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Multiple Trauma (multiple + trauma)

Distribution by Scientific Domains

Medical Sciences	57%

Selected Abstracts

Ancient injury recidivism: an example from the Kerma period of ancient Nubia

INTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 2 2002
Margaret Judd
Abstract A topical trend in clinical research has been the study of repeat trauma, referred to by clinicians as "injury recidivism," which lends itself to the assessment of accumulated injuries among ancient people. The present investigation examined the healed injuries among two archaeological skeletal samples from the Kerma period (ca. 2500,1500 BC) of Sudanese Nubia. Both groups were known to have a high prevalence of multiple trauma,80% of 54 adults from the rural sites (O16 and P37) located near Dongola and 42% of 212 adults from the urban site of Kerma sustained nonfatal injuries. It was observed that a higher frequency of multi-injured adults displayed one or more violence-associated injury (cranial trauma, parry fracture). When all injuries were considered 38% of individuals with violence-related injuries had other traumatic lesions in contrast to 22% of individuals who experienced injuries associated with accidental falls (e.g., Colles', Smiths', Galeazzi, and paired forearm fractures), although this difference was not significant. When only the skulls and long bones were evaluated 81% of adults with multiple injuries to these major bones bore one or more violence-related injuries, while 60% of adults with single injuries sustained violence-related injuries. Most individuals with multiple injuries were male and less than 35 years of age; there was no significant difference in the frequency of violence- or accident-related multiple injury between the rural and urban communities. Although it cannot be established whether or not some of an individual's injuries were experienced during simultaneous or independent incidents, the pattern of multiple injury among these two ancient Nubian skeletal samples reflected the profile of injury recidivism observed by modern clinicians cross-culturally. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2010
Andrew Tatarsky
Abstract Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence. This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies. A case is presented that illustrates the application of this approach with life-threatening substance use that was related to multiple trauma and suicidal depression. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66: 1,13, 2010. [source]

Perioperative care of children with nerve agent intoxication

PEDIATRIC ANESTHESIA, Issue 6 2001
Ron Ben Abraham MD
Nerve agents (NA) present a major threat to civilian populations. When a ballistic system is used for spreading poison, multiple trauma, as well as toxic trauma could be caused. Children are more susceptible, due to their smaller physiological reserve. Urgent surgical intervention for combined intoxication in the multiple-traumatized child could be a tremendous task in view of the background of physiological instability. Nerve agents affect the autonomic, as well as the central nervous system, leading occasionally to unexpected interactions with agents normally used for resuscitation. This can cause additional instability, and possibly systemic collapse. This review presents and emphasizes points concerning treatment of a child who suffers from combined multiple and toxic traumas. The review is based on scant knowledge of a database of similar cases of pesticide organophosphate poisoning in children since these compounds are alike. We also extrapolated data from reports concerning episodic civilian exposure to NA. [source]

Intestinal-FABP and Liver-FABP: Novel Markers for Severe Abdominal Injury

ACADEMIC EMERGENCY MEDICINE, Issue 7 2010
Borna Relja MSc
ACADEMIC EMERGENCY MEDICINE 2010; 17:729,735 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, Fatty acid,binding proteins (FABPs) have relatively high tissue concentrations and low plasma concentrations and are released into the circulation following organ injury. We explored the utility of intestinal-(I)-FABP and liver-(L)-FABP for the diagnosis of abdominal injury in patients with multiple trauma. Methods:, This prospective study included 102 trauma patients and 30 healthy volunteers. Plasma I-FABP and L-FABP levels were measured in the emergency department (ED) by enzyme-linked immunosorbent assay (ELISA). Forty-one patients suffered from serious or severe abdominal trauma (Abbreviated Injury Score [AIS] code "ai" for abdominal injury, AISai , 3) and nine were moderately abdominally injured (AISai < 3). Fifty-two had no abdominal injury. Results:, Median I-FABP and L-FABP levels in the AISai , 3 group (516 pg/mL and 135 ng/mL, respectively) were significantly higher compared to the AISai < 3 group (154 pg/mL and 13 ng/mL, respectively) or those without abdominal injury (207 pg/mL and 21 ng/mL, respectively) or normal controls (108 pg/mL and 13 ng/mL, respectively). The cutoff to distinguish the ai , 3 is 359 pg/mL for I-FABP and 54 ng/mL for L-FABP, with 93% specificity and 75% sensitivity for I-FABP and 93% and 82% for L-FABP, respectively. Conclusions:, High I-FABP and L-FABP levels correlate with relevant severity of abdominal tissue damage in patients with multiple trauma. I-FABP and L-FABP could be useful as markers for the early detection of significant abdominal injury in acute multiple trauma and identify patients who require rapid intervention. [source]

Development of renal failure during the initial 24 h of intensive care unit stay correlates with hospital mortality in trauma patients

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2006
T. Ala-Kokko
Background:, Although multiple organ failure is the leading late cause of death, there is controversy about the impact of acute organ dysfunction and failure on trauma survival. Methods:, Consecutive adult trauma admissions between January 2000 and June 2003, excluding isolated head traumas and burns, were analysed for parameters of organ function during the first 24 h following intensive care unit (ICU) admission using the Sequential Organ Failure Assessment (SOFA) scoring system. A national prospectively collected ICU data registry was used for analysis, including data from 22 ICUs in university and central hospitals in Finland. Results:, The study population consisted of 1044 eligible trauma admissions; 32% of the cases were treated at university hospital level, the rest being secondary referral central hospital admissions. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15 (SD8), ICU mortality was 5.6% and a further 1.6% of patients died during their post-ICU hospital stay. Forty-five per cent of the patients were categorized as having multiple traumas. In univariate analysis, APACHE II , 25 [odds ratio (OR), 35; 95% confidence interval (CI), 18,66] and renal failure (OR, 29.5; 95% CI, 14,63) produced the highest ORs for ICU mortality. In the APACHE II-, sex- and age-adjusted logistic regression model, renal failure was a significant risk factor for both ICU and hospital mortality (OR, 11.8; 95% CI, 3.9,35.4; OR, 8.2; 95% CI, 2.9,23.2, respectively). Conclusion:, The development of renal failure during the initial 24 h of ICU stay remained an independent risk factor for mortality in trauma patients requiring intensive care treatment even after adjusting for the APACHE II score, age and sex. [source]