Stories about: trauma

What we’ve been reading: Week of March 9, 2015

book in field









Protection Without a Vaccine (The New York Times)
Scientists at the Scripps Research Institute have successfully used a type of gene therapy to make monkeys resistant to HIV. Could this be applied to other diseases for diseases for which there is no vaccine?

More about that doctor shortage, er, poor distribution of physicians (The Washington Post)
On Tuesday, the American Association of Medical Colleges released a report predicting a national physician shortage of 90,000 doctors by 2025. But it may be that we have more of a distribution problem than a volume problem; we need more incentives for doctors to practice in medically underserved areas.

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Who is most at risk for PTSD after trauma? Lessons from the Boston Marathon bombings

PTSD risk in adolescents after Boston Marathon bombingsDaniel Busso, MSc, is a doctoral student at the Harvard Graduate School of Education and a researcher in the Sheridan Laboratory at Boston Children’s Hospital.

More than 60 percent of teenagers have experienced a traumatic event in their lifetime, but only a minority will develop post-traumatic stress disorder (PTSD). For both researchers and clinicians, this raises an important question: Why are some youth at greater risk for mental health problems after trauma? As our lab reports in two recent studies, conducted after the 2013 Boston Marathon bombings, the answer may lie in our neurobiology.

PTSD, which includes intrusive memories, increased anxiety and difficulty concentrating or sleeping, has been linked to a variety of psychosocial and biological risk factors, such as prior experiences of trauma or a history of mental health problems. Other studies suggest that disruptions to the body’s stress response system, or in patterns of brain activity when responding to threat, may predispose people to the disorder.

However, a common problem in this research is that biological and mental health data are collected only once, usually long after the traumatic event itself,

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Tourniquets go from combat to kids

(Scott Foresman/Wikimedia Commons)
(Scott Foresman/Wikimedia Commons)
In the aftermath of the Boston Marathon bombings, first responders did whatever they could to help victims. For many of those injured, tourniquets proved to be the difference between saving and losing a limb—or a life.

“There’s no doubt that tourniquets played a key role in treating the bombing victims,” says Boston Children’s Hospital Trauma Center Director David Mooney, MD.

Two children who were later treated at Boston Children’s had tourniquets applied at the site of the tragedy. One arrived with extensive lacerations caused by one of the two detonated bombs. The other was in worse condition, having suffered blood vessel damage among other problems. Both children are doing better, although one will require further treatment.

Dating back to Roman times, a simple tourniquet, encircling a limb just above a wound, was the go-to method to stop bleeding. Since then, tourniquets have been used on the battlefield and in emergency rooms and operating rooms. However, had the bombings taken place 10 or 15 years ago, those wounded might not have been treated with tourniquets, Mooney believes.

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The power of numbers: Rules for reining in the use of CT scans

When does a trauma patient need a CT scan? Clinical rules could help doctors decide, and in the process help reduce a child's lifetime radiation exposure. (Image: Andrew Ciscel/Flickr)

The use of computed tomography (CT) scans has dramatically changed the practice of medicine in the past two decades. Patients with abdominal pain are no longer routinely admitted for serial abdominal exams to evaluate for appendicitis, because now we can just get the CT. Children with head trauma may need less hospital observation time in the emergency department (ED), because we can just get the CT.

But “just getting the CT” comes with costs, not just medical healthcare dollars spent but the costs associated with lethal malignancies in the future caused by the radiation used in the course of CTs.

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