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https://www.readbyqxmd.com/read/29449604/intravenous-synthetic-platelet-synthoplate-nanoconstructs-reduce-bleeding-and-improve-golden-hour-survival-in-a-porcine-model-of-traumatic-arterial-hemorrhage
#1
DaShawn A Hickman, Christa L Pawlowski, Andrew Shevitz, Norman F Luc, Ann Kim, Aditya Girish, Joyann Marks, Simi Ganjoo, Stephanie Huang, Edward Niedoba, Ujjal D S Sekhon, Michael Sun, Mitchell Dyer, Matthew D Neal, Vikram S Kashyap, Anirban Sen Gupta
Traumatic non-compressible hemorrhage is a leading cause of civilian and military mortality and its treatment requires massive transfusion of blood components, especially platelets. However, in austere civilian and battlefield locations, access to platelets is highly challenging due to limited supply and portability, high risk of bacterial contamination and short shelf-life. To resolve this, we have developed an I.V.-administrable 'synthetic platelet' nanoconstruct (SynthoPlate), that can mimic and amplify body's natural hemostatic mechanisms specifically at the bleeding site while maintaining systemic safety...
February 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29447384/antimicrobial-prophylaxis-with-combat-related-open-soft-tissue-injuries
#2
Bradley A Lloyd, Clinton K Murray, Faraz Shaikh, M Leigh Carson, Dana M Blyth, Elizabeth R Schnaubelt, Timothy J Whitman, David R Tribble
Introduction: All Department of Defense (DoD) guidance documents recommend cefazolin or clindamycin as post-trauma antibiotic prophylaxis for open soft-tissue injuries. Although not advocated, some patients with open soft-tissue injuries also received expanded Gram-negative coverage (EGN) prophylaxis based on the judgment of front-line trauma providers. During the study period, revised guidelines in 2011/2012 re-emphasized recommendations for using cefazolin or clindamycin, and stewardship efforts in the DoD trauma community aimed to reduce the practice of adding EGN to guideline-recommended antibiotic prophylaxis...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29443866/factors-associated-with-trauma-patients-length-of-stay-at-role-2-facilities-in-afghanistan-october-2009-to-september-2014
#3
Amanda Staudt, Jennifer Gurney, Krystal Valdez-Delgado, Mithun Suresh, Jennifer Trevino, Tuan Le, Jason Seery, Stacy Shackelford, Shawn Nessen, Elizabeth Mann-Salinas
BACKGROUND: Understanding patients' length of stay at far-forward Role 2 surgical units may help to determine support needs, stabilization requirements, pre-deployment training, and necessity of increased care capability prior to or during transport to a higher level of care. The objectives of this study were to 1) evaluate the amount of time patients spent at Role 2 and 2) determine factors associated with trauma patients' length of stay at Role 2. METHODS: We conducted a secondary data analysis of the Joint Trauma System Role 2 Database...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29440320/left-of-bang-interventions-in-trauma-some-legal-implications-of-military-medical-prophylaxis
#4
Rain Liivoja
In the context of military medical care, Eisenstein and colleagues have introduced the notion 'left of bang intervention in trauma', which refers to interventions administered before trauma to reduce morbidity and mortality after injury. This paper responds to Eisenstein and colleagues' ethical analysis of such interventions, highlighting the difficulty in distinguishing between purely prophylactic and enhancing interventions. This response also addresses legal issues that arise from left of bang interventions under human rights law and the law of armed conflict, in particular the questions as to whether the consent of service members would need to be obtained and whether the adversary would as a consequence be authorised to resort to more injurious weapons...
February 13, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29433952/recent-intimate-partner-violence-and-housing-instability-among-women-veterans
#5
Ann Elizabeth Montgomery, Anneliese E Sorrentino, Meagan C Cusack, Scarlett L Bellamy, Elina Medvedeva, Christopher B Roberts, Melissa E Dichter
INTRODUCTION: Women Veterans are at increased risk of both housing instability and intimate partner violence compared with their non-Veteran counterparts. The objectives of the present study were (1) to assess the relationship between women Veterans' experience of intimate partner violence and various indicators of housing instability, and (2) to assess what correlates help to explain experiences of housing instability among women Veterans who experienced past-year intimate partner violence...
February 9, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29432381/systematic-review-of-prehospital-tourniquet-use-in-civilian-limb-trauma
#6
David S Kauvar, Michael A Dubick, Thomas J Walters, John F Kragh
BACKGROUND: Military enthusiasm for limb tourniquet use in combat casualty care has resulted in acceptance by the trauma community for use in the prehospital care of civilian limb injuries. To date there has been no report synthesizing the published data on civilian tourniquet use. The objective of this systematic review was to compile and analyze the content and quality of published data on the civilian use of tourniquets in limb trauma. METHODS: The MEDLINE database was searched for studies on civilian limb tourniquet use in adults published between 2001 and 2017...
February 9, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29428019/military-medical-skills-readiness-in-combat-advanced-trauma-life-support-performance-efficiency-at-afghanistan-role-3-hospitals
#7
Maj Andrew Hall, Cdr Jacob Glaser, Dennis Hanseman, Capt Ryan Parks, Capt Michael Brazeau
No abstract text is available yet for this article.
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29424278/culture-as-a-double-edged-sword-the-posttraumatic-experience-of-indigenous-ethnic-minority-veterans
#8
Shai Shorer, Hadass Goldblatt, Yael Caspi, Faisal Azaiza
The applicability of Western concepts regarding the treatment of trauma in soldiers from indigenous ethnic minority backgrounds has scarcely been researched. This study explored the subjective meaning of living with chronic posttraumatic stress disorder (PTSD) among indigenous Bedouin veterans of the Israel Defense Forces (IDF), who are of Arab ethnicity and Muslim faith. In-depth, semistructured qualitative interviews were conducted with 10 Bedouin veterans suffering from PTSD and three Bedouin mental health clinicians working with this population...
February 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29421372/icd-11-complex-ptsd-among-israeli-male-perpetrators-of-intimate-partner-violence-construct-validity-and-risk-factors
#9
Ohad Gilbar, Philip Hyland, Marylene Cloitre, Rachel Dekel
The International Classification of Diseases 11th Version (ICD-11) will include Complex Posttraumatic Stress Disorder (CPTSD) as a unique diagnostic entity comprising core PTSD and DSO (disturbances in self-organization) symptoms. The current study had three aims: (1) assessing the validity of CPTSD in a unique population of male perpetrators of intimate partner violence; (2) examining whether exposure to different types of traumatic events would be associated with the two proposed CPTSD factors, namely PTSD or DSO; and (3) assessing the differential association of various sociodemographic and symptom characteristics with each factor...
January 31, 2018: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/29420791/substance-use-and-psychological-distress-before-and-after-the-military-to-civilian-transition
#10
Karen J Derefinko, Troy A Hallsell, Matthew B Isaacs, Francisco I Salgado Garcia, Lauren W Colvin, Zoran Bursac, Meghan E McDevitt-Murphy, James G Murphy, Melissa A Little, Gerald W Talcott, Robert C Klesges
Background: Those currently serving in the military constitute a vulnerable population given their high-risk status for substance use, and population data suggest that veterans continue to engage in significant substance use long after their military service ends. Recent research suggests that the separation transition from active duty to civilian life may be critical in terms of the future functioning of the veteran. Methods: We sought to explore substance use prevalence, as well as potential emotional distress among veterans by retrospectively assessing substance use during active duty and following separation to examine possible changes in use over this period...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29419338/bridging-body-and-mind-considerations-for-trauma-informed-yoga
#11
Lauren Justice, Christiane Brems, Karrie Ehlers
Individuals who suffer from trauma-related symptoms are a unique population that could benefit from the mind-body practice of yoga-or have their symptoms reactivated by it, depending on the type of yoga. Trauma-informed yoga (TIY), that is, yoga adapted to the unique needs of individuals working to overcome trauma, may ameliorate symptoms by creating a safe, tailored practice for students to learn how to respond, rather than react, to symptoms and circumstances. Yoga not thus adapted, on the other hand, may increase reactivity and activate symptoms such as hyperarousal or dissociation...
February 8, 2018: International Journal of Yoga Therapy
https://www.readbyqxmd.com/read/29415229/military-personnel-who-seek-health-and-mental-health-services-outside-the-military
#12
Howard Waitzkin, Mario Cruz, Bryant Shuey, Daniel Smithers, Laura Muncy, Marylou Noble
Background: Although research conducted within the military has assessed the health and mental health problems of military personnel, little information exists about personnel who seek care outside the military. The purpose of this study is to clarify the personal characteristics, mental health diagnoses, and experiences of active duty U.S. military personnel who sought civilian sector services due to unmet needs for care. Materials and Methods: This prospective, multi-method study included 233 clients, based in the United States, Afghanistan, South Korea, and Germany, who obtained care between 2013 and 2016 from a nationwide network of volunteer civilian practitioners...
February 5, 2018: Military Medicine
https://www.readbyqxmd.com/read/29415222/military-tailored-yoga-for-veterans-with-post-traumatic-stress-disorder
#13
Robin E Cushing, Kathryn L Braun, Susan W Alden C-Iayt, Alan R Katz
Introduction: Among veterans of post-9/11 conflicts, estimates of post-traumatic stress disorder (PTSD) range from 9% shortly after returning from deployment to 31% a year after deployment. Clinical and pharmaceutically based treatments are underutilized. This could be due to concerns related to lost duty days, as well as PTSD patients' fears of stigma of having a mental health condition. Yoga has been shown to reduce PTSD symptoms in the civilian population, but few studies have tested the impact of yoga on veterans of post-9/11 conflicts...
February 5, 2018: Military Medicine
https://www.readbyqxmd.com/read/29415146/mental-health-across-the-reproductive-cycle-in-women-veterans
#14
Laura J Miller, Nafisa Y Ghadiali
Introduction: Premenstrual, perinatal, and/or perimenopausal psychiatric problems require specific screening, assessment, and treatment strategies. The scope of these reproductive-linked psychiatric symptoms among women veterans is unknown. Due to high rates of sexual trauma among women veterans, it is also important to ascertain relationships between sexual trauma experiences and reproductive cycle mood problems. This pilot study investigates the prevalence of self-reported premenstrual, perinatal, and perimenopausal emotional problems and whether these correlate with pre-military sexual abuse, military sexual harassment, and/or military sexual assault, among veterans receiving psychiatric evaluations within a Veterans Administration Women's Health Clinic...
February 5, 2018: Military Medicine
https://www.readbyqxmd.com/read/29401352/fibrinogen-concentrate-in-the-special-operations-forces-environment
#15
Steven Sanders, Homer Tien, Jeannie Callum, Barto Nascimento, Henry Peng, Chris Funk, Joanne Schmid, Sandro Rizoli, Shawn Rhind, Andrew Beckett
Introduction: Hemorrhage is the most common cause of death among Special Operations Force (SOF) soldiers. Bringing remote damage control resuscitation into the far-forward combat environment is logistically challenging, as it requires blood products that generally require a robust cold chain. Alternatively, lyophilized products such as fibrinogen concentrate, which does not require thawing or blood group compatibility testing before use, might be advantageous in damage control resuscitation in the battlefield...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29401336/cavh-in-the-combat-environment-a-case-report-and-lessons-learned-in-southern-afghanistan
#16
Jacob Glaser, Joseph Zeman, Stephen Noble, Nathanial Fernandez
Background: Acute kidney injury is a common complication of both civilian and military trauma. The lack of dedicated resources restrict dialysis in the forward setting. We report a case of a combat polytrauma and renal failure, using continuous arteriovenous hemofiltration to clear uremia and remove volume, allowing for ventilator liberation and safe disposition. Materials and Methods: The patient presented with traumatic lower extremity injuries and abdominal wounds and developed acute post-traumatic renal failure...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29396756/pre-hospital-management-of-pediatric-polytrauma-during-modern-conflict-experience-and-limits-of-the-french-military-health-service
#17
Victor Laville, Christophe Lebleu, Christophe Desterke, Pierre Mornand, Luc Aigle, Emmanuel Hornez
BACKGROUND: French military physicians serving in deployment are confronted with pediatric polytrauma patients (PPP) during the provision of medical aid to civilian populations. The objectives of this study were to describe the current care of PPPs during these missions, to report difficulties encountered and to evaluate the training of doctors for management of PPPs in the field. METHODS: A descriptive epidemiological study based on a questionnaire sent to physicians who had been deployed overseas...
February 2, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29392791/a-transfusion-prescription-template-and-other-human-factor-interventions-to-improve-balanced-transfusion-delivery-in-major-haemorrhage-due-to-trauma
#18
J Swieton, R Hawes, S Avery, H Watson, Y Scott, M Lannon, J P Wallis
OBJECTIVES: The aim of this study is to improve practice in the management of major haemorrhage, particularly in red cell to plasma transfusion ratios. BACKGROUND: A review of the management of major haemorrhage in trauma in Newcastle Hospitals Trust in 2012-2013 showed good mortality outcomes but found that red cell : plasma transfusion ratios could be improved. Human factors techniques transferable from industry and the military were identified, and a package of interventions was implemented, including an intensive multidisciplinary team training programme and a new major haemorrhage prescription template...
February 2, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29386714/forward-surgical-care-emerging-issues-and-challenges
#19
Bipin Puri
War strategies have been evolving with time and battlefield casualty care services have been trying to keep pace with the changing demands. Technological advances in the field of trauma care have revolutionised the way in which erstwhile 'non-salvageable' lives and limbs are managed with more favourable outcome. The quality of Pre-Hospital Trauma Care Services will largely determine the survival statistics of battle casualties. The surgeon has to acknowledge the various resource constraints imposed upon him in the course of delivery of expert trauma care in the battlefield...
October 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29384773/tranexamic-acid-promise-or-panacea-the-impact-of-air-medical-administration-of-tranexamic-acid-on-morbidity-mortality-and-length-of-stay
#20
Brian G Cornelius, Karen McCarty, Kristi Hylan, Angela Cornelius, Keith Carter, Kenneth W G Smith, Srdan Ristic, Daniel Vining, Urska Cvek, Marjan Trutschl
The MATTERs and CRASH-2 studies demonstrate that tranexamic acid (TXA) reduces mortality in patients with traumatic hemorrhage. However, their results, conducted in foreign countries and with U.S. military soldiers, provoke concerns over generalizability to civilian trauma patients in the United States was reported. The evaluation of patient outcomes following treatment with TXA by a civilian air medical program. A retrospective chart review of trauma patients transported by air service to a Level 1 trauma center was conducted...
January 2018: Advanced Emergency Nursing Journal
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