Trauma Care, Volume 1, Issue 3 (December 2021) – 7 articles

The prevention of recurrent ankle sprain and functional ankle instability in soccer players is essential. This study clarified hip joint mobility and dynamic balance ability in soccer players with functional ankle instability. This case–control study included 17 male college soccer players. All participants were assessed using the Cumberland Ankle Instability Tool and were divided into chronic ankle instability (CAI) and non-CAI groups for each of their dominant and nondominant legs. Bilateral passive hip range of motion (ROM) was assessed and the modified Star Excursion Balance Test (mSEBT) was measured for each leg. In the dominant leg, the reach in the posterolateral direction in the CAI group was significantly less than that in the non-CAI group. Hip internal rotation angles in the dominant leg in the CAI group were greater than those in the non-CAI group; however, no significant correlations with the three directions of mSEBT were observed. In the nondominant leg, mSEBT and hip ROMs did not show any significant differences between groups. The dominant leg in soccer players with CAI had poor dynamic balance ability while reaching posterolaterally. However, acquiring hip flexibility may not be necessary to improve the dynamic balance ability. These findings may help develop future research. Full article

Biological dressings such as collagen and hyaluronic acid represent the main advanced tools that plastic surgeons, dermatologists and vulnologists use today to treat chronic wounds or ulcers that do not tend to heal. These types of dressings are important because they create a moist and physiological interface at the wound level, are of natural origin, easy to use, hypo-allergenic, economical and do not create discomfort for the patient during dressing changes. We treated 128 patients (divided into four groups based on type of dressing) with non-complex superficial chronic wounds in comparison with a traditional dressing (fitostimoline gauze or polyurethane foam). We analyzed wound characteristics, healing time, and operator and patient satisfaction. A significantly higher recovery rate was observed in the “Collagen-coated plates” treatment group compared to Standard Treatment. Additionally, a significantly higher probability of recovery was observed compared to the alternative two experimental devices (Collagen-coated plates + HA and Collagen-based spray). However, the main limitation of the randomization of this study is the presence in the “Collagen-based spray” group of localized wounds, mainly in the fingers and hand. No side effects were reported in relation to the procedures or the experimental products. Collagen may be considered as a valuable therapeutic tool in non-complex chronic wounds by virtue of its low immunogenicity, flexibility and applicability in biocompatible scaffolds, and represents driving force toward enhanced wound care. Full article

Trauma and its related psychological and somatic consequences are associated with higher cardiovascular morbidity. The regulation of both the gasotransmitter hydrogen sulfide (H₂S) and the neuropeptide oxytocin (OT) have been reported to be affected during physical and psychological trauma. Both mediators are likely molecular correlates of trauma-induced cardiovascular complications, because they share parallel roles and signaling pathways in the cardiovascular system, both locally as well as on the level of central regulation and the vagus nerve. Meditation can alter the structure of specific brain regions and can have beneficial effects on cardiovascular health. This perspective article summarizes the evidence pointing toward the significance of H₂S and OT signaling in meditation-mediated cardio-protection. Full article

Severe acquired brain injuries (sABI) represent one of the main causes of disability and limitation in social life participation that need an intensive rehabilitation approach. The purpose of this study was to identify a possible correlation between different supposed conditioning factors and the efficiency of rehabilitation interventions. In this retrospective study, data were processed regarding 44 patients admitted to a neurorehabilitation department after sABI. A significant correlation with the efficiency of the rehabilitation intervention (expressed as the variation of the Barthel score between discharge and admittance in relation to the duration of the rehabilitative hospitalization) was found for both the etiology of the brain injury (p = 0.023), the precocity of the rehabilitation treatment (p = 0.0475), the presence of a tracheal cannula (p = 0.0084) and forms of nutrition other than oral (p < 0.0001). The results of this study suggest that improving the management of the respiratory system, swallowing and nutritional aspects, and favoring an early and personalized rehabilitation treatment, can help to optimize the overall care of patients suffering from sABI, thus allowing a reduction in complications, improvement in functional recovery and ensuring a better management of economic, social and health resources. Full article

In Italy, in only 2018, 3310 people died in road traffic accidents, more than in any other European country. Since the revelation of this occurrence, the authors carried out an analysis aimed at investigating if there was a difference in the injury patterns among different road users. A retrospective post-mortem study on road traffic fatalities was performed, which had been autopsied at the Institute of Forensic Medicine of Milan. First, the authors analyzed the epidemiological data of all the 1022 road traffic accidents subjected to an autopsy from 2007 to 2019. Secondly, further analysis of individual autopsy reports was carried out. For this purpose, 180 autopsies belonging to 5 different categories were analyzed: car, pedestrian, motorbike, bicycle, and truck. Seventy-six percent of road traffic fatalities were male, 54% were between 10 and 49 years of age, and 62% of the patients died before arriving at a hospital. “Multiple injuries” was the main cause of death. Traumatic brain injuries were particularly high in pedestrians and cyclists. In car, motorbike, and truck fatalities, thoracic and abdominal injuries were the most frequent. Therefore, pedestrians and cyclists had a higher prevalence for traumatic head injuries, while car, motorcycle, and truck occupants, on the other hand, had a higher prevalence for thoracic and abdominal injuries. Full article

Despite the high rates of discrimination and mental health issues experienced by lesbian, gay, bisexual, and transgender (LGBT) adults at an international level, very little research has focused on this population in Latin America. As a result, the purpose of this study was to explore relationships among discrimination experiences, mental health (i.e., anxiety and depressive symptoms), suicidal ideation, religiosity, and social support in LGBT adults in Latin America. A sample of 99 participants from the region completed an online survey assessing these constructs. Results suggested that 51.5% of the sample reported lifetime suicidal ideation. Experiences with harassment/rejection-type discrimination predicted suicidal ideation, while work/school-type discrimination predicted mental health problems (anxiety and depression). Depressive symptoms predicted suicidal ideation, while anxiety symptoms alone did not. Further, depressive symptoms mediated relationships between work/school discrimination and suicidal ideation, as well as between harassment/rejection discrimination and suicidal ideation. Moderated mediation analyses suggested that high, but not low or moderate levels of social support and religiosity buffered LGBT adults in Latin America against discrimination, specifically by weakening links among discrimination, depressive symptoms, and suicidal ideation. Clinical intervention research with LGBT adults in Latin America should focus on increasing social support networks for this population and on helping LGBT adults reconcile conflicts between religious identities and sexual or gender minority identities, as healthy religiosity may serve as a protective factor against mental health problems generally, and suicidal ideation specifically. Full article

Despite trauma-related injuries being a leading cause of death worldwide, low- and middle-income countries (LMICs) lack the infrastructure and resources required to offer immediate surgical care, further perpetuating the risk of morbidity and mortality. In high-income countries, trauma surgery simulation courses are routinely delivered to surgeons, teaching the fundamental skills of operative trauma. This study aimed to assess whether similar courses are beneficial in LMICs and how they can be improved. We performed a systematic review and meta-analysis using MEDLINE, Embase and Google Scholar, analysing studies evaluating trauma surgery simulation in LMICs. The outcomes measured included clinical knowledge improvement, participant confidence and general course-feedback. The review was carried out in-line with PRISMA guidelines. Five studies were included, summating a population of 172 participants. In three studies, meta-analysis showed an overall significant weighted mean improvement of knowledge post-course by 22.91% (95%CI 19.53, 26.29; p < 0.00001; I² = 0%). One study reported a significant increase in participant confidence for 20/22 of operative skills taught (p < 0.04). We conclude that these courses are beneficial in LMICs; however, further research is necessary to establish the optimum course design, and whether patient outcomes are improved following their implementation. Collaboration between international trauma institutions is essential for closing the educational resource inequality gap between higher- and lower-income countries. Full article