The Psychological Impact of Severe Hand Injury

2008 ◽  
Vol 33 (3) ◽  
pp. 358-362 ◽  
Author(s):  
M. GROB ◽  
N. A. PAPADOPULOS ◽  
A. ZIMMERMANN ◽  
E. BIEMER ◽  
L. KOVACS
Keyword(s):  
Psychological Impact ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Psychological Trauma ◽  
Positive Outcome ◽  
Hand Injury ◽  
Hand Injuries ◽  
Residual Functional ◽  
Constant State ◽  
Adaptation Processes

The final outcome of severe hand injuries is not solely determined by the residual functional impairment, but is also a function of non-functional criteria, including the sequelae of the accompanying psychological trauma. This paper reviews the literature with respect to the psychological impact of severe hand injuries, including the special impact of amputations, adaptation processes, adaptation stages, prognostic criteria and aesthetic issues influencing the final individual outcome, including present recommendations for promoting a positive outcome. Motivated and psychologically stable people are reported to do well irrespective of the severity of a hand injury. In patients who find it difficult to cope mentally, successful treatment strategies have been proposed. Their implementation is in a constant state of evolution and includes not only improved surgical techniques and advanced pharmacological pain management but also early psychotherapeutic input and involvement of patients in decision making for treatment.

New Trends and Developments in Patients with Severe Aortic Stenosis – Towards Optimal Treatment?

2009 ◽  
Vol 5 (2) ◽  
pp. 81 ◽  
Author(s):  
Martijn WA van Geldorp ◽  
Johanna JM Takkenberg ◽  
Ad JJC Bogers ◽  
A Pieter Kappetein ◽  
◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Treatment Modalities ◽  
Diagnostic Tools ◽  
Number Of Patients ◽  
Transcatheter Valve

Over the next few decades the number of patients diagnosed with aortic stenosis is expected to rise as the population ages and the use of several diagnostic tools expands. This will result in a growing need for both medical and surgical treatment and stimulate the development of new diagnostic and surgical techniques. This article briefly describes the prevalence, pathogenesis and clinical presentation of patients with aortic stenosis and focuses on developments in diagnostic tools, treatment strategies and treatment modalities: the use of echocardiography, tissue Doppler imaging, stress testing and biomarkers is discussed, as well as timing of surgery and the role microsimulation can play in prosthesis selection. Furthermore, newly developed transcatheter valve implantation techniques and their possible role in treating ‘inoperable’ or ‘elderly’ patients are discussed.

scholarly journals The Potential Association between the Risk of Post-Surgical Adhesion and the Activated Local Angiotensin II Type 1 Receptors: Need for Novel Treatment Strategies

2021 ◽  
pp. 1-8
Author(s):  
Mahmood Tavakkoli ◽  
Saeed Aali ◽  
Borzoo Khaledifar ◽  
Gordon A. Ferns ◽  
Majid Khazaei ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Molecular Mechanisms ◽  
Transforming Growth Factor ◽  
Therapeutic Potential ◽  
Angiotensin Receptor Blockers ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Transforming Growth Factor Β

<b><i>Background:</i></b> Post-surgical adhesion bands (PSABs) are a common complication after abdominal or pelvic surgeries for different reasons like cancer treatment. Despite improvements in surgical techniques and the administration of drugs or the use of physical barriers, there has only been limited improvement in the frequency of postoperative adhesions. Complications of PSAB are pain, infertility, intestinal obstruction, and increased mortality. The most important molecular mechanisms for the development of PSAB are inflammatory response, oxidative stress, and overexpression of pro-fibrotic molecules such as transforming growth factor β. However, questions remain about the pathogenesis of this problem, for example, the causes for individual differences or why certain tissue sites are more prone to post-surgical adhesions. <b><i>Summary:</i></b> Addressing the pathological causes of PSAB, the potential role of local angiotensin II/angiotensin II type 1 receptors (AngII/AT1R), may help to prevent this problem. <b><i>Key Message:</i></b> The objective of this article was to explore the role of the AngII/AT1R axis potential to induce PSAB and the therapeutic potential of angiotensin receptor blockers in the prevention and treatment of PSAB.

scholarly journals Pathogenesis and management of gastrointestinal inflammation and fibrosis: from inflammatory bowel diseases to endoscopic surgery

2021 ◽  
Vol 41 (1) ◽  
Author(s):  
Kentaro Iwata ◽  
Yohei Mikami ◽  
Motohiko Kato ◽  
Naohisa Yahagi ◽  
Takanori Kanai
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Tissue Repair ◽  
Relevant Literature ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Extended Resection ◽  
Bowel Diseases ◽  
Technical Advances ◽  
Inflammatory Bowel

AbstractGastrointestinal fibrosis is a state of accumulated biological entropy caused by a dysregulated tissue repair response. Acute or chronic inflammation in the gastrointestinal tract, including inflammatory bowel disease, particularly Crohn’s disease, induces fibrosis and strictures, which often require surgical or endoscopic intervention. Recent technical advances in endoscopic surgical techniques raise the possibility of gastrointestinal stricture after an extended resection. Compared to recent progress in controlling inflammation, our understanding of the pathogenesis of gastrointestinal fibrosis is limited, which requires the development of prevention and treatment strategies. Here, we focus on gastrointestinal fibrosis in Crohn’s disease and post-endoscopic submucosal dissection (ESD) stricture, and we review the relevant literature.

scholarly journals Posoncological Cutaneous Reconstruction of Penis with Scrotum Flaps about a Case

2019 ◽  
Vol 5 (2) ◽  
pp. 4-8
Author(s):  
Humberto Miguel Pontillo ◽  
◽  
Jhorbet C. Rodríguez Castillo ◽  
Tolentino Dos Santos ◽  
Keyword(s):  
Skin Flap ◽  
Cell Cancer ◽  
Surgical Techniques ◽  
Psychological Trauma ◽  
Developed Countries ◽  
Inguinal Lymph Node Dissection ◽  
Inguinal Lymphadenectomy ◽  
Skin Reconstruction ◽  
Keywords Cancer ◽  
The Developed Countries

!Objective: The penile cancer is a rare entity in the developed countries and its incidence increases in the developing countries, achieving up to 10% of the malignancies in men. There is a crucial association with the HPV, in the same way it relates to inadequate hygiene habits and the phimosis. The objective of the surgical treatment is resection with adequate margins, and the inguinal lymph node dissection when indicated. The restore skin coverage in these lesions is a challenge for the surgeon, as it seeks to achieve a phallus almost normal appearance, and restore the patient's tactile and the erogenous function, with the fewest possible interventions, trying to minimize the psychological trauma. Previously, many of these patients were considered inoperable and were recommended to radiation therapy to cure the injury. The evolution of the plastic surgical techniques using skin or the myocutaneous flaps, have provided the surgeon another option to keep the local oncological control with acceptable morbidity. Clinical Case: The aim of this paper is to present the case of a 56 years old male patient with diagnostic of squamous cell cancer of the penis stage II, who underwent the penile stripping, with bilateral inguinal lymphadenectomy; and rotation flap reconstruction of the scrotal skin. We found no published paper about the skin reconstruction of penile skin flap from scrotum for cancer patients, hence the importance of this work. Keywords: Cancer, Penile, HPV, Reconstruction, Faloplastia.

scholarly journals European refugee crisis: psychological trauma of refugees and care givers

2018 ◽  
Vol 14 (1) ◽  
pp. 106-116 ◽  
Author(s):  
Irena Papadopoulos ◽  
Sue Shea
Keyword(s):  
Social Issues ◽  
Psychological Impact ◽  
Psychological Trauma ◽  
Well Being ◽  
Psychological Support ◽  
Refugee Crisis ◽  
Emotional Trauma ◽  
Content Type ◽  
Rescue Workers ◽  
Care Givers

Purpose In recent years, the number of refugees and migrants entering Europe has increased dramatically. Such trauma may affect not only refugees themselves, but also care givers and rescue workers. The purpose of this paper is to discuss the intensity and psychological impact of the refugee crisis, with a view to suggesting ways of moving forward. Design/methodology/approach Based on recent literature, this paper briefly looks at the importance of attention to health and social issues, before discussing the psychological trauma of refugees and potential emotional trauma of those involved in rescue operations. Findings The provision of psychological support which is both compassionate and culturally competent should be viewed as essential. Furthermore, the development of resources and tools to assist with the current refugee crisis could enable care givers, rescue workers, and healthcare professionals to provide psychological support to migrants and refugees. Such resources could also encourage, and support, frontline responders in caring for their own personal psychological well-being. Originality/value The content of this paper could help to encourage further research in this field, including research into the emotional trauma of rescue workers. Furthermore, it is intended that this paper could contribute to an on-line knowledge base when considering the development of tools and resources to assist with the current refugee crisis.

The Colon, Appendix, Rectum, and Anus

2017 ◽  
Author(s):  
Daniel I. Chu ◽  
Margaret M Romine
Keyword(s):  
Colorectal Surgery ◽  
Water Absorption ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Vascular Anatomy ◽  
Lymphatic Drainage ◽  
Structural Features ◽  
Intestinal Wall ◽  
Clear Understanding ◽  
Functional Features

The colon, appendix, rectum, and anus have unique anatomic features, both structural and functional, that contribute to normal and pathologic states. Structural features discussed in this review include the layers of the intestinal wall, vascular anatomy, lymphatic drainage, and innervation. Functional features highlighted include the role(s) each organ plays in immunity, nutrient absorption, electrolyte secretion, water absorption, continence, and elimination of waste. A clear understanding of these structural and functional details is the foundation on which surgical techniques and treatment strategies are based when addressing surgical pathology. Key words: anus, appendix, colon, colorectal pathology, colorectal surgery, rectum

Aortic Regurgitation in Patients with Left Ventricular Assist Devices

2019 ◽  
pp. 338-344
Author(s):  
Marisa Cevasco ◽  
Koji Takeda ◽  
Masahiko Ando ◽  
Yoshifumi Naka
Keyword(s):  
Surgical Techniques ◽  
Treatment Strategies ◽  
Aortic Insufficiency ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist

Aortic insufficiency (AI) occurs as a complication in 25% to 37% of cases that receive left ventricular assist devices (LVAD). The incidence increases after implant by 1% to 6% per month of continued support. Uncertainty remains over the appropriate management of pump speeds to help delay this deterioration (complete emptying versus allowing native ventricular function open the aortic on a regular basis). Significant AI can lead to hemodynamic impairment with adverse outcomes over time. Due to the recirculation of blood, the calculated cardiac output of the LVAD may be markedly skewed. A number of surgical techniques have been proposed for the prevention and management of AI in the setting of LVAD therapy. This chapter details the causes, treatment strategies, and outcomes associated with this complication.

scholarly journals A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine

2020 ◽  
pp. 219256822093990 ◽  
Author(s):  
Murray Echt ◽  
William Ranson ◽  
Jeremy Steinberger ◽  
Reza Yassari ◽  
Samuel K. Cho
Keyword(s):  
Systematic Review ◽  
Thoracolumbar Spine ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Compression Fracture ◽  
Deformity Correction ◽  
Preventive Treatment ◽  
Cement Augmentation ◽  
Mineral Density ◽  
Junctional Kyphosis

Study Design: Systematic review Objectives: Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-known complications after long-segment fusions in the thoracolumbar spine of osteoporotic patients. Recent advances in anti-resorptive and anabolic medications, instrumentation, surgical technique, and cement augmentation have all aided in the avoidance of junctional kyphosis. In this article, current literature on the prevention of PJK and PJF in the osteoporotic spine is reviewed. Methods: A systematic literature review was conducted using the PubMed/MEDLINE and Embase databases in order to search for the current preventive treatment methods for PJK and PJF published in the literature (1985 to present). Inclusion criteria included (1) published in English, (2) at least 1-year mean and median follow-up, (3) preoperative diagnosis of osteoporosis, (4) at least 3 levels instrumented, and (5) studies of medical treatment or surgical techniques for prevention of junctional kyphosis. Results: The review of the literature yielded 7 studies with low levels of evidence ranging from level II to IV. Treatment strategies reviewed addressed prophylaxis against ligamentous failure, adjacent vertebral compression fracture, and/or bone-implant interface failure. This includes studies on the effect of osteoporosis medication, cement augmentation, multi-rod constructs, and posterior-tension band supplementation. The role of perioperative teriparatide therapy maintains the highest level of evidence. Conclusions: Perioperative teriparatide therapy represents the strongest evidence for preventive treatment, and further clinical trials are warranted. Use of cement augmentation, sublaminar tethers, and multi-rod constructs have low or insufficient evidence for recommendations. Future guidelines for adult spinal deformity correction may consider bone mineral density–adjusted alignment goals.

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