent Placement

    SciTech Connect

    Vernhet, Helene; Marty-Ane, Charles-Henri; Lesnik, Alvian; Chircop, Regis; Serres-Cousine, Olivier; Picard, Eric; Mary, Henry; Senac, Jean Paul

    1997-11-15

    We implanted stents in three patients who had traumatic abdominal aortic dissections, complicated by right limb ischemia in one case. The circulating false channel extended to the left iliac artery in one case and to both iliac arteries in the last case. Diagnosis and radiological follow-up included ultrasound, computed tomography, and arteriography. Two patients were treated with Wallstents, one with a Palmaz stent. The occlusion of the false channel was obtained in all patients without any significant residual stenosis. No early or late complication was noted in any of the patients. The longest follow-up was 2 years.We conclude that stent placement is an efficient method for the treatment of noniatrogenic inframesenteric aortic dissections.

  9. Recall of Childhood Trauma: A Prospective Study of Women's Memories of Child Sexual Abuse.

    ERIC Educational Resources Information Center

    Williams, Linda Meyer

    1994-01-01

    Of the 129 women interviewed, a large portion (38%) did not recall abuse reported 17 years earlier. Those who were younger when abuse occurred or were molested by an acquaintance were more likely to have no recall. Implications for research and practice are discussed. Periods with no memory should not suggest abuse never occurred. (52 references)…

  10. Abdominal gunshot wounds. An urban trauma center's experience with 300 consecutive patients.

    PubMed Central

    Feliciano, D V; Burch, J M; Spjut-Patrinely, V; Mattox, K L; Jordan, G L

    1988-01-01

    From July 1983 through December 1987, 300 consecutive patients with penetrating gunshot wounds of the abdomen causing visceral or vascular injuries were treated. Resuscitative thoracotomy was required in 20 patients (6.6%), and only two survived. The most commonly injured organs were the small bowel (60%), colon (41.6%), liver (29.3%), vascular structures (24.6%), stomach (17.3%), and kidney (17.0%). The overall survival rate for the series was 88.3%; however, if only the 226 patients without vascular injuries are considered, the survival rate was 97.3%. In the 35 patients who died, the blood pressure on admission was 51 mmHg, 18 required a resuscitative thoracotomy, four visceral or vascular injuries were present, and the median blood replacement was 18 units. The cause of death was perioperative shock in 30 patients (85.7%), whereas five patients (14.3%) died of sepsis and multiple organ failure. The most common postoperative complication in survivors and patients who died later in the study was an intra-abdominal abscess (3.0%). Rapid conservative operative techniques for civilian gunshot wounds leads to few postoperative complications and an excellent survival rate, especially if vascular injuries are not present. PMID:3421760

  11. The demographics and outcome of patients with penetrating abdominal trauma admitted to emergency medicine department: A descriptive cross-sectional study

    PubMed Central

    Derakhshanfar, Hojjat; Azizkhani, Reza; Masoumi, Babak; Hashempour, Azam; Amini, Afshin

    2013-01-01

    Background: This study was performed to determine the demographic and outcome of penetrating abdominal trauma in patients attending to emergency medicine department. Materials and Methods: This was a descriptive cross-sectional study in Imam Hossein Medical Center. Seventy five patients who came to our department with penetrating abdominal trauma during a 1 year period were enroled into this study and their demographic data and outcome (during the hospitalization) were recorded. The study was at Imam Hossein Medical Center, Tehran, Iran, from 2009 to 2010. Results: Our findings indicate these notable results: 84% of patients were less than 40 years old, most patients attended emergency department during the spring and summer, 72 patients (96%) arrived between 7 pm and 7 am, 74 patients (98.7%) had stab wound and one person (1.3%) was shot, eventually 46 patients (61%) had laparatomy performed and 2 patients (2.7%) died. 59 patients out of 75 study cases appealed to police department and legal medicine council. Conclusions: The incidence of abdominal penetrating trauma due to stab wound is much higher than gunshot in our community, which indicates the importance of educating the emergency staff and preparing the emergency department work place to attend to these patients, especially during the night hours. PMID:23977658

  12. Historical Trauma: Holocaust Victims, American Indians Recovering from Abuses of the Past

    ERIC Educational Resources Information Center

    Deschenie, Tina

    2006-01-01

    Natural disasters and terrorism have raised national awareness of major human trauma. In fall 2005, Hurricanes Katrina and Rita forced hundreds of thousands of people to evacuate from their homes. Among American Indian people, these times bring to mind the trauma suffered by their ancestors: The Trail of Tears during the 1830s removed 18,000…

  13. Historical Trauma among Urban American Indians: Impact on Substance Abuse and Family Cohesion

    ERIC Educational Resources Information Center

    Wiechelt, Shelly A.; Gryczynski, Jan; Johnson, Jeannette L.; Caldwell, Diana

    2012-01-01

    Historical trauma theory suggests that many American Indians are still affected by the cultural losses and injustices endured by previous generations. The current study examines historical trauma in an urban American Indian sample using validated measures of historical loss and associated symptoms (N = 120). Urban American Indians reported high…

  14. Assessing Trauma, Substance Abuse, and Mental Health in a Sample of Homeless Men

    ERIC Educational Resources Information Center

    Kim, Mimi M.; Ford, Julian D.; Howard, Daniel L.; Bradford, Daniel W.

    2010-01-01

    This study examined the impact of physical and sexual trauma on a sample of 239 homeless men. Study participants completed a self-administered survey that collected data on demographics, exposure to psychological trauma, physical health and mental health problems, and substance use or misuse. Binomial logistic regression analyses were used to…

  15. Trauma.

    PubMed

    Huisman, Thierry A G M; Poretti, Andrea

    2016-01-01

    Traumatic brain and spine injury (TBI/TSI) is a leading cause of death and lifelong disability in children. The biomechanical properties of the child's brain, skull, and spine, the size of the child, the age-specific activity pattern, and variance in trauma mechanisms result in a wide range of age-specific traumas and patterns of brain and spine injuries. A detailed knowledge about the various types of primary and secondary pediatric head and spine injuries is essential to better identify and understand pediatric TBI/TSI, which enhances sensitivity and specificity of diagnosis, will guide therapy, and may give important information about the prognosis. The purposes of this chapter are to: (1) discuss the unique epidemiology, mechanisms, and characteristics of TBI/TSI in children; (2) review the anatomic and functional imaging techniques that can be used to study common and rare pediatric TBI/TSI and their complications; (3) comprehensively review frequent primary and secondary brain injuries; and (4) to give a short overview of two special types of pediatric TBI/TSI: birth-related and nonaccidental injuries. PMID:27430465

  16. A finite element analysis of the retinal hemorrhages accompanied by shaken baby syndrome/abusive head trauma.

    PubMed

    Yoshida, Makoto; Yamazaki, Junpei; Mizunuma, Hiroshi

    2014-11-01

    We aimed to elucidate the mechanism of the retinal hemorrhage (RH) accompanied by shaken baby syndrome or abusive head trauma (SBS/AHT) by analyses using a computational model. We focused on a hypothesis that the vitreoretinal traction due to acceleration and deceleration caused by abusive shaking leads to retinal hemorrhage. A finite element (FE) mechanical model with simple spherical geometry was constructed. When the FE mechanical model was virtually shaken, the intensity of the stress applied to the retinal plane agreed well with the results from an analysis using a physical model made of agar gel. Impacts due to falling events induced more intensive tensile stresses, but with shorter duration, than the shake did. By applying a mathematical theory on tackiness, we propose a hypothesis that the time integration of the stress, in the unit of Pa·s, would be a good predictor of the RH accompanied by SBS/AHT. A single cycle of abusive shake amounted to 101Pa·s of time integration of inflicted stress, while a single impact event amounted to 36Pa·s. This would explain the paradoxical observation that shaking induces RH while RH due to impact events is only seen in a major event such as a fatal motor vehicle accident. PMID:25282076

  17. A finite element analysis of the retinal hemorrhages accompanied by shaken baby syndrome/abusive head trauma.

    PubMed

    Yoshida, Makoto; Yamazaki, Junpei; Mizunuma, Hiroshi

    2014-11-01

    We aimed to elucidate the mechanism of the retinal hemorrhage (RH) accompanied by shaken baby syndrome or abusive head trauma (SBS/AHT) by analyses using a computational model. We focused on a hypothesis that the vitreoretinal traction due to acceleration and deceleration caused by abusive shaking leads to retinal hemorrhage. A finite element (FE) mechanical model with simple spherical geometry was constructed. When the FE mechanical model was virtually shaken, the intensity of the stress applied to the retinal plane agreed well with the results from an analysis using a physical model made of agar gel. Impacts due to falling events induced more intensive tensile stresses, but with shorter duration, than the shake did. By applying a mathematical theory on tackiness, we propose a hypothesis that the time integration of the stress, in the unit of Pa·s, would be a good predictor of the RH accompanied by SBS/AHT. A single cycle of abusive shake amounted to 101Pa·s of time integration of inflicted stress, while a single impact event amounted to 36Pa·s. This would explain the paradoxical observation that shaking induces RH while RH due to impact events is only seen in a major event such as a fatal motor vehicle accident.

  18. Substance use coping as a mediator of the relationship between trauma symptoms and substance use consequences among incarcerated females with childhood sexual abuse histories.

    PubMed

    Asberg, Kia; Renk, Kimberly

    2012-06-01

    Rates of substance use and maltreatment are alarmingly high among incarcerated women. Although the direct link between trauma and substance use has been established, less is known about potential mediators. Thus, we examined substance use coping as a mediator between trauma symptoms and substance use consequences among a sample of incarcerated females (N = 111) who were survivors of childhood sexual abuse. Trauma symptoms predicted the severity of substance use consequences, with this relationship being mediated fully by avoidance coping (e.g., using substances to cope). Overall, trauma histories are important in predicting outcomes but must be examined in the context of current coping behaviors and substance use. Findings (data collected in 2007/2008) may help promote interventions that target patterns of coping and/or emotional avoidance among trauma survivors with substance use problems in incarcerated populations. The study's limitations are noted.

  19. Differences in Depression, Posttraumatic Stress Disorder, and Lifetime Trauma Exposure in Formerly Abused Women with Mild versus Moderate to Severe Chronic Pain

    ERIC Educational Resources Information Center

    Humphreys, Janice; Cooper, Bruce A.; Miaskowski, Christine

    2010-01-01

    Although associations between intimate partner violence, chronic pain, depression, posttraumatic stress disorder (PTSD), and lifetime trauma exposure are well known, previous studies are limited by their recruitment of women from shelters. These relationships were explored with a community-based sample of formerly abused women ( N = 84).…

  20. Hepatic Enzyme Decline after Pediatric Blunt Trauma: A Tool for Timing Child Abuse?

    ERIC Educational Resources Information Center

    Baxter, Amy L.; Lindberg, Daniel M.; Burke, Bonnie L.; Shults, Justine; Holmes, James F.

    2008-01-01

    Objectives: Previous research in adult patients with blunt hepatic injuries has suggested a pattern of serum hepatic transaminase concentration decline. Evaluating this decline after pediatric blunt hepatic trauma could establish parameters for estimating the time of inflicted injuries. Deviation from a consistent transaminase resolution pattern…

  1. Event Memory and Suggestibility in Abused and Neglected Children: Trauma-Related Psychopathology and Cognitive Functioning

    ERIC Educational Resources Information Center

    Chae, Yoojin; Goodman, Gail S.; Eisen, Mitchell L.; Qin, Jianjian

    2011-01-01

    This study examined event memory and suggestibility in 3- to 16-year-olds involved in forensic investigations of child maltreatment. A total of 322 children were interviewed about a play activity with an unfamiliar adult. Comprehensive measures of individual differences in trauma-related psychopathology and cognitive functioning were administered.…

  2. The Cedar Project: historical trauma, sexual abuse and HIV risk among young Aboriginal people who use injection and non-injection drugs in two Canadian cities.

    PubMed

    Cedar Project Partnership; Pearce, Margo E; Christian, Wayne M; Patterson, Katharina; Norris, Kat; Moniruzzaman, Akm; Craib, Kevin J P; Schechter, Martin T; Spittal, Patricia M

    2008-06-01

    Recent Indigenist scholarship has situated high rates of traumatic life experiences, including sexual abuse, among Indigenous peoples of North America within the larger context of their status as colonized peoples. Sexual abuse has been linked to many negative health outcomes including mental, sexual and drug-related vulnerabilities. There is a paucity of research in Canada addressing the relationship between antecedent sexual abuse and negative health outcomes among Aboriginal people including elevated risk of HIV infection. The primary objectives of this study were to determine factors associated with sexual abuse among participants of the Cedar Project, a cohort of young Aboriginal people between the ages of 14 and 30 years who use injection and non-injection drugs in two urban centres in British Columbia, Canada; and to locate findings through a lens of historical and intergenerational trauma. We utilized post-colonial perspectives in research design, problem formulation and the interpretation of results. Multivariate modeling was used to determine the extent to which a history of sexual abuse was predictive of negative health outcomes and vulnerability to HIV infection. Of the 543 eligible participants, 48% reported ever having experienced sexual abuse; 69% of sexually abused participants were female. The median age of first sexual abuse was 6 years for both female and male participants. After adjusting for sociodemographic variables and factors of historical trauma, sexually abused participants were more likely to have ever been on the streets for more than three nights, to have ever self-harmed, to have suicide ideation, to have attempted suicide, to have a diagnosis of mental illness, to have been in the emergency department within the previous 6 months, to have had over 20 lifetime sexual partners, to have ever been paid for sex and to have ever overdosed. The prevalence and consequences of sexual abuse among Cedar Project participants are of grave concern

  3. Abuse

    MedlinePlus

    ... also may fall prey to strangers who take advantage of their cognitive impairment. Types of abuse Signs ... property) to his or her disadvantage or the advantage of someone else Sexual abuse: touching, fondling or ...

  4. Assessment of Factors Resulting in Abuse Evaluations in Young Children with Minor Head Trauma

    ERIC Educational Resources Information Center

    Anderst, James D.

    2008-01-01

    Objective: The primary objective was to determine which of the examined factors prompted physicians to initiate a further abuse evaluation in young children with minor head injury. The recording of important historical elements in the charts of these patients was also evaluated. Methods: Charts of 349 children less than 3 years of age with minor…

  5. Bridging Worlds: Understanding and Facilitating Adolescent Recovery from the Trauma of Abuse.

    ERIC Educational Resources Information Center

    Kennedy, Joycee; McCarthy, Carol J.

    Descriptions of past social attitudes and policies that influence the present structure and thinking in the areas of child protection, juvenile justice, education, and mental health are provided by this handbook designed to aid in understanding and helping adolescents traumatized by abuse. This foundation is interwoven with current news examples…

  6. We Cannot Walk Away: DEC's Position of Child Abuse, Neglect, and Trauma

    ERIC Educational Resources Information Center

    Corr, Catherine

    2016-01-01

    This article details two important reasons why supporting young children with disabilities who have experienced abuse and neglect and their families is the responsibility and obligation of the Division for Early Childhood of the Council for Exceptional Children (DEC): (1) Although prevalent in their work, this population is overlooked; and (2)…

  7. Survivors of childhood sexual abuse diagnosed with cancer: managing the impact of early trauma on cancer treatment.

    PubMed

    Gallo-Silver, Les; Weiner, Michael O

    2006-01-01

    The incidence of survivors of childhood sexual abuse (CSA) diagnosed with cancer is unknown. It is estimated that one in three women and one in six men in the United States are survivors of CSA. Survivors of CSA diagnosed with cancer are presented with multiple and potentially accumulating traumas. The re-traumatizing nature of a cancer diagnosis and treatment affects all elements of the CSA survivor's care and may impede her/his treatment. To date, the impact of CSA on the medical treatment of people with cancer has been unexplored with the existing studies on female survivors of CSA with cancer focusing on the post-treatment experience and their higher incidence of sexual dysfunction. This article describes the impact of CSA on the cancer treatment of 18 survivors of CSA and the clinical interventions used to address the unique psychosocial needs of this population. Anecdotal information suggests that the survivors of CSA may find aspects of the cancer experience reminiscent of their history of abuse. All 18 survivors of CSA experienced distressing memories of their abuse during their cancer treatment. Fifteen CSA survivors presented traumatic memories that were inaccessible to conscious thought processes prior to their cancer diagnosis. Psychodynamic interventions address issues of disruption in the cancer treatment, non-adherence, and difficulties in relationships with the health care team. Containment of intense affect and distressing thoughts rather than exploration improved CSA survivors' adherence with cancer treatments. The acquisition of self-comforting skills helped CSA survivors feel less re-victimized by their cancer experience. The establishment of an environment of internal and external safety improved communication with the health care team. Health care/psychosocial clinicians' awareness and use of appropriate interventions can minimize the affects of re-traumatization and enhance the CSA survivor's treatment experience.

  8. Trauma and abuse in the case of Little Hans: a contemporary perspective.

    PubMed

    Ross, John Munder

    2007-01-01

    Newly available interviews with Max and Herbert Graf describe the severe pathology of Little Hans's mother and her mistreatment of her husband and her daughter, who committed suicide as an adult. Reread in this context, the text of "A Phobia in a Five-year-old Boy" provides ample evidence of Frau Graf's sexual seduction and emotional manipulation of her son, which exacerbated his age-expectable castration and separation anxiety, and her beating of her infant daughter. The boy's phobic symptoms can therefore be deconstructed not only as the expression of oedipal fantasy, but as a communication of the traumatic abuse occurring in the home. Through subliminal, indeed unconscious, injunctions conveyed in abusive behavior, parents can confirm the child's worst imaginings and immature views of the world and thereby render the child's oedipal conflicts and fantasies pathogenic. PMID:17915647

  9. Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team

    PubMed Central

    John, Simon; Vincent, Andrea L; Reed, Peter

    2015-01-01

    Aim To describe children referred for suspected abusive head trauma (AHT) to a hospital child protection team in Auckland, New Zealand. Methods Comparative review of demographics, histories, injuries, investigations and diagnostic outcomes for referrals under 15 years old from 1991 to 2010. Results Records were available for 345 children. Referrals increased markedly (88 in the first decade, 257 in the second), but the diagnostic ratio was stable: AHT 60%, accidental or natural 29% and uncertain cause 11%. The probability of AHT was similar regardless of socio-economic status or ethnicity. In children under 2 years old with accidental head injuries (75/255, 29%) or AHT (180/255, 71%), characteristics of particular interest for AHT included no history of trauma (88/98, 90%), no evidence of impact to the head (84/93, 90%), complex skull fractures with intracranial injury (22/28, 79%), subdural haemorrhage (160/179, 89%) and hypoxic ischaemic injury (38/39, 97%). In children over 2 years old, these characteristics did not differ significantly between children with accidental head injuries (21/47, 45%) and AHT (26/47, 55%). The mortality of AHT was higher in children over 2 years old (10/26, 38%) than under 2 years (19/180, 11%). Conclusions The striking increase in referrals for AHT probably represents increasing incidence. The decision to refer a hospitalised child with a head injury for assessment for possible AHT should not be influenced by socio-economic status or ethnicity. Children over 2 years old hospitalised for AHT are usually injured by mechanisms involving impact and should be considered at high risk of death. PMID:26130384

  10. Complete transection of common bile duct due to blunt abdominal trauma: a case report and literature review.

    PubMed

    Chung, Y C; Lee, P H; Huang, M T; Chang, C N

    1993-01-01

    A case of complete transection of the common bile duct due to abdominal blunt injury in a 49-year-old man is presented. The rarity of this injury and its initial presentation as a pancreatic pseudocyst warrant its description. This patient was diagnosed as having bile duct injury following ascites aspiration. Common bile duct transection was documented and a choledochostomy was done. However, bile leaked into the peritoneal cavity one week after the operation. A Roux-en-Y choledochojejunostomy was done successfully in a second operation. Delayed diagnosis is common in these kinds of injuries, but it should be considered when a patient has bile ascites, abdominal distention and jaundice after a blunt abdominal injury. A review of the literature, methods of diagnosis and the technique of surgical repair are described.

  11. Perceptions of participating in longitudinal trauma research among women exposed to intimate partner abuse.

    PubMed

    Hebenstreit, Claire L; DePrince, Anne P

    2012-04-01

    We examine motivations for, and costs/benefits of, participation in three interviews across a one-year period among women recently exposed to intimate partner abuse (IPA). Recruited from publicly accessible police reports, women were not informed that the study focused on IPA in recruiting materials or when they scheduled the first interview. Women's ratings on the Response to Research Participation Questionnaire (RRPQ) indicated a positive benefit-to-cost ratio across all three interviews. Negative responses to participation as well as severity of IPA and PTSD symptoms did not predict retention at the next interview. These data demonstrate that studies asking about IPA experiences, even when survivors do not know in advance that IPA will be the focus of study, can be implemented within a stable benefit-to-cost ratio over time. PMID:22565584

  12. Assessing the accuracy of the International Classification of Diseases codes to identify abusive head trauma: a feasibility study

    PubMed Central

    Berger, Rachel P; Parks, Sharyn; Fromkin, Janet; Rubin, Pamela; Pecora, Peter J

    2016-01-01

    Objective To assess the accuracy of an International Classification of Diseases (ICD) code-based operational case definition for abusive head trauma (AHT). Methods Subjects were children <5 years of age evaluated for AHT by a hospital-based Child Protection Team (CPT) at a tertiary care paediatric hospital with a completely electronic medical record (EMR) system. Subjects were designated as non-AHT traumatic brain injury (TBI) or AHT based on whether the CPT determined that the injuries were due to AHT. The sensitivity and specificity of the ICD-based definition were calculated. Results There were 223 children evaluated for AHT: 117 AHT and 106 non-AHT TBI. The sensitivity and specificity of the ICD-based operational case definition were 92% (95% CI 85.8 to 96.2) and 96% (95% CI 92.3 to 99.7), respectively. All errors in sensitivity and three of the four specificity errors were due to coder error; one specificity error was a physician error. Conclusions In a paediatric tertiary care hospital with an EMR system, the accuracy of an ICD-based case definition for AHT was high. Additional studies are needed to assess the accuracy of this definition in all types of hospitals in which children with AHT are cared for. PMID:24167034

  13. Abdominal Surgical Incision Induces Remote Preconditioning of Trauma (RPCT) via Activation of Bradykinin Receptors (BK2R) and the Cytochrome P450 Epoxygenase Pathway in Canine Hearts

    PubMed Central

    Gross, Garrett J.; Baker, John E.; Moore, Jeannine; Falck, John R.; Nithipatikom, Kasem

    2012-01-01

    Recently, a novel observation was made in which nonischemic trauma at a site remote from the heart produced by a transverse abdominal incision resulted in a marked reduction of infarct size (IS) in the mouse heart via activation of sensory nerve fibers in the skin and subsequent activation of bradykinin 2 receptors (BK2R). This phenomenon was termed remote preconditioning of trauma (RPCT). Since RPCT may have potential clinical implications we attempted to confirm these findings in a large animal model, the dog. The epoxyeicosatrienoic acids (EETs) have also recently been shown to be antinociceptive and have been shown to mimic ischemic preconditioning (IPC) and postconditioning (POC) in dogs, therefore, we tested the role of the EETs in RPCT. Anesthetized adult mongrel dogs of either sex were subjected to 60 min of left anterior descending (LAD) coronary artery occlusion followed by 3 h of reperfusion. In all groups except the controls (no slit), a transverse slit (9 cm) was applied to the abdominal wall of the dog being careful to only slit the skin. Subsequently, 15 min after the slit the heart was subjected to the ischemia/reperfusion protocol. In the control dogs, the IS as a percent of the area at risk (AAR) was 22.5 ± 2.4%, whereas in the dogs subjected to the slit alone the IS/AAR was reduced to 9.2 ± 1.2% (*P<0.01). The BR2R blocker, HOE 140 (50 ug/kg, iv) given 10 min prior to the slit, completely abolished the protective effects of RCPT as did pretreatment with 14,15-EEZE, a putative EET receptor blocker or pretreatment with the selective EET synthesis inhibitor, MSPPOH. These results suggest that BK and the EETs share cardioprotective properties in a large animal model of RPCT. PMID:21786213

  14. The Cortisol Paradox of Trauma-Related Disorders: Lower Phasic Responses but Higher Tonic Levels of Cortisol Are Associated with Sexual Abuse in Childhood

    PubMed Central

    Schalinski, Inga; Elbert, Thomas; Steudte-Schmiedgen, Susann; Kirschbaum, Clemens

    2015-01-01

    Objectives Inconsistent findings exist for the activity of the hypothalamic-pituitary-adrenal (HPA) axis in patients with stress related disorders. Recent studies point towards early life stress as a potential modulator. Methods We investigated the impact of childhood sexual abuse on phasic (saliva cortisol reactivity) and tonic (hair cortisol) regulation. Furthermore, we assessed predictors on cortisol accumulation in hair. Women (N = 43) with stress-related disorders underwent a standardized assessment of idiographic adverse and traumatic experiences and psychopathology, while measuring salivary cortisol and, heart rate and blood pressure. Results Comparing women with and without childhood sexual abuse revealed lower rates of responders and distinct levels of salivary cortisol to the interview in conjunction with a lower heart rate for the abused group. Childhood adversities, traumatic experiences, and depression contributed to higher hair cortisol levels. Conclusions Our finding of lower response rate and distinct salivary cortisol pattern in individuals with childhood sexual abuse compared to individuals without early sexual abuse supports the role of environmental programming for the HPA axis. Both, childhood adversities and traumatic stress emerge as crucial factors for long-term cortisol secretion. Lower or suppressed phasic cortisol responses to trauma-related stimuli may therefore be associated with higher tonic values. Thus, early exposure to adversities may result in a biological distinct phenotype in adult patients with stress-related disorders. PMID:26317554

  15. The Trauma of Commercial Sexual Exploitation of Youth: A Comparison of CSE Victims to Sexual Abuse Victims in a Clinical Sample.

    PubMed

    Cole, Jennifer; Sprang, Ginny; Lee, Robert; Cohen, Judith

    2016-01-01

    This study examined the demographic features, trauma profiles, clinical severity indicators, problem behaviors, and service utilization characteristics of youth victims of commercial sexual exploitation (CSE) compared with a matched sample of sexually abused/assaulted youth who were not exploited in commercial sex. Secondary data analysis and propensity score matching were used to select a sample of 215 help-seeking youth who were exploited in prostitution (n = 43) or who were sexually abused/assaulted but not exploited in prostitution (n = 172) from the National Child Traumatic Stress Network Core Data Set (NCTSN CDS). Propensity Score Matching was used to select a comparison sample based on age, race, ethnicity, and primary residence. Statistically significant differences were noted between the groups on standardized (e.g., UCLA Posttraumatic Stress Disorder Reaction Index [PTSD-RI], Child Behavior Checklist [CBCL]) and other measures of emotional and behavioral problems (e.g., avoidance and hyperarousal symptoms, dissociation, truancy, running away, conduct disorder, sexualized behaviors, and substance abuse). This study provides useful insight into the symptom and service utilization profiles of youth exploited in commercial sex as compared with youth with other types of sexually exploitive experiences. Targeted screening and event-sensitive measures are recommended to more accurately identify youth exploited in commercial sex. More research is needed to determine if and what modifications to trauma therapies may be required to address the more severe symptomatology and behavior problems associated with youth exploited in commercial sex. PMID:25381275

  16. [Focused surgical bedside ultrasound: E-FAST (focused assessment with sonography in trauma) - abdominal aortic aneurysm - cholecystolithiasis - acute appendicitis].

    PubMed

    Studer, Maria; Studer, Peter

    2014-06-01

    Ultrasound is an easy to learn and highly efficient diagnostic tool to complete the clinical examination and improve bedside decision-making. In the trauma room, surgeons are often required to make a quick decision as to whether or not a patient needs an emergency intervention or whether further diagnostics are required. For this reason, education of surgeons in performing focused emergency ultrasound is pivotal. The goal of ICAN is to improve and expand the education of surgeons in Switzerland. This article provides a short review of the most frequent surgical pathologies encountered in the emergency room.

  17. Delta-storage pool disease as a mimic of abusive head trauma in a 7-month-old baby: a case report.

    PubMed

    De Leeuw, Marc; Beuls, Emile; Jorens, Philippe; Parizel, Paul; Jacobs, Werner

    2013-07-01

    A seven-month-old baby was admitted to a hospital emergency department after collapsing suddenly while staying with his nanny. The baby displayed classic symptoms of shaken baby syndrome, including subdural haemorrhage, cytotoxic cerebral oedema, and bilateral retinal hemorrhages. Child protection services were informed, but both the parents and the nanny denied any involvement. In the subsequent weeks, the baby developed three other episodes of new subdural bleeding and a medico-legal investigation was started into the origin of the repeated subdural bleeding. Eventually, platelet aggregation tests and electron microscopy diagnosed a delta-storage pool disease; that is, a haemostatic disorder involving dense granules of the platelets. Initial minor blunt trauma may have resulted in subdural bleeding, while subsequent retinal haemorrhage could have been facilitated by the underlying haemostatic disorder. Delta-storage pool disease should be considered as a possible mimic of abusive head trauma similar to other rare conditions such as Menkes disease and type 1 glutaric aciduria.

  18. Trauma Symptoms, Sexual Behaviors, and Substance Abuse: Correlates of Childhood Sexual Abuse and HIV Risks among Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Gore-Felton, Cheryl; Benotsch, Eric; Cage, Marjorie; Rompa, David

    2004-01-01

    Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed…

  19. The Impact of Violence and Abuse on Women's Physical Health: Can Trauma-Informed Treatment Make a Difference?

    ERIC Educational Resources Information Center

    Weissbecker, Inka; Clark, Colleen

    2007-01-01

    A history of traumatic experiences has been associated with poor physical health. This study examined associations between trauma and physical health, as well as changes in physical health over time, in women with co-occurring disorders and histories of violence who received either integrated trauma-informed services or usual care. Results…

  20. Diagnostic imaging of child abuse

    SciTech Connect

    Kleinman, P.K.

    1987-01-01

    This book provides a description for all the known radiological alterations occurring in child abuse. This allows for precise interpretation of findings by radiologists. It also helps eliminate the confusion among both clinicians and non-medical personnel involved in the diagnosis, management, and legal issues related to child abuse. CONTENTS: Introduction; Skeletal trauma: general considerations; Extremity trauma; Bony thoracic trauma; Spinal trauma; Dating fractures; Visceral trauma; Head trauma; Miscellaneous forms of abuse and neglect; The postmortem examination; Differential diagnosis of child abuse; Legal considerations; Psychosocial considerations; Technical considerations and dosimetry.

  1. Trauma Ultrasound.

    PubMed

    Wongwaisayawan, Sirote; Suwannanon, Ruedeekorn; Prachanukool, Thidathit; Sricharoen, Pungkava; Saksobhavivat, Nitima; Kaewlai, Rathachai

    2015-10-01

    Ultrasound plays a pivotal role in the evaluation of acute trauma patients through the use of multi-site scanning encompassing abdominal, cardiothoracic, vascular and skeletal scans. In a high-speed polytrauma setting, because exsanguinations are the primary cause of trauma morbidity and mortality, ultrasound is used for quick and accurate detection of hemorrhages in the pericardial, pleural, and peritoneal cavities during the primary Advanced Trauma Life Support (ATLS) survey. Volume status can be assessed non-invasively with ultrasound of the inferior vena cava (IVC), which is a useful tool in the initial phase and follow-up evaluations. Pneumothorax can also be quickly detected with ultrasound. During the secondary survey and in patients sustaining low-speed or localized trauma, ultrasound can be used to help detect abdominal organ injuries. This is particularly helpful in patients in whom hemoperitoneum is not identified on an initial scan because findings of organ injuries will expedite the next test, often computed tomography (CT). Moreover, ultrasound can assist in detection of fractures easily obscured on radiography, such as rib and sternal fractures.

  2. Computed tomography in trauma

    SciTech Connect

    Toombs, B.D.; Sandler, C.M.

    1987-01-01

    This book begins with a chapter dealing with the epidemiology and mechanisms of trauma. Trauma accounts for more lives lost in the United States than cancer and heart disease. The fact that 30%-40% of trauma-related deaths are caused by improper or delayed diagnoses or treatment emphasizes the importance of rapid and accurate methods to establish a diagnosis. Acute thoracic, abdominal, and pelvic trauma and their complications are discussed. A chapter on high-resolution CT of spinal and facial trauma and the role of three-dimensional reconstruction images is presented.

  3. A Multi-Method Treatment for Child Survivors of Sexual Abuse: An Intervention Informed by Relational and Trauma Theories.

    ERIC Educational Resources Information Center

    Levendosky, Alytia A.; Buttenheim, Margaret

    2002-01-01

    Presents a case study of the treatment of a pre-adolescent female survivor of incest. The treatment integrated relational and trauma theory perspectives in focusing on reducing self-blame, preventing further isolation, creating a safe, secure environment, and helping the patient develop positive connections with others and feelings of…

  4. Child Abuse: Betrayal and Disclosure

    ERIC Educational Resources Information Center

    Foynes, Melissa Ming; Freyd, Jennifer J.; DePrince, Anne P.

    2009-01-01

    Objective: The current study tested several hypotheses about disclosure of childhood sexual, physical, and emotional abuse derived from Betrayal Trauma Theory [Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Cambridge, MA: Harvard University Press]. We predicted that the duration of time from abuse to its disclosure…

  5. A comparison of self-reported emotional and trauma-related concerns among sexually abused children with and without sexual behavior problems.

    PubMed

    Allen, Brian; Thorn, Brian L; Gully, Kevin J

    2015-05-01

    Numerous studies document concomitant features of sexual behavior problems (SBPs) among children 12 years of age or younger, but rarely does research involve child self-report assessments. This study provides the most comprehensive examination to date of self-reported concerns among children with SBP, using a large sample (N = 392) of clinically referred participants who reported sexual abuse histories. Children between the ages of 8 and 12 were categorized as demonstrating SBP (n = 203) or not demonstrating SBP (n = 189) as determined by scores on the Child Sexual Behavior Inventory. Children completed the Trauma Symptom Checklist for Children, and caregivers completed the Child Behavior Checklist. Self-reports of children showed that those with SBP reported significantly greater concerns in all areas, including sexual preoccupation and sexual distress, than their peers not demonstrating SBP. Caregivers of children in the SBP group reported greater concerns of internalizing and externalizing problems than the caregivers of children who did not have SBP. Implications for clinical practice and future research are discussed. Specifically, it is recommended that future research improve on the manner in which sexual abuse and SBPs were defined and assessed.

  6. Trauma, Helpfulness and Selfishness: The Effect of Abuse and Neglect on Altruistic, Moral and Pro-Social Capacities

    ERIC Educational Resources Information Center

    Music, Graham

    2011-01-01

    In this paper, I suggest that one major effect of abuse and neglect is that children become less interested in other people, less able to care for others, and are thus less altruistic. I argue that the capacity to care for others ordinarily co-emerges with a swathe of other capacities such as the ability to understand other minds, to empathise, to…

  7. Effects of a Behavioral Sleep Medicine Intervention on Trauma Symptoms in Adolescents Recently Treated for Substance Abuse

    ERIC Educational Resources Information Center

    Stevens, Sally; Haynes, Patricia L.; Ruiz, Bridget; Bootzin, Richard R.

    2007-01-01

    This study tested whether improvement in sleep by an integrative, behavioral sleep intervention was associated with improvement in traumatic stress (TS) symptoms in a sample of 20 adolescents who were recently treated for substance abuse. Sleep was measured throughout the intervention via daily sleep diaries, and traumatic stress symptoms were…

  8. The Experience of Trauma Recovery: A Qualitative Study of Participants in the Women Recovering from Abuse Program (WRAP)

    ERIC Educational Resources Information Center

    Parker, Alyson; Fourt, Anne; Langmuir, Judith I.; Dalton, E. Jane; Classen, Catherine C.

    2007-01-01

    The efficacy of intensive group treatment programs for child maltreatment has been established. The aim of this qualitative study was to understand how women with a history of child maltreatment experienced the Women Recovering from Abuse Program (WRAP), an existing intensive group treatment program. Seven women were interviewed following their…

  9. A case of abdominal trauma

    PubMed Central

    Stephens, Georgina C.; Claydon, Matthew H.

    2015-01-01

    Multiple injuries resulting from the use of nail guns have been described in the literature; however, to date there has been no report of a nail gun injury to the abdomen. We describe the case of a 30-year-old male tradesperson who suffered a penetrating nail gun injury to the epigastrium, resulting in multiple injuries to the bowel and an inferior vena caval injury with massive haemorrhage. This case demonstrates the wide range of injuries capable of being inflicted by a single penetrating injury, and emphasizes the need for proper training and safety measures in the use of nail guns. PMID:25687444

  10. Validating Female Psychopathy Subtypes: Differences in Personality, Antisocial and Violent Behavior, Substance Abuse, Trauma, and Mental Health

    PubMed Central

    Hicks, Brian M.; Vaidyanathan, Uma; Patrick, Christopher J.

    2010-01-01

    Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems including symptoms of post-traumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to non-violent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities. PMID:20582155

  11. Validating female psychopathy subtypes: differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.

    PubMed

    Hicks, Brian M; Vaidyanathan, Uma; Patrick, Christopher J

    2010-01-01

    Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities.

  12. Abdominal tap

    MedlinePlus

    Peritoneal tap; Paracentesis; Ascites - abdominal tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap ... abdominal cavity ( most often cancer of the ovaries ) Cirrhosis of the liver Damaged bowel Heart disease Infection ...

  13. Conservative management of abdominal injuries

    PubMed Central

    Okuş, Ahmet; Sevinç, Barış; Ay, Serden; Arslan, Kemal; Karahan, Ömer; Eryılmaz, Mehmet Ali

    2013-01-01

    Objective: Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results: The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring. PMID:25931868

  14. [Abdominal compartment syndrome].

    PubMed

    Pottecher, T; Segura, P; Launoy, A

    2001-04-01

    French physicians dealing with abdominal emergencies are not very familiar with the abdominal compartment syndrome (ACS). Increased abdominal pressure has deleterious consequences on local (intestine, liver, kidney) circulation, leading to death in the absence of correct treatment. Abdominal trauma and ruptured aortic aneurism are the main causes of ACS. Clinical presentation may be misleading: respiratory failure, oliguria or circulatory symptoms are often predominant. Abdominal palpation is inefficient for evaluating intra-abdominal pressure (IAP); only measurement of cystic pressure allows precise evaluation of IAP. Abdominal decompression is the treatment of choice. It must be performed as soon as IAP exceeds 25 mmHg. The procedure may be risky with a high incidence of severe complications when ischaemic territories are reperfused. Recent data underline the importance of compensation of hypovolemia before decompression. Abdominal closure may necessitate various techniques (aponevrotomy, Bogota bags, etc.). At any rate, IAP must remain low at the end of the procedure. In case of suspicion of ACS, early measurement of IAP is mandatory. If pressure is over 25 mmHg, a decompressive procedure must be initiated. PMID:11340703

  15. Computed tomography in the evaluation of trauma

    SciTech Connect

    Federle, M.P.; Brant-Zawadzki, M.

    1982-01-01

    This book is intended to be the current standard for computed tomography in the evaluation of trauma. It summarizes two years of experience at San Francisco General Hospital. The book is organized into seven chapters, covering head, maxillofacial, laryngeal, spinal, chest, abdominal, acetabular, and pelvic trauma. Extremity trauma is not discussed.

  16. Sexual Trauma, Spirituality, and Psychopathology

    ERIC Educational Resources Information Center

    Krejci, Mark J.; Thompson, Kevin M.; Simonich, Heather; Crosby, Ross D.; Donaldson, Mary Ann; Wonderlich, Stephen A.; Mitchell, James E.

    2004-01-01

    This study assessed the association between spirituality and psychopathology in a group of sexual abuse victims and controls with a focus on whether spirituality moderated the association between sexual trauma and psychopathology. Seventy-one sexual trauma victims were compared to 25 control subjects on spiritual well-being, the Eating Disorder…

  17. Vicarious Trauma: Predictors of Clinicians' Disrupted Cognitions about Self-Esteem and Self-Intimacy

    ERIC Educational Resources Information Center

    Way, Ineke; VanDeusen, Karen; Cottrell, Tom

    2007-01-01

    This study examined vicarious trauma in clinicians who provide sexual abuse treatment (N = 383). A random sample of clinical members from the Association for the Treatment of Sexual Abusers and American Professional Society on the Abuse of Children were surveyed. Vicarious trauma was measured using the Trauma Stress Institute Belief Scale…

  18. Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women.

    PubMed

    Peltan, Jessica R; Cellucci, Tony

    2011-10-01

    Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms.

  19. The child welfare response to serious nonaccidental head trauma.

    PubMed

    Jaudes, Paula Kienberger; Bilaver, Lucy A

    2004-01-01

    Serious nonaccidental head trauma (NHT) can leave permanent neurological damage in children who survive abuse. This study reports on child welfare's handling of NHT cases compared with cases of physical abuse and head trauma due to neglect with regard to placement in foster care, reunification with family, and safety issues. The results show that workers placed children with NHT in foster care immediately after the abuse but treated them no differently than other physically abused children regarding reunification. PMID:15002911

  20. Violence against Native Women in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saylors, Karen; Daliparthy, Nalini

    2006-01-01

    Many mental health problems among substance abusing populations are directly linked to high rates of abuse and trauma. There is increasing evidence of associations between childhood physical and sexual abuse to adult substance use and HIV-risk behavior. The relationship of abuse, mental health problems, substance abuse, and high-risk sexual…

  1. The Abusive Environment and the Child's Adaptation.

    ERIC Educational Resources Information Center

    Martin, Harold P.

    The biologic and developmental problems of abused children are usually thought of etiologically in relation to the physical trauma which has been suffered. Indeed, physical trauma can cause death, brain damage, developmental delays and deviations in personality development. The environment in which the abused child grows and develops is a most…

  2. The cumulative effect of different childhood trauma types on self-reported symptoms of adult male depression and PTSD, substance abuse and health-related quality of life in a large active-duty military cohort.

    PubMed

    Agorastos, Agorastos; Pittman, James O E; Angkaw, Abigail C; Nievergelt, Caroline M; Hansen, Christian J; Aversa, Laura H; Parisi, Sarah A; Barkauskas, Donald A; Baker, Dewleen G

    2014-11-01

    History of childhood trauma (CT) is highly prevalent and may lead to long-term consequences on physical and mental health. This study investigated the independent association of CT with symptoms of adult depression and posttraumatic stress disorder (PTSD), mental and physical health-related quality of life (HRQoL), as well as current tobacco consumption and alcohol abuse in a large homogenous cohort of 1254 never-deployed, young male Marines enrolled in the Marine Resiliency Study. Independent effects of CT history, number and type of CT on outcomes were analyzed using hierarchical multivariate logistic regression models. Our results suggested dose-dependent negative effect of an increasing number of trauma types of CT on depression, PTSD and HRQoL. Experience of single CT type demonstrated overall weak effects, while history of multiple CT types distinctively increased the likelihood of adult PTSD symptomology (OR: 3.1, 95% CI: 1.5-6.2), poor mental (OR: 2.3, 95% CI: 1.7-3.1) and physical HRQoL (OR: 1.4, 95% CI: 1.1-1.9). Risk for depression symptoms was similar for both single and multiple CT (OR: 2.2, 95% CI: 1.3-3.8 and OR: 2.1, 95% CI: 1.2-3.5 respectively). CT history had no effects on current tobacco use and alcohol abuse. Our study thus provides evidence for substantial additive effect of different CT types on adult mental and physical health with increasing levels of exposure.

  3. Carcinoma of the duodenum after trauma, radiotherapy and chemotherapy.

    PubMed

    Bayens, Y C; Wiggers, T; Meerwaldt, J H; Vroom, T M; Van Geel, A N

    1991-10-01

    The case history is reported of a patient with a carcinoma of the duodenum 30 years after blunt abdominal trauma at the site of the 'scar' in the duodenum. Thirteen years after the trauma the patient was treated with chemotherapy and abdominal irradiation for a relapse of Hodgkin's disease. At follow-up, 25 months after the operation, he had no local recurrence of Hodgkin's disease or duodenal cancer. The possible relation between the cancer and the abdominal trauma, chemotherapy and abdominal irradiation is discussed. PMID:1787905

  4. Carcinoma of the duodenum after trauma, radiotherapy and chemotherapy.

    PubMed

    Bayens, Y C; Wiggers, T; Meerwaldt, J H; Vroom, T M; Van Geel, A N

    1991-10-01

    The case history is reported of a patient with a carcinoma of the duodenum 30 years after blunt abdominal trauma at the site of the 'scar' in the duodenum. Thirteen years after the trauma the patient was treated with chemotherapy and abdominal irradiation for a relapse of Hodgkin's disease. At follow-up, 25 months after the operation, he had no local recurrence of Hodgkin's disease or duodenal cancer. The possible relation between the cancer and the abdominal trauma, chemotherapy and abdominal irradiation is discussed.

  5. Physical Abuse

    MedlinePlus

    Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...

  6. Sexual Abuse

    MedlinePlus

    Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...

  7. Niki de Saint Phalle's lifelong dialogue between art and diseases: psychological trauma of sexual abuse, transient selective IgA deficiency, occupational exposure to toxic plastic material, chronic lung disease, rheumatoid arthritis.

    PubMed

    Zeidler, Henning

    2013-05-01

    The French artist Niki de Saint Phalle (1930-2002) is one of the most famous female painter and sculptor of the 20th century. Her eventful live was full of emotional and physical burdens such as abuse by the father as a adolescent, early separation from family, nervous collapse, turbulent relationship with the artist Jean Tinguely, and last not least serious diseases. The psychological trauma of sexual abuse together with a "nervous breakdown" years later was the start of a life as an artist and is also a key to her art of the early years. She was affected from rheumatoid arthritis (RA) and was treated over 20 years with prednisolone and antimalarials leading to a good functional outcome and limited erosions of the wrist joint. Additionally, she had lifelong pulmonary disorders finally leading to death, which she attributed to polyester, the material used for her sculptures. An analysis of medical documents collected by her and provided by treating physicians gives another surprising explanation: selective IgA deficiency with multiple recurrent respiratory infections, asthma, milk intolerance, autoimmune thyroiditis, and RA compatible with hypogammaglobulinemia. Very unique in case of Niki de Saint Phalle is that IgA deficiency was transient. Nevertheless, it may be possible that the occupational exposure with art materials (polystyrene, polyester) has contributed in part or temporarily to her health problems. Altogether, her enormous artistic productivity represents an outstanding example of creative coping with RA and other lifelong health problems.

  8. The Clinical Correlates of Reported Childhood Sexual Abuse: An Association between Age at Trauma Onset and Severity of Depression and PTSD in Adults

    ERIC Educational Resources Information Center

    Schoedl, Aline Ferri; Costa, Mariana Cadrobbi Pupo; Mari, Jair J.; Mello, Marcelo Feijo; Tyrka, Audrey R.; Carpenter, Linda L.; Price, Lawrence H.

    2010-01-01

    This study investigated the relationship between the age of self-reported sexual abuse occurrence and the development of post-traumatic stress disorder and/or depressive symptoms in adulthood. Subjects were evaluated for the presence of post-traumatic stress disorder and/or depressive symptoms as well as for a self-reported history of sexual abuse…

  9. The Child Welfare Response to Serious Nonaccidental Head Trauma

    ERIC Educational Resources Information Center

    Jaudes, Paula Kienberger; Bilaver, Lucy A.

    2004-01-01

    Serious nonaccidental head trauma (NHT) can leave permanent neurological damage in children who survive abuse. This study reports on child welfare's handling of NHT cases compared with cases of physical abuse and head trauma due to neglect with regard to placement in foster care, reunification with family, and safety issues. The results show that…

  10. Facial trauma

    MedlinePlus

    Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . ... Facial trauma. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and ...

  11. Substance abuse and child maltreatment.

    PubMed

    Wells, Kathryn

    2009-04-01

    Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

  12. Ear trauma.

    PubMed

    Eagles, Kylee; Fralich, Laura; Stevenson, J Herbert

    2013-04-01

    Understanding basic ear anatomy and function allows an examiner to quickly and accurately identify at-risk structures in patients with head and ear trauma. External ear trauma (ie, hematoma or laceration) should be promptly treated with appropriate injury-specific techniques. Tympanic membrane injuries have multiple mechanisms and can often be conservatively treated. Temporal bone fractures are a common cause of ear trauma and can be life threatening. Facial nerve injuries and hearing loss can occur in ear trauma.

  13. The Role of Sexual Trauma in the Treatment of Chemically Dependent Women: Addressing the Relapse Issue.

    ERIC Educational Resources Information Center

    Wadsworth, Rick; And Others

    1995-01-01

    Explores issues surrounding sexual trauma and chemical dependency. Aims to provide direction for relapse prevention with a relapse-prone population and explores application of traditional milieu substance-abuse treatment for sexual-trauma survivors. Makes recommendations for working with sexual-trauma survivors who are also substance abusers. (RJM)

  14. Seduction trauma: representation, deferred action, and pathogenic development.

    PubMed

    Blum, H P

    1996-01-01

    Seduction trauma refers to a range of phenomena currently described under the rubric of child abuse. Freud elucidated the fantasy distortion and elaboration of traumatic experience and retained the importance of actual trauma. Psychic trauma is associated with the alteration of self and object representations and ensuing new identifications, e.g., with victim and aggressor. The "deferred action" of psychic trauma is an antiquated concept and psychic trauma has immediate effects as well as far reaching developmental consequences. Prior trauma predisposes to later traumatic vulnerability and to trauma linked to phase specific unconscious conflict. The pathogenesis of child sex abuse and the enactment of oedipal incest extends before and after the oedipal phase, is often associated with other forms of abuse, and has a history of pathogenic parent-child relationship.

  15. Elder Abuse and Substance Abuse

    MedlinePlus

    ... Additional Resources Return to: What is Elder Abuse? Elder Abuse and Substance Abuse Substance abuse has been identified ... the most frequently cited risk factor associated with elder abuse and neglect. It may be the victim and/ ...

  16. Systemic trauma.

    PubMed

    Goldsmith, Rachel E; Martin, Christina Gamache; Smith, Carly Parnitzke

    2014-01-01

    Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering.

  17. Systemic trauma.

    PubMed

    Goldsmith, Rachel E; Martin, Christina Gamache; Smith, Carly Parnitzke

    2014-01-01

    Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering. PMID:24617751

  18. Toxicology screening in urban trauma patients: drug prevalence and its relationship to trauma severity and management.

    PubMed

    Sloan, E P; Zalenski, R J; Smith, R F; Sheaff, C M; Chen, E H; Keys, N I; Crescenzo, M; Barrett, J A; Berman, E

    1989-12-01

    Although toxicology screening is often used when treating trauma patients, its utility and significance remain controversial. Data from 623 toxicology screens performed in urban trauma center patients with mental status alterations are reported. The study patients were predominantly black and male, with a mean age of 32 (+/- 22) years. Overall, 86% of screens were positive. Substances of abuse, including ethanol, were noted in 525 (84%) of urine toxicology screens. Ethanol, cannabinoids, and cocaine were the drugs most commonly found in urine, with positivity noted in 53%, 37%, and 34% of screens. Serum analysis was 44% positive, with ethanol noted in 41% of patients. In blacks, the odds ratio of illicit drug use before trauma ranged from 1.9 to 4.2 (p less than 0.005), and in those aged 17 to 40 years, the odds ratio for illicit urine drugs ranged from 4.7 to 16.8 (p less than 0.001). In patients older than 40 years, the odds of a positive serum ethanol level were 1.7 times greater than in younger patients, and a level above 300 mg% was 3.8 times more likely in this age group (p less than 0.001). When serum ethanol was detected, the odds ratio of a head injury was 1.4 relative to patients without serum ethanol (p less than 0.06), and the odds ratio for abdominal injury was 1.6 for patients with serum ethanol (p less than 0.03). The odds of a TS less than 12 were 1.8 (p less than 0.05), and the odds of a GCS less than 12 were 3.3 (p less than 0.001) with ethanol levels greater than 100 mg%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2593195

  19. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  20. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  1. Impact of trauma on children.

    PubMed

    Lubit, Roy; Rovine, Deborah; DeFrancisci, Lea; Eth, Spencer

    2003-03-01

    Millions of children are affected by physical and sexual abuse, natural and technological disasters, transportation accidents, invasive medical procedures, exposure to community violence, violence in the home, assault, and terrorism. Unfortunately, the emotional impact of exposure to trauma on children is often unappreciated and therefore untreated, and yet the impact of exposures to disaster and violence is profound and long-lasting. This article first briefly discusses the epidemiology of trauma in children, and then reviews the psychiatric and neurodevelopmental impact of trauma on children as well as the effects of trauma on children's emotional development. Trauma in children can lead to the development of posttraumatic stress disorder as well as to a variety of other psychiatric disorders, including depression, generalized anxiety disorder, panic attacks, borderline personality disorder, and substance abuse in adult survivors of trauma. Research has found that early exposure to stress and trauma causes physical effects on neurodevelopment which may lead to changes in the individual's long-term response to stress and vulnerability to psychiatric disorders. Exposure to trauma also affects children's ability to regulate, identify, and express emotions, and may have a negative effect on the individual's core identity and ability to relate to others. The authors also discuss what has been learned, based on recent experiences such as the World Trade Center catastrophe, about the role of television viewing in increasing the effects of traumatic events. The last section of the article provides guidance concerning the identification and clinical treatment of children and adolescents who are having emotional problems as a result of exposure to trauma.

  2. Paediatric Blunt Torso Trauma

    PubMed Central

    Bhatti, Khalid M.; Taqi, Kadhim M.; Al-Harthy, Ahmed Z. S.; Hamid, Rana S.; Al-Balushi, Zainab N.; Sankhla, Dilip K.; Al-Qadhi, Hani A.

    2016-01-01

    Objectives: Trauma is the greatest cause of morbidity and mortality in paediatric/adolescent populations worldwide. This study aimed to describe trauma mechanisms, patterns and outcomes among children with blunt torso trauma admitted to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective single-centre study involved all children ≤12 years old with blunt torso trauma admitted for paediatric surgical care at SQUH between January 2009 and December 2013. Medical records were analysed to collect demographic and clinical data. Results: A total of 70 children were admitted with blunt torso trauma during the study period, including 39 (55.7%) male patients. The mean age was 5.19 ± 2.66 years. Of the cohort, 35 children (50.0%) received their injuries after having been hit by cars as pedestrians, while 19 (27.1%) were injured by falls, 12 (17.1%) during car accidents as passengers and four (5.7%) by falling heavy objects. According to computed tomography scans, thoracic injuries were most common (65.7%), followed by abdominal injuries (42.9%). The most commonly involved solid organs were the liver (15.7%) and spleen (11.4%). The majority of the patients were managed conservatively (92.9%) with a good outcome (74.3%). The mortality rate was 7.1%. Most deaths were due to multisystem involvement. Conclusion: Among children with blunt torso trauma admitted to SQUH, the main mechanism of injury was motor vehicle accidents. As a result, parental education and enforcement of infant car seat/child seat belt laws are recommended. Conservative management was the most successful approach. PMID:27226913

  3. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    PubMed Central

    Mauritz, Maria W.; Goossens, Peter J. J.; Draijer, Nel; van Achterberg, Theo

    2013-01-01

    Background Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. Objective To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods We conducted a systematic review of four databases (1980–2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%), sexual abuse 37% (range 24–49%), and posttraumatic stress disorder (PTSD) 30% (range 20–47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI. PMID:23577228

  4. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  5. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  6. A fibromatosis case mimicking abdominal aorta aneurysm.

    PubMed

    Tasdemir, Arzu; Kahraman, Cemal; Tasdemir, Kutay; Mavili, Ertugrul

    2013-01-01

    Retroperitoneal fibrosis is a rare fibrosing reactive process that may be confused with mesenteric fibromatosis. Abdominal aorta aneurysm is rare too and mostly develops secondary to Behcet's disease, trauma, and infection or connective tissue diseases. Incidence of aneurysms occurring as a result of atherosclerotic changes increases in postmenopausal period. Diagnosis can be established with arteriography, tomography, or magnetic resonance imaging associated with clinical findings. Tumors and cysts should be considered in differential diagnosis. Abdominal ultrasound and contrast-enhanced computerized tomography revealed an infrarenal abdominal aorta aneurysm in a 41-year-old woman, but, on surgery, retroperitoneal fibrosis surrounding the aorta was detected. We present this interesting case because retroperitoneal fibrosis encircling the abdominal aorta can mimic abdominal aorta aneurysm radiologically.

  7. Handlebar Hernia: A Rare Type of Abdominal Wall Hernia

    PubMed Central

    Hassan, Khairi A. F.; Elsharawy, Mohamed A.; Moghazy, Khaled; AlQurain, Abdulaziz

    2008-01-01

    Handlebar hernias are abdominal wall hernias resulting from direct trauma to the anterior abdominal wall. They usually result at weak anatomic locations of the abdominal wall. Such traumatic hernias are rare, requiring a high index of suspicion for a clinical diagnosis. We report the case of a handlebar hernia resulting from an injury sustained during a vehicular injury, and discuss the management of such injuries. PMID:19568493

  8. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  9. Abdominal injuries in communal crises: The Jos experience

    PubMed Central

    Ojo, Emmanuel Olorundare; Ozoilo, Kenneth N.; Sule, Augustine Z.; Ugwu, Benjamin T.; Misauno, Michael A.; Ismaila, Bashiru O.; Peter, Solomon D.; Adejumo, Adeyinka A.

    2016-01-01

    Background: Abdominal injuries contribute significantly to battlefield trauma morbidity and mortality. This study sought to determine the incidence, demographics, clinical features, spectrum, severity, management, and outcome of abdominal trauma during a civilian conflict. Materials and Methods: A prospective analysis of patients treated for abdominal trauma during the Jos civil crises between December 2010 and May 2012 at the Jos University Teaching Hospital. Results: A total of 109 victims of communal conflicts with abdominal injuries were managed during the study period with 89 (81.7%) males and 20 (18.3%) females representing about 12.2% of the total 897 combat related injuries. The peak age incidence was between 21 and 40 years (range: 3–71 years). The most frequently injured intra-abdominal organs were the small intestine 69 (63.3%), colon 48 (44%), and liver 41 (37.6%). Forty-four (40.4%) patients had extra-abdominal injuries involving the chest in 17 (15.6%), musculoskeletal 12 (11%), and the head in 9 (8.3%). The most prevalent weapon injuries were gunshot 76 (69.7%), explosives 12 (11%), stab injuries 11 (10.1%), and blunt abdominal trauma 10 (9.2%). The injury severity score varied from 8 to 52 (mean: 20.8) with a fatality rate of 11 (10.1%) and morbidity rate of 29 (26.6%). Presence of irreversible shock, 3 or more injured intra-abdominal organs, severe head injuries, and delayed presentation were the main factors associated with mortality. Conclusion: Abdominal trauma is major life-threatening injuries during conflicts. Substantial mortality occurred with loss of nearly one in every 10 hospitalized victims despite aggressive emergency room resuscitation. The resources expenditure, propensity for death and expediency of timing reinforce the need for early access to the wounded in a concerted trauma care systems. PMID:26957819

  10. Sexual Abuse and the Problem of Embodiment.

    ERIC Educational Resources Information Center

    Young, Leslie

    1992-01-01

    Potential long-term effects of the trauma of severe sexual abuse on a child's sense of living in his/her body and in the world are explored. Trauma and dissociation are analyzed and linked to a posttraumatic sense of personal identity. Then dissociation, multiple personality disorder, eating disorders, somatization disorder, self-mutilation, and…

  11. Acoustic trauma

    MedlinePlus

    Acoustic trauma is a common cause of sensory hearing loss . Damage to the hearing mechanisms within the inner ... Symptoms include: Partial hearing loss that most often involves ... The hearing loss may slowly get worse. Noises, ringing in ...

  12. Childhood Trauma and Its Relation to Chronic Depression in Adulthood

    PubMed Central

    Negele, Alexa; Kaufhold, Johannes; Kallenbach, Lisa; Leuzinger-Bohleber, Marianne

    2015-01-01

    There is a large consensus indicating that childhood trauma is significantly involved in the development of depression. The aim of this study was to examine the prevalence of retrospectively recalled childhood trauma in chronically depressed patients and to investigate a more specific relationship between trauma type and depression. We further asked for the influence of multiple experiences of childhood trauma on the vulnerability to a chronic course of depression in adulthood. 349 chronically depressed patients of the German LAC Depression Study completed the Childhood Trauma Questionnaire, a self-report measure of traumatic experiences in childhood. 75.6% of the chronically depressed patients reported clinically significant histories of childhood trauma. 37% of the chronically depressed patients reported multiple childhood traumatization. Experiences of multiple trauma also led to significantly more severe depressive symptoms. Stepwise multiple regression analysis suggested that childhood emotional abuse and sexual abuse were significantly associated with a higher symptom severity in chronically depressed adults. Yet, expanding the regression model for multiple exposures showed that multiplicity was the only remaining significant predictor for symptom severity in chronically depressed patients. Clinical implications suggest a precise assessment of childhood trauma in chronically depressed patients with a focus on emotional abuse, sexual abuse, and multiple exposures to childhood trauma. This trial is registered with registration number ISRCTN91956346. PMID:26693349

  13. Bruising and Hemophilia: Accident or Child Abuse?

    ERIC Educational Resources Information Center

    Johnson, Charles F.; Coury, Daniel L.

    1988-01-01

    Two case histories illustrate the difficulty in evaluating abuse/neglect in children with bleeding problems such as hemophilia. Discussed are guidelines for diagnosis and prevention of abuse, including: screening techniques, the need for protection from environmental trauma, parental stress, evaluation of parents' disciplinary methods, and the…

  14. Holocaust Child Survivors and Child Sexual Abuse

    ERIC Educational Resources Information Center

    Lev-Wiesel, Rachel; Amir, Marianne

    2005-01-01

    This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the…

  15. Child Abuse, Dissociation, and Core Beliefs in Bulimic Disorders.

    ERIC Educational Resources Information Center

    Hartt, Joanne; Waller, Glenn

    2002-01-01

    A study involving 23 British women with bulimic disorders found no dimensional relationship between any form of child abuse and bulimic pathology. However, neglect and sexual abuse were correlated with dissociation. A subset of core beliefs was associated with child abuse, with different cognitive profiles associated with each trauma. (Contains…

  16. Thirty-Year Study Links Neuroscience, Specific Trauma, PTSD, Image Conversion, and Language Translation

    ERIC Educational Resources Information Center

    Spring, Dee

    2004-01-01

    Despite voluminous literature on trauma, studies on specific trauma and art expression remain sparse. Recurring graphic forms produced by sexual abuse victims have appeared in art therapy publications dating back to Naumburg (1958), but links between sexual abuse-assault and recurring graphic forms were not considered. In 1973, this author began a…

  17. A Cross-Validation Study of the Trauma Symptom Checklist: The Role of Mediating Variables.

    ERIC Educational Resources Information Center

    Gold, Steven R.; And Others

    1994-01-01

    Examines the responses to the Trauma Symptom Checklist (TSC) of college women (n=654) sexually abused as children, sexually assaulted as adults, sexually assaulted as children and adults, and nonabused. Results support the validity of the TSC as a measure of sexual abuse trauma and point to family patterns associated with prolonged symptomatology.…

  18. Inflicted Skeletal Trauma: The Relationship of Perpetrators to Their Victims

    ERIC Educational Resources Information Center

    Starling, Suzanne P.; Sirotnak, Andrew P.; Heisler, Kurt W.; Barnes-Eley, Myra L.

    2007-01-01

    Objective: Although inflicted skeletal trauma is a very common presentation of child abuse, little is known about the perpetrators of inflicted skeletal injuries. Studies exist describing perpetrators of inflicted traumatic brain injury, but no study has examined characteristics of perpetrators of inflicted skeletal trauma. Methods: All cases of…

  19. Working with Families Experiencing Homelessness: Understanding Trauma and Its Impact

    ERIC Educational Resources Information Center

    Guarino, Kathleen; Bassuk, Ellen

    2010-01-01

    The prevalence of traumatic stress in the lives of families who are homeless is extraordinarily high. Often these families are headed by single mothers who have experienced ongoing trauma in the form of childhood abuse and neglect, domestic violence, and community violence, as well as the trauma associated with poverty and the loss of home,…

  20. Prior Trauma Exposure for Youth in Treatment Foster Care

    ERIC Educational Resources Information Center

    Dorsey, Shannon; Burns, Barbara J.; Southerland, Dannia G.; Cox, Julia Revillion; Wagner, H. Ryan; Farmer, Elizabeth M. Z.

    2012-01-01

    Very little research has focused on rates of trauma exposure for youth in treatment foster care (TFC). Available research has utilized record review for assessing exposure, which presents limitations for the range of trauma types examined, as records are predominantly focused on abuse and neglect. The current study examines exposure rates and…

  1. Evaluation of a Spiritually Focused Intervention with Older Trauma Survivors

    ERIC Educational Resources Information Center

    Bowland, Sharon; Edmond, Tonya; Fallot, Roger D.

    2012-01-01

    This study evaluated the effectiveness of an 11-session, spiritually focused group intervention with older women survivors (age 55 years and older) of interpersonal trauma (child abuse, sexual assault, or domestic violence) in reducing trauma-related depressive symptoms, posttraumatic stress, and anxiety. Forty-three community-dwelling women…

  2. Magnetic Surgical Instruments for Robotic Abdominal Surgery.

    PubMed

    Leong, Florence; Garbin, Nicolo; Natali, Christian Di; Mohammadi, Alireza; Thiruchelvam, Dhan; Oetomo, Denny; Valdastri, Pietro

    2016-01-01

    This review looks at the implementation of magnetic-based approaches in surgical instruments for abdominal surgeries. As abdominal surgical techniques advance toward minimizing surgical trauma, surgical instruments are enhanced to support such an objective through the exploration of magnetic-based systems. With this design approach, surgical devices are given the capabilities to be fully inserted intraabdominally to achieve access to all abdominal quadrants, without the conventional rigid link connection with the external unit. The variety of intraabdominal surgical devices are anchored, guided, and actuated by external units, with power and torque transmitted across the abdominal wall through magnetic linkage. This addresses many constraints encountered by conventional laparoscopic tools, such as loss of triangulation, fulcrum effect, and loss/lack of dexterity for surgical tasks. Design requirements of clinical considerations to aid the successful development of magnetic surgical instruments, are also discussed.

  3. Casualties of Childhood: A Developmental Perspective on Sexual Abuse Using Projective Drawings.

    ERIC Educational Resources Information Center

    Kaufman, Bobbie; Wohl, Agnes

    Recognizing the compelling language of imagery available in the drawings of children who have been sexually abused, this book focuses on the link between sexual abuse during the latency period and specific developmental problems. Chapter 1, "Paradigms of Trauma and Sexual Abuse," presents sexual abuse as an external event associated with a…

  4. Retrospective Reports of Childhood Trauma in Adults with ADHD

    ERIC Educational Resources Information Center

    Rucklidge, Julia J.; Brown, Deborah L.; Crawford, Susan; Kaplan, Bonnie J.

    2006-01-01

    Objective: Although studies have documented higher prevalence of abuse in children with ADHD, no studies have investigated childhood reports of abuse in individuals identified with ADHD in adulthood. Method: Forty ADHD women, 17 ADHD males, 17 female controls, and 40 male controls complete the Childhood Trauma Questionnaire and other measures of…

  5. Trauma and Psychotherapy: Implications from a Behavior Analysis Perspective

    ERIC Educational Resources Information Center

    Prather, Walter

    2007-01-01

    Attachment theory provides a useful conceptual framework for understanding trauma and the treatment of abuse in children. This article examines attachment theory and traditional models of family therapy from the perspective of behavior analysis, and provides a rationale for a behavioral treatment approach for abused children and their foster or…

  6. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  7. Cirrhosis and trauma: a deadly duo.

    PubMed

    Christmas, A Britton; Wilson, Ashley K; Franklin, Glen A; Miller, Frank B; Richardson, J David; Rodriguez, Jorge L

    2005-12-01

    It has been previously reported that trauma patients with cirrhosis undergoing emergency abdominal operations exhibit a fourfold increase in mortality independent of their Child's classification. We undertook this review to assess the impact of cirrhosis on trauma patients. We reviewed the records of patients from 1993 to 2003 with documented hepatic cirrhosis and compared them to a 2:1 control population without hepatic cirrhosis and matched for age, sex, Injury Severity Score (ISS), and Glasgow Coma Score (GCS). Demographic, severity of injury, and outcome data were recorded. Student's t test and X2 were used for statistical analysis and a P < 0.05 was significant. Sixty-one patients had documented cirrhosis and were compared to 156 matched controls. Comparing the two groups demonstrates there was no difference in age, ISS, or GCS. Intensive care stay, hospital length of stay, blood requirements in the first 24 hours postinjury, and mortality (33% vs 1%) was significantly greater in the trauma patients with cirrhosis. Fifty-five per cent of deaths in the cirrhosis group was due to sepsis, and, as the Child's class increases, so does the mortality (Child's A, 15%; B, 37%; and C, 63%). In 64 per cent of cirrhotics without an emergent abdominal operation, mortality was 21 per cent. In the 36 per cent of cirrhotics who had emergent abdominal operation, mortality was 55 per cent. Hepatic cirrhosis in trauma patients, regardless of severity of injury or the need for an abdominal intervention, is a poor prognostic indicator. The necessity of an abdominal operative intervention further amplifies this effect. Trauma and cirrhosis is, in fact, a deadly duo.

  8. Genital trauma in children and adolescents.

    PubMed

    Merritt, Diane F

    2008-06-01

    Traumatic wounds of the female genitalia include accidental straddle injuries or impalement, chemical or thermal burns, insufflation injuries, blunt trauma, or crush injuries. Children and adolescents may be victims of rape, sexual abuse, and female genital mutilation. Information is provided on epidemiology, pathophysiology, and management. Treatment guidelines are offered using the best evidence available, and recommendations are provided when data are limited.

  9. Holocaust child survivors and child sexual abuse.

    PubMed

    Lev-Wiesel, Rachel; Amir, Marianne

    2005-01-01

    This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the Holocaust who were sexually abused during the war completed open-ended interviews. The data was qualitatively analyzed according to Tutty, Rothery, and Grinnell's (1996) guidelines. Three major themes were found: issues relating to the sexual abuse trauma, survivors' perceptions of the abuse, and survivors' general perspectives towards life. The identity of the offenders, Jewish or non-Jewish, determined the survivors' feelings towards themselves, the perpetrators, and about the worth of life.

  10. Abusive Head Trauma: A Perpetrator Confesses

    ERIC Educational Resources Information Center

    Bell, Erica; Shouldice, Michelle; Levin, Alex V.

    2011-01-01

    Objectives: To present a detailed confession from a perpetrator of Shaken Baby syndrome. Methods: Case study. Results: We present a confession of Shaken Baby syndrome describing how the perpetrator severely injured a 3 year old with repeated bursts of acceleration-deceleration (shaking). The child sustained retinal and intracranial hemorrhage.…

  11. Abusive Head Trauma (Shaken Baby Syndrome)

    MedlinePlus

    ... Ones & When? Smart School Lunches Emmy-Nominated Video "Cerebral Palsy: Shannon's Story" 5 Things to Know About Zika & ... problems with memory and attention severe mental retardation cerebral palsy Even in milder cases, in which babies look ...

  12. Suspension trauma

    PubMed Central

    Lee, Caroline; Porter, Keith M

    2007-01-01

    Suspension trauma (also known as “harness‐induced pathology” or “orthostatic shock while suspended”) is the development of presyncopal symptoms and loss of consciousness if the human body is held motionless in a vertical position for a period of time. It has been described in experiments of personal fall protection, and has been implicated in causes of death in mountaineering accidents, but it seems neither to be widely known about nor to have been presented to the medical profession. This article highlights the potential existence of suspension trauma and suggests that more robust medical research using modern harnesses and healthy volunteers would be beneficial to assess whether this is purely a theoretical risk. PMID:17384373

  13. Partner preferences among survivors of betrayal trauma.

    PubMed

    Gobin, Robyn L

    2012-01-01

    Betrayal trauma theory suggests that social and cognitive development may be affected by early trauma such that individuals develop survival strategies, particularly dissociation and lack of betrayal awareness, that may place them at risk for further victimization. Several experiences of victimization in the context of relationships predicated on trust and dependence may contribute to the development of relational schema whereby abuse is perceived as normal. The current exploratory study investigates interpersonal trauma as an early experience that might impact the traits that are desired in potential romantic partners. Participants in the current study were asked to rate the desirability of several characteristics in potential romantic partners. Although loyalty was desirable to most participants regardless of their trauma history, those who reported experiences of high betrayal trauma rated loyalty less desirable than those who reported experiences of traumas that were low and medium in betrayal. Participants who reported experiences of revictimization (defined as the experience of trauma perpetrated by a close other during 2 different developmental periods) differed from participants who only reported 1 experience of high betrayal trauma in their self-reported desire for a romantic partner who possessed the traits of sincerity and trustworthiness. Preference for a partner who uses the tactic of verbal aggression was also associated with revictimization status. These preliminary findings suggest that victimization perpetrated by close others may affect partner preferences.

  14. Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders

    PubMed Central

    2014-01-01

    Introduction Although a plethora of studies have delineated the relationship between childhood trauma and onset, symptom severity, and course of depression and anxiety disorders, there has been little evidence that childhood trauma may lead to interpersonal problems among adult patients with depression and anxiety disorders. Given the lack of prior research in this area, we aimed to investigate characteristics of interpersonal problems in adult patients who had suffered various types of abuse and neglect in childhood. Methods A total of 325 outpatients diagnosed with depression and anxiety disorders completed questionnaires on socio-demographic variables, different forms of childhood trauma, and current interpersonal problems. The Childhood Trauma Questionnaire (CTQ) was used to measure five different forms of childhood trauma (emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and the short form of the Korean-Inventory of Interpersonal Problems Circumplex Scale (KIIP-SC) was used to assess current interpersonal problems. We dichotomized patients into two groups (abused and non-abused groups) based on CTQ score and investigated the relationship of five different types of childhood trauma and interpersonal problems in adult patients with depression and anxiety disorders using multiple regression analysis. Result Different types of childhood abuse and neglect appeared to have a significant influence on distinct symptom dimensions such as depression, state-trait anxiety, and anxiety sensitivity. In the final regression model, emotional abuse, emotional neglect, and sexual abuse during childhood were significantly associated with general interpersonal distress and several specific areas of interpersonal problems in adulthood. No association was found between childhood physical neglect and current general interpersonal distress. Conclusion Childhood emotional trauma has more influence on interpersonal problems in adult patients with

  15. Childhood trauma and metabolic syndrome in men and women.

    PubMed

    Lee, Chioun; Tsenkova, Vera; Carr, Deborah

    2014-03-01

    The long-term effects of childhood trauma on health are well-documented, but few population-based studies have explored how childhood trauma affects the risk of developing metabolic syndrome (MetS) in adulthood. Using data from 1234 adults in the second wave of Midlife in the United States (MIDUS), we investigate (1) the extent to which childhood abuse affects the risk of developing MetS in adulthood; (2) how the severity of different types of abuse (emotional, physical, sexual, or cumulative abuse) affects this risk; and (3) the extent to which adult socioeconomic status (SES), maladaptive stress responses, and unhealthy behaviors mediate the association. We also test whether these associations differ significantly by sex. We find that emotional and physical abuse increase the risk of developing MetS for both sexes, whereas sexual abuse is a predictor for women only. For both sexes, individuals who experienced more cumulative abuse have a greater risk of developing MetS. Adult SES partially explains the association between childhood abuse and MetS. Maladaptive stress responses and unhealthy behaviors further explain the association. Among the potential mediators, poor sleep quality was a significant pathway for men and women, while stress-induced eating was a significant pathway for women only. Our findings suggest that the well-documented health consequences of early life trauma may vary by the nature of the trauma, the victim's sex, and the coping mechanisms that he or she employs. PMID:24524907

  16. Computed tomography of pancreatic trauma

    SciTech Connect

    Jeffrey, R.B. Jr.; Federle, M.P.; Crass, R.A.

    1983-05-01

    In a review of over 300 CT scans of abdominal trauma, we encountered 13 patients with surgically proved pancreatic injuries. CT correctly diagnosed pancreatic fractures, contusions, or posttraumatic pseudocysts in 11 of these patients. There were two false positive and two false negative diagnoses. The CT diagnosis of pancreatic trauma may be difficult in selected patients who are scanned soon after injury. Acutely, the actual plane of a pancreatic fracture may be difficult to identify with CT, and the peripancreatic soft-tissue changes of traumatic pancreatitis are often subtle. Eight of 11 correctly diagnosed pancreatic injuries showed thickening of the left anterior renal fascia on CT scans. This sign should prompt a critical evaluation of the pancreas of the traumatized patient.

  17. Abusive Relationships

    MedlinePlus

    ... relationships and friendships. Emotional abuse (stuff like teasing, bullying, and humiliating others) can be difficult to recognize ... How to Break Up Respectfully Abuse Dealing With Bullying Date Rape Getting Over a Break-Up Posttraumatic ...

  18. Taking a History of Childhood Trauma in Psychotherapy

    PubMed Central

    SAPORTA, JOSÉ A.; GANS, JEROME S.

    1995-01-01

    The authors examine the process of taking an initial history of childhood abuse and trauma in psychodynamic psychotherapy. In exploring the advantages, complexities, and potential complications of this practice, they hope to heighten the sensitivities of clinicians taking trauma histories. Emphasis on the need to be active in eliciting important historical material is balanced with discussion of concepts that can help therapists avoid interpersonal dynamics that reenact and perpetuate the traumas the therapy seeks to treat. Ensuring optimal psychotherapeutic treatment for patients who have experienced childhood trauma requires attention to the following concepts: a safe holding environment, destabilization, compliance, the repetition compulsion, and projective identification. PMID:22700250

  19. Childhood trauma and current psychological functioning in adults with social anxiety disorder.

    PubMed

    Kuo, Janice R; Goldin, Philippe R; Werner, Kelly; Heimberg, Richard G; Gross, James J

    2011-05-01

    Etiological models of social anxiety disorder (SAD) suggest that early childhood trauma contributes to the development of this disorder. However, surprisingly little is known about the link between different forms of childhood trauma and adult clinical symptoms in SAD. This study (1) compared levels of childhood trauma in adults with generalized SAD versus healthy controls (HCs), and (2) examined the relationship between specific types of childhood trauma and adult clinical symptoms in SAD. Participants were 102 individuals with generalized SAD and 30 HCs who completed measures of childhood trauma, social anxiety, trait anxiety, depression, and self-esteem. Compared to HCs, individuals with SAD reported greater childhood emotional abuse and emotional neglect. Within the SAD group, childhood emotional abuse and neglect, but not sexual abuse, physical abuse, or physical neglect, were associated with the severity of social anxiety, trait anxiety, depression, and self-esteem. PMID:21183310

  20. Clinicopathological Profile of Childhood Primary Abdominal Tumours in Kashmir.

    PubMed

    Khan, Parwez Sajad; Akhter, Zahida; Majeed, Showkat; Wani, Mohd Yousuf; Hayat, Humera

    2015-12-01

    Primary abdominal tumours attract considerable notice because of their serious prognosis, high cost of treatment and the emotional and psychological trauma. Abdominal tumours can present with pain, vomiting, constipation or less commonly intestinal obstruction. The presentation of cancer in children mimic those of childhood conditions like infections particularly viral infections, urinary tract infections, gastro-oesophageal reflux, malnutrition, constipation, lymphadnenitis, glomerulonephritis and congenital urinary tract anomalies. PMID:26730026

  1. Drug Abuse

    MedlinePlus

    ... as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug ...

  2. Child Abuse

    MedlinePlus

    ... or become violent. An older child may use drugs or alcohol, try to run away or abuse others. Child abuse is a serious problem. If you suspect a child is being abused or neglected, call the police or your local child welfare agency.

  3. Transdiaphragmatic Intercostal Herniation following Blunt Trauma

    PubMed Central

    Sarkar, Debkumar; Warta, Melissa; Solomon, Jason

    2012-01-01

    Intercostal herniation is very rarely and sporadically reported in the literature. Intercostal hernia can occur following blunt trauma and may be associated with rib fractures. We present a case of a patient who presented with rib fractures, diaphragmatic rupture, and intrathoracic herniation of abdominal contents with subsequent herniation of both lung and abdominal contents through an intercostal defect. The patient was successfully treated with primary surgical repair of the diaphragm and intercostal hernia. The presentation, pathophysiology, and management of this rare clinical entity are discussed. PMID:23198242

  4. PREVENTION AND OUTCOMES FOR VICTIMS OF CHILDHOOD SEXUAL ABUSE

    PubMed Central

    Ulibarri, Monica D.; Ulloa, Emilio C.; Salazar, Marissa

    2015-01-01

    This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18–34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues. PMID:25635897

  5. The Impact of Specific and Complex Trauma on the Mental Health of Homeless Youth.

    PubMed

    Wong, Carolyn F; Clark, Leslie F; Marlotte, Lauren

    2016-03-01

    This study investigates the relative impact of trauma experiences that occurred prior to and since becoming homeless on depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and self-injurious behaviors among a sample of homeless youth (N = 389). Youth (aged 13 to 25) who had been homeless or precariously housed in the past year completed a survey about housing history, experiences of violence and victimization, mental health, and service utilization. In addition to examining the impact associated with specific trauma types, we also considered the effect of "early-on" poly-victimization (i.e., cumulative number of reported traumas prior to homelessness) and the influence of a compound sexual trauma variable created to represent earlier complex trauma. This created-variable has values ranging from no reported trauma, single trauma, multiple non-sexual traumas, and multiple traumas that co-occurred with sexual abuse. Multivariate analyses revealed that specific traumatic experiences prior to homelessness, including sexual abuse, emotional abuse/neglect, and adverse home environment, predicted greater mental health symptoms. Poly-victimization did not add to the prediction of mental health symptoms after the inclusion of specific traumas. Results with early compound sexual trauma revealed significant differences between lower-order trauma exposures and multiple-trauma exposures. Specifically, experience of multiple traumas that co-occurred with sexual trauma was significantly more detrimental in predicting PTSD symptoms than multiple traumas of non-sexual nature. Findings support the utility of an alternate/novel conceptualization of complex trauma, and support the need to carefully evaluate complex traumatic experiences that occurred prior to homelessness, which can impact the design and implementation of mental health care and services for homeless youth.

  6. Geriatric Trauma: A Radiologist's Guide to Imaging Trauma Patients Aged 65 Years and Older.

    PubMed

    Sadro, Claudia T; Sandstrom, Claire K; Verma, Nupur; Gunn, Martin L

    2015-01-01

    Radiologists play an important role in evaluation of geriatric trauma patients. Geriatric patients have injury patterns that differ markedly from those seen in younger adults and are susceptible to serious injury from minor trauma. The spectrum of trauma in geriatric patients includes head and spine injury, chest and rib trauma, blunt abdominal injury, pelvic fractures, and extremity fractures. Clinical evaluation of geriatric trauma patients is difficult because of overall frailty, comorbid illness, and medication effects. Specific attention should be focused on the effects of medications in this population, including anticoagulants, steroids, and bisphosphonates. Radiologists should use age-appropriate algorithms for radiography, computed tomography (CT), and magnetic resonance imaging of geriatric trauma patients and follow guidelines for intravenous contrast agent administration in elderly patients with impaired renal function. Because there is less concern about risk for cancer with use of ionizing radiation in this age group, CT is the primary imaging modality used in the setting of geriatric trauma. Clinical examples are provided from the authors' experience at a trauma center where geriatric patients who have sustained major and minor injuries are treated daily. PMID:26065932

  7. Toxic trauma.

    PubMed

    Moles, T M; Baker, D J

    2001-01-01

    Hazardous materials (HAZMAT) carry many inherent dangers. Such materials are distributed widely in industrial and military sites. Toxic trauma (TT) denotes the complex of systemic and organ injury caused by toxic agents. Often, TT is associated with other injuries that also require the application of life-support techniques. Rapid onset of acute respiratory failure and consequent cardiovascular failure are of primary concern. Management of TT casualties is dependent upon the characteristics of the toxic agents involved and on the demographics surrounding the HAZMAT incident. Agents that can produce TT possess two pairs of salient characteristics: (1) causality (toxicity and latency), and (2) EMS system (persistency and transmissibility). Two characteristics of presentations are important: (1) incident presentation, and (2) casualty presentation. In addition, many of these agents complicate the processes associated with anaesthesia and must be dealt with. Failure of recognition of these factors may result in the development of respiratory distress syndromes and multiorgan system failure, or even death. PMID:11513285

  8. Review of Pancreaticoduodenal Trauma with a Case Report.

    PubMed

    Poyrazoglu, Yavuz; Duman, Kazim; Harlak, Ali

    2016-06-01

    Complex anatomical relation of the duodenum, pancreas, biliary tract, and major vessels plays to obscure pancreaticoduodenal injuries. Causes of pancreaticoduodenal injuries are blunt trauma (traffic accidents, sport injuries) in 25 % of cases and penetrating abdominal injuries (stab wounds and firearm injuries) in 75 % of cases. Duodenal injuries are reported to occur in 0.5 to 5 % of all abdominal trauma cases and are observed in 11 % of abdominal firearm wounds, 1.6 % of abdominal stab wounds, and 6 % of blunt trauma. Retroperitoneal and deep abdominal localization of duodenum as an organ contribute to the difficulty in diagnosis and treatment. There are three important major points regarding treatment of duodenal injuries: (1) operation timing and decision, (2) Intraoperative detection, and (3) post-operative care. Therefore, it is difficult to diagnose and treat duodenal trauma. We would like to present a 21-year-old male patient with pancreaticoduodenal injury who presented to our emergency service after firearm injury to his abdomen and discuss his treatment with a short review of related literature. PMID:27358516

  9. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

    PubMed Central

    Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  10. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot.

    PubMed

    Stefanou, Christos; Zikos, Nicolaos; Pappas-Gogos, George; Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  11. Group Work with Sexually Abused Children: A Practitioner's Guide.

    ERIC Educational Resources Information Center

    Grotsky, Lynn; Camerer, Carel; Damiano, Lynn

    Sexual assault is a trauma that affects the entire family as well as the individuals involved. It is a social disease that alters human development and the ability to relate to others. Without treatment, the effects of abuse can progressively undermine and overwhelm all areas of both the abused individual's and the family's functioning. This book…

  12. Adult Adjustment of Survivors of Institutional Child Abuse in Ireland

    ERIC Educational Resources Information Center

    Carr, Alan; Dooley, Barbara; Fitzpatrick, Mark; Flanagan, Edel; Flanagan-Howard, Roisin; Tierney, Kevin; White, Megan; Daly, Margaret; Egan, Jonathan

    2010-01-01

    Objective: To document the adult adjustment of survivors of childhood institutional abuse. Method: Two hundred and forty-seven adult survivors of institutional abuse with a mean age of 60 were interviewed with a protocol that included the Childhood Trauma Questionnaire, modules from the Structured Clinical Interview for Axis I Disorders of DSM IV…

  13. Spiritual abuse.

    PubMed

    Purcell, B C

    1998-01-01

    Spiritual abuse is the act of making people believe--whether by stating or merely implying--that they are going to be punished in this life and/or tormented in hell-fire forever for failure to live life good enough to please God and thus earn admission to heaven. Spiritual terrorism is the most extreme form of spiritual abuse and may cause serious mental health problems. Those people who have not been spiritually terrorized have not necessarily been spared from spiritual abuse and therefore may still be in need of competent, spiritual counseling. Spiritual abuse, which may be active or passive, can best be conceptualized on a continuum from terroristic to zero abuse. Severity is determined by intensity, age of onset, duration, and individual reaction. The underlying issue in all forms of abuse is control. PMID:9729974

  14. [Childhood trauma in the etiology of borderline personality disorder].

    PubMed

    Kuritárné, Ildikó Szabó

    2005-01-01

    Serious, prolonged intrafamilial childhood sexual abuse is considered to be the main etiological factor in about half of the patients with borderline personality disorder in the USA. Special features of childhood interpersonal trauma leading to the development of borderline personality disorder are the seriousness of the trauma and the fact that it is sexual in nature. Serious intrafamilial childhood abuse can lead not only to the classic post-traumatic stress syndrome, but can influence all aspects of personality development, including the distortion of the sense of identity, self-regulation, and the patterns of interpersonal relations. Viewed from the perspective of the trauma concept, the entire range of adult borderline symptoms are considered as being the consequences of severe complex traumatic experiences. Other clinicians regard such an abuse as a marker of the severity of familial dysfunction and emphasize the role of other pathogenic factors, such as biparental neglect and biological vulnerability of the pre-borderline child.

  15. Scroto-abdominal impalement injury in a skateboard rider.

    PubMed

    Carragher, A M; Sulaiman, S K; Panesar, K J

    1990-01-01

    The injuries sustained by skateboard riders vary from minor cuts and abrasions to fractures. This report describes a unique injury sustained by a young skateboard rider who was impaled on a metal rod. Literature review of over 1,254 skateboard injuries did not reveal any other instances of penetrating abdominal trauma.

  16. The Impact of Clergy-Perpetrated Sexual Abuse: The Role of Gender, Development, and Posttraumatic Stress

    ERIC Educational Resources Information Center

    Fogler, Jason M.; Shipherd, Jillian C.; Clarke, Stephanie; Jensen, Jennifer; Rowe, Erin

    2008-01-01

    The literature on clergy-perpetrated sexual abuse suggests that there are two modal populations of survivors: boys and adult women. We review what is known about trauma and post-traumatic stress disorder following sexual abuse and explore the different treatment needs for these two survivor groups. For children, clergy-perpetrated sexual abuse can…

  17. Shame and Guilt in Men Exposed to Childhood Sexual Abuse: A Qualitative Investigation

    ERIC Educational Resources Information Center

    Dorahy, Martin J.; Clearwater, Ken

    2012-01-01

    This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the…

  18. Extrasensory Perception Experiences and Childhood Trauma: A Rorschach Investigation.

    PubMed

    Scimeca, Giuseppe; Bruno, Antonio; Pandolfo, Gianluca; La Ciura, Giulia; Zoccali, Rocco A; Muscatello, Maria R A

    2015-11-01

    This study investigated whether people who report recurrent extrasensory perception (ESP) experiences (telepathy, clairvoyance, and precognition) have suffered more traumatic experiences and traumatic intrusions. Thirty-one nonclinical participants reporting recurrent ESP experiences were compared with a nonclinical sample of 31 individuals who did not report recurrent ESP phenomena. Past traumatic experiences were assessed via a self-report measure of trauma history (Childhood Trauma Questionnaire); traumatic intrusions were assessed via a performance-based personality measure (Rorschach Traumatic Content Index). Participants also completed the Anomalous Experience Inventory, the Minnesota Multiphasic Personality Inventory-2, the Dissociative Experience Scale, and the Revised Paranormal Belief Scale. The ESP group reported higher levels of emotional abuse, sexual abuse, emotional neglect, physical neglect, and traumatic intrusions. The association between ESP experiences and trauma was partly mediated by the effects of dissociation and emotional distress. Implications for health professionals are discussed. Results also showed the reliability of the twofold method of assessment of trauma. PMID:26488918

  19. Abdominal cerebrospinal fluid pseudocysts.

    PubMed

    Erşahin, Y; Mutluer, S; Tekeli, G

    1996-12-01

    Abdominal cerebrospinal fluid pseudocyst in an infrequent complication of ventriculoperitoneal (VP) shunts. We reviewed ten patients with abdominal pseudocyst. There were five girls and five boys, aged between 4 months and 14 years. The number of shunt procedures prior to the presentation varied between one and five. Only one patient had had a previous shunt infection. No patients had undergone prior abdominal surgery other than VP shunting. The time from the last shunting procedure to the development of abdominal pseudocyst ranged from 3 weeks to 5 years. Presenting symptoms and signs were mainly related to abdominal complaints in all patients. Three patients also had signs of shunt malfunction. The diagnosis was made by ultrasound in all patients. Shunt infection was determined in six patients. Repositioning if the peritoneal catheter seemed to have a higher rate of recurrence. The diagnosis of abdominal pseudocyst should be considered in VP-shunted patients presenting with abdominal complaints.

  20. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  1. Fetal Abuse.

    ERIC Educational Resources Information Center

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  2. Psychotherapy and Memories of Childhood Sexual Abuse.

    ERIC Educational Resources Information Center

    Lindsay, D. Stephen

    This conference address examines the question of whether "memory work"--using therapeutic techniques to help clients recover suspected hidden memories of childhood sexual abuse--has led some clients to develop illusory memories or false beliefs. Prospective research on memory for childhood trauma indicates that the gist of traumatic childhood…

  3. Childhood Abuse and the Content of Delusions

    ERIC Educational Resources Information Center

    Mason, Oliver J.; Brett, Emma; Collinge, Miriam; Curr, Helen; Rhodes, John

    2009-01-01

    Objectives: We aimed to investigate possible associations between histories of childhood abuse and the content of delusions for individuals with psychotic disorders. Methods: 39 participants with a psychotic disorder including one or more delusional beliefs successfully completed structured interviews about childhood trauma, delusional beliefs and…

  4. Attachment Styles, Abuse Experiences and Depression

    ERIC Educational Resources Information Center

    Gunduz, Bulent; Capri, Burhan; Akbay, Sinem Evin; Tunc, Aygul

    2013-01-01

    This study aims to examine the relationship between abuse experiences, depression and attachment styles. The data for this study was collected from 251 students (123 females and 128 males) who attend Mersin University. As a part of the data collection, students completed the Experiences in Affiliation Inventory, Childhood Trauma Scale and Brief…

  5. Childhood trauma is associated with maladaptive personality traits.

    PubMed

    de Carvalho, Hudson W; Pereira, Rebeca; Frozi, Julia; Bisol, Luísa W; Ottoni, Gustavo L; Lara, Diogo R

    2015-06-01

    The association between childhood trauma and personality traits has been poorly characterized and reported. Our aim was to evaluate whether distinct types of childhood abuse and neglect are associated with various personality dimensions using data from a large web-based survey. A total of 12,225 volunteers responded anonymously to the Internet versions of the Temperament and Character Inventory-Revised (TCI-R) and the Childhood Trauma Questionnaire (CTQ) via our research website, but only 8,114 subjects (75.7% women, mean age 34.8±11.3yrs) who met the criteria for validity were included in the analysis. Childhood trauma was positively associated with harm avoidance and was negatively associated with self-directedness and, to a lesser extent, with cooperativeness. The associations were robust with emotional abuse and neglect but were non-significant or mild with physical trauma. Emotional neglect was associated with reduced reward dependence and persistence. All types of abuse, but not neglect, were associated with increased novelty seeking scores. Reporting of childhood trauma, especially of an emotional nature, was associated with maladaptive personality traits. Further investigation of the effects of different types of childhood trauma on psychological and neurobiological parameters is warranted. PMID:25541148

  6. Effects of trauma and religiosity on self-esteem.

    PubMed

    Reiland, Sarah; Lauterbach, Dean

    2008-06-01

    Self-esteem is often lower among persons who have experienced trauma, but religiosity may ameliorate these psychological effects. The purpose of this paper was to examine the relationships among religiosity, self-esteem, and childhood exposure to trauma, utilizing data from the National Comorbidity Survey, a large (N = 8,098) nationally representative population survey in the 48 contiguous states of the USA that assessed religious practices, self-esteem, and exposure to trauma. Exposure to trauma in childhood was assessed through self-report of presence or absence of childhood physical abuse, sexual abuse, or neglect. Religiosity was assessed as the sum of responses to 4 self-report items (religious service attendance, use of religion for comfort and guidance, and importance of religion). Self-esteem was assessed on 9 self-report items adapted from the Rosenberg Self-Esteem Scale. Analysis of variance compared scores for persons who reported exposure to childhood abuse and differed in the value they placed on various religious practices on self-esteem. Persons who reported physical abuse, sexual abuse, or neglect in childhood had significantly lower mean self-esteem than those who did not report these events. There was also a main effect for religiosity in a comparison of persons who reported childhood sexual abuse with those who reported none. The High Religiosity group had higher mean self-esteem than the Medium and Low Religiosity groups. There was a significant interaction as those who reported childhood sexual abuse had lower mean self-esteem than peers who reported none in the Low and Medium Religiosity groups. Mean self-esteem for those who reported childhood sexual abuse was comparable to that of those who reported none in the High Religiosity group.

  7. Correlates of lifetime trauma exposure among pregnant women from Cape Town, South Africa

    PubMed Central

    Myers, Bronwyn; Jones, Hendrée E.; Doherty, Irene A.; Kline, Tracy L.; Key, Mary E.; Johnson, Kim; Wechsberg, Wendee M.

    2015-01-01

    A cross-sectional survey of 298 pregnant women from Cape Town, South Africa was conducted to examine socio-demographic, reproductive health, mental health, and relationship correlates of lifetime trauma exposure and whether these correlates vary as a function of age. Overall, 19.8% of participants reported trauma exposure. We found similarities and differences in correlates of trauma exposure among women in emerging adulthood and older women. Prior termination of pregnancy was associated with trauma exposure in both age groups. Difficulties in resolving arguments, lifetime substance use, and a prior sexually transmitted infection were associated with trauma exposure among women in emerging adulthood. In contrast, depression and awareness of substance abuse treatment programmes were associated with trauma exposure among older women. These findings highlight the need for interventions that prevent and treat trauma exposure among vulnerable women. Such interventions should be tailored to address the correlates of trauma exposure in each age group. PMID:27087804

  8. Massive rectal bleeding distant from a blunt car trauma.

    PubMed

    Gruden, E; Ragot, E; Arienzo, R; Revaux, A; Magri, M; Grossin, M; Leroy, C; Msika, S; Kianmanesh, R

    2010-09-01

    Mesenteric trauma is one of the possible injuries caused by the use of seat belts in case of motor vehicle crash. We report here a rare case of rectal bleeding by rupture of a mesosigmoid haematoma. An emergent laparotomy revealed a mesosigmoid haematoma with a centimetric rectal perforation. The wearing of safety belts added some specific blunt abdominal trauma, which directly depends on lap-and-sash belts. Mesenteric injuries are found out up to 5% of blunt abdominal traumas. "Seat belt mark" leads the surgical team to strongly suspect an intra-abdominal trauma. When "seat belt mark" sign is found, in patients with mild to severe blunt car injuries, CT-scan has to be realised to eliminate intra-abdominal complications, including mesenteric and mesosigmoid ones. In case of proved mesenteric haematoma associated to intestinal bleeding, a surgical treatment must be considered as first choice. Conservative approach remains possible in stable patients but surgical exploration remains necessary in unstable patients with active bleeding. PMID:20638207

  9. The Most Important Things Learned About Violence and Trauma in the Past 20 Years

    ERIC Educational Resources Information Center

    Carlson, Bonnie E.

    2005-01-01

    In the past 2 decades, important insights have been gained regarding violence and trauma. Complications occur in how violence and trauma, their causes, and their effects on victims should be defined. Violence and abuse to women- physical, sexual, and emotional - are not rare events and are most often perpetrated by partners or acquaintances rather…

  10. Childhood trauma, PTSD, and psychosis: Findings from a highly traumatized, minority sample☆

    PubMed Central

    Powers, Abigail; Fani, Negar; Cross, Dorthie; Ressler, Kerry J.; Bradley, Bekh

    2016-01-01

    Trauma, especially early life trauma, is a risk factor for the development of both posttraumatic stress disorder and psychosis. The goal of the present study was to determine specific associations between exposure to childhood abuse, PTSD symptoms, and current psychotic disorder. Subjects were recruited from a public, urban hospital (N = 328, >90% African American). Psychotic disorders were measured using the MINI International Neuropsychiatric Interview, PTSD was measured using the Clinician Administered PTSD Scale, child abuse was measured with the Childhood Trauma Questionnaire, and lifetime trauma exposure was measured with the Traumatic Events Inventory. Logistic regression analyses showed that both child abuse and current PTSD were statistically significant predictors of psychotic disorder beyond the effects of lifetime trauma load. When PTSD symptom clusters were examined, avoidance and numbing symptoms showed unique association with psychotic disorder independent of demographic variables and trauma exposure. Using bootstrapping techniques, we found a full indirect effect of PTSD on the association between child abuse and, suggesting a particularly important role of PTSD symptoms in relation to psychotic disorder in the presence of early life trauma. Because this is a cross-sectional study, continued research is needed to determine causality of such models. Identifying co-occurring psychosis and PTSD, particularly in populations with high levels of trauma exposure, is critical and will likely aid in more successful treatment interventions. PMID:27371800

  11. Childhood trauma, PTSD, and psychosis: Findings from a highly traumatized, minority sample.

    PubMed

    Powers, Abigail; Fani, Negar; Cross, Dorthie; Ressler, Kerry J; Bradley, Bekh

    2016-08-01

    Trauma, especially early life trauma, is a risk factor for the development of both posttraumatic stress disorder and psychosis. The goal of the present study was to determine specific associations between exposure to childhood abuse, PTSD symptoms, and current psychotic disorder. Subjects were recruited from a public, urban hospital (N=328, >90% African American). Psychotic disorders were measured using the MINI International Neuropsychiatric Interview, PTSD was measured using the Clinician Administered PTSD Scale, child abuse was measured with the Childhood Trauma Questionnaire, and lifetime trauma exposure was measured with the Traumatic Events Inventory. Logistic regression analyses showed that both child abuse and current PTSD were statistically significant predictors of psychotic disorder beyond the effects of lifetime trauma load. When PTSD symptom clusters were examined, avoidance and numbing symptoms showed unique association with psychotic disorder independent of demographic variables and trauma exposure. Using bootstrapping techniques, we found a full indirect effect of PTSD on the association between child abuse and, suggesting a particularly important role of PTSD symptoms in relation to psychotic disorder in the presence of early life trauma. Because this is a cross-sectional study, continued research is needed to determine causality of such models. Identifying co-occurring psychosis and PTSD, particularly in populations with high levels of trauma exposure, is critical and will likely aid in more successful treatment interventions. PMID:27371800

  12. Trauma-Informed Positive Education: Using Positive Psychology to Strengthen Vulnerable Students

    ERIC Educational Resources Information Center

    Brunzell, Tom; Stokes, Helen; Waters, Lea

    2016-01-01

    This paper explores the role of a positive education paradigm in mainstream and specialist classrooms for students who have experienced complex trauma resulting from abuse, neglect, violence, or being witness to violence. Existing trauma-informed education focuses on repairing regulatory abilities and repairing disrupted attachment in students.…

  13. Thoraco- abdominal impalement injury: a case report

    PubMed Central

    2014-01-01

    Background Impalement injury is an uncommon presentation in the emergency department (ED), and penetrating thoraco-abdominal injuries demand immediate life-saving measures and prompt care. Massive penetrating trauma by impalement in a pediatric case represents a particularly challenging presentation for emergency providers in non-trauma center settings. Case presentation We report a case of 10 year old male who presented in our ED with an alleged history of fall from an approximately 15 foot tall coconut tree, landing over an upright bamboo stake approximately 50 centimeter long, resulting in a trans-abdomino, trans-thoracic injury. In addition to prompt resuscitation and hospital transfer, assessment of damage to vital structures in conjunction with surgical specialty consultation was an immediate goal. Conclusion This article describes a case study of an impalement injury, relevant review of the available literature, and highlights the peculiar strategies required in the setting of a resource limited ED. PMID:24592862

  14. Gas at postmortem computed tomography--an evaluation of 73 non-putrefied trauma and non-trauma cases.

    PubMed

    Gebhart, Florin T F; Brogdon, B G; Zech, Wolf-Dieter; Thali, Michael J; Germerott, Tanja

    2012-10-10

    Postmortem computed tomography (PMCT) has become an important complement in investigating forensic cases allowing an accurate detection of gas accumulations. The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-traumatic deaths. Furthermore the possibility of pneumobilia secondary to blunt abdominal trauma was studied. Retrospectively, 73 cases, underwent a whole-body PMCT prior to autopsy. These were divided into four groups: penetrating trauma (20 gunshot cases, 13 stabbing cases), blunt abdominal trauma (20 cases) and a control group of 20 non-trauma cases. Exclusion criteria were visible signs of decomposition. Each group was screened for gas accumulations in the vascular system, internal organs, soft tissues and body cavities. Gas accumulations were present in 98% of the trauma cases, compared to 80% of the control group. The most affected structures and/or organs in the trauma group were soft tissues, vessels and the liver. In most cases of the trauma group gas was associated with open injuries and lacerations of vessels. Furthermore, in the gunshot group gas was frequently seen in the intracranial cavity. Pneumobilia occurred in one case of the blunt trauma group; in that control group gas was also seen, but less frequently. Gas accumulation showed a strong association with traumatic events, but even the majority of non-trauma cases showed gas accumulations. Despite the exclusion of cases with visible decomposition signs, a putrefactive origin of gas was assumed in some cases. Gas accumulations are a frequent finding in PMCT with a higher incidence in (open) trauma cases. Even though a differentiation between putrefactive and traumatic gas accumulations is still difficult, knowledge of the circumstance surrounding the case may help identify the origin of gas.

  15. Blunt Force Trauma in Veterinary Forensic Pathology.

    PubMed

    Ressel, L; Hetzel, U; Ricci, E

    2016-09-01

    Veterinary pathologists commonly encounter lesions of blunt trauma. The development of lesions is affected by the object's mass, velocity, size, shape, and angle of impact and by the plasticity and mobility of the impacted organ. Scrape, impact, and pattern abrasions cause localized epidermal loss and sometimes broken hairs and implanted foreign material. Contusions are best identified after reflecting the skin, and must be differentiated from coagulopathies and livor mortis. Lacerations-traumatic tissue tears-may have irregular margins, bridging by more resilient tissue, deviation of the wound tail, crushed hairs, and unilateral abrasion. Hanging or choking can cause circumferential cervical abrasions, contusions and rupture of hairs, hyoid bone fractures, and congestion of the head. Other special forms of blunt trauma include fractured nails, pressure sores, and dog bites. Ocular blunt trauma causes extraocular and intraocular hemorrhages, proptosis, or retinal detachment. The thoracic viscera are relatively protected from blunt trauma but may develop hemorrhages in intercostal muscles, rib fractures, pulmonary or cardiac contusions or lacerations with subsequent hemothorax, pneumothorax, or cardiac arrhythmia. The abdominal wall is resilient and moveable, yet the liver and spleen are susceptible to traumatic laceration or rupture. Whereas extravasation of blood can occur after death, evidence of vital injury includes leukocyte infiltration, erythrophagocytosis, hemosiderin, reparative lesions of fibroblast proliferation, myocyte regeneration in muscle, and callus formation in bone. Understanding these processes aids in the diagnosis of blunt force trauma including estimation of the age of resulting injuries. PMID:27381403

  16. Abdominal Compartment Syndrome Secondary to Chronic Constipation

    PubMed Central

    Flageole, Helene; Ouahed, Jodie; Walton, J. Mark; Yousef, Yasmin

    2011-01-01

    Abdominal compartment syndrome (ACS) is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not. PMID:22606517

  17. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  18. Forgetting sexual trauma: what does it mean when 38% forget?

    PubMed

    Loftus, E F; Garry, M; Feldman, J

    1994-12-01

    L. M. Williams (1994) has shown that many women who were sexually abused as children do not report the abuse when questioned 2 decades later. These findings do not support certain freely made claims about memory, but they do support other claims. The findings do not provide cogent support for the claim that a long stream of childhood sexual traumas is routinely banished from conscious awareness and then can be reliably recovered later. The findings do support the claim that many children can forget about a sexually abusive experience from their past. Extreme claims such as "if you were raped, you'd remember" are disproven by these findings.

  19. Traumatic abdominal wall hernia with concealed colonic perforation.

    PubMed

    Pathak, D; Mukherjee, R; Das, P; Pathak, D; Gangopadhyay, A; Das, S

    2016-09-01

    Traumatic abdominal wall hernia (TAWH) is a rare clinical entity in terms of aetiology. It occurs following a blunt abdominal injury with energy high enough to cause disruption of the musculoaponeurotic layer but not the elastic skin layer. It is often associated with underlying intra-abdominal injuries, which can be diagnosed either clinically or radiologically. We report a case of TAWH in a young man with associated large bowel transection, which remained undiagnosed in the preoperative period owing to its masked features. He was managed surgically, with no recurrence to date. Considering the high volume of blunt abdominal trauma cases that present to the accident and emergency department, only few cases of TAWH have been reported in the literature. Confusion still exists regarding the timing and mode of management of this condition. PMID:27241601

  20. Trauma Facts for Educators

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This paper offers facts which can help educators deal with children undergoing trauma. These include: (1) One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior; (2) Trauma can impact school performance; (3) Trauma can impair learning; (4) Traumatized children may experience…

  1. The Link between Childhood Trauma and Mental Illness: Effective Interventions for Mental Health Professionals.

    ERIC Educational Resources Information Center

    Everett, Barbara; Gallop, Ruth

    Many people seeking help from the mental health system have histories of childhood trauma from sexual and physical abuse. Little literature is available for counselors, mental health workers, and other professionals on the topic of specialized therapy for abuse survivors. Counselors have a crucial role in helping these clients heal and recover.…

  2. Trauma Resilience Scale: Validation of Protective Factors Associated with Adaptation following Violence

    ERIC Educational Resources Information Center

    Madsen, Machelle D.; Abell, Neil

    2010-01-01

    Objectives: The Trauma Resilience Scale (TRS), assessing protective factors associated with positive adaptation following violence, was tested in three waves of data collection. Empirical and theoretical literature shaped subscale and item formation emphasizing resilience following physical abuse, sexual abuse, intimate partner violence, and/or a…

  3. Childhood trauma and metabolic syndrome in men and women

    PubMed Central

    Lee, Chioun; Tsenkova, Vera; Carr, Deborah

    2014-01-01

    The long-term effects of childhood trauma on health are well-documented, but few population-based studies have explored how childhood trauma affects the risk of developing metabolic syndrome (MetS) in adulthood. Using data from 1,234 adults in the second wave of the Midlife Development in the U.S. survey (2004), we investigate (1) the extent to which childhood abuse affects the risk of developing MetS in adulthood; (2) how the severity of different types of abuse (emotional, physical, sexual, or cumulative abuse) affects this risk; and (3) the extent to which adult socioeconomic status (SES), maladaptive stress responses, and unhealthy behaviors mediate the association. We also test whether these associations differ significantly by sex. We find that emotional and physical abuse increase the risk of developing MetS for both sexes, whereas sexual abuse is a predictor for women only. For both sexes, individuals who experienced more cumulative abuse have a greater risk of developing MetS. Adult SES partially explains the association between childhood abuse and MetS. Maladaptive stress responses and unhealthy behaviors further explain the association. Among the potential mediators, poor sleep quality was a significant pathway for men and women, while stress-induced eating was a significant pathway for women only. Our findings suggest that the well-documented health consequences of early life trauma may vary by the nature of the trauma, the victim’s sex, and the coping mechanisms that he or she employs. PMID:24524907

  4. Trauma, gender, and mental health symptoms in individuals with substance use disorders.

    PubMed

    Keyser-Marcus, Lori; Alvanzo, Anika; Rieckmann, Traci; Thacker, Leroy; Sepulveda, Allison; Forcehimes, Alyssa; Islam, Leila Z; Leisey, Monica; Stitzer, Maxine; Svikis, Dace S

    2015-01-01

    Individuals with substance use disorders are often plagued by psychiatric comorbidities and histories of physical and/or sexual trauma. Males and females, although different in their rates of expressed trauma and psychiatric symptomatology, experience comparable adverse consequences, including poorer substance abuse treatment outcomes, diminished psychosocial functioning, and severe employment problems. The goal of the current study was to examine the relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender in a sample of individuals participating in outpatient substance abuse treatment. Study participants (N = 625) from six psychosocial counseling and five methadone maintenance programs were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index-Lite [ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma. PMID:24811286

  5. Trauma, gender, and mental health symptoms in individuals with substance use disorders.

    PubMed

    Keyser-Marcus, Lori; Alvanzo, Anika; Rieckmann, Traci; Thacker, Leroy; Sepulveda, Allison; Forcehimes, Alyssa; Islam, Leila Z; Leisey, Monica; Stitzer, Maxine; Svikis, Dace S

    2015-01-01

    Individuals with substance use disorders are often plagued by psychiatric comorbidities and histories of physical and/or sexual trauma. Males and females, although different in their rates of expressed trauma and psychiatric symptomatology, experience comparable adverse consequences, including poorer substance abuse treatment outcomes, diminished psychosocial functioning, and severe employment problems. The goal of the current study was to examine the relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender in a sample of individuals participating in outpatient substance abuse treatment. Study participants (N = 625) from six psychosocial counseling and five methadone maintenance programs were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index-Lite [ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma.

  6. Acute pseudohepatitis in a chronic substance abuser secondary to occult seat belt injury.

    PubMed

    Lam, E C; Janzen, R M; Meloche, R M; Trepanier, P J; Yoshida, E M

    1999-03-01

    Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis C seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents. PMID:10203436

  7. [Semeiotics of abdominal tuberculosis].

    PubMed

    Guseĭnov, G K; Ramazanova, A M; Guseĭnov, A G

    1984-01-01

    Examination of 119 patients with abdominal tuberculosis permitted the description of the characteristic semiotics of the illness. Today the patients with abdominal tuberculosis are mainly women of child-bearing age with a long-term tuberculosis catamnesis and intoxication, with a history of tuberculosis of different sites, those suffering from tuberculosis or its sequels at present (64%), those with pains (94%), discomfort or swelling of the abdomen (79%), malfunction of the gastrointestinal tract (65%), weight loss (86%), malnutrition (72%), anemia (63%), not infrequently with inflammatory induration (43%) or ascites in the abdominal cavity (39%). In addition to this characteristic semiotics, the patients with abdominal tuberculosis may demonstrate the most different and unexpected symptoms up to acute abdomen (23%). To make differential diagnosis of abdominal tuberculosis, one has often to resort to diagnostic laparotomy, laparoscopy, Koch's test and to trial therapy.

  8. Support for Students Exposed to Trauma: The SSET Program

    ERIC Educational Resources Information Center

    Jaycox, Lisa H.; Langley, Audra K.; Dean, Kristin L.

    2009-01-01

    Exposure to community and interpersonal violence is a public health crisis that adversely affects many children in American communities. After witnessing or experiencing trauma, many children experience symptoms of Post-Traumatic Stress Disorder and depression, behavioral problems, substance abuse, and poor school performance. The Support for…

  9. Forgetting Sexual Trauma: What Does It Mean When 38% Forget?

    ERIC Educational Resources Information Center

    Loftus, Elizabeth F.; And Others

    1994-01-01

    Discusses findings from L.M. Williams study (1994). Findings do not provide cogent support for claim that childhood sexual trauma is routinely banished from conscious awareness and then can be reliably recovered later. Findings do support claim that many children can forget about a sexually abusive experience from their past. (BF)

  10. Psychosocial Factors Influencing Competency of Children's Statements on Sexual Trauma

    ERIC Educational Resources Information Center

    Kim, Tae Kyung; Choi, Soul; Shin, Yee Jin

    2011-01-01

    Objectives: The objectives of this study are to assess children's competence to state their traumatic experience and to determine psychosocial factors influencing the competency of children's statements, such as emotional factors of children and parents and trauma-related variables, in Korean child sex abuse victims. Methods: We enrolled 214…

  11. Prior Trauma Exposure for Youth in Treatment Foster Care.

    PubMed

    Dorsey, Shannon; Burns, Barbara J; Southerland, Dannia G; Cox, Julia Revillion; Wagner, H Ryan; Farmer, Elizabeth M Z

    2012-10-01

    Very little research has focused on rates of trauma exposure for youth in treatment foster care (TFC). Available research has utilized record review for assessing exposure, which presents limitations for the range of trauma types examined, as records are predominantly focused on abuse and neglect. The current study examines exposure rates and association with emotional and behavioral outcomes for 229 youth in 46 TFC agencies. The youth in this study had exceptionally high rates of trauma exposure by foster parent report, similar to youth in traditional foster care, with nearly half of the sample exposed to four or more types of traumatic events. A composite child abuse and neglect exposure variable was associated with child and adolescent emotional and behavioral outcomes. Implications for services provided as part of TFC are discussed. PMID:23730144

  12. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  13. Alcohol, drugs, and urban violence in a small city trauma center.

    PubMed

    Buss, T F; Abdu, R; Walker, J R

    1995-01-01

    Substance abuse and urban trauma go hand in hand. But research focuses on large cities served by major academic medical centers. Do small cities face the same problems? Two hundred thirty-three urban trauma inpatients from a metro area of 250,000 were studied using patient interviews and medical records. As in large cities, one half used alcohol or drugs when attacked. Seventy percent were likely to be young, male, poor African-Americans. Only 3% were gang members, but demographic characteristics failed to explain substance abuse as they have for larger cities. A culture of violence pervades the small city, as it does in large urban ghettos. Two fifths were repeat urban trauma victims. Two fifths witnessed assaults in the past year. One third carried a knife or gun. Fifteen percent used a weapon on another person in the last year. Contextual variables, like being hurt in a bar, were related to drinking and drugs. The best predictor of present substance abuse and urban trauma was medical history of substance abuse. The need for (a) toxicology screens for all trauma victims, (b) referrals to substance abuse programs, (c) targeting at-risk populations for prevention, and (d) eliminating environments fostering violence and substance abuse is supported.

  14. Differential associations between childhood trauma subtypes and adolescent HPA-axis functioning

    PubMed Central

    Kuhlman, Kate R.; Geiss, Elisa G.; Vargas, Ivan; Lopez-Duran, Nestor L.

    2015-01-01

    Summary Studies examining the association between childhood trauma exposure and neuroendocrine functioning have returned inconsistent findings. To date, few studies have accounted for the role exposure to different types of childhood trauma may have on different neuroendocrine adaptations, and no study has examined this association using multiple indices of hypothalamic—pituitary—adrenal axis (HPA-axis) functioning. The purpose of this study was to characterize the unique associations between exposure to physical abuse, emotional abuse, and non-intentional trauma, and multiple indices of HPA-axis functioning. Methods A community sample of 138 youth (aged 9—16) completed the Socially Evaluated Cold Pressor Task (SE-CPT) while their parents completed the Early Trauma Inventory (ETI). All youth then collected 4 diurnal salivary cortisol samples at home across 2 consecutive weekdays. Results High reported exposure to non-intentional trauma was associated with intact diurnal regulation but elevated cortisol at bedtime, physical abuse was associated with faster reactivity to acute stress, and emotional abuse was associated with delayed recovery of cortisol following acute stress. Taken together, there was a heterogeneous relationship among different indices of HPA-axis functioning and trauma subtype. Discussion Different types of childhood trauma exposure are related to distinct anomalies in HPA-axis functioning. This study underscores the importance of research incorporating multiple indices of HPA-axis functioning to inform our understanding of the underlying neuroendocrine dysregulation that may later lead to stress-related psychopathology. PMID:25704913

  15. The relationship between eating disorders and sexual trauma.

    PubMed

    Madowitz, Jennifer; Matheson, Brittany E; Liang, June

    2015-09-01

    Research aimed at understanding the causes and comorbidities of eating disorders (ED) identifies sexual trauma as one potential pathway to the development and maintenance of eating disorders. Based on current literature, there are two main etiological pathways between sexual trauma and ED-body perceptions and psychological difficulties. However, previously published reviews on this topic are outdated and have not yielded consistent findings. Therefore, authors completed a literature review covering years 2004-2014 to examine the relationship between sexual trauma and ED according to both proposed pathway models. Authors utilized PubMed, GoogleScholar, and PsychINFO as search engines. Search terms included "sexual assault", "sexual abuse", "sexual trauma", and "rape" in conjunction with relevant ED terminology. Thirty-two studies met inclusion criteria for this review. Current data indicate an increased prevalence of sexual trauma for individuals with ED. Although limited, recent evidence suggests that sexual trauma precedes and contributes to the development of ED. Existing literature indicates that the body perceptions pathway may impact ED through body dissatisfaction, shame, sexual dysfunction, and fear of future sexual trauma. The psychological difficulties pathway indicates a link between ED and the desire to cope with the failure of the average expected environment, psychological diagnoses, the need for control, and the regulation of emotions. However, further research is needed to assess the potential causal role that sexual trauma may play in the etiology of ED. PMID:25976911

  16. The relationship between eating disorders and sexual trauma.

    PubMed

    Madowitz, Jennifer; Matheson, Brittany E; Liang, June

    2015-09-01

    Research aimed at understanding the causes and comorbidities of eating disorders (ED) identifies sexual trauma as one potential pathway to the development and maintenance of eating disorders. Based on current literature, there are two main etiological pathways between sexual trauma and ED-body perceptions and psychological difficulties. However, previously published reviews on this topic are outdated and have not yielded consistent findings. Therefore, authors completed a literature review covering years 2004-2014 to examine the relationship between sexual trauma and ED according to both proposed pathway models. Authors utilized PubMed, GoogleScholar, and PsychINFO as search engines. Search terms included "sexual assault", "sexual abuse", "sexual trauma", and "rape" in conjunction with relevant ED terminology. Thirty-two studies met inclusion criteria for this review. Current data indicate an increased prevalence of sexual trauma for individuals with ED. Although limited, recent evidence suggests that sexual trauma precedes and contributes to the development of ED. Existing literature indicates that the body perceptions pathway may impact ED through body dissatisfaction, shame, sexual dysfunction, and fear of future sexual trauma. The psychological difficulties pathway indicates a link between ED and the desire to cope with the failure of the average expected environment, psychological diagnoses, the need for control, and the regulation of emotions. However, further research is needed to assess the potential causal role that sexual trauma may play in the etiology of ED.

  17. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  18. A Review of Recent Literature on Trauma Among Individuals Living with HIV.

    PubMed

    LeGrand, Sara; Reif, Susan; Sullivan, Kristen; Murray, Kate; Barlow, Morgan L; Whetten, Kathryn

    2015-12-01

    Persons living with HIV (PLWH) report disproportionately high levels of exposure to traumatic events in childhood and adulthood. Traumatic experiences are associated with negative health and behavioral outcomes. Current research in this area seeks to further explicate the myriad health effects of trauma on PLWH and the pathways through which trauma operates. In this paper, we review articles published in English between January 2014 and June 2015 that examine traumatic experiences among PLWH, including intimate partner violence (IPV), domestic abuse, child abuse, and other forms of violence. A selection of studies examining trauma among PLWH and its associations with mental health, antiretroviral medication adherence, clinical outcomes, HIV disclosure, and sexual risk behaviors were included. Studies describing trauma coping strategies and interventions were also included. We conclude with recommendations for care of trauma-exposed PLWH and directions for future research. PMID:26419376

  19. A Review of Recent Literature on Trauma among Individuals Living with HIV

    PubMed Central

    Reif, Susan; Sullivan, Kristen; Murray, Kate; Barlow, Morgan L.; Whetten, Kathryn

    2016-01-01

    Persons living with HIV (PLWH) report disproportionately high levels of exposure to traumatic events in childhood and adulthood. Traumatic experiences are associated with negative health and behavioral outcomes. Current research in this area seeks to further explicate the myriad health effects of trauma on PLWH and the pathways through which trauma operates. In this paper, we review articles published in English between January 2014 and June 2015 that examine traumatic experiences among PLWH, including intimate partner violence (IPV), domestic abuse, child abuse, and other forms of violence. A selection of studies examining trauma among PLWH and its associations with mental health, antiretroviral medication adherence, clinical outcomes, HIV disclosure, and sexual risk behaviors were included. Studies describing trauma coping strategies and interventions were also included. We conclude with recommendations for care of trauma-exposed PLWH and directions for future research. PMID:26419376

  20. Childhood trauma and suicide risk in a sample of young individuals aged 14-35 years in southern Brazil.

    PubMed

    Barbosa, Luana Porto; Quevedo, Luciana; da Silva, Giovanna Del Grande; Jansen, Karen; Pinheiro, Ricardo Tavares; Branco, Jerônimo; Lara, Diogo; Oses, Jean; da Silva, Ricardo Azevedo

    2014-07-01

    Suicide is among the main causes of death of people aged between 15 and 44 years old. Childhood trauma is an important risk factor for suicide. Hence, the objective of this study was to verify the relationship between childhood trauma and current suicide risk (suicidal behavior and ideation) in individuals aged 14-35 years, in the city of Pelotas, Brazil. This is a cross-sectional, population-based study. Sample selection was performed by clusters. Suicide risk was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Moreover, the participants responded to a questionnaire concerning socioeconomic status, work, and substance use. The sample was composed of 1,380 individuals. The prevalence of suicide risk was 11.5%. The prevalence figures of childhood trauma were 15.2% (emotional neglect), 13.5% (physical neglect), 7.6% (sexual abuse), 10.1% (physical abuse), and 13.8% (emotional abuse). Suicide risk was associated (p<.001) with gender, work, alcohol abuse, tobacco use, and all types of childhood trauma. The odds of suicide risk were higher in women (OR=1.8), people who were not currently working (OR=2.3), individuals who presented alcohol abuse (OR=2.6), and among tobacco smokers (OR=3.4). Moreover, suicide risk was increased in all types of trauma: emotional neglect (OR=3.7), physical neglect (OR=2.8), sexual abuse (OR=3.4), physical abuse (OR=3.1), and emotional abuse (OR=6.6). Thus, preventing early trauma may reduce suicide risk in young individuals.

  1. Exploring the controversy in child abuse pediatrics and false accusations of abuse.

    PubMed

    Gabaeff, Steven C

    2016-01-01

    There is a controversy in child abuse pediatrics between an established corps of child abuse pediatricians aligned with hospital colleagues and law enforcement, and a multi-specialty challenger group of doctors and other medical professionals working with public interest lawyers. The latter group questions the scientific validity of the core beliefs of child abuse pediatricians and believes that there are a substantial number of false accusations of abuse occurring. An unproven primary hypothesis, crafted around 1975 by a small group of pediatricians with an interest in child abuse, lies at the foundation of child abuse pediatrics. With no scientific study, it was hypothesized that subdural hemorrhage (SDH) and retinal hemorrhage (RH) were diagnostic of shaking abuse. That hypothesis became the so-called "shaken baby syndrome." Through the period 1975-1985, in a coordinated manner, these child abuse specialists coalesced under the American Academy of Pediatrics and began working with district attorneys and social workers, informing them of the ways in which their hypothesis could be applied to prosecutions of child abuse and life-altering social service interventions. In a legal context, using then-prevailing evidentiary rules which treated scientific expert testimony as valid if it was "generally accepted" in the field, they represented falsely that there was general acceptance of their hypothesis and therefore it was valid science. As the ability to convict based on this unproven prime hypothesis (SDH and RH equals abuse) increased, some defense attorneys were professionally compelled by their own doubts to reach out to experts from other fields with experience with SDH and RH, trauma, and biomechanics, for second opinions. Medical and legal challenges to the established thinking soon emerged, based on both old and new evidenced-based literature. As the intensity of the controversy increased, the probability of false accusation became more apparent and the need

  2. Forensic child abuse evaluation: a review.

    PubMed

    Laraque, Danielle; DeMattia, Amy; Low, Christine

    2006-12-01

    This review discusses the forensic medical and psychological assessments of children and adolescents suspected of being victims of sexual or physical abuse/neglect. Evaluation of the whole child and the need to minimize trauma during the investigative and assessment processes are stressed. The forensic medical examination is reviewed, including the specifics of the pediatric anogenital examination. The key components of the forensic medical examination in sexual assault cases are also reviewed, with particular attention to maintaining the integrity of the process. Special emphasis is placed on the forensic interview in child sexual abuse cases, the best evidence available and areas in need of further research.

  3. Caring for Trauma Survivors.

    PubMed

    Antai-Otong, Deborah

    2016-06-01

    Although trauma exposure is common, few people develop acute and chronic psychiatric disorders. Those who develop posttraumatic stress disorder likely have coexisting psychiatric and physical disorders. Psychiatric nurses must be knowledgeable about trauma responses, implement evidence-based approaches to conduct assessments, and create safe environments for patients. Most researchers assert that trauma-focused cognitive-behavioral approaches demonstrate the most efficacious treatment outcomes. Integrated approaches, offer promising treatment options. This article provides an overview of clinical factors necessary to help the trauma survivor begin the process of healing and recovery and attain an optimal level of functioning. PMID:27229285

  4. Ventilation in chest trauma

    PubMed Central

    Richter, Torsten; Ragaller, Maximilian

    2011-01-01

    Chest trauma is one important factor for total morbidity and mortality in traumatized emergency patients. The complexity of injury in trauma patients makes it challenging to provide an optimal oxygenation while protecting the lung from further ventilator-induced injury to it. On the other hand, lung trauma needs to be treated on an individual basis, depending on the magnitude, location and type of lung or chest injury. Several aspects of ventilatory management in emergency patients are summarized herein and may give the clinician an overview of the treatment possibilities for chest trauma victims. PMID:21769213

  5. Associations between mental health, substance use, and sexual abuse experiences among Latinas.

    PubMed

    Ulibarri, Monica D; Ulloa, Emilio C; Salazar, Marissa

    2015-01-01

    This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18-34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues.

  6. Psychiatric disorders, spouse abuse and child abuse.

    PubMed

    Bland, R C; Orn, H

    1986-01-01

    The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.

  7. Pyogenic vertebral osteomyelitis complicating abdominal penetrating injury: case report and review of the literature

    PubMed Central

    2013-01-01

    Pyogenic vertebral osteomyelitis is a rare condition usually associated with endocarditis or spinal surgery. However, it may also occur following abdominal penetrating trauma with associated gastrointestinal perforation. Diagnosis might be challenging and appropriate treatment is essential to ensure a positive outcome. In trans-abdominal trauma, 48 hours of broad-spectrum antibiotics is generally recommended for prophylaxis of secondary infections. A case report of vertebral osteomyelitis complicating trans-colonic injury to the retroperitoneum is presented and clinical management is discussed in the light of literature review. PMID:24373134

  8. DAMAGE CONTROL TECHNIQUES IN THE MANAGEMENT OF SEVERE LUNG TRAUMA

    PubMed Central

    Garcia, Alberto; Martinez, Juan; Rodriguez, Julio; Millan, Mauricio; Valderrama, Gustavo; Ordoñez, Carlos; Puyana, Juan Carlos

    2014-01-01

    Background Damage Control (DC) has improved survival from severe abdominal and extremities injuries. The data on the surgical strategies and outcomes in patients managed with DC for severe thoracic injuries is scarce. Methods Retrospective review of the patients treated with DC for thoracic/pulmonary complex trauma at two level I trauma centers from 2006 to 2010. Subjects 14 and older, were included. Demographics, trauma characteristics, surgical techniques, and resuscitation strategies were reviewed. Results A total of 840 trauma thoracotomies were performed. Damage control thoracotomy (DCT) was done in 31 (3.7%). Pulmonary trauma was found in 25 of them. The median age was 28 (IQR 20–34) years, Revised Trauma Score was 7.11, (IQR 5.44–7.55), and Injury Severity Score was 26 (IQR 25–41). Nineteen patients had gunshot-wounds, four stab-wounds and two blunt trauma. Pulmonary trauma was managed by pneumorrhaphy in three cases, tractotomy in 12, wedge resection in one and packing as primary treatment in 8. Clamping of the pulmonary hilum was used as a last resource in 7 cases. Five patients returned to the ICU with the pulmonary hilum occluded by a vascular clamp or an en masse ligature. These patients underwent a deferred resection within 16 to 90 hours after the initial DCT. Four of them survived. Bleeding from other intra-thoracic sources was found in 20 cases: major vessels in nine, heart in three, and thoracic wall in nine. DCT mortality in pulmonary trauma was 6/25, (24%) due to coagulopathy or persistent bleeding in five cases and to multiorgan failure in one. Conclusion This series describes our experience with DCT in severe lung trauma. We describe pulmonary hilum clamping and deferred lung resection as a viable surgical alternative for major pulmonary injuries, and the use of packing as a definitive method for hemorrhage control. PMID:25539202

  9. The adult children of alcoholics trauma inventory.

    PubMed

    Mackrill, Thomas; Hesse, Morten

    2011-01-01

    The Adult Children of Alcoholics Trauma Inventory (ACATI) registers variations in the recalled experience of growing up with problem drinkers. The ACATI includes measures of the duration and severity of parental alcohol-use-related problems, the drinking parents' behavior when intoxicated and sober, physical, psychological, and sexual abuse, and environmental factors. The ACATI correlated well with the Family Tree Questionnaire and showed excellent 14-day test-retest reliability for most variables. The test-retest was carried out in 2009 at a counseling service for young adults from families with alcohol-use-related problems in Denmark (N = 49). PMID:21391809

  10. Laparoscopy in trauma: An overview of complications and related topics

    PubMed Central

    Kindel, Tammy; Latchana, Nicholas; Swaroop, Mamta; Chaudhry, Umer I; Noria, Sabrena F; Choron, Rachel L; Seamon, Mark J; Lin, Maggie J; Mao, Melissa; Cipolla, James; El Chaar, Maher; Scantling, Dane; Martin, Niels D; Evans, David C; Papadimos, Thomas J; Stawicki, Stanislaw P

    2015-01-01

    The introduction of laparoscopy has provided trauma surgeons with a valuable diagnostic and, at times, therapeutic option. The minimally invasive nature of laparoscopic surgery, combined with potentially quicker postoperative recovery, simplified wound care, as well as a growing number of viable intraoperative therapeutic modalities, presents an attractive alternative for many traumatologists when managing hemodynamically stable patients with selected penetrating and blunt traumatic abdominal injuries. At the same time, laparoscopy has its own unique complication profile. This article provides an overview of potential complications associated with diagnostic and therapeutic laparoscopy in trauma, focusing on practical aspects of identification and management of laparoscopy-related adverse events. PMID:26557490

  11. Maximizing Effectiveness Trials in PTSD and SUD Through Secondary Analysis: Benefits and Limitations Using the National Institute on Drug Abuse Clinical Trials Network "Women and Trauma" Study as a Case Example.

    PubMed

    Hien, Denise A; Campbell, Aimee N C; Ruglass, Lesia M; Saavedra, Lissette; Mathews, Abigail G; Kiriakos, Grace; Morgan-Lopez, Antonio

    2015-09-01

    Recent federal legislation and a renewed focus on integrative care models underscore the need for economical, effective, and science-based behavioral health care treatment. As such, maximizing the impact and reach of treatment research is of great concern. Behavioral health issues, including the frequent co-occurrence of substance use disorders (SUD) and posttraumatic stress disorder (PTSD), are often complex, with a myriad of factors contributing to the success of interventions. Although treatment guides for comorbid SUD/PTSD exist, most patients continue to suffer symptoms following the prescribed treatment course. Further, the study of efficacious treatments has been hampered by methodological challenges (e.g., overreliance on "superiority" designs (i.e., designs structured to test whether or not one treatment statistically surpasses another in terms of effect sizes) and short term interventions). Secondary analyses of randomized controlled clinical trials offer potential benefits to enhance understanding of findings and increase the personalization of treatment. This paper offers a description of the limits of randomized controlled trials as related to SUD/PTSD populations, highlights the benefits and potential pitfalls of secondary analytic techniques, and uses a case example of one of the largest effectiveness trials of behavioral treatment for co-occurring SUD/PTSD conducted within the National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) and producing 19 publications. The paper concludes with implications of this secondary analytic approach to improve addiction researchers' ability to identify best practices for community-based treatment of these disorders. Innovative methods are needed to maximize the benefits of clinical studies and better support SUD/PTSD treatment options for both specialty and non-specialty healthcare settings. Moving forward, planning for and description of secondary analyses in randomized trials should be given equal

  12. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  13. Treating childhood trauma.

    PubMed

    Terr, Lenore C

    2013-01-01

    This review begins with the question "What is childhood trauma?" Diagnosis is discussed next, and then the article focuses on treatment, using 3 basic principles-abreaction, context, and correction. Treatment modalities and complications are discussed, with case vignettes presented throughout to illustrate. Suggestions are provided for the psychiatrist to manage countertransference as trauma therapy proceeds.

  14. Effects of childhood trauma on personality in a sample of Chinese adolescents.

    PubMed

    Li, XianBin; Wang, ZhiMin; Hou, YeZhi; Wang, Ying; Liu, JinTong; Wang, ChuanYue

    2014-04-01

    Childhood trauma is a major public health problem which has an impact on personality development, yet no studies have examined the association between exposure to trauma and personality in a sample of Chinese adolescents. Four hundred eighty-five students completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the Eysenck Personality Questionnaire (EPQ). The CTQ-SF cut-off scores for exposure were used to calculate the prevalence of trauma. The possible associations between specific types of trauma and the EPQ subscale scores were examined. The rates of emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN) were 18.76%, 11.13%, 27.01%, 49.48%, and 68.66%, respectively. Individuals subjected to EA, PA, and SA had significantly higher neuroticism (EPQ-N) and psychoticism (EPQ-P) scores on the EPQ compared with those who had not experienced EA, PA, or SA (all p values<0.05). Significant positive correlations existed between CTQ-SF subscale scores for EA, SA, CTQ-SF total scores, and EPQ-N, EPQ-P scores (all p values<0.05). Significant number of subjects in this adolescent sample reported experience of childhood abuse and neglect. Exposure to childhood trauma is associated with personality development in Chinese adolescents.

  15. Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students.

    PubMed

    Craner, Julia R; Martinson, Amber A; Sigmon, Sandra T; McGillicuddy, Morgan L

    2015-01-01

    There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as "rape" or "abuse" as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general "label" questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women. PMID:26090864

  16. Children's life transition following sexual abuse.

    PubMed

    Hatlevig, Jacqueline

    2006-01-01

    The life transition of children 6 to 13 years old was studied for 1 to 3 years following sexual abuse. Data included transcripts from in-depth interviews about the children's daily living experiences and drawings were analyzed using the ADOPT analysis procedure. Implications for nursing include the use of drawings as a research technique and the effectiveness of strategies used by participants to manage the aftermath of the trauma.

  17. Primary closure of the abdominal wall after "open abdomen" situation.

    PubMed

    Kääriäinen, M; Kuokkanen, H

    2013-01-01

    "Open abdomen" is a strategy used to avoid or treat abdominal compartment syndrome. It has reduced mortality both in trauma and non-trauma abdominal catastrophes but also has created a challenging clinical problem. Traditionally, open abdomen is closed in two phases; primarily with a free skin graft and later with a flap reconstruction. A modern trend is to close the abdomen within the initial hospitalization. This requires multi-professional co-operation. Temporary abdominal closure methods, e.g. negative pressure wound therapy alone or combined with mesh-mediated traction, have been developed to facilitate direct fascial closure. Components separation technique, mesh reinforcement or bridging of the fascial defect with mesh and perforator saving skin undermining can be utilized in the final closure if needed. These techniques can be combined. Choice of the treatment depends on the condition of the patient and size of the fascia and skin defect, and the state of the abdominal contents. In this paper we review the literature on the closure of an open abdomen and present the policy used in our institution in the open abdomen situations.

  18. Diagnostic peritoneal lavage in evaluating acute abdominal pain.

    PubMed

    Barbee, C L; Gilsdorf, R B

    1975-06-01

    A study was performed to determine the value of peritoneal lavage in the acute abdomen not related to trauma. Lavage was performed in 33 patients in the evaluation of abdominal pain of sufficient degree to warrant consideration for surgical intervention. Peritoneal lavage was truly positive or truly negative in 64% of the cases. It showed false negative results in 28% and false positive results in 8%. The lavage was most accurate in the evaluation of appendicitis, colonic disease, and intra abdominal bleeding. It was highly inaccurate in the evaluation of cholecystitis and peptic ulcer disease. It was concluded that the peritoneal lavage can be a useful adjunct in the evaluation of patients with abdominal pain and should be considered in difficult diagnostic problems but not routinely employed.

  19. [The role of laparoscopy in emergency abdominal surgery].

    PubMed

    Balén, E; Herrera, J; Miranda, C; Tarifa, A; Zazpe, C; Lera, J M

    2005-01-01

    Abdominal emergencies can also be operated on through the laparoscopic approach: the approach can be diagnostic laparoscopy, surgery assisted by laparoscopy or laparotomy directed according to the findings of the laparoscopy. The general contraindications refer above all to the state of haemodynamic instability of the patient and to seriously ill patients (ASA IV). In the absence of any specific counter-indications for the specific laparoscopic procedure to be carried out, many abdominal diseases requiring emergency surgery can be performed with the laparoscopic approach. The most frequent indications are appendicitis, acute colecistitis, gastroduodenal perforation, occlusion of the small intestine, and some abdominal traumas. With a correct selection of patients and the appropriate experience of the surgeon, the results are excellent and better than open surgery (less infection of the wound, complications, hospital stay and postoperative pain). A detailed explanation is given of the basic aspects of the surgical technique in the most frequent procedures of emergency laparoscopy.

  20. Use of absorbable mesh as an aid in abdominal wall closure in the emergent setting.

    PubMed

    Buck, J R; Fath, J J; Chung, S K; Sorensen, V J; Horst, H M; Obeid, F N

    1995-08-01

    A surgeon has many options available to aid in the closure of abdominal wall defects in the elective setting. In the emergent setting, active infection or contamination increases the likelihood of infection of permanent prosthetic material and limits the surgical options. In such settings, we have used absorbable mesh (Dexon) as an adjunct to fascial closure until the acute complications resolve. To evaluate the effectiveness of this technique, we reviewed the outcome of such closures in 26 critically ill patients. Between July 1987 and June 1993, 26 patients were identified who had placement of absorbable mesh as part of an emergent laparotomy at a major urban trauma center. Through a retrospective chart review, the incidence of complications and outcome of the closure were tabulated. Seven patients were initially operated on for trauma. Two of the patients had mesh placement at their initial procedure secondary to fascial loss from trauma. The remainder of the patients hd mesh placement during a subsequent laparotomy for complications related to their initial procedure. Indications for these laparotomies included combinations of wound dehiscence, intra-abdominal abscess, anastomotic disruption, and perforation. Mesh placement in patients with intra-abdominal infection created effectively open abdominal wounds that allowed continued abdominal drainage, but required extensive wound care. Despite the absorbable nature of the mesh and often prolonged hospital stay in these ill patients, none of them required reoperation for dehiscence, recurrence of intra-abdominal abscess, or infection of the mesh.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Childhood Psychological Abuse and Adult Aggression: The Mediating Role of Self-Capacities

    ERIC Educational Resources Information Center

    Allen, Brian

    2011-01-01

    The current study examines the utility of self-trauma theory for explaining the long-term impact of childhood psychological abuse on aggression. Specifically, the self-capacities of interpersonal relatedness, identity, and affect regulation are tested as mediators of the impact of psychological abuse on various types of aggression in adulthood.…

  2. An Exploratory Study of Group Therapy for Sexually Abused Adolescents and Nonoffending Guardians

    ERIC Educational Resources Information Center

    Smith, Amanda P.; Kelly, Adrian B.

    2008-01-01

    Adolescent survivors of sexual abuse frequently report severe trauma, depression, anxiety, and low self-esteem. While cognitive-behavioral group interventions show promise, interpreting efficacy is problematic due to commonly high attrition. This article reports promising exploratory study findings relating to a 12-week multimodal abuse-specific…

  3. Treating Sexually Abused Children: 1 Year Follow-Up of a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Cohen, J.A.; Mannarino, A.P.; Knudsen, K.

    2005-01-01

    Objective:: To measure the durability of improvement in response to two alternative treatments for sexually abused children. Method:: Eighty-two sexually abused children ages 8-15 years old and their primary caretakers were randomly assigned to trauma-focused cognitive-behavioral therapy (TF-CBT) or non-directive supportive therapy (NST) delivered…

  4. The Relationship between Seclusion and Restraint Use and Childhood Abuse among Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Hammer, Joseph H.; Springer, Justin; Beck, Niels C.; Menditto, Anthony; Coleman, James

    2011-01-01

    Seclusion and restraint (S/R) is a controversial topic in the field of psychiatry, due in part to the high rates of childhood physical and sexual abuse found among psychiatric inpatients. The trauma-informed care perspective suggests that the use of S/R with previously abused inpatients may result in retraumatization due to mental associations…

  5. Sarah's Story: Using Ritual Therapy to Address Psychospiritual Issues in Treating Survivors of Childhood Sexual Abuse.

    ERIC Educational Resources Information Center

    Parker, Radha J.; Horton, H. Shelton, Jr.; Watson, Terri

    1997-01-01

    Describes an individual's healing from the trauma of childhood sexual abuse through counseling, spiritual growth, and the use of therapeutic ritual. Explores relationships between the psychospiritual issues associated with childhood sexual abuse and commonly designated treatment goals. Claims that addressing psychospiritual issues is crucial in…

  6. No evidence for verbal learning impairments in women with a history of childhood abuse.

    PubMed

    Jelicic, Marko; Geraerts, Elke; Merckelbach, Harald

    2008-01-15

    We examined verbal learning in 54 women with a history of childhood abuse and 40 women without trauma history. Although women with a history of abuse reported higher levels of psychological distress than controls, the two groups did not differ in their verbal learning performance.

  7. Childhood Emotional Abuse and Disordered Eating among Undergraduate Females: Mediating Influence of Alexithymia and Distress

    ERIC Educational Resources Information Center

    Hund, Anita R.; Espelage, Dorothy L.

    2006-01-01

    Objective: Drawing from stress-vulnerability and trauma theory (e.g., Rorty & Yager, 1996), this paper presents a model of associations among child emotional abuse (CEA), alexithymia, general distress (GD), and disordered eating (DE). This study extended previous research on psychological outcomes of child physical and sexual abuse to explore…

  8. Child Abuse: Definition.

    ERIC Educational Resources Information Center

    Wilson, Timothy L.-Y.

    The purpose of this paper was to elaborate on the definitions of child abuse in order to improve the understanding of child abuse. The definitions given by the U.S. House Joint Committee on Child Abuse in the Child Abuse Prevention and Treatment Act, and in research by Holden (1984), are cited. These definitions refer to the nature of abusive acts…

  9. Reviewing the Association between the History of Parental Substance Abuse and the Rate of Child Abuse

    PubMed Central

    Yaghoubi-Doust, Mahmoud

    2013-01-01

    Background Substance abuse is a social, and health problem in Middle Eastern countries such as Iran. One of its most devastating effects is domestic violence against children. This study examined the association between the history of parental substance abuse, and rate of child abuse in Ahvaz, Iran. Methods This was a case-control study. The study population included all parents with high school children in Ahwaz within the academic year 2012-2013. The sample size was 384 people in two groups; with a history of substance abuse (case group) and no history of substance abuse (control group). Multi-stage cluster random sampling method was used through the Cochran formula. The data collection tools included a Childhood Trauma Questionnaire (CTQ) (Bernstein, 1995), a demographic questionnaire, Duncan Socioeconomic Index (DSI), and a researcher-made questionnaire for the history of substance abuse. For data analysis, statistical indicators such as percentage, mean, standard deviation, t-test, and correlation and regression analysis were used. Findings Data analysis showed that there was a significant positive correlation among parents with a history of substance abuse and domestic violence toward children. Mean and standard deviation of the violence level in families with normal parents were 61.34 ± 16.88, and in families with a history of substance abuse were 98.99 ± 32.07. Therefore, the test results showed that there was a significant difference between normal families and families with history of substance abuse and violence toward children (P < 0.001, t = 8.60). Conclusion Based on the findings, the history of domestic violence and parental substance abuse (physical and emotional abuse, emotional and physical neglect) had a significant positive correlation with their behavior toward their children. After matching the two groups we found that the most common types of violence against children by their parents were, respectively, emotional violence (r = 58

  10. [Abdominal actinomycosis: four cases].

    PubMed

    Ghannouchi Jaafoura, N; Kaabia, N; Khalifa, M; Ben Jazia, I; Hachfi, W; Braham, A; Letaief, A; Bahri, F

    2008-12-01

    The abdominal actinomycosis (AA) is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic Gram positive bacteria, Actinomyces israelii. Abdominal actinomycosis is responsible for pseudotumoral syndrome often leading, to a large and mutilating surgery whereas a prolonged treatment by antibiotics would have permitted to cure the disease. The diagnosis is obtained generally from anatomopathologic exam. We report four cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis was only made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had a relapse of the infectious process. These four observations confirm the diagnostic and therapeutic difficulties previously reported by other authors.

  11. Trauma-Informed Approach to Survivors of Intimate Partner Violence.

    PubMed

    Anyikwa, Victoria A

    2016-01-01

    Trauma leads to deleterious effects on individuals and families causing many to seek treatment from social work practitioners across systems of care. Trauma comes in all forms, from community violence to domestic violence, including physical and sexual abuse of children and violence among intimate partners that leaves its victims devastatingly impacted. Women make up the majority of survivors of intimate partner violence (IPV) with studies revealing significant associated mental health problems. Social workers are bound to work with survivors of IPV and must be prepared to deliver effective trauma-informed services. While trauma-specific services exist for specific populations, researchers are finding that negative events in childhood and in family functioning can impact individuals' lives in negative ways thus having implications for treatment across systems. For women survivors of IPV, the traumatic stress may be cumulative with varied emotional and mental health impacts that may force them to seek services across systems, not just domestic violence specific systems. As such it is imperative that social workers increase awareness of trauma, its impact on women, and the importance of the approach and environment in which they provide services. In this article the author aims to broaden social workers knowledge of the use of a TIC approach developed by the Substance Abuse and Mental Health Services Administration that's applicable across systems of care, particularly when working with women survivors of IPV. PMID:27142906

  12. Veterans of a Secret War: Survivors of Childhood Sexual Trauma Compared to Vietnam War Veterans with PTSD.

    ERIC Educational Resources Information Center

    Cameron, Catherine

    1994-01-01

    A longitudinal study of women survivors of childhood sexual abuse documents the presence of the same posttraumatic stress disorder (PTSD) symptoms experienced by Vietnam veterans. In both cases, traumatic violence was the antecedent, but abuse survivors differed by context, age, length of trauma, and isolation. (JPS)

  13. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  14. Psychological Mechanisms Mediating Effects Between Trauma and Psychotic Symptoms: The Role of Affect Regulation, Intrusive Trauma Memory, Beliefs, and Depression.

    PubMed

    Hardy, Amy; Emsley, Richard; Freeman, Daniel; Bebbington, Paul; Garety, Philippa A; Kuipers, Elizabeth E; Dunn, Graham; Fowler, David

    2016-07-01

    Evidence suggests a causal role for trauma in psychosis, particularly for childhood victimization. However, the establishment of underlying trauma-related mechanisms would strengthen the causal argument. In a sample of people with relapsing psychosis (n = 228), we tested hypothesized mechanisms specifically related to impaired affect regulation, intrusive trauma memory, beliefs, and depression. The majority of participants (74.1%) reported victimization trauma, and a fifth (21.5%) met symptomatic criteria for Posttraumatic Stress Disorder. We found a specific link between childhood sexual abuse and auditory hallucinations (adjusted OR = 2.21, SE = 0.74, P = .018). This relationship was mediated by posttraumatic avoidance and numbing (OR = 1.48, SE = 0.19, P = .038) and hyperarousal (OR = 1.44, SE = 0.18, P = .045), but not intrusive trauma memory, negative beliefs or depression. In contrast, childhood emotional abuse was specifically associated with delusions, both persecutory (adjusted OR = 2.21, SE = 0.68, P = .009) and referential (adjusted OR = 2.43, SE = 0.74, P = .004). The link with persecutory delusions was mediated by negative-other beliefs (OR = 1.36, SE = 0.14, P = .024), but not posttraumatic stress symptoms, negative-self beliefs, or depression. There was no evidence of mediation for referential delusions. No relationships were identified between childhood physical abuse and psychosis. The findings underline the role of cognitive-affective processes in the relationship between trauma and symptoms, and the importance of assessing and treating victimization and its psychological consequences in people with psychosis. PMID:27460616

  15. Psychological Mechanisms Mediating Effects Between Trauma and Psychotic Symptoms: The Role of Affect Regulation, Intrusive Trauma Memory, Beliefs, and Depression

    PubMed Central

    Hardy, Amy; Emsley, Richard; Freeman, Daniel; Bebbington, Paul; Garety, Philippa A.; Kuipers, Elizabeth E.; Dunn, Graham; Fowler, David

    2016-01-01

    Evidence suggests a causal role for trauma in psychosis, particularly for childhood victimization. However, the establishment of underlying trauma-related mechanisms would strengthen the causal argument. In a sample of people with relapsing psychosis (n = 228), we tested hypothesized mechanisms specifically related to impaired affect regulation, intrusive trauma memory, beliefs, and depression. The majority of participants (74.1%) reported victimization trauma, and a fifth (21.5%) met symptomatic criteria for Posttraumatic Stress Disorder. We found a specific link between childhood sexual abuse and auditory hallucinations (adjusted OR = 2.21, SE = 0.74, P = .018). This relationship was mediated by posttraumatic avoidance and numbing (OR = 1.48, SE = 0.19, P = .038) and hyperarousal (OR = 1.44, SE = 0.18, P = .045), but not intrusive trauma memory, negative beliefs or depression. In contrast, childhood emotional abuse was specifically associated with delusions, both persecutory (adjusted OR = 2.21, SE = 0.68, P = .009) and referential (adjusted OR = 2.43, SE = 0.74, P = .004). The link with persecutory delusions was mediated by negative-other beliefs (OR = 1.36, SE = 0.14, P = .024), but not posttraumatic stress symptoms, negative-self beliefs, or depression. There was no evidence of mediation for referential delusions. No relationships were identified between childhood physical abuse and psychosis. The findings underline the role of cognitive-affective processes in the relationship between trauma and symptoms, and the importance of assessing and treating victimization and its psychological consequences in people with psychosis. PMID:27460616

  16. Indications for embolization in a French level 1 trauma center.

    PubMed

    Frandon, J; Arvieux, C; Thony, F

    2016-08-01

    Abdominal trauma accounts for nearly 20% of all traumatic injuries. It often involves young patients sustaining multiple injuries, with a high associated mortality rate. Management should begin at the scene of injury and relies on a structured chain of care in order to transport the trauma patient to the appropriate hospital center. Management is multi-disciplinary, involving intensive care specialists, surgeons and radiologists. Imaging to precisely define injury is best performed with whole body dual phase computed tomography, which can also identify the source of bleeding. Non-operative management has developed considerably over the years: this includes selective embolization in case of active bleeding or vascular anomalies in stable or stabilized patients after resuscitation. Embolization has become one of the corner stones of abdominal trauma management and interventional radiologists must play an active role on the trauma team. This overview details the different embolization procedures according to the involved organ and embolic agent used. PMID:27374109

  17. Structural Pathways between Child Abuse, Poor Mental Health Outcomes and Male-Perpetrated Intimate Partner Violence (IPV)

    PubMed Central

    Machisa, Mercilene T.; Christofides, Nicola; Jewkes, Rachel

    2016-01-01

    Background Violent trauma exposures, including child abuse, are risk factors for PTSD and comorbid mental health disorders. Child abuse experiences of men exacerbate adult male-perpetrated intimate partner violence (IPV). The relationship between child abuse, poor mental health and IPV perpetration is complex but research among the general population is lacking. This study describes the relationship and pathways between history of child abuse exposure and male-perpetrated IPV while exploring the potentially mediating effect of poor mental health. Methods We analysed data from a randomly selected, two-stage clustered, cross-sectional household survey conducted with 416 adult men in Gauteng Province of South Africa. We used multinomial regression modelling to identify associated factors and Structural Equation Modelling (SEM) to test the primary hypothesis that poor mental health (defined as abusing alcohol or having PTSD or depressive symptoms) mediates the relationship between child abuse and IPV perpetration. Results Eighty eight percent of men were physically abused, 55% were neglected, 63% were emotionally abused and 20% were sexually abused at least once in their childhood. Twenty four percent of men had PTSD symptoms, 24% had depressive symptoms and 36% binge drank. Fifty six percent of men physically abused and 31% sexually abused partners at least once in their lifetime. Twenty two percent of men had one episode and 40% had repeat episodes of IPV perpetration. PTSD symptomatology risk increased with severity of child trauma and other trauma. PTSD severity increased the risk for binge drinking. Child trauma, other trauma and PTSD symptomatology increased the severity of depressive symptoms. PTSD symptomatology was comorbid with alcohol abuse and depressive symptoms. Child trauma, having worked in the year before the survey, other trauma and PTSD increased the risk of repeat episodes of IPV perpetration. Highly equitable gender attitudes were protective

  18. Imaging of head trauma.

    PubMed

    Rincon, Sandra; Gupta, Rajiv; Ptak, Thomas

    2016-01-01

    Imaging is an indispensable part of the initial assessment and subsequent management of patients with head trauma. Initially, it is important for diagnosing the extent of injury and the prompt recognition of treatable injuries to reduce mortality. Subsequently, imaging is useful in following the sequelae of trauma. In this chapter, we review indications for neuroimaging and typical computed tomography (CT) and magnetic resonance imaging (MRI) protocols used in the evaluation of a patient with head trauma. We review the role of CT), the imaging modality of choice in the acute setting, and the role of MRI in the evaluation of patients with head trauma. We describe an organized and consistent approach to the interpretation of imaging of these patients. Important topics in head trauma, including fundamental concepts related to skull fractures, intracranial hemorrhage, parenchymal injury, penetrating trauma, cerebrovascular injuries, and secondary effects of trauma, are reviewed. The chapter concludes with advanced neuroimaging techniques for the evaluation of traumatic brain injury, including use of diffusion tensor imaging (DTI), functional MRI (fMRI), and MR spectroscopy (MRS), techniques which are still under development. PMID:27432678

  19. Estimating Local Child Abuse.

    ERIC Educational Resources Information Center

    Ards, Sheila

    1989-01-01

    Three conceptual approaches to estimating local child abuse rates using the National Incidence Study of Child Abuse and Neglect data set are evaluated. All three approaches yield estimates of actual abuse cases that exceed the number of reported cases. (SLD)

  20. Child Sexual Abuse

    MedlinePlus

    ... victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or ... can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, ...

  1. How to Handle Abuse

    MedlinePlus

    ... them. Another word for hurting someone is "abuse." Child abuse (say: ah-BYOOS) can affect all kinds of ... a babysitter, teacher, coach, or a bigger kid. Child abuse can happen anywhere — at home, school, childcare, or ...

  2. Trauma and Mobile Radiography

    SciTech Connect

    Drafke, M.W.

    1989-01-01

    Trauma and Mobile Radiography focuses on the radiography of trauma patients and of patients confined to bed. This book offers students a foundation in the skills they need to produce quality radiograms without causing additional injury or pain to the patient. Features of this new book include: coverage of the basics of radiography and patient care, including monitoring of heavily sedated, immobile, and accident patients. Information on the injuries associated with certain types of accidents, and methods for dealing with these problems. Detailed explanation of the positioning of each anatomical area. A Quick Reference Card with information on evaluating, monitoring and radiographing trauma patients.

  3. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  4. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  5. Physical abuse of children: an update.

    PubMed

    Sirotnak, A P; Krugman, R D

    1994-10-01

    Now, more than ever, physicians must be willing to suspect child abuse and report their concerns. New information from the past decade warns us that reports of violence against children continue to increase. We are learning that MRI imaging of the head may, in some cases, help date subdural hematomas, but long-term developmental follow-up studies of "shaken" infants are lacking. Intentional thoracic and abdominal injuries carry a high mortality. Finally, new information in the field of child abuse--in particular, physical abuse--is slow to come. Lack of funding for basic medical child abuse research and lack of trained researchers in the field are the two most important barriers. Preventive intervention at the community and family level needs to be supported by both the pediatrician and the local and national government leaders. As the U.S. Advisory Board on Child Abuse and Neglect says, "We need to make it as easy for parents to pick up the telephone and get help before they abuse their child as it is now for their neighbor or physician to pick up the telephone and report them after it has happened." Child health practitioners may be in the best position to implement such a policy.

  6. Physical abuse of children: an update.

    PubMed

    Sirotnak, A P; Krugman, R D

    1997-07-01

    Now, more than ever, physicians must be willing to suspect child abuse and report their concerns. New information from the past decade warns us that reports of violence against children continue to increase. We are learning that MRI imaging of the head may, in some cases, help date subdural hematomas, but long-term developmental follow-up studies of "shaken" infants are lacking. Intentional thoracic and abdominal injuries carry a high mortality. Finally, new information in the field of child abuse-in particular, physical abuse-is slow to come. Lack of funding for basic medical child abuse research and lack of trained researchers in the field are the two most important barriers. Preventive intervention at the community and family level needs to be supported by both the pediatrician and the local and national government leaders. As the U.S. Advisory Board on Child Abuse and Neglect says, "We need to make it as easy for parents to pick up the telephone and get help before they abuse their child as it is now for their neighbor or physician to pick up the telephone and report them after it has happened." Child health practitioners may be in the best position to implement such a policy.

  7. Child abuse: Cross-sectional survey of general dentists

    PubMed Central

    Kaur, Harsimran; Chaudhary, Seema; Choudhary, Nidhi; Manuja, Naveen; Chaitra, T.R.; Amit, Sinha Ashish

    2015-01-01

    Background Child abuse continues to be a social menace causing both physical and emotional trauma to benevolent children. Census has shown that nearly 50–75% of child abuse include trauma to mouth, face, and head. Thus, dental professionals are in strategic position to identify physical and emotional manifestations of abuse. Aim A cross-sectional survey was undertaken to assess knowledge and attitude of dental practitioners regarding child abuse and to identify the barriers in reporting the same. Methods With prior consent, a 20-question survey including both multiple choice and dichotomous (Yes/No) questions was mailed to 120 state-registered general dentists, and the data collected were subjected to statistical analysis. Results Overall response rate to the questionnaires was 97%. Lack of knowledge about dentist's role in reporting child abuse accounted to 55% in the reasons for hesitancy to report. Pearson chi-square test did not show any significant difference between male and female regarding reason for hesitancy to report and legal obligation of dentists. Conclusion Although respondent dentists were aware of the diagnosis of child abuse, they were hesitant and unaware of the appropriate authority to report. Increased instruction in the areas of recognition and reporting of child abuse and neglect should be emphasized. PMID:27195209

  8. Resilience in Child Sexual Abuse Survivors: Healing Power of Illusions.

    ERIC Educational Resources Information Center

    Himelein, Melissa J.; And Others

    Because research has focused on psychopathology rather than psychological health, little is known about how child sexual abuse (CSA) survivors escape childhood trauma unharmed. This investigation sought to identify cognitive characteristics associated with resilience following a history of CSA. The study sample of 180 women was drawn from a small,…

  9. Barriers to Successful Treatment Completion in Child Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    McPherson, Paul; Scribano, Philip; Stevens, Jack

    2012-01-01

    Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental…

  10. Nuances in pediatric trauma.

    PubMed

    Kenefake, Mary Ella; Swarm, Matthew; Walthall, Jennifer

    2013-08-01

    Pediatric trauma evaluation mimics adult stabilization in that it is best accomplished with a focused and systematic approach. Attention to developmental differences, anatomic and physiologic nuances, and patterns of injury equip emergency physicians to stabilize and manage pediatric injury.

  11. Acquired Cerebral Trauma: Epilogue.

    ERIC Educational Resources Information Center

    Bigler, Erin D., Ed.

    1988-01-01

    The article summarizes a series of articles concerning acquired cerebral trauma. Reviewed are technological advances, treatment, assessment, potential innovative therapies, long-term outcome, family impact of chronic brain injury, and prevention. (DB)

  12. Trauma-Informed Schools.

    PubMed

    Wiest-Stevenson, Courtney; Lee, Cindy

    2016-01-01

    Violence has impacted every aspect of daily life. These tragedies have shocked the world. This has resulted in school communities being fractured. Additionally, The National Survey of Children Exposed to Violence found that 60% of the children surveyed have been exposed to some form of trauma, either in or out of school. Traumatology research has shown most people respond to a wide range of traumatic events in similar ways. The common responses include traumatic responses, posttraumatic stress responses, and posttraumatic stress disorder (PTSD). In this article the authors outline the impact of trauma on children within school systems; discuss the mental health services schools are providing; present a trauma-informed school model; identifies tools which can be utilized in schools; and provide resources needed for a trauma-informed school, along with additional tools and resources. The authors discuss future recommendations for the community and schools as traumatic events continue to grow and impact a large number of children.

  13. Review of pancreatic trauma.

    PubMed Central

    Glancy, K E

    1989-01-01

    In reviewing the literature on pancreatic trauma (1,984 cases), I found that it resulted from penetrating trauma in 73% and blunt trauma in 27% of cases. Associated injuries were common (average 3.0 per patient). Increased mortality was associated with shotgun wounds, an increasing number of associated injuries, the proximity of the injury to the head of the pancreas, preoperative shock, and massive hemorrhage. High mortality was found for total pancreatectomy, duct reanastomosis, and lack of surgical treatment, with lower mortality for Roux-en-Y anastomoses, suture and drainage, distal pancreatectomy, and duodenal exclusion and diverticulization techniques. Most patients required drainage only. The preoperative diagnosis of pancreatic trauma is difficult, with the diagnosis usually made during surgical repair for associated injuries. Blood studies such as amylase levels, diagnostic peritoneal lavage, and plain radiographs are not reliable. Computed tomographic scanning may be superior, but data are limited. PMID:2669347

  14. [First aid for multiple trauma patients: investigative survey in the Firenze-Bologna area].

    PubMed

    Crescioli, G L; Donati, D; Federici, A; Rasero, L

    1999-01-01

    Overall mortality ascribable to multiple traumas, that in Italy is responsible for about 8,000 death/year, is strictly dependent on the function of the so called Trauma Care System. This study reports on an epidemiological survey conducted in the urban area of Florence along a 23-month period (from Jan 97 to Nov 99), with the aim to identify the typology of traumas and the first aid care delivered to the person until hospital admission. These data were compared to those collected in the urban area of Bologna because the composition of the first-aid team is different, being nurses, in Bologna, an integral component of the first aid system. On a total of 118 multiple traumas, 17% was represented by isolated head trauma, while in 72% involvement of other organs was present in addition to the head; 11% of cases were abdominal or thoracic traumas, 1% of lower extremities. In 46% the cause of trauma was a car accident. The complexity of care delivered to the person with trauma was less in the Florence survey, as indicated by the immobilization of patients, performed in only 11% of cases as compared to 47% in Bologna, by the application of the cervical collar, applied in 12% versus 62% of traumas. Although the two samples are not strictly comparable, these data suggest that the presence of nurses in the Trauma Care System can be one of the elements of improvement of the quality of delivered care.

  15. The Relationship Between Childhood Abuse and Adult Personality Disorder Symptoms

    PubMed Central

    Grover, Kelly E.; Carpenter, Linda L.; Price, Lawrence H.; Gagne, Gerard G.; Mello, Andrea F.; Mello, Marcelo F.; Tyrka, Audrey R.

    2015-01-01

    This study assessed personality disorder symptomatology in a community sample of healthy adults without diagnosable DSM-IV-TR Axis I psychiatric disorders who reported a history of childhood abuse. Twenty-eight subjects with a history of moderate to severe physical, sexual, and/or emotional abuse according to the Childhood Trauma Questionnaire were compared to 33 subjects without an abuse history on symptoms of personality disorders. Subjects in the Abuse group were more likely to report subclinical symptoms of paranoid, narcissistic, borderline, antisocial, obsessive compulsive, passive-aggressive, and depressive personality disorders. These findings link reports of childhood abuse with symptoms of personality disorders in the absence of Axis I psychiatric disorders in a community sample of healthy adults. PMID:17685839

  16. Penetrating extremity trauma.

    PubMed

    Ivatury, Rao R; Anand, Rahul; Ordonez, Carlos

    2015-06-01

    Penetrating extremity trauma (PET) usually becomes less important when present along with multiple truncal injuries. The middle eastern wars documented the terrible mortality and morbidity resulting from PET. Even in civilian trauma, PET can lead to significant morbidity and mortality. There are now well-established principles in the evaluation and management of vascular, bony, soft tissue, and neurologic lesions that will lead to a reduction of the poor outcomes. This review will summarize some of these recent concepts.

  17. Childhood Trauma is Associated with Altered Cortical Arousal: Insights from an EEG Study

    PubMed Central

    Howells, Fleur Margaret; Stein, Dan J.; Russell, Vivienne A.

    2012-01-01

    Background: Childhood trauma is associated with psychiatric disorders, yet the underlying psychobiological mechanisms that account for this link are not well understood. Alterations in cortical arousal may, however, play a key role in mediating this association. We hypothesized that childhood trauma would be associated with alterations in arousal during a task that required sustained attention and behavioral inhibition. Materials and Methods: Fifty-three healthy adults completed the Childhood Trauma Questionnaire which assesses physical neglect, emotional neglect, emotional abuse, physical abuse, sexual abuse, and denial of childhood trauma. These individuals underwent cortical (electroencephalography) and peripheral (heart rate, skin conductance responses, and salivary cortisol) physiological recordings at rest (eyes open and eyes closed) and during performance of a visual go/no-go (GNG) task. Associations between reported childhood trauma and physiological measures were determined. Results: Physical and emotional neglect were correlated with decreased left parietal tonic α band power during resting conditions and during the GNG task. Emotional abuse was correlated with decreased right frontal α band power during rest, increased θ band power during the GNG task, and cortisol at the end of the testing session. Physical and sexual abuse were correlated with delayed P300 latency and enhanced P300 amplitude during the no-go conditions of the GNG task. The denial scale was correlated with a decrease in θ and increase in α band power during the no-go conditions of the GNG task. Conclusion: The present study provides evidence that childhood trauma is associated with altered cortical arousal and that the pattern of this association is dependent on the form of childhood trauma experienced. PMID:23269916

  18. Quality of trauma care and trauma registries.

    PubMed

    Pino Sánchez, F I; Ballesteros Sanz, M A; Cordero Lorenzana, L; Guerrero López, F

    2015-03-01

    Traumatic disease is a major public health concern. Monitoring the quality of services provided is essential for the maintenance and improvement thereof. Assessing and monitoring the quality of care in trauma patient through quality indicators would allow identifying opportunities for improvement whose implementation would improve outcomes in hospital mortality, functional outcomes and quality of life of survivors. Many quality indicators have been used in this condition, although very few ones have a solid level of scientific evidence to recommend their routine use. The information contained in the trauma registries, spread around the world in recent decades, is essential to know the current health care reality, identify opportunities for improvement and contribute to the clinical and epidemiological research.

  19. Paediatric penetrating thoraco-abdominal injury: role of minimallly invasive surgery.

    PubMed

    Donati-Bourne, Jack; Bader, Mohammad I; Parikh, Dakshesh; Jester, Ingo

    2014-01-01

    We report two cases of penetrating thoraco-abdominal injuries who presented to our trauma centre. One with stab to lower left chest and the other one had pallet injury to right upper abdomen. The clinical presentation, radiological investigations and operative intervention are reviewed. PMID:24841025

  20. Noninvasive ventilation in trauma

    PubMed Central

    Karcz, Marcin K; Papadakos, Peter J

    2015-01-01

    Trauma patients are a diverse population with heterogeneous needs for ventilatory support. This requirement depends mainly on the severity of their ventilatory dysfunction, degree of deterioration in gaseous exchange, any associated injuries, and the individual feasibility of potentially using a noninvasive ventilation approach. Noninvasive ventilation may reduce the need to intubate patients with trauma-related hypoxemia. It is well-known that these patients are at increased risk to develop hypoxemic respiratory failure which may or may not be associated with hypercapnia. Hypoxemia in these patients is due to ventilation perfusion mismatching and right to left shunt because of lung contusion, atelectasis, an inability to clear secretions as well as pneumothorax and/or hemothorax, all of which are common in trauma patients. Noninvasive ventilation has been tried in these patients in order to avoid the complications related to endotracheal intubation, mainly ventilator-associated pneumonia. The potential usefulness of noninvasive ventilation in the ventilatory management of trauma patients, though reported in various studies, has not been sufficiently investigated on a large scale. According to the British Thoracic Society guidelines, the indications and efficacy of noninvasive ventilation treatment in respiratory distress induced by trauma have thus far been inconsistent and merely received a low grade recommendation. In this review paper, we analyse and compare the results of various studies in which noninvasive ventilation was applied and discuss the role and efficacy of this ventilator modality in trauma. PMID:25685722

  1. Airway management in trauma.

    PubMed

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration. PMID:19412149

  2. Pediatric pancreatic trauma: trending toward nonoperative management?

    PubMed

    Cuenca, Alex G; Islam, Saleem

    2012-11-01

    Pancreatic trauma is rare in children and optimal care has not been defined. We undertook this study to review the cumulative experience from three centers. After obtaining Institutional Review Board approval at each site, the trauma registries of three institutions were searched for pancreatic injuries. The charts were reviewed and data pertaining to demographics, hospital course, and outcome were obtained and analyzed. During the study period, a total of 79 pancreatic injuries were noted. The most common mechanism of injury was motor vehicle crash (44%) followed by child abuse (11%) and bicycle crashes (11%). Computed tomographic (CT) scans were obtained in 95 per cent with peripancreatic fluid the most common finding. Median Injury Severity Score (ISS) was 9, whereas median organ injury score was 2, and a higher grade correlated with need for operation (P = 0.001). Pancreatic operations were performed in 32 patients, whereas nonoperative management was noted in 47 cases. We noted no differences in length of stay, age, ISS, or initial blood pressure in operative versus nonoperatively managed cases. Pancreatic injuries were rare in children with trauma. CT scans were the most common method of diagnosis. Nonoperative management appeared to be safe and was more common, especially for the lower grade injuries.

  3. Oral and dental signs of child abuse and neglect

    PubMed Central

    COSTACURTA, M.; BENAVOLI, D.; ARCUDI, G.; DOCIMO, R.

    2015-01-01

    SUMMARY Aim The aim of this report is to identify the main oral and dental aspects of physical and sexual abuse and dental neglect in childhood, contributing to the precocious identification and diagnosis in a dental practice. Methods The oral and dental manifestations were divided and classified according to the type of child abuse: physical abuse, sexual abuse, neglect. Physical abuse Several studies in the literature have shown that oral or facial trauma occurs in about 50% of physically abused children; the oral cavity may be a central focus for physical abuse. Oro-facial manifestations of physical abuse include bruising, abrasions or lacerations of tongue, lips, oral mucosa, hard and soft palate, gingiva, alveolar mucosa, frenum; dental fractures, dental dislocations, dental avulsions; maxilla and mandible fractures. Sexual abuse Although the oral cavity is a frequent site of sexual abuse in children, visible oral injuries or infections are rare. Some oral signs may represent significant indications of sexual abuse, as erythema, ulcer, vescicle with purulent drainage or pseudomembranus and condylomatous lesions of lips, tongue, palate and nose-pharynx. Furthermore, if present erythema and petechiae, of unknown etiology, found on soft and hard palates junction or on the floor of the mouth, can be certainly evident proofs of forced oral sex. Dental neglect Oral signs of neglect are easily identifiable and are: poor oral hygiene, halitosis, Early Childhood Caries (ECC), odontogenous infections (recurrent and previous abscesses), periodontal disease, aptha lesions as a consequence of a nutritional deficiency status. Moreover, it is analyzed the assessment of bite marks because often associated with child abuse, the identification and collection of clinical evidence of this type of injury. Conclusion A precocious diagnosis of child abuse, in a dental practice, could considerably contribute in the identification of violence cases and in an early intervention. PMID

  4. Childhood trauma and eating psychopathology: a mediating role for dissociation and emotion dysregulation?

    PubMed

    Moulton, Stuart J; Newman, Emily; Power, Kevin; Swanson, Vivien; Day, Kenny

    2015-01-01

    The present study examined the relationship between different forms of childhood trauma and eating psychopathology using a multiple mediation model that included emotion dysregulation and dissociation as hypothesised mediators. 142 female undergraduate psychology students studying at two British Universities participated in this cross-sectional study. Participants completed measures of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect), eating psychopathology, dissociation and emotion dysregulation. Multiple mediation analysis was conducted to investigate the study's proposed model. Results revealed that the multiple mediation model significantly predicted eating psychopathology. Additionally, both emotion dysregulation and dissociation were found to be significant mediators between childhood trauma and eating psychopathology. A specific indirect effect was observed between childhood emotional abuse and eating psychopathology through emotion dysregulation. Findings support previous research linking childhood trauma to eating psychopathology. They indicate that multiple forms of childhood trauma should be assessed for individuals with eating disorders. The possible maintaining role of emotion regulation processes should also be considered in the treatment of eating disorders.

  5. Trauma and Conditional Risk of Posttraumatic Stress Disorder in Two American Indian Reservation Communities

    PubMed Central

    Beals, Janette; Belcourt-Dittloff, Annjeanette; Garroutte, Eva M.; Croy, Calvin; Jervis, Lori L.; Whitesell, Nancy Rumbaugh; Mitchell, Christina M.; Manson, Spero M.

    2012-01-01

    Purpose To determine conditional risk of posttraumatic stress disorder (PTSD) in two culturally distinct American Indian reservation communities. Method Data from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project, a cross-sectional population-based survey completed between 1997 and 2000. This study focused on 1,967 participants meeting the DSM-IV criteria for trauma exposure. Traumas were grouped into interpersonal, non-interpersonal, witnessed, and “trauma to close others” categories. Analyses examined distribution of worst traumas, conditional rates of PTSD following exposure, and distributions of PTSD cases deriving from these events. Bivariate and multivariate logistic regressions estimated associations of lifetime PTSD with trauma type. Results Overall, 15.9% of those exposed to DSM-IV trauma qualified for lifetime PTSD, a rate comparable to similar U.S. studies. Women were more likely to develop PTSD than were men. The majority (60%) of cases of PTSD among women derived from interpersonal trauma exposure (in particular, sexual and physical abuse); among men, cases were more evenly distributed across trauma categories. Conclusions Previous research has demonstrated higher rates of both trauma exposure and PTSD in American Indian samples compared to other Americans. This study shows that conditional rates of PTSD are similar to those reported elsewhere, suggesting that the elevated prevalence of this disorder in American Indian populations is largely due to higher rates of trauma exposure. PMID:23135256

  6. Relationship between type of trauma exposure and posttraumatic stress disorder among urban children and adolescents.

    PubMed

    Luthra, Rohini; Abramovitz, Robert; Greenberg, Rick; Schoor, Alan; Newcorn, Jeffrey; Schmeidler, James; Levine, Paul; Nomura, Yoko; Chemtob, Claude M

    2009-11-01

    This study examines the association between trauma exposure and posttraumatic stress disorder (PTSD) among 157 help-seeking children (aged 8-17). Structured clinical interviews are carried out, and linear and logistic regression analyses are conducted to examine the relationship between PTSD and type of trauma exposure controlling for age, gender, and ethnicity. Confrontation with traumatic news, witnessing domestic violence, physical abuse, and sexual abuse are each significantly associated with PTSD. Witnessing a crime, being the victim of a crime, and exposure to accidents, fire, or disaster are not associated with PTSD. These findings underscore the association between interpersonal violence and childhood PTSD. PMID:18945918

  7. Relationship between type of trauma exposure and posttraumatic stress disorder among urban children and adolescents.

    PubMed

    Luthra, Rohini; Abramovitz, Robert; Greenberg, Rick; Schoor, Alan; Newcorn, Jeffrey; Schmeidler, James; Levine, Paul; Nomura, Yoko; Chemtob, Claude M

    2009-11-01

    This study examines the association between trauma exposure and posttraumatic stress disorder (PTSD) among 157 help-seeking children (aged 8-17). Structured clinical interviews are carried out, and linear and logistic regression analyses are conducted to examine the relationship between PTSD and type of trauma exposure controlling for age, gender, and ethnicity. Confrontation with traumatic news, witnessing domestic violence, physical abuse, and sexual abuse are each significantly associated with PTSD. Witnessing a crime, being the victim of a crime, and exposure to accidents, fire, or disaster are not associated with PTSD. These findings underscore the association between interpersonal violence and childhood PTSD.

  8. Trauma systems and the costs of trauma care.

    PubMed Central

    Goldfarb, M G; Bazzoli, G J; Coffey, R M

    1996-01-01

    OBJECTIVE. This study examines the cost of providing trauma services in trauma centers organized by publicly administered trauma systems, compared to hospitals not part of a formal trauma system. DATA SOURCES AND STUDY SETTING. Secondary administrative discharge abstracts for a national sample of severely injured trauma patients in 44 trauma centers and 60 matched control hospitals for the year 1987 were used. STUDY DESIGN. Retrospective univariate and multivariate analyses were conducted to examine the impact of formal trauma systems and trauma center designation on the costs of treating trauma patients. Key dependent variables included length of stay, charge per day per patient, and charge per hospital stay. Key impact variables were type of trauma system and level of trauma designation. Control variables included patient, hospital, and community characteristics. DATA COLLECTION/EXTRACTION METHODS. Data were selected for hospitals based on (1) a large national hospital discharge database, the Hospital Cost and Utilization Project, 1980-1987 (HCUP-2) and (2) a special survey of trauma systems and trauma designation undertaken by the Hospital Research and Educational Trust of the American Hospital Association. PRINCIPAL FINDINGS. The results show that publicly designated Level I trauma centers, which are the focal point of most trauma systems, have the highest charge per case, the highest average charge per day, and similar or longer average lengths of stay than other hospitals. These findings persist after controlling for patient injury and health status, and for demographic characteristics and hospital and community characteristics. CONCLUSIONS. Prior research shows that severely injured trauma patients have greater chances of survival when treated in specialized trauma centers. However, findings here should be of concern to the many states developing trauma systems since the high costs of Level I centers support limiting the number of centers designated at this

  9. Childhood Trauma History Differentiates Amygdala Response to Sad Faces within MDD

    PubMed Central

    Grant, Merida M.; Cannistraci, Christopher; Hollon, Steven D.; Gore, John; Shelton, Richard

    2010-01-01

    Objective Heightened amygdala reactivity to aversive stimuli in major depression is regarded as a core feature of the underlying physiology but individual differences in amygdala response may also arise secondary to persistent changes in limbic function during early neurodevelopment relative to stressors such as childhood trauma. We sought to determine whether heightened amygdala response is a core feature of depression or a general risk factor for psychopathology secondary to early life stress. Method Twenty unipolar depressed patients with and without a history of significant early life trauma and 16 healthy comparison subjects underwent functional MRI in a cross-sectional study comparing neural response to sad and neutral faces. Results We observed a robust positive correlation between physical abuse and right amygdala response. A much weaker relationship with other forms of abuse and neglect was also found, suggesting differences between abuse subtypes and amygdala response. Group differences in amygdala response suggest heightened reactivity was not characteristic of persons with depression in general but was true primarily in those with a significant history of abuse. Conclusion These findings suggest the relationship between childhood trauma and risk for depression is mediated by heightened amygdala response but varies by abuse type. Preliminary evidence for two distinct depression phenotypes based on trauma history was also supported, consistent with differential etiology. PMID:21276593

  10. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  11. Predictors of substance abuse treatment participation among homeless adults.

    PubMed

    Ibabe, Izaskun; Stein, Judith A; Nyamathi, Adeline; Bentler, Peter M

    2014-03-01

    The current study focuses on the relationships among a trauma history, a substance use history, chronic homelessness, and the mediating role of recent emotional distress in predicting drug treatment participation among adult homeless people. We explored the predictors of participation in substance abuse treatment because enrolling and retaining clients in substance abuse treatment programs is always a challenge particularly among homeless people. Participants were 853 homeless adults from Los Angeles, California. Using structural equation models, findings indicated that trauma history, substance use history and chronicity of homelessness were associated, and were significant predictors of greater recent emotional distress. The most notable result was that recent emotional distress predicted less participation in current substance abuse treatment (both formal and self-help) whereas a substance use history alone predicted significantly more participation in treatment. Implications concerning treatment engagement and difficulties in obtaining appropriate dual-diagnosis services for homeless mentally distressed individuals are discussed. PMID:24238716

  12. Prevalence of narcotic bowel syndrome in opioid abusers in iran.

    PubMed

    Ahmadi, Bizhan; Arab, Peyman; Zahedi, Mohammad Javad; Shafieipour, Sara; Drossman, Douglas A; Banivaheb, Ghodseyeh

    2014-10-01

    BACKGROUND In spite of the increasing trend in opioid abusers worldwide, the prevalence of narcotic bowel syndrome (NBS) is undetermined. We aimed to estimate the prevalence of NBS and other opioid bowel dysfunction (OBD) in opioid abusers in Kerman, southeast Iran. According to the best of our knowledge, this is the first study to assess the prevalence of NBS in opioid abusers. METHODS By referring to addiction treatment centers in Kerman city and in a cross-sectional study, 577 subjects with opium or opioid subtracts abuse were included in our study. A validated questionnaire was used for OBD assessment and diagnosis of NBS was made according to both the presence of chronic abdominal pain despite increasing the opioid dose and ruling out other causes of abdominal pain. SPSS software version 16 was used for data analysis. p value<0.05 was considered as statistically significant. RESULTS Constipation, regurgitation, and heartburn were the most gastrointestinal complaints that were found in 132(22.9%), 123(21.3%) and 91(15.8%) subjects, respectively. Only 16(2.8%) participants fulfilled all the NBS criteria. Simultaneous use of non-narcotic sedative drugs increased the risk of NBS significantly (the odds ratio 3:1 and p=0.049). CONCLUSION NBS is not rare among opioid abusers and should be considered as a cause of chronic abdominal pain in this group. PMID:25349684

  13. PTSD Symptom Severities, Interpersonal Traumas, and Benzodiazepines Are Associated with Substance-Related Problems in Trauma Patients

    PubMed Central

    Guina, Jeffrey; Nahhas, Ramzi W.; Goldberg, Adam J.; Farnsworth, Seth

    2016-01-01

    Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs), DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs), most PTSSs (especially negative beliefs, recklessness, and avoidance), and interpersonal traumas (e.g., assaults and child abuse). Conclusion: In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment. PMID:27517964

  14. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  15. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  16. Parent Abuse: A Review

    ERIC Educational Resources Information Center

    Kennair, Nicola; Mellor, David

    2007-01-01

    A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily…

  17. Counseling Abused Children.

    ERIC Educational Resources Information Center

    McFadden, Emily Jean

    This guide on counseling abused children was written to help counselors meet the needs of children and adolescents and to provide ways of working with the child's family. Chapter 1 presents an overview of child maltreatment by identifying types of maltreatment (neglect, physical abuse, sexual abuse and exploitation, and emotional abuse or neglect)…

  18. Systemic inflammation after trauma.

    PubMed

    Lenz, Andreas; Franklin, Glen A; Cheadle, William G

    2007-12-01

    Trauma is still one of the main reasons for death among the population worldwide. Mortality occurring early after injury is due to "first hits", including severe organ injury, hypoxia, hypovolaemia or head trauma. Massive injury leads to activation of the immune system and the early inflammatory immune response after trauma has been defined as systemic inflammatory response syndrome (SIRS). "Second hits" such as infections, ischaemia/reperfusion or operations can further augment the pro-inflammatory immune response and have been correlated with the high morbidity and mortality in the latter times after trauma. SIRS can lead to tissue destruction in organs not originally affected by the initial trauma with subsequent development of multi-organ dysfunction (MOD). The initial pro-inflammatory response is followed by an anti-inflammatory response and can result in immune suppression with high risk of infection and sepsis. Trauma causes activation of nearly all components of the immune system. It activates the neuroendocrine system and local tissue destruction and accumulation of toxic byproducts of metabolic respiration leads to release of mediators. Extensive tissue injury may result in spillover of these mediators into the peripheral bloodstream to further maintain and augment the pro-inflammatory response. Hormones like ACTH, corticosteroids and catecholamines as well as cytokines, chemokines and alarmins play important roles in the initiation and persistence of the pro-inflammatory response after severe injury. The purpose of this review is therefore to describe the immunological events after trauma and to introduce important mediators and pathways of the inflammatory immune response.

  19. Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress

    PubMed Central

    Roberts, Andrea L.; Koenen, Karestan C.; Lyall, Kristen; Robinson, Elise; Weisskopf, Marc G.

    2016-01-01

    Persons with autistic traits may be at elevated risk for interpersonal victimization across the life course. Children with high levels of autistic traits may be targeted for abuse, and deficits in social awareness may increase risk of interpersonal victimization. Additionally, persons with autistic traits may be at elevated risk of posttraumatic stress disorder (PTSD) symptoms subsequent to trauma. We examined retrospectively reported prevalence of childhood abuse, trauma victimization and PTSD symptoms by autistic traits among adult women in a population-based longitudinal cohort, the Nurses’ Health Study II (N=1077). Autistic traits were measured by the 65-item Social Responsiveness Scale. We estimated odds ratios (OR) for childhood sexual and physical/emotional abuse and PTSD symptoms by quintiles of autistic traits. We examined possible mediation of PTSD risk by abuse and trauma type. Women in the highest versus lowest quintile of autistic traits were more likely to have been sexually abused (40.1% versus 26.7%), physically/emotionally abused (23.9% versus 14.3%), mugged (17.1% versus 10.1%), pressured into sexual contact (25.4% versus 15.6%) and have high PTSD symptoms (10.7% versus 4.5%). Odds of PTSD were elevated in women in the top three quintiles of autistic traits compared with the reference group (OR range=1.4 to 1.9). Childhood abuse exposure partly accounted for elevated risk of PTSD in women with autistic traits. We identify for the first time an association between autistic traits, childhood abuse, trauma victimization, and PTSD. Levels of autistic traits that are highly prevalent in the general population are associated with abuse, trauma and PTSD. PMID:25957197

  20. Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress.

    PubMed

    Roberts, Andrea L; Koenen, Karestan C; Lyall, Kristen; Robinson, Elise B; Weisskopf, Marc G

    2015-07-01

    Persons with autistic traits may be at elevated risk for interpersonal victimization across the life course. Children with high levels of autistic traits may be targeted for abuse, and deficits in social awareness may increase risk of interpersonal victimization. Additionally, persons with autistic traits may be at elevated risk of posttraumatic stress disorder (PTSD) symptoms subsequent to trauma. We examined retrospectively reported prevalence of childhood abuse, trauma victimization and PTSD symptoms by autistic traits among adult women in a population-based longitudinal cohort, the Nurses' Health Study II (N=1,077). Autistic traits were measured by the 65-item Social Responsiveness Scale. We estimated odds ratios (OR) for childhood sexual and physical/emotional abuse and PTSD symptoms by quintiles of autistic traits. We examined possible mediation of PTSD risk by abuse and trauma type. Women in the highest versus lowest quintile of autistic traits were more likely to have been sexually abused (40.1% versus 26.7%), physically/emotionally abused (23.9% versus 14.3%), mugged (17.1% versus 10.1%), pressured into sexual contact (25.4% versus 15.6%) and have high PTSD symptoms (10.7% versus 4.5%). Odds of PTSD were elevated in women in the top three quintiles of autistic traits compared with the reference group (OR range=1.4 to 1.9). Childhood abuse exposure partly accounted for elevated risk of PTSD in women with autistic traits. We identify for the first time an association between autistic traits, childhood abuse, trauma victimization, and PTSD. Levels of autistic traits that are highly prevalent in the general population are associated with abuse, trauma and PTSD.

  1. Clinical holistic medicine: holistic treatment of rape and incest trauma.

    PubMed

    Ventegodt, Søren; Kandel, Isack; Neikrug, Shimshon; Merric, Joav

    2005-04-01

    Studies indicate that at least 15% of the female population in western countries has experienced sexual abuse and severe sexual traumas. This paper explains how even serious sexual abuse and trauma can be healed when care and resources encourage the patient to return to the painful life events. When the physician cares and receives the trust of the patient, emotional holding and processing will follow quite naturally. Spontaneous regression seems to be an almost pain-free way of integrating the severe traumas from earlier experiences of rape and incest. This technique is a recommended alternative to classical timeline therapy using therapeutic commands. When traumatized patients distance themselves from their soul (feelings, sexuality, and existential depth), they often lose their energy and enjoyment of life. However, this does not mean that they are lost to life. Although it may seem paradoxical, a severe trauma may be a unique opportunity to regain enjoyment of life. The patient will often be richly rewarded for the extensive work of clearing and sorting out in order to experience a new depth in his or her existence and emotional life, with a new ability to understand life in general and other people in particular. So what may look like a tragedy can be transformed into a unique gift; if the patient gets sufficient support, there is the possibility of healing and learning. Consciousness-based medicine seems to provide severely traumatized patients with the quality of support and care needed for their soul to heal.

  2. Childhood trauma levels in individuals attending adult mental health services: An evaluation of clinical records and structured measurement of childhood trauma.

    PubMed

    Rossiter, Amy; Byrne, Fintan; Wota, Anna Paulina; Nisar, Zafar; Ofuafor, Thomas; Murray, Ivan; Byrne, Charles; Hallahan, Brian

    2015-06-01

    Despite an increased awareness regarding the prevalence and impact of childhood trauma, especially childhood sexual abuse (CSA), few studies examine the clinical reporting of such childhood experiences. This study compared the prevalence of childhood trauma recorded in individual's clinical notes to those ascertained with a structured validated questionnaire, examined which forms of childhood trauma were less likely to be reported to the treating mental health team and established which demographic or clinical factors were associated with reporting of childhood trauma. The prevalence of childhood trauma was ascertained using both the Childhood Trauma Questionnaire (CTQ) and a lifetime retrospective clinical note review in 129 individuals attending a general adult mental health service. Individuals were evaluated for the presence of mental health disorders, impulsivity, symptom severity and disability. Using the CTQ, childhood trauma was noted in 77% of individuals and recorded in 38% of individual's clinical notes (p<0.001). The greatest differences between CTQ reporting and clinical note documentation were noted for emotional neglect (62% versus 13.2%), physical neglect (48.1% versus 5.4%) and CSA (24.8% versus 8.5%). Childhood trauma was associated with increased psychopathology and greater symptom severity, and was particularly prevalent for individuals with personality disorders. This study demonstrated high rates of childhood trauma amongst adults attending a general adult mental health service. Furthermore, we demonstrated high rates of either non-enquiry from mental health professionals and/or high rates of non-documentation of childhood trauma by mental health professionals. Given the disparity between reporting of childhood trauma in clinical notes and findings with the CTQ, the use of a standardised questionnaire for the assessment of childhood trauma should be considered when performing a comprehensive mental health history. PMID:25636522

  3. Management of penetrating abdominal and thoraco-abdominal wounds: A retrospective study of 186 patients.

    PubMed

    Barbois, S; Abba, J; Guigard, S; Quesada, J L; Pirvu, A; Waroquet, P A; Reche, F; Risse, O; Bouzat, P; Thony, F; Arvieux, C

    2016-08-01

    This is a single center retrospective review of abdominal or abdomino-thoracic penetrating wounds treated between 2004 and 2013 in the gastrointestinal and emergency unit of the university hospital of Grenoble, France. This study did not include patients who sustained blunt trauma or non-traumatic wounds, as well as patients with penetrating head and neck injury, limb injury, ano-perineal injury, or isolated thoracic injury above the fifth costal interspace. In addition, we also included cases that were reviewed in emergency department morbidity and mortality conferences during the same period. Mortality was 5.9% (11/186 patients). Mean age was 36 years (range: 13-87). Seventy-eight percent (145 patients) suffered stab wounds. Most patients were hemodynamically stable or stabilized upon arrival at the hospital (163 patients: 87.6%). Six resuscitative thoracotomies were performed, five for gunshot wounds, one for a stab wound. When abdominal exploration was necessary, laparotomy was chosen most often (78/186: 41.9%), while laparoscopy was performed in 46 cases (24.7%), with conversion to laparotomy in nine cases. Abdominal penetration was found in 103 cases (55.4%) and thoracic penetration in 44 patients (23.7%). Twenty-nine patients (15.6%) had both thoracic and abdominal penetration (with 16 diaphragmatic wounds). Suicide attempts were recorded in 43 patients (23.1%), 31 (72.1%) with peritoneal penetration. Two patients (1.1%) required operation for delayed peritonitis, one who had had a laparotomy qualified as "negative", and another who had undergone surgical exploration of his wound under general anesthesia. In conclusion, management of clear-cut or suspected penetrating injury represents a medico-surgical challenge and requires effective management protocols. PMID:27318585

  4. The perceptions of pediatricians regarding their self-efficacy in child neglect and abuse.

    PubMed

    Gül, Hesna; Yürümez, Esra; Yaylalı, Fatma Hülya; Gül, Ahmet

    2015-01-01

    Child abuse is one of the most severe forms of childhood trauma which has pervasive and long-lasting effects on children, their families, and the society. These effects, impairing the development of the victims, extend far beyond childhood into adolescence and adulthood. Pediatricians are the most common group of clinicians who encounter abused children immediately. Therefore, it is important for a pediatrician to be aware of the symptoms of abuse and neglect, and to feel sufficient about reporting in order to release and prevent the trauma. We aimed to assess awareness and self-efficacy about recognizing, diagnosing and reporting. Pediatricians completed the questionnaire created by the researchers. There were differences about pediatricians' perception of self-efficacy and approach to abuse. Pediatricians experience difficulties about the diagnosis of child abuse and neglect through the process from examination to reporting. PMID:27411414

  5. Epidemiology of severe trauma.

    PubMed

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions.

  6. Epidemiology of severe trauma.

    PubMed

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. PMID:25241267

  7. Male genital trauma

    SciTech Connect

    Jordan, G.H.; Gilbert, D.A.

    1988-07-01

    We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disabling chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. 38 references.

  8. A comprehensive analysis of craniofacial trauma.

    PubMed

    Hussain, K; Wijetunge, D B; Grubnic, S; Jackson, I T

    1994-01-01

    A review of the literature identified a need for a prospective study of the complete range of craniofacial trauma. The aims of this study were to determine the incidence, etiology, and mechanisms of craniofacial and associated injuries, enabling a greater understanding of their range and magnitude. Nine hundred fifty consecutive patients seen at an urban university hospital with any degree of craniofacial trauma were prospectively investigated. Craniofacial trauma was found to be very common at all ages. The causes were directly related to age, sex, and alcohol consumption, and determine the type and severity of injury. The commonest cause of soft-tissue injury was falls, whereas that of fractures was interpersonal violence. Falls accounted for most of the injuries in children and the elderly, whereas interpersonal violence was mainly responsible for those occurring in patients aged 15 to 50 years. Interpersonal violence mostly involved young male adults: fights occurring mainly between strangers who had consumed excessive amounts of alcohol. Women were usually assaulted by assailants known to them, their partners. Pedestrians showed a propensity to sustain cranial fractures, whereas motor vehicle occupants tended to sustain midfacial fractures and bicyclists mandibular fractures. Pedestrians incurred the severest injuries of all road users, and a significant proportion of road user collisions involved bicyclists. Sports were responsible for a significant proportion of craniofacial injuries in youths and young adults. Craniofacial soft-tissue injuries overall occurred most frequently on the forehead, nose, lips, and chin, and a method for their classification is proposed. The commonest craniofacial fracture was that of the nasal bones (45%), followed by cranial bones (24%), mandible (13%), zygoma (13%), orbital blow-out (3%), and maxilla (2%). The incidence of craniofacial trauma can be greatly reduced by improvements in interior home design, school education in

  9. Endovascular management of lap belt-related abdominal aortic injury in a 9-year-old child.

    PubMed

    Papazoglou, Konstantinos O; Karkos, Christos D; Kalogirou, Thomas E; Giagtzidis, Ioakeim T

    2015-02-01

    Blunt abdominal aortic trauma is a rare occurrence in children with only a few patients having been reported in the literature. Most such cases have been described in the context of lap belt injuries. We report a 9-year-old boy who suffered lap belt trauma to the abdomen during a high-speed road traffic accident resulting to the well-recognized pattern of blunt abdominal injury, that is, the triad of intestinal perforation, fractures of the lumbar spine, and abdominal aortic injury. The latter presented with lower limb ischemia due to dissection of the infrarenal aorta and right common iliac artery. Revascularization was achieved by endovascular means using 2 self-expanding stents in the infrarenal aorta and the right common iliac artery. This case is one of the few reports of lap belt-related acute traumatic abdominal aortic dissection in a young child and highlights the feasibility of endovascular management in the pediatric population. PMID:25463338

  10. Endovascular management of lap belt-related abdominal aortic injury in a 9-year-old child.

    PubMed

    Papazoglou, Konstantinos O; Karkos, Christos D; Kalogirou, Thomas E; Giagtzidis, Ioakeim T

    2015-02-01

    Blunt abdominal aortic trauma is a rare occurrence in children with only a few patients having been reported in the literature. Most such cases have been described in the context of lap belt injuries. We report a 9-year-old boy who suffered lap belt trauma to the abdomen during a high-speed road traffic accident resulting to the well-recognized pattern of blunt abdominal injury, that is, the triad of intestinal perforation, fractures of the lumbar spine, and abdominal aortic injury. The latter presented with lower limb ischemia due to dissection of the infrarenal aorta and right common iliac artery. Revascularization was achieved by endovascular means using 2 self-expanding stents in the infrarenal aorta and the right common iliac artery. This case is one of the few reports of lap belt-related acute traumatic abdominal aortic dissection in a young child and highlights the feasibility of endovascular management in the pediatric population.

  11. Influence of Child Abuse on Adult Depression

    PubMed Central

    Bradley, Rebekah G.; Binder, Elisabeth B.; Epstein, Michael P.; Tang, Yilang; Nair, Hemu P.; Liu, Wei; Gillespie, Charles F.; Berg, Tiina; Evces, Mark; Newport, D. Jeffrey; Stowe, Zachary N.; Heim, Christine M.; Nemeroff, Charles B.; Schwartz, Ann; Cubells, Joseph F.; Ressler, Kerry J.

    2008-01-01

    Context Genetic inheritance and developmental life stress both contribute to major depressive disorder in adults. Child abuse and trauma alter the endogenous stress response, principally corticotropin-releasing hormone and its downstream effectors, suggesting that a gene × environment interaction at this locus may be important in depression. Objective To examine whether the effects of child abuse on adult depressive symptoms are moderated by genetic polymorphisms within the corticotropin-releasing hormone type 1 receptor (CRHR1) gene. Design Association study examining gene × environment interactions between genetic polymorphisms at the CRHR1 locus and measures of child abuse on adult depressive symptoms. Setting General medical clinics of a large, public, urban hospital and Emory University, Atlanta, Georgia. Participants The primary participant population was 97.4% African American, of low socioeconomic status, and with high rates of lifetime trauma (n=422). A supportive independent sample (n=199) was distinct both ethnically (87.7% Caucasian) and socioeconomically (less impoverished). Main Outcome Measures Beck Depression Inventory scores and history of major depressive disorder by the Structured Clinical Interview for DSM-IV Axis I Disorders. Results Fifteen single-nucleotide polymorphisms spanning 57 kilobases of the CRHR1 gene were examined. We found significant gene × environment interactions with multiple individual single-nucleotide polymorphisms (eg, rs110402, P=.008) as well as with a common haplotype spanning intron 1 (P <.001). Specific CRHR1 polymorphisms appeared to moderate the effect of child abuse on the risk for adult depressive symptoms. These protective effects were supported with similar findings in a second independent sample (n=199). Conclusions These data support the corticotropin-releasing hormone hypothesis of depression and suggest that a gene × environment interaction is important for the expression of depressive symptoms in adults

  12. [Maternal affect regulation of mothers with a history of abuse in mother-infant-interaction].

    PubMed

    Kress, Sandra; Cierpka, Manfred; Möhler, Eva; Resch, Franz

    2012-01-01

    Maternal intuitive skills can be threatened as a result of severe deprivation or unresolved trauma in the own childhood and can even be inaccessible to the mother. A mother's own childhood experience of abuse maybe a risk factor for repeated child abuse. As a follow-up study to assess the emotional availability of abused mothers it was investigated how a physical or sexual abuse appears in the mother-child interaction and communication in the context of "cycle of abuse" and whether it could give effect to it. Interactions of mothers with abuse experience were compared with those of mothers without an abuse experience and evaluated five months postpartum with the Munich clinical communication scale (MKK). The results suggest that maltreatment experienced mothers show less emotion tuning to their child in a standardized interaction sequence.

  13. Transfusion practices in trauma.

    PubMed

    Ramakrishnan, V Trichur; Cattamanchi, Srihari

    2014-09-01

    Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury. PMID:25535424

  14. Transfusion practices in trauma

    PubMed Central

    Ramakrishnan, V Trichur; Cattamanchi, Srihari

    2014-01-01

    Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury. PMID:25535424

  15. The Role of Childhood Trauma and Posttraumatic Stress Disorder in Postpartum Sleep Disturbance

    PubMed Central

    Swanson, Leslie M.; Hamilton, Lindsay; Muzik, Maria

    2015-01-01

    In the present study, we examined sleep complaints in postpartum women with a past history of childhood trauma relative to postpartum women who were not exposed to childhood trauma. We also assessed whether sleep was differentially affected by the type of childhood trauma experienced and the relative contribution of posttraumatic stress disorder. Participants completed questionnaires related to mental health over the phone at four months postpartum (n = 173). We found that after adjusting for covariates, participants who reported childhood neglect or physical abuse (regardless of sexual abuse) were significantly more likely to endorse difficulty falling asleep and staying asleep relative to participants who were not exposed to childhood trauma. Furthermore, PTSD was associated with sleep problems, such that mothers with childhood trauma who had recovered from a past history of PTSD were more likely to have difficulty falling and staying asleep than mothers who were exposed to childhood trauma but never developed PTSD, while mothers with persistent PTSD were at the highest risk for reporting sleep problems. Our findings affirm the contribution of childhood trauma and PTSD to postpartum sleep problems, and suggest that sleep may be disturbed in the postpartum even in women who have recovered from PTSD. PMID:25403425

  16. Sonography of scrotal trauma.

    PubMed

    Rao, Meka Srinivasa; Arjun, Kalyanpur

    2012-10-01

    The purpose of this article is to depict the spectrum of scrotal injuries in blunt trauma. Scrotal injuries are not very common and are mostly due to blunt trauma from direct injury, sports injuries or motor vehicle accidents. To minimize complications and ensure testicular salvage, rapid and accurate diagnosis is necessary. High-resolution USG is the investigation of choice, as it is readily available, accurate and has been seen to improve outcomes. An understanding of and familiarity with the sonographic appearance of scrotal injuries on the part of the radiologist/sonographer is therefore of key importance. PMID:23833421

  17. Transforming the legacies of childhood trauma in couple and family therapy.

    PubMed

    Basham, Kathryn

    2004-01-01

    A multi-theoretical couple/family therapy clinical social work practice model synthesizes various social, family, trauma, and psychodynamic theories to inform a biopsychosocial assessment that guides clinical interventions. The client population involves adult partners who have negotiated the impact of childhood trauma, i.e., physical, sexual, and emotional abuses, including culturally sanctioned trauma. Couples may also be dealing with the aftermath of acute trauma related to interpersonal violence, political conflict, and/or the dislocations related to refugee or new immigrant status. Clinical examples demonstrate the usefulness of the model as well as contraindications when active physical violence is present. The construct of resilience remains a central focus in assessment and treatment. Specific attention to cultural and racial diversity enriches both assessment and treatment interventions with these high-risk couples and families. This practice model will be explicated in depth in an upcoming publication from Columbia University Press titled Transforming the Legacies of Trauma in Couple Therapy.

  18. Transforming the legacies of childhood trauma in couple and family therapy.

    PubMed

    Basham, Kathryn

    2004-01-01

    A multi-theoretical couple/family therapy clinical social work practice model synthesizes various social, family, trauma, and psychodynamic theories to inform a biopsychosocial assessment that guides clinical interventions. The client population involves adult partners who have negotiated the impact of childhood trauma, i.e., physical, sexual, and emotional abuses, including culturally sanctioned trauma. Couples may also be dealing with the aftermath of acute trauma related to interpersonal violence, political conflict, and/or the dislocations related to refugee or new immigrant status. Clinical examples demonstrate the usefulness of the model as well as contraindications when active physical violence is present. The construct of resilience remains a central focus in assessment and treatment. Specific attention to cultural and racial diversity enriches both assessment and treatment interventions with these high-risk couples and families. This practice model will be explicated in depth in an upcoming publication from Columbia University Press titled Transforming the Legacies of Trauma in Couple Therapy. PMID:15774396

  19. Trauma-Focused CBT for Youth Who Experience Ongoing Traumas

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura K.

    2011-01-01

    Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will…

  20. Trauma-Focused CBT for Youth who Experience Ongoing Traumas

    PubMed Central

    Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura A.

    2011-01-01

    Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will this in some way impair their responding to current or ongoing trauma? The paper addresses practical strategies for implementing one evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with ongoing traumas. Collaboration with local therapists and families participating in TF-CBT community and international programs elucidated effective strategies for applying TF-CBT with these youth. These strategies included: 1) enhancing safety early in treatment; 2) effectively engaging parents who experience personal ongoing trauma; and 3) during the trauma narrative and processing component focusing on a) increasing parental awareness and acceptance of the extent of the youths’ ongoing trauma experiences; b) addressing youths’ maladaptive cognitions about ongoing traumas; and c) helping youth differentiate between real danger and generalized trauma reminders. Case examples illustrate how to use these strategies in diverse clinical situations. Through these strategies TF-CBT clinicians can effectively improve outcomes for youth experiencing ongoing traumas. PMID:21855140

  1. [Child sexual abuse: an irremediable hurt?].

    PubMed

    Di Giacomo, Ester; Alamia, Alberto; Cicolari, Federica; Cimolai, Valentina; Clerici, Massimo

    2013-01-01

    The aim of this review was to provide the state of art of child sexual abuse and its psychophysical consequences. We assessed the evidence-based literature derived from PubMed, Embase, Medline, PsychINFO databases, including a thorough analysis of what has been published in the last 5 years, not neglecting previous publications essential to the argument for their scientific validity (methodological accuracy, recruited survey). Child sexual abuse is ubiquitous both regarding victims' gender and socio-economic conditions. The important consequences linked to what they suffered--either immediately or with adolescent or adult onset--are mediated by age and family support to trauma reprocessing as well as by the frequency of repetition of the abuse or familiarity with the abuser. These factors appear to be of primary importance--both at a physical and psychic level--and may be expressed in multiple manifestations, hence it is of utmost importance to pay timely attention to possible alarm signals revealing suspected abuse suffered by any underage person. Special emphasis is addressed towards some of the consequences for which child sexual abuse is considered to be a primary cause (e.g. post-traumatic stress disorder) and the perpetuation of such abuse, both short-term as well as long-term. Poor training, regarding this field, of various professionals (pediatricians, teachers, etc.) who each day work with minors, as well as the paucity of available treatment options point to an urgent need for prevention (including in-depth diagnosis/therapy) and early intervention.

  2. [Child sexual abuse: an irremediable hurt?].

    PubMed

    Di Giacomo, Ester; Alamia, Alberto; Cicolari, Federica; Cimolai, Valentina; Clerici, Massimo

    2013-01-01

    The aim of this review was to provide the state of art of child sexual abuse and its psychophysical consequences. We assessed the evidence-based literature derived from PubMed, Embase, Medline, PsychINFO databases, including a thorough analysis of what has been published in the last 5 years, not neglecting previous publications essential to the argument for their scientific validity (methodological accuracy, recruited survey). Child sexual abuse is ubiquitous both regarding victims' gender and socio-economic conditions. The important consequences linked to what they suffered--either immediately or with adolescent or adult onset--are mediated by age and family support to trauma reprocessing as well as by the frequency of repetition of the abuse or familiarity with the abuser. These factors appear to be of primary importance--both at a physical and psychic level--and may be expressed in multiple manifestations, hence it is of utmost importance to pay timely attention to possible alarm signals revealing suspected abuse suffered by any underage person. Special emphasis is addressed towards some of the consequences for which child sexual abuse is considered to be a primary cause (e.g. post-traumatic stress disorder) and the perpetuation of such abuse, both short-term as well as long-term. Poor training, regarding this field, of various professionals (pediatricians, teachers, etc.) who each day work with minors, as well as the paucity of available treatment options point to an urgent need for prevention (including in-depth diagnosis/therapy) and early intervention. PMID:24056826

  3. Sexual abuse of children and adolescents.

    PubMed

    Sugar, M

    1983-01-01

    Parents, relatives, and friends may inflict their passions on children of the same or opposite sex. This is often initiated by sleeping together. Sexual abuse contributes to and causes emotional trauma, although the child's turmoil, confusion, wish for acceptance, and anxiety may be overlooked by the parent and professional. Mutual silence aided by threats adds to the anxiety. Despite the notion that reports of parental sexual exploitation of their children are usually fantasies, there appear to be increasing data that incest and sexual abuse are frequent traumata. At present, there is increased risk of lowering the incest barrier because of increased rates of divorce and step- or surrogate parenthood, since they provide additional potential for being sexually and emotionally traumatized. Sexual abuse seems to be part of a constellation involving neglect and a pathological symbiosis. That sexual abuse is emotionally traumatic is apparent, but it needs emphasizing. Children's defensive reactions may cloud this, and it may be years before such incidents are connected to symptomatic behavior, even when the child is in intensive therapy. In the reported cases, there appears to be a pattern of reactions and defenses related to the traumata that are embedded in imprinting and identification with the aggressor. This leads to sexual abuse being a legacy passed on to the next generation of victims, as the victim becomes the molester through identification. Adolescent self-destructive behavior may stem from guilt about sexually abusing younger children. Therapists may be better able to understand and deal with some of their patients' symptoms if sexual abuse is considered as a possible factor in one or both directions. PMID:6677153

  4. The effect of resilience on posttraumatic stress disorder in trauma-exposed inner-city primary care patients.

    PubMed

    Wrenn, Glenda L; Wingo, Aliza P; Moore, Renee; Pelletier, Tiffany; Gutman, Alisa R; Bradley, Bekh; Ressler, Kerry J

    2011-07-01

    Posttraumatic stress disorder (PTSD) has previously been associated with increased risk for a variety of chronic medical conditions and it is often underdiagnosed in minority civilian populations. The current study examined the effects of resilience on the likelihood of having a diagnosis of PTSD in an inner-city sample of primary care patients (n=767). We measured resilience with the Connor-Davidson Resilience Scale, trauma with the Childhood Trauma Questionnaire and Trauma Events Inventory, and assessed for PTSD with the modified PTSD symptom scale. Multiple logistic regression model with presence/absence of PTSD as the outcome yielded 3 significant factors: childhood abuse, nonchild abuse trauma, and resilience. One type of childhood abuse in moderate to severe range (OR, 2.01; p = .0001), 2 or more types of childhood abuse in moderate to severe range (OR, 4.00; p < or = .0001), and 2 or more types of nonchildhood abuse trauma exposure (OR, 3.33; p < or = .0001), were significantly associated with an increased likelihood of PTSD, while resilience was robustly and significantly associated with a decreased likelihood of PTSD (OR, 0.93; p < or = .0001). By understanding the role of resilience in recovery from adverse experiences, improved treatment and interventional methods may be developed. Furthermore, these results suggest a role for assessing resilience in highly traumatized primary care populations as a way to better characterize risk for PTSD and direct screening/psychiatric referral efforts.

  5. Advances in prehospital trauma care

    PubMed Central

    Williamson, Kelvin; Ramesh, Ramaiah; Grabinsky, Andreas

    2011-01-01

    Prehospital trauma care developed over the last decades parallel in many countries. Most of the prehospital emergency medical systems relied on input or experiences from military medicine and were often modeled after the existing military procedures. Some systems were initially developed with the trauma patient in mind, while other systems were tailored for medical, especially cardiovascular, emergencies. The key components to successful prehospital trauma care are the well-known ABCs of trauma care: Airway, Breathing, Circulation. Establishing and securing the airway, ventilation, fluid resuscitation, and in addition, the quick transport to the best-suited trauma center represent the pillars of trauma care in the field. While ABC in trauma care has neither been challenged nor changed, new techniques, tools and procedures have been developed to make it easier for the prehospital provider to achieve these goals in the prehospital setting and thus improve the outcome of trauma patients. PMID:22096773

  6. Lifetime Physical and Sexual Abuse and Self-Harm in Women With Severe Mental Illness.

    PubMed

    O'Hare, Thomas; Shen, Ce; Sherrer, Margaret V

    2016-09-01

    In a sample of 242 women in treatment for severe mental illness (SMI), we used regression analysis to test the hypothesis that lifetime physical and sexual abuse would correlate with self-harm behaviors (thoughts of self-harm and suicide, self-harming behaviors, and suicide attempts) when controlling for psychiatric symptoms, substance abuse, and negative appraisals of trauma. Lifetime physical abuse and alcohol use were the only significant factors in the model. Women with SMI should be screened regularly for physical abuse, alcohol use, as well as thoughts and behaviors related to self-harming behaviors. Limitations of the study include its cross-sectional design.

  7. Childhood experiences of abuse, later substance use, and parenting outcomes among low-income mothers.

    PubMed

    Marcenko, M O; Kemp, S P; Larson, N C

    2000-07-01

    Relationships among childhood abuse, subsequent adult functioning (with a focus on severity of substance abuse), and child placement were explored in an urban sample of low-income, African-American mothers. Childhood sexual trauma and age were found to be correlated with severity of later drug use; history of physical or sexual abuse was significantly related to psychological distress in adulthood; and addiction was highly correlated with child placement. Implications of the findings are discussed, with particular reference to collaborations between child welfare and substance abuse treatment. PMID:10953778

  8. Diaphragmatic hernia repair more than four years after severe trauma: Four case reports

    PubMed Central

    de Nadai, Tales Rubens; Lopes, José Carlos Paiva; Inaco Cirino, Caio César; Godinho, Maurício; Rodrigues, Alfredo José; Scarpelini, Sandro

    2015-01-01

    Introduction Diaphragmatic rupture is an infrequent complication of trauma, occurring in about 5% of those who suffer a severe closed thoracoabdominal injury and about half of the cases are diagnosed early. High morbidity and mortality from bowel strangulation and other sequelae make prompt surgical intervention mandatory. Case presentation Four Brazilian men with a delayed diagnosis of a rare occurrence of traumatic diaphragmatic hernia. Patient one had diaphragmatic rupture on the right side of thorax and the others three patients on the left thoracic side, all they had to approach by a laparotomy and some approach in the chest, either thoracotomy or VATS. This injuries required surgical repositioning of extensively herniated abdominal viscera and intensive postoperative medical management with a careful control of intra-abdominal pressure. Discussion The negative pressure of the thoracic cavity causes a gradually migration of abdominal contents into the chest; this sequestration reduces the abdomen’s ability to maintain the viscera in their normal anatomical position. When the hernia is diagnosed early, the repair is less complicated and requires less invasive surgery. Years after the initial trauma, the diaphragmatic rupture produces dense adhesions between the chest and the abdominal contents. Conclusions All cases demonstrated that surgical difficulty increases when diaphragmatic rupture is not diagnosed early. It should be noted that when trauma to the thoraco-abdominal transition area is blunt or penetrating, a thorough evaluation is required to rule out diaphragmatic rupture and a regular follow-up to monitor late development of this comorbidity. PMID:26241166

  9. Leaking mycotic abdominal aortic aneurysm.

    PubMed

    Sing, T M; Young, N; O'Rourke, I C; Tomlinson, P

    1994-11-01

    A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature. A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis. Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non-dilated abdominal aorta. There was considerable retroperitoneal blood accumulating in a mass-like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system. Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck. Culture of the thrombus grew Streptococcus pyogenes. PMID:7993259

  10. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  11. Has the pendulum swung too far? The impact of missed abdominal injuries in the era of nonoperative management.

    PubMed

    Fairfax, Lindsay M; Christmas, A Britton; Deaugustinis, Matthew; Gordon, Latiffany; Head, Karen; Jacobs, David G; Sing, Ronald F

    2009-07-01

    Nonoperative management for traumatic injuries has significantly influenced trauma care during the last decade. We undertook this study to assess the impact of nontherapeutic laparotomies for suspected abdominal injuries compared with delayed laparotomies for questionable abdominal injuries for patients with abdominal trauma. The records of patients admitted to the trauma service between 2002 and 2007 who underwent laparotomies deemed nontherapeutic or delayed were retrospectively reviewed. Demographics, severity of injury, management scheme, and outcome data were analyzed. Sixteen patients underwent delayed laparotomies, whereas 26 patients incurred nontherapeutic laparotomies. Injury severity scores, Glasgow coma scale scores, abdominal abbreviated injury scale score (AIS), and age were similar for both populations. Delayed laparotomies occurred an average of 7 +/- 9 days postinjury. Intensive care unit length of stay (26 +/- 24 vs 10 +/- 6 days), hospital length of stay (40 +/- 37 vs 11 +/- 10 days), ventilator days (31 +/- 29 vs 11 +/- 10), and number of abdominal operative procedures (1.9 +/- 1.5 vs 1 +/- 0) were significantly higher in the delayed laparotomies group versus the nontherapeutic laparotomies group, respectively. Delayed diagnosis of intra-abdominal injuries yielded a significantly increased morbidity and mortality. During the evolving era of technological imaging for traumatic injuries, we must not allow the nonoperative pendulum to swing too far.

  12. Supervising Helpers Who Work with the Trauma of Sexual Abuse

    ERIC Educational Resources Information Center

    Etherington, Kim

    2009-01-01

    This paper contributes to the ongoing discussion in this journal about counsellors' experiences of vicarious traumatisation (Sexton, 1999; Dunkley & Whelan, 2006a, b). It builds on my previous paper (Etherington, 2000a) that focused on the role of supervision in moderating the potential impact on helpers, and on the helping relationship, of…

  13. Mesothelioma as a rapidly developing Giant Abdominal Cyst.

    PubMed

    Vyas, Dinesh; Pihl, Kerent; Kavuturu, Srinivas; Vyas, Arpita

    2012-01-01

    The benign cystic mesothelioma of the peritoneum is a rare lesion and is known for local recurrence. This is first case report of a rapidly developing massive abdominal tumor with histological finding of benign cystic mesothelioma (BCM). We describe a BCM arising in the retroperitoneal tis[sue on the right side, lifting ascending colon and cecum to the left side of abdomen. Patient was an active 58-year-old man who noticed a rapid abdominal swelling within a two month time period with a weight gain of 40 pounds. Patient had no risk factors including occupational (asbestos, cadmium), family history, social (alcohol, smoking) or history of trauma. We will discuss the clinical, radiologic, intra-operative, immunohistochemical, pathologic findings, and imaging six months after surgery. Patient has no recurrence and no weight gain on follow up visits and imaging.

  14. Penetrating injuries of the abdominal inferior vena cava.

    PubMed Central

    Degiannis, E.; Velmahos, G. C.; Levy, R. D.; Souter, I.; Benn, C. A.; Saadia, R.

    1996-01-01

    This is a retrospective study of 74 patients with penetrating injuries of the abdominal inferior vena cava; the cause of injury was gunshot in 91% and stabbing in 9%. Of the patients, 77% underwent lateral venorrhaphy, 5% underwent infrarenal ligation of the inferior vena cava (IVC), and 18% died perioperatively before any caval repair could be carried out. There was an overall perioperative mortality of 39%. Persistent shock, the site of the venous injury, particularly in the retrohepatic position, and the number of associated vascular injuries were directly related to mortality. Irrespective of the improvements in resuscitation and the various operative methods available, penetrating trauma of the abdominal IVC remains a life-threatening injury. PMID:8943628

  15. Trauma and the endocrine system.

    PubMed

    Mesquita, Joana; Varela, Ana; Medina, José Luís

    2010-12-01

    The endocrine system may be the target of different types of trauma with varied consequences. The present article discusses trauma of the hypothalamic-pituitary axes, adrenal glands, gonads, and pancreas. In addition to changes in circulating hormone levels due to direct injury to these structures, there may be an endocrine response in the context of the stress caused by the trauma.

  16. Simultaneous multisystem surgery: An important capability for the civilian trauma hospital.

    PubMed

    Moore, Justin M; Thomas, Piers A W; Gruen, Russell L; Chan, Patrick; Rosenfled, Jeffrey V

    2016-09-01

    Head injury commonly presents in association with torso or limb injuries, especially in blunt trauma mechanisms. Stopping life-threatening thoraco-abdominal hemorrhage and preventing secondary brain injury are time critical priorities. Although simultaneous operative management by multiple teams has been common practice in the recent wars in Iraq and Afghanistan, simultaneous surgery is rare in most civilian settings. Nevertheless, situations arise whereby simultaneous craniotomy and chest or abdominal surgery is necessary to prevent mortality or reduce severe morbidity. We discuss two recent cases at our level one trauma centre, the challenges that surgeons and the operating room staff face and propose that with appropriate planning this surgical capability can be integrated into the systems of contemporary advanced trauma units. PMID:27359088

  17. Evaluation of Preventive Service to Families with a Prior History in Child Protective Services: A Comparison of Treatment as Usual to Trauma Systems Therapy

    ERIC Educational Resources Information Center

    Coombes, Margaret Lillian

    2011-01-01

    Children who are abused or maltreated may experience negative consequences or trauma symptoms that are not immediately apparent or may emerge over time. Child welfare interventions are intended to prevent future incidents of child abuse and decrease the negative outcomes that result from such traumatic events (English, et al., 2005; Herrenkohl &…

  18. Pediatric spinal trauma.

    PubMed

    Huisman, Thierry A G M; Wagner, Matthias W; Bosemani, Thangamadhan; Tekes, Aylin; Poretti, Andrea

    2015-01-01

    Pediatric spinal trauma is unique. The developing pediatric spinal column and spinal cord deal with direct impact and indirect acceleration/deceleration or shear forces very different compared to adult patients. In addition children are exposed to different kind of traumas. Moreover, each age group has its unique patterns of injury. Familiarity with the normal developing spinal anatomy and kind of traumas is essential to correctly diagnose injury. Various imaging modalities can be used. Ultrasound is limited to the neonatal time period; plain radiography and computer tomography are typically used in the acute work-up and give highly detailed information about the osseous lesions. Magnetic resonance imaging is more sensitive for disco-ligamentous and spinal cord injuries. Depending on the clinical presentation and timing of trauma the various imaging modalities will be employed. In the current review article, a summary of the epidemiology and distribution of posttraumatic lesions is discussed in the context of the normal anatomical variations due to progressing development of the child. PMID:25512255

  19. Structured Sensory Trauma Interventions

    ERIC Educational Resources Information Center

    Steele, William; Kuban, Caelan

    2010-01-01

    This article features the National Institute of Trauma and Loss in Children (TLC), a program that has demonstrated via field testing, exploratory research, time series studies, and evidence-based research studies that its Structured Sensory Intervention for Traumatized Children, Adolescents, and Parents (SITCAP[R]) produces statistically…

  20. Minimizing Promotion Trauma.

    ERIC Educational Resources Information Center

    Darling, LuAnn W.; McGrath, Loraine

    1983-01-01

    Nursing administrators can minimize promotion trauma and its unnecessary cost by building awareness of the transition process, clarifying roles and expectations, and attending to the promoted employee's needs. This article will help nursing administrators develop a concept of manager care combined with programs for orientation of new managers,…

  1. Early Childhood Trauma

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2010

    2010-01-01

    Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants' and young children's reactions may be different from older children's, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the…

  2. Trauma induced myocardial infarction.

    PubMed

    Lolay, Georges A; Abdel-Latif, Ahmed K

    2016-01-15

    Chest Trauma in athletes is a common health problem. However, myocardial infarction secondary to coronary dissection in the setting of blunt chest trauma is extremely rare. We report a case of acute inferior wall myocardial infarction following blunt chest trauma. A 32-year-old male with no relevant medical problems was transferred to our medical center for retrosternal chest pain after being elbowed in the chest during a soccer game. Few seconds later, he started experiencing sharp retrosternal chest pain that was severe to that point where he called the emergency medical service. Upon arrival to the trauma department patient was still complaining of chest pain. ECG demonstrated ST segment elevation in the inferior leads with reciprocal changes in the lateral leads all consistent with active ischemia. After rolling out aortic dissection, patient was loaded with ASA, ticagerlor, heparin and was emergently taken to the cardiac catheterization lab. Coronary angiography demonstrated 100% thrombotic occlusion in the distal right coronary artery with TIMI 0 flow distally. After thrombus aspiration, a focal dissection was noted on the angiogram that was successfully stented. Two days after admission patient was discharged home. Echocardiography prior to discharge showed inferior wall akinesis, normal right ventricular systolic function and normal overall ejection fraction.

  3. [Abdominal cavity adhesions. Some issues of pathogenesis, prophylaxis and treatment].

    PubMed

    Tishchenko, V V

    2010-07-01

    The abdominal cavity adhesions (ACA) constitute frequent consequence of various abdominal cavity diseases and traumas and frequent cause of the abdominal adhesive disease and its complications. In spite of the known pathogenesis of ACA, the surgeons had failed throughout the decades of years to find out the measures and methods of its prophylaxis. There are several causes of such a situation and the main of them is that ACA in its origin constitutes a philogenetically developed defense biologic reaction of organism. Because of the fact, that an organism constitutes the self-regulated biological system, any external inputs (including the treatment), directed on qualitative or quantitative signs of these reactions, meet systemic counteraction and become annihilated. The forced overcome of such a counteraction may cause the development of severe systemic disorders in organism. The only prophylactic measures against ACA, which were already tested throughout the time, are the tactical and technical methods, promoting the reduction of severity of morphological changes in peritoneum and abdominal organs, thus causing reduction of natural reaction of organism. When the adhesions formation is inevitable it is necessary to apply surgical methods of governing such a process, and omentoparietopexy may constitutes one of such methods.

  4. Cough and Cold Medicine Abuse

    MedlinePlus

    ... and Cold Medicine Abuse DrugFacts: Cough and Cold Medicine Abuse Email Facebook Twitter Revised May 2014 Some ... diverted for abuse. How Are Cough and Cold Medicines Abused? Cough and cold medicines are usually consumed ...

  5. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  6. Evaluation for bleeding disorders in suspected child abuse.

    PubMed

    Anderst, James D; Carpenter, Shannon L; Abshire, Thomas C

    2013-04-01

    Bruising or bleeding in a child can raise the concern for child abuse. Assessing whether the findings are the result of trauma and/or whether the child has a bleeding disorder is critical. Many bleeding disorders are rare, and not every child with bruising/bleeding concerning for abuse requires an evaluation for bleeding disorders. In some instances, however, bleeding disorders can present in a manner similar to child abuse. The history and clinical evaluation can be used to determine the necessity of an evaluation for a possible bleeding disorder, and prevalence and known clinical presentations of individual bleeding disorders can be used to guide the extent of the laboratory testing. This clinical report provides guidance to pediatricians and other clinicians regarding the evaluation for bleeding disorders when child abuse is suspected.

  7. Child sexual abuse in Turkey: an analysis of 1002 cases.

    PubMed

    Aydin, Berna; Akbas, Seher; Turla, Ahmet; Dundar, Cihad; Yuce, Murat; Karabekiroglu, Koray

    2015-01-01

    This study investigated the characteristics of abuse suffered by children, the dimensions of the psychiatric effects associated with abuse, and the factors affecting these. One thousand two cases aged under 18, exposed to sexual abuse, and referred over a 7-year period were assessed. Girls represented 80.8% of cases, and the numbers rose with age. The aggressors were all male, and 88.2% were known to their victim. Approximately half the children were exposed to sexual abuse involving penetration. Psychological pathology was identified in 62.1%. Female gender, the presence of penetration, physical violence, and incest significantly increased the development of psychological pathology. Levels of awareness in people close to and trusted by the child must be raised to minimize the adverse effects of trauma in the long term, preventive measures must be taken, and medical and social support units from which victims can receive assistance need to be established.

  8. Evaluation for bleeding disorders in suspected child abuse.

    PubMed

    Anderst, James D; Carpenter, Shannon L; Abshire, Thomas C

    2013-04-01

    Bruising or bleeding in a child can raise the concern for child abuse. Assessing whether the findings are the result of trauma and/or whether the child has a bleeding disorder is critical. Many bleeding disorders are rare, and not every child with bruising/bleeding concerning for abuse requires an evaluation for bleeding disorders. In some instances, however, bleeding disorders can present in a manner similar to child abuse. The history and clinical evaluation can be used to determine the necessity of an evaluation for a possible bleeding disorder, and prevalence and known clinical presentations of individual bleeding disorders can be used to guide the extent of the laboratory testing. This clinical report provides guidance to pediatricians and other clinicians regarding the evaluation for bleeding disorders when child abuse is suspected. PMID:23530182

  9. Childhood sexual abuse, dissociation, and adult self-destructive behavior.

    PubMed

    Rodriguez-Srednicki, O

    2001-01-01

    Female college students reporting a history of childhood sexual abuse (N=175) and not reporting a history of childhood sexual abuse (N=260) were compared on indices of six self-destructive behaviors, including drug use, alcohol abuse, binge eating, self-mutilation, risky sex, and suicidality. The samples were also compared on two measures of dissociation, the Trauma Symptom Checklist dissociation subscale and the Dissociative Experiences Scale. The CSA group had significantly higher mean scores on all the indices of self-destructive behavior except self-mutilation (where the mean difference approached significance), and on both measures of dissociation. One or both dissociation measures were related significantly to each index of self-destructive behavior except binge eating. Multiple regression mediation analyses provided support for the hypothesis that dissociation mediates the relationships between CSA and both drug use and alcohol abuse. Dissociation also explained significant variability when added to the regressions of risky sex and suicidality on CSA.

  10. Child sexual abuse in Turkey: an analysis of 1002 cases.

    PubMed

    Aydin, Berna; Akbas, Seher; Turla, Ahmet; Dundar, Cihad; Yuce, Murat; Karabekiroglu, Koray

    2015-01-01

    This study investigated the characteristics of abuse suffered by children, the dimensions of the psychiatric effects associated with abuse, and the factors affecting these. One thousand two cases aged under 18, exposed to sexual abuse, and referred over a 7-year period were assessed. Girls represented 80.8% of cases, and the numbers rose with age. The aggressors were all male, and 88.2% were known to their victim. Approximately half the children were exposed to sexual abuse involving penetration. Psychological pathology was identified in 62.1%. Female gender, the presence of penetration, physical violence, and incest significantly increased the development of psychological pathology. Levels of awareness in people close to and trusted by the child must be raised to minimize the adverse effects of trauma in the long term, preventive measures must be taken, and medical and social support units from which victims can receive assistance need to be established. PMID:25066376

  11. Sexual trauma and the female brain.

    PubMed

    Shors, Tracey J; Millon, Emma M

    2016-04-01

    Sexual aggression and violence against women (VAM) are not only social problems; they are mental health problems. Women who experience sexual trauma often express disruptions in emotional and cognitive processes, some of which lead to depression and post-traumatic stress disorder (PTSD). Animal models of neurogenesis and learning suggest that social yet aggressive interactions between a pubescent female and an adult male can disrupt processes of learning related to maternal care, which in turn reduce survival of new neurons in the female hippocampus. Mental and Physical (MAP) Training is a novel clinical intervention that was translated from neurogenesis research. The intervention, which combines meditation and aerobic exercise, is currently being used to help women learn to recover from traumatic life experiences, especially those related to sexual violence and abuse. PMID:27085856

  12. Sexual trauma and the female brain.

    PubMed

    Shors, Tracey J; Millon, Emma M

    2016-04-01

    Sexual aggression and violence against women (VAM) are not only social problems; they are mental health problems. Women who experience sexual trauma often express disruptions in emotional and cognitive processes, some of which lead to depression and post-traumatic stress disorder (PTSD). Animal models of neurogenesis and learning suggest that social yet aggressive interactions between a pubescent female and an adult male can disrupt processes of learning related to maternal care, which in turn reduce survival of new neurons in the female hippocampus. Mental and Physical (MAP) Training is a novel clinical intervention that was translated from neurogenesis research. The intervention, which combines meditation and aerobic exercise, is currently being used to help women learn to recover from traumatic life experiences, especially those related to sexual violence and abuse.

  13. Darkness into Light: The Dream Journal of an Addicted Trauma Survivor

    ERIC Educational Resources Information Center

    Southern, Stephen

    2004-01-01

    This article applies dream work to the case of an addicted survivor of sexual abuse trauma using models of C. G. Jung (1974) and L. S. Leonard (1989). It then relates the dreams of the fictional client to St. Teresa of Avila's (1577/1989) classic model for spiritual growth, The Interior Castle. The goal of working with dreams in the context of…

  14. Factor Structure and Reliability of the Childhood Trauma Questionnaire in a Canadian Undergraduate Student Sample

    ERIC Educational Resources Information Center

    Paivio, Sandra, C.; Cramer, Kenneth, M.

    2004-01-01

    Objective: The aims of this study were to examine (1) the psychometric properties of the Childhood Trauma Questionnaire [CTQ; Bernstein, D., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, K., Sapareto, E., & Ruggiero, J. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal…

  15. Development and Validation of a Brief Screening Version of the Childhood Trauma Questionnaire.

    ERIC Educational Resources Information Center

    Bernstein, David P.; Stein, Judith A.; Newcomb, Michael D.; Walker, Edward; Pogge, David; Ahluvalia, Taruna; Stokes, John; Handelsman, Leonard; Medrano, Martha; Desmond, David; Zule, William

    2003-01-01

    Exploratory and confirmatory factor analyses of 70 Childhood Trauma Questionnaire (CTQ) items were used to create a shorter 28-item version and test the measurement invariance of the 25 clinical items across adult substance abusing patients, adolescent psychiatric inpatients, and control populations (n=1,978). Items performed equivalently across…

  16. Students and Drug Abuse

    ERIC Educational Resources Information Center

    Todays Educ, 1969

    1969-01-01

    Introduction to "Students and Drug Abuse, prepared by the Public Information Branch and Center for Studies of Narcotic and Drug Abuse, National Institute of Mental Health, in cooperation with the staff of Today's Education.

  17. Cough & Cold Medicine Abuse

    MedlinePlus

    ... I Help a Friend Who Cuts? Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold Medicine Abuse ... DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  18. Abuse during Pregnancy

    MedlinePlus

    ... depressed, eat unhealthy foods, or pick up bad habits such as smoking or drinking . An abusive partner may try to ... depressed, eat unhealthy foods, or pick up bad habits such as smoking or drinking . An abusive partner may try to ...

  19. Prescription Drug Abuse

    MedlinePlus

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include narcotic painkillers, ...

  20. Being My Own Virgil: My Journey Through Inferno From Military Sexual Trauma.

    PubMed

    2015-11-01

    This article provides a first-hand experience of military sexual abuse and trauma. The course of the abusive events unfolded over a span of 12 months. The abuse started almost immediately and continued over time, despite direct comments to stop, report to others, and other attempts by the victim at obtaining help to stop the abuse. The fact that the victim did not manifest the expected behaviors of a victim of abuse led many either to not see the effects or not view the effects as having significant impact on the victim. At different choice points, both colleagues and senior personnel either blamed the victim or refused to concern themselves with the events or get involved. Although the military system eventually understood and resolved the situation, it was a long, arduous, and painful process for the victim.

  1. Rapid development of intestinal cell damage following severe trauma: a prospective observational cohort study

    PubMed Central

    de Haan, Jacco J; Lubbers, Tim; Derikx, Joep P; Relja, Borna; Henrich, Dirk; Greve, Jan-Willem; Marzi, Ingo; Buurman, Wim A

    2009-01-01

    Introduction Loss of intestinal integrity has been implicated as an important contributor to the development of excessive inflammation following severe trauma. Thus far, clinical data concerning the occurrence and significance of intestinal damage after trauma remain scarce. This study investigates whether early intestinal epithelial cell damage occurs in trauma patients and, if present, whether such cell injury is related to shock, injury severity and the subsequent inflammatory response. Methods Prospective observational cohort study in 96 adult trauma patients. Upon arrival at the emergency room (ER) plasma levels of intestinal fatty acid binding protein (i-FABP), a specific marker for damage of differentiated enterocytes, were measured. Factors that potentially influence the development of intestinal cell damage after trauma were determined, including the presence of shock and the extent of abdominal trauma and general injury severity. Furthermore, early plasma levels of i-FABP were related to inflammatory markers interleukin-6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP). Results Upon arrival at the ER, plasma i-FABP levels were increased compared with healthy volunteers, especially in the presence of shock (P < 0.01). The elevation of i-FABP was related to the extent of abdominal trauma as well as general injury severity (P < 0.05). Circulatory i-FABP concentrations at ER correlated positively with IL-6 and PCT levels at the first day (r2 = 0.19; P < 0.01 and r2 = 0.36; P < 0.001 respectively) and CRP concentrations at the second day after trauma (r2 = 0.25; P < 0.01). Conclusions This study reveals early presence of intestinal epithelial cell damage in trauma patients. The extent of intestinal damage is associated with the presence of shock and injury severity. Early intestinal damage precedes and is related to the subsequent developing inflammatory response. PMID:19505335

  2. Child Abuse: Educator's Responsibilities. Revised.

    ERIC Educational Resources Information Center

    California State Office of the Attorney General, Sacramento. Crime Prevention Center.

    This document presents the educator with a guide to child abuse. A section defining child abuse examines the issues of physical abuse, physical neglect, sexual abuse, and emotional maltreatment. Areas discussed for these types of abuse include abuse indicators, location of injury, history, behavioral indicators, and types of injury. Incestuous and…

  3. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  4. Dynamics of liver trauma: tearing of segments III and IV at the level of the hepatic ligament.

    PubMed

    Rulli, Francesco; Galatà, Gabriele; Maura, Angelo; Cadeddu, Federica; Olivi, Giulia; Farinon, Attilio Maria

    2008-01-01

    The liver is the most commonly injured intra-abdominal organ. Liver mass is the key factor in determining the extent of the inertial force and consequently of damage in the case of sudden deceleration. In this respect, high-speed accidents usually produce characteristic lesions where the III-IV segments tear at the level of the hepatic ligament causing grade I-III liver injuries. The pathophysiology of such traumas is the subject of the present contribution. All trauma patients who sustained a blunt abdominal injury from January 1 to December 31 2004 were identified by the trauma registry at the Policlinico di Tor Vergata In order to select high-speed and sudden deceleration traumas, clinical records were reviewed for demographics, severity of injury, severity of liver injury, associated concomitant injuries, and management scheme. The grade of liver injury was determined on the basis of the initial CT or the intraoperative findings. A total of 159 patients who incurred abdominal injuries due to blunt trauma were identified. In 14 (8.8 percent) one or more liver lesions were associated. Among the low-grade injuries, 3 were grade I, and 8 grade II. Forty percent were high-grade injuries consisting in 6 grade III and 1 grade IV. We observed no grade V or grade VI injuries in this series. The most frequent occurrence was a tear between hepatic segments III and IV caused by the acute impact of the liver on the hepatic ligament. A hepatic injury caused by the round ligament was diagnosed intraoperatively in 1 out of 5 liver trauma patients (20 percent) and preoperatively in 4 out of 5 (80 percent) in our one-year abdominal blunt trauma series. Our clinical contribution underlines the high frequency of such lesions that seems to be related to, and characteristic of, high-speed trauma. In these cases immediate deceleration due to the impact may be a relevant factor in the pathophysiology of the lesion.

  5. [The abdominal drop flap].

    PubMed

    Bodin, F; Liverneaux, P; Seigle-Murandi, F; Facca, S; Bruant-Rodier, C; Dissaux, C; Chaput, B

    2015-08-01

    The skin between the mastectomy scar and the future infra-mammary fold may be managed in different ways in delayed breast reconstruction using a DIEP (deep inferior epigastric perforator). Conserving this skin and positioning the flap skin paddle in the middle of the breast usually highlights skin color disparity because of two visible transition zones. Resection of the entire skin under the scar may be more aesthetic but limits direct closure possibility in case of flap failure. In order to benefit from both aesthetic result and safe surgical method, we propose the abdominal drop flap. The inferior thoracic skin flap is detached from the thoracic wall beyond the future infra-mammary fold, preserved and pushed under the breast.

  6. Substance Abuse. Policy Statement.

    ERIC Educational Resources Information Center

    National Collaboration for Youth, Washington, DC.

    This paper presents the policy statement on substance abuse from the National Collaboration for Youth (NCY). The policy statement section lists programs and activities supported by the NCY. A section on background includes a statement of the issue of substance abuse. Areas examined in this section include alcohol abuse and drunk driving among…

  7. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Morrow, Marilyn J.; Doyle, Kathleen

    The Elder Abuse Awareness Project was developed to determine the incidence of abuse and neglect of elderly people in several rural counties in central Illinois. A primary purpose of the study was to survey service providers as to their actual encounters with elder abuse and neglect. Each provider was asked about warning signs or cues that were…

  8. Child Abuse and Neglect.

    ERIC Educational Resources Information Center

    International Children's Centre, Paris (France).

    A series of four documents address the definition and identification of child abuse and neglect. In the first, which is designed for professionals, a historical review is followed by discussion of clinical and social evidence of abuse. Resources for managing child abuse are described, and personnel functions are outlined. The second document,…

  9. Dynamics of Parental Abuse

    PubMed Central

    Hardin, Eugene; Schlater, Theodore L.

    1987-01-01

    The dynamics of the various categories of parental abuse are examined with special emphasis on abuse by adult offspring living in the same household or adults acting as caretakers or legal guardians for their elderly parents. Society's role in the dynamics of parental abuse is examined.

  10. Explaining homeless youths' criminal justice interactions: childhood trauma or surviving life on the streets?

    PubMed

    Yoder, Jamie Rae; Bender, Kimberly; Thompson, Sanna J; Ferguson, Kristin M; Haffejee, Badiah

    2014-02-01

    Homeless youth are at increased risk for involvement in the criminal justice system. This study investigated childhood trauma as a risk factor for arrest or jail among a sample of youth seeking services at drop in, shelter, and transitional housing settings, while controlling for more established risk factors including: substance use, peer deviance, and engagement in survival behaviors. Standardized and researcher developed measures collected quantitative data through face-to-face interviews with youth (N = 202). Two sequential logic regression models identified significant predictors of arrest and jail, with a particular interest in the effects of childhood maltreatment. Youth with a history of physical abuse were nearly twice as likely to be arrested and to be jailed compared to non-abused youth, controlling for the significant influence of drug use and survival behaviors. These findings suggest the need for trauma screening and trauma-informed services for homeless youth at risk of illegal behavior. PMID:24337524

  11. Explaining homeless youths' criminal justice interactions: childhood trauma or surviving life on the streets?

    PubMed

    Yoder, Jamie Rae; Bender, Kimberly; Thompson, Sanna J; Ferguson, Kristin M; Haffejee, Badiah

    2014-02-01

    Homeless youth are at increased risk for involvement in the criminal justice system. This study investigated childhood trauma as a risk factor for arrest or jail among a sample of youth seeking services at drop in, shelter, and transitional housing settings, while controlling for more established risk factors including: substance use, peer deviance, and engagement in survival behaviors. Standardized and researcher developed measures collected quantitative data through face-to-face interviews with youth (N = 202). Two sequential logic regression models identified significant predictors of arrest and jail, with a particular interest in the effects of childhood maltreatment. Youth with a history of physical abuse were nearly twice as likely to be arrested and to be jailed compared to non-abused youth, controlling for the significant influence of drug use and survival behaviors. These findings suggest the need for trauma screening and trauma-informed services for homeless youth at risk of illegal behavior.

  12. Female sex offenders: exploring issues of personality, trauma, and cognitive distortions.

    PubMed

    Strickland, Susan M

    2008-04-01

    Few studies have investigated the characteristics of female sex offenders and factors and/or causes of female deviance. Research to date has been descriptive in nature, with few comparison studies. Using a correlational design and three valid instruments, female sexual offenders and a matched group of female nonsexual offenders are compared in the areas of personality disorders, chemical dependency, childhood trauma, sexual trauma, emotional neediness, cognitive distortions, and social competence. A sample of 130 incarcerated females, 60 sex offenders, and 70 nonsexual offenders is used. Significant results are found in the areas of total childhood trauma and severity of sexual abuse suffered and social and sexual adequacy. No differences are found in abuse of substances, personality disorders, emotional neediness, or cognitive distortions.

  13. Trauma Tactics: Rethinking Trauma Education for Professional Nurses.

    PubMed

    Garvey, Paula; Liddil, Jessica; Eley, Scott; Winfield, Scott

    2016-01-01

    According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ). Although several courses exist for trauma education, many nurses have not received adequate education in trauma management (B. ; L. ). Trauma Tactics, a 2-day course that focuses on high-fidelity human patient simulation, was created to meet this educational need. This descriptive study was conducted retrospectively to assess the effectiveness of the Trauma Tactics course. Pre- and postsurveys, tests, and simulation performance were used to evaluate professional nurses who participated in Trauma Tactics over a 10-month period. Fifty-five nurses were included in the study. Pre- and postsurveys revealed an increase in overall confidence, test scores increased by an average of 2.5 points, and simulation performance scores increased by an average of 16 points. Trauma Tactics is a high-quality course that provides a valuable and impactful educational experience for nurses. Further research is needed to evaluate the long-term effects of Trauma Tactics and its impacts on quality of care and patient outcomes. PMID:27414143

  14. Revictimization and information processing in women survivors of childhood sexual abuse.

    PubMed

    Field, N P; Classen, C; Butler, L D; Koopman, C; Zarcone, J; Spiegel, D

    2001-01-01

    This study examined the effect of sexual revictimization on information processing of trauma-related stimuli in a sample of child sexual abuse (CSA) survivors diagnosed with posttraumatic stress disorder (PTSD). Fifty-one treatment-seeking women participated in this study. Participants completed the Sexual Experiences Survey regarding sexual revictimization in the last 6 months and performed a modified emotional Stroop task in which they named the colors of neutral words (e.g., apple), general threat words (e.g., malignant and death), and sexual/victimization words (e.g., penis and abuser). As predicted, the revictimized participants (n = 16) took significantly longer to color-name sexual/victimization words than did the nonrevictimized participants. These results suggest that revictimization serves to prime preexisting "trauma" memory networks, thereby amplifying the impact of childhood sexual trauma on selective attention toward trauma-related stimuli.

  15. The effect of different types of abdominal binders on intra-abdominal pressure

    PubMed Central

    Zhang, Hua-Yu; Liu, Dong; Tang, Hao; Sun, Shi-Jin; Ai, Shan-Mu; Yang, Wen-Qun; Jiang, Dong-Po; Zhang, Lian-Yang

    2016-01-01

    Objectives: To investigate the effect of non-elastic/elastic abdominal binders on intra-vesical pressure (IVP), physiological functions, and clinical outcomes in laparotomy patients at the perioperative stage. Methods: This prospective study was conducted from May to October 2014 at the Trauma Surgery Department, Daping Hospital, Chongqing, China. Laparotomy patients were randomly divided into non-elastic abdominal binder group (28 patients), and elastic abdominal binder group (29 patients). Binders were applied for 14 days following the operation, or until discharge. Demographic information, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores (prior to the operation, on the first day after operation, the day IVP measurement was stopped, and one day before discharge), and outcomes were recorded. The IVP was measured before the operation to postoperative day 7. Results: There were no significant differences in the demographic information, outcomes, SOFA or APACHE-II scores between the 2 groups. Initial out-of-bed mobilization occurred earlier in the elastic binder group (3.2 ± 2.0 versus 5.0 ± 3.7 days, p=0.028). A greater increase in IVP was observed in the non-elastic binder group than in the elastic binder group (2.9 ± 1.1 versus 1.1 ± 0.7 mm Hg, p=0.000). Conclusion: Elastic binders have relatively little effect on IVP and are more helpful at promoting postoperative recovery than non-elastic binders. Therefore, elastic binders are more suitable for clinical use. PMID:26739977

  16. Training in Trauma Surgery

    PubMed Central

    Reilly, Patrick M.; Schwab, C William; Haut, Elliott R.; Gracias, Vicente H.; Dabrowski, G Paul; Gupta, Rajan; Pryor, John P.; Kauder, Donald R.

    2003-01-01

    Objective: To describe outcomes from a clinical trauma surgical education program that places the board-eligible/board-certified fellow in the role of the attending surgeon (fellow-in-exception [FIE]) during the latter half of a 2-year trauma/surgical critical care fellowship. Summary Background Data: National discussions have begun to explore the question of optimal methods for postresidency training in surgery. Few objective studies are available to evaluate current training models. Methods: We analyzed provider-specific data from both our trauma registry and performance improvement (PI) databases. In addition, we performed TRISS analysis when all data were available. Registry and PI data were analyzed as 2 groups (faculty trauma surgeons and FIEs) to determine experience, safety, and trends in errors. We also surveyed graduate fellows using a questionnaire that evaluated perceptions of training and experience on a 6-point Likert scale. Results: During a 4-year period 7,769 trauma patients were evaluated, of which 46.3% met criteria to be submitted to the PA Trauma Outcome Study (PTOS, ie, more severe injury). The faculty group saw 5,885 patients (2,720 PTOS); the FIE group saw 1,884 patients (879 PTOS). The groups were similar in respect to mechanism of injury (74% blunt; 26% penetrating both groups) and injury severity (mean ISS faculty 10.0; FIEs 9.5). When indexed to patient contacts, FIEs did more operations than the faculty group (28.4% versus 25.6%; P < 0.05). Death rates were similar between groups (faculty 10.5%; FIEs 10.0%). Analysis of deaths using PI and TRISS data failed to demonstrate differences between the groups. Analysis of provider-specific errors demonstrated a slightly higher rate for FIEs when compared with faculty when indexed to PTOS cases (4.1% versus 2.1%; P < 0.01). For both groups, errors in management were more common than errors in technique. Twenty-one (91%) of twenty-three surveys were returned. Fellows’ feelings of preparedness

  17. Childhood trauma as a risk factor for the onset of subclinical psychotic experiences: Exploring the mediating effect of stress sensitivity in a cross-sectional epidemiological community study.

    PubMed

    Rössler, Wulf; Ajdacic-Gross, Vladeta; Rodgers, Stephanie; Haker, Helene; Müller, Mario

    2016-04-01

    Childhood trauma is a risk factor for the onset of schizophrenic psychosis. Because the psychosis phenotype can be described as a continuum with varying levels of severity and persistence, childhood trauma might likewise increase the risk for psychotic experiences below the diagnostic threshold. But the impact of stressful experiences depends upon its subjective appraisal. Therefore, varying degrees of stress sensitivity possibly mediate how childhood trauma impacts in the end upon the occurrence of subclinical psychotic experiences. We investigated this research question in a representative community cohort of 1500 participants. A questionnaire, comprising five domains of physical and emotional neglect, as well as physical, emotional, and sexual abuse, was used to assess childhood trauma. Based on different symptoms of subclinical psychotic experiences, we conducted a latent profile analysis (LPA) to derive distinct profiles for such experiences. Path modeling was performed to identify the direct and indirect (via stress sensitivity) pathways from childhood trauma to subclinical psychotic experiences. The LPA revealed four classes - unaffected, anomalous perceptions, odd beliefs and behavior, and combined anomalous perceptions/odd beliefs and behavior, that - except for sexual abuse - were all linked to childhood trauma. Moreover, except for physical abuse, childhood trauma was significantly associated with stress sensitivity. Thus, our results revealed that the pathways from emotional neglect/abuse and physical neglect to subclinical psychotic experiences were mediated by stress sensitivity. In conclusion, we can state that subclinical psychotic experiences are affected by childhood traumatic experiences in particular through the pathway of a heightened subjective stress appraisal. PMID:26874870

  18. Etiology and clinical course of pseudoseizures. Relationship to trauma, depression, and dissociation.

    PubMed

    Bowman, E S

    1993-01-01

    Twenty-seven outpatients with video-EEG-documented pseudoseizures were interviewed by a psychiatrist to determine the historical course of seizures and diagnose the current presence of these DSM-III-R diagnoses: affective disorders (85%), dissociative disorders (85%), and posttraumatic stress disorder (33%). Their mean (26.7) and median (26.9) Dissociative Experiences Scale scores were elevated. Eighty-eight percent of subjects had sustained significant trauma, including sexual abuse/rape (77%) and physical abuse (70%). Four psychodynamic pathways to pseudoseizures were noted. Most commonly, pseudoseizures originated from dissociated personalities or ego states, were expressions of dissociated memories of child abuse, and were triggered by recent stresses or traumas.

  19. Risky business: trauma exposure and rate of posttraumatic stress disorder in African American children and adolescents.

    PubMed

    Hunt, Kristin L; Martens, Patricia M; Belcher, Harolyn M E

    2011-06-01

    Demographics, parental risk factors, and experiencing interpersonal trauma (domestic violence, community violence, and physical and sexual abuse) are related to childhood posttraumatic stress disorder (PTSD). Little is known about these factors and the risk of PTSD in African American children. This study examined associations between PTSD symptoms and gender, age, parent mental illness, parent substance abuse, and interpersonal trauma in African American children. Participants were 257 children and adolescents, ages 8-17 years (M = 11.7, SD = 2.5), who received outpatient mental health treatment. Being female and witnessing domestic violence was associated with more PTSD symptoms. Exposure to community violence and physical abuse increased the odds of clinically significant PTSD symptomatology by more than 2 times. The rate of PTSD (16%) was lower in the current study than in other same-age study populations (25%-40%). Risk factors and identification strategies for PTSD are discussed.

  20. Control of road trauma epidemic in Australia.

    PubMed Central

    McDermott, F.

    1978-01-01

    This lecture discusses initiatives taken by the Road Trauma Committee of the Royal Australasian College of Surgeons to reduce fatality and injury on Australian roads. In 1970 the Road Trauma Committee and the communications media initiated a national campaign in support of legislation for the compulsory wearing of seat belts. Public ignorance and Parliamentary inertia were countered. Victoria became the first State in the Western world to introduce this legislation. All other Australian States followed. Significant and marked reductions in fatality and injury were achieved and have been maintained. Recognising alcohol as the single most important cause of serious road crashes and injuries in Australia, the committee advocated legislation for compulsory blood alcohol tests on all adult road crash casualties. In 1973-74 legislation was enacted in South Australia and Victoria and in 1976 in Queensland. Results show that more than one-quarter of driver casualties have alcohol concentrations above the legal limit of 0.05 g%. Half of these exceed 0.15 g%. On the other hand less than 3% of the general driving population exceed the legal limit. Further advocacy led in 1976 to the enactment of random roadside breath-test legislation in Victoria. The majority of Australian convicted drinking drivers have alcohol-related social problems. A quarter incur reconvictions. The conventional penal approach has failed. At present the Road Trauma Committee is campaigning for compulsory medical assessment of convicted drinking drivers. Reissue of a driving licence would be dependent upon evidence of re-education and/or rehabilitation. Pilot re-education programmes have been shown to lessen recidivism markedly. Prevention of drink-driving behaviour is the major strategy. The tactics entail deterence, improved secondary-school and driver education, and the implementation of a national policy for control of alcohol abuse. PMID:718071

  1. [Immunonutrition after trauma].

    PubMed

    Felbinger, T W; Sachs, M; Richter, H P

    2011-11-01

    Immunonutrition may be superior to standard clinical nutrition in specific clinical situations. After severe trauma, an enteral immuno-enhancing diet, enriched with arginine, omega-3 fatty acids, and nucleotides, decreases infectious complications. During acute respiratory distress syndrome, a continuous enteral diet with high-dose omega-3 fatty acids, gamma-linolenic acid, and antioxidants improved clinical outcome. Glutamine should be administered enterally or parenterally whenever total parenteral nutrition is indicated.

  2. Trauma, genes, and the neurobiology of personality disorders.

    PubMed

    Goodman, Marianne; New, Antonia; Siever, Larry

    2004-12-01

    A model for personality dysfunction posits an interaction between inherited susceptibility and environmental factors such as childhood trauma. Core biological vulnerabilities in personality include dimensions of affective instability, impulsive aggression, and cognition/perceptual domains. For the dimension of impulsive aggression, often seen in borderline personality disorder (BPD), the underlying neurobiology involves deficits in central serotonin function and alterations in specific brain regions in the cingulate and the medial and orbital prefrontal cortex. The role of trauma in the development of personality disorder and especially for BPD remains unclear. Although recent studies suggest that BPD is not a trauma-spectrum disorder and that it is biologically distinct from posttraumatic stress disorder, high rates of childhood abuse and neglect do exist for individuals with personality dysfunction. Personality symptom clusters seem to be unrelated to specific abuses, but they may relate to more enduring aspects of interpersonal and family environments in childhood. Whereas twin and family studies indicate a partially heritable basis for impulsive aggression, studies of serotonin-related genes to date suggest only modest contributions to behavior. Gene-environment interactions involving childhood maltreatment are demonstrated in recent studies on antisocial behaviors and aggressive rhesus monkeys and highlight the need for further research in this important area.

  3. Psychometric properties of the Trauma and Distress Scale, TADS, in an adult community sample in Finland

    PubMed Central

    Salokangas, Raimo K. R.; Schultze-Lutter, Frauke; Patterson, Paul; von Reventlow, Heinrich Graf; Heinimaa, Markus; From, Tiina; Luutonen, Sinikka; Hankala, Juha; Kotimäki, Mika; Tuominen, Lauri

    2016-01-01

    Background There is increasing evidence that a history of childhood abuse and neglect is not uncommon among individuals who experience mental disorder and that childhood trauma experiences are associated with adult psychopathology. Although several interview and self-report instruments for retrospective trauma assessment have been developed, many focus on sexual abuse (SexAb) rather than on multiple types of trauma or adversity. Methods Within the European Prediction of Psychosis Study, the Trauma and Distress Scale (TADS) was developed as a new self-report assessment of multiple types of childhood trauma and distressing experiences. The TADS includes 43 items and, following previous measures including the Childhood Trauma Questionnaire, focuses on five core domains: emotional neglect (EmoNeg), emotional abuse (EmoAb), physical neglect (PhyNeg), physical abuse (PhyAb), and SexAb. This study explores the psychometric properties of the TADS (internal consistency and concurrent validity) in 692 participants drawn from the general population who completed a mailed questionnaire, including the TADS, a depression self-report and questions on help-seeking for mental health problems. Inter-method reliability was examined in a random sample of 100 responders who were reassessed in telephone interviews. Results After minor revisions of PhyNeg and PhyAb, internal consistencies were good for TADS totals and the domain raw score sums. Intra-class coefficients for TADS total score and the five revised core domains were all good to excellent when compared to the interviewed TADS as a gold standard. In the concurrent validity analyses, the total TADS and its all core domains were significantly associated with depression and help-seeking for mental problems as proxy measures for traumatisation. In addition, robust cutoffs for the total TADS and its domains were calculated. Conclusions Our results suggest the TADS as a valid, reliable, and clinically useful instrument for assessing

  4. Rethinking historical trauma.

    PubMed

    Kirmayer, Laurence J; Gone, Joseph P; Moses, Joshua

    2014-06-01

    Recent years have seen the rise of historical trauma as a construct to describe the impact of colonization, cultural suppression, and historical oppression of Indigenous peoples in North America (e.g., Native Americans in the United States, Aboriginal peoples in Canada). The discourses of psychiatry and psychology contribute to the conflation of disparate forms of violence by emphasizing presumptively universal aspects of trauma response. Many proponents of this construct have made explicit analogies to the Holocaust as a way to understand the transgenerational effects of genocide. However, the social, cultural, and psychological contexts of the Holocaust and of post-colonial Indigenous "survivance" differ in many striking ways. Indeed, the comparison suggests that the persistent suffering of Indigenous peoples in the Americas reflects not so much past trauma as ongoing structural violence. The comparative study of genocide and other forms of massive, organized violence can do much to illuminate both common mechanisms and distinctive features, and trace the looping effects from political processes to individual experience and back again. The ethics and pragmatics of individual and collective healing, restitution, resilience, and recovery can be understood in terms of the self-vindicating loops between politics, structural violence, public discourse, and embodied experience. PMID:24855142

  5. Cervical spine trauma

    PubMed Central

    Torretti, Joel A; Sengupta, Dilip K

    2007-01-01

    Cervical spine trauma is a common problem with a wide range of severity from minor ligamentous injury to frank osteo-ligamentous instability with spinal cord injury. The emergent evaluation of patients at risk relies on standardized clinical and radiographic protocols to identify injuries; elucidate associated pathology; classify injuries; and predict instability, treatment and outcomes. The unique anatomy of each region of the cervical spine demands a review of each segment individually. This article examines both upper cervical spine injuries, as well as subaxial spine trauma. The purpose of this article is to provide a review of the broad topic of cervical spine trauma with reference to the classic literature, as well as to summarize all recently available literature on each topic. Identification of References for Inclusion: A Pubmed and Ovid search was performed for each topic in the review to identify recently published articles relevant to the review. In addition prior reviews and classic references were evaluated individually for inclusion of classic papers, classifications and previously unidentified references. PMID:21139776

  6. Imaging of laryngeal trauma.

    PubMed

    Becker, Minerva; Leuchter, Igor; Platon, Alexandra; Becker, Christoph D; Dulguerov, Pavel; Varoquaux, Arthur

    2014-01-01

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed.

  7. Imaging of laryngeal trauma.

    PubMed

    Becker, Minerva; Leuchter, Igor; Platon, Alexandra; Becker, Christoph D; Dulguerov, Pavel; Varoquaux, Arthur

    2014-01-01

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed. PMID:24238937

  8. Inhalant Abuse and Dextromethorphan.

    PubMed

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. PMID:27338970

  9. The trauma team--a system of initial trauma care.

    PubMed Central

    Adedeji, O. A.; Driscoll, P. A.

    1996-01-01

    Trauma remains the leading cause of death under the age of 35 years. England and Wales lost 252,000 working years from accidental deaths, including poison, in 1992. In this country, preventable deaths from trauma are inappropriately high. In many hospitals there are not enough personnel; in the majority, there are no recognisable trauma care systems, which can reduce preventable deaths to a minimum. The appropriateness of trauma centres for this country is being assessed in Stoke-on-Trent, and a report is due out later this year. Even if the recommendation is made to establish such centres, it is unlikely that many will be set up. Consequently most hospitals will have to rely on their own resources to set up and run a trauma team. This type of trauma care system is the subject of this article. PMID:8977939

  10. Dissociation as a mediator of child abuse across generations.

    PubMed

    Egeland, B; Susman-Stillman, A

    1996-11-01

    To test the hypothesis that dissociative process is the mechanism that accounts for the transmission of maltreatment across generations, a group of mothers who were abused and maltreated their children were compared to a group of mothers who broke the cycle of abuse. Mothers who were abused and are abusing their children were rated higher on idealization, inconsistency, and escapism in their description of their childhood and they scored higher on the Dissociative Experience Scale compared to mothers who broke the cycle. Mothers who were abused and abused their children recalled the care they received as children in a fragmented and disconnected fashion whereas those who broke the cycle integrated their abusive experience into a more coherent view of self. Even after partialing out the effects of IQ, large differences were found indicating that dissociative process plays a part in the transmission of maltreatment across generations. Possible reasons why some maltreated individuals coped with the trauma by dissociating and others integrate the experience were discussed.

  11. Traumatic disruption of the abdominal wall: lap-belt injuries in children.

    PubMed

    Moremen, Jacob R; Nakayama, Don K; Ashley, Dennis W; Astin, Matthew; Nolan, Tracy L

    2013-04-01

    Traumatic abdominal wall hernia (TAWH) from high speed mechanism is a unique finding in adult trauma, and exceedingly rare in pediatrics. The majority of reports are of low-speed "handlebar" hernias associated with direct injury by bicycle handlebars. We report a series of three pediatric patients in motor vehicle collisions (MVC) who experienced TAWH by lap-belt and associated intra-abdominal injuries necessitating immediate operative intervention. Different operative approaches were used in each case to manage the varying types of disruptions. This adds to the pediatric literature the largest series of its kind.

  12. Maladaptive Schemas as Mediators in the Relationship Between Child Sexual Abuse and Displaced Aggression.

    PubMed

    Estévez, Ana; Ozerinjauregi, Nagore; Herrero-Fernández, David

    2016-01-01

    Child sexual abuse is one of the most serious forms of abuse due to the psychological consequences that persist even into adulthood. Expressions of anger among child sexual abuse survivors remain common even years after the event. While child sexual abuse has been extensively studied, the expression of displaced aggression has been studied less. Some factors, such as the maladaptive early schemas, might account for this deficiency. The objective of this study was to analyze the relationships between child sexual abuse, displaced aggression, and these schemas according to gender and determine if these early schemas mediate the relationship between child sexual abuse and displaced aggression. A total of 168 Spanish subjects who were victims of child sexual abuse completed measures of childhood trauma, displaced aggression, and early maladaptive schemas. The results depict the relationship between child sexual abuse, displaced aggression, and early maladaptive schemas. Women scored higher than men in child sexual abuse, emotional abuse, disconnection or rejection and impaired autonomy. Mediational analysis found a significant mediation effect of disconnection or rejection on the relationship between child sexual abuse and displaced aggression; however, impaired autonomy did not mediate significantly.

  13. Maladaptive Schemas as Mediators in the Relationship Between Child Sexual Abuse and Displaced Aggression.

    PubMed

    Estévez, Ana; Ozerinjauregi, Nagore; Herrero-Fernández, David

    2016-01-01

    Child sexual abuse is one of the most serious forms of abuse due to the psychological consequences that persist even into adulthood. Expressions of anger among child sexual abuse survivors remain common even years after the event. While child sexual abuse has been extensively studied, the expression of displaced aggression has been studied less. Some factors, such as the maladaptive early schemas, might account for this deficiency. The objective of this study was to analyze the relationships between child sexual abuse, displaced aggression, and these schemas according to gender and determine if these early schemas mediate the relationship between child sexual abuse and displaced aggression. A total of 168 Spanish subjects who were victims of child sexual abuse completed measures of childhood trauma, displaced aggression, and early maladaptive schemas. The results depict the relationship between child sexual abuse, displaced aggression, and early maladaptive schemas. Women scored higher than men in child sexual abuse, emotional abuse, disconnection or rejection and impaired autonomy. Mediational analysis found a significant mediation effect of disconnection or rejection on the relationship between child sexual abuse and displaced aggression; however, impaired autonomy did not mediate significantly. PMID:27266539

  14. Prior Sexual Trauma and Adjustment Following the Virginia Tech Campus Shootings: Examination of the Mediating Role of Schemas.

    PubMed

    Littleton, Heather L; Grills-Taquechel, Amie E; Axsom, Danny; Bye, Kimberly; Buck, Katherine S

    2012-11-01

    A sizable body of research supports trauma's cumulative nature. However, few studies have evaluated potential mechanisms through which the experience of multiple traumas leads to elevated distress. The current study sought to evaluate differences between sexual trauma victims and women who had not experienced sexual trauma in their adjustment following a mass trauma (college women exposed to the 2007 Virginia Tech campus shooting). In addition, the study examined whether maladaptive schema change (lower self-worth and less belief in benevolence) and social support mediated the relationship between experiencing multiple traumas (sexual trauma and the campus shooting) and distress. The sample consisted of 215 college women who were assessed preshooting as well as two months and one year following the campus shooting. Women who had experienced sexual trauma (either contact sexual abuse or sexual assault) were compared to those who had not on their one-year postshooting PTSD and depressive symptoms. Results supported that sexual trauma victims reported significantly more depressive symptoms and shooting-related PTSD as well as less belief in benevolence and lower family support. Family support and benevolence beliefs at the two month postshooting assessment were significant medi-ators of the association between sexual trauma history and depression and PTSD. Implications of the findings for future research evaluating the cumulative impact of multiple traumatic experiences are discussed. PMID:23795237

  15. [Blunt trauma with bullet-proof vests. Skin lesions are no reliable predictor of injury severity].

    PubMed

    Doll, D; Illert, B; Bohrer, S; Richter, C; Woelfl, C

    2009-04-01

    It is well known that so-called bullet-proof vests offer protection against a wide range of penetrating trauma, but their protection against blunt trauma is less well understood. Fast projectiles may result in hematomas and contusions behind the armour. We report a traffic accident involving a young soldier wearing a ballistic protection vest resulting in a right thoracoabdominal blunt trauma leading to a confined liver compression rupture. As nearly no skin marks were detectable, we point out that every emergency department surgeon should be very suspicious if a patient wore a ballistic vest at the time of the accident--there may be no skin marks despite severe intra-abdominal trauma. Our patient recovered following hypotensive ICU treatment, thrombocyte mobilization, and factor VIIa substitution. PMID:18854963

  16. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  17. Preventing and Recognizing Prescription Drug Abuse

    MedlinePlus

    ... Abuse » Preventing and recognizing prescription drug abuse Prescription Drug Abuse Email Facebook Twitter Preventing and recognizing prescription drug abuse To ensure proper medical care, patients should discuss ...

  18. Embolization of Isolated Lumbar Artery Injuries in Trauma Patients

    SciTech Connect

    Sofocleous, Constantinos T. Hinrichs, Clay R.; Hubbi, Basil; Doddakashi, Satish; Bahramipour, Philip; Schubert, Johanna

    2005-12-15

    Purpose. The purpose of the study was to evaluate the angiographic findings and results of embolotherapy in the management of lumbar artery trauma. Methods. All patients with lumbar artery injury who underwent angiography and percutaneous embolization in a state trauma center within a 10-year period were retrospectively reviewed. Radiological information and procedural reports were reviewed to assess immediate angiographic findings and embolization results. Long-term clinical outcome was obtained by communication with the trauma physicians as well as with chart review. Results. In a 10-year period, 255 trauma patients underwent abdominal aortography. Eleven of these patients (three women and eight men) suffered a lumbar artery injury. Angiography demonstrated active extravasation (in nine) and/or pseudoaneurysm (in four). Successful selective embolization of abnormal vessel(s) was performed in all patients. Coils were used in six patients, particles in one and gelfoam in five patients. Complications included one retroperitoneal abscess, which was treated successfully. One patient returned for embolization of an adjacent lumbar artery due to late pseudoaneurysm formation. Conclusions. In hemodynamically stable patients, selective embolization is a safe and effective method for immediate control of active extravasation, as well as to prevent future hemorrhage from an injured lumbar artery.

  19. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  20. What Can Happen to Abused Children When They Grow Up--If No One Notices, Listens or Helps? Some Statistics from the Research.

    ERIC Educational Resources Information Center

    Maine State Dept. of Behavioral and Developmental Services, Augusta.

    Mental health professionals are becoming more aware of problems resulting from trauma. The earlier a trauma is identified and treated the better the chances of recovery, yet professionals do not always recognize symptoms or know what to do. If no one notices or intervenes, childhood abuse can lead to serious mental health problems in the adult…