PubMed · 5686808
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K Solheim. 1968-05-15. [Closed thoracic injuries].. https://pubmed.ncbi.nlm.nih.gov/5686808/
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BACKGROUND: Previous research examining biological correlates of posttraumatic stress disorder (PTSD) in children has suggested that children with chronic PTSD have altered levels of catecholamines and cortisol compared to similarly traumatized children who do not meet diagnostic criteria. The present study extended these findings by examining whether urinary hormone levels collected soon after a trauma were related to subsequent acute PTSD symptoms in child trauma victims. METHODS: Initial 12-h urine samples were collected from 82 children aged 8-18 admitted to a Level 1 trauma center. Collection was begun immediately upon admission, and samples were assayed for levels of catecholamines and cortisol. PTSD and depressive symptomatology were assessed 6 weeks following the accident. RESULTS: Initial urinary cortisol levels were significantly correlated with subsequent acute PTSD symptoms (r=0.31). After removing the variance associated with demographic variables and depressive symptoms, urinary cortisol and epinephrine levels continued to predict a significant percentage (7-10%) of the variance in 6-week PTSD symptoms. Examination of boys and girls separately suggested that significance was primarily driven by the strength of the relationships between hormone levels and acute PTSD symptoms in boys. CONCLUSIONS: The present findings suggest that high initial urinary cortisol and epinephrine levels immediately following a traumatic event may be associated with increased risk for the development of subsequent acute PTSD symptoms, especially in boys.
In the face of mounting concern at traffic congestion in the vicinity of schools and the associated risks of child pedestrian injury, the 'walking school bus' (WSB) idea has been rapidly adopted within metropolitan Auckland. WSBs involve volunteers guiding children to and from school in an orderly manner following established walking routes. This paper reports on a survey of the 34 Auckland primary schools which had adopted the scheme by November 2002. Despite rates of child pedestrian injury being highest in areas of socio-economic deprivation, our survey found WSB developments highly concentrated in low deprivation neighbourhoods. The inequitable socio-spatial distribution of WSBs in Auckland suggests that the ability to respond to road safety issues is closely correlated with socio-economic privilege. While our respondents identified a number of individual and community health benefits accruing from WSBs, we conclude that the initiative has a limited ability to address public health challenges originating within an inequitable and car-dominated urban political system.
PURPOSE: To evaluate the pattern of ocular and visual complications of head injury. METHOD: A prospective study of 225 head-injured patients managed at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. For the purpose of extracting visual complications, a Neurosurgeon and an Ophthalmologist examined each patient and appropriate investigations were carried out. Patients with ocular morbidity were analysed for age, sex, cause of injury, admission Glasgow coma score, and associated injuries in addition to findings at ophthalmic and neurosurgical evaluations. RESULTS: Two major types of ocular and visual complications were observed in 57 (25.3%) of 225 head-injured patients studied. Soft-tissue injury to the globe and adnexae included periorbital ecchymosis, subconjuctival haemorrhage, lid laceration, or rarely globe rupture in 29 patients. Neuro-ophthalmic ocular cranial nerve palsies occurred in 28 patients, while orbital fracture was encountered in two patients. Ocular injuries were multiple in 60% of cases. The patients, comprising 37 male and 20 female subjects, were aged 9 months to 57 years (mean=28 years). Traffic accident was the leading cause of head injuries (84.2%), while fall from height (7%), assault (7%), and gunshot (1.8%) were miscellaneous causes. CONCLUSION: Injury to the globe and adnexae and ocular cranial nerve palsies constitute the most common oculovisual complications following head injury in our centre.