Incidence Of Trauma Research Articles

The Hidden Toll: Exploring the Impact of Challenging Patron Behaviors on Australian Public Library Staff

ABSTRACT As a public-facing profession, public library workers are often exposed to challenging behaviors that raise concern for their safety. To understand these concerns, this study explores these staff safety issues in Australian public libraries through semi-structured interviews with 59 staff members from six library services. Findings reveal that library workers frequently encounter challenging and sometimes violent behaviors from patrons. These incidents impact staff wellbeing, causing stress, anxiety, and potential long-term psychological effects. Many workers receive insufficient workplace support following traumatic incidents, leading to internalization of the trauma the experiences cause. The study highlights the need for improved institutional support and better safety measures. It also recognizes the tension created by libraries’ open-door policies, which may expose workers to potential harm.

Pyoderma Gangrenosum-like Ulcers Associated Granulomatosis with Polyangiitis

Granulomatosis with polyangiitis is an ANCA-positive vasculitis primarily affectingsmall to medium-sized vessels, typically involving the lungs and kidneys. This articlepresents a remarkable case of a patient with an unusual pyoderma gangrenosum-likeulcer on the face and granulomatosis with polyangiitis. A 28-year-old man, previouslydiagnosed with granulomatosis with polyangiitis, presented at a dermatology clinic with a 6-month-old ulcer in the right preauricular region following a traumatic incident. A spindle biopsy revealed suppurative granulomatous dermatitis with secondary vascular damage, while cultures showed no signs of infection. The patient was subsequently treated with rituximab, leading to a positive clinical response. This case underscores the challenge of diagnosing this rare manifestation of granulomatosis with polyangiitis and suggests that rituximab could be a valuable treatment option.

Epidemiological analysis of 2106 geriatric trauma patients in a level I trauma center in Lanzhou City, Gansu Province, China.

As the global population ages, geriatric trauma gains attention. Limited studies on geriatric trauma in developing countries necessitate comprehensive investigation. This study aims to delineate the epidemiological characteristics of geriatric trauma, providing insights for prevention and enhanced elderly trauma care. Clinical data of 2106 geriatric trauma patients (age ≥ 60) treated from November 1, 2020, to October 31, 2023, at the trauma center of the First Hospital of Lanzhou University were retrospectively analyzed. Descriptive statistics covered temporal and monthly distribution, trauma sites, causes, and length of stay. Inclusive were 2106 geriatric patients (941 males, 1165 females; male-to-female ratio 1:1.24). Trauma incidence was higher in summer and autumn (May-October) than winter (November-December). Peak incidents occurred between 14:00-16:00, with concentrations at 12:00-16:00 and 20:00-22:00. Falls (59.35%), road traffic accidents (16.62%), other traumas (14.10%), cutting/stabbing (4.56%), violence (3.42%), mechanical injuries (1.61%), winter sports injuries (0.14%), burns (0.14%), and animal bites (0.06%) were major causes. Extremity and skin injuries prevailed, with significant site distribution differences (P < .001). Average length of stay at the trauma center was 78.35 ± 48.32 minutes. The gender distribution, timing, causes, and sites of trauma in the elderly differ significantly from other age groups. Unlike the higher occurrence of trauma in young men compared to women, among the elderly, it is more prevalent in women than men, mainly attributed to falls. It is crucial to implement specific measures to prevent trauma in the elderly, and the advancement of information technology in the trauma care system could additionally improve the quality of care.

Examining the relationship between religious volunteering and mental health screeners among firefighters

ABSTRACT Firefighters experience a high level of traumatic incidents in their work. This high level of exposure puts them at risk for trauma-related symptoms. These trauma symptoms include PTSD, suicide risk, alcohol misuse, and depression, and anxiety. Furthermore, repeated exposure has been found to lead to desensitization, flashbacks, irritability, and PTSD. Exposure to natural disasters may also impact ecospirituality. A survey was designed to include the Life Events Checklist, PHQ-9, GAD-7, PCL-5, and the SBQ-R. This survey was administered to firefighters from Northwest Florida in the fall of 2020 and spring of 2021. Participants were found to have higher levels of PTSD, anxiety, depression, and suicidal risk than the general population. Participants were further asked about their volunteering for religious organization activity. A significant relationship was found between volunteering for religious organization and mental health screeners. Religious volunteering predicted lower levels of PTSD symptoms, depression, and anxiety. The effect size was small.

Contemporary issues of the birth trauma

Background. Birth trauma is a group of diseases caused by mechanical factors during childbirth. Birth trauma is an interdisciplinary problem, affecting various fields of medicine, such as obstetrics, pediatrics, child neurology and other sciences. Birth trauma occupies an important place in the structure of perinatal morbidity and mortality. Birth injuries of newborns during vaginal birth occur in 3.6% of cases, during cesarean section — in 1.2%. However, at present, despite a comprehensive study of the problem, the incidence of birth trauma in newborns remains high. Along with obstetric birth trauma, spontaneous birth trauma also occurs — not associated with any obstetric care.Purpose of review. To summarize and analyze the available data on the causes of birth trauma in newborns depending on the type of birth injury.Materials and methods. The review includes published data over the past 10 years regarding the study of the causes of the main types of birth injuries in newborns. The literature search was conducted in Web of Science, Google Scholar, PubMed, and ELibrary databases.Results. The problem of fetal-pelvic disproportion in the genesis of the development of risk factors for maternal-fetal trauma remains relevant. Fetal macrosomia is one of the most significant factors in birth trauma. The most common skull injury in newborns is cephalohematoma. According to the mechanism of occurrence, birth trauma is divided into spontaneous — occurring during physiological childbirth — and obstetric — associated with any obstetric benefits. The degree of configuration of the fetal head plays a significant role in the pathogenesis of birth trauma. Birth trauma is considered as a systemic reaction on the part of the newborn’s body, which leads to a breakdown of compensatory and adaptive mechanisms and the development of critical damage to the central nervous system and is differentiated from birth damage, which includes only local changes.Conclusion. To search for preventive measures aimed at preventing birth injuries in newborns, it is necessary to systematize the groups of causes that influence the increased risk of birth injury. Timely assessment of the pathological configuration of the fetal head is extremely important when deciding on the advisability of using obstetric aids during vaginal operative delivery, since it is an early predictor of the formation of fetal-pelvic disproportion — a significant factor in birth trauma in the newborn. In recent years, taking into account the active study of molecular genetic mechanisms in the genesis of the formation of various pathological conditions, the search for various genetic and epigenetic factors that influence the risk of developing birth traumatic injuries in a newborn against the background of individual susceptibility to the effects of any physical factors during childbirth.

Relationship between trauma, post-traumatic stress and post-traumatic growth for police officials: A path analysis

Background &amp; Objective: Police officials tend to face a high frequency of potentially traumatic incidents due to nature of their job. A dichotomous distinction among these traumatic incidents is witnessing of threat or harm to others and the experiencing of threat or harm directly to oneself. Previous research suggests that different types of traumas (direct and indirect) exposure can produce different levels of negative responses including posttraumatic stress disorder (PTSD) symptoms and positive outcomes such as posttraumatic growth (PTG) in police officials and other law enforcement agencies officials. Our objective was to study post-traumatic stress and post traumatic growth among police officials. Methods: In this cross-sectional study conducted from January 2019 to December 2022. The sample consisted of 400 police officials (having direct and indirect exposure of war trauma) who participated in war on terror in FATA Pakistan. Non probability purposive sampling technique was used for sample selection. Relationship among trauma, PTS (Post traumatic stress) and PTG (Post traumatic growth) was assessed. Results: Findings from the present study indicated that stress played vital role in paving pathway from trauma to growth (β =0.08). Study results also confirmed that moderate level of stress is linked with positive changes like posttraumatic growth. R-square change in linear relationship among stress and posttraumatic growth was 0.59 but in curvilinear relationship among stress and posttraumatic growth R-square change was 0.77 which is higher than linear relationship which confirmed the curvilinear relationship between stress and growth and these findings proved that moderate level of stress after war trauma exposure produced higher levels of post traumatic growth. Conditional indirect effect of exposure to trauma on growth is highly significant (***p &lt; .001) so the role of stress as mediator has been confirmed. Conclusion: The study provided initial evidence that after trauma exposure levels of posttraumatic stress which is experienced play a significant role in the promotion of PTG. Moreover, the results from the present study also revealed the possibility of positive changes in behaviors facilitated by moderate exposure of trauma and stress. doi: https://doi.org/10.12669/pjms.40.10.8897 How to cite this: Azeem A, Kiran N. Relationship between trauma, post-traumatic stress and post-traumatic growth for police officials: A path analysis. Pak J Med Sci. 2024;40(10):2223-2227. doi: https://doi.org/10.12669/pjms.40.10.8897 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Exploring the nexus between post-traumatic stress disorder and patriarchy: a gender-based variation

Respected Editor, Post-traumatic stress disorder (PTSD) is a psychological disorder resulting from witnessing or experiencing trauma, aggravated by repeated exposure to stress and anxiety. We aim to highlight the underrepresentation of PTSD in a third-world country, its gender-specific variations, and its disproportionate prevalence in women in a male-dominated society. According to recent studies, gender-based differences in PTSD are reported as 2:1, favouring women. Statistics reveal that men face more traumatic incidents, ranging from violence, bloodshed, and natural disasters.1. Yet women are more susceptible to PTSD because men, encountering such occurrences regularly, perceive it as a norm and find it easier to cope with it than their female counterparts, who happen to have a more significant post-trauma recovery time, which may be a result of fluctuating gonadal hormone levels in young females, as hypothesized by recent studies.2 Furthermore, Pimlott-Kubiak’s theory of trauma and PTSD (2003) suggests that patriarchy exacerbates mental health disorders in women as a vast majority of victims of abuse happen to have their spouses as assailants, categorizing as intimate partner violence.3 Being considered a taboo, women who have experienced assault are silenced due to stigmatization. They become a target of victim shaming and are discouraged from discussing the matter. With no therapy, self-blame ensues, along with a wide spectrum of symptoms of PTSD, like borderline personality disorder, flashbacks, eating disorders, disassociation, and depression, forcing the ‘labelled’ women to sever all positive connections and distance themselves from their loved ones due to fear of being judged.4 Complex Chronic PTSD may result from witnessing or experiencing assault since childhood in an abusive household from an aggressive male, which can trigger mental health issues when dealing with life's challenges as adults.5 Failing to find any discussion on this topic in medical research databases including PubMed and PakMediNet, solidifies our point that lack of awareness and research about the adverse effects of patriarchy on the mental health of women living in a developing country leads to a society where negligence prevails, fueling a vicious cycle of psychological disorders, passed on from generation to generation. Being a disorder that haunts victims for life, PTSD should be tackled with awareness, therapies, and emotional support to ensure a healthy life for all women. More research should be conducted to highlight this issue so that people can talk about such concerns more comfortably and the harm caused by PTSD in Pakistani society can be minimized.

6978 Traumatic Presentation Of A Pancreatic Neuroendocrine Tumor

Abstract Disclosure: C.J. Kahn: None. J. Mai: None. A.E. Cabrera: None. A.D. Anderson: None. D.H. Huynh: None. Background: Insulinomas are a subset of functional pancreatic neuroendocrine tumors associated with neuroglycopenic symptoms, fasting hypoglycemia, and rapid resolution of symptoms with glucose administration. Despite this classic presentation, patients often spend years undiagnosed before formal diagnosis and definitive management. Clinical Case: We report the case of a 37-year-old post-partum female with a history of gestational diabetes who presented to our trauma center after losing consciousness while driving and colliding with a utility pole. Emergency Medical Services reported seizure-like activity on the scene with altered sensorium. Her initial blood glucose level of 32 mg/dL improved to 100 mg/dL after 100 ml of 10% dextrose. Initial biochemical analysis obtained from the trauma bay demonstrated a negative serum ethanol level, negative urine toxicology and sulfonylurea level, and elevated C-peptide of 6.71 ng/mL. After stabilization, she underwent a 72-hour fasting test. At the 12-hour mark, she developed hypoglycemia (blood glucose 36 mg/dL) correlated with elevated insulin (28.8 mU/L), proinsulin (173.1 pmol/L), and C-peptide (7.86 ng/mL). Although an initial CT scan of the abdomen and pelvis did not demonstrate any pancreatic abnormalities, an abdominal MRI demonstrated a 13 mm lesion in the tail of the pancreas consistent with a pancreatic neuroendocrine tumor. She subsequently underwent a laparoscopic distal pancreatectomy during the same hospital admission and recovered expeditiously. Final pathology demonstrated a 10 by 15 mm, grade two, well-differentiated neuroendocrine tumor with negative margins. The specimen stained strongly positive for synaptophysin and chromogranin, consistent with the clinical diagnosis of insulinoma. During the patient's postoperative recovery, she had no further episodes of hypoglycemia and did not require insulin for post-pancreatectomy hyperglycemia. She was discharged home with a glucometer and a follow-up scheduled with endocrinology and general surgery. Conclusion: The presentation of patients with insulinomas can vary from vague, nonspecific symptoms to altered levels of consciousness placing patients in potentially lethal situations. Moreover, the insulin resistance experienced by pregnant patients may mask clinical manifestations of hypoglycemia during the peripartum period, making diagnosis more elusive for this population. A high index of suspicion along with prompt diagnosis, in this case, led to definitive surgical management, effectively preventing future traumatic incidents secondary to hypoglycemia. Reference: 1. Dobrindt EM, Mogl M, Goretzki PE, Pratschke J, Dukaczewska AK. Insulinoma in pregnancy (a case presentation and systematic review of the literature). Rare Tumors. 2021;13. doi:10.1177/2036361320986647 Presentation: 6/3/2024

Impact of the COVID-19 Pandemic on the Incidence, Etiology, Demographics, and Treatment of Craniomaxillofacial Trauma.

To compare the incidence, etiology, demographics, and treatment of craniomaxillofacial (CMF) trauma before, during, and after COVID-19. Retrospective cohort. Eighty-three health care organizations across the United States. The TriNetX Research Network identified 77,977,880 patients during 2017 to 2022. CMF fractures and soft tissue injuries during March to August of each year, aligning with the 2020 pandemic lockdown, were analyzed. In 2020, compared to immediately prepandemic in 2019, there were significant reductions of -17.5% in facial fractures and -19.0% in soft tissue injuries (P < .001). Conversely, in 2021, both injury types increased by +16.7% and +16.3%, respectively, compared to 2020 (P < .001). Changes in injury mechanisms in 2020 included significant decreases in athletic injuries (-57.6%), falls (-16.8%), assaults (-15.5%), motor vehicle collisions (-8.7%), and pedestrian accidents (-6.9%) (P < .01), while off-road vehicle (+48.4%), bicycle (+16.2%), and motorcycle (+8.9%) accidents increased (P < .01). The 10- to 14- and 5- to 9-year-old age groups experienced the most substantial reductions in facial fractures (-39.7% and -29.9%, respectively) and soft tissue injuries (-29.2% and -28.3%, respectively) in 2020 compared to 2019 (P < .001). Operative management of fractures and soft tissue injuries dropped by -20.3% and -12.4%, respectively, in 2020 versus 2019, and then rebounded with +15.8% and +14.6% increases in 2021 compared to 2020 (P < .001). In 2022, compared to prepandemic rates of 2019, there were fewer patients with facial fractures (-2.8%), soft tissue injuries (-4.5%), and operative repairs (-6.9% for fractures, -1.2% for soft tissue injuries) (P < .03). CMF trauma decreased in 2020, with subsequent years showing a rebound to levels slightly below those immediately prior to pandemic onset. Changes in etiology, demographics, and treatment highlight the complex dynamics of traumatic injuries during periods of societal disruption.

Autistic children and their parents in the context of war: Preliminary findings.

While existing literature on the intersection of trauma and autism is limited, emerging evidence suggests heightened vulnerability of autistic children to the psychological consequences of traumatic events, including an elevated risk of developing posttraumatic stress disorder (PTSD). Additionally, parents of autistic children often experience elevated levels of negative emotional states, compared to parents of typically developing children. This study investigates the impact of terrorism and war on autistic and non-autistic children and their parents, presenting preliminary results from the initial data collection phase of a year-long longitudinal investigation of the experience of autistic children and their parents following Hamas' 7 October 2023 attack on Israel. Data gathered within 30days of the initial attack reveal that both autistic and non-autistic children exhibited clinically significant post-traumatic stress symptoms, with autistic children demonstrating a more pronounced manifestation. Moreover, parents of autistic children reported significantly higher levels of depression, anxiety, and stress in the aftermath of the events, compared to an independent cohort of parents of autistic children assessed prior to the crisis. These results underscore the heightened susceptibility of autistic children to post-traumatic stress and the unique challenges confronted by their parents during times of conflict. The study highlights the imperative for tailored support services for autistic children and their families amidst traumatic incidents and stresses the need for further research in comparable contexts globally.

The Double 90 Rule: A New Strategy for Resuscitation in Non-academic Level II Trauma Centers

BackgroundEfficient resuscitation after trauma and shorter time to definitive hemorrhage control help improve trauma outcomes. We aimed to improve the speed and efficiency of resuscitation for critically ill trauma patients in the emergency department by involving interventional radiology and a second surgeon. Study DesignIn 2017 our community, non-academic level II trauma center implemented the Double 90 rule—for trauma patients with 2 confirmed systolic blood pressures less than 90 mm Hg—which involves a second activation including the interventional radiology team, backup trauma surgeon, and operating room charge nurse. We retrospectively reviewed our trauma registry to compare data for high-level trauma patients before (2016, “Pre-Dbl90”) and 3 consecutive years after intervention (2018-2020, “Dbl90”). ResultsAmong 613 patients who met criteria for our highest level of trauma activation, 100 either had activation of the Double 90 rule (Dbl90 patients, n=76) or met Double 90 rule criteria (Pre-Dbl90 patients, n=24). The groups were similar in age, sex, injury severity score, penetrating trauma incidence, and admission vitals. Median time to computed tomography decreased throughout the study period, from 34 minutes in 2016 to 18 minutes in 2020 (P<.001). Median time to first hemorrhage control procedure decreased from 118 minutes (2016) to 43 minutes (2020), (P=.013).Mean packed red blood cell transfusion decreased from 9.1 to 4.8 units (P = 0.016). Mortality rates were similar between groups. ConclusionThe Double 90 rule is effective for expediting trauma care starting in the emergency department, shortening the times to computed tomography, hemorrhage control intervention, and decreasing packed red blood cell transfusion.

Psychological Impact of Childhood Trauma on Adolescents: A Scoping Review

Violence experienced in childhood will lead to a period of crisis when a person is in adolescence. The crisis period that arises is unique to adolescence. Some adolescents become increasingly experiencing crises or problems when in childhood they experience an unpleasant event or even trauma. Traumatic experiences in childhood will have their own impact on adolescents. Objektive: This study aims to get a clear picture of the psychological impact of childhood trauma on adolescents. Methods: Researchers use the scoping review method. The literature search was conducted using the search keywords "adolescents" AND "psychological" AND "childhood" AND "trauma". The databases used were Sciencedirect, Scopus, and Pubmed. Inclusion criteria were articles reviewed from publications within the last 5 years (2019-2023), articles that were in English, quantitative and/or qualitative research with a study population of former adolescents who experienced childhood trauma, and the full article was accessible. Stepwise screening was conducted and documented according to the PRISMA flowchart. Results: Based on identification, there were 463 articles from search engines from sciencedirect, scopus, and pubmed. The final results obtained were 6 articles that fit the criteria after going through the selection process. Childhood trauma has psychological effects that can arise such as the impact of mental distress at risk of suicide, the impact of suicide, psychosis (mental disorders), psychiatric disorders in offspring, borderline personality disorder and the impact on internet addiction. Researchers used the PEO (population, exposure, outcome) question format to find related research articles. Conclusion: Based on the analysis of the 6 literatures that have been reviewed, it can be concluded that the incidence of childhood trauma in adolescents will have a psychological impact.

Dental trauma in primary dentition and possible outcomes on permanent successors

Objectives. The aim of this study is to determine if there is a correlation between a traumatic dental injury suffered by a deciduous tooth and the alterations that may appear in the structure of the permanent one. Materials and methods. For this narrative review, we collected articles written in English from PubMed, Scopus, and Embase. A total of 116 papers were assessed, with 20 included in the review. Results. The review found that there is a strong relationship between a traumatic incident suffered by the temporary tooth and the developmental disturbances that appear in the permanent successors. The majority of traumatic dental injuries take place around the age of 1-3 years, when the child is learning how to walk. The developmental disturbances that may appear are categorized as mild or severe, with the difference between them being the age of the child when the trauma occurred, the type of trauma, the degree of root resorption, and the force of the impact. Conclusion. The amount of injury to a primary tooth without address it when it happens has detrimental effects on the growth and emergence of permanent teeth, requiring more prolonged and costly treatment.

Incidence of Dentoalveolar Trauma and its Correlation with Temporomandibular Disorders – A Systematic Review

Abstract Temporomandibular disorders (TMDs) represent a diverse set of conditions affecting the temporomandibular joint, masticatory muscles and associated structures. Previous studies suggested a notable correlation between dentoalveolar trauma (DAVT) and the incidence of TMDs. This systematic review aims to further elucidate this relationship. A comprehensive search was conducted in electronic databases to identify relevant studies published up to 2023. The included studies investigated the association between DAVT and TMDs in diverse populations. Data were extracted based on study characteristics, participant demographics and key findings. The quality of the included studies was evaluated using the established assessment tools. Five studies were included in the final review. The studies revealed a strong association between DAVT and TMDs across different populations, including adolescents, students and high-contact sports practitioners. The correlation was evident in the form of significantly higher odds ratios, increased prevalence of specific TMD subtypes and more severe symptoms in individuals with a history of DAVT. Furthermore, the studies highlighted the significant role of high-contact sports and trauma history in TMD’s prevalence and severity. The findings from this systematic review provide compelling evidence of the significant correlation between DAVT and TMD. The results underline the importance of early detection and management of DAVT, particularly in high-risk groups such as high-contact sports practitioners, to prevent the development and progression of TMDs. Future research should focus on understanding the underlying mechanisms of this association and developing effective preventive and therapeutic strategies.

Analysis of moderate and severe traumatic brain injury associated with skull base fracture: a local tertiary center experience

BackgroundTraumatic brain injury (TBI) is a major medical and social concern in developing countries. TBI-related morbidity and mortality statistics in Egypt are lacking and do not reflect the actual magnitude of the problem.ObjectivesTo overview the incidence of moderate and severe head trauma in a heavily populated developing country and document the outcome of moderate and severe TBI associated with skull base fracture (SBF).MethodologyData of patients admitted to our center with moderate and severe TBI associated with skull base fracture (SBF) were reviewed in the period between January 2019 and March 2023.ResultsThe most common type of trauma was road traffic accidents in 54.2% of the patients; 91.2% had Single SBF (middle cranial fossa fracture was predominant 58.5%). 25.5% had an initial GCS of ≤ 8. Periorbital ecchymosis was the most common presenting sign in 36.3%. The most frequent complication (37.3%) was pneumocephalus. The presence of skull base fracture inversely affected the Glasgow outcome scale extended GOSE (P = 0.001, r = 0.674). Higher initial GCS scores were positively correlated with good GOSE (GOSE) (P = 0.001, r =− 0.222).ConclusionsRTA represents a significant cause for moderate and severe TBI in young male population. SBF is associated with poor outcome in moderate and severe TBI. Higher initial GCS score was positively correlated with good GOSE. It is important to have an overview of different types of TBI in Egypt.

Perimortem cesarean section after severe injury: What you need to know.

When pregnant patients are involved in traumatic incidents, the trauma clinician encounters two patients-both the mother and the unborn child. Advanced trauma life support dictates that the first priority is the life of the mother; however, there are rare situations where to provide the greatest chance of survival for both the mother and baby, an emergency cesarean section (perimortem cesarean delivery [PMCD]) must be performed. The decision to perform this procedure must occur quickly, and the reality is that a board-certified obstetrician is rarely present, particularly in rural areas. In this review, we provide a rationale for why trauma clinicians should be conversant with PMCDs, present the specific time limitations for performing a PMCD, and discuss the technique to perform a successful PMCD that makes it distinctly different from an elective cesarean delivery. Finally, we will discuss some things that a trauma program can do proactively in an obstetrical resource-poor area of the country to prepare for the rare instances where these procedures are necessary.

Traumatic Dental Injuries among Adolescents and Young Adults in Iași, Romania: Legal and Medical Perspectives.

This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals' predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at "Sf. Spiridon" Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence. Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241). Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups.

Correlation between alcohol consumption and facial trauma in patients from Dr. João Lúcio Pereira Machado Emergency Hospital in Manaus/AM

Alcohol consumption is a significant health issue in Brazil, contributing to a high incidence of trauma. Recent research indicates that 67% of the population consumes alcohol, with a growing number of alcohol-related facial traumas. This study aims to gather recent data on patients treated for trauma at a Brazilian emergency hospital and assess the relationship between alcohol abuse and facial trauma. Patients arriving at the emergency room were evaluated and categorized by gender, alcohol influence, and subsequent medical interventions. All data were then analyzed. The study found that 528 patients were treated for trauma at Dr. João Lúcio Pereira Emergency Hospital. Of these, 206 had consumed alcohol, with 166 males and 40 females. Among the males, 68 were discharged, 28 required immediate hospital treatment, and 35 were referred to specialized services. Of the females, 18 were discharged, 6 were admitted, and 16 were referred to specialists. The findings indicate that males have a higher incidence of alcohol-related facial trauma compared to females, representing 39% of trauma service visits. These results highlight the need for stricter evaluation of alcohol distribution and enforcement of laws against driving under the influence.

Posterior Cruciate Ligament Avulsion Fracture of Tibia: Fixation with Screw and Augmentation Using Ethibond Suture for Improved Clinical Outcomes.

The posterior cruciate ligament (PCL) is a vital structure in knee biomechanics, and its avulsion fractures present a unique challenge. This prospective cohort study was conducted at Grant Government Medical College and JJ Hospital, Mumbai, aimed to assess the clinical outcomes of open reduction and internal fixation (ORIF) utilizing cancellous screws and ethibond suture augmentation for PCL avulsion fractures. PCL avulsion fractures often result from traumatic incidents, such as road traffic accidents, and are associated with complications if left untreated. Patients aged 20-45 years with isolated PCL avulsion fractures, confirmed by clinical and radiological assessments, were included. Seven eligible patients underwent ORIF, and outcomes were evaluated through clinical assessments, radiological imaging, and the Lysholm knee scoring system. Follow-ups were conducted for a mean time of 13.2 months, assessing stability, range of motion, and complications. The study demonstrated a mean post-operative Lysholm score of 93.8, significantly improved from the pre-operative score of 49.6. Post-operative knee flexion averaged 125.2°. Fracture healing was observed in all cases, and complications were minimal. The study provides evidence of the effectiveness of ORIF with ethibond suture augmentation for PCL avulsion fractures. The study concludes that the proposed surgical technique yields positive outcomes, including enhanced knee functionality, successful fracture healing, and minimal complications. This approach, combining cancellous screws and ethibond suture augmentation, presents a promising option for the management of PCL avulsion fractures, contributing to the diverse landscape of effective treatment modalities.

Management of spinal trauma in pregnant patients: A systematic review of the literature.

Despite the high incidence of spine trauma globally, traumatic spinal cord injury (tSCI) during pregnancy is considered a rare medical emergency. The literature on acute management of these patients is sparse compared with that of mothers with preexisting tSCI. This systematic review aims to evaluate management strategies for tSCI during pregnancy in improving neurologic, obstetric, and neonatal outcomes. A systematic review of PubMed/MEDLINE was performed without language restriction from inception until November 2, 2023 for patients who acquired tSCI during pregnancy. Excluded articles described postpartum trauma, trauma before pregnancy, or SCI of nontraumatic etiology such as neoplastic, vascular, hemorrhagic, or ischemic origin. Primary outcomes investigated were maternal American Spinal Injury Association (ASIA) grade, pregnancy termination, cesarean delivery, prematurity, and neonatal adverse events. Data from 73 patients were extracted from 43 articles from 1955 to 2023. The mothers' median age was 24 years (interquartile range, 23-30 years), and the average gestational age at the time of injury was 21.1 ± 7.7 weeks. The thoracic spine was the most common segment affected (41.1%) and had the greatest proportion of complete tSCI (46.6%). Furthermore, ASIA score improvement was observed in 17 patients with 3 patients experiencing a 2-score improvement and 1 patient experiencing a 3-score improvement. Among these patients, 86% of ASIA B and 100% of ASIA C patients showed neurologic improvement, compared to only 17% of ASIA A patients. Surgically managed patients had a lower rate of neonatal adverse events than conservatively managed patients (11% vs. 34%). Acute tSCI requires a coordinated effort between a multidisciplinary team with careful consideration. While maternal neurologic improvement was observed more often following a better ASIA grade on presentation, the presence of neonatal adverse events was less common in patients treated with surgery than in patients who were managed conservatively. Systematic Review; Level IV.