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Military trauma

Ryan Holliday, Nicholas Holder, Lindsey L Monteith, Alina Surís
Posttraumatic stress disorder (PTSD) is associated with suicidal ideation (SI) and suicidal self-directed violence (SDV). Military sexual trauma (MST) is a common precursor to PTSD among veterans. Survivors of MST are more likely to be diagnosed with PTSD and are at greater risk for SI than survivors of other forms of trauma. Suicide-specific beliefs (e.g., unlovability, unbearability, unsolvability) have been shown to be strong predictors of SI and future suicidal SDV. Suicide-specific beliefs were examined over the course of treatment and follow-up in 32 veterans (23 women, 9 men) who received cognitive processing therapy (CPT) for MST-related PTSD...
June 14, 2018: Journal of Nervous and Mental Disease
Camille Choufani, Olivier Barbier, Aurélie Mayet, Sylvain Rigal, Laurent Mathieu
Introduction: A deployed military orthopedic surgeon is a trauma surgeon working in austere conditions. The first aim of this study was to analyze the current activity of French military orthopedic surgeons in the field and to identify the differences of the combat zone with their daily practice. The second aim was to assess the adequacy of the preparedness they received before their deployment and to identify additional needs that could be addressed in future training. Methods: An evaluation survey was sent to all French military orthopedic surgeons deployed in theaters of operations between 2004 and 2014...
June 13, 2018: Military Medicine
Caryn A Turner, Jean A Orman, Zsolt T Stockinger, Steven J Hudak
Introduction: Genitourinary surgery constitutes approximately 1.15% of procedures performed for combat injuries. During forward deployment, surgeons usually deploy without urology support. To better understand the training and skills maintenance needs for genitourinary procedures by describing in detail the genitourinary surgical workload during 15 years of combat operations and compare our findings with those from previously published articles. Material and Methods: A retrospective analysis of the Department of Defense Trauma Registry (DoDTR) was performed for all Roles 2 and 3 medical treatment facilities in Iraq and Afghanistan, from January 2002 to May 2016...
June 13, 2018: Military Medicine
Frank K Butler
No abstract text is available yet for this article.
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Theodore T Redman, Kevin E Mayberry, Alejandra G Mora, Brock A Benedict, Elliot M Ross, Julian G Mapp, Russ S Kotwal
BACKGROUND: Historically, documentation of prehospital combat casualty care has been relatively nonexistent. Without documentation, performance improvement of prehospital care and evacuation through data collection, consolidation, and scientific analyses cannot be adequately accomplished. During recent conflicts, prehospital documentation has received increased attention for point-of-injury care as well as for care provided en route on medical evacuation platforms. However, documentation on casualty evacuation (CASEVAC) platforms is still lacking...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Eric Pierce, Renato Rapada, Penelope Anne Herder, Anthony J LaPorta, Tuan N Hoang, Mathew Pena, Jeff Blankenship, Jeff Kiser, Sarah Ashley Catlin
BACKGROUND: The US Navy initiated design concepts for a Medical Mission Module Support Container (M3SC), a mobile operating room capable of rapid installation aboard maneuverable ships within proximity of active combat units. The M3SC provides an alternative echelon of care in the current trauma system by decreasing the time between point of injury, arrival, and surgical intervention. The mobile ships used as M3SC platforms, however, are more susceptible to oceanic conditions that can induce detrimental physiologic motion sickness in medical personnel and patients aboard the vessels...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Steven G Schauer, Andrew D Fisher, Michael D April, Katherine A Stolper, Cord W Cunningham, Robert Carter, Jessie Renee D Fernandez, James A Pfaff
BACKGROUND: Military operations place injured Servicemembers at high risk for open wounds. Austere environments and initial wound contamination increase the risk for infection. Wound infections continue to cause significant morbidity among injured Servicemembers. Limited evidence suggests that early antibiotic therapy for open wounds reduces infection rates. METHODS: We obtained data from the Prehospital Trauma Registry (PHTR) from January 2013 through September 2014...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Michaela Binder, Leslie Quade
On the 21st -22nd of May1809 Napoleon Bonaparte saw his first major defeat on land at the Battle of Aspern, just north-east of Vienna. Of the 167,000 soldiers who fought for the French and Austrian armies, a total of 55,000 died on the battlefield. Salvage excavations prior to the construction of large urban development project (2008-2016) have revealed several burial sites related to the Battle of Aspern. The skeletal remains of 30 soldiers were excavated and underwent a detailed bioarchaeological study to elucidate both the impact of 19th-century military conditions on soldiers in life, as well as how they died on the battlefield...
June 7, 2018: International Journal of Paleopathology
Eamonn Arble, Ana M Daugherty, Bengt B Arnetz
The term "first responders" refers to a range of professional occupations, including police officers, fire fighters, search and rescue personnel, ambulance personnel, and military personnel. Research by the present authors has developed empirical models of first responder coping, identifying 2 coping pathways with differential outcomes: approach and avoidance coping. The present investigation considers police officers as a unique group and measures the extent to which police officers differ from other first responders in coping behaviours following trauma, based upon a nationally representative survey of 917 Swedish police officers...
June 8, 2018: Stress and Health: Journal of the International Society for the Investigation of Stress
Anton I Sytine, Thomas W Britt, Cynthia L S Pury, Patrick J Rosopa
Engaging in firefights or witnessing death and other types of combat experiences are occupational hazards associated with Post Traumatic Stress Disorder (PTSD) and depression in military personnel returning from combat deployments. The present study examined savouring beliefs as a moderator of the relationship between combat exposure and mental health symptoms among U.S. Army soldiers deployed to Operation Iraqi Freedom and Operation Enduring Freedom. Soldiers (N = 885) completed measures of combat exposure, savouring beliefs, PTSD, and depression...
June 7, 2018: Stress and Health: Journal of the International Society for the Investigation of Stress
David R Tribble, Louis R Lewandowski, Benjamin K Potter, Joseph L Petfield, Daniel J Stinner, Anuradha Ganesan, Margot Krauss, Clinton K Murray
OBJECTIVES: We assessed osteomyelitis risk factors in U.S. military personnel with combat-related open tibia fractures (2003-2009). METHODS: Patients with open tibia fractures who met diagnostic criteria of osteomyelitis were identified as cases using Military Health System data and verified through medical record review. Controls were patients with open tibia fractures who did not meet osteomyelitis criteria. Gustilo-Andersen (GA) fracture classification scheme was modified to include transtibial amputations (TTAs) as the most severe level...
May 24, 2018: Journal of Orthopaedic Trauma
Murray B Stein, Barbara O Rothbaum
Traumatic stressors have always been a part of the human experience. What is now referred to as posttraumatic stress disorder (PTSD) was first studied in the context of military trauma during the Civil War and World War I but most extensively in World War II. Much of what we know about the medical and psychological management of PTSD has its origins in military psychiatric approaches, and a review of these practices reveals important tenets that should be applied in current treatment for both military and nonmilitary PTSD...
June 1, 2018: American Journal of Psychiatry
Sitaji Gurung, Ana Ventuneac, H Jonathon Rendina, Elizabeth Savarese, Christian Grov, Jeffrey T Parsons
Despite the repeal of Don't Ask, Don't Tell, Don't Pursue (DADT) and the update to the Transgender Policy, there remain concerns about the persistence of military sexual trauma (MST) and sexual orientation discrimination against lesbian, gay, bisexual, and transgender (LGBT) service members. A sample of 253 participants (89 women, 164 men) completed an Internet-based survey that assessed the prevalence of sexual orientation discrimination (e.g., offensive speech, physical or discriminatory behaviors) and MST (e...
March 2018: Sexuality Research & Social Policy
Kathryn K Carroll, Ashton M Lofgreen, Darian C Weaver, Philip Held, Brian J Klassen, Dale L Smith, Niranjan S Karnik, Mark H Pollack, Alyson K Zalta
BACKGROUND: Unique aspects of military sexual trauma (MST) may result in specific maladaptive cognitions among survivors. Understanding which posttraumatic cognitions are particularly strong among MST survivors could help clinicians target and improve treatment for these individuals. This study explored the impact of experiencing MST on posttraumatic cognitions among veterans with posttraumatic stress disorder (PTSD). METHODS: Veterans enrolled in an Intensive Outpatient Program for PTSD (N = 226) were assessed for MST, PTSD severity, depression severity, and posttraumatic cognitions as part of a standard clinical intake...
May 19, 2018: Journal of Affective Disorders
Amy C Weintrob, Clinton K Murray, Jiahong Xu, Margot Krauss, William Bradley, Tyler E Warkentien, Bradley A Lloyd, David R Tribble
BACKGROUND: During the conflicts in Iraq and Afghanistan, more than 52,000 U.S. military members were wounded in action. The battlefield mortality rate was lower than in past conflicts, however, those surviving often had complex soft tissue and bone injuries requiring multiple surgeries. This report describes the rates, types, and risks of infections complicating the care of combat casualties. PATIENTS AND METHODS: Infection and microbiology data obtained from the Trauma Infectious Disease Outcomes Study (TIDOS), a prospective observational study of infections complicating deployment-related injuries, were used to determine the proportion of infection, types, and associated organisms...
April 2018: Surgical Infections
Russ S Kotwal, Amanda M Staudt, Edward L Mazuchowski, Jennifer M Gurney, Stacy A Shackelford, Frank K Butler, Zsolt T Stockinger, John B Holcomb, Shawn C Nessen, Elizabeth A Mann-Salinas
BACKGROUND: Timely and optimal care can reduce mortality among critically injured combat casualties. US military Role 2 surgical teams were deployed to forward positions in Afghanistan on behalf of the battlefield trauma system. They received prehospital casualties, provided early damage control resuscitation and surgery, and rapidly transferred casualties to Role 3 hospitals for definitive care. A database was developed to capture Role 2 data. METHODS: A retrospective review and descriptive analysis was conducted of battle-injured casualties transported to US Role 2 surgical facilities in Afghanistan from February 2008 to September 2014...
May 30, 2018: Journal of Trauma and Acute Care Surgery
Janet Ellis, Ari Zaretsky
PURPOSE: The goal of this article is to increase clinicians' understanding of posttraumatic stress disorder (PTSD) and improve skills in assessing risk for and diagnosing PTSD. The importance and sequelae of lifetime trauma burden are discussed, with reference to trends in prevention, early intervention, and treatment. RECENT FINDINGS: PTSD has different clinical phenotypes, which are reflected in the changes in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria...
June 2018: Continuum: Lifelong Learning in Neurology
Jessica Wiblin, Nicholas Holder, Ryan Holliday, Alina Surís
Military sexual trauma (MST) and posttraumatic stress disorder (PTSD) both increase risk for suicidal self-directed violence (SDV). Suicide cognitions (i.e., unbearability, unlovability, and unsolvability) are strong predictors of future suicidal SDV. The present study investigated potential predictors of unbearability, unlovability, and unsolvability in veterans with MST-related PTSD. Suicide cognitions, depression, PTSD, quality of life, trauma-related negative cognitions, physical health functioning, mental health functioning, and childhood sexual assault were assessed in 12 male and 103 female veterans with MST-related PTSD...
May 1, 2018: Journal of Interpersonal Violence
Tuan D Le, Jennifer M Gurney, Nina S Nnamani, Kirby R Gross, Kevin K Chung, Zsolt T Stockinger, Shawn C Nessen, Anthony E Pusateri, Kevin S Akers
Importance: Nonbattle injury (NBI) among deployed US service members increases the burden on medical systems and results in high rates of attrition, affecting the available force. The possible causes and trends of NBI in the Iraq and Afghanistan wars have, to date, not been comprehensively described. Objectives: To describe NBI among service members deployed to Iraq and Afghanistan, quantify absolute numbers of NBIs and proportion of NBIs within the Department of Defense Trauma Registry, and document the characteristics of this injury category...
May 30, 2018: JAMA Surgery
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