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https://www.readbyqxmd.com/read/28424745/distinguishing-the-unique-neuropathological-profile-of-blast-polytrauma
#1
W Brad Hubbard, Shaylen Greenberg, Carly Norris, Joseph Eck, Erin Lavik, Pamela VandeVord
Traumatic brain injury sustained after blast exposure (blast-induced TBI) has recently been documented as a growing issue for military personnel. Incidence of injury to organs such as the lungs has decreased, though current epidemiology still causes a great public health burden. In addition, unprotected civilians sustain primary blast lung injury (PBLI) at alarming rates. Often, mild-to-moderate cases of PBLI are survivable with medical intervention, which creates a growing population of survivors of blast-induced polytrauma (BPT) with symptoms from blast-induced mild TBI (mTBI)...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28422897/outcomes-associated-with-blast-versus-nonblast-related-traumatic-brain-injury-in-us-military-service-members-and-veterans-a-systematic-review
#2
Nancy Greer, Nina Sayer, Eva Koeller, Tina Velasquez, Timothy J Wilt
OBJECTIVES: To systematically review the literature on comparative clinical and functional outcomes following blast-related versus nonblast-related traumatic brain injury (TBI) among US service members and Veterans. DESIGN: MEDLINE search (January 2001 to June 2016) supplemented with hand search of reference lists and input from peer reviewers. RESULTS: Thirty-one studies (in 33 articles) reported on health outcomes; only 2 were rated low risk of bias...
April 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28419850/overpressure-blast-injury-induced-oxidative-stress-and-neuroinflammation-response-in-rat-frontal-cortex-and-cerebellum
#3
Hale Z Toklu, Zhihui Yang, Sehkar Oktay, Yasemin Sakarya, Nataliya Kirichenko, Michael K Matheny, Judy Muller-Delp, Kevin Strang, Philip J Scarpace, Kevin K W Wang, Nihal Tümer
BACKGROUND & AIM: Overpressure blast-wave induced brain injury (OBI) and its long-term neurological outcome pose significant concerns for military personnel. Our aim is to investigate the mechanism of injury due to OBI. METHODS: Rats were divided into 3 groups: 1) Control, 2) OBI (exposed 30psi peak pressure, 2-2.5ms), 3) Repeated OBI (r-OBI) (three exposures over one-week period). Lung and brain (cortex and cerebellum) tissues were collected at 24h post injury...
April 15, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28403239/simulated-blast-overpressure-induces-specific-astrocyte-injury-in-an-ex-vivo-brain-slice-model
#4
Saranya Canchi, Malisa Sarntinoranont, Yu Hong, Jeremy J Flint, Ghatu Subhash, Michael A King
Exposure to explosive blasts can produce functional debilitation in the absence of brain pathology detectable at the scale of current diagnostic imaging. Transient (ms) overpressure components of the primary blast wave are considered to be potentially damaging to the brain. Astrocytes participate in neuronal metabolic maintenance, blood-brain barrier, regulation of homeostatic environment, and tissue remodeling. Damage to astrocytes via direct physical forces has the potential to disrupt local and global functioning of neuronal tissue...
2017: PloS One
https://www.readbyqxmd.com/read/28400939/intracardiac-penetrating-injury-with-right-femoral-artery-embolism-due-to-blast-injury
#5
Ahmed Abdulaziz Abuzaid, Thamer Al-Abbasi, Zaid Arekat
Embolization due to blast injury with projectiles entering the bloodstream from the heart is a rare event that is unlikely to be suspected during the initial assessment of trauma patients. We report a case in which a missile penetrating the heart chambers managed to embolize and occlude the right common femoral artery. This was successfully managed by means of a multidisciplinary approach that included exploration, cardiorrhaphy, and embolectomy.
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28390515/chronic-traumatic-encephalopathy-known-causes-unknown-effects
#6
REVIEW
Diego Iacono, Sharon B Shively, Brian L Edlow, Daniel P Perl
Chronic traumatic encephalopathy (CTE) is a neuropathologic diagnosis typically made in human brains with a history of repetitive traumatic brain injury (rTBI). It remains unknown whether CTE occurs exclusively after rTBI, or whether a single TBI (sTBI) can cause CTE. Similarly, it is unclear whether impact (eg, motor vehicle accidents) and non-impact (eg, blasts) types of energy transfer trigger divergent or common pathologies. While it is established that a history of rTBI increases the risk of multiple neurodegenerative diseases (eg, dementia, parkinsonism, and CTE), the possible pathophysiologic and molecular mechanisms underlying these risks have yet to be elucidated...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28390182/early-local-delivery-of-vancomycin-suppresses-ectopic-bone-formation-in-a-rat-model-of-trauma-induced-heterotopic-ossification
#7
Jonathan G Seavey, Benjamin M Wheatley, Gabriel J Pavey, Allison M Tomasino, Margaret A Hanson, Erin M Sanders, Devaveena Dey, Kaitlyn L Moss, Benjamin K Potter, Jonathan A Forsberg, Ammar T Qureshi, Thomas A Davis
Heterotopic ossification (HO) is a debilitating sequela of high-energy injuries. It frequently requires surgical excision once symptomatic and there is no practical prophylaxis for combat-injured patients. In this study, we examined the effect of local vancomycin powder on HO formation in a small animal model of blast-related, post-traumatic HO. Male Sprague-Dawley rats were subjected to a polytraumatic extremity injury and amputation with or without methicillin-resistant Staphylococcus aureus infection. Animals were randomized to receive a single local application of vancomycin (20 mg/kg) at the time of injury (POD-0, n = 34) or on postoperative day-3 (POD-3, n = 11)...
April 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28386605/blast-scaling-parameters-transitioning-from-lung-to-skull-base-metrics
#8
Brandon P Lucke-Wold, Ryan C Turner, Aric Flint Logsdon, Charles L Rosen, Rabia Qaiser
Neurotrauma from blast exposure is one of the single most characteristic injuries of modern warfare. Understanding blast traumatic brain injury is critical for developing new treatment options for warfighters and civilians exposed to improvised explosive devices. Unfortunately, the pre-clinical models that are widely utilized to investigate blast exposure are based on archaic lung based parameters developed in the early 20th century. Improvised explosive devices produce a different type of injury paradigm than the typical mortar explosion...
2017: J Surg Emerg Med
https://www.readbyqxmd.com/read/28383472/battlefield-pain-management-a-view-of-17-years-in-israel-defense-forces
#9
Avi Benov, Margaux M Salas, Helit Nakar, Ben Antebi, Bader Tarif, Avraham Yitzhak, Elon Glassberg
INTRODUCTION: Pain control in trauma is an integral part of treatment in combat casualty care (CCC). More soldiers injured on the battlefield will need analgesics for pain than those who will need life-saving interventions (LSI). It has been shown that early treatment of pain improves outcomes after traumatic injury, while inadequate treatment leads to higher rates of PTSD. The purpose of this article is to report the Israel Defense Forces Medical Corps (IDF-MC) experience with point of injury (POI) use of analgesia...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#10
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28382215/central-cord-syndrome-from-blast-injury-after-gunshot-wound-to-the-spine-a-case-report-and-a-review-of-the-literature
#11
Juan Galloza, Juan Valentin, Edwardo Ramos
INTRODUCTION: Central Cord Syndrome (CCS) is the most common of the spinal cord injury syndromes. Few cases have been presented with gunshot wound (GSW) as a cause of a central cord syndrome, and none, to our knowledge, has been presented without any evidence of central canal bullet/bone fragments. CASE PRESENTATION: A 27-year-old male suffered two close-range gunshot wounds, one to the left neck and one to the left shoulder. CT scan showed C5 spinous process fracture and paraspinal muscle hemorrhage without evidence of central canal stenosis or bullet/bone fragments...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28366471/phosphodiesterase-4-inhibition-restored-hippocampal-long-term-potentiation-after-primary-blast
#12
Edward W Vogel, Fatima N Morales, David F Meaney, Cameron R Bass, Barclay Morrison
Due to recent military conflicts and terrorist attacks, blast-induced traumatic brain injury (bTBI) presents a health concern for military and civilian personnel alike. Although secondary blast (penetrating injury) and tertiary blast (inertia-driven brain deformation) are known to be injurious, the effects of primary blast caused by the supersonic shock wave interacting with the skull and brain remain debated. Our group previously reported that in vitro primary blast exposure reduced long-term potentiation (LTP), the electrophysiological correlate of learning and memory, in rat organotypic hippocampal slice cultures (OHSCs) and that primary blast affects key proteins governing LTP...
March 31, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28341786/effectiveness-of-foot-fasciotomies-in-foot-and-ankle-trauma
#13
Katherine M Bedigrew, D J Stinner, J F Kragh, B K Potter, S B Shawen, J R Hsu
BACKGROUND: Foot compartment syndrome (FCS) has been reported to cause neuropathic pain, claw or hammer toes, and motor and sensory disturbances. The optimal treatment of FCS is controversial. The purpose of this study was to determine if foot fasciotomies improve patient outcomes in high-energy, combat-related lower extremity trauma. METHODS: Medical records of patients with documented FCS from May 2007 to January 2009 were retrospectively reviewed. Consecutive, matched control patients were identified based on similar hindfoot, mid-foot and/or forefoot injuries who did not undergo foot fasciotomy during the same period...
March 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28329435/face-shield-design-against-blast-induced-head-injuries
#14
Long Bin Tan, Kwong Ming Tse, Yuan Hong Tan, Mohamad Ali Bin Sapingi, Vincent Beng Chye Tan, Heow Pueh Lee
Blast-induced traumatic brain injury (TBI) has been on the rise in recent years due to the increasing use of improvised explosive devices (IEDs) in conflict zones. Our study investigates the response of a helmeted human head subjected to a blast of 1 atm peak overpressure, for cases with and without a standard polycarbonate (PC) face shield and for face shields comprising of composite PC and aerogel materials and with lateral edge extension. The novel introduction of aerogel into the laminate face shield is explored and its wave-structure interaction mechanics and performance in blast mitigation is analysed...
March 22, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28328632/use-of-processed-nerve-allografts-to-repair-nerve-injuries-greater-than-25-mm-in-the-hand
#15
Brian Rinker, Jozef Zoldos, Renata V Weber, Jason Ko, Wesley Thayer, Jeffrey Greenberg, Fraser J Leversedge, Bauback Safa, Gregory Buncke
Processed nerve allografts (PNAs) have been demonstrated to have improved clinical results compared with hollow conduits for reconstruction of digital nerve gaps less than 25 mm; however, the use of PNAs for longer gaps warrants further clinical investigation. Long nerve gaps have been traditionally hard to study because of low incidence. The advent of the RANGER registry, a large, institutional review board-approved, active database for PNA (Avance Nerve Graft; AxoGen, Inc, Alachua, FL) has allowed evaluation of lower incidence subsets...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28323898/perfluorocarbon-reduces-cell-damage-from-blast-injury-by-inhibiting-signal-paths-of-nf-%C3%AE%C2%BAb-mapk-and-bcl-2-bax-signaling-pathway-in-a549-cells
#16
Zhaorui Zhang, Zhixin Liang, Huaidong Li, Chunsun Li, Zhen Yang, Yanqin Li, Danyang She, Lu Cao, Wenjie Wang, Changlin Liu, Liangan Chen
BACKGROUND AND OBJECTIVE: Blast lung injury is a common type of blast injury and has very high mortality. Therefore, research to identify medical therapies for blast injury is important. Perfluorocarbon (PFC) is used to improve gas exchange in diseased lungs and has anti-inflammatory functions in vitro and in vivo. The aim of this study was to determine whether PFC reduces damage to A549 cells caused by blast injury and to elucidate its possible mechanisms of action. STUDY DESIGN AND METHODS: A549 alveolar epithelial cells exposed to blast waves were treated with and without PFC...
2017: PloS One
https://www.readbyqxmd.com/read/28322622/central-nervous-system-changes-induced-by-underbody-blast-induced-hyperacceleration-an-in-vivo-diffusion-tensor-imaging-and-magnetic-resonance-spectroscopy-study
#17
Shiyu Tang, Su Xu, William L Fourney, Ulrich H Leiste, Julie L Proctor, Gary Fiskum, Rao P Gullapalli
Blast-related traumatic brain injury (bTBI) resulting from improvised explosive devices is the hallmark injury of recent wars, and affects many returning veterans who experienced either direct or indirect exposure. Many of these veterans have long-term neurocognitive symptoms. However, there is very little evidence to show whether blast-induced acceleration alone, in the absence of secondary impacts, can cause mild TBI. In this study, we examine the effect of under-vehicle blast-induced hyperacceleration (uBIH) of ∼1700 g on the biochemical and microstrucutral changes in the brain using diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS)...
March 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28293522/a-case-report-of-the-first-nonburn-related-military-trauma-victim-treated-with-spray-skin-regenerative-therapy-in-combination-with-a-dermal-regenerate-template
#18
Ian L Valerio, Daniel A Hammer, Juan L Rendon, Kerry P Latham, Mark E Fleming
Massive soft tissue and skin loss secondary to war-related traumas are among the most frequently encountered challenges in the care of wounded warriors. This case report outlines the first military nonburn-related trauma patient treated by a combination of regenerative modalities. Our case employs spray skin technology to an established dermal regenerate matrix. Our patient, a 29-year-old active duty male, suffered a combat blast trauma in 2010 while deployed. The patient's treatment course was complicated by a severe necrotizing fasciitis infection requiring over 100 surgical procedures for disease control and reconstruction...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28292391/endovascular-treatment-of-carotid-internal-jugular-venous-fistula-in-a-bomb-blast-victim
#19
Tariq Ashraf, Navedullah Khan, K M Yousaf, Maha Zainab Z. Yaqub
Carotid-internal jugular venous fistula is one of the rarest presentations among victims of bomb blast injuries. Treatment of such fistula is open surgery with high mortality and morbidity. Endovascular treatment with covered stent seems to have an optimal result with low complications. We present a case report of a bomb blast victim having carotid-jugular venous fistula with hemodynamic compromise. The patient was successfully managed with endovascular graft stent. There was an optimal result with no immediate and long-term complications...
February 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28291503/regenerative-and-antibacterial-properties-of-acellular-fish-skin-grafts-and-human-amnion-chorion-membrane-implications-for-tissue-preservation-in-combat-casualty-care
#20
Skuli Magnusson, Baldur Tumi Baldursson, Hilmar Kjartansson, Ottar Rolfsson, Gudmundur Fertram Sigurjonsson
BACKGROUND: Improvised explosive devices and new directed energy weapons are changing warfare injuries from penetrating wounds to large surface area thermal and blast injuries. Acellular fish skin is used for tissue repair and during manufacturing subjected to gentle processing compared to biologic materials derived from mammals. This is due to the absence of viral and prion disease transmission risk, preserving natural structure and composition of the fish skin graft. OBJECTIVES: The aim of this study was to assess properties of acellular fish skin relevant for severe battlefield injuries and to compare those properties with those of dehydrated human amnion/chorion membrane...
March 2017: Military Medicine
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