创伤与治疗杂志

The traumatic experiences of victims of physical and sexual abuse within families have been studied in depth. However, the trauma of emotional abuse within families has received little attention in the literature.

Engaging parents and caregivers in the prevention of child sexual abuse (CSA) is “a type of maltreatment that refers to the involvement of the child in sexual activity to provide sexual gratification or financial benefit to the perpetrator, including contacts for sexual purposes, molestation, statutory rape, prostitution, pornography, exposure, incest, or other sexually exploitative activities”. CSA includes contact and noncontact sexually abusive acts that are both overt and covert in nature.

Background: Traumatic eye injury is one of the most common causes of unilateral blindness worldwide and it remains a core root of avoidable blindness worldwide. Traumatic glaucoma can result in severe visual impairment. Recognition of factors related to poor visual outcome, appropriate medical therapy, surgical intervention when indicated and careful follow up will help in preserving vision in these patients. This study is aimed at determining the frequency, clinical forms and types of therapy of traumatic glaucomas as seen in our hospital.

Methods: All consecutive patients with ocular injury who received treatment at the eye clinic of Ekiti state university teaching hospital, Ado Ekiti, from January 2012 to December 2014 were selected for the study. All subjects had thorough ophthalmic examinations. The patients with ocular injury and subsequently developed glaucoma were selected extracting from the medical records the demographic data, visual acuity at presentation, clinical form of glaucoma and various therapies for management. The data were analysed using SPSS version 18 (Illinois, Chicago, USA) and presented as tables, and figures, in frequencies, percentage.

Result: A total of 5568 patients were seen during this study at the ophthalmology clinic, 365 of them had ocular trauma out of which 31(8.5%) was traumatic glaucoma. Peripheral anterior synerchae (29%), adherent leucoma (16.1%) and Hyphema (16.1%) were the common clinical manifestations (anatomic changes) of traumatic glaucoma. The clinical types of traumatic glaucoma are secondary open angle glaucoma (54.8%) which is higher than the secondary closed angle type (45.2%). 22 (71%) of these patients had medical interventions with antiglaucoma drugs.

Conclusion: The prevalence of traumatic glaucoma is 8.5%, this glaucoma may result in severe visual impairment if treatment is not instituted early.

Objective: Bisphenol-A (BPA) is a xenoestrogen used in many consumer products. Here we present a case of dysfunctional uterine bleeding after exposure to dental sealant containing BPA.

Design: Case Report

Setting: Academic Medical Center

Intervention: Dysfunctional uterine bleeding was diagnosed, and no therapy was initiated.

Results: The patient continued to experience bleeding following each exposure.

Conclusion: Female patients undergoing dental procedures that use BPA containing compounds may experience dysfunctional bleeding.

The most common cause of traumatic diaphragmatic rupture is blunt or penetrating thoraco-abdominal trauma. The proper diagnosis can be difficult to make due to the non-specific clinical picture. The surgical approach in managing diaphragmatic rupture includes laparotomy, thoracotomy, or both. This article presents a case of a 60- year-old woman with post-traumatic peritoneopericardial diaphragmatic hernia. The study suggests that diaphragmatic injury should be considered in patients with blunt or penetrating thoraco-abdominal trauma.

The pathogenesis of inflammatory complication after chest trauma and pulmonary injury is incompletely understood. Injury can trigger a systemic inflammatory response, which leads to pre-activation of neutrophils in blood. The aim of this study was to determine the specific expression profiles of neutrophil receptors in relation to the systemic inflammatory response after chest trauma. Blood samples from fifty patients with isolated thoracic injury were analysed for changes in the neutrophil phenotype within 3, 6 and 24 hours after injury. Study patients was assessed for any inflammatory complications during the first 24 hours. L-Selectin expression remained decreased until 24 hrs while CXCR1, CXCR2 and C5aR levels gradually increased. Expression of FcγRII and expression of the active form were lower in trauma patients, no patients developed ARDS. Thoracic trauma leads to activation of the circulating neutrophils which is transient accompanied by mobilization of young neutrophils into the circulation which leads to systemic inflammatory reactions which need a second stimulus to cause inflammatory complications like ARDS.

Thrombosis is caused by many diseases or complications, such as cerebrovascular disease, coronary heart disease, pulmonary thromboembolism, deep vein thrombosis after surgery and trauma, thus effective antithrombotic therapy has very important significance to the health of human beings. However, more and more clinical reports showed hemorrhage issues induced by antithrombotic treatment, especially in the central nervous system. Accordingly, in this paper, the relationship between common oral anticoagulants applied in clinic and the related problems about intracerebral hemorrhage will be reviewed.

The contamination of the surgical field can be a potential risk of infection that can be devastating to patients undergoing hip fracture fixation surgery. Drapes peeling off during such operation is a recognized challenge that can lead to such a contamination. We describe and validate a simple technique to prevent drapes peeling off the operative field during hip fracture fixation surgery using the smart-draping technique. The smart-draping entails applying a sterile disposable single large adhesive op-sheet to the inferior aspect of the thigh, just under the proposed surgical incision, followed by applying the usual plastic vertical isolation drape. Fourteen neck-of-femur fracture patients undergoing dynamic hip screw (DHS) fixation were recruited and randomized into a study and control groups to measure fluid leakage, as an indirect measurement of the vertical drapes peeling off the surgical site. Incontinence pads were placed on the floor to collect all leaked fluid in all patients. The average weight of the fluid collected in the study groups was 11.4 gm (SD ± 12.1) while that of the control group was 354.3 gm (SD ± 175). There was a statistical significant difference between the two methods favoring the smart-draping method over the control one. (P<0.001) We conclude that smart-draping technique will make it harder for the drapes to peel off thus, avoiding the potential contamination of the surgical field and ultimately avoiding potential infection of the surgical site in hip fracture fixation surgery.

An 87-year-old man presented to the emergency department complaining of a frontal head injury. Brain computed tomography scan revealed hyperdensity in the vitreous cavity of the right eye, suggesting intraocular hemorrhage. The patient’s family reported that he had a history of retinal detachment, which was presumably treated by tamponade with silicone oil. Eye examination by an ophthalmologist indicated no vitreous or retinal hemorrhage. Since intraocular silicone oil is being increasingly used for treatment of retinal detachment, emergency physicians must become familiar with its unique characteristic of mimicking hemorrhage in medical imaging.

Prescription opioid use has increased dramatically in the past 20 years with prescriptions for opioids and overdoses both increasing by 400% in what is now being called an opioid epidemic. The CDC’s Guidelines for Prescribing Opioids for Chronic Pain were released in March 2016 and the result has been increasing scrutiny of opioid prescriptions. For pain patients, this means minimizing opioid use and decreasing reliance, while others are being tapered off opioids altogether. Opioid tapers are predictably revealing unanticipated levels of opioid use disorder and unsupportable demand for enrollment in opioid assisted treatment (OAT) via buprenorphine/naloxone (Suboxone®) or methadone treatment programs. In July 2016, the Department of Health and Human Services released a final rule increasing prescribing limits of buprenorphine/naloxone (Suboxone®) to allow qualifying providers to treat up to 275 patients rather than capping panel size at 100. In addition to increased use in the treatment of opioid use disorder, there are new formulations of buprenorphine approved for chronic pain management. Therefore, while opioid use overall is decreasing, use of buprenorphine itself is dramatically increasing and introducing new challenges to treatment in trauma and acute pain settings based on its unique pharmacology. In recent years, case reports highlighting the challenge of managing pain when patients are treated with buprenorphine were published but until now were rarely seen in practice. It is, therefore, incumbent on all providers in these settings to become intimately familiar with buprenorphine and prepare to safely and effectively manage pain in these challenging patients.

In the context of last attacks affecting many countries, a medical and psychological coverage must be organized for all who are concerned, soldiers, emergency and security team and of course, victims. It leads on the development of resiliency.

Pellet gun injuries is quite commonly faced emergency nowadays in Kashmir because of recent turmoil in valley and has invited a different challenges in modern day to day practice of surgeons mostly otolaryngologists and ophthalmologists . For this reason a study was conducted in an only tertiary care of Otolaryngology Head and Neck Referral Center, ENT, SMHS, Srinagar between July 2016 to September 2016. The pattern, severity and outcome of injuries in head and neck and maxilla-facial region among pellets gun victims in Kashmir region was studied and their management was categorized based on demand and need.

“The Family: People Helping People Project” is a community-based group process intervention involving personal sharing to confront social fragmentation in the Bahamas. A preliminary study suggested that the family may influence gradual change in the Bahamian community, and was followed by a 3-year extension that examined aspects of resocialization in the community. Participants reported several changes after Family enrollment, with increasing significance in some areas. While earlier testing periods showed decreases in negative parameters and no changes in positive factors, later periods showed tapering of improvements in negativity with increased positive tendencies. The need to measure resocialization following therapy in The family necessitated the development and validation of a novel instrument. The Allen Resocialization Scale™ attempts to define resocialization based on many established constructs of personal growth, and is a promising tool with many potential applications across populations.

Background: Primary metaepiphyseal haematogenous osteomyelitis (HOM) with subperiostal abscess formation at initial admission is a rare but serious condition. A considerate treatment strategy is crucial to avoid damage to the adjacent physics.

Methods: Charts and radiographic data of two cases were reviewed and reported in a retrospective study approved by the Institutional Review Board.

Results: Two children presented with limping, painful restriction of movement and very mild laboratory findings. No trauma was remembered. Conventional radiography showed no abnormalities, but subsequent MRI revealed metaepiphyseal HOM as well as an adjacent sub-periostal abscess collection.

Conclusions: Antibiotic therapy and immediate surgical debridement provided for uncomplicated healing.

Pets are useful to people in the psychological sense. Livestock, poultry and working animals cannot be surrogates for pets. In the modern society pets are gaining more and more importance. In Turkey, too, pet-keeping is getting to be a widespread practice in recent times. Pets represent animal love and they especially contribute to children’s healthy emotional development.

Children of drug addicted mothers are exposed to highly stressful experiences and experience high levels of psychological and emotional distress, alongside psychiatric nosology with multiple comorbid symptoms. The following study extends the work of Lombard, et al. classify the consequences of prolonged or ongoing trauma of children of addicted mothers using lifespan domains. Children of addicted mothers are often exposed to severe and ongoing events of trauma, or environments that are not conducive to adequate development, resulting in a complex array of comorbid and compounding physical and psychological problems. Results showed that the prevalence of trauma experienced by children were categorized as being from social and physical domains, with the emotional domain (reported neglect=26) also being high. These experiences resulted predominantly in behavioral problems and emotional problems. The most salient problems included a child who reported hearing the devil speak to them in an ongoing manner, two children reporting attempted homicides on siblings, and three children reporting hurting animals. Further research in capturing and detailing the extent of the trauma experienced and the resulting lifespan domain problems is necessary.