Danish medical journal
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Danish medical journal · Aug 2014
ReviewTraumatized refugees: morbidity, treatment and predictors of outcome.
Despite large numbers of traumatized refugees, little is known about effective treatment of war trauma in refugees and immigrants. Few studies evaluating treatment have been published and most studies are follow-up studies with methodological limitations and little comparability across studies. ⋯ Traditionally, treatment of traumatized refugees have focused on PTSD, but this study demonstrates that patients suffer from numerous psychiatric and somatic co-morbidities and the comprehensiveness of PTSD in explaining symptoms of traumatized refugees is questionable. This has implications for the type and implementation of treatment. PTF1 is the largest randomized clinical trial published on the treatment of traumatized refugees. It is a strength of PTF1 that it includes a waiting list control group thereby accounting for any effects due to spontaneous recovery and that treatment modalities are examined separately and in combination. In both FORLOB and PTF1, treatment adherence and patient compliance with treatment was thoroughly documented. Effect sizes were moderate in FORLOB and small in PTF1. There were discrepancies between the results in FORLOB and PTF1 with regards to the effect measured on self-ratings that can only partially be explained by methodological limitations of the follow-up study. Both studies are undertaken under pragmatic and realistic circumstances and the results are therefore relevant to other contexts. Patients are representative of patients in other North-European studies of traumatized refugees but differ from patients in trials published on culturally adapted CBT and Narrative Exposure Therapy.
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Danish medical journal · Aug 2014
Base fractures of the fifth proximal phalanx can be treated conservatively with buddy taping and immediate mobilisation.
Treatment of base fractures in the proximal phalanx depends on the fracture type, the degree of displacement and whether fracture reduction is stable or not. Internal fixation often leads to decreased mobility of the injured finger despite exact reduction of the fracture. Our treatment is focused upon function and to a lesser extent on exact reposition of the fractured fifth digit. Buddy taping was used after initial, closed reduction of the fracture allowing for immediate mobilisation. ⋯ Not relevant.
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Danish medical journal · Aug 2014
Most central nervous system tumours in children are diagnosed with little delay after admission.
Children with central nervous system (CNS) tumours often have a long symptom interval before diagnosis. We investigated delays in diagnosis and surgical management after the first admission with tumour-related symptoms. ⋯ Not relevant.