[Dutch Military Casualties of the War in Afghanistan – Quality of Life and Level of Participation After Rehabilitation].

[Dutch military casualties of the war in Afghanistan – Quality of life and level of participation after rehabilitation].

Filed under: Rehab Centers

Ned Tijdschr Geneeskd. 2012; 155(35): A4233
de Kruijff LG, Mert A, van der Meer A, Huizinga EP, de Wissel MJ, van der Wurff P

To describe the distribution of injuries and the quality of life and functioning at activity and participation level of rehabilitated Dutch military personnel who were wounded during the mission to Afghanistan.Retrospective, descriptive.The study population consisted of military war casualties who followed multidisciplinary rehabilitation treatment for injuries sustained in combat in Afghanistan. Distribution and degree of injuries were classified according to the ‘Abbreviated Injury Scale’ (AIS) and the ‘Injury Severity Score’ (ISS). Quality of life and functional disabilities were assessed with a semi-structured interview, and the following questionnaires: EuroQol-5D with an extra dimension ‘cognition’ (EQ-6D), the ‘Assessment of Life Habits’ shortened version 3.0 (LIFE-H 3.0) and the ‘Lower Extremity Functional Scale'(LEFS). Coping style was assessed with the Cognitive Emotion Regulation Questionnaire’ (CERQ).A total of 48 servicemen cooperated. A total of 248 injuries; 54% of which affected the extremities. In 9 victims an amputation of the lower extremity was performed; 4 of them had to have a double amputation. 31 servicemen were still receiving specialist medical care at the time of the interview. 39 servicemen had to adjust their career plans. The mean quality of life, measured by EQ-5D, had an index score of 0.72 (Dutch population norm: 0.88). The mean score on the LEFS was 58 (maximum score 80). Changes in mobility and occupation appeared to be predictive factors for quality of life.The quality of life and functional level of Dutch military personnel who were injured in combat in Afghanistan seemed to be lower than in the general population after 2.3 years. For a large part this could be explained by the level of mobility and occupation.
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Effect of penetrating and blunt ocular trauma on the outcome of traumatic cataract in children in northern India.

Filed under: Rehab Centers

J Trauma Acute Care Surg. 2012 Sep; 73(3): 726-30
Ram J, Verma N, Gupta N, Chaudhary M

We studied the demographic profile and outcome of traumatic cataract after penetrating and blunt ocular trauma in children in northern India.We reviewed the medical records of children with penetrating and blunt ocular trauma associated with traumatic cataract who underwent cataract surgery with posterior chamber intraocular lens implantation and having more than 1 year follow up. We evaluated the demographic characteristics and visual outcome in the affected eye.Of the 100 children (100 eyes), 65 were penetrating trauma and 35 were blunt trauma. The common modes of injury in the penetrating group were wooden splinters in 30.8% and bow and arrow in 15.4%. Fire crackers and trauma during play with ball were seen in 34% and 11.4% of blunt eye trauma, respectively. The age ranged from 1 to 14 years (mean, 7.8 years) in the penetrating trauma and 2 to 15 years (mean, 8.3 years) in the blunt trauma group. The best corrected visual acuity of 20/40 or better was achieved in 57.6% eyes in penetrating group compared with 71.4% in the blunt trauma group. Visually significant posterior capsular opacification developed in 32.3% eyes in penetrating group and 28.6% eyes in blunt trauma group. Glaucoma was diagnosed in 4.6% eyes in penetrating group and 8.6% in blunt trauma group.Eye injuries with traumatic cataract are associated with significant visual impairment. There were more children with penetrating eye injuries as compared with blunt trauma. Cataract surgery with intraocular lens implantation is a preferred method for visual rehabilitation in these children.Epidemiologic study, level IV.
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The hammock effect of wheelchair cushion covers: Persistent redness over the ischial tuberosities in a patient with spinal cord injury – A case report.

Filed under: Rehab Centers

J Tissue Viability. 2012 Aug 25;
Morita T, Tujimura K, Matsuda K, Yamada T

We report a case of a 28-year-old man with a complete C5 level spinal cord injury who developed persistent redness over his ischial tuberosities due to his wheelchair cushion cover’s hammock effect. He had purchased wheelchairs and cushions in 2004 and 2008. Persistent redness occurred over his ischial tuberosities when using the second cushion purchased in 2008. Pressure mapping did not detect any differences in pressure over the ischial tuberosities with different cushions. When comparing cushions without their covers, we noticed that the first cushion had a greater air volume than the second cushion. We exchanged the cushion covers to evaluate the hammock effect due to different covers. We found that the redness occurred at any time the second cushion cover was used. After the patient’s family changed the top of the second cushion cover to a more elastic material, the redness resolved. As we were unable to detect the influence of the hammock effect using pressure mapping, it would be useful to develop an alternative method to evaluate this phenomenon. It would also be valuable to find a readily available solution for other patients experiencing this problem.
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