scholarly journals Transitional Care of Service Members With Genitourinary Injury

2021 ◽  
Author(s):  
Humberto Villareal ◽  
Sam Al-Bayati ◽  
Chen-Pin Wang ◽  
Mary Jo Pugh ◽  
Michael A Liss
Keyword(s):  
Mental Health ◽  
Transitional Care ◽  
Service Members ◽  
Health Administration ◽  
Long Term Effects ◽  
Post Traumatic Stress ◽  
Term Care ◽  
Post Traumatic ◽  
Health Diagnosis

ABSTRACT Objective To improve urotrauma care by describing veterans’ current demographics and needs assessment during transitional care to the Veteran Health Administration (VHA) system. Methods We utilized our previously identified cohorts obtained from the DoD Trauma Registry data for male service members injured in theater linked with VHA electronic health records. We included veterans who received care at VHA at least once from October 2001 through September 2011 for chart review. We investigate demographics, opportunities for care, combat-related trauma, disability, and associated mental health or urologic conditions specifically at the initial encounter with a VHA healthcare provider. Results We queried 580 veterans’ records in VHA from the linked databases. We idenfied that 141 (24.4%) veterans received addional care outside VHA and 17.1% (n = 99) of charts had insufficient data for injury validation. Reference to the urotrauma was mentioned in 72% of VHA initial visits (n = 416/580). The most common urotrauma occurred to the lower/external genitourinary injury (298, 51%). Of all the veterans identified with genitourinary trauma, approximately 28% (n = 160) were referred for urologic consultation, but only 14% were related to the original urotrauma. Ninety percent (522/580) of service members with urotrauma also had a mental health diagnosis, largely post-traumatic stress disorder (PTSD, 70.8%). Conclusions The majority of men with urotrauma did have contact with VHA, yet there is no systematic approach to baseline assessment or long-term care strategy. However, only a small proportion of DoD-documented urotrauma requires ongoing care. We identified that coordinating care with mental health pathways (PTSD/traumatic brain injury) may be an opportunity to evaluate the long-term effects of urotrauma.

scholarly journals Mental Health Outcomes Among Military Service Members After Severe Injury in Combat and TBI

2019 ◽  
Vol 185 (5-6) ◽  
pp. e711-e718 ◽  
Author(s):  
David L Chin ◽  
John E Zeber
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Military Service ◽  
Mental Health Outcomes ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Military Service Members ◽  
Severe Tbi ◽  
Post Traumatic

Abstract Introduction Studies examining the mental health outcomes of military personnel deployed into combat zones have focused on the risk of developing post-traumatic stress disorder conferred by mild or moderate traumatic brain injury (TBI). However, other mental health outcomes among veterans who sustained critical combat injuries have not been described. Materials and Method We examined the associations of moderate and severe TBI and combat injury with the risk for anxiety and mood disorders, adjustment reactions, schizophrenia and other psychotic disorders, cognitive disorders, and post-traumatic stress disorder. We conducted a retrospective cohort study of U.S. military service members critically injured in combat during military operations in Iraq and Afghanistan from February 1, 2002, to February 1, 2011. Health care encounters from (1) the Department of Defense (DoD) Trauma Registry (TR), (2) acute and ambulatory care in military facilities, and (3) civilian facilities are reimbursed by Tricare. Service members who sustained severe combat injury require critical care. We estimated the risk of mental health outcomes using risk-adjusted logit models for demographic and clinical factors. We explored the relationship between TBI and the total number of mental health diagnoses. Results Of the 4,980 subjects who met inclusion criteria, most injuries occurred among members of the Army (72%) or Marines (25%), with mean (SD) age of 25.5(6.1) years. The prevalence of moderate or severe TBI was 31.6% with explosion as the most common mechanism of injury (78%). We found 71% of the cohort was diagnosed with at least one poor mental health condition, and the adjusted risk conferred by TBI ranged from a modest increase for anxiety disorder (odds ratio, 1.27; 95% confidence interval [CI], 1.11–1.45) to a large increase for cognitive disorder (odds ratio, 3.24; 95% CI, 2.78–3.77). We found TBI was associated with an increased number of mental health diagnoses (incidence rate ratio, 1.52; 95% CI, 1.42–1.63). Conclusions Combat-associated TBI may have a broad effect on several mental health conditions among critically injured combat casualties. Early recognition and treatment for trauma-associated mental health are crucial to improving outcomes among service personnel as they transition to post-deployment care in the DoD, Department of Veterans Affairs, or community health systems.

scholarly journals Treatment of victims of trauma

2007 ◽  
Vol 13 (5) ◽  
pp. 358-368 ◽  
Author(s):  
Gwen Adshead ◽  
Scott Ferris
Keyword(s):  
Acute Stress ◽  
Stress Disorders ◽  
Ptsd Symptoms ◽  
Stress Reactions ◽  
Long Term Effects ◽  
Post Traumatic Stress ◽  
Acute And Chronic Stress ◽  
Post Traumatic ◽  
Traumatic Symptoms

Not all traumatic events cause post-traumatic stress disorder (PTSD), and people develop PTSD symptoms after events that do not seem to be overwhelmingly traumatic. In order to direct services appropriately, there is a need to distinguish time-limited post-traumatic symptoms and acute stress reactions (that may improve spontaneously without treatment or respond to discrete interventions) from PTSD, with its potentially more chronic pathway and possible long-term effects on the personality. In this article, we describe acute and chronic stress disorders and evidence about the most effective treatments.

Rapid Triage of Mental Health Risk in Emergency Medical Workers: Findings From Typhoon Haiyan

2017 ◽  
Vol 12 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Lauren Sylwanowicz ◽  
Merritt Schreiber ◽  
Craig Anderson ◽  
Carlos Primero D. Gundran ◽  
Emelie Santamaria ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
The Philippines ◽  
Stepped Care ◽  
Post Traumatic Stress ◽  
Emergency Medical ◽  
Patient Health ◽  
Post Traumatic ◽  
Subclinical Depression

AbstractObjectiveTo determine the ability of a novel responder mental health self-triage system to predict post-traumatic stress disorder (PTSD) in emergency medical responders after a disaster.MethodsParticipants in this study responded to Typhoon Haiyan, which struck the Philippines in November 2013. They completed the Psychological Simple Triage and Rapid Treatment (PsySTART) responder triage tool, the PTSD Checklist (PCL-5) and the Patient Health Questionnaire-8 (PHQ-8) shortly after responding to this disaster. The relationships between these 3 tools were compared to determine the association between different risk exposures while providing disaster medical care and subsequent levels of PTSD or depression.ResultsThe total number of PsySTART responder risk factors was closely related to PCL-5 scores ≥38, the threshold for clinical PTSD. Several of the PsySTART risk factors were predictive of clinical levels of PTSD as measured by the PCL-5 in this sample of deployed emergency medical responders.ConclusionsThe presence of a critical number and type of PsySTART responder self-triage risk factors predicted clinical levels of PTSD and subclinical depression in this sample of emergency medical workers. The ability to identify these disorders early can help categorize an at-risk subset for further timely “stepped care” interventions with the goals of both mitigating the long-term consequences and maximizing the return to resilience. (Disaster Med Public Health Preparedness. 2018;12:19–22)

Psychiatric and post-traumatic stress disorders among COVID-19 survivors

2020 ◽  
Vol 18 (7) ◽  
pp. 157-160
Author(s):  
Ammar Ahmed ◽  
Naeem Aslam Chughtai, PhD ◽  
Qurat- Ul- Ain
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Brain Injuries ◽  
Digital Health ◽  
Stress Disorders ◽  
Health Issues ◽  
Post Traumatic Stress ◽  
Traumatic Stress Disorders ◽  
Post Traumatic

Evidences related to neuropsychological impact of COVID-19 and its long-term side effects are beginning to emerge that may take years to catalogue the number of diseases and their treatments. Nonetheless, as neuropsychologists are evaluating COVID-19 survivors, a debate related to the psychiatric and neurocognitive sequels of past outbreaks, along with the recurrent co- occurrence of PTSD and acquired brain injuries, may be enlightening. This paper is highlighting the emergence of mental health issues that can be addressed and treatments can be provided according to the need of time. Technology has also been increasing day by day according to the current needs of public. COVID- 19 crisis has now shifted the focus towards the role of digital health care. For ensuring the best and right use of tele-health and app tools in such crises, it is suggested that there is a need for training of mental health professionals to ensure proper protocols for improved efficacy.

scholarly journals Case presentation of Safe and Effective Use of Medical Cannabis in the Elderly

2021 ◽  
Vol 1 (1) ◽  
pp. 9-16
Author(s):  
Luisa Barton ◽  
Clara Nisan ◽  
Carey Burleigh ◽  
Suzanne Fredericks
Keyword(s):  
Palliative Care ◽  
Traumatic Stress ◽  
The Elderly ◽  
Medical Cannabis ◽  
Post Traumatic Stress ◽  
Term Care ◽  
Case Presentation ◽  
Post Traumatic ◽  
Effective Use

Introduction: The therapeutic benefits of medical cannabis have been demonstrated for a number of chronic conditions impacting the elderly population, such as pain management, and as alternatives to antipsychotic and opioid interventions, as well as end of life treatments. However, this therapeutic intervention has not become part of routine care for seniors living in long-term care facilities because of reduced public acceptance and stigma. The aim of this paper was to present case studies outlining the effective use of medical cannabis to treat elderly patients with a variety of medical conditions and symptoms such as: post traumatic stress disorder, pain, anxiety, delusions, as well as palliative care. Cannabis was also used to taper antipsychotic medications, and for managing those in palliative care.   Case Presentation: Three cases highlighting the use of medical cannabis are described, from the perspective of a nurse practitioner-led interdisciplinary team approach. Management and Outcome: Using a variety of combinations of medical cannabis (cannabidiol and delta-9-tetrahydrocannabinol) in oral formulations, the long-term care facility has achieved a dramatic reduction in the use of antipsychotic medications. Medical cannabis has shown alleviation of many symptoms such as: pain, dyspnea, agitation, fatigue, weakness, loss of appetite, nausea, vomiting, and twitching. Positive results were noted in several palliative care patients who received medical cannabis for pain and symptom management. Conclusion: As an adjunct therapy for managing post traumatic stress disorder and other conditions, medical cannabis has been effective in reducing symptoms and for improving the patients’ overall quality of life. Continued evaluation into the long effectiveness of medical cannabis provided to individuals over the age of 65 years is suggested. This nurse practitioner-led therapeutic intervention highlights the potential health benefits of medical cannabis and has clinical implications for practice and education.

scholarly journals The Relationship Between Inflammation and Post-traumatic Stress Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Yajing Sun ◽  
Yuanyuan Qu ◽  
Jianwei Zhu
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Stress Disorders ◽  
Inflammatory Factors ◽  
Long Term Effects ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Relationship

Background: Stress disorders, such as post-traumatic stress disorder (PTSD), are attracting much attention. However, the relationship between traumatic stress and inflammation is rarely discussed.Subjects and Methods: As studies have linked PTSD to altered susceptibility to various diseases, such a psychiatric condition may lead to long-term systematic changes in physiological functions. We searched PubMed with the keywords “traumatic stress,” “stress disorders,” “post-traumatic stress disorder,” and “inflammation.”Results: Based on 65 previously published studies, we reviewed the long-term effects of PTSD, as well as traumatic events, on inflammatory function from both epidemiological and biological perspectives. Post-traumatic stress disorder is related to the immune response, including an increase in inflammatory factors and a reduction in anti-inflammatory factors. Additionally, it has been demonstrated that traumatic stress disorder and immune disease share a common genetic basis at the gene expression level.Conclusions: Understanding this relationship is of great significance for optimizing treatment plans for patients with PTSD.

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