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Military trauma

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https://www.readbyqxmd.com/read/29051628/deadly-acute-decompression-sickness-in-risso-s-dolphins
#1
A Fernández, E Sierra, J Díaz-Delgado, S Sacchini, Y Sánchez-Paz, C Suárez-Santana, M Arregui, M Arbelo, Y Bernaldo de Quirós
Diving air-breathing vertebrates have long been considered protected against decompression sickness (DCS) through anatomical, physiological, and behavioural adaptations. However, an acute systemic gas and fat embolic syndrome similar to DCS in human divers was described in beaked whales that stranded in temporal and spatial association with military exercises involving high-powered sonar. More recently, DCS has been diagnosed in bycaught sea turtles. Both cases were linked to human activities. Two Risso's dolphin (Grampus griseus) out of 493 necropsied cetaceans stranded in the Canary Islands in a 16-year period (2000-2015), had a severe acute decompression sickness supported by pathological findings and gas analysis...
October 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29049136/comparisons-of-traditional-metabolic-markers-and-compensatory-reserve-as-early-predictors-of-tolerance-to-central-hypovolemia-in-humans
#2
Alicia M Schiller, Jeffrey T Howard, Kristen R Lye, Christian G Magby, Victor A Convertino
Circulatory shock remains a leading cause of death in both military and civilian trauma. Early, accurate and reliable prediction of decompensation is necessary for the most efficient interventions and clinical outcomes. Individual tolerance to reduced central blood volume can serve as a model to assess the sensitivity and specificity of vital sign measurements. The compensatory reserve (CRM) is the measurement of this capacity. Measurements of muscle oxygen saturation (SmO2), blood lactate and end tidal CO2 (EtCO2) have recently gained attention as prognostic tools for early assessment of the status of patients with progressive hemorrhage, but lack the ability to adequately differentiate individual tolerance to hypovolemia...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29040202/re-examination-of-a-battlefield-trauma-golden-hour-policy
#3
Jeffrey T Howard, Russ S Kotwal, Alexis R Santos, Matthew J Martin, Zsolt T Stockinger
BACKGROUND: Most combat casualties who die, do so in the prehospital setting. Efforts directed toward alleviating prehospital combat trauma death, known as killed in action (KIA) mortality, have the greatest opportunity for eliminating preventable death. METHODS: 4,542 military casualties injured in Afghanistan from September 11, 2001 to March 31, 2014 were included in this retrospective analysis to evaluate proposed explanations for observed KIA reduction following a mandate by Secretary of Defense Robert M...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29037487/-chronic-chest-pain-after-rib-fracture-it-can-cause-a-disability
#4
S Rabiou, Y Ouadnouni, M Lakranbi, A Traibi, F Antoini, M Smahi
INTRODUCTION: The rib fractures and instability of the chest wall are the main lesions of closed chest trauma. These lesions can be a source of chronic, often disabling with daily discomfort resulting limitation of some activities. The objective of this study was to assess the prevalence of this phenomenon in order to improve the quality of early care. METHODOLOGY: Through an observational retrospective cohort study on a number of 41 patients supported and monitored for traumatic rib fractures at the Military Hospital of Meknes during the period from October 2010 to March 2016...
October 13, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29036483/a-decade-of-war-prospective-trajectories-of-post-traumatic-stress-disorder-symptoms-among-deployed-us-military-personnel-and-the-influence-of-combat-exposure
#5
Carrie J Donoho, George A Bonanno, Ben Porter, Lauren Kearney, Teresa M Powell
Post-traumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies across individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and inability to account for combat-related trauma. To determine the trajectories of PTSD symptoms among deployed military personnel with and without combat exposure, we used data from a population-based representative sample of 8,178 US service members participating in the Millennium Cohort Study from 2001-2011...
September 27, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29024028/emotion-dysregulation-and-social-support-in-ptsd-and-depression-a-study-of-trauma-exposed-veterans
#6
Daniel W Cox, A Myfanwy Bakker, James A Naifeh
Emotion dysregulation has been associated with impaired interpersonal functioning and increased risk of posttraumatic psychopathology. Given that social support is a robust predictor of psychiatric morbidity following trauma exposure, we examined whether emotion dysregulation was associated with posttraumatic psychopathology through its negative effect on social support. Using self-report data from 90 military veterans (89.9% men) enrolled in an outpatient psychotherapy program for posttraumatic stress disorder (PTSD), we found that social support partially mediated the effect of emotion dysregulation on PTSD (PM = ...
October 12, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29022736/preliminary-evaluation-of-treatment-outcomes-at-a-military-intensive-outpatient-program
#7
Tim Hoyt, David Barry, So Heui Kwon, Claire Capron, Noriko De Guzman, James Gilligan, Amanda Edwards-Stewart
Recent U.S. Army policy has established intensive outpatient programs at several installations as part of a comprehensive behavioral health system of care. This study presents retrospective program evaluation data from a case series without randomization or a control group at 1 recently established intensive outpatient program for active duty service members at a joint military installation. Out of 240 patients referred to the program at 1 installation, 200 enrolled in treatment. Of these, 169 completed treatment in a Skills & Resiliency Track (n = 97), Trauma Track (n = 34), or both (Combined Track; n = 38)...
October 12, 2017: Psychological Services
https://www.readbyqxmd.com/read/29017066/a-psychometric-evaluation-of-the-posttraumatic-cognitions-inventory-with-veterans-seeking-treatment-following-military-trauma-exposure
#8
Minden B Sexton, Margaret T Davis, Diana C Bennett, David H Morris, Sheila A M Rauch
Trauma-related beliefs have salient relationships to the development and maintenance of Posttraumatic Stress Disorder (PTSD) following stress exposure. The Posttraumatic Cognitions Inventory (PTCI) has the potential to be a standard assessment of this critical construct. However, some critical aspects of validity and reliability appear to vary by population. To date, the PTCI has not been psychometrically evaluated for use with military-specific traumas such as combat and military sexual trauma (MST). Based on exploratory and confirmatory analyses with 949 Veterans seeking trauma-focused treatment for military traumas, we found a four factor model (negative view of the self, negative view of the world, self-blame, and negative beliefs about coping competence) provided the best fit...
September 27, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29016157/assailant-identity-and-self-reported-nondisclosure-of-military-sexual-trauma-in-partnered-women-veterans
#9
Rebecca K Blais, Emily Brignone, Jamison D Fargo, Nathan W Galbreath, Adi V Gundlapalli
OBJECTIVE: Department of Veterans Affairs estimates of military sexual trauma (MST) suggest 27% of female veterans have experienced MST. However, Department of Defense data (Department of Defense, 2014) show that a subgroup of active-duty women do not report sexual assaults to a military authority, suggesting barriers to disclosure exist among military samples. No study of female veterans has examined rates of nondisclosure among those with previous screens for MST; these data could inform screening efforts and establishment of safe havens for candid disclosures...
October 9, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28994869/acute-acoustic-trauma-how-to-manage-and-how-to-prevent
#10
Ali Mardassi, Senda Turki, Hajer Mbarek, Amani Hachicha, Sonia Benzarti, Maher Abouda
INTRODUCTION: The consequence of an exposure to intense sounds can be a temporary or permanent hearing loss and even with a rapid therapeutic management, severe sensorineural sequelae may persist. METHODS: the authors report a retrospective study about 64 patients followed for an acute acoustic trauma during a period of 8 years (2006 to 2013). For all the cases, a clinical examination associated to a pure-tone audiometry was conducted. Hearing levels were measured at the frequencies 500, 1000, 2000 and 3000 Hertz...
November 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28993489/civilian-and-military-doctors-knowledge-of-tranexamic-acid-txa-use-in-major-trauma-a-comparison-study
#11
Jonathan Blair Thomas Herron, R French, A D Gilliam
INTRODUCTION: Tranexamic acid (TXA) administration within the recommended time of 3 hours has been demonstrated to improve outcomes following trauma. The aim of this study was to identify potential knowledge gaps in the administration of TXA in order to target further educational training in those doctors responsible for the management of acute trauma. METHODS: 104 military and 852 civilian doctors were invited to complete a four-item web-based questionnaire pertaining to the indications, dose, side effects and evidence base for TXA administration in trauma...
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28988805/prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#12
Jacqueline V Mclennan, Kevin C Mackway-Jones, Jason E Smith
BACKGROUND: The predominant cause of preventable trauma death is bleeding, and many of these patients need resuscitation with massive blood transfusion. In resource-constrained environments, early recognition of such patients can improve planning and reduce wastage of blood products. No existing decision rule is sufficiently reliable to predict those patients requiring massive blood transfusion. This study aims to produce a decision rule for use on arrival at hospital for patients sustaining battlefield trauma...
September 28, 2017: Injury
https://www.readbyqxmd.com/read/28988190/the-outcome-of-patients-in-traumatic-cardiac-arrest-presenting-to-deployed-military-medical-treatment-facilities-data-from-the-uk-joint-theatre-trauma-registry
#13
Ed B G Barnard, P A F Hunt, P E H Lewis, J E Smith
BACKGROUND: The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns. METHODS: A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken...
October 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28985866/a-novel-model-of-highly-lethal-uncontrolled-torso-hemorrhage-in-swine
#14
Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, John Kevin Grayson, Timothy K Williams, Joseph M Galante, Lucas P Neff
INTRODUCTION: A reproducible, lethal noncompressible torso hemorrhage model is important to civilian and military trauma research. Current large animal models balancing clinical applicability with standardization and internal validity. As such, large animal models of trauma vary widely in the surgical literature, limiting comparisons. Our aim was to create and validate a porcine model of uncontrolled hemorrhage that maximizes reproducibility and standardization. METHODS: Seven Yorkshire-cross swine were anesthetized, instrumented, and splenectomized...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985608/the-role-of-neutrophil-gelatinase-associated-lipocalin-ngal-in-the-detection-of-blast-lung-injury-in-a-military-population
#15
Andrew Lumley, Erik Osborn, Adrian Mellor, Elise LaCroix, George Johnson, Mary Wallace, Mike Stacey, Jason E Smith, David Woods
PURPOSE: To study the relationship between serum neutrophil gelatinase-associated lipocalin (NGAL) and military blast and gunshot wound (GSW) to establish whether potential exists for NGAL as a biomarker for blast lung injury (BLI). METHOD: Patients from the intensive care unit (ICU) of the Role 3 Medical Treatment Facility at Camp Bastion, Helmand Province, Afghanistan were studied over a five month period commencing in 2012. Age, mechanism, trauma injury severity score (TRISS) and serum NGAL were recorded on ICU admission (NGAL1)...
September 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28981347/neuroimaging-of-deployment-associated-traumatic-brain-injury-tbi-with-a-focus-on-mild-tbi-mtbi-since-2009
#16
David H Salat, Meghan E Robinson, Danielle R Miller, Dustin C Clark, Regina E McGlinchey
OBJECTIVES: A substantial body of recent research has aimed to better understand the clinical sequelae of military trauma through the application of advanced brain imaging procedures in Veteran populations. The primary objective of this review was to highlight a portion of these recent studies to demonstrate how imaging tools can be used to understand military-associated brain injury. METHODS: We focus here on the phenomenon of mild traumatic brain injury (mTBI) given its high prevalence in the Veteran population and current recognition of the need to better understand the clinical implications of this trauma...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28975240/research-gaps-and-controversies-in-chronic-traumatic-encephalopathy-a-review
#17
REVIEW
Breton M Asken, Molly J Sullan, Steven T DeKosky, Michael S Jaffee, Russell M Bauer
Importance: Scientific and lay interest in negative outcomes associated with exposure to repetitive brain trauma (RBT) continues to strengthen. Concerns about the association between RBT and dementia began more than a century ago, but have resurfaced in the last decade with the more recently described chronic traumatic encephalopathy (CTE). Chronic traumatic encephalopathy is a tauopathy associated with RBT that has become inextricably linked to conversations about sport-related concussion and mild traumatic brain injury...
October 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28972278/a-retrospective-study-of-ketamine-administration-and-the-development-of-acute-or-post-traumatic-stress-disorder-in-274-war-wounded-soldiers
#18
G Mion, J Le Masson, C Granier, C Hoffmann
The objective of this study was to explore whether ketamine prevents or exacerbates acute or post-traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010-2012). The diagnosis of post-traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain...
October 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28971847/the-civilian-validation-of-the-modified-physiological-triage-tool-mptt-an-evidence-based-approach-to-primary-major-incident-triage
#19
James Vassallo, Jason Smith, Omar Bouamra, Fiona Lecky, Lee A Wallis
INTRODUCTION: Triage is a key principle in the effective management of a major incident. Existing triage tools have demonstrated limited performance at predicting need for life-saving intervention (LSI). Derived on a military cohort, the Modified Physiological Triage Tool (MPTT) has demonstrated improved performance. Using a civilian trauma registry, this study aimed to validate the MPTT in a civilian environment. METHODS: Retrospective database review of the Trauma Audit and Research Network (TARN) database for all adult patients (>18 years) between 2006 and 2014...
September 29, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28961597/political-affiliation-probable-ptsd-and-symptoms-of-depression-in-iraq-and-afghanistan-combat-veterans-a-pilot-study
#20
Jeffrey M Lating, Rich A Moore, Martin F Sherman, Matthew W Kirkhart, George S Everly, Justin K Chen
Ideological commitment of military personnel has been associated with mitigating trauma and protecting mental health. This pilot study assessed whether Democratic and Republican political affiliation differentially predicted probable posttraumatic stress disorder (PTSD) and symptoms of depression in 62 male Iraq and Afghanistan combat veterans. The Liberalism-Conservatism Scale, the PTSD Checklist-Military Version (PCL-M), and the Patient Health Questionnaire-9 (PHQ-9) were assessment measures. Results revealed that Democratic combat veterans had stronger liberal attitudes than Republican combat veterans (r = 0...
October 2017: Journal of Nervous and Mental Disease
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