Trauma, defining

Association of Pain, neuropathic pain is defined as pain initiated or caused by a primary lesion, dysfunction in the nervous system". Neuropathy can be divided broadly into peripheral and central neuropathic pain, depending on whether the primary lesion or dysfunction is situated in the peripheral or central nervous system. In the periphery, neuropathic pain can result from disease or inflammatory states that affect peripheral nerves (e.g. diabetes mellitus, herpes zoster, HIV) or alternatively due to neuroma formation (amputation, nerve transection), nerve compression (e.g. tumours, entrapment) or other injuries (e.g. nerve crush, trauma). Central pain syndromes, on the other hand, result from alterations in different regions of the brain or the spinal cord. Examples include tumour or trauma affecting particular CNS structures (e.g. brainstem and thalamus) or spinal cord injury. Both the symptoms and origins of neuropathic pain are extremely diverse. Due to this variability, neuropathic pain syndromes are often difficult to treat. Some of the clinical symptoms associated with this condition include spontaneous pain, tactile allodynia (touch-evoked pain), hyperalgesia (enhanced responses to a painful stimulus) and sensory deficits. 

Cellulitis is characterized by erythema and edema of the skin. The lesion, which may be extensive, is painful and nonelevated and has poorly defined margins. Tender lymphadenopathy associated with lymphatic involvement is common. Malaise, fever, and chills are also commonly present. There is usually a history of an antecedent wound from minor trauma, an ulcer, or surgery. 

Synonyms of adverse reactions generally include adverse medical effects, untoward effects, side effects, adverse drug experiences, and adverse drug reactions. Specific distinctions among some of these terms may be defined operationally. For example, the term adverse reaction is used to denote those signs and symptoms at least possibly related to a medicine, whereas the term adverse experience is used to include nonmedicine-related medical problems in a trial such as those emanating from trauma or concurrent illness. Distinctions among side effects, adverse events, and adverse reactions are illustrated in the definitions of the two former terms. 

We will rely heavily on a literature review for this section (Aman, 1993). Self-injury may be defined as external trauma resulting from repetitive acts directed against oneself. Within residential institutions, the prevalence of self-injury is typically between 10% and 15%, whereas outside of institutions the prevalence is often reported as being between 1% and 2.5% (Aman, 1993). Factors associated with self-injury include se-... 

Osteoporosis is defined as a generalized decrease in bone mass (osteopenia) that equally affects bone matrix and mineral content and is associated with a change in spon-giosal architecture. This condition predisposes to collapse of vertebral bodies and bone fractures with trivial trauma (e.g., hip fractures). 

In addition to problems with study design and study instruments, the DSM-IV diagnostic criteria themselves lack specificity, making case definitions difficult in epidemiologic studies of mass trauma victims. For example, the DSM-IV criteria for PTSD define exposure vaguely as the person experienced, witnessed, or was confronted with the event (6,7). Fortunately, the accompanying explanatory text... 

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