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8 results

  • Pain Influences Neuropsychological Performance Following Electrical Injury: A Cross-Sectional Study

  • Katherine E. Dorociak, Jason R. Soble, Patricia A. Rupert, Joseph W. Fink, Raphael C. Lee, Magdalena Anitescu, David Weiss, Gerald Cooke, Zachary J. Resch, Neil H. Pliskin
  • Journal:
    Journal of the International Neuropsychological Society / Volume 29 / Issue 1 / January 2023
    Published online by Cambridge University Press:
    18 January 2022, pp. 35-45
    • Article
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  • Objective:

    Electrical injury (EI) is a significant, multifaceted trauma often with multi-domain cognitive sequelae, even when the expected current path does not pass through the brain. Chronic pain (CP) research suggests pain may affect cognition directly and indirectly by influencing emotional distress which then impacts cognitive functioning. As chronic pain may be critical to understanding EI-related cognitive difficulties, the aims of the current study were: examine the direct and indirect effects of pain on cognition following EI and compare the relationship between pain and cognition in EI and CP populations.

    Method:

    This cross-sectional study used data from a clinical sample of 50 patients with EI (84.0% male; M age = 43.7 years) administered standardized measures of pain (Pain Patient Profile), depression, and neurocognitive functioning. A CP comparison sample of 93 patients was also included.

    Results:

    Higher pain levels were associated with poorer attention/processing speed and executive functioning performance among patients with EI. Depression was significantly correlated with pain and mediated the relationship between pain and attention/processing speed in patients with EI. When comparing the patients with EI and CP, the relationship between pain and cognition was similar for both clinical groups.

    Conclusions:

    Findings indicate that pain impacts mood and cognition in patients with EI, and the influence of pain and its effect on cognition should be considered in the assessment and treatment of patients who have experienced an electrical injury.

  • Mild Traumatic Brain Injury in Older Adults: Early Cognitive Outcome

  • Glynda J. Kinsella, John Olver, Ben Ong, Russell Gruen, Eleanor Hammersley
  • Journal:
    Journal of the International Neuropsychological Society / Volume 20 / Issue 6 / July 2014
    Published online by Cambridge University Press:
    16 May 2014, pp. 663-671

  • Severe traumatic brain injury (TBI) in older age is associated with high rates of mortality. However, little is known about outcome following mild TBI (mTBI) in older age. We report on a prospective cohort study investigating 3 month outcome in older age patients admitted to hospital-based trauma services. First, 50 mTBI older age patients and 58 orthopedic controls were compared to 123 community control participants to evaluate predisposition and general trauma effects on cognition. Specific brain injury effects were subsequently evaluated by comparing the orthopedic control and mTBI groups. Both trauma groups had significantly lower performances than the community group on prospective memory (d=0.82 to 1.18), attention set-shifting (d=−0.61 to −0.69), and physical quality of life measures (d=0.67 to 0.84). However, there was only a small to moderate but non-significant difference in the orthopedic control and mTBI group performances on the most demanding task of prospective memory (d=0.37). These findings indicate that, at 3 months following mTBI, older adults are at risk of poor cognitive performance but this is substantially accounted for by predisposition to injury or general multi-system trauma. (JINS, 2014, 20, 1–9)

  • Impact of Dual-Polarization Radar Technology and Twitter on the Hattiesburg, Mississippi Tornado

  • Part of
  • Alexis L. Cates, Brent W. Arnold, Guy Paul Cooper, Jr, Violet Yeager, Josh Stake, Mohammed Ali, Richard C. Calderone, James Wilkinson, Edbert Hsu, Steven Parrillo, Steven Piper, Italo Subbarao
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 7 / Issue 6 / December 2013
    Published online by Cambridge University Press:
    21 January 2014, pp. 585-592
  • Objective

    Dual-Polarization Radar and Twitter were analyzed to determine the impact on injuries sustained by the Hattiesburg EF-4 tornado.

    Method

    Tracking data provided from the Dual-Pol radar systems in National Weather Service Jackson were reviewed. Twitter data from four local Twitter handles were obtained. The change in tweets and followers for the day of the storm were compared to historical averages. A Student t-test was utilized in determining statistical significance (p<0.05). Medical records from two local emergency departments were reviewed for patients treated up to 24 hours after the tornado. An Injury Severity Score (ISS) was calculated for trauma records related to the tornado.

    Results

    Radar detection of the tornado gave approximately 30 minutes of advanced warning time. Statistical significance in follower growth was seen in all four Twitter handles. Out of 50 patients, the average ISS was 3.9 with a range of 1 to 29. There were zero fatalities.

    Conclusions

    An ISS average of 3.9 was significantly less than two previous tornadoes of similar strength that occurred prior to increased usage of Dual-pol radar and Twitter as a means for communicating severe weather information. Early detection from Dual-pol radar improved warning time. Tweets informed citizens to seek appropriate shelter. (Disaster Med Public Health Preparedness. 2013;7:585-592)

  • 20 - Adult congenital heart disease

  • from Section 2 - Practical issues in transesophageal echocardiography
  • Edited by Robert Feneck, John Kneeshaw, Marco Ranucci
  • Book:
    Core Topics in Transesophageal Echocardiography
    Published online:
    10 May 2010
    Print publication:
    15 April 2010, pp 324-338

  • Summary

    Transesophageal echocardiography (TEE) is a valuable means of assessing diseases of the thoracic aorta. The portion of descending aorta between the left subclavian artery proximally and the ligamentum arteriosum distally is known as the aortic isthmus. A number of the branches of the aorta can be imaged using TEE. Coarctation of the aorta may present as a partial narrowing, or rarely a complete occlusion, of the aorta. The ductus arteriosus connects the pulmonary artery to the aorta in the fetal circulation. Supravalvular aortic stenosis is a narrowing of the aorta usually at the level of the border of the sinus of Valsalva. The etiology of a true aortic aneurysm has much in common with aortic dissection. True tumors of the aorta, including leiomyosarcoma, fibroelastoma, and epithelioma, are fortunately extremely rare. Traumatic injury to the aorta usually occurs as a result of rapid deceleration injury or blunt chest trauma.

  • 34 - Tornadoes

  • from SECTION B - ENVIRONMENTAL EVENTS
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 553-561

  • Summary

    Tornadoes occur with very little or no advanced warning, causing considerable structural damage, traumatic injury, and death. This chapter reviews risk factors for injury and death, injury patterns, and mass casualty scenarios by using modeling and real event reports. Risk of injury or death has been associated with storm strength, victim age, type of material used for dwelling construction, shelter location, income level, and time of day. Injury patterns can be categorized by the time at which they occur in relation to the storm. This approach may affect treatment strategies. Initial emergency medical services (EMS) transports could then attempt even distribution of the victims to appropriate medical centers, avoiding overloading one facility as much as possible. Research is necessary to develop best practices that guide strategies for designation and management of off-site facilities that can rapidly be converted to temporary shelters for some group of victims.

  • 6 - Thoracolumbar Spine and Pelvis Plain Radiography

  • from PART I - PLAIN RADIOGRAPHY
  • Edited by J. Christian Fox, University of California, Irvine
  • Book:
    Clinical Emergency Radiology
    Published online:
    07 December 2009
    Print publication:
    29 September 2008, pp 106-116

  • Summary

    Radiographic evaluation of the pelvis and spine often starts with plain radiographs, most commonly ordered after a traumatic injury. Patients with non-traumatic back pain do not routinely need radiographs. Indications for plain films in these patients include age older than 55 years, or back pain lasting longer than 4 weeks. Thoracolumbar radiology is capable of diagnosing fractures of the vertebral bodies, such as burst or compression fractures, or transverse fractures due to distraction injuries. Ligamentous injuries can be identified by widening or rotation of the spinous processes, or by dislocation of one vertebral body relative to another. Osteomyelitis, tumors, and Paget disease may be diagnosed if thoracolumbar involvement is present. In the thoracolumbar spine, a burst fracture may be mistaken for a less serious compression fracture. Computed tomography (CT) of the abdomen and pelvis, performed on many trauma patients, may be more accurate in diagnosing injuries of the thoracolumbar spine.

  • Experimental studies on traumatic facial nerve injury

  • Zhigang Cai, Guangyan Yu, Daquan Ma, Jing Tan, Zhaohui Yang, Xiaoming Zhang
  • Journal:
    The Journal of Laryngology & Otology / Volume 112 / Issue 3 / March 1998
    Published online by Cambridge University Press:
    29 June 2007, pp. 243-247
    Print publication:
    March 1998

  • Purpose The purpose of this study was to investigate the outcome of different injuries to the facial nerve.

    Materials and methods Six patterns of injuries (exposure, compression, crushing, stretching, division and post-division anastomosis) were produced in the buccal branches of the facial nerve in 60 rabbits. Electroneuronography (ENoG) and histology at definite time were used to evaluate the results.

    Results and conclusions Exposure and compression injuries produced a neuropraxic injury and rapid recovery. Crushing and stretching injuries resulted in axonotmesis and whilst complete recovery can take place it may be very slow. Division and post-division anastomosis fall into neurotmesis injury and do not completely recover within six months; the former recovers slower and later than the latter.