Enduring association between irritable bowel syndrome and war trauma during the Nicaragua civil war period:A population-based study

BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.

Construction and application of time-effect assessment database for experiments on war-traumatized animals

Background:High-quality real war trauma data are important,but they are still lacking.Using the database to realize the networked,systematic,standardized,and dynamic management of war injury animal experimental data can provide a real and reliable supplement for the research of war injury treatment.Methods:Through demand analysis,module design,architecture design,compilation and debugging,and other processes,JAVA language development tools were used to develop a time-effect assessment database for experiments on war-traumatized animals,where the browser/server architecture(B/S architecture)is used as the technical architecture and SQL Server as the database management system.Results:A time-effect assessment database for experiments on war-traumatized animals that features reasonable structural design,rich data resources,and convenient use has been established,in which case efficient collection,storage,display,retrieval,and management of animal experimental data have been achieved.At present,the database is running well and has good data quality.