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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
Rosemary Shields, Linda Shields
Emma Maud McCarthy was one of the most decorated nurses of the First World War. Born in Sydney in 1859, she trained as a nurse at The London Hospital in England. She was one of the first nurses to go to the South African War and in 1914 was one of the first members of Queen Alexandra's Imperial Nursing Service. Maud McCarthy went to France as Matron-in-Chief of British, Colonial and US nursing services until the end of hostilities in 1918. After the First World War she became Matron-in-Chief of the Territorial Army Nursing Service and retired five years later...
February 19, 2015: Journal of Medical Biography
Susan M Stankorb, Casside Ramsey, Heidi Clark, Tamara Osgood
This article describes the experience of nutrition support practitioners, specifically dietitians, providing care to combat casualties. It provides a brief overview of dietitians' induction into armed service but focuses primarily on their role in providing nutrition support during the most recent conflicts in Iraq and Afghanistan. The current system of combat casualty care is discussed with specific emphasis on providing early and adequate nutrition support to U.S. combat casualties from injury, care in theater combat support hospitals (CSHs)/expeditionary medical support (EMEDs), and en route care during critical care air transport (CCAT) up to arrival at treatment facilities in the United States...
October 2014: Nutrition in Clinical Practice
Nick Wilson, Christine Clement, Jennifer A Summers, John Bannister, Glyn Harper
OBJECTIVE: To identify the impact of the first world war on the lifespan of participating military personnel (including in veterans who survived the war). DESIGN: Comparison of two cohorts of military personnel, followed to death. SETTING: Military personnel leaving New Zealand to participate in the first world war. PARTICIPANTS: From a dataset of the New Zealand Expeditionary Forces, we randomly selected participants who embarked on troopships in 1914 and a comparison non-combat cohort who departed on troopships in late 1918 (350 in each group)...
2014: BMJ: British Medical Journal
John Hedley-Whyte, Debra R Milamed
The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC...
September 2014: Ulster Medical Journal
Randy Russell, Alastair Reid, Guy Borgers, Henry Wassink, Andreas Grove, David W Niebuhr
BACKGROUND: Each time a deployed military member has an exacerbation of a pre-existing chronic disease there is a potential risk to mission success, individual health, and the safety of the unit. Currently, North Atlantic Treaty Organization (NATO) member nations employ different approaches to assessing an individual's medical fitness for deployment. OBJECTIVE: To set the minimum medical standards for NATO deployments. METHODS: A seven nation task group met periodically from 2008 to 2012 to develop guidelines for frontline military physicians to assess medical fitness for deployment...
December 2014: Military Medicine
Mark E Edsell, Yashvi H Wimalasena, William L Malein, Kimberly M Ashdown, Carla A Gallagher, Chris H Imray, Alex D Wright, Stephen D Myers
OBJECTIVE: Ascent to high altitude leads to a reduction in ambient pressure and a subsequent fall in available oxygen. The resulting hypoxia can lead to elevated pulmonary artery (PA) pressure, capillary stress, and an increase in interstitial fluid. This fluid can be assessed on lung ultrasound (LUS) by the presence of B-lines. We undertook a chamber and field study to assess the impact of high-intensity exercise in hypoxia on the development of pulmonary interstitial edema in healthy lowlanders...
December 2014: Wilderness & Environmental Medicine
K D Hussey
When Britain went to war in 1914, the British Expeditionary Force was deployed without a single dentist. Initially considered combatants, the only dental professionals who could serve at the Front were medically qualified dental surgeons in the Royal Army Medical Corps. In treating the traumatic facial and jaw injuries caused by trench warfare, the dental surgeons of this era earned their place on specialist surgical teams and established the principles of oral and maxillofacial surgery. This article will examine the contribution of specialist dental surgeons to the management of facial and jaw wounds in the First World War along the chain of evacuation from the battlefield to the home front, using illustrative examples from the Hunterian Museum at the Royal College of Surgeons of England...
November 2014: British Dental Journal
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