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[PMID]:29310377
[Au] Autor:Lin YN; Chuang CH; Huang SH; Huang SH; Lin TM; Lin IW; Lin SD; Kuo YR
[Ad] Endereço:Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University.
[Ti] Título:Fat grafting for resurfacing an exposed implant in lower extremity: A case report.
[So] Source:Medicine (Baltimore);96(48):e8901, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. PATIENT CONCERNS: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. She refused additional major surgery and negative pressure wound therapy. DIAGNOSES: The diagnosis of a tibia and fibula shaft open fracture (type IIIA) complicated with an exposed implant was made. INTERVENTIONS: The procedure was performed by deploying purified and emulsified fat with a Micro-Autologous Fat Transplantation gun. The required lipoaspirate amount was grossly estimated using a standard formula: 0.5 cc of a lipoaspirate per square centimeter of wound. We prepared the lipoaspirate simply through centrifugation followed by physical emulsification. The endpoint of fat grafting was when lipoaspirate began to flow out of the wound. The initial dressing after the procedure included the topical usage of biomycin ointment with AQUACEL Foam (ConvaTec Inc., NC, USA) coverage, which was later changed to INTRASITE gel (Smith & Nephew, London, UK) with a gauze dressing for 4 weeks. After 4 weeks, dressing components were changed to Mepilex (Mölnlycke Health Care, Gothenburg, Sweden) alone. OUTCOMES: The wound healed completely without requiring major flap surgery by 18 weeks after surgery. LESSONS: Fat grafting is one kind of cell therapy and potentially has regenerative effects during wound healing. Fat grafting is critical in the healing processes of complicated wounds and might be considered a step in reconstruction surgery.
[Mh] Termos MeSH primário: Tecido Adiposo/transplante
Fíbula/lesões
Fíbula/cirurgia
Fixação Interna de Fraturas/instrumentação
Fixadores Internos
Traumatismos da Perna/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Fraturas da Tíbia/cirurgia
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Traumatismos da Perna/etiologia
Retalhos Cirúrgicos
Cicatrização
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008901


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[PMID]:29310353
[Au] Autor:Zhou Y; Guo H; Cai Z; Zhang Y
[Ad] Endereço:Tianjin Medical University.
[Ti] Título:Complex pelvic ring injuries associated with floating knee in a poly-trauma patient: A case report.
[So] Source:Medicine (Baltimore);96(48):e8783, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO). PATIENT CONCERN: Our case involved a 45-year-old lady who was hit by a dilapidated building. The patient was anxious, pale and hemodynamically stable at the initial examination. The pelvis was unstable and there were obvious deformities in the left lower extremities. Significant degloved injuries in the left leg were noted. Her radiographs and physical examination verified the above signs. DIAGNOSES: Unstable pelvic fractures, multiple fractures of bilateral lower limbs with floating knee injury, multiple pelvic and rib fractures and multiple degloving injuries and soft tissue contusion formed the characteristics of the multiple-injury. INTERVENTIONS: The algorithm of DCO was determined as the treatment. Early simplified procedures such as wound debridement, pelvis fixation, closed reduction and EF of the right shoulder joint, and chest wall fixation were conducted as soon as possible. After a period of time, internal fixations were applied to the fracture sites. The subsequent functional exercise was also conducted in accordance with this algorithm. OUTCOMES: This patient got recovery after the treatments which were guided by the criterion of DCO. The restoration of limb functional and the quality of life greatly improved. LESSONS: The DCO plays a decisive role in the first aid and follow-up treatment of this patient. The guidelines of management of complex pelvic ring injuries and floating knee should be established by authorities.
[Mh] Termos MeSH primário: Fraturas Ósseas/terapia
Traumatismos do Joelho/terapia
Traumatismo Múltiplo/terapia
Ossos Pélvicos/lesões
[Mh] Termos MeSH secundário: Contusões/etiologia
Contusões/terapia
Desbridamento
Feminino
Primeiros Socorros
Fraturas Ósseas/diagnóstico por imagem
Fraturas Ósseas/etiologia
Seres Humanos
Traumatismos do Joelho/diagnóstico por imagem
Traumatismos do Joelho/etiologia
Traumatismos da Perna/diagnóstico por imagem
Traumatismos da Perna/etiologia
Traumatismos da Perna/terapia
Meia-Idade
Traumatismo Múltiplo/diagnóstico por imagem
Traumatismo Múltiplo/etiologia
Ossos Pélvicos/diagnóstico por imagem
Fraturas das Costelas/diagnóstico por imagem
Fraturas das Costelas/etiologia
Fraturas das Costelas/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008783


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[PMID]:27771822
[Au] Autor:Kohler RE; Tomlinson J; Chilunjika TE; Young S; Hosseinipour M; Lee CN
[Ad] Endereço:Harvard TH Chan School of Public Health; Dana Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02115, USA. Racquel_kohler@dfci.harvard.edu.
[Ti] Título:"Life is at a standstill" Quality of life after lower extremity trauma in Malawi.
[So] Source:Qual Life Res;26(4):1027-1035, 2017 04.
[Is] ISSN:1573-2649
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Low- and middle-income countries face a disproportionate burden of death and disability from injuries, many of which are due to road traffic accidents or falls. Lower extremity injuries in particular have implications not only for physical disabilities affecting work and school performance, but also for quality of life (QOL) of the individual. This qualitative study explores the psychosocial impact and QOL changes due to lower extremity injuries among trauma patients in central Malawi. METHODS: We transcribed and translated interviews with 20 patients who received care for a trauma to the lower extremity at a tertiary hospital in Lilongwe. We used NVivo to organize and thematically analyze the data. RESULTS: Participants reported limitations in physical functioning, activities of daily living, social roles, and vocational and social activities. Limited mobility led to unplanned long-term disruptions in work, personal financial loss, and household economic hardship. As a result, psychological distress, fears and worries about recovery, and poor perceptions of health and QOL were common. Several contextual factors influenced patient outcomes including socioeconomic status, religious beliefs, social networks, local landscape, housing structures, and transportation accessibility. CONCLUSION: Lower extremity trauma led to physical suffering and ongoing social and economic costs among Malawians. Injuries affecting mobility have broad QOL and economic consequences for patients and affected family members. Interventions are needed to improve post-injury recovery and QOL. Better access to trauma surgery and social and welfare support services for people living with disabling conditions are needed to alleviate the consequences of injuries.
[Mh] Termos MeSH primário: Atividades Cotidianas
Transtornos de Ansiedade/psicologia
Traumatismos da Perna/psicologia
Qualidade de Vida
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Escala de Gravidade do Ferimento
Entrevistas como Assunto
Malaui
Masculino
Meia-Idade
Apoio Social
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1007/s11136-016-1431-2


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[PMID]:29190257
[Au] Autor:Scerbo MH; Holcomb JB; Taub E; Gates K; Love JD; Wade CE; Cotton BA
[Ad] Endereço:From the Center for Translational Injury Research (CeTIR) (M.H.S., J.B.H., C.E.W., B.A.C.), Department of Surgery (M.H.S., J.B.H., E.T., J.D.L., C.E.W., B.A.C.), and Department of Emergency Medicine (K.G.), The University of Texas Health Science Center, Houston, Texas; and Life Flight, Memorial Hermann Hospital, Houston, Texas (J.D.L.).
[Ti] Título:The trauma center is too late: Major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock.
[So] Source:J Trauma Acute Care Surg;83(6):1165-1172, 2017 Dec.
[Is] ISSN:2163-0763
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To date, no civilian studies have demonstrated that pre-hospital (PH) tourniquets improve survival. We hypothesized that late, trauma center (TC) tourniquet use would increase death from hemorrhagic shock compared to early (PH) placement. METHODS: All patients arriving to a Level 1, urban TC between October 2008 and January 2016 with a tourniquet placed before (T-PH) or after arrival to the TC (T-TC) were evaluated. Cases were assigned the following designations: indicated (absolute indication [vascular injury requiring repair/ligation, operation within 2 hours for extremity injury, or traumatic amputation] or relative indication [major musculoskeletal/soft tissue injury requiring operation 2-8 hours after arrival, documented large blood loss]) or non-indicated. Outcomes were death from hemorrhagic shock, physiology upon arrival to the TC, and massive transfusion requirements. After univariate analysis, logistic regression was carried out to assess independent predictors of death from hemorrhagic shock. RESULTS: A total of 306 patients received 326 tourniquets for injuries to 157 upper and 147 lower extremities. Two hundred eighty-one (92%) had an indication for placement. Seventy percent of patients had a blunt mechanism of injury. T-TC patients arrived with a lower systolic blood pressure (SBP, 101 [86, 123] vs. 125 [100, 145] mm Hg, p < 0.001), received more transfusions in the first hour of arrival (55% vs. 34%, p = 0.02), and had a greater mortality from hemorrhagic shock (14% vs. 3.0%, p = 0.01). When controlling for year of admission, mechanism of injury and shock upon arrival (SBP ≤90 mm Hg or HR ≥120 bpm or base deficit ≤ 4) indicated T-TC had a 4.5-fold increased odds of death compared to T-PH (OR 4.5, 95% CI 1.23-16.4, p = 0.02). CONCLUSIONS: Waiting until TC arrival to control hemorrhage with a tourniquet was associated with worsened blood pressure and increased transfusion within the first hour of arrival. In routine civilian trauma patients, delaying to T-TC was associated with 4.5-fold increased odds of mortality from hemorrhagic shock. LEVEL OF EVIDENCE: Level IV.
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/métodos
Hemorragia/complicações
Técnicas Hemostáticas/instrumentação
Choque Hemorrágico/mortalidade
Tempo para o Tratamento/tendências
Torniquetes/utilização
[Mh] Termos MeSH secundário: Adulto
Traumatismos do Braço/complicações
Feminino
Seguimentos
Hemorragia/mortalidade
Hemorragia/terapia
Seres Humanos
Traumatismos da Perna/complicações
Masculino
Meia-Idade
Estudos Retrospectivos
Choque Hemorrágico/etiologia
Choque Hemorrágico/terapia
Taxa de Sobrevida/tendências
Texas/epidemiologia
Centros de Traumatologia
População Urbana
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1097/TA.0000000000001666


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[PMID]:28745705
[Au] Autor:Karyakin NN; Klemenova IA; Luzan AS
[Ad] Endereço:Volga Federal Medical Research Center, Health Ministry of Russia, Nizhny Novgorod, Russia.
[Ti] Título:[The outcomes of lower extremities burn wounds management by using of controlled moist environment].
[Ti] Título:Rezul'taty lecheniia ozhogovykh ran konechnostei v usloviiakh vlazhnoi sredy..
[So] Source:Khirurgiia (Mosk);(7):40-43, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To the outcomes of lower extremities burn wounds management by using of controlled moist environment. MATERIAL AND METHODS: Burn wounds management by using of controlled moist environment in 23 patients is presented in the article. Physiological moist conditions on the surface of wounds were created with isotonic sodium chloride solution and sterile polyethylene diaphanous containers. Сontrol group included 12 patients who were treated with hydrocolloid patch. RESULTS: It was shown that burn wounds management with moist environment allows to use and improve this method further. This technique gives good analgesic effect within the first days after burn trauma, allows to implement permanent clinical monitoring of the wound and preserve functional activity of the limbs.
[Mh] Termos MeSH primário: Curativos Hidrocoloides
Queimaduras
Traumatismos da Perna
Administração dos Cuidados ao Paciente/métodos
Cloreto de Sódio/uso terapêutico
Cicatrização
[Mh] Termos MeSH secundário: Adulto
Queimaduras/diagnóstico
Queimaduras/etiologia
Queimaduras/fisiopatologia
Queimaduras/cirurgia
Feminino
Seres Humanos
Soluções Isotônicas/uso terapêutico
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/etiologia
Traumatismos da Perna/cirurgia
Masculino
Manejo da Dor/métodos
Federação Russa
Índices de Gravidade do Trauma
Resultado do Tratamento
Cicatrização/efeitos dos fármacos
Cicatrização/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Isotonic Solutions); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017740-43


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[PMID]:29132576
[Au] Autor:Evans C; Chaplin T; Zelt D
[Ad] Endereço:Trauma Services, Department of Emergency Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario K7L 2V7, Canada. Electronic address: c.evans@queensu.ca.
[Ti] Título:Management of Major Vascular Injuries: Neck, Extremities, and Other Things that Bleed.
[So] Source:Emerg Med Clin North Am;36(1):181-202, 2018 Feb.
[Is] ISSN:1558-0539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Vascular injuries represent a significant burden of mortality and disability. Blunt injuries to the neck vessels can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiography and managed with either antiplatelet medications or anticoagulation. In contrast, patients with penetrating injuries to the neck vessels require airway management, hemorrhage control, and damage control resuscitation before surgical repair. The keys to diagnosis and management of peripheral vascular injury include early recognition of the injury; hemorrhage control with direct pressure, packing, or tourniquets; and urgent surgical consultation.
[Mh] Termos MeSH primário: Hemorragia/terapia
Lesões do Sistema Vascular/terapia
[Mh] Termos MeSH secundário: Traumatismos do Braço/diagnóstico
Traumatismos do Braço/terapia
Angiografia por Tomografia Computadorizada
Hemorragia/diagnóstico
Hemorragia/etiologia
Seres Humanos
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/terapia
Pescoço/irrigação sanguínea
Lesões do Pescoço/diagnóstico
Lesões do Pescoço/terapia
Lesões do Sistema Vascular/diagnóstico
Lesões do Sistema Vascular/diagnóstico por imagem
Ferimentos não Penetrantes/diagnóstico
Ferimentos não Penetrantes/diagnóstico por imagem
Ferimentos não Penetrantes/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171115
[St] Status:MEDLINE


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[PMID]:28742790
[Au] Autor:Borrelli J
[Ad] Endereço:BayCare Medical Group, St. Joseph Hospital-North, Lutz, FL.
[Ti] Título:Invited Commentary related to: Cost-Utility Analysis of Reconstruction Compared With Primary Amputation for Patients With Severe Lower Limb Trauma in Colombia.
[So] Source:J Orthop Trauma;31(9):e294-e295, 2017 09.
[Is] ISSN:1531-2291
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Amputação
Análise Custo-Benefício
[Mh] Termos MeSH secundário: Colômbia
Seres Humanos
Traumatismos da Perna/cirurgia
Salvamento de Membro
Extremidade Inferior/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1097/BOT.0000000000000969


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[PMID]:29068940
[Au] Autor:Stranix JT; Lee ZH; Jacoby A; Anzai L; Avraham T; Thanik VD; Saadeh PB; Levine JP
[Ad] Endereço:New York, N.Y. From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center; and the Division of Plastic Surgery, Department of Surgery, Mount Sinai Health System.
[Ti] Título:Not All Gustilo Type IIIB Fractures Are Created Equal: Arterial Injury Impacts Limb Salvage Outcomes.
[So] Source:Plast Reconstr Surg;140(5):1033-1041, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical outcomes. METHODS: In a retrospective review of 806 lower extremity reconstructions between 1979 and 2016, 361 soft-tissue flaps performed for Gustilo type IIIB/C coverage met inclusion criteria. Patient demographics, flap characteristics, and outcomes were analyzed. RESULTS: Most patients suffered type IIIB [n = 332 (91.9 percent)] injuries; 29 (8.0 percent) had type IIIC injuries. Preoperative angiography [n = 243 (67.3 percent)] demonstrated arterial injury in 126 (51.8 percent); 27 arterial injuries were identified intraoperatively; and the overall incidence was 153 of 361 (42.4 percent). Complications occurred in 143 flaps (39.6 percent) and included 37 partial losses (10.2 percent) and 31 total losses (8.6 percent). Injured recipient arteries [n = 62 (17.2 percent)] had more complications (p = 0.004); specifically, increased take-backs (p = 0.009). Decreasing vessel runoff increased the risk of complications (p = 0.025), take-backs (p = 0.007), and total flap failures (p = 0.024) accordingly. Specifically, among grade IIIB injuries, controlling for age, sex, time since injury, and vein number, single-vessel runoff was associated with higher rates of complications (relative risk, 3.07; p = 0.012), take-backs (relative risk, 3.43; p = 0.013), and total flap failures (relative risk, 4.80; p = 0.010) compared with three-vessel runoff. CONCLUSIONS: Arterial injury was common among Gustilo type IIIB patients and correlated with increased reconstructive complications. Nonischemic arterial injury appears to negatively impact reconstructive outcomes and should be accounted for when considering free tissue transfer for lower extremity salvage. The authors propose a 3-2-1 modification of the Gustilo type IIIB classification to incorporate degree of arterial injury, as it appears to add prognostic value and certainly influences the reconstructive plan. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, IV.
[Mh] Termos MeSH primário: Artérias/lesões
Fíbula/lesões
Fraturas Expostas/cirurgia
Retalhos de Tecido Biológico/transplante
Salvamento de Membro
Fraturas da Tíbia/cirurgia
Lesões do Sistema Vascular/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Artérias/cirurgia
Criança
Feminino
Fraturas Expostas/complicações
Fraturas Expostas/diagnóstico
Seres Humanos
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/cirurgia
Masculino
Meia-Idade
Artéria Poplítea/lesões
Artéria Poplítea/cirurgia
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Artérias da Tíbia/lesões
Artérias da Tíbia/cirurgia
Fraturas da Tíbia/complicações
Fraturas da Tíbia/diagnóstico
Índices de Gravidade do Trauma
Resultado do Tratamento
Lesões do Sistema Vascular/complicações
Lesões do Sistema Vascular/diagnóstico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003766


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[PMID]:28953439
[Au] Autor:Bayer ML; Magnusson SP; Kjaer M; Tendon Research Group Bispebjerg
[Ad] Endereço:Bispebjerg Hospital, Copenhagen, Denmark monika.lucia.bayer@regionh.dk.
[Ti] Título:Early versus Delayed Rehabilitation after Acute Muscle Injury.
[So] Source:N Engl J Med;377(13):1300-1301, 2017 09 28.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Traumatismos em Atletas/reabilitação
Traumatismos da Perna/reabilitação
Músculo Esquelético/lesões
Entorses e Distensões/reabilitação
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Tempo para o Tratamento
Resultado do Tratamento
[Pt] Tipo de publicação:LETTER; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1708134


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[PMID]:28844553
[Au] Autor:Young-McCaughan S; Bingham MO; Vriend CA; Inman AW; Gaylord KM; Miaskowski C
[Ad] Endereço:Division of Behavioral Medicine, Department of Psychiatry, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX. Electronic address: YoungS1@uthscsa.edu.
[Ti] Título:The impact of symptom burden on the health status of service members with extremity trauma.
[So] Source:Nurs Outlook;65(5S):S61-S70, 2017 Sep - Oct.
[Is] ISSN:1528-3968
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Service members injured in combat undergo repeated surgeries and long recoveries following a traumatic injury that produce a myriad of physical and psychological symptoms. PURPOSE: To describe the severity of pain, sleep disturbance, depression, and anxiety in service members with extremity trauma sustained during combat operations at the time of discharge from the hospital and to evaluate for differences in health status between those with and without symptom burden. METHOD: Descriptive study of 130 United States Army service members. DISCUSSION: More than 80% of the service members were classified as having symptom burden. Service members who reported one or more clinically meaningful levels of pain, sleep disturbance, depression, or anxiety reported significantly worse health status compared to those without symptom burden. CONCLUSIONS: Service members with extremity trauma experience clinically significant levels of pain, sleep disturbance, depression, and/or anxiety at the time of discharge from the hospital. The greater the service members' symptom burden, the worse their reported health status.
[Mh] Termos MeSH primário: Transtornos de Ansiedade/epidemiologia
Efeitos Psicossociais da Doença
Transtorno Depressivo/epidemiologia
Traumatismos da Perna/psicologia
Militares
Transtornos do Sono-Vigília/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Amputação/psicologia
Feminino
Nível de Saúde
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE



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