Trauma and Posttraumatic Stress Disorder Among Transition-Age Youth With Serious Mental Health Conditions.

Trauma and Posttraumatic Stress Disorder Among Transition-Age Youth With Serious Mental Health Conditions.

J Trauma Stress. 2013 May 20;
Frounfelker R, Klodnick VV, Mueser KT, Todd S

There is little information on trauma, posttraumatic stress disorder (PTSD), and associated risk factors in transition-age youth with mental health conditions. This study aimed at understanding the correlates and predictors of PTSD in 84 transition-age youth, between 16 and 21 years old, residing in supported community housing. Chi-square analyses and t tests were used to compare youth with a diagnosis of PTSD to those without a PTSD diagnosis. Stepwise logistic regression analyses were performed to identify unique predictors of PTSD. Of the 84 individuals, 79 (94%) reported a history of trauma, of whom 30 (36%) had PTSD. Sexual abuse was significantly associated with a PTSD diagnosis (r = .47) and the only unique predictor of PTSD (Cox r(2) = .20). Transition-age youth in supported community housing had higher rates of trauma exposure and PTSD than the general adolescent population, suggesting the need for routine assessment and treatment of PTSD in this population. HubMed – rehab


Report of a patient with developmental delay, hearing loss, growth retardation, and cleft lip and palate and a deletion of 7q34-36.1: Review of distal 7q deletions.

Am J Med Genet A. 2013 May 21; 0
Rush ET, Stevens JM, Sanger WG, Olney AH

The use of aCGH has improved our ability to find subtle cytogenetic abnormalities as well as to find more precise information in patients with previously known abnormalities. In addition, it has allowed more specific genotype-phenotype correlation. In this report we describe a patient with a chromosomal deletion initially diagnosed with conventional cytogenetic analysis which was redemonstrated and more specifically described upon aCGH analysis. Our patient is a 12-year-old female born to a 26-year-old G1P0 mother. She was noted as a neonate to have a bilateral cleft lip and cleft palate, abnormal external ears, dysmorphic facies, and moderate to severe hearing loss. She has subsequently shown developmental delay, hyperreflexia, seizures, hyperactivity, and absence of speech. Chromosomal analysis showed deletion of 7q34q36.1. FISH studies confirmed the deletion was interstitial. Parental chromosomes were performed and did not show any cytogenetic abnormalities. aCGH was recently performed for the patient to further characterize the breakpoints of the deletion and confirmed the deletion was interstitial and of 13.2?Mb in size. Both proximal and terminal 7q deletion show a different phenotype than that of our patient. A number of patients with similar deletions have been found and while significant variability is observed, a number of findings appear to be common to deletions in this region. Therefore, we feel that distal interstitial deletions of chromosome 7q represent a recognizable phenotype and could be considered a separate deletion syndrome. © 2013 Wiley Periodicals, Inc. HubMed – rehab


The Rate of Sural Nerve Violation Using the Achillon Device: A Cadaveric Study.

Foot Ankle Int. 2013 Jan 31;
Aibinder WR, Patel A, Arnouk J, El-Gendi H, Korshunov Y, Mitgang J, Uribe J

BACKGROUND: Management of acute Achilles tendon rupture remains controversial. Open repair results in lower rerupture rates but is associated with complications from wound healing. Percutaneous and limited open repairs minimize soft tissue complications; however, there is a theoretical increased risk of sural nerve injury. We evaluated the risk of sural nerve violation with the Achillon limited open repair device in cadavers. METHODS: This cadaveric study consisted of 2 parts. The first part evaluated the frequency and location of sural nerve violation using the standard Achillon protocol in 18 intact embalmed left lower limbs. The second part involved device manipulation with 30 degrees of either internal or external rotation in 13 paired, intact embalmed lower limbs. RESULTS: In the first part, 5 of 18 specimens had at least 1 suture passing through the sural nerve. Eight of the 54 needle passes (14.8%) directly pierced the substance of the sural nerve. With internal rotation, 8 of 13 specimens had at least 1 violation of the nerve. Ten of the 39 needle passes (25.6%) directly pierced the substance of the sural nerve. With external rotation, no nerves were violated, significantly decreasing the risk of sural nerve violation versus neutral (P = .038) and internal rotation (P = .001). When sural nerve violation was evaluated in regard to instrument outlet, there was a higher risk in the proximal needle passer (outlet no. 3) compared with the distal needle passer (outlet no. 1) with both neutral testing and internal rotation (P = .027). CONCLUSION: This study demonstrated the potential risk for sural nerve injury using the Achillon device. CLINICAL RELEVANCE: External rotation of the Achillon decreased the rate of sural nerve violation. This may optimize its use in Achilles tendon repairs. HubMed – rehab


High-dose thiamine improves the symptoms of fibromyalgia.

BMJ Case Rep. 2013; 2013:
Costantini A, Pala MI, Tundo S, Matteucci P

Living with fibromyalgia means living with chronic pain, fatigue, sleep disorders and other associated key symptoms. To date, pharmacotherapy generally produces modest benefits. Some observations indicate that the large majority of symptoms of fibromyalgia could be the clinical manifestation of a mild thiamine deficiency due to a dysfunction of the active transport of thiamine from the blood to the mitochondria or to enzymatic abnormalities. Between June and July 2011, we recruited three female patients affected by fibromyalgia. We proceeded with the study of the patients’ history, a physical examination, an evaluation of chronic widespread pain using the Visual Numeric Scale and an evaluation of the fatigue using the Fatigue Severity Scale were also performed. The levels of thiamine and thiamine pyrophosphate in the blood were determined. After the therapy with high doses of thiamine, in the patients, there was an appreciable improvement of the symptoms. HubMed – rehab