The ENT problems following the Birmingham bombings

Pahor, A. L.

doi:10.1017/s0022215100090873

Cited by 68 publications

(74 citation statements)

References 12 publications

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“…Hurricanes, tornados, and other weatherrelated disasters can be equally dangerous, often resulting in traumatic injuries as well as frequent minor injuries, with the most common being lacerations, blunt trauma, and puncture wounds (Shultz, Russell, & Espinel, 2005). Terrorist bombings may cause distinctive patterns of injury such as eardrum perforation (Pahor, 1981;Turegano-Fuentes et al, 2008). A common health hazard of human-made disasters is the release of disease agents or noxious substances, which is often the case in large-scale terrorist attacks, as was poignantly illustrated in the 1995 sarin gas attack on the Tokyo subway system.…”

Section: Injury-related Health Problemsmentioning

confidence: 99%

Weighing the Costs of Disaster

Bonanno

Brewin

Kaniasty

et al. 2010

Psychol Sci Public Interest

909

443

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SummaryDisasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research-studies that use prospective designs or include multivariate analyses of predictor and outcome measures-relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention.1. Disasters cause serious psychological harm in a minority of exposed individuals. People exposed to disaster show myriad psychological problems, including PTSD, grief, depression, anxiety, stress-related health costs, substance abuse, and suicidal ideation. However, severe levels of these problems are typically observed only in a relatively small minority of exposed individuals. In adults, the proportion rarely exceeds 30% of most samples, and in the vast majority of methodologically sound studies, the level is usually considerably lower. Among youth, elevated symptoms are common in the first few months following a high-impact disaster, but again, chronic symptom elevations rarely exceed 30% of the youth sampled.2. Disasters produce multiple patterns of outcome, including psychological resilience. In addition to chronic dysfunction, other patterns of disaster outcome are typically observed. Some survivors recover their psychological equilibrium within a period ranging from several months to 1 or 2 years. A sizeable proportion, often more than half of those exposed, experience only transient distress and maintain a stable trajectory of healthy functioning or resilience. Resilient outcomes have been evidenced across different methodologies, including recent studies that identified patterns of outcome using relatively sophisticated data analytic approaches, such as latent growth mixture modeling.3. Disaster outcome depends on a combination of risk and resilience factors. As is true for most highly aversive events, individual differences in disaster outcomes are informed by a number of unique risk and resilience factors, including variables related to the context in which the disaster occurs, variables related to proximal exposure during the disaster, and variables related to distal exposure in the disaster's aftermath. Multivariate studies indicate that there is no one single dominant predictor of disaster outcomes. Rather, as with traumatic life events more generally, most predictor variables exert small...

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Section: Injury-related Health Problemsmentioning

confidence: 99%

Weighing the Costs of Disaster

Bonanno

Brewin

Kaniasty

et al. 2010

Psychol Sci Public Interest

909

443

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“…Some investigators have suggested that dizziness and imbalance are a result of CNS damage caused by TBI [55][56]; however, dizziness and imbalance can result from damage by the blast wave to the peripheral vestibular system and not from the head injury itself. Vestibular injury can occur to one or both ears and may affect the sensory organs, the vestibular nerve, or other components of the vestibular pathway.…”

Section: Labyrinthine Damagementioning

confidence: 99%

Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

Fausti¹,

Wilmington²,

Gallun³

et al. 2009

JRRD

185

117

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Abstract-The dramatic escalation of blast exposure in military deployments has created an unprecedented amount of traumatic brain injury (TBI) and associated auditory impairment. Auditory dysfunction has become the most prevalent individual service-connected disability, with compensation totaling more than 1 billion dollars annually. Impairment due to blast can include peripheral hearing loss, central auditory processing deficits, vestibular impairment, and tinnitus. These deficits are particularly challenging in the TBI population, as symptoms can be mistaken for posttraumatic stress disorder, mentalhealth issues, and cognitive deficits. In addition, comorbid factors such as attention, cognition, neuronal loss, noise toxicity, etc., can confound assessment, causing misdiagnosis. Furthermore, some auditory impairments, such as sensorineural hearing loss, will continue to progress with age, unlike many other injuries. In the TBI population, significant clinical challenges are the accurate differentiation of auditory and vestibular impairments from multiple, many times overlapping, symptoms and the development of multidisciplinary rehabilitation strategies to improve treatment outcomes and quality of life for these patients.

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“…25 This finding has led some authors to suggest that early operative intervention may be warranted in patients with large perforations that are unlikely to heal. Location of the perforation also affects healing rates.…”

Section: February Supplement 2008mentioning

confidence: 99%