Trauma Group Research Articles

Severe traumatic injury is associated with profound changes in DNA methylation

Whether DNA methylation changes follow human physical trauma is uncertain. We aimed to investigate if severe trauma was associated with DNA methylation changes. In a prospective, observational, clinical study, we included severely injured adults and adults undergoing elective surgery (controls). Blood was obtained from trauma patients (n = 60) immediately- and 30-45 days post-trauma, and from surgical patients (n = 57) pre-, post-, and 30-45 days post-surgery. Epigenome-wide DNA methylation profiling was performed and analyzed for significant differentially methylated CpGs and -regions (DMRs) within and between groups. Within the trauma group we identified 10,126 significant differentially methylated CpGs and 1169 DMRs. No significant differential methylation was found in the surgical group. In the trauma group, differentially methylated sites were enriched in genes and pathways involved in blood coagulation and inflammatory response. Severe trauma was associated with profound alterations in the DNA methylome of circulating leucocytes, and differential methylation was located in trauma-relevant genes.

Diagnostic Value of Serum Clara Cell Secretory Protein Level in an Experimental Blunt Chest Trauma Model

Objective: Blunt chest trauma is a significant clinical problem leading to injury of the lungs that may be fatal. Experimental blunt chest trauma is well established in animal models. This study aimed to investigate whether Clara cell secretory protein (CC16) can be a biomarker in an experimentally created blunt chest trauma model. Material and Methods: A total of 30 rabbits were used in our study. A modified bilateral blunt thoracic trauma model was used to produce different levels of lung contusion. We divided the rabbits into four groups according to the energy level at which blunt thoracic trauma was applied. Blood samples were taken from the control and trauma groups to evaluate CC16 levels at 0, 12, and 24 hours. Results: The CC16 levels measured at the start of the experiment were significantly lower in the control and low-energy groups compared to the medium- and high-energy groups (p =.002). While there was a significant difference in CC16 levels measured at the 12th hour (p =.004), no significant difference was found among the groups at the 24th hour. Upon analyzing the change in CC16 levels over time within the groups, we observed that CC16 levels decreased from 0–12 hours and subsequently increased after the 12th hour. Histopathologically, we observed that the level of contusion increased in proportion to the severity of trauma across the different groups. Conclusion: With the designed platform, we created a reproducible experimental model of pulmonary contusion from blunt thoracic trauma in rabbits. Increased levels of CC16 following a lung contusion could serve as a foundation for clinical decision-making. Thus, CC16 has the potential to serve as a rapid and simple biochemical indicator for acute traumatic lung injury.

The Effect of Thymoquinone on Acoustic Trauma-Induced Hearing Loss in Rats.

Background The aim of this study was to investigate the protective effect of thymoquinone, an antioxidant, on hearing loss induced by acoustic trauma in rats. Material and methods This study included 32 Wistar Albino rats divided into four groups: control, acoustic trauma, thymoquinone + acoustic trauma, and thymoquinone only, with eight rats per group. The control group received 0.5 mL of corn oil intraperitoneally for 10 days. The acoustic trauma group was exposed to 100 dB white noise at 4 kHz for 16 hours. The thymoquinone + acoustic trauma group received thymoquinone (10 mg/kg) intraperitoneally for two days before acoustic trauma and eight days after acoustic trauma. The thymoquinone only group received thymoquinone (10 mg/kg) for 10 days. Distortion product otoacoustic emissions (DPOAEs) were measured before and after treatments on days 1, 4, and 10. Results In the control group, DPOAE measurements showed no significant change over the study period. The acoustic trauma group exhibited a significant decrease in DPOAE on the first day after trauma, followed by some recovery. The thymoquinone + acoustic trauma group showed no significant decrease in DPOAE on the first day post-trauma, suggesting a protective effect. The thymoquinone only group also indicated no significant change in DPOAE measurements, suggesting that thymoquinone alone did not affect hearing function. Conclusion Thymoquinone demonstrated a protective effect against acoustic trauma-induced hearing loss in rats, as evidenced by stable DPOAE measurements post-trauma. These findings suggest that thymoquinone may help preserve hearing function by reducing oxidative stress in the cochlea. Further studies are needed to confirm these results in humans and optimize dosage and treatment protocols.

TRANSFORMing theory to practice: Developing and implementing an anti-racist, community-based racial stress and trauma group intervention for BIPOC youth

Evidence-informed trauma interventions developed specifically by and for Black, Indigenous, and People of Color (BIPOC) that address racial, historical, and intergenerational trauma are sparse, particularly for youth. To meet this need, the current study developed and piloted a new intervention – Trauma and Racism Addressed by Navigating Systemic Forms of Oppression using Resistance Methods (TRANSFORM) – using a and community-engaged research-to-practice approach. Across two phases, we documented the community-participatory development of TRANSFORM and analyzed preliminarily quantitative data collected in a pilot study with N = 19 BIPOC youth. Phase 1 reports on the process and lessons learned from the community centered co-development. The phase 2 pilot study results revealed statistically significant pretest-to-posttest reductions in racial discrimination stress as well as trauma-related symptoms interfering with daily functioning for youth. Implications for community-based approaches to disrupting and healing racial stress and trauma within and across youth-serving systems are discussed.

Omega-3 fatty acids protect cartilage from acute injurie by reducing the mechanical sensitivity of chondrocytes

Acute cartilage injuries, such as intra-articular fractures and blunt impacts, frequently result in chondrocyte death and extracellular matrix (ECM) degradation, significantly elevating the risk of post-traumatic osteoarthritis (PTOA). Despite advances in treatment, no effective therapies currently exist to fully cure PTOA or halt its progression. This study explores the protective effects of the dietary fatty acid eicosapentaenoic acid (EPA) on human primary chondrocytes (HPCs) and cartilage explants exposed to mechanical overload and blunt trauma. HPCs were isolated and subjected to mechanical stretching using BioFlex six-well culture plates, while cartilage explants were subjected to impact loading via a customized drop tower. EPA was incorporated into the culture medium, followed by assays to evaluate cell viability, calcium (Ca²⁺) influx, apoptosis, reactive oxygen species (ROS) levels, and collagen type II alpha (Col-2a) expression. EPA treatment markedly decreased chondrocyte mechanical sensitivity, as demonstrated by enhanced cell viability and reduced lactate dehydrogenase (LDH) release. Furthermore, EPA inhibited Piezo1 activation, leading to lower intracellular Ca²⁺ concentrations, decreased apoptosis, and diminished ROS levels. In cartilage explants, EPA improved chondrocyte viability, minimized structural damage, and sustained higher Col-2a expression compared to the blunt trauma group. These results indicate that EPA effectively shields chondrocytes and cartilage explants from mechanical overload-induced damage by inhibiting Piezo1 activation and mitigating Ca²⁺ influx, apoptosis, and oxidative stress. The findings suggest that EPA supplementation could offer a promising strategy for preventing PTOA progression following acute cartilage injuries. Further research is warranted to assess the clinical applications of EPA and confirm its efficacy in larger animal models and human trials.

Functional Outcomes of a Dynamic Condylar Screw for Unstable Femoral Intertrochanteric Fractures in Patients Above 50.

Hip fractures areamong the most common fractures encountered in the emergency departments by orthopedic trauma teams. The optimal treatment method and implant choice for unstable intertrochanteric fractures are subject to debate, with various options available, including intramedullary and extramedullary implants. In this descriptive cross-sectional study, the researchers examined patients with unstable intertrochanteric fractures (classified as 31A2 according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification) who had undergone open reduction and internal fixation with a 95° dynamic condylar screw (DCS). The study was conducted at the Gezira Centre for Orthopedic Surgery and Traumatology (GCOST) during the latter half of 2022. Functional outcomes were assessed using the modified Harris Hip Score (mHHS). A total of 30 patients were enrolled in this study, with a mean age of 73 ± 12.27 years. Of these, 11 (36.7%) were male, and 19 (63.3%) were female. The mHHS was 73.6 ± 14.654. Among the surveyed patients, seven (23.3%) reported poor outcomes, 13 (43.3%) reported fair outcomes, six (20%) reported good outcomes, and four (13.3%) reported excellent outcomes. The Kruskal-Wallis test revealed statistically differences in mean mHHS scores between gender groups (p = 0.024) and between age groups (p = 0.04). However, no significant differences were found across different modes of trauma groups (p = 0.73), affected hip groups (p = 0.35), comorbidity groups (p = 0.84), or postoperative complication groups (p = 0.06). Our study found that DCS treatment for unstable intertrochanteric fractures yielded acceptable functional outcomes, making it a viable and effective treatment option.

Return to Work One Year after Moderate to Severe Traumatic Injury in a Working Age Population.

Background/Objectives: Physical trauma may cause long-term disabilities. The importance of place of residence in the return to work after injuries is little researched. The primary aims of this study were to describe return to work or school (RTW) at 6 and 12 months after moderate to severe traumatic injury and to investigate demographic and injury-related predictors for RTW with an initial focus on geographic centrality of residency. The secondary aim was to investigate the association between RTW and functioning. Methods: A prospective cohort study conducted at two Norwegian trauma centres. Inclusion criteria: age 18 to 70 years, at least a two-day hospital stay and a New Injury Severity Score > 9. Information about centrality, demographics, injuries, and return to work were collected. Associations between possible predictors and RTW were assessed using binary logistic regression. Results: Of the 223 participants, 68% had returned to work after 6 months and 77% after 12 months. Twelve-month RTW was 89% after thorax/abdomen injuries, 78% after extremity/spine injuries and 73% after head injuries. More central residency was a significant predictor for RTW in univariable but only within the extremity/spine injury subgroup in multivariable analysis. Negative factors were age, having a blue-collar job, number of injuries and rehabilitation complexity. Function 12 months post-injury was associated with RTW in the multivariable model. Conclusions: RTW after one year was high in all major trauma groups. Demographic and injury-related factors were more important predictors of RTW than centrality of residency. Blue-collar workers and patients with multiple injuries and high rehabilitation complexity should be given special attention to support RTW.

Analysis of the Dynamic Expression of the SMAD Family in the Periosteum During Guided Bone Regeneration.

The aim of this study was to investigate the dynamic expression of the SMAD family during guided bone regeneration for the reconstruction of cranio-maxillofacial bone defects. A swine model of guided bone regeneration was established with one side of the rib as the trauma group and the contralateral as control group. Periosteal and regenerative tissue specimens were harvested at 9 time points in the early, middle, and late phases, and were subjected to gene sequencing and tissue staining. Expression data of each SMAD family were extracted for further analysis, in which the correlation of the expression of the respective members within and between groups and at different time points was analyzed. The expression of individual members of the SMAD family fluctuates greatly, especially during the first month. The SMAD3 and SMAD4 genes were the most highly expressed. The foldchange value of SMAD6 was the largest and remained above 1.5 throughout the process. The dynamic expression levels of SMAD2, SMAD4, SMAD5, SMAD6, and SMAD9 showed a significant positive correlation in both groups. The expression levels of each gene showed a positive correlation with other SMAD genes. Tissue staining showed that the overall contour of the regenerated bone tissue was basically formed within the first 1 month. The first month of guided bone regeneration is a critical period for bone regeneration and is an important period for the SMAD family to play a role. The SMAD6 may play an important role in the whole process of guided bone regeneration.

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).

Characteristics and surgical outcomes of giant retinal tear associated rhegmatogenous retinal detachment

Giant retinal tear-associated rhegmatogenous retinal detachment (GRT–RRD) presents a significant surgical challenge. Trauma stands out as one of the risk factors. This retrospective case series aims to assess the outcomes of GRT–RRD patients treated with pars plana vitrectomy (PPV), distinguishing between non-trauma and blunt ocular trauma cases. The medical records and relevant retinal imaging of 60 GRT–RRD patients undergoing PPV and followed with a mean (SD) of 21.2 (13.4) months were reviewed (47 were non-trauma-related and 13 were trauma-related). Both the non-trauma and trauma groups exhibited comparable distribution of proliferative vitreoretinopathy grade (P = 0.067). Following the primary operation, there was no statistically significant difference in the proportion of patients achieving single surgery anatomical success between the non-trauma group (27/47 patients, 57.5%) and the trauma-related group (9/13 patients, 69.2%) (P = 0.534). At the final follow-up, 17 patients remained tamponade with silicone oil. Among the remaining 43 patients, 33/34 patients (97.1%) in the non-trauma group and 9/9 patients (100%) in the non-trauma group (P = 0.661) achieved comparable final surgical anatomical success. Additionally the final vision was comparable between the two trauma categories (Snellen equivalent of 20/125 for the non-trauma group and 20/200 for the trauma group, P = 0.331). In multivariable regression, no significant factors related to primary reattachment rate or final vision were identified. Non-penetrating ocular trauma did not emerge as a significant risk factor for recurrent detachment post-surgery. This study supports that PPV outcomes in GRT–RRD patients are unaffected by the ocular trauma association and reports the effectiveness of PPV in managing these patients.

Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Optimizing Management and Minimizing Risk of Osteoporotic Vertebral Fractures - Perspectives of the AO Spine KF Trauma and Infection Group Key Opinion Leaders.

Literature review with clinical recommendations. To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders. 4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice. Recommendations were graded as strong or conditional following the GRADE methodology. 4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. Conditional recommendation to incorporate the OF score in the management of fractures to improve clinical results. Article 2: a randomized multicenter study comparing romosozumab/alendronate vs alendronate to decrease the incidence of new vertebral fractures. Strong recommendation that the group receiving romosozumab/alendronate had a decreased risk of new OF when compared with the alendronate only group only. Article 3: a systematic literature review of spinal orthoses in the management of. Conditional recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A conditional recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF. Management of patients with OF is still complex and challenging. This review provides some recommendations that may help surgeons to better manage these patients and improve their clinical practice.

Aging Influences Fracture Healing on the Cellular Level and Alters Systemic RANKL and OPG Concentrations in a Murine Model.

Clinical complications frequently follow polytrauma and bleeding fractures, increasing the risk of delayed fracture healing and nonunions, especially in aged patients. Therefore, this study examines age's impact on fracture repair with and without severe bleeding in mice. Young (17-26 weeks) and aged (64-72 weeks) male C57BL/6J mice (n=72 in total, n=6 per group) are allocated into 3 groups: the fracture group (Fx) undergoes femur osteotomy stabilized via external fixator, the combined trauma group (THFx) additionally receives pressure-controlled trauma hemorrhage (TH) and Sham animals are implanted with catheter and fixator without blood loss or osteotomy. Femoral bones are evaluated histologically 24h and 3 weeks post-trauma, while RANKL/OPG and β-CTx are measured systemically via ELISA after 3 weeks. Aging results in less mineralized bone and fewer osteoclasts within the fracture of aged mice in contrast to young groups after three weeks. Systemically, aged animals exhibit increased RANKL and OPG levels after fracture compared to their young counterparts. The RANKL/OPG ratio rises in aged Fx animals compared to young mice, with a similar trend in THFx groups. In conclusion, age has an effect during the later course of fracture healing on the cellular and systemic levels.

Childhood trauma and differential response to long-term psychoanalytic versus cognitive-behavioural therapy for chronic depression in adults.

Childhood trauma is a major risk factor for chronic depression. It has been suggested that adults with chronic depression who have experienced childhood trauma may require long-term treatment owing to a breakdown of basic trust and related difficulties in developing a productive therapeutic relationship. As empirical studies have been preliminary and scarce, we studied the effects of psychoanalytic therapy (PAT) versus cognitive-behavioural therapy (CBT) for chronic depression in adults with a history of childhood trauma. In this subgroup, we expected a greater symptom reduction in PAT compared with CBT. In a large trial of long-term psychotherapies for chronic depression (LAC-Study; Clinical Trial Register ISRCTN91956346), 210 adults received open-ended CBT or PAT in an out-patient setting and were examined yearly over 5 years on the Beck Depression Inventory - II (BDI-II). Based on a linear mixed model approach, we tested participant-reported childhood trauma based on the Childhood Trauma Questionnaire (CTQ) as a predictor and moderator of treatment outcome. CTQ subscales were examined exploratively. Depressive symptoms decreased over time (b = -4.55, s.e. = 0.90, 95% CI -6.32 to -2.81, T = -5.08; P < 0.001). A significant three-way interaction between childhood trauma, time and therapy group (b = -0.05, s.e. = 0.02, 95% CI -0.09 to -0.01, T = -2.42; P = 0.016) indicated that participants with childhood trauma profited especially well from PATs. Our results indicate differential benefits from PAT compared with CBT among adults with chronic depression and a history of childhood trauma. The results have important implications for differential indication and policy.

The effect of adipose-derived stem cells (ADSC) treatment on kidney histopathological appearance on the Wistar rat models with grade five kidney trauma.

Kidney trauma is the most common urological trauma. Technological advances have made conservative management possible for almost all kidney trauma. However, grade five kidney trauma needs to be carefully examined dueto its various complications, especially late complications that often delayed in recognition thus forming irreversible morbidity, with the most common late complication is kidney damage due to ischemic and fibrotic process. This study aims to confirm the effect of Adipose-Derived Stem Cells (ADSC) onthe prevention of fibrosis in grade five kidney trauma using Wistar rat models, where the fibrosis process will be measured with histopathological examination which had features of glomerular sclerosis, tubular atrophy, and interstitial fibrosis in kidney tissue, then followed by histopathological scoring and total renal score. A total of 22 adult rats were divided into five groups: one healthy control group, two trauma groups without ADSC, and two others trauma groups with ADSC. Two different treatment times were set: two weeks and four weeks after treatment. The data were tested for normality (Shapiro-Wilk test), while differences between groups were assessed using one-way ANOVA or Kruskal-Wallis test if the distribution was not normal. For the result of total renal score, statistical analysis reveal a significant difference in the total renal score in the kidney trauma with ADSC group compared with kidney trauma without ADSC group in fourth week of observation (p=0.001). These findings highlighted ADSC capability toprevent fibrosis caused by grade five kidney trauma on the Wistar rat models, as proven by significantly reduced histopathological grading on fibrosis.

Occlusal trauma aggravates periodontitis through the plasminogen/plasmin system.

Periodontitis is a common oral disease that is aggravated by occlusal trauma. Fibrin is a protein that participates in blood clotting and is involved in several human diseases. The deposition of fibrin in periodontal tissues can induce periodontitis, while mechanical forces may regulate the degradation of fibrin. Our study investigated how occlusal trauma aggravating periodontitis through regulating the plasminogen/plasmin system and fibrin deposition. This study included 84 C57BL/6 mice in which periodontitis was induced with or without occlusal trauma. Micro-computed tomography was used to assess bone resorption. Fibrin, fibrinogen, plasminogen, plasmin, tissue plasminogen activator (t-PA), and urokinase plasminogen activator (u-PA) levels were measured using Frazer-Lendrum staining, quantitative reverse transcription polymerase chain reaction, enzyme-linked immunosorbent assay, western blotting, immunofluorescence staining, and immunohistochemistry staining. Occlusal trauma aggravated inflammation and bone resorption. The periodontitis group showed significant fibrin deposition. Occlusal trauma increased fibrin deposition and neutrophil aggregation. The periodontitis with occlusal trauma group had decreased fibrinogen, t-PA, and u-PA expression and plasmin and fibrin degradation product levels, as well as increased plasminogen levels. Occlusal trauma promotes excessive fibrin deposition by suppressing the plasminogen/plasmin system, thus exacerbating periodontitis.

Assessment of the Psychological Effects on Firefighters in the Aftermath of the Pazarcik and Elbistan Earthquakes in 2023.

In February 2023, two catastrophic earthquakes in Turkey resulted in over 50,000 fatalities and over 300,000 injuries. This study investigated the psychological effects on firefighters who engage in rescue operations following these earthquakes, focusing on trauma-related symptoms, depression, anxiety, stress, and resilience. The research employed validated psychometric instruments, including the Post-earthquake Trauma Level Determination Scale (PETLDS); Depression, Anxiety, Stress Scale-21 (DASS-21); PTSD Checklist for DSM-5 (PCL-5); and Brief Resilience Scale (BRS), to assess the psychological states of firefighters. The primary goal of this study was to evaluate the psychological impact of earthquakes on firefighters. Specific objectives include quantifying trauma levels; identifying the prevalence of post-traumatic stress disorder (PTSD), depression, anxiety, and stress among firefighters; and investigating the role of psychological resilience in mitigating the effects of disaster-related psychological trauma. This study is also aimed at providing empirical evidence to inform the development of psychological support and intervention strategies for firefighters in the aftermath of these earthquakes. In this study of 223 primarily male firefighters, significant psychological impacts from earthquake trauma were observed. The PETLDS scores indicated high trauma levels in 28 participants and modest levels in 195. Subscales revealed affective responses and cognitive structure were most affected. DASS-21 scores showed higher depression, anxiety, and stress in the high trauma group. PCL-5 and BRS analyses confirmed higher PTSD symptoms and lower resilience in high-trauma individuals. Correlation analysis highlighted strong associations between trauma, psychological distress, and decreased resilience. These findings highlight the necessity for targeted mental health interventions and support mechanisms for firefighters, contribute to the establishment of training programs to enhance psychological resilience among firefighters, and add valuable insights to the field of disaster psychology.

Epidemiology of Neurosurgical and Orthopedic Trauma in Children: A Study in the West of Iran

Background: Trauma can be categorized based on the characteristics of its cause into penetrating, blunt, thermal, or compressive trauma. Another type of classification is based on anatomical location, as trauma may occur at any anatomical site of the body. Objectives: This study aimed to determine the epidemiology of neurosurgical and orthopedic trauma among children in the city of Ilam. Methods: In this retrospective study, the health records of all patients aged 6 to 18 years with orthopedic and neurosurgical trauma who were referred to the hospital in Ilam were investigated. Since Imam Khomeini Hospital is the only public hospital for trauma patients in this city, only the records of patients who were referred to this hospital were reviewed. Results: Results showed that in the neurosurgical trauma group, out of 145 reviewed cases, 96 (66.2%) patients were male and 49 (33.8%) were female. In relation to orthopedic traumas, out of 570 investigated cases, 386 (67.7%) were male and 184 (32.2%) were female. Additionally, results showed that 224 (39.3%) patients had fractures in the right hand, 255 (44.7%) had fractures in the left hand, and 91 (16%) had fractures in both hands. Furthermore, 21 (14.5%) patients had cervical spine injuries, 35 (24.1%) had thoracic spine injuries, 54 (37.2%) had lumbar spine injuries, and 35 (24.1%) had brain trauma. Conclusions: In the present study, the epidemiology of neurosurgical and orthopedic trauma in children was investigated. Given the prevalence of these types of trauma in Ilam, it is necessary to provide essential training to prevent or reduce their occurrence in the future.

Quality of Life and Spiritual Health in Motorcycle Accident Survivors: An Analysis Using the SF-36 Questionnaire and Spiritual Scale

Abstract Introduction Motorcycle traffic accidents rate remained high in Taiwan letting post-trauma care an imperative issue. This study investigates the spiritual, psychological, and physical impacts of motorcycle traffic accidents in Taiwan, focusing on the role of the Injury Severity Score (ISS) in influencing quality of life (QOL) and spiritual well-being outcomes, aiming to enhance holistic recovery strategies for trauma survivors. Methods A prospective study was conducted from April 2022 to March 2024 in a level I trauma center. Patients aged 20 and above with trauma from motorcycle accidents were enrolled and divided into major (ISS ≥ 16) and non-major (ISS &lt; 16) trauma groups. QOL and spiritual health were assessed using 36-item short-form general health survey measures (SF-36) and spiritual scale before discharge and six months later. Results Of 98 patients, we observed significant post-discharge declines in both physical and mental QOL scores, regardless of ISS. However, spiritual scores improved significantly after discharge, with notable enhancements in interpersonal relationships and adversity transcendence observed in patients with ISS &lt; 16, but not in those with ISS ≥ 16. SF-36 analysis revealed that non-religious groups experienced significant declines in mental health scores post-discharge, unlike religious groups, which remained stable. Additionally, religious individuals showed significant post-discharge improvements in interpersonal relationships and adversity transcendence, while non-religious showed no improvement. This suggests a beneficial link between religious adherence and enhanced spiritual well-being. Conclusion Motorcycle accidents reduce QOL and heighten spiritual needs for survivors, regardless of accident severity categorized by ISS score. Integrating spirituality into rehabilitation processes can positively impact overall well-being. Holistic care, addressing physical, psychological, social, and spiritual needs, is vital for optimizing long-term recovery and improving prognosis in trauma survivors, especially in regions with high rates of traffic accidents like Taiwan.

Decompressive craniectomy in children: indications and outcome from a tertiary centre.

The role of decompressive craniectomy (DC) is as a rescue therapy for the treatment of intracranial hypertension. The indications for the DC are variable. The clinical details, imaging, operative findings and follow-up data of children less than or equal to 18years of age were reviewed for more information on the children who underwent DC in the last 5years. During the study period, a total of 128 children underwent DC. The trauma cases were 66, and the non-trauma cases were 62. The common indication for DC was pure acute subdural hematoma 33 (50%), followed by contusion 10 (15%) in the trauma group, and in non-trauma, arterial infarction in 20 (32%) and cerebral venous thrombosis in 17 (27%). Hemicraniectomy was done in 114 (89%), and bifrontal craniectomy was done in 7 (5.4%) cases. The median duration follow-up was 7months in non-trauma and 6months in trauma. GCS was less than 8, the motor score was less than 3, and pupillary asymmetry, hypotension and basal cistern effacement were factors related to an unfavourable outcome in the non-trauma group. In regression analysis, only a motor score of less than three was associated with the non-trauma group. Age less than 10years, GCS less than 8, motor score less than three and preoperative infarction were the predictive factors in univariate analysis, and only GCS less than 8 was the predictive factor for unfavourable factors in regression analysis in the trauma group. The DC is performed as a lifesaving procedure. The unfavourable outcome is slightly higher in non-trauma cases compared to trauma cases. However, the mortality rate is high in trauma cases.

Profiles of Trauma Exposure Type and Its Associations With Pain-Related Outcomes Among Adults With Chronic Pain: A 2-Year Longitudinal Study

Individuals with chronic pain report disproportionally higher rates of trauma, yet it is unclear whether different types of trauma (eg, sexual, accidental trauma) are associated with worse pain outcomes. The present study sought to 1) identify subgroups of people with chronic pain based on trauma type, and 2) determine whether subgroups differ in terms of pain characteristics over a 2-year period. Individuals with chronic pain (N = 1,451) participated in an online study and completed self-report questionnaires at baseline, 3-, 12-, and 24-month follow-up. Trauma was assessed via the Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Pain intensity and interference were measured via the Brief Pain Inventory, and pain distribution was evaluated using the Widespread Pain Index. Latent class analyses produced a 3-class solution consisting of individuals with high and diverse trauma (16.3%), high sexual trauma (18.4%), and low/accidental trauma (57.1%) with the rest of the sample endorsing no trauma history (8.2%). After controlling for key demographic variables and baseline outcome levels, individuals in the high- and diverse trauma group endorsed higher levels of pain severity and interference at the 3- and 12-month follow-ups compared with the group with no trauma (P < .01). Additionally, relative to the no trauma group, individuals in the high sexual trauma group reported higher levels of pain interference and more widespread pain at the 3-month follow-up (P < .05). The findings underscore the importance of screening for trauma and suggest that the type and variety of trauma experienced may be relevant to pain-related outcomes. PerspectiveThis article highlights how an individual’s unique trauma history may be related to their current pain experience. Knowledge of the type and frequency of past trauma may have relevant clinical implications for the treatment of chronic pain.