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https://www.readbyqxmd.com/read/28814441/left-of-bang-interventions-in-trauma-ethical-implications-for-military-medical-prophylaxis
#1
Neil Eisenstein, David Naumann, Daniel Burns, Sarah Stapley, Heather Draper
Advances in medical capability should be accompanied by discussion of their ethical implications. In the military medical context there is a growing interest in developing prophylactic interventions that will mitigate the effects of trauma and improve survival. The ethics of this novel capability are currently unexplored. This paper describes the concept of trauma prophylaxis (Left Of Bang Interventions in Trauma) and outlines some of the ethical issues that need to be considered, including within concept development, research and implementation...
August 16, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28810996/rhabdomyolysis-after-crawling-military-training
#2
Danit Atias-Varon, Haggai Sherman, Ran Yanovich, Yuval Heled
INTRODUCTION: Rhabdomyolysis is a syndrome characterized by muscle necrosis followed by release of intracellular muscle contents into the circulation. Exertional rhabdomyolysis (ER) occurs in response to nonfamiliar and/or excessive, prolonged, or repetitive exercises, with eccentric characteristics. In military populations, due to the type of intense, all out physical loads, ER is a significant threat, particularly when training under heat stress. However, many other etiologies exist, and clinical presentations vary greatly...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810991/posterior-cruciate-ligament-injuries-associated-with-military-survival-swim-training
#3
Michael S Crowell, John S Mason, Matthew A Posner, Chad A Haley
OBJECTIVES: Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810979/women-veterans-a-population-at-risk-for-fibromyalgia-the-associations-between-fibromyalgia-symptoms-and-quality-of-life
#4
Rita F D'Aoust, Alicia Gill Rossiter, Amanda Elliott, Ming Ji, Cecile Lengacher, Maureen Groer
BACKGROUND: The Institute of Federal Health Care recently published an executive summary from a round table discussion indicating that active duty and retired female military personnel are at high risk for adverse health outcomes unique to military service including complications related to post-traumatic stress disorder (PTSD), unreported sexual trauma, and musculoskeletal problems. In 2008, the Institute of Medicine began to review, evaluate, and summarize the literature on health outcomes in Gulf War-deployed and found sufficient evidence of a causal relationship with PTSD and suggestive evidence of an association with fibromyalgia (FM)...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810959/a-retrospective-review-of-clinical-admissions-to-afghan-national-security-forces-health-care-institutions
#5
Christian W Ertl, David Royal, Jairo Espinosa
BACKGROUND: Few published reports have examined the numbers of civilian injuries treated at Military Treatment Facilities in the Afghan Theater of Operations. However, review of Department of Defense Trauma Registry revealed a persistent percentage of civilians treated by NATO, and this study compares the proportion of civilians served by Afghan and Coalition military hospitals between 2009 and 2013. METHODS: A retrospective review of records from Department of Defense trauma Registry for Coalition data, and Afghan data from the Office of the Inspector General...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810268/swallowing-mechanics-associated-with-artificial-airways-bolus-properties-and-penetration-aspiration-status-in-trauma-patients
#6
Angela M Dietsch, Christopher B Rowley, Nancy Pearl Solomon, William G Pearson
Purpose: Artificial airway procedures such as intubation and tracheotomy are common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in relation to mechanical features of swallowing. Method: Coordinates of anatomical landmarks were extracted at minimum and maximum hyolaryngeal excursion from 228 videofluoroscopic swallowing studies representing 69 traumatically injured U...
August 15, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28806368/increased-health-care-utilization-and-costs-among-veterans-with-a-positive-screen-for-military-sexual-trauma
#7
Emily Brignone, Adi V Gundlapalli, Rebecca K Blais, Rachel Kimerling, Tyson S Barrett, Richard E Nelson, Marjorie E Carter, Matthew H Samore, Jamison D Fargo
BACKGROUND: The effects of sexual trauma on long-term health care utilization and costs are not well understood due to infrequent documentation of sexual trauma history in health care systems. The Veteran's Health Administration provides a unique opportunity to address this constraint as sexual trauma is actively screened for as part of routine care. METHODS: We used a retrospective cohort design to analyze Veteran's Health Administration mental health and medical service utilization and costs as a function of a positive screen for exposure to military sexual trauma (MST) among Veterans of recent conflicts in Iraq and Afghanistan...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28802575/military-experience-can-influence-women-s-eating-habits
#8
Jessica Y Breland, Rosemary Donalson, Andrea Nevedal, Julie V Dinh, Shira Maguen
BACKGROUND: Disordered eating, ranging from occasional binge eating or restriction to behaviors associated with eating disorder diagnoses, is common among military personnel and veterans. However, there is little information on how military service affects eating habits. OBJECTIVE: To describe possible pathways between military service and disordered eating among women veterans, a high risk group. MATERIALS AND METHODS: Twenty women veterans who reported changing eating habits in response to stress participated in audio-recorded focus groups or dyadic interviews between April 2013 and October 2014...
August 9, 2017: Appetite
https://www.readbyqxmd.com/read/28797041/repeat-low-level-blast-exposure-increases-transient-receptor-potential-vanilloid-1-trpv1-and-endothelin-1-et-1-expression-in-the-trigeminal-ganglion
#9
Elaine D Por, Melody L Sandoval, Chiquita Thomas-Benson, Teresa A Burke, Allison Doyle Brackley, Nathaniel A Jeske, Jeffery M Cleland, Brian J Lund
Blast-associated sensory and cognitive trauma sustained by military service members is an area of extensively studied research. Recent studies in our laboratory have revealed that low-level blast exposure increased expression of transient receptor potential vanilloid 1 (TRPV1) and endothelin-1 (ET-1), proteins well characterized for their role in mediating pain transmission, in the cornea. Determining the functional consequences of these alterations in protein expression is critical to understanding blast-related sensory trauma...
2017: PloS One
https://www.readbyqxmd.com/read/28793834/a-preliminary-examination-of-the-role-of-psychotherapist-fidelity-on-outcomes-of-cognitive-processing-therapy-during-an-rct-for-military-sexual-trauma-related-ptsd
#10
Nicholas Holder, Ryan Holliday, Rush Williams, Kacy Mullen, Alina Surís
While cognitive processing therapy (CPT) is an effective evidence-based treatment for many veterans with military-related post-traumatic stress disorder (PTSD), not all veterans experience therapeutic benefit. To account for the discrepancy in outcomes, researchers have investigated patient- and research design-related factors; however, therapist factors (e.g. fidelity) have received less attention. The present study is a preliminary examination of the effect of psychotherapists' fidelity during CPT on clinical outcomes during a randomized clinical trial (RCT) for military sexual trauma-related PTSD...
August 10, 2017: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/28790873/parent-child-interaction-therapy-current-perspectives
#11
REVIEW
Corey C Lieneman, Laurel A Brabson, April Highlander, Nancy M Wallace, Cheryl B McNeil
Parent-Child Interaction Therapy (PCIT) is an empirically supported intervention originally developed to treat disruptive behavior problems in children between the ages of 2 and 7 years. Since its creation over 40 years ago, PCIT has been studied internationally with various populations and has been found to be an effective intervention for numerous behavioral and emotional issues. This article summarizes progress in the PCIT literature over the past decade (2006-2017) and outlines future directions for this important work...
2017: Psychology Research and Behavior Management
https://www.readbyqxmd.com/read/28771018/treatment-of-co-occurring-posttraumatic-stress-disorder-and-substance-use-does-order-of-onset-influence-outcomes
#12
Kaitlin E Bountress, Christal Badour, Julianne Flanagan, Amanda K Gilmore, Sudie E Back
OBJECTIVE: Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) represent major public health concerns, particularly among veterans. They are associated with significant distress and impairment, and are highly comorbid. Little is known, however, about what role the temporal order of diagnostic onset may play in severity of presenting symptomatology and treatment outcomes. The aim of this study, therefore, was to examine treatment outcomes by order of onset. METHOD: Participants were 46 U...
August 3, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28767012/role-of-borderline-personality-disorder-in-the-treatment-of-military-sexual-trauma-related-posttraumatic-stress-disorder-with-cognitive-processing-therapy
#13
Nicholas Holder, Ryan Holliday, Anushka Pai, Alina Surís
Cognitive Processing Therapy (CPT) is an effective evidence-based treatment for many, but not all, veterans with posttraumatic stress disorder (PTSD). Understanding the factors that contribute to poorer response to CPT is important for providing the best care to veterans diagnosed with PTSD. Researchers investigating the effectiveness of CPT for individuals with comorbid personality symptoms have found that borderline personality disorder (BPD) characteristics do not negatively affect treatment outcome; however, participants in those studies were not diagnosed with BPD...
July 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28759775/forensic-mental-health-evaluations-of-military-personnel-with-traumatic-life-event-in-a-university-hospital-in-ankara-turkey
#14
Huseyin Balandiz, Abdullah Bolu
INTRODUCTION: The definition of psychological trauma has been rephrased with the DSM-5. From now on, witnessing someone else's traumatic event is also accepted as a traumatic life event. Therefore, the psychiatric examination of forensic cases gains importance for not overlooking a psychiatric trauma. This research aims to discuss the psychiatric examinations of military personnel who had a traumatic life event and to reveal psychiatric states of soldiers after trauma. MATERIALS AND METHODS: The forensic reports prepared at Gulhane Military Medical Academy (GMMA), Forensic Medicine polyclinic between January 1, 2011 and November 30, 2014 were examined, and among them the cases sent to GMMA Psychiatry polyclinic for psychiatric examination were analyzed retrospectively...
July 25, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28758768/characteristics-of-veterans-and-military-service-members-who-endorse-causing-harm-injury-or-death-to-others-in-the-military
#15
Philip Held, Randy A Boley, Niranjan S Karnik, Mark H Pollack, Alyson K Zalta
OBJECTIVE: The purpose of the present research was to examine the demographic and mental health characteristics of veterans and service members who endorsed having caused harm, injury, or death to another person on deployment, while taking these individuals' total number of other lifetime traumas into account. METHOD: Data for the present study were collected as part of the standard clinical evaluation for 228 treatment-seeking veterans and service members. RESULTS: Those who reported having caused harm, injury, or death to another person on deployment (22...
July 31, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28754476/primary-care-providers-with-more-experience-and-stronger-self-efficacy-beliefs-regarding-women-veterans-screen-more-frequently-for-interpersonal-violence
#16
Lisa S Meredith, Gulrez Azhar, Adeyemi Okunogbe, Ismelda A Canelo, Jill E Darling, Amy E Street, Elizabeth M Yano
BACKGROUND: Military sexual trauma (MST) and/or intimate partner violence (IPV) are common experiences in the growing group of women veterans using the Veterans Health Administration health care system. And even though MST screening is closely monitored at the facility level, little is known about individual primary care provider (PCP) behavior with regard to screening women for MST and IPV. OBJECTIVES: To understand how PCP experiences and beliefs regarding women's health care influence PCP-reported screening for MST and IPV...
July 25, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28751941/did-king-philip-ii-of-ancient-macedonia-suffer-a-zygomatico-orbital-fracture-a-maxillofacial-surgeon-s-approach
#17
Panagiotis Stathopoulos
Philip II, father of Alexander the Great, succeeded his brother, Perdiccas III, to the throne of Macedonia in 360 BC. He has been described by historians as a generous king and military genius who managed to achieve his ambitious plans by expanding the Macedonian city-state over the whole Greek territory and the greater part of the Balkan Peninsula. The aim of our study was to present the evidence with regard to the facial injury of King Philip II of Macedonia and discuss the treatment of the wound by his famous physician, Critobulos...
September 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28750794/mediastinal-injury-is-the-strongest-predictor-of-mortality-in-mounted-blast-amongst-uk-deployed-forces
#18
A Phillip Pearce, Anthony M J Bull, Jonathon C Clasper
BACKGROUND: Blast injury has been the most common cause of morbidity and mortality encountered by UK forces during recent conflicts. Injuries sustained by blast are categorised by the injuring component of the explosion and depend upon physical surroundings. Previous work has established that head injuries and intra cavity haemorrhage are the major causes of death following exposure to under body (mounted) blast but has yet to explore the precise nature of these torso injuries nor the effect of particular injuries upon survival...
July 19, 2017: Injury
https://www.readbyqxmd.com/read/28748419/can-we-train-military-surgeons-in-a-civilian-trauma-center
#19
H Uchino, V Y Kong, G V Oosthuizen, J L Bruce, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The objective of this study was to review the trauma workload and operative exposure in a major South African trauma center and provide a comparison with contemporary experience from major military conflict. MATERIALS AND METHODS: All patients admitted to the PMTS following trauma were identified from the HEMR. Basic demographic data including mechanism of injury and body region injured were reviewed. All operative procedures were categorized. The total operative volume was compared with those available from contemporary literature documenting experience from military conflict in Afghanistan...
July 26, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28745075/outcomes-of-lisfranc-injuries-in-an-active-duty-military-population
#20
Michael P Hawkinson, David J Tennent, Jeffrey Belisle, Patrick Osborn
BACKGROUND: Traumatic injuries to the tarsometatarsal or Lisfranc joints can be complex problems associated with long-term morbidity. Currently there is no clear consensus regarding optimal fixation methods. The purpose of this study was to evaluate the association between time from injury to treatment and treatment method with outcome. It is hypothesized that patients who underwent open reduction internal fixation (ORIF) more acutely would have higher return to duty rates. METHODS: This study is a retrospective review of 171 low-energy closed tarsometatarsal dislocations and fracture dislocations in patients identified using a Department of Defense trauma registry...
July 1, 2017: Foot & Ankle International
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