Previous Trauma Research Articles

Comparison Of Surgical Techniques Used In Post-Traumatic And Non-Traumatic Rhinoseptoplasty

Introduction: The main goals of septorhinoplasty are to correct cosmetic and functional defects, which may occur in a patient with no history of previous trauma. As the most prominent facial feature, the nose has an increased risk of injury. Nasal fracture may eventually result in significant defects; posing challenges to the surgeon.Aim: The aim of the study is to compare the technique used in post-traumatic and non -traumatic cases of rhinoplasties.Materials and methods: The study group consisted of 227 patients, mean age 37.511.4 years, median 36 years, age range from 18 to 79 years. Statistical analysis was performed using the Statistica 13.3 package StatSoft, Dell Statistica. Categorical variables are presented as frequencies and percentages. The Chi2 or Fisher’s exact test - when the number in cells were less than 5, was respectively used to check whether there was a correlation between nasal injuries and surgical technique. The level of statistical significance was assumed to be equal to α=0.05.Results: Statistically significant differences were found in the use of five techniques. Septal filtration to the spine (44.1% vs 10.7%), septal extension graft (5.9% vs 1.3%), spreader graft (41.1% vs 21.1%) and osteotomy (85.3% vs 61.0%) were all performed more in patients with nasal trauma. On the other hand, LC steal was performed significantly more often in patients without nasal trauma (36.5% vs 22.1%).Conclusions: Nose injuries lead to cosmetic and functional complications pose a challenge to the rhinoplasty surgeon. Optimal management in the case of posttraumatic nose requires surgeon's experience and precise surgical planning.

Risk Factors, Clinical Characteristics, and Antibiotic Susceptibility Patterns of Streptococcal Keratitis: An 18-Year Retrospective Study from a Tertiary Hospital in China

Purpose: Our aim was to investigate risk factors, clinical characteristics, and antibiotic susceptibility patterns of cornea-isolated Streptococcus species collected at a tertiary hospital in China over 18 years. Methods: This retrospective study reviewed data from 350 patients diagnosed with Streptococcal keratitis at Beijing Tongren Hospital between January 2006 and December 2023, including demographics, risk factors, clinical signs, in vivo confocal microscopy (IVCM) imaging, and antibiotic susceptibility testing. Results: The predominant type was Streptococcus pneumoniae (n = 108, 29.8%), followed by Streptococcus mitis (n = 90, 24.9%) and Streptococcus oralis (n = 85, 23.5%). Main risk factors included previous ocular surface disease (24.6%), ocular surgery (21.4%), and trauma (16.3%). Significant differences in clinical characteristics were observed among S. pneumoniae, S. oralis, and S. mitis regarding infiltration location (p = 0.038) and size (p = 0.037), as well as hypopyon presence (p = 0.006). IVCM revealed deeper inflammatory cell distribution and structural disruption as the disease progressed. Resistance rates of aminoglycosides, β-lactams, and fluoroquinolones have increased, with significant differences among species for amikacin (p = 0.010), gentamicin (p = 0.007), and others. Poor outcomes correlated with disease duration over one month, central corneal ulcers, dense infiltrations, hypopyon, and scar tissue presence on IVCM. Conclusions:Streptococcal keratitis is a complex ocular infection with multiple risk factors. S. pneumoniae, S. mitis, and S. oralis are the primary causative agents, exhibiting varying clinical features and antibiotic resistance patterns. Key factors associated with poor outcomes include long disease duration, central corneal ulcers, and severe infiltration.

Craniomaxillofacial trauma increases the risk of temporomandibular joint disorders and days of work disability—a SWEREG-TMD registry-based study

Although craniomaxillofacial (CMF) trauma is a factor recognized as contributing to the development of temporomandibular joint disorders (TMJD), large population-based research on CMF trauma and subsequent TMJD is lacking. Additionally, it is unknown how previous CMF trauma affects work disability reimbursements for patients with TMJD (pwTMJD). This Swedish registry-based study included 33,315 pwTMJD matched to 333,122 individuals from the general population. Both a case–control design and a cohort design were used in this study to evaluate the association between CMF trauma and TMJD, and to investigate how CMF trauma impacts the number of days on work disability among pwTMJD. The main study finding was that many types of previous CMF trauma were strongly associated with TMJD, with mandibular fractures having the strongest association (adjusted odds ratio 11.4). Furthermore, the strongest association for an increased number of annual days on work disability was found for pwTMJD with a history of CMF trauma. These results suggest that CMF trauma influences the developmental path of TMJD, even in a population-based sample.

A shoulder pain: Not so minor – An emergency department case report study

Introduction and importanceShoulder pain frequently presents as a low priority case in the Emergency Department (ED). However, this is associated with many potential aetiologies, including sickle cell crisis. A thorough history taking and comprehensive assessment, along with an open-minded approach can enhance clinical decision-making processes when caring for patients presenting with shoulder pain. Case presentationA 35-year-old male presented to the ED with left shoulder pain. He was given a low priority score as he did not report any significant previous history or trauma, appeared well, and reported a low pain score at the time of presentation. Clinical discussionThe open-minded approach by the Advanced Nurse Practitioner led to an appropriate diagnosis, pain management, care, and follow up for the patient. ConclusionThis case underscored the critical importance of ‘probe and probe again’ until a clear rationale emerged for the aetiology of the shoulder pain experienced by a young and healthy patient.

Systematic Review of the Psychosocial Impacts of the COVID-19 Pandemic on West African Migrants in Victoria, Australia

Background: The COVID-19 pandemic impacted among others on physical and mental health, and this is profound and, projected to persist for a long period. The impact was compounded by measures such as social distancing and community lockdowns especially in Victoria, Australia to control the spread. Aim: To review published studies that focus on the psychosocial impact of COVID-19 pandemic on Victorians in Australia. Methods: This study followed the PRISMA-ScR process. The McMasters critical appraisal tool was utilised to appraise the identified studies of which 76% were quantitative, the SPICE framework was used to identify the studies. Results: Data search yielded 232,159 articles, out of which only 33 were included for critical appraisal. Most (87%) of the articles reported on psychosocial distress relative to 33% on social support, and 24% on coping strategies. Considerably less of the studies focused on other phenomenona of interests including 15% on life satisfaction, 9% on past trauma histories, and minimal 1% on memory of the previous traumatic events. Conclusion: This review highlights the extent that past studies have focused on phenomena around psychosocially distress from COVID-19, and the subsequent coping strategies, which are imperative for patient care. Therefore, this report highlights a void in literature, especially regarding strongest memory of events and previous trauma history. The implication of this report is on how findings can guide mental health policy and trauma-informed care for migrant communities affected by multiple traumas.

Natural History of Chronic Subdural Hematoma following Middle Meningeal Artery Embolization: A Retrospective Analysis

The efficacy of middle meningeal artery (MMA) embolization in the management of chronic subdural hematoma (cSDH) has been increasingly supported by recent randomized controlled trials. However, long-term data on the natural history of cSDH post-treatment remain limited. This study aims to evaluate the natural history and outcomes of cSDH over a 12-month period following MMA embolization. We conducted a retrospective analysis of 61 MMA embolization for the treatment of cSDH in 49 consecutive patients at a single institution between October 2019 and December 2022. Patients underwent MMA embolization as the primary treatment of cSDH, concurrently with surgical evacuation, or after initial surgical evacuation and subsequent recurrence. Clinical data, including patient demographics, hematoma maximal thickness, midline shift size, procedural details, and outcomes, were collected and analyzed. The primary outcomes assessed were time to resolution of hematoma maximal thickness, midline shift reduction and clinical improvement. Secondary outcomes included occurrence of complications, recurrence rate and the characteristics of the group of patients who needed surgical rescue. Tables and Kaplan-Meier curves were created, broken down by the percentage of reduction in current hematoma maximal thickness. Results for the primary, concurrent and recurrent groups were compared. The mean age of included patients was 73 ± 10.8 years. Among them, 33 patients (67.3%) reported a history of previous trauma, with falls being the main mechanism of injury (65.3%). The majority of patients (77.5%) were male. The most frequent neurological symptom was headache (61.2%). The mean hematoma thickness and midline shift were 15.9±7.1 and 5.6±2.6 mm, respectively. There was a significant improvement in clinical symptoms within 1 month following middle meningeal artery embolization. Kaplan-Meier curves were generated for resolution of hematoma size and midline shift. At one month post procedure, only 25% of patients had at least a 25% reduction in hematoma size. However, by three months, 75% had a decrease in hematoma size by 50%. 85% of patients had complete resolution of hematoma by 7 months and all patients had resolution of hematoma by 12 months. Four patients underwent surgical rescue hematoma evacuation and the mean timeframe between the embolization and the surgical rescue was 2 weeks. Hematoma size and midline shift resolved faster for patients who underwent concurrent or rescue surgical evacuation of the hematoma in addition to embolization. No difference in results between the liquid embolics n-BCA and Onyx-18 was found. This study demonstrated a favorable resolution of subdural hematoma within 7 months in 85% of patients and in all patients by 12 months. By 3 months, 50% of patients had a decrease in hematoma size by 50% or more. A complete resolution of midline shift within 7 months, and a significant improvement in clinical symptoms within 1 month following middle meningeal artery embolization. Hematoma size and midline shift resolved faster for patients who underwent embolization for recurrent hematoma or concurrent surgical evacuation of the hematoma in addition to embolization.

The Impact of Affectionate Communication and Emotional Intelligence on Sexual Stress Among College Women

Stress is a pervasive challenge in the lives of college students, with women experiencing higher stress levels than men. This study investigates the unique stress experiences of college women, particularly in the context of sexual stress. Using affection exchange theory (AET; Floyd, 2002) as a theoretical framework, trait affection and emotional intelligence are examined as predictors of sexual stress. Using survey data collected from U.S. college women (N = 337), results indicated that higher levels of both trait affection and emotional intelligence were associated with lower sexual stress. Additionally, emotional intelligence partially mediated the relationship between trait affection and sexual stress. Future research should explore sexual stress in diverse populations and consider additional factors such as previous trauma and hormonal responses to stress. Overall, this research sheds light on an under examined area and underscores the importance of addressing sexual stress in the college population.

Prospective study of individual characteristics and posttraumatic stress disorder (PTSD) symptoms following childbirth: Birth satisfaction as a moderator.

The goal of this study was to (a) examine the association between childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms and possible risk factors of previous trauma, individual characteristics (neuroticism, anxiety sensitivity, and resilience), type of birth, and birth satisfaction and (b) explore whether birth satisfaction moderates any association between individual characteristics and CB-PTSD symptoms. This was a longitudinal questionnaire study during pregnancy and postpartum. Pregnant women (N = 396) were recruited from antenatal clinics and completed questionnaires during mid-late pregnancy (Time 1) and 6-12 weeks after childbirth (Time 2). Time 1 questionnaires measured anxiety sensitivity (Anxiety Sensitivity Index), neuroticism (International Personality Item Pool-50, Neuroticism subscale), resilience (Brief Resilience Scale), and trauma history. Time 2 questionnaires measured birth satisfaction and CB-PTSD (Birth-Related and General Symptoms subscales). Regression analysis showed that previous sexual trauma, higher levels of neuroticism, and lower levels of birth satisfaction predicted higher levels of CB-PTSD symptoms. Anxiety sensitivity and resilience were not significant predictors of CB-PTSD. Additionally, birth satisfaction moderated the relationship between higher neuroticism and higher levels of CB-PTSD (total and general symptoms) and between lower resilience and higher CB-PTSD general symptoms. Effects were stronger when low birth satisfaction was reported. Individual characteristics and birth satisfaction interact in the development of posttraumatic stress disorder following childbirth, with previous traumatic experiences playing an additional role. These findings can inform screening and care pathways for women at greater risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

024. Case Report: Giant Cell Tumor Intravertebra

Background: Giant cell tumor is a rare neoplasm that most frequently occurs at the end of long bones and accounts for approximately 5% of all primary bone tumors in adults. The prevalence of spinal giant cell tumors is estimated at 2%–15% of all spinal giant cell tumors. However, Giant cell tumor is a rare finding in the spine, especially in the pediatric population. Case: A 6-year-old male patient presented with back pain that had spread to both legs for 1.5 years and had worsened in the past 4 months. The pain is intermittent. The patient also felt tingling in the waist and legs, which then turned into a thickening feeling from the waist to the toes since the last 6 months. The patient also complained of weakness in both legs since 1 year ago. Currently the patient is only on bed rest. The patient cannot walk but can still stand with assistance. Defecation and urination remain within normal limits. History of previous trauma (-) Prolonged cough (-), bed wetting (-), headache (-), seizures (-), decreased consciousness (-), progressive weight loss (-), nausea (-) vomiting (-), history of contact with TB sufferers (-). Conclusion: Complete resection of tumor by laminectomy was performed successfully followed by spinal fusion with a pedicle screw. The screws were placed correctly at all four levels of Vertebrae. The decision was made to give stability for spine and it was scheduled to remove the pedicle screw one year follow-up after surgery. Histopathology results showed characteristic findings of giant cell tumor.

Right cranial lung lobe torsion in a domestic ferret (Mustela putorius furo).

A 3-year-old male castrated domestic ferret presented with a 24h history of lethargy, weakness, and anorexia. The ferret was tachypneic, painful, dehydrated, pale, and obtunded on physical examination. Radiographs and thoracic CT were utilized to diagnose a 360° right cranial lung lobe torsion (LLT) with secondary pneumothorax and pleural effusion. This was confirmed on gross necropsy and histopathology. The LLT was suspected to be secondary to previous trauma based on chronic bilateral rib fractures. Lung lobe torsions are life-threatening conditions infrequently described in veterinary medicine. Based on our review of the literature, this is the first description of an LLT in a ferret.

Trauma a major contributing factor of retronychia: Case series

IntroductionRetronychia is defined as a condition where the proximal nail plate grows into the proximal nail fold with the formation of multiple layers of nail plates. It relates to frequent microtrauma that affects the toenails, especially the big toe and it is less common on the fingernails. Case presentationCase 1: A 14-year-old female presented with nail growth stopped and painful swelling in her left hallux that did not respond to antibiotics. The patient had been traumatized at the same toenail. Retronychia was diagnosed, and nail avulsion was performed. Case 2: An 18-year-old man came with painful swelling and stopped growth in his right great toenail that did not improve with antibiotics. The patient had previously trauma the same toenail. Retronychia was diagnosed clinically, and nail avulsion was performed. Case 3: A 30-years-old woman presented with Inflammation and pain in her right toenail. She mentioned a previous trauma to her foot. Retronychia was diagnosed clinically and she underwent onychectomy. DiscussionRetronychia is a chronic nail abnormity based on unresolved chronic proximal paronychia caused by disintegrated nail growth and several generations of nail plate localization underneath the damaged nail. The most common reason for retronychia is trauma which also happens after repetitive micro-trauma. Clinical diagnosis is the basis of retronychia. Retronychia treatment varies between surgical treatment and conservative treatment. ConclusionThis paper highlights the importance of considering retronychia as a potential differential diagnosis in cases of chronic paronychia, and stresses the significance of early detection to prevent complications.

The Predictability of Clinical Findings and Radiographs for Detecting Tarsal Coalition.

Tarsal coalition is a disorder of the foot characterized by the abnormal union between 2 or more of the tarsal bones. A minority of patients will develop pain and limited motion when reaching adolescence, for whom surgical resection of the coalition may be necessary. The diagnostic value of clinical and radiologic signs remains unclear. The aim of this study is to assess the predictive value of clinical symptoms and plain x-rays to diagnose tarsal coalition in symptomatic patients. We performed a retrospective chart review of patients with clinical suspicion of tarsal coalition between January 2011 and November 2019. Patient demographic data; clinical data on pain, limited motion, peroneal spasm, recurrent, or previous trauma; and radiologic data on the presence and type of coalition were collected. Multivariable general estimating equations analysis was used to assess associations between demographic and clinical characteristics and the likelihood of a positive coalition diagnosis. The study cohort was 336 patients (672 feet) with a mean age of 13 years and a 1:1 sex distribution. Thirt-eight percent of feet were diagnosed with a coalition of which 53% were talocalcaneal and 41% were calcaneonavicular. Coalitions were significantly more common in younger patients, males (OR 1.66, P=0.04), patients with lower BMI (OR 0.96, P=0.045), and patients who presented with painful feet (OR 1.59, P=0.04) or feet with limited motion (OR 7.49, P<0.001). Diagnostic utility of plain x-ray compared with CT diagnosis yielded a sensitivity of 76% and a specificity of 94%, with higher sensitivity (90%) in calcaneonavicular coalitions than in talocalcaneal (66%). Our study shows that limited subtalar movement, male sex, and low BMI have a high predictive value for tarsal coalition in symptomatic patients. Classic clinical findings that were not predictive of coalition in our cohort of symptomatic patients included peroneal spasm, recurrent ankle sprains, and recent trauma. Plain x-rays offer a reliable alternative to CT for diagnosis, especially for calcaneonavicular coalitions. Level III-retrospective comparative study.

Study of Carpal Tunnel Syndrome Using Electroneurography and Ultrasound in a Spanish Cohort

Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Its diagnosis is clinically supported by the electroneurography (ENG). The use of ultrasound (US) has increased in recent years. Our objectives are: to describe the ENG and US findings in patients with suspected CTS, based on age, sex and anthropometric data; and to study the correlation of both tests based on the severity of CTS. Material and methods: prospective study of patients with suspected CTS who undergo ENG and US. ENG examination: antidromic sensory median at 3rd and 4th finger; distal motor of median. US: crosssectional area (CSA) prior to or within the tunnel (higher values). Inclusion criteria: patients aged 18 to 85 years. Exclusion criteria: previous trauma or previous surgery for CTS or forearm, carpus or hand. Statistical study with the SPSS 29.0 program. Results: 400 nerves from 266 patients (52.59 ± 12.09 years) were studied, 183 women and 83 men. According to the ENG, 129 did not have CTS, 61 were incipient, 113 mild, 19 moderate and 75 severe. The mean CSA was 8.37 ± 1.21 mm2 in non-CTS, 10.09 ± 1.45 mm2 in early, 11.33 ± 1.87 mm2 in mild, 14.63 ± 1.92 mm2 in moderate and 15.46 ± 3.33 mm2 in severe CTS, with a significance of p&lt;0.01 (95% CI) in the ANOVA test. The highest and inverse correlation appears between the conduction velocities (CV) at the 4th finger with CSA (-0.816) and CV at the 3rd finger with CSA (-0.800), which coincides with the most sensitive ENG values for the diagnosis of CTS. Discussion: CSA is an appropriate test as a complement to ENG in the diagnosis of CTS. However, it has limitations when establishing the cut-off point between normality and neuropathy, as well as when classifying based on severity

Primary Cutaneous Cryptococcus Following Traumatic Exposure: A Case Report and Retrospective Analysis

Primary cutaneous cryptococcus (PCC) is a form of Cryptococcal neoformans infection characterized by localized cutaneous colonization and proliferation. In this case study, we present PCC occurring following a previous trauma in a 77-year-old male with a history of renal organ transplant maintained by immunosuppressive therapy. Colonies of C. neoformans were successfully identified during a secondary workup after the patient had been misdiagnosed. Despite the delay in treatment, complete remission was achieved through aggressive antifungal therapy. Our case highlights common clinical pitfalls that contribute to the prolonged diagnosis of PCC. Our findings and retrospective analysis underscore commonalities in disease presentation, such as high-risk patient populations, transmission routes, and associated symptoms. Integrating these insights into clinical practice may heighten provider suspicion and enhance patient outcomes.

Diversity and Inclusion Through Collaboration: Co-Producing a Simulation Curriculum to Address Discrimination Against Trainees.

Discrimination toward trainees is a pervasive problem, with surveys showing it is often perpetrated by patients. For several years, residents and faculty in an internal medicine residency have participated in a workshop offering a framework for responding to discriminatory behavior by patients. As part of a larger effort to reinforce this teaching and promote an inclusive environment, the authors pursued a multi-pronged simulation curriculum that could be incorporated into graduate medical education programs across their institution. First, the authors conducted trainee and faculty focus groups to better understand their experiences. Qualitative data was collected, including recommendations for responding to discrimination, characteristics of the most common experiences, and trainees' own ideas for worthwhile simulation scenarios. Trainees and faculty were then brought together in a collaborative process to co-develop simulation cases that were later implemented in curricula across multiple learner levels, specialties, and contexts. Participants in these simulations reported improved comfort in responding to discrimination in the moment and/or in the wake of such incidents. Through trainee-faculty collaboration, the project yielded authentic and impactful simulation experiences for learners, while also giving trainees an opportunity to turn previous trauma into constructive learning opportunities that promote an inclusive environment.

B - 68 Executive Functioning Skills of Verbal and Emotional Intelligence and Borderline Personality Predict Posttraumatic Growth

Abstract Objective Research found a positive connection between emotional intelligence and both borderline personality and posttraumatic growth. Prior research has not examined the combination of emotional intelligence, borderline personality, and cognitive intelligence as predictors of posttraumatic growth (PTG); our research helped fill this gap. Method American adults (N = 402; M age = 38.7 years, SD = 13.0) were recruited from Prolific to complete an online survey including Shipley Institute of Living Scale-2, Assessing Emotions Scale, Posttraumatic Growth Inventory-Expanded, and screening questionnaire for DSM-5 Personality Disorders. PTG was measured in relation to any previous trauma. Participants reported being white (67.2%), African American/Black (9.7%), Asian/Asian American (9.7%), Hispanic/Latinx (9.0%), and other ethnicities (4.5%), and men (48.0%), women (47.8%), non-binary (1.5%), transgender men (1.2%) or women (0.5%), or other genders (0.9%). Results Hierarchical regression revealed that emotional and verbal intelligence significantly predicted PTG, F(2, 391) = 78.54, p &amp;lt; 0.001, adj. R2 = 0.28, 95% CI [0.20, 0.35]. Adding borderline characteristics to the model resulted in significantly greater prediction of PTG, F(3, 390) = 61.22, p &amp;lt; 0.001, F change p &amp;lt; 0.001, and explained 32% of the variance in PTG, adj. R2 = 0.32, 95% CI [0.24, 0.39]. Greater emotional intelligence (beta = 0.535), more borderline personality characteristics (beta = 0.189), and lower verbal reasoning (beta = −0.159) predicted more PTG. Conclusion Our findings suggest that executive functions and borderline characteristics play a complex role in the development of posttraumatic growth after trauma.

Case report of idiopathic scapular dyskinesia: Revisiting involuntary scapular movements from a neurologist’s perspective

Abstract Scapular dyskinesia, one of the rare forms of focal dyskinesia, is usually considered a peripheral induced movement disorder (PIMD), occurring in the background of previous trauma or surgery. Different terms are used interchangeably with scapular dyskinesia, many of which are misleading. In this article, we present 2 cases of patients with abnormal involuntary scapular movement suggestive of scapular dyskinesia. In both cases, there is no history of preceding trauma or surgical intervention. We will review the literature and try to understand the fundamental difference between the various terms used for abnormal scapular movement in literature. Our cases highlight the difference between the two commonly used terms for scapular movement, i.e., scapular dyskinesia and scapular dyskinesis. We further suggest that shoulder girdle dyskinesia should be preferred over scapular dyskinesia. Although scapular dyskinesia is often considered PIMD, not all cases of scapular dyskinesia are peripherally induced.

Trauma-Informed Development and Education: Turning the TIDE on Transition to Practice.

Transition to practice (TTP), the first year of a nurse's career postlicensure, is widely recognized as a stressful time. Previous trauma exposure and additional workplace trauma exacerbate the stress of this transitional period. Trauma-informed environments are associated with clinician wellness and engagement. Because workforce training for leaders is a necessary precursor to developing supportive environments, we studied changes in trauma knowledge, awareness, and attitudes among TTP leaders. Our mixed methods study included administering the Attitudes Related to Trauma-Informed Care Scale (ARTIC) pre- and post-training, with additional open-ended questions about the impact of training. Paired data from participants showed overall mean improvement that was statistically significant, with a large effect size. Statistically significant knowledge gains related to trauma recognition and safety, how to respond to trauma, and how to promote healthy behaviors. Our study underscores the importance of trauma education, which not only increased awareness but also prompted nurse leaders to reflect on enhanced support for early nursing professionals. [J Contin Educ Nurs. 2024;55(10):501-508.].

Incidence of Posterior Capsule Rupture During Phacoemulsification Cataract Surgery Among Patients Treated With Intravitreal Bevacizumab Injections.

To assess whether intravitreal bevacizumab injections increase the risk of posterior capsular rupture during phacoemulsification cataract surgery in diabetic patients. A retrospective study that included diabetic patients who underwent phacoemulsification cataract surgery at King Hussein Medical Center of the Jordanian Royal Medical Services during a one-year period from January 2023 until January 2024. Patients were categorized into four groups. The first group did not receive an intravitreal bevacizumab injection; the second group received only one injection; the third group received two injections; and the fourth group received three or more injections. Results from the four groups were compared with a control group for patients who underwent phacoemulsification surgery and were not known to have diabetes mellitus and did not receive previous intravitreal injections. All injections were received within a period of one year before the time of phacoemulsification surgery. Inclusion criteria for the study groups included diabetic patients with a history of diabetes of more than 10 years with the presence of diabetic retinopathy. Exclusion criteria included patients who received intravitreal injections other than bevacizumab, previous intraocular surgery or trauma, and the presence of ocular pathology that led to an increased risk of posterior capsular rupture. The incidence of posterior capsular rupture was compared among these groups. A p-value was used to assess statistical significance and was considered to be statistically significant if ≤0.05. The number of patients in the control group (group 0) was 1440 patients with a mean age of 64.9, and in the study groups were 1306 patients. Group 1 included 244 patients (18.7%) with a mean age of 62.4 years, compared to 306 patients (23.4%) in group 2 with a mean age of 66.1 years, 352 patients (27%) in group 3 with a mean age of 64.2 years, and 404 patients (30.9%) in group 4 with a mean age of 63.1 years. Posterior capsular rupture occurred more significantly in patients with group 4. It occurred in 21 patients, representing 5.2% of them, compared to four patients (1.6%) of group 1, six patients (2%) of group 2, and eight patients (2.3%) of group 3, while in the control group, the number of patients with posterior capsular rupture was 20 (1.4%). Intravitreal bevacizumab in diabetic patients is considered a risk factor for posterior capsular rupture in phacoemulsification cataract surgery in patients receiving more than three injections.

The impact of adolescent profiles of posttraumatic stress, emotion regulation, and disorganized attachment on posttraumatic growth and psychiatric symptoms: Academic stress and egocentrism as covariates.

The present study aimed to examine the profile patterns of co-occurring posttraumatic stress disorder (PTSD), cognitive emotion regulation (CER), and disorganized attachment in traumatized adolescents. It also aimed to examine whether these adolescents with different profiles would differ in posttraumatic growth (PTG) and comorbid psychiatric symptoms after controlling for academic stress and egocentrism. Nine hundred and forty-nine (N = 949) adolescents were recruited from two secondary schools in China. They completed measures on PTSD, comorbid psychiatric symptoms, PTG, CER, disorganized attachment, and covariates of egocentrism and academic stress. Latent profile analysis identified a four-class model as the optimal solution: low trauma group (Class 1), adaptive copers (Class 2), moderate trauma group (Class 3), and high trauma group (Class 4). After controlling for demographics and levels of egocentrism and academic stress, Class 4 had more severe comorbid psychiatric symptoms than the other three classes. Class 3 had higher levels of comorbid psychiatric symptoms than Class 2 and Class 1, while these latter two were comparable in comorbid psychiatric symptoms. Conversely, Class 4 students had lower levels of PTG than individuals in the other three classes. Class 3 had similar levels of PTG to Class 1, and these two classes reported lower levels of PTG than Class 2. Chinese adolescents may experience both negative and positive changes after stressful events. The extent of these psychological outcomes could vary depending on the adolescents' previous trauma experiences, emotion regulation, and attachment qualities. Implications for clinical practice were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).