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No complications were recorded in either the operative or non-operative groups. In total, 32 patients (86%) were treated non-operatively. Five patients (14%) underwent exploratory laparotomy (3 of which were non-therapeutic). Length of stay was dependent on the unique requirements of each individual patient as determined by the state department for returning across the border.
We propose that in battle related casualties, acute survivable penetrating abdominal trauma may be safely treated non-operatively in selected patients who are hemodynamically normal and in whom there is an absence of abdominal pain or tenderness on repeated clinical assessment.
We propose that in battle related casualties, acute survivable penetrating abdominal trauma may be safely treated non-operatively in selected patients who are hemodynamically normal and in whom there is an absence of abdominal pain or tenderness on repeated clinical assessment.
Mental stress and depressive disorders have negative effect on bone biology and increase fracture risk. Fluoxetine is a widely used selective serotonin reuptake inhibitor in the treatment of these disorders. We aimed to evaluate the effects of social stress and fluoxetine treatment on fracture healing.
This study was performed with 32 male Sprague-Dawley® rats. Rats were randomly divided into four groups with eight rats in each group. Social stress regimen was performed in groups 3 and 4 for 15 days. Placebo for groups 1 and 3 and fluoxetine for groups 2 and 4 was administrated. Rat femur open (osteotomy) fracture model was performed. Placebo and fluoxetine were continued to be given to the same groups for four weeks until sacrification of animals. Sacrificed right femurs of subjects were evaluated histologically and radiologically. The obtained data were statistically analyzed using the SPSS 23 (Statistical Package for the Social Sciences) program.
Fracture healing score that evaluates the fracture heaOur findings indicate that fluoxetine, which minimizes the negative effects of social stress on bone healing, can be used safely in the treatment of depressive disorders in patients with fractures.
The positive and negative effects of fluoxetine, which is used in the treatment of depressive disorders, on wound, tendon, or bone healing have been shown in the literature. In this study, we showed the negative effects of depression on the early stages of fracture healing. Although fluoxetine had no detrimental effect on fracture healing in non-depressive rats, impaired fracture healing was reversed and better radiological and histological findings were obtained in depressive rats treated with fluoxetine. Our findings indicate that fluoxetine, which minimizes the negative effects of social stress on bone healing, can be used safely in the treatment of depressive disorders in patients with fractures.
Patellar fractures constitute almost 1% of total skeletal injuries. Existing common operative methods include the use of different types of Tension band wiring techniques like cannulated screws and K-wires. The Patellar plating construct is a relatively newer operative method for patellar fracture fixation with promising outcomes with fewer complications.
We conducted a pilot prospective study at our Apex Trauma center in twenty patients aged 18-65years with displaced patellar fractures, AO type A2, A3, B2, B3, C1, C2, C3. Fractures were fixed with low profile patellar plates (1.8mm). Radiological and functional follow-up was done using X-rays, CT scans and BKS scoring (Bostman-Knee-Scale), Knee Society Score(KSS), and Tegner Lysholm knee scores respectively for two years.
Mean functional outcome scores at 6 weeks, 3 months, 6 months and 2 years was 25.5, 28.3, 29.05 and 29.9 for BKS; 64.62, 84.12, 90.6, and 97.5 for KSS; 73.75, 89.7,94.8, and 99.3 for Tegner Lysholm knee score respectively. Radiological union, confirmed by CT scan, was observed in all patients at 3 months. Two patients had superficial surgical site infection (SSI) at 2 weeks. Implant impingement was also found in 2 patients at 3 months. FF-10101 None of the patients had a failure of fixation at the end of the study.
Patients with low profile patellar plate constructs have favorable clinical and radiological outcomes with minimal non-specific complications.
Patients with low profile patellar plate constructs have favorable clinical and radiological outcomes with minimal non-specific complications.
The psychological wellbeing of healthcare workers has been impacted by the high levels of stress many have experienced during the Coronavirus Disease 2019 (COVID-19) pandemic. This study aimed to examine the feasibility and acceptability of a brief online course focused on introducing evidence-based skills that could increase resilience and decreases emotional distress in healthcare workers during the pandemic.
Employees of a large healthcare system completed a mental health survey at baseline, and then one month and two months after some employees participated in an online resilience-enhancement course consisting of three 12-19min videos focused on mindfulness, mentalization, and self-compassion.
A total of 554 participants completed the baseline survey, endorsing moderate to high levels of emotional distress. Of those who completed all three assessments and participated in the course (n=38), significant improvements in resilience and reductions in emotional distress were found one and two months later, in comparison to those who did not participate in the course (n=110).
These findings suggest that a brief, online intervention can improve the mental health of healthcare workers during a crisis such as the COVID-19 pandemic.
These findings suggest that a brief, online intervention can improve the mental health of healthcare workers during a crisis such as the COVID-19 pandemic.
The behavioral summarized evaluation scales, the BSE and its revised version the BSE-R, were developed and validated in the 1980-1990s. The BSE-R is still used daily by clinical teams in France and foreign countries, and it is recommended by the French Health Authority (2018). link2 Having taken into account knowledge improvement in neurodevelopment and autism spectrum disorder (ASD) and the importance of observation by relatives in ecological context, the second version of the BSE was developed. This paper presents the construction and the validation study of the second version of the behavioral summarized evaluation scale, the BSE2 and the BSE2-P rated by parents.
Construct validity of the BSE2 scale has been studied in a population of 244 children and adolescents with ASD according to DSM-5 criteria, aged from 30 months to 18 years. Discriminant validity has been analyzed using a population of 86 patients of the same age, with neurodevelopmental disorder (NDD) without comorbidity of ASD.
BSE2 comprises 30 other neurodevelopmental diagnoses. Furthermore, this scale allows to expand the rating context, involving parents to define and adjust the individualized therapeutic project. Thus the BSE2 is a valuable clinical tool for practitioners for both diagnosis and follow-up.
BSE2 scale for children and adolescents is a clinical tool with good psychometric properties. Its two-dimensional structure is in accordance with DSM-5 criteria. This scale covers all spectrum of ASD clinical forms in both children and adolescents. It can be used to identify ASD in complex neurodevelopmental disorders with several comorbidities and can help to distinguish autism symptomatology from other neurodevelopmental diagnoses. Furthermore, this scale allows to expand the rating context, involving parents to define and adjust the individualized therapeutic project. Thus the BSE2 is a valuable clinical tool for practitioners for both diagnosis and follow-up.
Transversal grouping of addictions under the heading "Substance related and addictive disorders" in the DSM-5has led to a common policy on addictions and the promotion of addiction services covering all types of addictions, including behavioral addictions.
The main objective of this study was to describe the prevalence of problem gambling in a population of patients seeking treatment in addictive disorders center. Secondary objectives were to describe the use of Internet and the prevalence of gaming disorder, sexual addiction and compulsive buying online; to describe a population of patients consulting in addictive disorders center; to explore associated factors related to problem gambling. A self-questionnaire was built, evaluating the socio-demographic elements, the addiction pathway, problem gambling and Internet use with a focus on video game disorder, sexual addiction and compulsive buying. It was offered to consultants from five addictology centers in Brittany.
252 patients seeking treatment for at in care, both in the identification of behavioral addictions and in follow-up.
The prevalence of problem gambling is almost 4 times higher among addictology consultants, compared to the general population, probably related to addictive comorbidities. The identification of gambling habits concerned a small proportion of the patients included, whether in specialized care or outside. There is significant room for improvement in the identification of problem gambling, in addictology and beyond. It is important to question gambling habits for any reason for addiction consultation and to repeat this identification over time. As the Internet is widely used by addictology consultants, it can represent a key element in care, both in the identification of behavioral addictions and in follow-up.Acute myocardial infarction (AMI)-related mortality has been decreasing within the United States because of improvements in management and preventive efforts; however, persistent disparities in demographic subsets such as race may exist. In this study, the nationwide trends in mortality related to AMI in adults in the United States from 1999 to 2019 are described. Trends in mortality related to AMI were assessed through a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. link3 Age-adjusted mortality rates per 100,000 people and associated annual percentage change and average annual percentage changes with 95% confidence intervals (CIs) were determined. Joinpoint regression was used to assess the trends in the overall, demographic (gender, race/ethnicity, age), and regional groups. Between 1999 and 2019, a total of 3,655,274 deaths related to AMI occurred. In the overall population, age-adjusted mortality rates decreased from 134.7 (95% CI 134.2 to 135.3) in 1999 to 48.5 (95% CI 48.3 to 48.8) in 2019 with an average annual percentage change of -5.0 (95% CI -5.5 to -4.6). Higher mortality rates were seen in Black individuals, men, and those living in the South. Patients older than 85 years experienced substantial decreases in mortality. In addition, rural counties had persistently higher mortality rates in comparison with urban counties. In conclusion, despite decreasing mortality rates in all groups, persistent disparities continued to exist throughout the study period.Considerable advancements have been made in the quantification of biofluid-based biomarkers for traumatic brain injury (TBI), which provide a clinically accessible window to investigate disease mechanisms and progression. Methods with improved analytical sensitivity compared with standard immunoassays are increasingly used, and blood tests are being used in the diagnosis, monitoring, and outcome prediction of TBI. Most work to date has focused on acute TBI diagnostics, while the literature on biomarkers for long-term sequelae is relatively scarce. In this review, we give an update on the latest developments in biofluid-based biomarker research in TBI and discuss how acute and prolonged biomarker changes can be used to detect and quantify brain injury and predict clinical outcome and neuropsychiatric sequelae.
