Upper limb reconstructive transplantation in military recipients

2018 ◽  
Vol 104 (1) ◽  
pp. 6-11 ◽  
Author(s):  
C A Fries ◽  
H L Stark ◽  
D Tuder ◽  
S Iyer ◽  
V S Gorantla ◽  
...  
Keyword(s):  
Upper Limb ◽  
Sensory Function ◽  
Tissue Loss ◽  
Human Hand ◽  
Post Traumatic Stress ◽  
American Military ◽  
Current State ◽  
Reconstructive Transplantation ◽  
Medical Teams ◽  
Medical Advances

AbstractLessons from conflict have contributed to military medical advances which have significantly improved the survivability of critically injured servicemen and women. However, survival following such severe combat polytrauma is often associated with devastating tissue loss and functional deficits that challenge conventional reconstruction. Despite recent advances, upper extremity prosthetic alternatives lack the fidelity to restore the complex intrinsic and sensory function of the human hand. Upper Limb Reconstructive Transplantation, or Vascularised Composite Allotransplantation (VCA), is currently an experimental procedure offering superior anatomical and functional outcomes compared to prostheses.Military candidates for VCA usually enjoy high pre-morbid fitness, mental health resilience and support, and relatively rich provision of rehabilitation. However, co-morbidities of polytrauma, such as traumatic brain injury and post-traumatic stress disorder, may have an impact on outcomes.Since 1998, over 120 upper limb transplants have been performed worldwide. Of these, six have been performed on servicemen and women across three continents. The morbidity and mortality associated with the requirement for lifelong immunosuppression, however, continues to skew the risk-benefit considerations of these promising procedures when compared to prostheses. Thus, although the technical surgical feasibility of upper limb and other VCA such as face, abdominal wall, uterus and penis transplants has been established over the past decade, these procedures remain restricted to recipients fulfilling stringent inclusion criteria.We review the current state of VCA in military recipients, and summarise ongoing collaborative VCA research conducted by British and American military medical teams.

scholarly journals Likely Exacerbation of Psychological Disorders from Covid-19 Response

2021 ◽  
Vol 12 ◽  
pp. 215013272110167
Author(s):  
Tara Rava Zolnikov ◽  
Tanya Clark ◽  
Tessa Zolnikov
Keyword(s):  
Psychological Disorders ◽  
Emotional Reactions ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Current State ◽  
The Face ◽  
Adults And Children ◽  
Post Traumatic ◽  
Anxiety Depression

Anxiety and fear felt by people around the world regarding the coronavirus pandemic is real and can be overwhelming, resulting in strong emotional reactions in adults and children. With depressive and anxiety disorders already highly prevalent in the general population (300 million worldwide), depression and/or anxiety specifically because of the pandemic response is likely. Moreover, the current state of panic in the face of uncertainty is apt to produce significant amounts of stress. While this situation has the potential to cause psychological disorders in previously unaffected populations, perhaps more impactful is the exacerbation of symptoms of many existing disorders including anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and hoarding disorder.

scholarly journals Lymphatic and Sensory Function of the Upper Limb After Brachioplasty in Post-Bariatric Massive Weight Loss Patients

2017 ◽  
Vol 37 (9) ◽  
pp. 1022-1031 ◽  
Author(s):  
Stefano Gentileschi ◽  
Maria Servillo ◽  
Gabriella Ferrandina ◽  
Marzia Salgarello
Keyword(s):  
Weight Loss ◽  
Upper Limb ◽  
Massive Weight Loss ◽  
Sensory Function

Functional Neuroimaging of PTSD

2016 ◽  
Author(s):  
Marie-France Marin ◽  
Mohammed R. Milad
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Functional Neuroimaging ◽  
Post Traumatic Stress ◽  
Key Factors ◽  
Current State ◽  
Recent Developments ◽  
Post Traumatic ◽  
Novel Approaches

The merger of neuroscience and psychiatry during the last two decades has enabled psychiatric neuroscience, as a newly refined discipline, to make great advances in understanding pathophysiology of psychiatric disorders, including post-traumatic stress disorder (PTSD). The advent of neuroimaging tools and the continued exponential growth and sophistication of the methods are key factors underlying advances in the field. In this chapter, informed by neuroimaging tools and basic neuroscience, the authors paint an optimistic canvas to illustrate the current state of knowledge pertaining to the etiology and pathophysiology of PTSD. The chapter describes the state of some recent developments and what is coming on the horizon in terms of novel approaches that may be applied toward the diagnosis and treatment of PTSD.

scholarly journals Headaches in Moria: a reflection on mental healthcare in the refugee camp population of Lesbos

2019 ◽  
Vol 16 (04) ◽  
pp. 96-98 ◽  
Author(s):  
Tom Nutting
Keyword(s):  
Traumatic Stress ◽  
Mental Healthcare ◽  
Refugee Camp ◽  
Lifestyle Changes ◽  
Depression And Anxiety ◽  
Post Traumatic Stress ◽  
Current State ◽  
Post Traumatic ◽  
The Common ◽  
Perfect Storm

Having returned from a period of volunteering with a healthcare charity working with the refugee camp population of Lesbos in Greece, a junior doctor reflects on the common presentations he saw and the current state of mental healthcare for these patients. The placement of already-traumatised people in an overcrowded and under-resourced camp environment creates a perfect storm for the emergence of post-traumatic stress disorder, depression and anxiety. With extremely limited psychiatric care in place, he considers the simple interventions he could use to help his patients with their distressing symptoms. This prompts exploration of the importance of giving time to listen as well as encouraging small but significant lifestyle changes. After exploring the ethics of psychiatric diagnosis in this setting, the author concludes that while we must acknowledge the political origins of some of the symptomatology in this population, we must continue to strive to treat psychiatric illness with all the appropriate interventions available to us in order to help those in this patient group recover and move forward.

scholarly journals Psychological consequences of traumatic upper limb peripheral nerve injury: A systematic review

Hand Therapy ◽  
2016 ◽  
Vol 22 (1) ◽  
pp. 35-45 ◽  
Author(s):  
Caroline Miller ◽  
Aimie L Peek ◽  
Dominic Power ◽  
Nicola R Heneghan
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Upper Limb ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Peripheral Nerve Injury ◽  
Stress Disorder ◽  
Psychological Consequences ◽  
Post Traumatic Stress ◽  
Post Traumatic

Introduction Traumatic upper limb peripheral nerve injuries significantly impact individuals’ function and ability to return to work. Patients with peripheral nerve injury experience ongoing psychological impairments for which they are not routinely treated. The aim of this review was to investigate the psychological consequences of traumatic upper limb peripheral nerve injury. Methods A systematic review of MEDLINE, Embase, PsycINFO, CINAHL, AMED, BNI, the Cochrane libraries and grey literature up to October 2015 was undertaken. Two reviewers independently assessed methodological quality in accordance with Cochrane Collaboration recommendations. Eligibility criteria comprised: adults or adolescents with traumatic upper limb peripheral nerve injury using any measurement of psychological well-being. Results Six studies ( n = 245) met the inclusion criteria. Methodological quality varied widely. Evidence of post-traumatic stress disorder at one month, which decreased over time, was reported in three studies. Two studies found a statistically significant correlation between the early presence of post-traumatic stress disorder and reduction in function at 12 or more months. Limited information was available on anxiety, depression and mental quality of life. Combined nerve injuries (in two studies) had significantly higher levels of post-traumatic stress disorder, at one month, compared to those with an isolated nerve injury. Conclusion There is some evidence of early post-traumatic stress disorder following traumatic upper limb peripheral nerve injury, which may have an impact on functional outcome. However, high-quality studies using prospective cohorts are required to further evaluate the psychological aspects associated with this traumatic injury.

TMS in the study and treatment of anxiety disorders

2012 ◽  
Author(s):  
Benjamin Greenberg ◽  
Sarah H. Lisanby
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Therapeutic Effects ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Systematic Testing ◽  
Compulsive Disorder ◽  
Current State ◽  
Post Traumatic ◽  
Disorder Treatment

A few studies of transcranial magnetic stimulation (TMS) as an anxiety disorder treatment have been reported. In treatment studies, the focal application of TMS in the treatment of anxiety disorders has been guided by the present understanding of the neurocircuitry underlying these disorders. This article reviews the current state of the literature on the uses of TMS in the study and treatment of anxiety disorders, and discusses the implications for understanding their patho-etiology. Investigation of the possible therapeutic effects of repetitive TMS in obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or any anxiety disorder remains at a preliminary stage. There have been promising initial observations in OCD, which require systematic testing in controlled studies. As far as PTSD is concerned, the available data suggest that additional TMS work is required. The observations need to be replicated in controlled settings to determine whether this approach will have value in treating anxiety disorders.

Review and Perspective: Sensory Feedback in Upper Limb Prosthesis

2013 ◽  
Vol 303-306 ◽  
pp. 261-265
Author(s):  
Peng Zhang ◽  
Qi Xu ◽  
Ji Ping He
Keyword(s):  
Upper Limb ◽  
Sensory Feedback ◽  
Sensory Function ◽  
Tactile Sensation ◽  
Tactile Receptors ◽  
Upper Limb Prosthesis ◽  
Human Upper Limb ◽  
Limb Prosthesis ◽  
Sensory Functions

An emerging challenge in developing intelligent prostheses is to replicate or recreate the sensory functions of natural limbs for amputees. Such functions mainly include tactile sensation and proprioception. This paper reviews the tactile receptors and proprioceptors in human upper limb, the artificial sensors in upper limb prosthesis, and the sensory feedback technology used for reconstruction of lost sensory function in the amputee’s upper limb.

Sign in / Sign up

Export Citation Format

Share Document