Risk of permanent medical impairment after road traffic crashes: A systematic review / 中华创伤杂志(英文版)

PURPOSE@#To systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding permanent impairment following road traffic crashes.@*METHODS@#We conducted this systematic review according to the preferred reporting items for systematic reviews and meta-analysis statement. An extended search of the literature was carried out in 4 major electronic databases for scientific research papers published from January 1980 to February 2020. Two teams include 2 reviewers each, screened independently the titles/abstracts, and after that, reviewed the full text of the included studies. The quality of the studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. A third reviewer was assessed any discrepancy and all data of included studies were extracted. Finally, the data were systematically analyzed, and the related data were interpreted.@*RESULTS@#Five out of 16 studies were evaluated as high-quality according to the STROBE checklist. Fifteen studies ranked the initial injuries according to the abbreviated injury scale 2005. Five studies reported the total risk of permanent medical impairment following RTIs which varied from 2% to 23% for car occupants and 2.8% to 46% for cyclists. Seven studies reported the risk of permanent medical impairment of the different body regions. Eleven studies stated the most common body region to develop permanent impairment, of which 6 studies demonstrated that injuries of the cervical spine and neck were at the highest risk of becoming permanent injured.@*CONCLUSION@#The finding of this review revealed the necessity of providing a globally validated method to evaluate permanent medical impairment following RTIs across the world. This would facilitate decision-making about traffic injuries and efficient management to reduce the financial and psychological burdens for individuals and communities.

Time dependent antinociceptive effects of morphine and tramadol in the hot plate test: using different methods of drug administration in female rats

Morphine and tramadol which have analgesic effects can be administered acutely or chronically. This study tried to investigate the effect of these drugs at various times by using different methods of administration [intraperitoneal, oral, acute and chronic]. Sixty adult female rats were divided into six groups. They received saline, morphine or tramadol [20 to 125 mg/Kg] daily for 15 days. A hot plate test was performed for the rats at the 1[st], 8[th] and 15[th] days. After drug withdrawal, the hot plate test was repeated at the 17[th], 19[th], and 22[nd] days. There was a significant correlation between the day, drug, group, and their interaction [P<0.001]. At 1[st] day [d1], both morphine, and tramadol caused an increase in the hot plate time comparing to the saline groups [P<0.001], while there was no correlation between drug administration methods of morphine and/or tramadol. At the 8[th] day [d8], morphine and tramadol led to the most powerful analgesic effect comparing to the other experimental days [P<0.001]. At the 15[th] day [d15], their effects diminished comparing to the d8. After drug withdrawal, analgesic effect of morphine, and tramadol disappeared. It can be concluded that the analgesic effect of morphine and tramadol increases with the repeated use of them. Thereafter, it may gradually decrease and reach to a level compatible to d1. The present data also indicated that although the analgesic effect of morphine and tramadol is dose-and-time dependent, but chronic exposure to them may not lead to altered nociceptive responses later in life

Increasing and decreasing factors of hope in infertile women with failure in infertility treatment: a phenomenology study

Assisted reproductive technology [ART] provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. The purpose of this study was to explore the lived experience of infertile women from increasing and decreasing factors of hope in infertile women with failure in infertility treatment. Using a qualitative research design [Phenomenology study], 23 subjects were selected who had experienced infertility failure visited by gynecologist [Rasekh Infertility center] in 2012. The data were collected through semi structured interviews and analyzed using interpretive research strategies of phenomenology by Collizi's seven-stage method. Totally 96 codes were identified. The data arranged in two categories. The factors decreasing and increasing hope in infertility treatments. Totally 5 themes and 20 sub themes were extracted. The increasing factors which emerged from the data contain "spiritual source", "family interaction and support" and "information through the media", and decreasing factors contain "nature of treatments" and "negatively oriented mind"

[Comparison of the effects of chronic administration of morphine and tramadol in infancy on acute pentylenetetrazol-induced seizure in prepubertal rats]

It is demonstrated that morphine and tramadol affects seizure but the mode of action of these drugs on seizure has not been compared yet with increasing of age. The aim of this study was to compare the impact of exposure to these drugs on Pentylenetetrazol-induced seizure in immature rat. Male neonate rats were randomly chosen and divided into three groups namely Saline [n=21], Morphine [n=12] and Tramadol [n=13]. On postnatal days 8-14, Saline group received normal saline and two other groups received morphine and tramadol with additive doses, respectively. On postnatal days 22-28, the saline treated rats divided into three subgroups and received saline [n=8], morphine [n=8] or tramadol [n=5]. Morphine treated rats received saline or morphine [each n=6], and tramadol treated rats received saline [n=7] or tramadol [n=6]. At postnatal day 29, they were evaluated for PTZ-induced seizure. Number of tonic-clonic seizure was increased in all groups compared with control and tramadol+saline groups [P<0.05]. Duration of tonic-clonic seizure was decreased in tramadol+saline group compared with other tramadol groups [P<0.05]. Latency of tonic-clonic seizurewas decreased in tramadol+saline group compared with control rats [P<0.05], But it was increased in saline+tramadol group compared with other groups except to saline group [P<0.05]. Latency of myoclonic contractions in saline+morphine and saline+tramadol groups was lower than in control rats [P<0.05]. Similar age-related changes may occur inchronic exposure to morphine and tramadol in the neonatal period which leads to an increase in severity of seizures in rats on postnatal days 22-28. The effect of morphine and tramadol does not show any significant difference