Articles: trauma.
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A child's risk of developing cancer from radiation exposure associated with computed tomography (CT) imaging is estimated to be as high as 1/500. Chest CT (CCT), often as part of a "pan-scan," is increasingly performed after blunt trauma in children. We hypothesized that routine CCT for the initial evaluation of blunt injured children does not add clinically useful information beyond chest radiograph (CXR) and rarely changes management. ⋯ Clinically useful information found on CCT had good correlation to information obtained from CXR and did not change patient management, however, did add significantly to the radiation exposure of initial imaging. We recommend selective use of CCT, particularly in the presence of an abnormal mediastinal silhouette on CXR after a significant deceleration injury.
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Imaging after blunt cervical trauma is being used increasingly to screen patients for injury of the vertebral artery (VA). There are no guidelines for imaging of the VA for nonpenetrating cervical trauma. The purpose of this study was to determine the effect of VA injury on clinical outcome after blunt cervical trauma. ⋯ The clinical outcome of patients with blunt cervical trauma was not associated with the presence of VA abnormalities. Given the rare but potentially devastating consequences of a VA injury, however, screening may still be worthwhile.
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The majority of injury combinations in multiply injured patients entail the chest, abdomen and extremities. Numerous pig models focus on the investigation of posttraumatic pathophysiology, organ performance monitoring and on potential treatment options. Depending on the experimental question, previous authors have included isolated insults (controlled or uncontrolled hemorrhage, chest trauma) or a combination of these injuries (hemorrhage with abdominal trauma, chest trauma, traumatic brain injury and/or long bone fractures). ⋯ Therefore, a longer observation period is required to study the effects of therapeutic approaches during intensive care treatment when using animal models. These long-term studies of combined trauma models will allow the development of valuable therapeutic approaches relevant for the later posttraumatic course. This review summarizes the existing porcine models and outlines the need for long term models in order to provide real effective novel therapeutics for multiple injured patients to improve organ function and clinical outcome.
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Psychiatry research · Aug 2013
Investigation of the relationship between trauma and pain catastrophising: the roles of emotional processing and altered self-capacity.
This study aimed to investigate the interrelationship between posttraumatic stress, emotional processing difficulties, altered self-capacity, and pain catastrophising. A cross-sectional design gathered data from 249 participants completing an internet based survey. Respondents completed: The Posttraumatic Stress Diagnostic Scale; Emotional Processing Scale (EPS), the Inventory of Altered Self-Capacities (IASC), General Health Questionnaire-28 (GHQ-28) and the Pain Catastrophising Scale (PCS). ⋯ Emotional processing difficulties mediated the association between altered self-capacity and pain catastrophising and poor psychological well-being. To conclude, people's psychological well-being and perceptions of pain are closely related to PTSD severity from past traumas as well as self-capacities. Furthermore, the way in which they process their emotions also has an important role to play.