Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Association Between Low Cortisol Level and Whiplash Syndrome and the Effect of a Single Hydrocortisone Injection on Neck Symptoms Among Motor Vehicle Accident Victims: a Randomized Placebo Controlled Double Blinded Study
Brief Summary: The investigators hypothesis is that low (or low relatively to the situation) cortisol levels might be a causative factor of whiplash injury or post traumatic stress disorder following road accidents. In this study the investigators enroll patients who sustained a road accident. From all patients a blood sample will be withdrawn to measure cortisol concentrations. Than, the patients will be divided into 2 groups: the study group will receive a single injection of intravenous Hydrocortisone 100 milligram (a synthetic steroid used routinely for many years). The control group will receive a same volume of normal saline which would be used as a placebo treatment. The investigators assume that patients with low cortisol levels would tend to have a higher incidence of whiplash injuries and / or post traumatic stress disorders, and that a single bolus of hydrocortisone may prevent these untoward sequelas of trauma.


Options:
A: Inclusion Criteria:

* victims of motor vehicle accidents
* signed informed consent

Exclusion Criteria:

* pregnancy
* traumatic brain injury
* psychiatry disorders
* active cancerous conditions
* adrenal diseases
* medical treatment by estrogens, anti-depressants, melatonin, pain control.
* substance abuse
* hospitalization due to the trauma
* contra indication to hydrocortisone treatment
* over 6 hours from time of injury
B: Inclusion Criteria:

* Third-trimester pregnant women being followed at the Massachusetts General Hospital (MGH) Obstetrics Program
* At risk of postpartum depression (PPD)

Exclusion Criteria:

* Failure to participate in regular prenatal check-ups
* Current diagnosis Diagnostic and Statistical Manual of Mental Disorders (DSM-5) mental disorder pertaining to psychosis or substance abuse
* Suicidality
* Obstetric complication (e.g., preeclampsia, excessive hemorrhaging)
* Use of potentially confounding or interacting medications
* Complicating pediatric medical condition in the newborn
C: Inclusion Criteria:

1. Males and females aged 18-90 years with multiple-trauma or head trauma admitted to the ICU.
2. Enteral nutrition can be initiated within 36 hours of admission/ injury.
3. Mechanical ventilation.

Exclusion criteria:

1. Severe underlying systemic disease and /or treatment with immunosuppressive agents.
2. Contra-indication for Enteral Nutrition (mechanical or functional bowel. obstruction, high-output fistula, severe necrotizing pancreatitis).
3. 2nd /3rd degree burns covering \> 66% BSA.
4. Pregnancy.
5. Participants under the age of 18.
D: Inclusion Criteria:

* Admission to the Shriners Hospital or Massachusetts General Hospital for an acute burn, injury, or reconstructive surgery following a burn
* Between the ages of 6 - 20 years
* Recent experience of an acute burn, injury, or surgery meeting the Diagnostic and Statistical Manual(DSM-IV) A1 stressor criterion
* Child's response to the stressor meets Diagnostic and Statistical Manual(DSM-IV) A2 response criterion
* Proficiency in either English or Spanish

Exclusion Criteria:

* No memory of the injury
* Current use of an anti-depressant
* Known hypersensitivity to sertraline
* Diagnosis of Bipolar Disorder
* Diagnosis of PTSD
* Mental Retardation
* Traumatic Brain Injury
* New onset or marked worsening of a seizure disorder

Answer: A