Articles: trauma.
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Cerebral vasospasm is a preventable cause of death and disability in patients who experience aneurysmal subarachnoid hemorrhage (SAH). The aim of this study is to investigate the incidence of cerebral vasospasm following traumatic SAH and its relationship with different brain injuries and severity of trauma. ⋯ Traumatic SAH is associated with a high incidence of cerebral vasospasm with a higher probability in patients with severe TBI.
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With the onset of improved protective equipment against fragmentation, blast-induced neurotrauma has emerged as the "signature wound" of the current conflicts in the Middle East. Current research has focused on this phenomenon; however, the exact mechanism of injury and ways to mitigate the ensuing pathophysiology remain largely unknown. The data presented and literature reviewed formed the fundamentals of a successful grant from the U.S. Office of Naval Research to Wayne State University. ⋯ A physiologic- or biofidelic-based blast-induced tolerance curve may redefine current acceleration-based curves that are only valid to assess tertiary blast injury. Identification of additional pharmaceutical candidates will both confirm or deny current hypotheses on neural pathways of continued injury and help to develop novel prophylactic treatments.
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Eur J Trauma Emerg S · Oct 2009
Management of blunt bowel and mesenteric injuries: Experience at the Alfred hospital.
The incidence of blunt bowel and mesenteric injury (BBMI) has increased recently in blunt abdominal trauma, possibly due to an increasing number of high-speed motor accidents and the use of seat belts. ⋯ The timing of surgical intervention in cases of BBMI is mostly determined by the clinical examination and the results of the helical CT scan findings. The FAST lacks sensitivity and specificity for identifying bowel and mesenteric trauma. A delayed diagnosis of > 48 h has a significantly higher bowelrelated morbidity but not mortality.
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Curr Treat Option Ne · Sep 2009
Current treatment options for depression after mild traumatic brain injury.
Mild traumatic brain injury (MTBI) is the most common neurologic condition in the United States; about 503 of every 100,000 persons visiting the emergency department have this diagnosis. A complex cluster of neurologic signs and symptoms are associated with an acceleration-deceleration mechanism of injury. Unfortunately, many persons do not seek treatment for MTBI. ⋯ Thus, evidence-based treatment of post-MTBI depression is quite limited. Because depressive symptoms can develop as early as 1 week after injury and can be exacerbated by stress, pain, and comorbidities, it seems prudent to begin early interventions focused on managing pain and stress, along with providing psychoeducational and problem-solving therapies. Efficacy studies are needed to determine whether telemedicine approaches, group interventions, or peer counseling may be helpful methods of delivering such interventions during the early months as ways to attenuate the development of a major depressive disorder.