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https://www.readbyqxmd.com/read/28102530/surgeon-preparedness-for-mass-casualty-events-adapting-essential-military-surgical-lessons-for-the-home-front
#1
Kyle N Remick, Stacy Shackelford, John S Oh, Jason M Seery, Daniel Grabo, John Chovanes, Kirby R Gross, Shawn C Nessen, Nigel Rm Tai, Rory F Rickard, Eric Elster, C W Schwab
Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28096246/chronic-traumatic-encephalopathy-is-latency-in-symptom-onset-explained-by-tau-propagation
#2
Joshua Kriegel, Zachary Papadopoulos, Ann C McKee
Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive mild brain trauma. CTE, previously termed "dementia pugilistica," has been identified in American football, ice hockey, baseball, rugby and soccer players, boxers, wrestlers, and military personnel exposed to blast and other traumatic brain injuries. There is often a long latency period between an individual's exposure to repetitive brain trauma and the clinical symptoms of CTE. The pathology of CTE is characterized by a progression from isolated focal perivascular hyperphosphorylated tau lesions in the cerebral cortex to a widespread tauopathy that involves diffuse cortical and medial temporal lobe regions...
January 17, 2017: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/28089222/-etiology-and-prognosis-of-the-eye-traumas-by-war-weapons-in-the-senegalese-army
#3
S M Seck, M Diakhaté, M N Ndiaye Sow, M Dieng, G Agboton, N N Guèye
INTRODUCTION: The aim of this work is to identify the main weapons causing eye injuries during the campaigns of the Senegalese army in the south of the country, as well as the prognosis of these traumas. PATIENTS AND METHODS: This study is retrospective and concerns soldiers wounded by the weapons of war during the exercise of their mission within the Senegalese armed forces of 1991 in 2005. They are mainly soldiers affected in the south of the country during a war, clashes with the rebels or in Guinea-Bissau during operation Gabou in 1998...
January 11, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28080076/adverse-childhood-experiences-and-risk-for-suicidal-behavior-in-male-iraq-and-afghanistan-veterans-seeking-ptsd-treatment
#4
Timothy D Carroll, Joseph M Currier, Wesley H McCormick, Kent D Drescher
OBJECTIVE: Adverse childhood experiences (ACEs) are associated with increased risk for suicide and appear to occur in disproportionately high rates among men who served in the U.S. military. However, research has yet to examine a comprehensive range of ACEs among Iraq/Afghanistan veterans with combat-related posttraumatic stress disorder (PTSD) or whether these premilitary stressors may contribute to suicidal behavior in this highly vulnerable population. METHOD: A sample of 217 men entering a residential program for combat-related PTSD completed measures for ACEs, combat exposure, and lifetime suicidal ideation and attempts...
January 12, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28068166/risk-factors-for-injuries-during-military-static-line-airborne-operations-a-systematic-review-and-meta-analysis
#5
Joseph Knapik, Ryan Steelman
OBJECTIVE:  To identify and analyze articles in which the authors examined risk factors for soldiers during military static-line airborne operations. DATA SOURCES:  We searched for articles in PubMed, the Defense Technical Information Center, reference lists, and other sources using the key words airborne, parachuting, parachutes, paratrooper, injuries, wounds, trauma, and musculoskeletal. STUDY SELECTION:  The search identified 17 684 potential studies...
November 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/28068141/ethnoracial-differences-in-ptsd-symptoms-and-trauma-related-cognitions-in-treatment-seeking-active-duty-military-personnel-for-ptsd
#6
Brittany N Hall-Clark, Antonia N Kaczkurkin, Anu Asnaani, Jody Zhong, Alan L Peterson, Jeffrey S Yarvis, Elisa V Borah, Katherine A Dondanville, Elizabeth A Hembree, Brett T Litz, Jim Mintz, Stacey Young-McCaughan, Edna B Foa
OBJECTIVE: It is uncertain whether ethnoracial factors should be considered by clinicians assessing and treating posttraumatic stress disorder (PTSD) among service members. The purpose of this study was to shed light on ethnoracial variation in the presentation of PTSD symptoms, trauma-related cognitions, and emotions among treatment-seeking active duty military personnel. METHOD: Participants were 303 male active duty military members with PTSD participating in a clinical trial (60% were self-identified as White, 19% as African American, and 21% as Hispanic/Latino)...
January 9, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#7
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28013081/perceived-barriers-and-facilitators-of-mental-health-service-utilization-in-adult-trauma-survivors-a-systematic-review
#8
REVIEW
Viktoria Kantor, Matthias Knefel, Brigitte Lueger-Schuster
Many trauma survivors seem to be reluctant to seek professional help. The aim of the current review was to synthesize relevant literature, and to systematically classify trauma survivors' perceived barriers and facilitators regarding mental health service utilization. The systematic search identified 19 studies addressing military personnel and 17 studies with trauma survivors of the general population. The data analysis revealed that the most prominent barriers included concerns related to stigma, shame and rejection, low mental health literacy, lack of knowledge and treatment-related doubts, fear of negative social consequences, limited resources, time, and expenses...
December 8, 2016: Clinical Psychology Review
https://www.readbyqxmd.com/read/28003301/safety-and-feasibility-of-sublingual-microcirculation-assessment-in-the-emergency-department-for-civilian-and-military-patients-with-traumatic-haemorrhagic-shock-a-prospective-cohort-study
#9
David N Naumann, Clare Mellis, Iain M Smith, Jasna Mamuza, Imogen Skene, Tim Harris, Mark J Midwinter, Sam D Hutchings
OBJECTIVES: Sublingual microcirculatory monitoring for traumatic haemorrhagic shock (THS) may predict clinical outcomes better than traditional blood pressure and cardiac output, but is not usually performed until the patient reaches the intensive care unit (ICU), missing earlier data of potential importance. This pilot study assessed for the first time the feasibility and safety of sublingual video-microscopy for THS in the emergency department (ED), and whether it yields useable data for analysis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27998375/sleep-disturbances-in-oef-oif-ond-veterans-associations-with-ptsd-personality-and-coping
#10
Mackenzie J Lind, Emily Brown, Leah Farrell-Carnahan, Ruth C Brown, Sage Hawn, Erin Berenz, Scott McDonald, Treven Pickett, Carla Kmett Danielson, Suzanne Thomas, Ananda B Amstadter
STUDY OBJECTIVES: Sleep disturbances are well documented in relation to trauma exposure and posttraumatic stress disorder (PTSD), but correlates of such disturbances remain understudied in veteran populations. We conducted a preliminary study of sleep disturbances in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 133; mean [standard deviation] age = 29.8 [4.7] y). METHODS: Veterans were assigned to one of three groups based on responses to the Clinician Administered PTSD Scale: control (no trauma-exposure [TE] or PTSD), TE, and PTSD...
December 16, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27998147/chitosan-coated-diatom-silica-as-hemostatic-agent-for-hemorrhage-control
#11
Chao Feng, Jing Li, Guang Sheng Wu, Yu Zhi Mu, Ming Kong, Chang Qing Jiang, Xiao Jie Cheng, Ya Liu, Xi Guang Chen
Uncontrolled hemorrhage leads to high death risk both in military and civilian trauma. Current hemostatic agents still have various limitations and side effects. In this study, natural diatom silica obtained from diatomite and diatom culture was purified and developed for hemorrhage control. To improve the biocompatibility and hemostatic performance of diatom silica, a series of chitosan-coated diatom (CS-diatom) was developed. The composition of CS-diatom prepared was optimized by in vitro hemocompatibility and blood coagulation evaluation for that prepared with 0...
December 21, 2016: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/27993357/amputation-not-a-failure-for-severe-lower-extremity-combat-injury
#12
Thijs T C F van Dongen, Eelco P Huizinga, Loes G M de Kruijff, Arie C van der Krans, Jochem M Hoogendoorn, Luke P H Leenen, Rigo Hoencamp
INTRODUCTION: The use of improvised explosive devices is a frequent method of insurgents to inflict harm on deployed military personnel. Consequently, lower extremity injuries make up the majority of combat related trauma. The wounding pattern of an explosion is not often encountered in a civilian population and can lead to substantial disability. It is therefore important to study the impact of these lower extremity injuries and their treatment (limb salvage versus amputation) on functional outcome and quality of life...
December 10, 2016: Injury
https://www.readbyqxmd.com/read/27991460/acute-acoustic-trauma-in-the-french-armed-forces-during-2007-2014
#13
Doris R Medina-Garin, Aissata Dia, Gabriel Bedubourg, Xavier Deparis, Franck Berger, Remy Michel
CONTEXT: Despite existing preventive measures, the number of acute acoustic trauma (AAT) cases reported to the French Military Epidemiological Surveillance System (MESS) remains high. AIMS: The objective of this study was to describe AAT and the preventive measures already implemented. SUBJECTS AND METHODS: We conducted a descriptive cross-sectional analysis of AAT using data from the MESS for the period 2007-2014. In addition, we reviewed the current prevention measures that exist in the French armed forces...
November 2016: Noise & Health
https://www.readbyqxmd.com/read/27986702/a-systems-science-approach-to-understanding-polytrauma-and-blast-related-injury-bayesian-network-model-of-data-from-a-survey-of-the-florida-national-guard
#14
Peter A Toyinbo, Rodney D Vanderploeg, Heather G Belanger, Andrea M Spehar, William A Lapcevic, Steven G Scott
We sought to further define the epidemiology of the complex, multiple injuries collectively known as polytrauma/blast-related injury (PT/BRI). Using a systems science approach, we performed Bayesian network modeling to find the most accurate representation of the complex system of PT/BRI and identify key variables for understanding the subsequent effects of blast exposure in a sample of Florida National Guard members (1,443 deployed to Operation Enduring Freedom/Operation Iraqi Freedom and 1,655 not deployed) who completed an online survey during the period from 2009 to 2010...
December 16, 2016: American Journal of Epidemiology
https://www.readbyqxmd.com/read/27977074/the-efficacy-of-prazosin-for-the-treatment-of-posttraumatic-stress-disorder-nightmares-in-u-s-military-veterans
#15
Annamarie Breen, Kory Blankley, Julie Fine
BACKGROUND AND PURPOSE: Nightmares associated with posttraumatic stress disorder (PTSD) are a hallmark symptom among U.S. military veterans who have seen combat. Management of combat-related nightmares can be difficult and current pharmacologic options are limited and tend to have adverse side effects. The aim of this review is to explore recent literature regarding the efficacy of prazosin for the treatment of nightmare disorder in the veteran population. METHODS: Recent literature consisting of three systematic reviews was reviewed, as well as current clinical guidelines published by The Department of Veterans Affairs (VA) and The Department of Defense (DoD) and the American Academy of Sleep Medicine (AASM)...
December 15, 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27973670/fixed-distance-model-for-balloon-placement-during-fluoroscopy-free-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-a-civilian-population
#16
Pierre Pezy, Alexandros N Flaris, Nicolas J Prat, François Cotton, Peter W Lundberg, Jean-Louis Caillot, Jean-Stéphane David, Eric J Voiglio
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an innovative procedure in the treatment of noncompressible truncal hemorrhage. However, readily available fluoroscopy remains a limiting factor in its widespread implementation. Several methods have been proposed to perform REBOA without fluoroscopic guidance, and these methods were adapted predominantly from the military theater. Objective: To develop a method for performing REBOA in a civilian population using a standardized distance from a set point of entry...
December 14, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27959967/transfusion-80%C3%A2-c-frozen-blood-products-are-safe-and-effective-in-military-casualty-care
#17
Femke Noorman, Thijs T C F van Dongen, Marie-Christine J Plat, John F Badloe, John R Hess, Rigo Hoencamp
INTRODUCTION: The Netherlands Armed Forces use -80°C frozen red blood cells (RBCs), plasma and platelets combined with regular liquid stored RBCs, for the treatment of (military) casualties in Medical Treatment Facilities abroad. Our objective was to assess and compare the use of -80°C frozen blood products in combination with the different transfusion protocols and their effect on the outcome of trauma casualties. MATERIALS AND METHODS: Hemovigilance and combat casualties data from Afghanistan 2006-2010 for 272 (military) trauma casualties with or without massive transfusions (MT: ≥6 RBC/24hr, N = 82 and non-MT: 1-5 RBC/24hr, N = 190) were analyzed retrospectively...
2016: PloS One
https://www.readbyqxmd.com/read/27936411/a-network-analysis-of-dsm-5-posttraumatic-stress-disorder-symptoms-and-correlates-in-u-s-military-veterans
#18
Cherie Armour, Eiko I Fried, Marie K Deserno, Jack Tsai, Robert H Pietrzak
OBJECTIVE: Recent developments in psychometrics enable the application of network models to analyze psychological disorders, such as PTSD. Instead of understanding symptoms as indicators of an underlying common cause, this approach suggests symptoms co-occur in syndromes due to causal interactions. The current study has two goals: (1) examine the network structure among the 20 DSM-5 PTSD symptoms, and (2) incorporate clinically relevant variables to the network to investigate whether PTSD symptoms exhibit differential relationships with suicidal ideation, depression, anxiety, physical functioning/quality of life (QoL), mental functioning/QoL, age, and sex...
November 27, 2016: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/27933610/resilience-mediates-impact-of-some-childhood-maltreatment-on-post-traumatic-stress-symptoms-in-conscripted-marines-in-the-republic-of-korea
#19
Heejung Kim, Sun Ah Kim, Seongsook Kong
Although it is known that post-traumatic stress symptoms (PTSS) can result from military service, the variance in PTSS unexplained by military service warrants further investigation, and no researchers have investigated South Korean Marines' vulnerability during their 2-year conscripted service as the first line of national defense against threats from North Korea. This study was designed to examine whether resilience mediated the relationship between childhood maltreatment and PTSS in 169 Korean conscripts into the Marine Corps...
February 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/27931783/reduced-p3b-brain-response-during-sustained-visual-attention-is-associated-with-remote-blast-mtbi-and-current-ptsd-in-u-s-military-veterans
#20
Casey S Gilmore, Craig A Marquardt, Seung Suk Kang, Scott R Sponheim
Approximately 275,000 American service members deployed to Iraq or Afghanistan have sustained a mild traumatic brain injury (mTBI), with 75% of these incidents involving an explosive blast. Combat-related mTBI is frequently associated with comorbid mental health disorders, especially posttraumatic stress disorder (PTSD). Attention problems, including sustained attention, are common cognitive complaints of veterans with TBI and PTSD. The present study sought to examine neural correlates of sustained attention in veterans with blast mTBI and/or current PTSD...
December 5, 2016: Behavioural Brain Research
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