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Nicholas M Studer, Michael D April, F Bowling, Paul D Danielson, Andrew P Cap
Optimal fluid resuscitation on the battlefield in the absence of blood products remains unclear. Contemporary Combat medics are generally limited to hydroxyethyl starch or crystalloid solutions, both of which present significant drawbacks. Obtaining US Food and Drug Administration (FDA)-approved freeze-dried plasma (FDP) is a top casualty care research priority for the US Military. Interest in this agent reflects a desire to simultaneously expand intravascular volume and address coagulopathy. The history of FDP dates to the Second World War, when American expeditionary forces used this agent frequently...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Rebekah Higgitt
Making use of a source previously unknown to historians, this article sheds new light on the British expedition to the Sandwich Islands to observe the 1874 transit of Venus. This source, a series of caricature drawings that follow the expedition from departure to return, gives insight into expeditionary culture and the experience of a previously unremarked member of this astronomical expedition, Evelyn J.W. Noble, a career officer of the Royal Marine Artillery. It also reveals overlapping military, scientific and masculine identities, developed in dialogue with, and often deliberately subverting, more public accounts...
June 2, 2017: Annals of Science
Nadeem Toodayan
Sir Victor Alexander Haden Horsley (1857-1916), the pioneering British neurological surgeon, passed away 100 years ago. He died young in his sixtieth year from the effects of heat stroke while serving as consulting military surgeon to the Mediterranean Expeditionary Force in Amarah, modern-day Iraq, and was buried in the now largely abandoned "Amara War Cemetery." By the time of his death in 1916, Victor Horsley had established himself as one of the most eminent innovators of modern neurological surgery. His pioneering researches in cerebral physiology earned him an early reputation in the field, and his experiences with vivisection allowed him to confidently operate on the brain and spinal cord at a time when surgical intervention of the nervous system was fraught with uncertainty...
July 2017: Journal of the History of the Neurosciences
Linda C Benavides, Iain M Smith, Jerome M Benavides, Douglas M Bowley, Heidi A Doughty, Jonathan B Lundy
BACKGROUND: Noncompressible hemorrhage is the leading cause of potentially preventable battlefield death. Combining casualty retrieval from the battlefield and damage control resuscitation (DCR) within the "golden hour" increases survival. However, transfusion requirements may exceed the current blood component stocks held by forward surgical teams. Warm fresh whole blood (WFWB) is an alternative. We report WFWB transfusion training developed by and delivered to a US Golden Hour Offset Surgical Treatment Team and the resulting improvement in confidence with WFWB transfusion...
June 2017: Journal of Trauma and Acute Care Surgery
Mark Reichenbach, Tom Frederick, Lou Cubrich, Walter Bircher, Nathan Bills, Marsha Morien, Shane Farritor, Dmitry Oleynikov
This study aimed to evaluate the capability of performing telesurgery via radio transmission for military arenas where wired internet connections may not be practical. Most existing robotic surgery systems are too large to effectively deploy with first responders. The miniature surgical platform in this study consists of a multifunctional robot suite that can fit easily into a briefcase. METHODS: The focus of this study is to explore the implications of radio control of the robot. The hypothesis is that an in vivo robot and its control boards can be controlled using off-the-shelf wireless components...
March 2017: Military Medicine
Anthony P Cardile, Christopher T Littell, Michael G Backlund, Richard A Heipertz, Jerod A Brammer, Sean M Palmer, Todd J Vento, Felix A Ortiz, William R Rosa, Michael J Major, Patrick M Garman
BACKGROUND: The U.S. Army 1(st) Area Medical Laboratory (1(st) AML) is currently the only deployable medical CBRNE (Chemical, Biological, Radiological, Nuclear, and Explosives) laboratory in the Army's Forces Command. In support of the United States Agency for International Development Ebola response, the U.S. military initiated Operation United Assistance (OUA), and deployed approximately 2,500 service members to support the Government of Liberia's Ebola control efforts. Due to its unique molecular diagnostic and expeditionary capabilities, the 1(st) AML was ordered to deploy in October of 2014 in support of OUA via establishment of Ebola testing laboratories...
November 2016: Military Medicine
Owen Hill, Lakmini Bulathsinhala, Susan L Eskridge, Kimberly Quinn, Daniel J Stinner
Advancements in ankle-foot orthotic devices, such as the Intrepid Dynamic Exoskeletal Orthosis (IDEO), are designed to improve function and reduce pain of the injured lower extremity. There is a paucity of research detailing the demographics, injury patterns and amputation outcomes of patients who have been prescribed an IDEO. The purpose of this study was to describe the demographics, presenting diagnosis and patterns of amputation in patients prescribed an IDEO at the Center for the Intrepid (CFI). The study population was comprised of 624 service members who were treated at the CFI and prescribed an IDEO between 2009 and 2014...
November 2016: Military Medicine
Myles R McKenzie, Ernest W Parrish, Ethan A Miles, James C Spradling, Lanny F Littlejohn, Mark D Quinlan, George A Barbee, David R King
During an assault on an extremely remote target, a US Special Operations Soldier sustained multiple gunshot and fragmentation wounds to the thorax, resulting in a traumatic arrest and subsequent survival. His care, including care under fire, tactical field care, tactical evacuation care, and Role III, IV, and V care, is presented. The case is used to illustrate the complex dynamics of Special Operations care on the modern battlefield and the exceptional outcomes possible when evidence-based medicine is taken to the warfighter with effective, farforward, expeditionary medical-force projection...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Marionne Cronin
In May 1926, U.S. newspapers were full of the story that Richard Byrd, an American aviator, had become the first person to reach the North Pole by air. The announcement triggered patriotic outpourings across the country and Byrd was widely hailed as a national hero. The young aviator's flight was part of a burgeoning interwar expeditionary practice that placed machines at the heart of new modes of exploration. This development, however, challenged preexisting notions of masculine heroism and threatened to undercut the explorer's heroic status...
April 2016: Technology and Culture
J M Broadbent, J K Singh, N S Masri, D C Tong, W J Duncan
BACKGROUND AND OBJECTIVES: During the First World War, 10% of New Zealand's population served in the armed forces, and around one in five of those were killed. In commemoration of 100 years since WW1, this study uses retrospective data to report on the oral health of NZ service personnel. METHODS: 325 Pākehā, 165 Māori and 150 Samoan male recruits who served in the NZ Expeditionary Force between 1914 and 1918 were randomly selected and their personnel files accessed through Archives New Zealand...
March 2016: New Zealand Dental Journal
Miroslaw J Smogorzewski
The first alarming reports about a new disease called "trench nephritis" affecting soldiers of the British Expeditionary Forces in Flanders appeared in British medical press in 1915th. Soon, the Medical Research Council initiated a special research investigation on trench nephritis at St. Bartholomews Hospital and the results of these studies were discussed during the Royal Society of Medicine meeting in February 1916. William Osler was invited as one of the four main speakers for this presentation. He had lived in England since 1906 and served as the Regius Professor of Medicine at Oxford...
February 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Marvin J Stone
John Finney (1863-1942) was born near Natchez, Mississippi. After receiving his medical degree from Harvard, he interned at Massachusetts General Hospital and then went to Baltimore to become one of the first interns at the new Johns Hopkins Hospital. He met William Osler the day the hospital opened and became a lifelong admirer of "the Chief." Finney specialized in gastrointestinal surgery and was recognized for his expertise in the field. Osler recommended Finney to a physician colleague, writing, "You could not be in better hands…...
January 2016: Proceedings of the Baylor University Medical Center
Ali Ünlü, Ulrich Dettweiler
Self-determination theory, as proposed by Deci and Ryan, postulated different types of motivation regulation. As to the introjected and identified regulation of extrinsic motivation, their internalizations were described as "somewhat external" and "somewhat internal" and remained undetermined in the theory. This paper introduces a constrained regression analysis that allows these vaguely expressed motivations to be estimated in an "optimal" manner, in any given empirical context. The approach was even generalized and applied for simplex structure analysis in self-determination theory...
December 2015: Psychological Reports
Kandace Bogaert
OBJECTIVES: This research analyses morbidity and mortality during the 1918 influenza pandemic among Ontario soldiers in the Canadian Expeditionary Force (CEF). This paper asks: did exposure to influenza during the first wave confer protection against illness and death during the second wave of the pandemic? METHODS: Pneumonia and influenza (P&I) cases and deaths among Ontario soldiers were transcribed from the 1918 Admission and Discharge books for the CEF. Following the methods of Barry et al...
December 16, 2015: Vaccine
Peter D Strube, Andrew D Perkins
Revolutionary innovations and technical advances in the disciplines of medicine, surgery, and anesthesia are inextricably connected to military conflict. The demonstrated lifesaving value of these novel approaches in high-acuity trauma has provided the impetus for translation of these elements into injury care in the civilian environment. One element of this battlefield medical revolution is the implementation and refinement of forward surgical care. All US military services have unique configurations of this surgical team to match their expeditionary capacity...
August 2015: AANA Journal
James R Wright, Leland B Baskin
CONTEXT: Historical research on pathology and laboratory medicine services in World War I has been limited. In the Spanish American War, these efforts were primarily focused on tropical diseases. World War I problems that could be addressed by pathology and laboratory medicine were strikingly different because of the new field of clinical pathology. Geographic differences, changing war tactics, and trench warfare created new issues. OBJECTIVES: To describe the scope of pathology and laboratory medicine services in World War I and the value these services brought to the war effort...
September 2015: Archives of Pathology & Laboratory Medicine
Alex Rewegan, Kandace Bogaert, Melissa Yan, Alain Gagnon, D Ann Herring
OBJECTIVES: This article evaluates the evidence for the presence of the first, mild wave of the 1918 influenza pandemic among soldiers in the Canadian Expeditionary Force (CEF). METHODS: Death records for soldiers in the CEF who died in Canada in 1917 and 1918 were extracted from the Commonwealth War Graves Commission and record-linked to the Canada War Graves Registers, Circumstances of Casualty database. Monthly mortality rates from pneumonia and influenza (P&I) were compared with mortality rates from all other causes for 1917 and 1918, and by region for 1918...
September 2015: American Journal of Human Biology: the Official Journal of the Human Biology Council
Matthew W Keller, Peggy P Han, Michael R Galarneau, Matthew T Brigger
OBJECTIVES: Airway stabilization is critical in combat maxillofacial injury as normal anatomical landmarks can be obscured. The study objective was to characterize the epidemiology of airway management in maxillofacial trauma. STUDY DESIGN: Retrospective database analysis. SETTING: Military treatment facilities in Iraq and Afghanistan and stateside tertiary care centers. SUBJECTS: In total, 1345 military personnel with combat-related maxillofacial injuries sustained March 2004 to August 2010 were identified from the Expeditionary Medical Encounter Database using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes...
October 2015: Otolaryngology—Head and Neck Surgery
Matthew W Keller, Peggy P Han, Michael R Galarneau, Curtis W Gaball
The study objectives were to characterize maxillofacial injuries and assess the safety of in-theater facial fracture repair in U.S. military personnel with severe combat trauma from Iraq and Afghanistan. We performed a retrospective chart review of the Expeditionary Medical Encounter Database from 2004 to 2010. 1,345 military personnel with combat-related maxillofacial injuries were identified. Injury severity was quantified with the Abbreviated Injury Scale and Injury Severity Score. Service members with maxillofacial injury and severe combat trauma (Injury Severity Score ≥ 16) were included...
March 2015: Military Medicine
Olivia K Faull, Josephine Robertson, Owen Thomas, Arthur R Bradwell, Chrystalina A Antoniades, Kyle T S Pattinson
OBJECTIVE: The effect of altitude on brain function is not yet well understood, nor is the influence of height and speed of ascent. Additionally, the relationship between acute mountain sickness (AMS) symptoms and brain function at altitude is unclear. We hypothesized that a deterioration from baseline measures of brain function occurs after rapid, mechanical ascent to 3459 m and would be less pronounced in persons taking acetazolamide. METHODS: In this double blind, randomized, placebo-controlled study, 20 healthy volunteers (14 men, 6 women; mean age [±SD] 43 ± 16 years) were alternately allocated to acetazolamide 250 mg or to placebo, taken every 12 hours commencing 3 days before ascent...
March 2015: Wilderness & Environmental Medicine
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